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Matta A, Ohlmann P, Nader V, Moussallem N, Carrié D, Roncalli J. A review of therapeutic approaches for post-infarction left ventricular remodeling. Curr Probl Cardiol 2024; 49:102562. [PMID: 38599556 DOI: 10.1016/j.cpcardiol.2024.102562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 04/07/2024] [Indexed: 04/12/2024]
Abstract
Left ventricular remodeling is an adaptive process initially developed in response to acute myocardial infarction (AMI), but it ends up with negative adverse outcomes such as infarcted wall thinning, ventricular dilation, and cardiac dysfunction. A prolonged excessive inflammatory reaction to cardiomyocytes death and necrosis plays the crucial role in the pathophysiological mechanisms. The pharmacological treatment includes nitroglycerine, β-blockers, ACEi/ARBs, SGLT2i, mineralocorticoid receptor antagonists, and some miscellaneous aspects. Stem cells therapy, CD34+ cells transplantation and gene therapy constitute the promissing therapeutic approaches for post AMI cardiac remodeling, thereby enhancing angiogenesis, cardiomyocytes differenciation and left ventricular function on top of inhibiting apoptosis, inflammation, and collagen deposition. All these lead to reduce infarct size, scar formation and myocardial fibrosis.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France; School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon.
| | - Patrick Ohlmann
- Department of Cardiology, Strasbourg University Hospital, Strasbourg, France
| | - Vanessa Nader
- Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France
| | - Nicolas Moussallem
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O.Box 446, Jounieh, Lebanon
| | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Jerome Roncalli
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
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2
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Matta A, Roncalli J, Carrié D. Erratum to "Update review on myocardial bridging: New insights," [Trends in Cardiovascular Medicine, volume 34, issue 1, pages 10-15, 2024]. Trends Cardiovasc Med 2024:S1050-1738(24)00021-5. [PMID: 38584067 DOI: 10.1016/j.tcm.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Affiliation(s)
- Anthony Matta
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France; Department of cardiology, Intercommunal Hospital Centre Castres-Mazamet, Castres, France; Faculty of medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon.
| | - Jerome Roncalli
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Didier Carrié
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
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3
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Lutz M, Abizaid A, Nielsen Holck E, Lansky A, Carrié D, Weber-Albers J, Dudek D, Frey N, Christiansen EH, Holm NR, Stone GW. Long-term safety and effectiveness of the Fantom bioresorbable coronary artery scaffold: final results of the FANTOM II trial. EUROINTERVENTION 2024; 20:e453-e456. [PMID: 38562069 PMCID: PMC10979385 DOI: 10.4244/eij-d-23-00504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/02/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Matthias Lutz
- Department of Cardiology, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Alexandre Abizaid
- Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Emil Nielsen Holck
- Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
| | - Alexandra Lansky
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Didier Carrié
- Department of Cardiology, University Hospital Rangueil, Toulouse, France
| | | | - Darius Dudek
- Institute of Cardiology, Jagiellonian University Medical College, University Hospital, Krakow, Poland
| | - Norbert Frey
- Department of Cardiology, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Niels Ramsing Holm
- Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark
| | - Gregg W Stone
- Columbia University Medical Center/NewYork-Presbyterian Hospital, The Cardiovascular Research Foundation, New York, NY, USA
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4
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De Maria GL, Greenwood JP, Zaman AG, Carrié D, Coste P, Valgimigli M, Behan M, Berry C, Erglis A, Panoulas VF, Van Belle E, Juhl Terkelsen C, Hunziker Munsch L, Jain AK, Lassen JF, Palmer N, Stone GW, Banning AP. Pressure-Controlled Intermittent Coronary Sinus Occlusion (PiCSO) in Acute Myocardial Infarction: The PiCSO-AMI-I Trial. Circ Cardiovasc Interv 2024; 17:e013675. [PMID: 38626079 DOI: 10.1161/circinterventions.123.013675] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/09/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Primary percutaneous coronary intervention (pPCI) has improved clinical outcomes in patients with ST-segment-elevation myocardial infarction. However, as many as 50% of patients still have suboptimal myocardial reperfusion and experience extensive myocardial necrosis. The PiCSO-AMI-I trial (Pressure-Controlled Intermittent Coronary Sinus Occlusion-Acute Myocardial Infarction-I) evaluated whether PiCSO therapy can further reduce myocardial infarct size (IS) in patients undergoing pPCI. METHODS Patients with anterior ST-segment-elevation myocardial infarction and Thrombolysis in Myocardial Infarction flow 0-1 were randomized at 16 European centers to PiCSO-assisted pPCI or conventional pPCI. The PiCSO Impulse Catheter (8Fr balloon-tipped catheter) was inserted via femoral venous access after antegrade flow restoration of the culprit vessel and before proceeding with stenting. The primary end point was the difference in IS (expressed as a percentage of left ventricular mass) at 5 days by cardiac magnetic resonance. Secondary end points were the extent of microvascular obstruction and intramyocardial hemorrhage at 5 days and IS at 6 months. RESULTS Among 145 randomized patients, 72 received PiCSO-assisted pPCI and 73 conventional pPCI. No differences were observed in IS at 5 days (27.2%±12.4% versus 28.3%±11.45%; P=0.59) and 6 months (19.2%±10.1% versus 18.8%±7.7%; P=0.83), nor were differences between PiCSO-treated and control patients noted in terms of the occurrence of microvascular obstruction (67.2% versus 64.6%; P=0.85) or intramyocardial hemorrhage (55.7% versus 60%; P=0.72). The study was prematurely discontinued by the sponsor with no further clinical follow-up beyond 6 months. However, up to 6 months of PiCSO use appeared safe with no device-related adverse events. CONCLUSIONS In this prematurely discontinued randomized trial, PiCSO therapy as an adjunct to pPCI did not reduce IS when compared with conventional pPCI in patients with anterior ST-segment-elevation myocardial infarction. PiCSO use was associated with increased procedural time and contrast but no increase in adverse events up to 6 months. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT03625869.
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Affiliation(s)
- Giovanni Luigi De Maria
- Oxford Heart Centre, Oxford University Hospitals NHS Trust, United Kingdom (G.L.D.M., A.P.B.)
- National Institute for Health Research Oxford Biomedical Research Centre, United Kingdom (G.L.D.M., A.P.B.)
| | - John P Greenwood
- Leeds University and Leeds Teaching Hospitals NHS Trust, United Kingdom (J.P.G.)
| | - Azfar G Zaman
- Cardiothoracic Centre, Freeman Hospital and Newcastle University, Newcastle upon Tyne, United Kingdom (A.G.Z.)
| | | | - Pierre Coste
- Hôpital Cardiologique du Haut Lévéque, University of Bordeaux, France (P.C.)
| | - Marco Valgimigli
- Istituto Cardiocentro Ticino-Ente Ospedaliero Cantonale, Lugano, Switzerland (M.V.)
| | - Miles Behan
- Edinburgh Heart Centre, United Kingdom (M.B.)
| | - Colin Berry
- Golden Jubilee National Hospital, Glasgow, United Kingdom (C.B.)
| | - Andrejs Erglis
- Pauls Stradins Clinical University Hospital, University of Latvia, Riga, Latvia (A.E.)
| | - Vasileios F Panoulas
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (V.F.P.)
| | - Eric Van Belle
- Institut Coeur-Poumon, Centre Hospitalier Regional, INSERM U1011, Lille Cedex, France (E.V.B.)
| | | | | | - Ajay K Jain
- Barts Heart Centre, London, United Kingdom (A.K.J.)
| | | | - Nick Palmer
- Liverpool Heart and Chest Hospital, United Kingdom (N.P.)
| | - Gregg W Stone
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (G.W.S.)
| | - Adrian P Banning
- Oxford Heart Centre, Oxford University Hospitals NHS Trust, United Kingdom (G.L.D.M., A.P.B.)
- National Institute for Health Research Oxford Biomedical Research Centre, United Kingdom (G.L.D.M., A.P.B.)
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Canitrot R, Carrié D, Lhermusier T, Servoz C. Snare technique failure in extracting an embolized coronary sinus reducer to the pulmonary artery. J Invasive Cardiol 2024; 36. [PMID: 38441993 DOI: 10.25270/jic/23.00230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
We report the case of a 79-year-old male patient who benefited from the implantation of a coronary sinus reducer (CSR) (Reducer; Neovasc, Inc.) in the management of typical angina with mild exertion with optimal medical treatment.
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Affiliation(s)
- Ronan Canitrot
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | | | - Clément Servoz
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
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6
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Matta A, Lhermusier T, Ohlmann P, Laszlo L, Nader V, Parada FC, Elbaz M, Roncalli J, Carrié D. Survival outcomes of TAVR and self-expanding versus balloon-expandable valves in patients with advanced cardiac dysfunction. ESC Heart Fail 2024. [PMID: 38318998 DOI: 10.1002/ehf2.14697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
AIMS There is a growing body of literature on long-term outcomes post-transcatheter aortic valve replacement (TAVR), but to our knowledge, few research have focused on patients with advanced cardiac dysfunction. This challenging category of patients was excluded from the Partner 3 clinical trial. There are no data to guide the choice of valve type in patients with severely depressed ejection fraction. This study evaluates the safety, efficacy, and outcomes of TAVR in patients with severe aortic stenosis and left ventricular ejection fraction (LVEF) ≤ 35%. It compares post-TAVR survival outcomes with self-expanding (SEV) versus balloon-expandable (BEV) valves in the context of cardiac dysfunction. METHODS AND RESULTS A retrospective cohort was conducted on 977 patients who underwent TAVR at Toulouse University Hospital between January 2016 and December 2020. The study population included two groups: LVEF ≤ 35% (N = 157) and LVEF ≥ 50% (N = 820). The group of LVEF ≤ 35% was divided into two subgroups according to the type of implanted device: self-expanding (N = 66) versus balloon-expandable (N = 91). The living status of each of study's participants was observed in December 2022. Patients with low ejection fraction were younger (82 vs. 84.6 years) and commonly males (71.3% vs. 45.6%). Procedural success was almost 98% in both study groups (97.5% vs. 97.9%). The prevalence of all in-hospital post-TAVR complications [acute kidney injury (3.8% vs. 2.2%), major bleeding events (2.5% vs. 3.2%), stroke (1.3% vs. 1.6%), pacemaker implantation (10.2% vs. 10.7%), major vascular complication (4.5% vs. 4.5%), new onset atrial fibrillation (3.2% vs. 3.4%), and in-hospital death (3.2% vs. 2.8%)] were similar between groups (LVEF ≤ 35% vs. LVEF ≥ 50%). No difference in long-term survival has been revealed over 3.4 years (P = 0.268). In patients with LVEF ≤ 35%, except for post-TAVR mean aortic gradient (7.8 ± 4.2 vs. 10.2 ± 3.6), baseline and procedural characteristics were comparable between SEV versus BEV subgroups. An early improvement in LVEF (from 29.2 ± 5.5 to 37.4 ± 10.8) was observed. In patients with LVEF ≤ 35%, the all-cause mortality rate was significantly higher in BEV than that in SEV subgroups, respectively (40.7% vs. 22.7%, P = 0.018). Kaplan-Meier curve showed better survival outcomes after SEV implantation (P = 0.032). A Cox regression identified BEV as independent predictor of mortality [HR = 3.276, 95% CI (1.520-7.060), P = 0.002]. CONCLUSIONS In the setting of low LVEF, TAVR remains a safe and effective procedure not associated with an increased risk of complications and mortality. SEV implantation may likely result in superior survival outcomes in patients with advanced cardiac dysfunction.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France
| | | | - Patrick Ohlmann
- Department of Cardiology, Strasbourg University Hospital, Strasbourg, France
| | - Levai Laszlo
- Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France
| | - Vanessa Nader
- Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France
| | | | - Meyer Elbaz
- Department of Cardiology, Toulouse University Hospital, Rangueil, France
| | - Jerome Roncalli
- Department of Cardiology, Toulouse University Hospital, Rangueil, France
| | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Rangueil, France
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7
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Matta A, Ohlmann P, Nader V, Levai L, Kang R, Carrié D, Roncalli J. A review of the conservative versus invasive management of ischemic heart failure with reduced ejection fraction. Curr Probl Cardiol 2024; 49:102347. [PMID: 38103822 DOI: 10.1016/j.cpcardiol.2023.102347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
Heart failure is increasing in terms of prevalence, morbidity, and mortality rates. Clinical trials and studies are focusing on heart failure as it is the destiny end-stage for several cardiovascular disorders. Recently, medical therapy has dramatically progressed with novel classes of medicines providing better quality of life and survival outcomes. However, heart failure remains a heavy impactful factor on societies and populations. Current guidelines from the American and European cardiac societies are not uniform with respect to the class and level of treatment recommendations for coronary artery disease patients with heart failure and reduced ejection fraction. The discrepancy among international recommendations, stemming from the lack of evidence from adequately powered randomized trials, challenges physicians in choosing the optimal strategy. Hybrid therapy including optimal medical therapy with revascularization strategies are commonly used for the management of ischemic heart failure. Coronary artery bypass graft (CABG) has proved its efficacy on improving long term outcome and prognosis while no large randomized clinical trials for percutaneous coronary intervention (PCI) are still available. Regardless of the lack of data and recommendations, the trends of performing PCI in ischemic heart failure prevailed over CABG whereas lesion complexity, chronic total occlusion and complete revascularization achievement are limiting factors. Lastly, regenerative medicine seems a promising approach for advanced heart failure enhancing cardiomyocytes proliferation, reverse remodeling, scar size reduction and cardiac function restoration.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Civilian Hospital of Colmar, Colmar, France.
| | - Patrick Ohlmann
- Department of Cardiology, University Hospital of Strasbourg, Strasbourg, France
| | - Vanessa Nader
- Department of Cardiology, Civilian Hospital of Colmar, Colmar, France
| | - Laszlo Levai
- Department of Cardiology, Civilian Hospital of Colmar, Colmar, France
| | - Ryeonshi Kang
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Jerome Roncalli
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
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Abstract
Myocardial bridging (MB) is a common congenital abnormality that remains asymptomatic in a large proportion of patients. The peak of clinical manifestation occurs during the third and fourth decades of life. MB provokes myocardial ischemia through different mechanisms including supply-demand mismatch, endothelial dysfunction, coronary microvascular dysfunction and external mechanical compression. The association between MB and atherosclerotic disease is controversial. Recent studies established a significant association of MB with myocardial infarction and non-obstructive coronary artery disease. The first line medical treatment is based on beta-blockers and calcium channel blockers. Ivabradine is used in second line therapy. Invasive approaches involving percutaneous coronary intervention, coronary artery bypass graft and myotomy are performed in patients with symptoms refractory to maximally tolerated medical treatment. The choice of revascularization technique depends on anatomical characteristics, clinical condition and physician experience. Available data derived from anecdotal evidence view the lack of randomized clinical trials.
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Affiliation(s)
- Anthony Matta
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France; Department of cardiology, Intercommunal Hospital Centre Castres-Mazamet, Castres, France; Faculty of medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Jerome Roncalli
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Didier Carrié
- Department of cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.
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Servoz C, Matta A, Bataille V, Philippe J, Laszlo L, Blanco S, Elbaz M, Bouisset F, Campelo-Parada F, Carrié D, Lhermusier T. Outcomes of Provisional Stenting With Versus Without Side Branch Intervention in Patients With Bifurcation Lesion-Related ST-Segment Elevation Myocardial Infarction. Am J Cardiol 2023; 208:190-194. [PMID: 37871531 DOI: 10.1016/j.amjcard.2023.09.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/05/2023] [Accepted: 09/09/2023] [Indexed: 10/25/2023]
Abstract
To date, the best approach to coronary bifurcation lesion remains unsettled, and the parameters to guide side branch ballooning or stenting are not yet defined. This study aimed to compare the survival outcomes after provisional stenting with versus without side branch intervention. A cohort was conducted on 132 patients who underwent coronary angiography at Toulouse University Hospital for ST-segment elevation myocardial infarction with large culprit nonleft main coronary bifurcation lesion. Study participants were divided into 2 groups depending on the performance or not of a side branch intervention. We observed the living status at 1-year after hospital discharge. Side branch intervention by balloon inflation or final balloon kissing technique was performed in 34.1% of study participants. At 1-year follow-up, the incidence of all-cause mortality was 7.8 per 100 person-years (95% confidence interval [CI] 4.1 to 15), and although it seemed higher in the side branch intervention group (10 per 100 person-years [95% CI 3.8 to 26.7] vs 6.6 per 100 persons-years [95% CI 2.8 to 15.9]), the survival analyses showed no differences in survival outcomes (hazard ratio side branch intervention 1.55 [0.42 to 5.78], p = 0.513). In conclusion, in the setting of a coronary bifurcation causing ST-segment elevation myocardial infarction, simple provisional stenting without side branch intervention showed a low mortality rate and no differences in the 1-year survival outcomes.
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Affiliation(s)
- Clément Servoz
- Department of Cardiology, Toulouse University Hospital, Toulouse, France.
| | - Anthony Matta
- Department of cardiology, Civilians Hospital of Colmar, Colmar, France
| | - Vincent Bataille
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - John Philippe
- Department of cardiology, Civilians Hospital of Colmar, Colmar, France
| | - Levai Laszlo
- Department of cardiology, Civilians Hospital of Colmar, Colmar, France
| | - Stéphanie Blanco
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Meyer Elbaz
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Frédéric Bouisset
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | | | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
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10
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Matta A, Regueiro A, Urena M, Nombela-Franco L, Riche M, Rodriguez-Gabella T, Amat-Santos I, Chamandi C, Akiki T, Gabani R, Vera-Urquiza R, Lhermusier T, Bouisset F, Carrié D, Campelo-Parada F. Comparison of Paravalvular Leak in SAPIEN 3 and EVOLUT PRO Valves in Transcatheter Aortic Valve Replacement: A Multicenter Registry. Am J Cardiol 2023; 207:114-120. [PMID: 37734300 DOI: 10.1016/j.amjcard.2023.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/09/2023] [Accepted: 08/17/2023] [Indexed: 09/23/2023]
Abstract
Paravalvular leak (PVL), conduction disturbances, and vascular complications remain the most common complications after TAVR. To address these adverse outcomes, the third generation of transcatheter heart valves has been developed. The last generation prosthesis provides an outer pericardial wrap for enhanced sealing and PVL prevention. This study aimed to compare the incidence and severity of PVL and 1-year survival after TAVR using SAPIEN 3 with those using EVOLUT PRO. An observational retrospective analysis was conducted in 1,481 patients who underwent TAVR for symptomatic severe aortic stenosis in 6 different European centers. The primary end point was to assess the frequency and severity of PVL at 30 days after TAVR. The secondary end point was to compare 1-year survival using EVOLUT PRO with that using SAPIEN 3. SAPIEN 3 transcatheter heart valve was implanted in 78.3% of study participants (n = 1,160) whereas EVOLUT PRO was implanted in 21.7% (n = 321). PVL is more commonly observed in patients treated with EVOLUT PRO at prehospital discharge (55.1% vs 37.3%) and at 1-month (51% vs 41.4%) and 1-year (51.3% vs 39.3%) follow-up. This difference mainly concerns low-grade (mild/trace) PVL. The frequency of high-degree (moderate/severe) PVL was almost similar in both groups throughout the study period (5.3% vs 5.8% before hospital discharge, 4% vs 3.1% at 1 month, and 3.2% vs 4.9% at 1 year). No significant difference in survival over 1 year has been observed (hazard ratio 0.73 [0.33 to 1.63], p = 0.442) (Graphical abstract). In conclusion, the detection rate of PVL after TAVR with third-generation heart valves remains high, and there are no major differences between the devices regarding the frequency of significant (moderate/severe) PVL and survival.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Hôpital Rangueil, CHU-Toulouse, Toulouse, France; Department of Cardiology, Civilian Hospitals of Colmar, Colmar, France
| | - Ander Regueiro
- Department of Cardiology, Hospital Clinic de Barcelona, Spain
| | - Marina Urena
- Department of Cardiology, Hôpital Bichat, AP-HP, Paris, France
| | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Maya Riche
- Department of Cardiology, Hôpital Rangueil, CHU-Toulouse, Toulouse, France
| | | | - Ignacio Amat-Santos
- Department of Cardiology, Hospital Clínico Universitario de Valladolid, Spain
| | - Chekrallah Chamandi
- Department of Cardiology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Tanios Akiki
- Department of Cardiology, Hôpital Européen Georges-Pompidou, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - Rami Gabani
- Department of Cardiology, Hospital Clinic de Barcelona, Spain
| | - Rafael Vera-Urquiza
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Thibault Lhermusier
- Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Frédéric Bouisset
- Department of Cardiology, Hôpital Rangueil, CHU-Toulouse, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Hôpital Rangueil, CHU-Toulouse, Toulouse, France
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11
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Barbato E, Gallinoro E, Abdel-Wahab M, Andreini D, Carrié D, Di Mario C, Dudek D, Escaned J, Fajadet J, Guagliumi G, Hill J, McEntegart M, Mashayekhi K, Mezilis N, Onuma Y, Reczuch K, Shlofmitz R, Stefanini G, Tarantini G, Toth GG, Vaquerizo B, Wijns W, Ribichini FL. Management strategies for heavily calcified coronary stenoses: an EAPCI clinical consensus statement in collaboration with the EURO4C-PCR group. Eur Heart J 2023; 44:4340-4356. [PMID: 37208199 DOI: 10.1093/eurheartj/ehad342] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/21/2023] Open
Abstract
Since the publication of the 2015 EAPCI consensus on rotational atherectomy, the number of percutaneous coronary interventions (PCI) performed in patients with severely calcified coronary artery disease has grown substantially. This has been prompted on one side by the clinical demand for the continuous increase in life expectancy, the sustained expansion of the primary PCI networks worldwide, and the routine performance of revascularization procedures in elderly patients; on the other side, the availability of new and dedicated technologies such as orbital atherectomy and intravascular lithotripsy, as well as the optimization of the rotational atherectomy system, has increased operators' confidence in attempting more challenging PCI. This current EAPCI clinical consensus statement prepared in collaboration with the EURO4C-PCR group describes the comprehensive management of patients with heavily calcified coronary stenoses, starting with how to use non-invasive and invasive imaging to assess calcium burden and inform procedural planning. Objective and practical guidance is provided on the selection of the optimal interventional tool and technique based on the specific calcium morphology and anatomic location. Finally, the specific clinical implications of treating these patients are considered, including the prevention and management of complications and the importance of adequate training and education.
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Affiliation(s)
- Emanuele Barbato
- Department of Clinical and Molecular Medicine, Sapienza University, Via di Grottarossa n. 1035, Rome, 00189, Italy
| | - Emanuele Gallinoro
- Division of University Cardiology, IRCCS Galeazzi-Sant'Ambrogio Hospital, University of Milan, Milan, Italy
| | | | - Daniele Andreini
- Division of University Cardiology, IRCCS Galeazzi-Sant'Ambrogio Hospital, University of Milan, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Didier Carrié
- Service de Cardiologie B, CHU Rangueil, Université Paul Sabatier, Toulouse, France
| | - Carlo Di Mario
- Interventional Structural Cardiology Division, Department of Clinical & Experimental Medicine, Careggi University Hospital, Florence, Italy
| | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University, Collegium Medicum, Krakow, Poland
| | - Javier Escaned
- Hospital Clínico San Carlos IDISCC, Complutense University of Madrid, Madrid, Spain
| | | | | | - Jonathan Hill
- Department of Cardiology, Royal Brompton Hospital, London, UK
| | - Margaret McEntegart
- West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Kambis Mashayekhi
- Department of Internal Medicine and Cardiology, MediClin Heart Institute Lahr/Baden, Lahr & Division of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | | | - Yoshinobu Onuma
- Department of Cardiology, Cardiovascular Center, Fujita Health University Hospital, Toyoake, Japan
- Department of Cardiology, National University of Ireland, Galway, Ireland
| | - Krzyszstof Reczuch
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | - Giulio Stefanini
- Humanitas Clinical and Research Hospital IRCCS & Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Gabor G Toth
- University Heart Center Graz, Medical University of Graz, Graz, Austria
| | - Beatriz Vaquerizo
- Unidad de Cardiología Intervencionista, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - William Wijns
- The Lambe Institute for Translational Medicine, The Smart Sensors Laboratory, Corrib Core Laboratory and Curam, National University of Ireland, Galway, Ireland
| | - Flavio L Ribichini
- Cardiovascular Section of the Department of Medicine, University of Verona, Verona, Italy
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12
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Matta A, Rabès JP, Taraszkiewicz D, Carrié D, Roncalli J, Ferrières J. Effect of causative genetic variants on atherosclerotic cardiovascular disease in heterozygous familial hypercholesterolemia patients. Front Cardiovasc Med 2023; 10:1182554. [PMID: 37539087 PMCID: PMC10395089 DOI: 10.3389/fcvm.2023.1182554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/28/2023] [Indexed: 08/05/2023] Open
Abstract
Background Heterozygous familial hypercholesterolemia (HFH) is an autosomal dominant genetic disorder leading to a lifetime exposure to high low-density lipoprotein cholesterol (LDL-c) level and an increased risk of premature atherosclerotic cardiovascular disease (ASCVD). We evaluate the effect of a causative genetic variant to predict ASCVD in HFH patients undergoing treatment. Materials and methods A retrospective cohort was conducted on 289 patients with possible, probable, and definite diagnosis of HFH according to Dutch Lipid Clinic Network Score and in whom DNA analyses were performed and mean LDL-c level was above 155 mg/dl. The study population was divided into groups based on the presence or not of a causative variant (pathogenic or likely pathogenic). We observed each of the study's participants for the occurrence of ASCVD. Results A causative variant was detected in 42.2% of study participants, and ASCVD has occurred in 21.5% of HFH patients. The incidence of ASCVD (27% vs. 17.4%, p = 0.048) and the mean of LDL-c under an optimal medical treatment (226 ± 59 mg/dl vs. 203 ± 37 mg/dl, p = 0.001) were higher in HFH-causative variant carriers than others. After adjusting on confounders, ASCVD was positively associated with LDL-c level [OR = 2.347; 95% (1.305-4.221), p = 0.004] and tends toward a negative association with HDL-c level [OR = 0.140; 95% (0.017-1.166), p = 0.059]. There is no more association between the detection of a causative variant and the occurrence of ASCVD [OR = 1.708; 95% (0.899-3.242), p = 0.102]. Kaplan Meier and log rank test showed no significant differences in event-free survival analysis between study groups (p = 0.523). Conclusion In this study population under medical care, it seems that the presence of a causative variant did not represent an independent predictor of adverse cardiovascular outcomes in HFH patients, and LDL-c level played an undisputable causal role.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Civilians Hospital of Colmar, Colmar, France
- Department of Cardiology, Notre Dame des Secours University Hospital Center, Byblos, Lebanon
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Jean Pierre Rabès
- Department of Biochemistry and Molecular Genetics, Ambroise Paré University Hospital (APHP), Université Paris-Saclay, Paris, France
- UFR (Unité de Formation et de Recherche) Simone Veil-Santé, Versailles-Saint-Quentin-en-Yvelines University, Paris, France
| | | | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Rangueil, France
| | - Jérôme Roncalli
- Department of Cardiology, Toulouse University Hospital, Rangueil, France
| | - Jean Ferrières
- Department of Cardiology, Toulouse University Hospital, Rangueil, France
- Department of Epidemiology, Health Economics and Public Health, UMR INSERM 1295, Toulouse-Rangueil University Hospital, Toulouse University School of Medicine, Toulouse, France
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13
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Nader V, Matta A, Kang R, Deney A, Azar R, Rouzaud-Laborde C, Kunduzova O, Itier R, Fournier P, Galinier M, Carrié D, Roncalli J. Mortality rate after coronary revascularization in heart failure patients with coronary artery disease. ESC Heart Fail 2023. [PMID: 37376752 PMCID: PMC10375079 DOI: 10.1002/ehf2.14445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 05/21/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
AIMS Coronary artery disease (CAD) is a common cause of heart failure (HF). It remains unclear who, when and why to direct towards coronary revascularization. The outcomes of coronary revascularization in HF patients are still a matter of debate nowadays. This study aims to evaluate the effect of revascularization strategy on all-cause of death in the context of ischaemic HF. METHODS AND RESULTS An observational cohort was conducted on 692 consecutive patients who underwent coronary angiography at the University Hospital of Toulouse between January 2018 and December 2021 for either a recent diagnosis of HF or a decompensated chronic HF, and in whom coronary angiograms showed at least 50% obstructive coronary lesion. The study population was divided into two groups according to the performance or not of a coronary revascularization procedure. The living status (alive or dead) of each of the study's participants was observed by April 2022. Seventy-three per cent of the study population underwent coronary revascularization either by percutaneous coronary intervention (66.6%) or coronary artery bypass grafting (6.2%). Baseline characteristics including age, sex and cardiovascular risk factors did not differ between the invasive and conservative groups, respectively. Death occurred in 162 study participants resulting in an all-cause mortality rate of 23.5%; 26.7% of observed deaths have occurred in the conservative group versus 22.2% in the invasive group (P = 0.208). No difference in survival outcomes has been observed over a mean follow-up period of 2.5 years (P = 0.140) even after stratification by HF categories (P = 0.132) or revascularization modalities (P = 0.366). CONCLUSIONS Findings from the present study showed comparable all-cause mortality rates between groups. Coronary revascularization does not modify short-term survival outcomes in HF patients compared with optimal medical therapy alone outside the setting of acute coronary syndrome.
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Affiliation(s)
- Vanessa Nader
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
- Faculty of Sciences, Paul-Sabatier Toulouse III University, Toulouse, France
- INSERM I2MC - UMR1297, Toulouse, France
| | - Anthony Matta
- Department of cardiology, Civilians Hospital of Colmar, Colmar, France
- Notre Dame des Secours University Hospital Center, Lebanon/School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Ryeonshi Kang
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
- Faculty of Sciences, Paul-Sabatier Toulouse III University, Toulouse, France
| | - Antoine Deney
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Rania Azar
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Charlotte Rouzaud-Laborde
- INSERM I2MC - UMR1297, Toulouse, France
- Clinical Department of Pharmacy, Faculty of Pharmacy, UFR Toulouse III, Toulouse, France
| | | | - Romain Itier
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
- Faculty of Sciences, Paul-Sabatier Toulouse III University, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
- Faculty of Sciences, Paul-Sabatier Toulouse III University, Toulouse, France
| | - Jerome Roncalli
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
- Faculty of Sciences, Paul-Sabatier Toulouse III University, Toulouse, France
- INSERM I2MC - UMR1297, Toulouse, France
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14
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Arunothayaraj S, Behan MW, Lefèvre T, Lassen JF, Chieffo A, Stankovic G, Burzotta F, Pan M, Ferenc M, Hovasse T, Spence MS, Brunel P, Cotton JM, Cockburn J, Carrié D, Baumbach A, Maeng M, Louvard Y, Hildick-Smith D. Stepwise provisional versus systematic culotte for stenting of true coronary bifurcation lesions: five-year follow-up of the multicentre randomised EBC TWO Trial. EUROINTERVENTION 2023; 19:EIJ-D-23-00211. [PMID: 37946522 PMCID: PMC10333921 DOI: 10.4244/eij-d-23-00211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 04/28/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The multicentre European Bifurcation Club Trial (EBC TWO) showed no significant differences in 12-month clinical outcomes between patients randomised to a provisional stenting strategy or systematic culotte stenting in non-left main true bifurcations. AIMS This study aimed to investigate the 5-year clinical results of the EBC TWO Trial. METHODS A total of 200 patients undergoing stent implantation for non-left main bifurcation lesions were recruited into EBC TWO. Inclusion criteria required a side branch diameter ≥2.5 mm and side branch lesion length >5 mm. Five-year follow-up was completed for 197 patients. The primary endpoint was the composite of all-cause mortality, myocardial infarction, or target vessel revascularisation. RESULTS The mean side branch stent diameter was 2.7±0.3 mm and mean side branch lesion length was 10.3±7.2 mm. At 5-year follow-up, the primary endpoint occurred in 18.4% of provisional and 23.7% of systematic culotte patients (hazard ratio [HR] 0.75, 95% confidence interval [CI]: 0.41-1.38). No significant differences were identified individually for all-cause mortality (7.8% vs 7.2%, HR 1.11, 95% CI: 0.40-3.05), myocardial infarction (8.7% vs 13.4%, HR 0.64, 95% CI: 0.27-1.50) or target vessel revascularisation (6.8% vs 9.3%, HR 1.12, 95% CI: 0.37-3.34). Stent thrombosis rates were also similar (1.9% vs 3.1%, HR 0.63, 95% CI: 0.11-3.75). There was no significant interaction between the extent of side branch disease and the primary outcome (p=0.34). CONCLUSIONS In large non-left main true bifurcation lesions, the use of a systematic culotte strategy showed no benefit over provisional stenting for the composite outcome of all-cause mortality, myocardial infarction, or target vessel revascularisation at 5 years. The stepwise provisional approach may be considered preferable for the majority of true coronary bifurcation lesions. CLINICALTRIALS gov: NCT01560455.
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Affiliation(s)
| | | | - Thierry Lefèvre
- Institut Cardiovasculaire Paris Sud, Hôpital privé Jacques Cartier, Ramsay Santé, Massy, France
| | - Jens F Lassen
- Department of Cardiology B, Odense University Hospital, Odense, Denmark and University of Southern Denmark, Odense, Denmark
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Goran Stankovic
- Department of Cardiology, University Clinical Centre of Serbia, Belgrade, Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Francesco Burzotta
- Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Manuel Pan
- Department of Cardiology, Reina Sofia Hospital, University of Cordoba, (IMIBIC), Cordoba, Spain
| | - Miroslaw Ferenc
- University Heart Center Freiburg - Bad Krozingen, Bad Krozingen, Germany
| | - Thomas Hovasse
- Institut Cardiovasculaire Paris Sud, Hôpital privé Jacques Cartier, Ramsay Santé, Massy, France
| | - Mark S Spence
- Department of Cardiology, Royal Victoria Hospital, Belfast, UK
| | - Philippe Brunel
- Hôpital privé Dijon Bourgogne, Clinique Valmy, Dijon, France
| | - James M Cotton
- Royal Wolverhampton University Hospital NHS Trust, Wolverhampton, UK
| | - James Cockburn
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton, UK
| | - Didier Carrié
- Department of Cardiology, Toulouse University, Rangueil Hospital, Toulouse, France
| | - Andreas Baumbach
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, UK
| | - Michael Maeng
- Department of Cardiology, Aarhus University Hospital & Aarhus University, Aarhus, Denmark
| | - Yves Louvard
- Institut Cardiovasculaire Paris Sud, Hôpital privé Jacques Cartier, Ramsay Santé, Massy, France
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Abstract
Takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy, is a reversible syndrome commonly found among patients presenting for acute coronary syndromes, especially women. With the COVID-19 pandemic, the incidence of takotsubo cardiomyopathy was dramatically increased. However, this clinical cardiac entity remains underdiagnosed, largely due to the interplay with acute coronary syndrome. The pathophysiology of takotsubo cardiomyopathy is miscellaneous, including coronary vasospasm, microcirculatory dysfunction, catecholamine surge, and sympathetic overdrive. Diagnosing takotsubo cardiomyopathy requires a high index of clinical suspicion and multimodality tests. To date, there are no guidelines for the management of takotsubo cardiomyopathy. Thus, available data are derived from case series, retrospective analyses, and experts' opinions. Heart failure medicines were investigated in takotsubo cardiomyopathy patients. Evidence supports the benefits of angiotensin-converting enzyme inhibitors and angiotensin receptors blockers use on mortality and recurrence rates, while results from use of beta-blockers are controversial. In complicated cases, inotropes are preferred over vasopressors, except in the presence of left ventricular outflow tract obstruction, in which medical therapy is limited to fluids administration and beta-blockers. Use of oral vitamin K antagonist can benefit patients at high thrombo-embolic risk for up to 3 months. Mechanical supports are reserved for refractory hemodynamically unstable cases. This review aims to provide an update on the epidemiology, diagnosis, and outcomes of takotsubo cardiomyopathy, and an extended discussion on the management of complicated and non-complicated cases.
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Affiliation(s)
- Anthony Georges Matta
- Department of Cardiology, Toulouse University Hospital, Toulouse, France.,Department of Cardiology, Hôpitaux Civils de Colmar, Colmar, France
| | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
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16
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Matta A, Levai L, Roncalli J, Elbaz M, Bouisset F, Nader V, Blanco S, Campelo Parada F, Carrié D, Lhermusier T. Comparison of in-hospital outcomes and long-term survival for valve-in-valve transcatheter aortic valve replacement versus the benchmark native valve transcatheter aortic valve replacement procedure. Front Cardiovasc Med 2023; 10:1113012. [PMID: 36844743 PMCID: PMC9949886 DOI: 10.3389/fcvm.2023.1113012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/20/2023] [Indexed: 02/11/2023] Open
Abstract
Background In recent years, the number of patients with failed surgically implanted aortic bioprostheses and the number of candidates for valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) have been increasing. Objectives The purpose of this study is to evaluate the efficacy, safety, and long-term survival outcomes of VIV-TAVR compared with the benchmark native valve transcatheter aortic valve replacement (NV-TAVR). Methods A cohort study was conducted on patients who underwent TAVR in the department of cardiology at Toulouse University Hospital, Rangueil, France between January 2016 and January 2020. The study population was divided into two groups: NV-TAVR (N = 1589) and VIV-TAVR (N = 69). Baseline characteristics, procedural data, in-hospital outcomes, and long-term survival outcomes were observed. Results In comparison with NV-TAVR, there are no differences in TAVR success rate (98.6 vs. 98.8%, p = 1), per-TAVR complications (p = 0.473), and length of hospital stay (7.5 ± 50.7 vs. 4.4 ± 2.8, p = 0.612). The prevalence of in-hospital adverse outcomes did not differ among study groups, including acute heart failure (1.4 vs. 1.1%), acute kidney injury (2.6, 1.4%), stroke (0 vs. 1.8%, p = 0.630), vascular complications (p = 0.307), bleeding events (0.617), and death (1.4 vs. 2.6%). VIV-TAVR was associated with a higher residual aortic gradient [OR = 1.139, 95%CI (1.097-1.182), p = 0.001] and a lower requirement for permanent pacemaker implantation [OR = 0.235 95%CI (0.056-0.990), p = 0.048]. Over a mean follow-up period of 3.44 ± 1.67 years, no significant difference in survival outcomes has been observed (p = 0.074). Conclusion VIV-TAVR shares the safety and efficacy profile of NV-TAVR. It also represents a better early outcome but a higher non-significant long-term mortality rate.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, Toulouse University Hospital, Toulouse, France,Department of Cardiology, Hôpitaux Civils de Colmar, Colmar, France
| | - Laszlo Levai
- Department of Cardiology, Hôpitaux Civils de Colmar, Colmar, France
| | - Jerome Roncalli
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Meyer Elbaz
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Frederic Bouisset
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Vanessa Nader
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Stephanie Blanco
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | | | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Toulouse, France,*Correspondence: Didier Carrié,
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Bouisset F, Ribichini F, Bataille V, Reczuch K, Lhermusier T, Dobrzycki S, Meyer-Gessner M, Bressollette E, Zajdel W, Faurie B, Mezilis N, Palazuelos J, Vaquerizo B, Ferenc M, Cayla G, Barbato E, Carrié D. Clinical Outcomes of Left Main Coronary Artery PCI With Rotational Atherectomy. Am J Cardiol 2023; 186:36-42. [PMID: 36343444 DOI: 10.1016/j.amjcard.2022.09.031] [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] [Received: 06/18/2022] [Revised: 09/10/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022]
Abstract
Data regarding rotational atherectomy percutaneous coronary intervention (RA PCI) angioplasty in the left main (LM) coronary artery are scarce, and mostly outdated. We aimed to describe clinical outcomes of RA PCI in LM. Patients requiring RA in 8 European countries and 19 centers were prospectively and consecutively included in the European registry of Cardiac Care of Calcified and Complex patients registry. In-hospital data collection and 1-year follow-up were performed for each patient. Between October 2016 and July 2018, 966 patients with complete data were included. Among them, 241 presented with an LM lesion, and 171 required an LM lesion preparation by RA. The latter, allocated to the LM-RA group, were compared with the 725 patients in the non-LM-RA group. Clinical success of the RA procedure was comparable in both groups, but in-hospital major adverse cardiac events were higher in the RA-LM group (7.6% vs 3.2%, adjusted p = 0.04), mainly driven by a higher in-hospital mortality rate (5.3 vs 0.3%, adjusted p = 0.005). At 1-year follow-up, mortality and major adverse cardiac event rates were comparable in both groups (12.9% vs 8.0%, adjusted p value: 0.821, and 15.8% vs 10.9%, adjusted p value: 0.329, respectively), but the rate of target vessel revascularization remained higher in the RA-LM group (5.3% vs 3.2%, adjusted p = 0.021). In conclusion, RA PCI is an efficient option for calcified LM lesions, providing acceptable outcomes regarding this population with high risk at 1 year, and yields comparable outcomes with RA PCI performed on non-LM lesions.
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Affiliation(s)
- Frédéric Bouisset
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France.
| | | | - Vincent Bataille
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France; Association pour la Diffusion de la Médecine de Prévention (ADIMEP), Toulouse, France
| | - Krzysztof Reczuch
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Thibault Lhermusier
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France
| | | | | | | | - Wojciech Zajdel
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Benjamin Faurie
- Cardiovascular Institute, Groupe Hospitalier Mutualiste, Grenoble, France
| | - Nikolaos Mezilis
- Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece
| | - Jorge Palazuelos
- Department of Cardiology, Interventional Cardiology Unit, Hospital La Luz, Madrid, Spain
| | - Beatriz Vaquerizo
- Department of Cardiology, Hospital del Mar, Barcelona, Spain; Heart Diseases Biomedical Research Group (GREC), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Medicine, School of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | - Miroslaw Ferenc
- Department of Cardiology and Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Guillaume Cayla
- Department of Cardiology, Centre Hospitalier Universitaire de Nîmes, Université de Montpellier, Nîmes, France
| | - Emanuele Barbato
- Division of Cardiology, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Didier Carrié
- Department of Cardiology, Rangueil Toulouse University Hospital, University Paul Sabatier, Toulouse, France
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18
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Garot P, Brunel P, Dibie A, Morelle JF, Abdellaoui M, Levy R, Carrié D, Karsenty B, Robin C, Berland J, Copt S, Sadozai Slama S, Oldroyd K, Morice MC, Lipiecki J. Comparison of outcomes in patients with or without ARC-HBR criteria undergoing PCI with polymer-free biolimus coated stents: The BioFreedom France study. Catheter Cardiovasc Interv 2023; 101:60-71. [PMID: 36378683 DOI: 10.1002/ccd.30481] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/12/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The polymer-free biolimus coated stent (BioFreedom) was shown to be superior to bare metal stents in the LEADERS FREE randomized trial in high bleeding risk (HBR) patients treated with 1-month dual antiplatelet therapy (DAPT). However, there is limited outcome data with this device in an all-comers' population. METHODS We conducted a prospective single-arm study of patients undergoing percutaneous coronary intervention with the polymer-free biolimus coated stent in 25 centers in France with wide inclusion criteria including multivessel disease, complex lesions, and acute coronary syndromes. The primary endpoint was the incidence of target lesion failure (TLF), a composite of cardiac death or target-vessel myocardial infarction (MI) or clinically indicated target lesion revascularization (ci-TLR) at 1-year. The patient population was classified according to the presence (or not) of HBR criteria according to the recent ARC-HBR definition. RESULTS Between April 2019 and April 2020, 1497 patients were enrolled. TLF occurred in 101 (6.9%) patients, including cardiac death in 35 (2.4%), target vessel MI in 20 (1.4%) and ci-TLR in 65 (4.5%) of them. There were 491 HBR patients (32.8%) and 1006 non-HBR patients. The median duration of DAPT was 74 days in the HBR group versus 348 days in the non-HBR group (p < 0.0001). TLF occurred in 44 (9.2%) of the HBR group and in 57 (5.8%) of the non-HBR group (relative risk 1.62 [95% confidence interval: 1.10-2.41], p = 0015). Compared to the non-HBR group, HBR patients had higher rates of cardiac death (4.4% vs. 1.4%, p = 0.0005) and target vessel MI (2.9% vs. 0.6%, p = 0.0003), but similar rates of ci-TLR. BARC 3-5 bleeding occurred in 6.2% of the HBR group versus 1.4% of the non-HBR group (p < 0.0001). CONCLUSION In this multicenter all-comers study, HBR patients treated with a polymer-free biolimus coated stent had, compared to non-HBR patients, an increased risk of cardiac death and MI, and despite a shorter duration of DAPT, continued to have higher rates of BARC 3-5 bleeding.
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Affiliation(s)
- Philippe Garot
- Institut Cardiovasculaire Paris-Sud (ICPS), Hôpital Privé Jacques Cartier, Ramsay-Santé, Massy, France
| | - Philippe Brunel
- Institut Cardio-Vasculaire Dijon Bourgogne, Hôpital Privé Dijon Bourgogne, Ramsay-Santé, Dijon, France
| | - Alain Dibie
- Institut Mutualiste Montsouris, Paris, France
| | | | | | - Raphy Levy
- Hôpital Privé Saint-Martin, ELSAN, Bordeaux, France
| | | | | | | | | | - Samuel Copt
- Biosensors International, Morges, Switzerland
| | | | | | - Marie-Claude Morice
- Institut Cardiovasculaire Paris-Sud (ICPS), Hôpital Privé Jacques Cartier, Ramsay-Santé, Massy, France
- Centre Européen de Recherche Cardiovasculaire (CERC), Ramsay-Santé, Massy, France
| | - Janusz Lipiecki
- Clinique des Domes, Pole Santé République, ELSAN, Clermont-Ferrand, France
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Garot P, Brunel P, Dibie A, Morelle JF, Abdellaoui M, Levy R, Carrié D, Karsenty B, Robin C, Berland J, Copt S, Sadozai S, Olroyd K, Morice MC, Lipiecki J. 2 years outcomes in patients with or without ARC-HBR criteria undergoing PCI with polymer-free biolimus coated stents: The Biofreedom France Study. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.005] [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: 12/31/2022]
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20
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Matta A, Campelo-Parada F, Nader V, Lhermusier T, Bouisset F, Blanco S, Roncalli J, Carrié D. Long-term outcomes of conservative versus invasive approach of coronary aneurysm. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.012] [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: 01/01/2023]
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21
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Beneyto M, Maury P, Rollin A, Mondoly P, Mandel F, Pascal P, Cariou E, Carrié D, Galinier M, Lairez O. Phase analysis for ventricular arrhythmia prediction: A retrospective monocentric cohort study. J Nucl Cardiol 2022; 29:3086-3098. [PMID: 34877639 DOI: 10.1007/s12350-021-02864-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/01/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Prediction of ventricular arrhythmias (VA) mostly relies on left ventricular ejection fraction (LVEF), but with limited performance. New echocardiographic parameters such as mechanical dispersion have emerged, but acoustic window sometimes precludes this measurement. Nuclear imaging may be an alternative. We aimed to assess the ability of mechanical dispersion, measured with phase standard deviation (PSD) on radionuclide angiocardiography (RNA), to predict VAs. METHODS This retrospective monocentric observational study included all patients who underwent a tomographic RNA from 2015 to 2019. Phase analysis yielded PSD and follow-up was examined to identify VAs, heart transplantation, and death. RESULTS The study population consisted of 937 patients, mainly with LVEF ≤ 35% (425, 45%). Most had ischemic (334, 36%) or dilated cardiomyopathies (245, 26%). We identified 86 (9%) VAs. PSD was strongly associated with the occurrence of VA [hazard ratio per 10 ms increase (HR10) 1.12 (1.09-1.16)], heart transplantation [HR10 1.09 (1.06-1.12)], and death [HR10 1.03 (1.00-1.05)]. The association between PSD and VA persisted after adjustment for age, sex, QRS duration, LVEF, global longitudinal strain (GLS), and echocardiography-assessed mechanical dispersion. CONCLUSION The occurrence of ventricular arrhythmias was predicted by mechanical dispersion assessed by RNA, even after adjustment for LVEF and GLS.
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Affiliation(s)
- Maxime Beneyto
- Department of Cardiology, Toulouse University Hospital, Toulouse, France.
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.
| | - Philippe Maury
- Department of Pacing and Electrophysiology, Toulouse University Hospital, Toulouse, France
- I2MC, INSERM UMR 1297, Toulouse, France
| | - Anne Rollin
- Department of Pacing and Electrophysiology, Toulouse University Hospital, Toulouse, France
| | - Pierre Mondoly
- Department of Pacing and Electrophysiology, Toulouse University Hospital, Toulouse, France
| | - Franck Mandel
- Department of Pacing and Electrophysiology, Toulouse University Hospital, Toulouse, France
| | - Pierre Pascal
- Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France
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Matta A, Campelo-Parada F, Nader V, Lhermusier T, Bouisset F, Blanco S, Elbaz M, Roncalli J, Carrié D. Long-Term Outcomes of Conservative Versus Invasive Approach of Coronary Aneurysm. Rev Cardiovasc Med 2022. [DOI: 10.31083/j.rcm2308281] [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: 11/06/2022] Open
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23
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Mauler-Wittwer S, Sievert H, Ioppolo AM, Mahfoud F, Carrié D, Lipiecki J, Nickenig G, Fajadet J, Eckert S, Morice MC, Garot P. Study Evaluating the Use of RenalGuard to Protect Patients at High Risk of AKI. JACC Cardiovasc Interv 2022; 15:1639-1648. [DOI: 10.1016/j.jcin.2022.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 12/12/2022]
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24
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Matta A, Lhermusier T, Bouisset F, Parada FC, ELBaz M, Nader V, Blanco S, Roncalli J, Carrié D. Outcomes of Transcatheter Aortic Valve Implantation in Nonagenarians Compared to Younger than 90 Year Old Patients. Am J Med 2022; 135:745-751. [PMID: 35296400 DOI: 10.1016/j.amjmed.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Given that life expectancy has improved, nonagenarians have become a significant proportion of world population. As aortic stenosis is primarily a disease of the elderly, the need for invasive cardiac approaches is expected to increase in people of extreme age. Herein, we compare the in-hospital adverse clinical outcomes and mortality after transcatheter aortic valve implantation (TAVI) procedures in nonagenarians to younger than 90 year old patients. METHODS A retrospective study was conducted on 1336 patients who underwent TAVI between January 2016 and March 2020 at Toulouse University Hospital, Rangueil, France. Post-TAVI adverse clinical outcomes were defined according to Valve Academic Research Consortium-2 Criteria. The studied population was divided into 2 groups according to age. RESULTS Out of 1336 patients, 250 (18.7%) were nonagenarians with a mean age of 91.8 ± 1.9 years. Pacemaker implantation (12.4% vs 12.1%), stroke (2% vs 1.8%), and major vascular complications (9.2% vs 6.7%) were more common in nonagenarians, whereas acute kidney injury (1.2% vs 2.7%) and major bleeding events (3.2% vs 3.4%) were more common in the <90-year-old group. Nonagenarians are more likely to develop major vascular complications (odds ratio [OR] = 1.76 95% confidence interval [CI] 1.04-3, P = .03). The prevalence of in-hospital mortality in nonagenarians and <90-year-old patients were 5.2% and 2%, respectively. Survival analysis showed a significant difference in mortality during hospitalization period only ( P = .04). CONCLUSION The prevalence of TAVI procedural success is remarkably high in nonagenarians and comparable to that of younger patients. However, the in-hospital mortality rate was 2-fold more than that of <90-year-old patients.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, University Hospital Toulouse, Rangueil, France; Faculty of Medicine, Holy Spirit University of Kaslik, Jounieh, Lebanon.
| | | | - Fréderic Bouisset
- Department of Cardiology, University Hospital Toulouse, Rangueil, France
| | | | - Meyer ELBaz
- Department of Cardiology, University Hospital Toulouse, Rangueil, France
| | - Vanessa Nader
- Department of Cardiology, University Hospital Toulouse, Rangueil, France
| | - Stephanie Blanco
- Department of Cardiology, University Hospital Toulouse, Rangueil, France
| | - Jerome Roncalli
- Department of Cardiology, University Hospital Toulouse, Rangueil, France
| | - Didier Carrié
- Department of Cardiology, University Hospital Toulouse, Rangueil, France
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Servoz C, Matta A, Carrié D, Blanco S. Stent angioplasty for coronary compression syndrome related to prosthetic aortic valve. Eur Heart J Case Rep 2022; 6:ytac133. [PMID: 35434510 PMCID: PMC9007425 DOI: 10.1093/ehjcr/ytac133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/19/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Clément Servoz
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
- University Toulouse III - Paul-Sabatier, Toulouse, France
| | - Anthony Matta
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
- University Toulouse III - Paul-Sabatier, Toulouse, France
- Faculty of Medicine, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
- University Toulouse III - Paul-Sabatier, Toulouse, France
| | - Stephanie Blanco
- Department of Cardiology, Toulouse University Hospital, Toulouse, France
- University Toulouse III - Paul-Sabatier, Toulouse, France
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Matta A, Delmas C, Campelo-Parada F, Lhermusier T, Bouisset F, Elbaz M, Nader V, Blanco S, Roncalli J, Carrié D. Takotsubo cardiomyopathy. Rev Cardiovasc Med 2022; 23:38. [DOI: 10.31083/j.rcm2301038] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 11/06/2022] Open
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27
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Deney A, Nader V, Matta A, Itier R, Fournier P, Lairez O, Pizzinat N, Carrié D, Boal F, Galinier M, Kunduzova O, Azar R, Roncalli J. Retrospective Study of 573 Patients with Heart Failure Evaluated for Coronary Artery Disease at Toulouse University Center, France. Med Sci Monit 2022; 28:e934804. [PMID: 34974513 PMCID: PMC8734094 DOI: 10.12659/msm.934804] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Heart failure (HF) most commonly occurs due to ischemic heart disease from stenotic coronary artery disease (CAD). HF is classified into 3 groups based on the percentage of the ejection fraction (EF): reduced (HFrEF), mid-range (HFmrEF), and preserved (HFpEF). This retrospective study included 573 patients who presented with HF based on the evaluation of EF and were evaluated for CAD by coronary angiography before undergoing coronary angioplasty at a single center in Toulouse, France. Material/Methods This retrospective observational study included patients recently diagnosed with HF or acute decompensation of chronic HF and referred for coronary angiography at Toulouse University Hospital between January 2019 and May 2020. Results Significant CAD was found in 55.8%, 55%, and 55% of the whole population, HFpEF, and HFrEF groups, respectively. Older age, male sex, and diabetes mellitus were the main risk factors for ischemic HF. Except for age and sex, patients with ischemic HFpEF were comparable to those with non-ischemic HFpEF, unlike the ischemic HFrEF group, which had more common cardiovascular risk factors than the non-ischemic HFrEF group. The ischemic HFpEF group had an older age and higher rate of dyslipidemia than the ischemic HFrEF group. Conclusions At our center, CAD was diagnosed in more than half of patients who presented with heart failure with preserved or reduced EF. Older age and male sex were the common risk factors in patients with HFpEF and HFrEF.
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Affiliation(s)
- Antoine Deney
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Vanessa Nader
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Anthony Matta
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.,Faculty of Medicine, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Romain Itier
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Nathalie Pizzinat
- National Institute of Health and Medical Research (INSERM) U1297, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Frédéric Boal
- National Institute of Health and Medical Research (INSERM) U1297, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France
| | - Oksana Kunduzova
- National Institute of Health and Medical Research (INSERM) U1297, Toulouse, France
| | - Rania Azar
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Jerome Roncalli
- Department of Cardiology, Institute CARDIOMET, University Hospital of Toulouse, Toulouse, France.,National Institute of Health and Medical Research (INSERM) U1297, Toulouse, France
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28
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Matta A, Nader V, Canitrot R, Delmas C, Bouisset F, Lhermusier T, Blanco S, Parada F, Elbaz M, Carrié D, Galinier M, Roncalli J. Myocardial Bridging is Significantly Related to Myocardial Infarction with Non-Obstructive Coronary Artery Disease. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.018] [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: 10/19/2022]
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29
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Matta A, Lhermusier T, Parada F, Bouisset F, Ronan C, Nader V, Blanco S, Elbaz M, Roncalli J, Carrié D. Impact of Coronary Artery Disease and Percutaneous Coronary Intervention on Transcatheter Aortic Valve Implantation. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.016] [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: 10/19/2022]
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Lipiecki J, Brunel P, Dibie A, Morelle J, Abdellauoi M, Levy R, Carrié D, Karsenty B, Robin C, Berland J, Maillard L, Pankert M, Depoli F, Delarche N, Boiffard E, Champagne S, Piot C, Morel O, Chapon P, Garot P. Biofreedom France registry: A prospective evaluation of clinical outcomes in real-world patients treated by coronary angioplasty with Biolimus A9 polymer-free Biofreedom stents. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.012] [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: 11/26/2022]
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31
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Matta A, Lhermusier T, Bouisset F, Parada F, Elbaz M, Nader V, Blanco S, Roncalli J, Carrié D. Outcomes of transcatheter aortic valve implantation in nonagenarians compared to < 90 years patients. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.143] [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: 11/30/2022]
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32
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Cariou E, Sanchis K, Rguez K, Blanchard V, Cazalbou S, Fournier P, Huart A, Roussel M, Cintas P, Galinier M, Carrié D, Maury P, Lavie-Badie Y, Lairez O. New Oral Anticoagulants vs. Vitamin K Antagonists Among Patients With Cardiac Amyloidosis: Prognostic Impact. Front Cardiovasc Med 2021; 8:742428. [PMID: 34917658 PMCID: PMC8670403 DOI: 10.3389/fcvm.2021.742428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Atrial arrhythmia (AA) is common among patients with cardiac amyloidosis (CA), who have an increased risk of intracardiac thrombus. The aim of this study was to explore the prognostic impact of vitamin K-antagonists (VKA) and direct oral anticoagulants (DOAC) in patients with CA. Methods and Results: 273 patients with CA and history of AA with long term anticoagulation−69 (25%) light chain amyloidosis (AL), 179 (66%) wild-type transthyretin amyloidosis (ATTRwt) and 25 (9%) variant transthyretin amyloidosis (ATTRv)–were retrospectively included between January 2012 and July 2020. 147 (54%) and 126 (46%) patients received VKA and DOAC, respectively. Patient receiving VKA were more likely to have AL with renal dysfunction, higher NT-proBNP and troponin levels. Patients with ATTRwt were more likely to receive DOAC therapy. There were more bleeding complications among patients with VKA (20 versus 10%; P = 0.013) but no difference for stroke events (4 vs. 2%; P = 0.223), as compared to patients with DOAC. A total of 124 (45%) patients met the primary endpoint of all-cause mortality: 96 (65%) and 28 (22%) among patients with VKAs and DOACs, respectively (P < 0.001). After multivariate analysis including age and renal function, VKA was no longer associated with all-cause mortality. Conclusion: Among patients with CA and history of AA receiving oral anticoagulant, DOACs appear to be at least as effective and safe as VKAs.
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Affiliation(s)
- Eve Cariou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Kevin Sanchis
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Khailène Rguez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Virginie Blanchard
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Stephanie Cazalbou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Antoine Huart
- Department of Nephrology and Referral Center for Rare Diseases, Rangueil University Hospital, Toulouse, France
| | | | - Pascal Cintas
- Department of Neurology, Purpan University Hospital, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Philippe Maury
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Yoan Lavie-Badie
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
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Bouchau R, Cariou E, Deney A, Belaid S, Itier R, Blanchard V, Fournier P, Duparc A, Galinier M, Carrié D, Lairez O, Lavie-Badie Y. Sports participation and myocarditis: Influence of sport types on disease severity. Int J Cardiol Heart Vasc 2021; 37:100895. [PMID: 34765717 PMCID: PMC8571161 DOI: 10.1016/j.ijcha.2021.100895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study, in the context of acute myocarditis (AM) in sportsmen, the association between the category of sport practiced and the severity of AM. DESIGN Retrospective study. SETTING Single tertiary center. PATIENTS 82 sportspeople (≥2.5 h of sport per week) who presented an AM. ASSESSMENT OF RISK FACTORS The type of sport activity before AM were collected. MAIN OUTCOME MEASURES Complicated AM was defined by a left ventricular ejection fraction <50% or the use of inotropic drugs or ventricular assist device. RESULTS Mean age was 29 ± 9 year-old, 77 (94%) were men. Sixteen (20%) had a complicated AM. Practicing sport over 6 h a week or a Mitchell's Class IIIA sport were associated with complicated AM (44 vs. 17%, p = 0.019 and 38 vs. 11%, p = 0.008, respectively). Practicing a Mitchell's Class IC sport was associated with uncomplicated AM (6 vs. 38%, p = 0.008). CONCLUSION In sportspeople's AM, the pattern of sport activity (static or dynamic component, practice intensity) is associated with the disease's severity.
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Affiliation(s)
- Robin Bouchau
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Antoine Deney
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Slimane Belaid
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Romain Itier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Cardiovascular Rehabilitation, Rangueil University Hospital, Toulouse, France
| | - Virginie Blanchard
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Alexandre Duparc
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Yoan Lavie-Badie
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
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Patterson T, Clayton T, Dodd M, Khawaja Z, Morice MC, Wilson K, Kim WK, Meneveau N, Hambrecht R, Byrne J, Carrié D, Fraser D, Roberts DH, Doshi SN, Zaman A, Banning AP, Eltchaninoff H, Le Breton H, Smith D, Cox I, Frank D, Gershlick A, de Belder M, Thomas M, Hildick-Smith D, Prendergast B, Redwood S. ACTIVATION (PercutAneous Coronary inTervention prIor to transcatheter aortic VAlve implantaTION): A Randomized Clinical Trial. JACC Cardiovasc Interv 2021; 14:1965-1974. [PMID: 34556269 DOI: 10.1016/j.jcin.2021.06.041] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study sought to determine if percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) in patients with significant coronary artery disease would produce noninferior clinical results when compared with no PCI (control arm). BACKGROUND PCI in patients undergoing TAVR is not without risk, and there are no randomized data to inform clinical practice. METHODS Patients with severe symptomatic aortic stenosis and significant coronary artery disease with Canadian Cardiovascular Society class ≤2 angina were randomly assigned to receive PCI or no PCI prior to TAVR. The primary endpoint was a composite of all-cause death or rehospitalization at 1 year. Noninferiority testing (prespecified margin of 7.5%) was performed in the intention-to-treat population. RESULTS At 17 centers, 235 patients underwent randomization. At 1 year, the primary composite endpoint occurred in 48 (41.5%) of the PCI arm and 47 (44.0%) of the no-PCI arm. The requirement for noninferiority was not met (difference: -2.5%; 1-sided upper 95% confidence limit: 8.5%; 1-sided noninferiority test P = 0.067). On analysis of the as-treated population, the difference was -3.7% (1-sided upper 95% confidence limit: 7.5%; P = 0.050). Mortality was 16 (13.4%) in the PCI arm and 14 (12.1%) in the no-PCI arm. At 1 year, there was no evidence of a difference in the rates of stroke, myocardial infarction, or acute kidney injury, with higher rates of any bleed in the PCI arm (P = 0.021). CONCLUSIONS Observed rates of death and rehospitalization at 1 year were similar between PCI and no PCI prior to TAVR; however, the noninferiority margin was not met, and PCI resulted in a higher incidence of bleeding. (Assessing the Effects of Stenting in Significant Coronary Artery Disease Prior to Transcatheter Aortic Valve Implantation; ISRCTN75836930).
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Affiliation(s)
- Tiffany Patterson
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom
| | - Tim Clayton
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matthew Dodd
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zeeshan Khawaja
- Cardiology Department, Lewisham and Greenwich NHS Foundation Trust, United Kingdom
| | - Marie Claude Morice
- Institut Cardiovasculaire Paris Sud, Massy, France; Cardiovascular European Research Center, Massy, France
| | - Karen Wilson
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom
| | - Won-Keun Kim
- Cardiology Department, Kerckhoff-Klinik Bad Nauheim Abteilung Kardiologie, Bad Nauheim, Germany
| | - Nicolas Meneveau
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France; EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Rainer Hambrecht
- Cardiology Department, Klinikum Links der Weser GmbH, Bremen, Germany
| | - Jonathan Byrne
- Cardiothoracic Department, King's College Hospital, London, United Kingdom
| | - Didier Carrié
- Cardiology Department, Hôpital Rangueil, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Doug Fraser
- Cardiology Department, Manchester Royal Infirmary, Manchester, United Kingdom
| | - David H Roberts
- Lancashire Cardiac Centre, Blackpool Victoria Hospital NHS Trust, Blackpool, United Kingdom
| | - Sagar N Doshi
- Cardiology Department, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Azfar Zaman
- Cardiology Department, Newcastle upon Tyne Hospitals NHS Foundation Trust of the Freeman Hospital, Newcastle, United Kingdom
| | - Adrian P Banning
- Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Hélène Eltchaninoff
- Cardiology Department, Hôpital Charles-Nicolle, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Hervé Le Breton
- Service de Cardiologie, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - David Smith
- Cardiology Department, Morriston Hospital, Swansea, United Kingdom
| | - Ian Cox
- Cardiology Department, Derriford Hospital, Plymouth, United Kingdom
| | - Derk Frank
- Cardiology Department, Oberarzt Facharzt für Innere Medizin und Kardiologie, Kiel, Germany
| | - Anthony Gershlick
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, United Kingdom
| | - Mark de Belder
- Cardiology Department, Barts Heart Centre, London, United Kingdom
| | | | - David Hildick-Smith
- Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom
| | - Bernard Prendergast
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom
| | - Simon Redwood
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom.
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Volle K, Delmas C, Ferrières J, Toulza O, Blanco S, Lairez O, Lhermusier T, Biendel C, Galinier M, Carrié D, Elbaz M, Bouisset F. Prevalence and Prognosis Impact of Frailty Among Older Adults in Cardiac Intensive Care Units. CJC Open 2021; 3:1010-1018. [PMID: 34505040 PMCID: PMC8413242 DOI: 10.1016/j.cjco.2021.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background Whether frailty, defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors, may impact the outcomes of elderly patients admitted to a cardiac intensive care unit (CICU) remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted to a CICU. Methods This prospective single-centre observational study was conducted among patients aged ≥ 80 years admitted to a CICU in a tertiary centre. Frailty was assessed using the Edmonton Frail Scale (EFS), which provides a score ranging from 0 (not frail) to 17 (very frail). The population was divided into 3 classes: EFS-score of 0-3, EFS-score of 4-6, and EFS-score > 7. Results A total of 199 patients were included, and median follow-up duration was 365 days. The mean age was 84.8 years, and 50 patients (25.1%) died during the follow-up period. In all, 45 (22.6%), 60 (30.2%), and 94 patients (47.2%) had an EFS-score of 0-3, 4-6, and ≥ 7, respectively. The all-cause mortality rate was 4.4%, 27.1%, and 37.2% in the 0-3, 4-6, and ≥ 7 EFS-score groups, respectively (P < 0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: hazard ratio was 2.60 (95% confidence interval 0.54-12.45) within the 4-6 EFS-score group, and 5.46 (95% confidence interval 1.23-24.08) within the ≥ 7 EFS-score group. Conclusions Frailty is highly prevalent in older adults admitted to the population hospitalized in a CICU and represents a strong prognostic factor for 1-year all-cause mortality.
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Affiliation(s)
- Kim Volle
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Clément Delmas
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Jean Ferrières
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France.,UMR1027, INSERM-Toulouse University III, Toulouse, France.,Department of Epidemiology, University Hospital of Toulouse, Toulouse, France
| | - Olivier Toulza
- Department of Gerontology, University Hospital of Toulouse, Toulouse, France
| | - Stephanie Blanco
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | | | - Caroline Biendel
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Meyer Elbaz
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France
| | - Frédéric Bouisset
- Department of Cardiology, University Hospital of Toulouse, Toulouse, France.,UMR1027, INSERM-Toulouse University III, Toulouse, France
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36
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Blanc A, Lairez O, Cariou E, Fournier P, Poenar AM, Marcheix B, Cron C, Grunenwald E, Porterie J, Labaste F, Elbaz M, Galinier M, Carrié D, Lavie-Badie Y. Participating in Sports After Mitral Valve Repair for Primary Mitral Regurgitation: A Retrospective Cohort Study. Clin J Sport Med 2021; 31:414-422. [PMID: 31809282 DOI: 10.1097/jsm.0000000000000769] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 02/22/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Participating in either competitive or leisure sports is restrictive after surgical mitral valve repair (MVR). In this study, we examine the impact of sports on outcomes after MVR. DESIGN Retrospective cohort study. SETTING Patients aged 18 to 65 years who underwent a first-time MVR for primary mitral regurgitation (MR) in a tertiary care center. PATIENTS One hundred twenty-one consecutive patients were included in the study. The exclusion criteria were as follows: other concomitant procedures, early perioperative death or repeat intervention, noncardiac death or endocarditis during follow-up, and general contraindications for normal physical activity. ASSESSMENT OF RISK FACTORS Participation in sports was quantified by the number of hours per week during the past 6 months, classified according to the Mitchell classification and assessed with the International Physical Activity Questionnaire (IPAQ) short form. MAIN OUTCOME MEASURES The primary composite endpoint was MVR failure defined as MR grade ≥2 or mean transmitral gradient ≥8 mm Hg, signs and symptoms of heart failure, or late-onset postoperative AF (>3 months). RESULTS The mean age was 50 ± 11 years, and there were 85 (71%) men. The median follow-up was 34 months [interquartile range (IQR): 20-50]. Fifty-six (46%) patients participated in sports regularly (median of 3 h/wk; IQR: 2-5). Twenty (17%) patients reached the primary composite endpoint with no correlation with participation in sports (P = 0.537), IPAQ categories (P = 0.849), in any of the Mitchell classification subgroups and a high level of participation in sports ≥6 hours (P = 0.679). CONCLUSIONS Sports seem to be unrelated to the worst outcome after MVR.
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Affiliation(s)
- Adrien Blanc
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
| | - Ana Maria Poenar
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
| | - Bertrand Marcheix
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - Christophe Cron
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - Etienne Grunenwald
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - Jean Porterie
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
| | - François Labaste
- Department of Cardiac Surgery, University Hospital of Rangueil, Toulouse, France
- Department of Anesthesiology, University Hospital of Rangueil, Toulouse, France ; and
| | - Meyer Elbaz
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Rangueil, Paul Sabatier University, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Medical School of Purpan, Paul Sabatier University, Toulouse, France
| | - Yoan Lavie-Badie
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Department of Nuclear Medicine, University Hospital of Rangueil, Toulouse, France
- Heart Valve Center, University Hospital of Rangueil, Toulouse, France
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Lavie-Badie Y, Vannier F, Cariou E, Fournier P, Itier R, Cazalbou S, Blanchard V, Galinier M, Carrié D, Lairez O, Bouisset F, Lhermusier T. Severe mitral regurgitation recurrence after successful percutaneous mitral edge-to-edge repair by Mitraclip in primary mitral regurgitation: Insights from a three-dimensional echocardiography study. Echocardiography 2021; 38:1514-1523. [PMID: 34296463 DOI: 10.1111/echo.15158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/08/2021] [Accepted: 07/06/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The sustainability of the results of Mitraclip procedures is a source of concern. AIMS To investigate risk factors of severe mitral regurgitation (MR) recurrence after Mitraclip in primary MR. METHODS AND RESULTS Eighty-three patients undergoing successful Mitraclip procedures were retrospectively included. Valve anatomy and Mitraclips placement were comprehensively analyzed by post-processing 3D echocardiographic acquisition. The primary composite endpoint was the recurrence of severe MR. The average age was 83±7 years-old, 37 (44%) were female. Median follow-up was 381 days (IQR 195-717) and 17 (20%) patients reached the primary endpoint. Main causes of recurrence of severe MR were relapse of a prolapse (64%) and single leaflet detachment (23%). Posterior coaptation line length (HR 1.06 95%CI 1.01-1.12 p = 0.02), poor imaging quality (HR 3.84, 95%CI 1.12-13.19; p = 0.03), and inter-clip distance (HR 1.60, 95%CI 1.27-2.02; p < 0.01) were associated with the occurrence of the primary endpoint. CONCLUSIONS Recurrence of severe MR after a MitraClip procedure for primary MR results from a complex interplay between anatomical (tissue excess) and procedural criteria (quality of ultrasound guidance and MitraClips spacing).
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Affiliation(s)
- Yoan Lavie-Badie
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Fabien Vannier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Romain Itier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Stéphanie Cazalbou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Virginie Blanchard
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Medical School of Toulouse, Paul Sabatier University, Toulouse, France
| | - Fréderic Bouisset
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France
| | - Thibault Lhermusier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Heart Valve Center, Rangueil University Hospital, Toulouse, France.,Medical School of Toulouse, Paul Sabatier University, Toulouse, France
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Didier R, Lhermusier T, Auffret V, Eltchaninoff H, Le Breton H, Cayla G, Commeau P, Collet JP, Cuisset T, Dumonteil N, Verhoye JP, Beurtheret S, Lefèvre T, Teiger E, Carrié D, Himbert D, Albat B, Cribier A, Sudre A, Blanchard D, Bar O, Rioufol G, Collet F, Houel R, Labrousse L, Meneveau N, Ghostine S, Manigold T, Guyon P, Delepine S, Favereau X, Souteyrand G, Ohlmann P, Doisy V, Beygui F, Gommeaux A, Claudel JP, Bourlon F, Bertrand B, Iung B, Gilard M. TAVR Patients Requiring Anticoagulation: Direct Oral Anticoagulant or Vitamin K Antagonist? JACC Cardiovasc Interv 2021; 14:1704-1713. [PMID: 34274294 DOI: 10.1016/j.jcin.2021.05.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Using French transcatheter aortic valve replacement (TAVR) registries linked with the nationwide administrative databases, the study compared the rates of long-term mortality, bleeding, and ischemic events after TAVR in patients requiring oral anticoagulation with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). BACKGROUND The choice of optimal drug for anticoagulation after TAVR remains debated. METHODS Data from the France-TAVI and FRANCE-2 registries were linked to the French national health single-payer claims database, from 2010 to 2017. Propensity score matching was used to reduce treatment-selection bias. Two primary endpoints were death from any cause (efficacy) and major bleeding (safety). RESULTS A total of 24,581 patients who underwent TAVR were included and 8,962 (36.4%) were treated with OAC. Among anticoagulated patients, 2,180 (24.3%) were on DOACs. After propensity matching, at 3 years, mortality (hazard ratio [HR]: 1.37; 95% confidence interval [CI]: 1.12-1.67; P < 0.005) and major bleeding including hemorrhagic stroke (HR: 1.64; 95% CI: 1.17-2.29; P < 0.005) were lower in patients on DOACs compared with those on VKAs. The rates of ischemic stroke (HR: 1.32; 95% CI: 0.81-2.15; P = 0.27) and acute coronary syndrome (HR: 1.17; 95% CI: 0.68-1.99; P = 0.57) did not differ among groups. CONCLUSIONS In these large multicenter French TAVR registries with an exhaustive clinical follow-up, the long-term mortality and major bleeding were lower with DOACs than VKAs at discharge. The present study supports preferential use of DOACs rather than VKAs in patients requiring oral anticoagulation therapy after TAVR.
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Affiliation(s)
- Romain Didier
- Department of Cardiology, Brest University Hospital, Brest, France
| | | | | | | | | | | | | | - Jean Philippe Collet
- Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | - Emmanuel Teiger
- University Hospital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Dominique Himbert
- Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Bernard Albat
- University Hospital of Montpellier, Montpellier, France
| | | | | | - Didier Blanchard
- University Hospital Paris Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | - Remi Houel
- Saint Joseph Hospital, Marseille, France
| | | | | | - Said Ghostine
- Hospital Marie Lannelongue, Le Plessis-Robinson, France
| | - Thibaut Manigold
- University of Nantes, Department of Cardiologie, Saint-Herblain, France
| | | | | | - Xavier Favereau
- Private Hospital of Parly II, Le Chesnay-Rocquencourt, France
| | | | | | | | | | | | | | | | - Bernard Bertrand
- Department of Cardiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Bernard Iung
- Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Martine Gilard
- Department of Cardiology, Brest University Hospital, Brest, France.
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Eyharts D, Lavie-Badie Y, Cazalbou S, Fournier P, Cariou E, Pascal P, Campelo-Parada F, Marcheix B, Galinier M, Berry I, Carrié D, Lairez O. Quantitative assessment of tricuspid regurgitation using right and left ventricular stroke volumes obtained from tomographic equilibrium radionuclide ventriculography. J Nucl Cardiol 2021; 28:864-872. [PMID: 31201690 DOI: 10.1007/s12350-019-01781-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Quantitative assessment of valve regurgitation using volumetric method by comparing right and left ventricular stroke volumes is still under investigations. AIMS To investigate the accuracy of tomographic equilibrium radionuclide ventriculography (t-ERV) for the quantification of tricuspid regurgitation (TR). METHODS AND RESULTS Sixty-one patients (44 men; mean age 59 ± 12 years) who underwent both t-ERV and transthoracic echocardiography (TTE) studies within 2 weeks for right ventricular systolic function assessment were eligible for inclusion. A sub-group of 22 patients underwent both t-ERV and CMR. Patients with mitral/aortic regurgitation by TTE were excluded of the study. TR regurgitant volume (RVol) was calculated using the proximal isovelocity surface area (PISA) method from TTE and the volumetric method (right ventricular stroke volume minus left ventricular stroke volume) from t-ERV. There was a significant correlation between RVol as assess by ERV and by TTE (R = 0.95, P < 0.0001). Intraclass correlation coefficient between TTE and ERV for TR quantification was 0.95 (P < 0.0001). Among patients who underwent CMR, the correlation between RVol obtained by TTE and by t-ERV and CMR were R = 0.81 and R = 0.75, respectively (all P < 0.0001). CONCLUSION TR assessment using the t-ERV correlates well with PISA from TTE in patients referred for right ventricular systolic function assessment.
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Affiliation(s)
- Damien Eyharts
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Yoan Lavie-Badie
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Stéphanie Cazalbou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Eve Cariou
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Pierre Pascal
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
| | - Francisco Campelo-Parada
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Bertrand Marcheix
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
- Department of Cardiac Surgery, Rangueil University Hospital, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Isabelle Berry
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
- Medical School of Purpan, University Paul Sabatier, Toulouse, France
- Heart Valve Center, Toulouse University Hospital, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.
- Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.
- Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France.
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France.
- Heart Valve Center, Toulouse University Hospital, Toulouse, France.
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40
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Robin G, Cognet T, Bouisset F, Cariou E, Méjean S, Pradel S, Colombat M, Galinier M, Carrié D, Lairez O. Value of Longitudinal Strain to Identify Wild-Type Transthyretin Amyloidosis in Patients With Aortic Stenosis. Circ J 2021; 85:1494-1504. [PMID: 33980765 DOI: 10.1253/circj.cj-20-1064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Wild-type transthyretin-related amyloidosis (ATTRwt) and degenerative aortic stenosis (AS) are both age-related. Diagnosis of cardiac amyloidosis (CA) among patients with AS may be difficult due to overlapping morphological and functional criteria. The aim of this study was to describe an echocardiographic longitudinal strain (LS) pattern among patients with AS with and without ATTRwt.Methods and Results:Patients who have AS with ATTRwt (n=30), AS without ATTRwt (n=50) and ATTRwt without AS (n=31) underwent two-dimensional speckle-tracking echocardiography. Transthyretin CA was based on positive bone scintigraphy without monoclonal gammopathy. All patients showed a gradual decrease in LS from the base to the apex resulting in a decrease of the global LS. A cut-off value of 1.0 for relative apical LS (average apical LS/[average basal LS+mid-LS]) was sensitive (88%) but less specific (68%) in differentiating ATTRwt among patients with severe AS. The best cut-off value for relative apical LS for identifying patients with ATTRwt among the whole population was 0.9 (sensitivity 74%, specificity 66%); however, 35%, 25% and 11% of patients who have ATTRwt without AS, with moderate AS and with severe AS, respectively, did not reach this threshold. CONCLUSIONS A decrease of global and relative apical LS is common in patients with AS, even in the absence of ATTRwt. ATTRwt CA can be present even in the absence of relative apical sparing of LS.
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Affiliation(s)
- Guillaume Robin
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital
| | - Thomas Cognet
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital.,Department of Nuclear Medicine, Toulouse University Hospital
| | | | - Eve Cariou
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital
| | - Simon Méjean
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital.,Department of Nuclear Medicine, Toulouse University Hospital
| | - Sarah Pradel
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital
| | | | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital.,Medical School, Toulouse III Paul Sabatier University
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital.,Medical School, Toulouse III Paul Sabatier University
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital.,Cardiac Imaging Center, Toulouse University Hospital.,Department of Nuclear Medicine, Toulouse University Hospital.,Medical School, Toulouse III Paul Sabatier University
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41
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Fajadet J, Mennuni MG, Carrié D, Barragan P, Coste P, Vert M, Lafont A. First-in-Man trial of a drug-free bioresorbable stent designed to minimize the duration of coronary artery scaffolding. J Biomater Sci Polym Ed 2021; 32:1251-1266. [PMID: 33792525 DOI: 10.1080/09205063.2021.1910919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
For the last two decades, various degradable stents have been proposed to treat coronary artery diseases and replace metallic stents to avoid residual foreign material after healing. To date, the right balance between suitable scaffolding and loss of radial strength soon after endothelium restoration is still an unmet need. The present article reports on the First-in-Man trial of a drug-free bioresorbable stent based on a lactic acid stereocopolymer composed of 98% l-lactyl units selected to release stress shielding earlier than in the case of homopoly(l-lactic acid). Thirty patients with single de novo coronary lesions were included in the trial. The fate of scaffolds was monitored by clinical and imaging follow-ups to assess rate of adverse events, acute recoil, late luminal loss, and late lumen recovery. There was no death, no myocardial infarction, and no stent thrombosis observed over the 36 months trial. Dismantling occurred about 3 months after implantation. Bioresorption was almost completed at 2 years. The late lumen loss observed at the end of the first year was partly compensated one year later by enlarging remodeling. At one year, a neointimal hyperplasia slightly greater than for drug-eluting metallic and bioresorbable stents was shown using optical coherence tomography. The excess of hyperplasia was discussed relative to struts thickness, absence of anti-proliferative drug, and release of degradation by-products.
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Affiliation(s)
| | - Marco G Mennuni
- Hôpital Européen Georges Pompidou, Centre Hospitalier Universitaire Paris-Descartes, APHP, Paris, France
| | - Didier Carrié
- Centre Hospitalier Universitaire Rangueil, Toulouse, France
| | | | - Pierre Coste
- Centre Hospitalier Universitaire Bordeaux Pessac, Bordeaux University, Bordeaux, France
| | - Michel Vert
- UMR CNRS 5247, Faculty of Pharmacy, University-ENSCM, Montpellier, France
| | - Antoine Lafont
- Hôpital Européen Georges Pompidou, Centre Hospitalier Universitaire Paris-Descartes, APHP, Paris, France
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Domain G, Chouquet C, Réant P, Bongard V, Vedis T, Rollin A, Mandel F, Delasnerie H, Voglimacci-Stephanopoli Q, Mondoly P, Beneyto M, Cariou E, Fournier P, Delmas C, Galinier M, Carrié D, Lafitte S, Lairez O, Ferrières J, Cochet H, Maury P. Relationships between left ventricular mass and QRS duration in diverse types of left ventricular hypertrophy. Eur Heart J Cardiovasc Imaging 2021; 23:560-568. [PMID: 33842939 DOI: 10.1093/ehjci/jeab063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 03/27/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Hypertrophic cardiomyopathy (HCM) may be associated with very narrow QRS, while left ventricular hypertrophy (LVH) may increase QRS duration. We investigated the relationships between QRS duration and LV mass (LVM) in subtypes of abnormal LV wall thickness. METHODS AND RESULTS Automated measurement of LVM on MRI was correlated to automated measurement of QRS duration on ECG in HCM, left ventricular non compaction (LVNC), left ventricular hypertrophy (LVH), and controls with healthy hearts. Uni and multivariate analyses were performed between groups including explanatory variables expected to influence LVM and QRS duration. The relationships between QRS duration and LVM were further studied within each group. Two hundred and twenty-one HCM, 28 LVNC, 16 LVH, and 40 controls were retrospectively included. Mean QRS duration was 92 ms for HCM, 104 for LVNC, 110 for LVH, and 92 for controls (P < 0.01). Mean LVM was 100, 90, 108, and 68 g/m2 (P < 0.01). QRS duration, LVM, hypertension, maximal wall thickness, and late gadolinium enhancement were significantly linked to HCM in multivariate analysis (w/wo bundle branch block). An independent negative correlation was found between LVM and QRS duration in the HCM group, while the relationship was reverse in LVNC, LVH, and controls. CONCLUSION QRS duration increases with LVM in LVNC, LVH, or in healthy hearts, while reverse relationship is present in HCM. These relationships were independent from other parameters. These results warrant additional investigations for refining diagnosis criteria for HCM in the future.
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Affiliation(s)
- Guillaume Domain
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Cecile Chouquet
- Department of Mathematics, Toulouse Mathematics Institute, Toulouse, France
| | - Patricia Réant
- Department of Cardiology, University Hospital Pessac, Bordeaux, France
| | - Vanina Bongard
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France.,INSERM U 1027, Toulouse, France
| | - Theo Vedis
- Department of Mathematics, Toulouse Mathematics Institute, Toulouse, France
| | - Anne Rollin
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Franck Mandel
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Hubert Delasnerie
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | | | - Pierre Mondoly
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Maxime Beneyto
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Eve Cariou
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Clément Delmas
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Michel Galinier
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Didier Carrié
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Stéphane Lafitte
- Department of Cardiology, University Hospital Pessac, Bordeaux, France
| | - Olivier Lairez
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France
| | - Jean Ferrières
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France.,INSERM U 1027, Toulouse, France
| | - Hubert Cochet
- Department of Cardiology, University Hospital Pessac, Bordeaux, France
| | - Philippe Maury
- Department of Cardiology, University Hospital Rangueil, 1 avenue Pr. Jean Poulhès 31400 Toulouse, France.,I2MC, INSERM UMR 1297, Toulouse, France
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Bouisset F, Ribichini F, Bataille V, Reczuch K, Dobrzycki S, Meyer-Gessner M, Bressollette E, Zajdel W, Faurie B, Mezilis N, Palazuelos J, Spedicato L, Valdés M, Vaquerizo B, Ferenc M, Cayla G, Barbato E, Carrié D. Effect of Sex on Outcomes of Coronary Rotational Atherectomy Percutaneous Coronary Intervention (From the European Multicenter Euro4C Registry). Am J Cardiol 2021; 143:29-36. [PMID: 33359202 DOI: 10.1016/j.amjcard.2020.12.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/28/2022]
Abstract
Data regarding the potential influence of gender on outcomes of rotational atherectomy (RA) percutaneous coronary intervention (PCI) are scarce and conflicting. Using the Euro4C registry, an international prospective multicentric registry of RA PCI, we evaluated the influence of gender on clinical outcomes of RA PCI. Between October 2016 and July 2018, 966 patients were included. In them, 267 (27.6%) were females. Female patients were older than males (77.7 years old ± 9.8 vs 73.3 ± 9.5 years old respectively, p < 0.001) had a poorer renal function (43,1% of females had a GFR < 60 ml/min:1.73m² vs 30.4% of males, p < 0.001) and were more frequently admitted for an acute coronary syndrome (32.2% vs 22.3% p = 0.002). During RA procedure, women were less likely to be treated by radial approach (65.0% vs 74.4%, p = 0.004). In-hospital major adverse cardiac event rate-defined as cardiovascular death, myocardial infarction, stroke/transient ischemic attack, target lesion revascularization, and coronary artery bypass grafting surgery-was higher in the female group (7.1% vs 3.7%, p = 0.043). However, coronary perforation, dissection, slow/low flow and tamponade did not significantly differ in gender, neither did cardiovascular medications at discharge. At 1 year follow-up, rate of major adverse cardiac event was 18.4% in the female group vs 11.2% in the male group (adjusted Hazard Ratio 1.82 [1.24 to 2.67], p = 0.002). No significant bleeding differences were observed in gender, neither in hospital, nor during follow-up. In conclusion women had worse clinical outcomes following RA PCI during hospitalization and at 1 year follow-up than did men.
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Touafchia A, Bagheri H, Carrié D, Durrieu G, Sommet A, Chouchana L, Montastruc F. Serious bradycardia and remdesivir for coronavirus 2019 (COVID-19): a new safety concerns. Clin Microbiol Infect 2021; 27:S1198-743X(21)00094-X. [PMID: 33647441 PMCID: PMC7910147 DOI: 10.1016/j.cmi.2021.02.013] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/12/2021] [Accepted: 02/06/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES In recent clinical trials some cardiac arrhythmias were reported with use of remdesivir for COVID-19. To address this safety concern, we investigated whether use of remdesivir for COVID-19 is associated with an increased risk of bradycardia. METHODS Using VigiBase®, the World Health Organization Global Individual Case Safety Reports database, we compared the cases of bradycardia reported in COVID-19 patients exposed to remdesivir with those reported in COVID-19 patients exposed to hydroxychloroquine, lopinavir/ritonavir, tocilizumab or glucocorticoids. All reports of patients with COVID-19 registered up to the 23 September 2020 were included. We conducted disproportionality analyses allowing the estimation of reporting odds ratios (RORs) with 95% CI. RESULTS We found 302 cardiac effects including 94 bradycardia (31%) among the 2603 reports with remdesivir prescribed in COVID-19 patients. Most of the 94 reports were serious (75, 80%), and in 16 reports (17%) evolution was fatal. Compared with hydroxychloroquine, lopinavir/ritonavir, tocilizumab or glucocorticoids, the use of remdesivir was associated with an increased risk of reporting bradycardia (ROR 1.65; 95% CI 1.23-2.22). Consistent results were observed in other sensitivity analyses. DISCUSSION This post-marketing study in a real-world setting suggests that the use of remdesivir is significantly associated with an increased risk of reporting bradycardia and serious bradycardia when compared with the use of with hydroxychloroquine, lopinavir/ritonavir, tocilizumab or glucocorticoids. This result is in line with the pharmacodynamic properties of remdesivir.
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Affiliation(s)
- Anthony Touafchia
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France; Department of Cardiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France
| | - Haleh Bagheri
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France; CIC 1436, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS », Toulouse University Hospital, France
| | - Didier Carrié
- Department of Cardiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France
| | - Geneviève Durrieu
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France; CIC 1436, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS », Toulouse University Hospital, France
| | - Agnès Sommet
- Department of Medical and Clinical Pharmacology, Centre of PharmacoVigilance and Pharmacoepidemiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France; CIC 1436, Team PEPSS « Pharmacologie En Population cohorteS et biobanqueS », Toulouse University Hospital, France
| | - Laurent Chouchana
- Department of Pharmacology, Regional Pharmacovigilance Center, Cochin Hospital, AP-HP.Centre - Université de Paris. Paris, France
| | - François Montastruc
- Department of Cardiology, Toulouse University Hospital (CHU), Faculty of Medicine, Toulouse, France.
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Eyharts D, Pascal P, Lavie-Badie Y, Cariou E, Cazalbou S, Karsenty C, Prévot G, Carrié D, Berry I, Noël-Savina E, Lairez O. Impact of pulmonary perfusion defects by scintigraphy on pulmonary vascular resistances, functional capacity and right ventricular systolic function in patients with chronic thromboembolic pulmonary hypertension. Am J Nucl Med Mol Imaging 2021; 11:20-26. [PMID: 33688452 PMCID: PMC7936249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/02/2021] [Indexed: 06/12/2023]
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a major cause of chronic pulmonary hypertension leading to right heart failure and death. Ventilation/perfusion single photon emission computed tomography (V/Q SPECT) is the screening test of choice showing mismatch in at least one segment or two sub-segments. Our aim was to investigate the relationship between the extent of pulmonary perfusion defects and hemodynamic, echocardiographic, biological and functional parameters. Between 2012 and 2019, 46 patients with CTEPH were retrospectively enrolled in the study. The diagnosis of pulmonary hypertension was made by the referral team of the expert center according to the European guidelines. All patients underwent pulmonary V/Q SPECT, right heart catheterization, transthoracic echocardiography (TTE), functional tests and natriuretic peptides assays. There was a slight correlation between the extent of pulmonary perfusion defects and pulmonary vascular resistances (R=0.510, P < 0.001). However, there was no correlation between the extent of pulmonary perfusion defects and NYHA stage, NT-proBNP level, functional parameters (6 minutes-walk distance-6 MWD), right ventricular function assessed by TTE. Pulmonary perfusion defects extension by V/Q lung SPECT are correlated with pulmonary vascular resistances in CTEPH. However, it is not correlated with right ventricular function and functional parameters.
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Affiliation(s)
- Damien Eyharts
- Department of Cardiology, Rangueil University HospitalToulouse, France
- Cardiac Imaging Center, University Hospital of ToulouseFrance
| | - Pierre Pascal
- Cardiac Imaging Center, University Hospital of ToulouseFrance
- Department of Nuclear Medicine, University Hospital of ToulouseFrance
| | - Yoan Lavie-Badie
- Department of Cardiology, Rangueil University HospitalToulouse, France
- Cardiac Imaging Center, University Hospital of ToulouseFrance
- Department of Nuclear Medicine, University Hospital of ToulouseFrance
| | - Eve Cariou
- Department of Cardiology, Rangueil University HospitalToulouse, France
- Cardiac Imaging Center, University Hospital of ToulouseFrance
| | - Stéphanie Cazalbou
- Department of Cardiology, Rangueil University HospitalToulouse, France
- Cardiac Imaging Center, University Hospital of ToulouseFrance
| | - Clément Karsenty
- Department of Cardiology, Rangueil University HospitalToulouse, France
- Department of Cardiopediatry, Purpan University HospitalToulouse, France
- Medical School, Toulouse III Paul Sabatier UniversityToulouse, France
| | - Grégoire Prévot
- Department of Pneumology, Larrey University HospitalToulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University HospitalToulouse, France
- Cardiac Imaging Center, University Hospital of ToulouseFrance
- Medical School, Toulouse III Paul Sabatier UniversityToulouse, France
| | - Isabelle Berry
- Cardiac Imaging Center, University Hospital of ToulouseFrance
- Department of Nuclear Medicine, University Hospital of ToulouseFrance
- Medical School, Toulouse III Paul Sabatier UniversityToulouse, France
| | - Elise Noël-Savina
- Department of Pneumology, Larrey University HospitalToulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University HospitalToulouse, France
- Cardiac Imaging Center, University Hospital of ToulouseFrance
- Department of Nuclear Medicine, University Hospital of ToulouseFrance
- Medical School, Toulouse III Paul Sabatier UniversityToulouse, France
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Fagot J, Lavie‐Badie Y, Blanchard V, Fournier P, Galinier M, Carrié D, Lairez O, Cariou E. Impact of tricuspid regurgitation on survival in patients with cardiac amyloidosis. ESC Heart Fail 2021; 8:438-446. [PMID: 34643339 PMCID: PMC7835605 DOI: 10.1002/ehf2.13093] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/21/2020] [Accepted: 10/22/2020] [Indexed: 01/15/2023] Open
Abstract
AIMS Tricuspid regurgitation (TR) is a common finding and has been associated with poorer outcome in patients with heart failure. This study sought to investigate the prognostic value of TR in patients with cardiac amyloidosis (CA). METHODS AND RESULTS Two-hundred and eighty-three patients with CA-172 (61%) wild-type transthyretin amyloidosis (ATTRwt) and 111 (39%) light-chain amyloidosis (AL)-were consecutively enrolled between December 2010 and September 2019. Transthoracic echocardiographies at time of diagnosis were reviewed to establish the presence and severity of TR and its relationship with all-cause mortality during patients' follow-up. Seventy-four (26%) patients had a moderate-to-severe TR. Moderate-to-severe TR was associated with New York Heart Association status (P < 0.001), atrial fibrillation (P = 0.003), greater levels of natriuretic peptides (P = 0.002), worst renal function (P = 0.03), lower left ventricular ejection fraction (P = 0.02), reduced right ventricular systolic function (P = 0.001), thicker tricuspid leaflets (P = 0.019), greater tricuspid annulus diameter (P = 0.001), greater pulmonary artery pressure (P = 0.001), greater doses of furosemide (P = 0.001), and anti-aldosterone (P = 0.01) and more anticoagulant treatment (P = 0.001). One hundred and thirty-four (47%) patients met the primary endpoint of all-cause mortality. After multivariate Cox analysis, moderate-to-severe TR was significantly associated with mortality [hazard ratio 1.89, 95% confidence interval (1.01-3.51), P = 0.044] in patients with ATTRwt. There was no correlation between TR and death [hazard ratio 0.84, 95% confidence interval (0.46-1.51), P = 0.562] in patients with AL. CONCLUSIONS Moderate-to-severe TR is frequent in CA, and it is an independent prognosis factor in patients with ATTRwt but not in patients with AL.
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Affiliation(s)
- Jerome Fagot
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
| | - Yoan Lavie‐Badie
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
- Department of Nuclear MedicineToulouse University HospitalToulouseFrance
| | - Virginie Blanchard
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
- Department of Nuclear MedicineToulouse University HospitalToulouseFrance
- Medical SchoolToulouse III Paul Sabatier UniversityToulouseFrance
| | - Pauline Fournier
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
| | - Michel Galinier
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
- Medical SchoolToulouse III Paul Sabatier UniversityToulouseFrance
| | - Didier Carrié
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
- Medical SchoolToulouse III Paul Sabatier UniversityToulouseFrance
| | - Olivier Lairez
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
- Department of Nuclear MedicineToulouse University HospitalToulouseFrance
- Medical SchoolToulouse III Paul Sabatier UniversityToulouseFrance
| | - Eve Cariou
- Department of CardiologyRangueil University Hospital1, avenue Jean Poulhès, TSA 50032Toulouse Cedex 931059France
- Cardiac Imaging CenterToulouse University HospitalToulouseFrance
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Beneyto M, Cariou E, Brunel J, Scripcariu A, Delasnerie H, Brun S, Lavie-Badie Y, Dupin Deguine D, Galinier M, Carrié D, Lairez O. Tip of the iceberg: a tertiary care centre retrospective study of left ventricular hypertrophy aetiologies. Open Heart 2021; 8:e001462. [PMID: 33441470 PMCID: PMC7812093 DOI: 10.1136/openhrt-2020-001462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/16/2020] [Accepted: 12/01/2020] [Indexed: 11/05/2022] Open
Abstract
AIMS To phenotype patients referred to a tertiary centre for the exploration of a left ventricular hypertrophy (LVH) starting from 12 mm of left ventricular wall thickness (LVWT). METHODS AND RESULTS Consecutive patients referred for aetiological workup of LVH, beginning at 12 mm of LVWT were retrospectively included in this tertiary single-centred observational study. Patients presenting with severe aortic stenosis were excluded. Aetiological workup was reviewed for each subject and aetiologies were adjudicated by expert consensus.Among 591 patients referred for LVH aetiological workup, 41% had a maximal LVWT below 15 mm. LVH aetiologies were led by cardiac amyloidosis (CA, 34.3%), followed by sarcomeric hypertrophic cardiomyopathy (S-HCM, 32.1%), hypertensive cardiomyopathy (21.7%), unknown aetiology (7.6%) and other (4.2%), including Anderson-Fabry's disease (1.7%). CA and S-HCM affected over 50% of patients with mild LVH (12-14 mm); the prevalence of these aetiologies rose with LVH severity. Among patients with Anderson-Fabry's disease, 4 (40%) had a maximal LVWT <15 mm. CONCLUSIONS Mild LVH (ie, 12-14 mm) conceals multiple aetiologies that can lead to specific treatment, cascade family screening and specific follow-up. Overall, CA is nowadays the leading cause of LVH in tertiary centers.
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Affiliation(s)
- Maxime Beneyto
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Eve Cariou
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Jérémy Brunel
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Alex Scripcariu
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Hubert Delasnerie
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Stéphanie Brun
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Yoan Lavie-Badie
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Nuclear Medicine, CHU Toulouse Département de Médecine Nucléaire, Toulouse, France
| | | | - Michel Galinier
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Didier Carrié
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
| | - Olivier Lairez
- Cardiology, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Cardiac Imaging Centre, CHU Toulouse Pôle Cardiovasculaire et Métabolique, Toulouse, France
- Nuclear Medicine, CHU Toulouse Département de Médecine Nucléaire, Toulouse, France
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48
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Roger-Rollé A, Cariou E, Rguez K, Fournier P, Lavie-Badie Y, Blanchard V, Roncalli J, Galinier M, Carrié D, Lairez O. Can myocardial work indices contribute to the exploration of patients with cardiac amyloidosis? Open Heart 2020; 7:openhrt-2020-001346. [PMID: 33051335 PMCID: PMC7555098 DOI: 10.1136/openhrt-2020-001346] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/19/2020] [Accepted: 09/02/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Cardiac amyloidosis (CA) is a life-threatening restrictive cardiomyopathy. Identifying patients with a poor prognosis is essential to ensure appropriate care. The aim of this study was to compare myocardial work (MW) indices with standard echocardiographic parameters in predicting mortality among patients with CA. METHODS Clinical, biological and transthoracic echocardiographic parameters were retrospectively compared among 118 patients with CA. Global work index (GWI) was calculated as the area of left ventricular pressure-strain loop. Global work efficiency (GWE) was defined as percentage ratio of constructive work to sum of constructive and wasted works. Sixty-one (52%) patients performed a cardiopulmonary exercise. RESULTS GWI, GWE, global longitudinal strain (GLS), left ventricular ejection fraction (LVEF) and myocardial contraction fraction (MCF) were correlated with N-terminal prohormone brain natriuretic peptide (R=-0.518, R=-0.383, R=-0.553, R=-0.382 and R=-0.336, respectively; p<0.001). GWI and GLS were correlated with peak oxygen consumption (R=0.359 and R=0.313, respectively; p<0.05). Twenty-eight (24%) patients died during a median follow-up of 11 (4-19) months. The best cut-off values to predict all-cause mortality for GWI, GWE, GLS, LVEF and MCF were 937 mm Hg/%, 89%, 10%, 52% and 15%, respectively. The area under the receiver operator characteristic curve of GWE, GLS, GWI, LVEF and MCF were 0.689, 0.631, 0.626, 0.511 and 0.504, respectively. CONCLUSION In CA population, MW indices are well correlated with known prognosis markers and are better than LVEF and MCF in predicting mortality. However, MW does not perform better than GLS.
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Affiliation(s)
- Aénora Roger-Rollé
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Eve Cariou
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Khailène Rguez
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Pauline Fournier
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France
| | - Yoan Lavie-Badie
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France
| | - Virginie Blanchard
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Jérôme Roncalli
- Cardiology, Rangueil University Hospital, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Michel Galinier
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Didier Carrié
- Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
| | - Olivier Lairez
- Cardiology, Rangueil University Hospital, Toulouse, France .,Cardiac Imaging Center, University Hospital of Toulouse, Toulouse, France.,Department of Nuclear Medicine, University Hospital of Toulouse, Toulouse, France.,Medical School, Toulouse III Paul Sabatier University, Toulouse, France
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49
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Onuma Y, Chevalier B, Ono M, Cequier À, Dudek D, Haude M, Carrié D, Sabaté M, Windecker S, Rapoza RR, West NEJ, Reith S, de Sousa Almeida M, Campo G, Íñiguez-Romo A, Serruys PW. Bioresorbable scaffolds versus everolimus-eluting metallic stents: five-year clinical outcomes of the randomised ABSORB II trial. EUROINTERVENTION 2020; 16:e938-e941. [PMID: 32515738 DOI: 10.4244/eij-d-20-00024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland
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50
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Matta A, Zouari F, Campelo-Parada F, Carrié D. A Giant Left Anterior Descending Artery (LAD) Coronary Artery Aneurysm Treated by Covered Stent Angioplasty: A Case Report. Am J Case Rep 2020; 21:e925820. [PMID: 33208724 PMCID: PMC7684431 DOI: 10.12659/ajcr.925820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Coronary artery aneurysm (CAA) is uncommon angiographic finding with unclear pathophysiology. Atherosclerosis is the main contributing risk factor in adults. To date, there are no standardized recommendations for the management of CAA. Therefore, this case report describes the effectiveness of PCI as therapeutic approach for giant CAA. CASE REPORT We present the case of a 69-year-old male smoker brought to the Emergency Department (ED) due to the crescendo angina. Coronary angiography showed a giant saccular proximal left anterior descending coronary artery aneurysm, which was successfully treated with covered stent implantation, leading to good outcome. CONCLUSIONS The management of CAA is individualized and depends on several parameters such as aneurysm characteristics, technical challenges, and clinical situation. Future clinical trials investigating the role of PCI are needed.
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Affiliation(s)
- Anthony Matta
- Department of Cardiology, CHU-Toulouse, Hopital Rangueil, Toulouse, France.,Faculty of Medicine, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Fourat Zouari
- Department of Cardiology, CHU-Toulouse, Hopital Rangueil, Toulouse, France
| | | | - Didier Carrié
- Department of Cardiology, CHU-Toulouse, Hopital Rangueil, Toulouse, France
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