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Bouali Y, Donal E, Laurin C, Gallard A, Hubert A, Bidaut A, Leclercq C, Galli E. Prognostic role of myocardial work in patients with heart failure and reduced ejection fraction treated by sacubitril/valsartan. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Galli E, Bouali Y, Laurin C, Gallard A, Hubert A, Bidaut A, Leclercq C, Donal E. Prognostic role of myocardial work in patients with heart failure and reduced ejection fraction treated by sacubitril/valsartan. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The non-invasive assessment of myocardial work (MW) by pressure-strain loops analysis (PSL) is a relative new tool for the evaluation of myocardial performance. Sacubitril/Valsartan is a treatment for heart failure with reduced ejection fraction (HFrEF) which has a spectacular effect on the reduction of cardiovascular events (MACEs).
Purposes of this study were to evaluate 1) the short and medium term effect of Sacubitril/Valsartan treatment on MW parameters; 2) the prognostic value of MW in this specific group of patients.
Methods
79 patients with HFrEF (mean age: 66±12 years; LV ejection fraction: 28±9%) were prospectively included in the study and treated with Sacubitril/Valsartan. Echocardiographic examination was performed at baseline, and after 6- and 12-month of therapy with Sacubitril/Valsartan.
Results
Sacubitril/Valsartan significantly increased global myocardial constructive work (CW) (1023±449 vs 1424±484 mmHg%, p<0.0001) and myocardial work efficiency (WE) [87 (78–90) vs 90 (86–95), p<0.0001]. During FU (2.6±0.9 years), MACEs occurred in 13 (16%) patients. After correction for LV size, LVEF and WE, CW was the only predictor of MACEs (Table 1). A CW<910 mmHg (AUC=0.81, p<0.0001, Figure 1A) identified patients at particularly increase risk of MACEs [HR 11.09 (1.45–98.94), p=0.002, log-rank test p<0.0001] (Figure 1 B).
Conclusions
In patients with HFrEF who receive a comprehensive background beta-blocker and mineral-corticoid receptor antagonist therapy, Sacubitril/Valsartan induces a significant improvement of myocardial CW and WE. In this population, the estimation of CW before the initiation of Sacubitril/Valsartan therapy allows the prediction of MACEs.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- E Galli
- Hospital Pontchaillou of Rennes, Rennes, France
| | - Y Bouali
- Hospital Pontchaillou of Rennes, Rennes, France
| | - C Laurin
- Hospital Pontchaillou of Rennes, Rennes, France
| | - A Gallard
- Hospital Pontchaillou of Rennes, Rennes, France
| | - A Hubert
- Hospital Pontchaillou of Rennes, Rennes, France
| | - A Bidaut
- Hospital Pontchaillou of Rennes, Rennes, France
| | - C Leclercq
- Hospital Pontchaillou of Rennes, Rennes, France
| | - E Donal
- Hospital Pontchaillou of Rennes, Rennes, France
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Hubert A, Le Rolle V, Galli E, Bidaut A, Hernandez A, Donal E. New expectations for diastolic function assessment in TTE based on a semi-automated computing of strain-volume loops. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Early diagnosis of heart failure with preserved ejection fraction (HFpEF) by determination of diastolic dysfunction is challenging. Strain-volume loop (SVL) is a new tool to analyze left ventricular function.
Purpose
We propose a new semi-automated method to calculate SVL area and explore the added value of this index for diastolic function assessment.
Methods
50 patients (25 amyloidosis, 25 HFpEF) were included in the study and compared with 25 healthy control subjects. All patients underwent standard echocardiography. SVL area were also assessed.
Results
Left ventricular ejection fraction was preserved and similar between groups. Classical indices of diastolic function were pathological in HFpEF and amyloidosis groups with greater left atrial volume index, greater mitral average E/e' ratio, faster tricuspid regurgitation (p<0.0001 compared with controls). SVL analysis demonstrated a significant difference of the global area between groups, with the smaller area in amyloidosis group, the greater in controls and a mid-range value in HFpEF group (37 vs 120 vs 72 ml.%, respectively, p<0.0001) (Table 1). Applying a Linear Discriminant Analysis (LDA) classifier, results show a mean area under the curve (AUC) of 0.89 for the comparison between HFpEF and amyloidosis groups (Figure 1).
Conclusion
Strain-volume loops area is efficient to identify patients with a diastolic dysfunction. This new semi-automated tool is very promising for future development of automated diagnosis with machine-learning algorithms.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Hubert
- Univ. Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - V Le Rolle
- Univ. Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - E Galli
- Univ. Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - A Bidaut
- Univ. Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - A.I Hernandez
- Univ. Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - E Donal
- Univ. Rennes, Inserm, LTSI - UMR 1099, Rennes, France
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Gallard A, Donal E, Le Rolle V, Hubert A, Bidaut A, Leclercq C, Galli E, Hernandez A. 539 Optimized multiparametric analysis of cardiac dyssynchrony: machine learning and prediction of response to cardiac resynchronization therapy based of the apical 4-chamber view. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims. We hypothesized that a multiparametric evaluation, based on the combination of electrocardiographic and echocardiographic parameters, could enhance the appraisal of the likelihood of reverse remodeling and prognosis of favorable clinical evolution after cardiac resynchronization therapy (CRT). Also, we sought to test the respective value of automatically extracted parameters from left ventricular (LV) strain curves recorded in apical 4-chamber view as compared to the other echocardiographic views.
Methods and results;
This is a machine learning study based on a dataset of 161 patients who were treated by CRT according to current ESC-guidelines. The longitudinal strain curves of the 6 LV-segments of the left ventricle were plot for the three different apical views. Several features as times or integrals were extracted as previously published. These features were classified by importance using the out-of-bag method(fig1). Half of the most important features come from the 4-chamber view and a third from the 2-chamber view. The correlation between the most important features was studied to determine the relationship between them. Almost all the features from the 2-chamber and apical long-axis views are correlated with others and generally with one acquired from the 4-chamber view.
Conclusion
The high number of important features indicate the relevance of the 4-chamber as unique view for applying machine learning approaches on strain curves. Optimizing selection of patients for CRT should be possible just on the dataset coming from one apical 4-chamber view.
Abstract 539 Figure. fig1
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Affiliation(s)
- A Gallard
- Laboratory Signal Processing and Image, Rennes, France
| | - E Donal
- University Hospital of Rennes - Hospital Pontchaillou, Rennes, France
| | - V Le Rolle
- Laboratory Signal Processing and Image, Rennes, France
| | - A Hubert
- University Hospital of Rennes - Hospital Pontchaillou, Rennes, France
| | - A Bidaut
- University Hospital of Rennes - Hospital Pontchaillou, Rennes, France
| | - C Leclercq
- University Hospital of Rennes - Hospital Pontchaillou, Rennes, France
| | - E Galli
- University Hospital of Rennes - Hospital Pontchaillou, Rennes, France
| | - A Hernandez
- Laboratory Signal Processing and Image, Rennes, France
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Kupper J, Bidaut A, Waldvogel A, Emmenegger B, Naegeli H. Behandlung einer chronischen Kupfervergiftung mit oralem Ammoniummolybdat und Natriumsulfat bei Milchschafen. SCHWEIZ ARCH TIERH 2012; 147:219-24. [PMID: 15929603 DOI: 10.1024/0036-7281.147.5.219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Four weeks after the introduction of a new ration, a herd of sheep in the Swiss midland area was affected by depression, anorexia, decreased milk production, anemia, hemoglobinuria and frequent recumbency. Seventeen ewes died within a few days. A diagnosis of chronic copper poisoning was based on the results of feed analysis, histopathological findings and the toxicological examination of liver tissue. The remaining sheep were treated with oral ammonium molybdate and sodium sulfate, which together provide an inexpensive alternative to the chelator D-penicillamine.This combination not only prevents further copper intake, but also supports its elimination from the hepatocellular storage compartments. Serum copper levels have been determined to monitor the mobilization of copper following this antidote therapy.
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Affiliation(s)
- J Kupper
- Institut für Veterinärpharmakologie und -toxikologie der Universität Zürich.
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Lezmi S, Thibault-Duprey K, Bidaut A, Hardy P, Pino M, Macary GS, Barbellion S, Brunel P, Dorchies O, Clifford C, Leconte I. Spontaneous Metritis Related to the Presence of Vaginal Septum in Pregnant Sprague Dawley Crl:CD(SD) Rats. Vet Pathol 2010; 48:964-9. [DOI: 10.1177/0300985810391113] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recently, 6% of 1,176 Sprague Dawley rats examined in our reproductive toxicity studies presented with dark-red uterine contents with or without fetuses demonstrating delayed development. Sometimes, a high proportion of the litter was found dead, and dystocia with death or preterminal euthanasia of the dam occurred. Microscopic findings in the uterus consisted of necrohemorrhagic and suppurative periplacentitis associated with the presence of bacterial colonies identified as Escherichia coli. In the vagina, similar findings were observed that were associated with mucus accumulation and the presence of a transverse occlusive or partially occlusive thin membrane identified as a vaginal septum. Microscopically, this septum consisted of a thin band of connective tissue covered on both sides by a mucous epithelium that was continuous with vaginal epithelium. In some cases, there was only mucus accumulation retained by a septum in the vagina without evidence of bacterial infection. Serological and histological examinations did not reveal any specific pathogenic agent. The presence of these septa in the vagina most likely favored mucus accumulation, nonspecific ascending bacterial infection, and dystocia. This colony of rats presented with an unusually high incidence of vaginal septa as it was described in different strains of mice and rats in the past. We hypothesized that the use of an impedance meter by the breeder—to determine the phase of the estrous cycle by introducing a probe in the vagina—likely facilitated gestation by perforating the vaginal septum in some cases.
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Affiliation(s)
- S. Lezmi
- sanofi-aventis R&D, Drug Safety Evaluation, Porcheville, France
| | - K. Thibault-Duprey
- sanofi-aventis R&D, Drug Safety Evaluation & Laboratory Animal Science and Welfare, 94140 Alfortville, France
| | - A. Bidaut
- sanofi-aventis R&D, Drug Safety Evaluation & Laboratory Animal Science and Welfare, 94140 Alfortville, France
| | - P. Hardy
- sanofi-aventis R&D, Drug Safety Evaluation & Laboratory Animal Science and Welfare, 94140 Alfortville, France
| | - M. Pino
- sanofi-aventis R&D, Drug Safety Evaluation & Laboratory Animal Science and Welfare, 94140 Alfortville, France
| | - G. Saint Macary
- sanofi-aventis R&D, Drug Safety Evaluation, Porcheville, France
| | - S. Barbellion
- sanofi-aventis R&D, Drug Safety Evaluation & Laboratory Animal Science and Welfare, 94140 Alfortville, France
| | - P. Brunel
- sanofi-aventis R&D, Drug Safety Evaluation & Laboratory Animal Science and Welfare, 94140 Alfortville, France
| | - O. Dorchies
- sanofi-aventis R&D, Drug Safety Evaluation & Laboratory Animal Science and Welfare, 94140 Alfortville, France
| | - C. Clifford
- Charles River Laboratories, Wilmington, MA, USA
| | - I. Leconte
- sanofi-aventis R&D, Drug Safety Evaluation, Porcheville, France
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Rüfenacht S, Straub R, Steinmann B, Winand N, Bidaut A, Stoffel MH, Gerber V, Wyder M, Müller E, Roosje PJ. [Swiss warmblood horse with symptoms of hereditary equine regional dermal asthenia without mutation in the cyclophylin B gene (PPIB)]. SCHWEIZ ARCH TIERH 2010; 152:188-92. [PMID: 20361398 DOI: 10.1024/0036-7281/a000042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hereditary equine dermal asthenia (HERDA) is an autosomal recessive skin disease that affects predominantly Quarter Horses and related breeds. Typical symptoms are easy bruising and hyperextensible skin on the back. The prognosis is guarded, as affected horses cannot be ridden normally and are often euthanised. In the Quarter Horse, HERDA is associated with a mutation in cyclophilin B (PPIB), an enzyme involved in triple helix formation of collagen. Here we describe the case of a Swiss Warmblood filly with symptoms of HERDA without PPIB-mutation and in which we also could exclude Ehlers-Danlos syndrome Type IV, VI, VIIA, VIIB and VIIC (dermatosparaxis type) as etiological diseases.
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Affiliation(s)
- S Rüfenacht
- Abteilung für klinische Dermatologie der Universität Bern.
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