1
|
Badawi S, Leboullenger C, Chourrout M, Gouriou Y, Paccalet A, Pillot B, Augeul L, Bolbos R, Bongiovani A, Mewton N, Bochaton T, Ovize M, Tardivel M, Kurdi M, Canet-Soulas E, Da Silva CC, Bidaux G. Oxidation-reduction imaging of myoglobin reveals two-phase oxidation in the reperfused myocardium. Basic Res Cardiol 2024:10.1007/s00395-024-01040-6. [PMID: 38499702 DOI: 10.1007/s00395-024-01040-6] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 03/20/2024]
Abstract
Myocardial infarction (MI) is a serious acute cardiovascular syndrome that causes myocardial injury due to blood flow obstruction to a specific myocardial area. Under ischemic-reperfusion settings, a burst of reactive oxygen species is generated, leading to redox imbalance that could be attributed to several molecules, including myoglobin. Myoglobin is dynamic and exhibits various oxidation-reduction states that have been an early subject of attention in the food industry, specifically for meat consumers. However, rarely if ever have the myoglobin optical properties been used to measure the severity of MI. In the current study, we develop a novel imaging pipeline that integrates tissue clearing, confocal and light sheet fluorescence microscopy, combined with imaging analysis, and processing tools to investigate and characterize the oxidation-reduction states of myoglobin in the ischemic area of the cleared myocardium post-MI. Using spectral imaging, we have characterized the endogenous fluorescence of the myocardium and demonstrated that it is partly composed by fluorescence of myoglobin. Under ischemia-reperfusion experimental settings, we report that the infarcted myocardium spectral signature is similar to that of oxidized myoglobin signal that peaks 3 h post-reperfusion and decreases with cardioprotection. The infarct size assessed by oxidation-reduction imaging at 3 h post-reperfusion was correlated to the one estimated with late gadolinium enhancement MRI at 24 h post-reperfusion. In conclusion, this original work suggests that the redox state of myoglobin can be used as a promising imaging biomarker for characterizing and estimating the size of the MI during early phases of reperfusion.
Collapse
Affiliation(s)
- Sally Badawi
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
- Laboratory of Experimental and Clinical Pharmacology, Department of Chemistry and Biochemistry, Doctoral School of Sciences and Technology, Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Clémence Leboullenger
- Univ. Lille, CNRS, Inserm, Institut Pasteur de Lille, US 41-UAR 2014-PLBS, CHU Lille, 59000, Lille, France
| | - Matthieu Chourrout
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, BIORAN, Université Claude Bernard Lyon 1, 69500, Bron, France
| | - Yves Gouriou
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
| | - Alexandre Paccalet
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
| | - Bruno Pillot
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
| | - Lionel Augeul
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
| | | | - Antonino Bongiovani
- Univ. Lille, CNRS, Inserm, Institut Pasteur de Lille, US 41-UAR 2014-PLBS, CHU Lille, 59000, Lille, France
| | - Nathan Mewton
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
- Centre d'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
| | - Thomas Bochaton
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
| | - Michel Ovize
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
| | - Meryem Tardivel
- Univ. Lille, CNRS, Inserm, Institut Pasteur de Lille, US 41-UAR 2014-PLBS, CHU Lille, 59000, Lille, France
| | - Mazen Kurdi
- Laboratory of Experimental and Clinical Pharmacology, Department of Chemistry and Biochemistry, Doctoral School of Sciences and Technology, Faculty of Sciences, Lebanese University, Beirut, Lebanon
| | - Emmanuelle Canet-Soulas
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
| | - Claire Crola Da Silva
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France
| | - Gabriel Bidaux
- Univ-Lyon, CarMeN Laboratory, Inserm U1060, INRAE U1397, Université Claude Bernard Lyon 1, 69550, Bron, France.
- Groupement Hospitalier EST, Département de Cardiologie, IHU-OPERA, Hospices Civils de Lyon, Bâtiment B13, 69500, Bron, France.
| |
Collapse
|
2
|
Huet F, Mariano-Goulart D, Aguilhon S, Delbaere Q, Lacampagne A, Fauconnier J, Leclercq F, Macia JC, Akodad M, Jammoul N, Prunier F, Mewton N, Angoulvant D, Lozza C, Soltani S, Rodier A, Grandemange S, Dupuy AM, Cristol JP, Amico M, Nagot N, Roubille F. Colchicine to prevent sympathetic denervation after acute myocardial infarction: the COLD-MI trial. Eur Heart J 2024; 45:725-727. [PMID: 38289979 DOI: 10.1093/eurheartj/ehae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/27/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024] Open
Affiliation(s)
- Fabien Huet
- Department of Cardiology, Vannes Regional Hospital, 20 Bd Général Maurice Guillaudot, 56000 Vannes, France
- Department of Cardiology, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Denis Mariano-Goulart
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
- Department of Nuclear Medecine, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Sylvain Aguilhon
- Department of Cardiology, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Quentin Delbaere
- Department of Cardiology, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Alain Lacampagne
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Jérémy Fauconnier
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Florence Leclercq
- Department of Cardiology, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Jean-Christophe Macia
- Department of Cardiology, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Mariama Akodad
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
- Institut cardiovasculaire Paris Sud, Hôpital Privé Jacques-Cartier, Ramsay Santé, 6 Av. du Noyer Lambert, 91300 Massy, France
| | - Nidal Jammoul
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Fabrice Prunier
- University Angers, UMR CNRS 6015, Inserm U1083, Unité MitoVasc, Team Carme, SFR ICAT, 2 rue Haute de Reculée, 49045 Angers cedex, France
- Department of Cardiology, Angers University Hospital, 4 Rue Larrey, 49933 Angers Cedex, France
| | - Nathan Mewton
- Heart Failure Department, Clinical Investigation Center, INSERM 1060 & 1407, Hospices Civils de Lyon, University Claude Bernard Lyon 1, 59 Bd Pinel, 69500 Bron, France
| | - Denis Angoulvant
- Cardiology Department and EA4245 Transplantation Immunologie Inflammation, CHRU de Tours & Université de Tours, Av. de la République, 37170 Chambray-lès-Tours, France
| | - Catherine Lozza
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Sonia Soltani
- Department of Cardiology, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - Annabelle Rodier
- Department of Public Health, Clinical Research Unit, CHU Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Sylvie Grandemange
- Department of Public Health, Clinical Research Unit, CHU Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Anne-Marie Dupuy
- Department of Biochemistry, University Hospital of Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Jean-Paul Cristol
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
- Department of Biochemistry, University Hospital of Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Mailis Amico
- Biostatistics and Research Unit, CHU Montpellier, Univ Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Nicolas Nagot
- Biostatistics and Research Unit, CHU Montpellier, Univ Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - François Roubille
- Department of Cardiology, Montpellier University Hospital, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
- INI-CRCT (Investigation Network Initiative Cardiovascular and Rénal Clinical Trialist), CHRU de Nancy - Hôpitaux de Brabois, 4 Rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| |
Collapse
|
3
|
Berthelot E, Eliahou L, Jagu A, Damy T, Hanon O, Hulot JS, Meune C, Roig C, Roubille F, Sabouret P, Logeart D, Mewton N. [Natriuretic peptides in the diagnosis and monitoring of heart failure]. Rev Prat 2024; 74:185-193. [PMID: 38415425] [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: 02/29/2024]
Abstract
NATRIURETIC PEPTIDES IN THE DIAGNOSIS AND MONITORING OF CARDIAC FAILURE. Heart failure (HF) is a serious and common disease requiring a prompt diagnosis for appropriate management. Natriuretic peptides, such as BNP and NT-proBNP, play a crucial role in diagnosing HF due to their s pecificity and reproducibility. It is important to measuring natriuretic peptides, especially in cases of acute dyspnea, to differentiate cardiac causes from others. Specific thresholds are recommended, with high values strongly suggest HF, while normal levels rule out the diagnosis. Clinical characteristics, such as age, renal function, atrial fibrillation, obesity, and gender, influence natriuretic peptides levels and should be considered in interpretation. For diabetic, hypertensive, and obese patients, early screening for HF through natriuretic peptides measurement is crucial. Furthermore, these natriuretic peptides are useful for monitoring chronic heart failure patients. They assist in confirming decompensation, titrating treatment, evaluating treatment response, and establishing prognosis. However, it's essential to choose a single biomarker (BNP or NT-proBNP) to avoid confusion.
Collapse
Affiliation(s)
| | - Ludivine Eliahou
- Centre national de référence pour le syndrome de Marfan et les maladies apparentées, VASCERN HTAD European Reference Centre, AP-HP, hôpital Bichat-Claude-Bernard, Paris, France. Service de cardiologie, AP-HP, hôpital Bichat-Claude-Bernard, Paris, France
| | - Annabelle Jagu
- Service de cardiologie, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - Thibaud Damy
- Service de cardiologie, Center for Cardiac Amyloidosis, GRC Amyloid Research Institute, DHU A-TVB, AP-HP CHU Henri-Mondor et université Paris-Est Créteil, France
| | - Olivier Hanon
- EA4468 université de Paris, service de gériatrie, hôpital Broca, AP-HP, Hôpitaux universitaires Paris Centre, France
| | | | - Christophe Meune
- Service de cardiologie, hôpital Avicenne, AP-HP, université de Paris, Paris, France
| | - Clemence Roig
- Service de cardiologie, Institut mutualiste Montsouris, Paris, France
| | - François Roubille
- INSERM U661, Montpellier, France. hôpital Arnaud-de-Villeneuve, université de Montpellier-1 et 2, Montpellier, France
| | - Pierre Sabouret
- Département de cardiologie médicale de l'Institut de cardiologie de Paris et Collège national des cardiologues français, hôpital La Pitié-Salpêtrière, université La Sorbonne, Paris, France
| | - Damien Logeart
- Service de cardiologie, AP-HP, hôpital Lariboisière, Paris, France, université de Paris, Paris, France
| | - Nathan Mewton
- Hôpital cardiovasculaire Louis-Pradel, centre d'investigation clinique INSERM 1407, service insuffisance cardiaque, Hospices civils de Lyon ; université Claude-Bernard Lyon-1, INSERM U1060 CarMeN, Lyon, France
| |
Collapse
|
4
|
Leboube S, Camboulives L, Bochaton T, Amaz C, Bergerot C, Altman M, Loppinet T, Cherpaz M, Monsec T, Sportouch C, Trinh A, Soulier C, Bernard A, Derumeaux G, Mewton N, Ovize M, Thibault H. What underlies sex differences in heart failure onset within the first year after a first myocardial infarction? Front Cardiovasc Med 2024; 10:1290375. [PMID: 38322272 PMCID: PMC10844509 DOI: 10.3389/fcvm.2023.1290375] [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: 09/07/2023] [Accepted: 12/13/2023] [Indexed: 02/08/2024] Open
Abstract
Background Women are more likely to develop heart failure (HF) after myocardial infarction. However, diagnosis and reperfusion are often delayed. Objectives To compare the prevalence of HF after primary percutaneous coronary intervention (PPCI)-treated ST segment myocardial infarction (STEMI) between sexes and to study its associations with comorbidities, infarct size, and left ventricular (LV) systolic and diastolic dysfunctions (DD). Methods The patients with PPCI-treated anterior STEMI, from the CIRCUS study cohort, were followed up for 1 year and HF events were recorded. Evaluation of ejection fraction (LVEF) and DD were performed at baseline and at 1 year. The elevated LV filling pressure (LVFP) included Grades 2 and 3 DD. Results Of the 791 patients from the CIRCUS study, 135 were women. At 1 year, the proportion of patients who developed HF was 21% among men and 34% among women (p = 0.001). In the subset of 407 patients with available diastolic parameters, the rate of HF was also higher in women. HF during the initial hospitalization was comparable between the sexes. However, women had a higher incidence of rehospitalization for HF within the first year after STEMI (14.1% vs. 4.1%, p = 0.005). Women were older with a higher prevalence of hypertension. The infarct size and LVEF were similar between the sexes. Elevated LVFP was observed more frequently in women than in men during the initial hospitalization and at 1 year (26% vs. 12%, p = 0.04, and 22% vs. 12%, p = 0.006, respectively). Interestingly, only initial elevated LVFP (HR 5.9, 95% CI: 2.4-14.5, p < 0.001), age, and hypertension were independently associated with rehospitalization for HF. Conclusions After PPCI-treated anterior STEMI, despite comparable infarct size and LVEF, women presented a higher proportion of rehospitalization for HF than men. That was likely due to a greater DD associated with older age and hypertension.
Collapse
Affiliation(s)
- Simon Leboube
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
- Laboratoire CarMeN – IRIS Team, INSERM, INRA, Université Claude Bernard Lyon-1, 21 Univ-Lyon, Bron, France
| | - Louise Camboulives
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Thomas Bochaton
- Laboratoire CarMeN – IRIS Team, INSERM, INRA, Université Claude Bernard Lyon-1, 21 Univ-Lyon, Bron, France
- Centre d'investigation clinique de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Camille Amaz
- Centre d'investigation clinique de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Cyrille Bergerot
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Mikhail Altman
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Thomas Loppinet
- Centre d'investigation clinique de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Maelle Cherpaz
- Laboratoire CarMeN – IRIS Team, INSERM, INRA, Université Claude Bernard Lyon-1, 21 Univ-Lyon, Bron, France
| | - Thierry Monsec
- Service de Cardiologie, Centre Hospitalier de Valence, Valence, France
| | | | - Annie Trinh
- Service de Cardiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | - Anne Bernard
- Service de Cardiologie, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Genevieve Derumeaux
- Service de Cardiologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Nathan Mewton
- Laboratoire CarMeN – IRIS Team, INSERM, INRA, Université Claude Bernard Lyon-1, 21 Univ-Lyon, Bron, France
- Centre d'investigation clinique de Lyon, Hospices Civils de Lyon, Lyon, France
| | - Michel Ovize
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
- Laboratoire CarMeN – IRIS Team, INSERM, INRA, Université Claude Bernard Lyon-1, 21 Univ-Lyon, Bron, France
| | - Hélène Thibault
- Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
- Laboratoire CarMeN – IRIS Team, INSERM, INRA, Université Claude Bernard Lyon-1, 21 Univ-Lyon, Bron, France
| |
Collapse
|
5
|
Bouleti C, Viscogliosi S, Bresson D, Leboube S, Bochaton T, El-Jonhy N, Amaz C, Prunier F, Bidaux G, Roubille F, Angoulvant D, Mewton N. Colchicine in acute myocardial infarction: cardiovascular events at 1-year follow up. Open Heart 2024; 11:e002474. [PMID: 38233042 PMCID: PMC10806482 DOI: 10.1136/openhrt-2023-002474] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/24/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE In the COVERT-MI randomised placebo-controlled trial, oral administration of high-dose colchicine at the time of reperfusion and for 5 days in acute ST-elevated myocardial infarction did not reduce infarct size but was associated with a significant increase in left ventricular thrombus (LVT) in comparison to placebo. We aimed to assess the 1-year clinical outcomes of the study population. METHODS This study is a follow-up analysis of the COVERT-MI study on prespecified secondary clinical endpoints at 1 year. The primary endpoint of this study was a composite of major adverse cardiovascular events (MACEs), including all-cause death, acute coronary syndromes, heart failure events, ischaemic strokes, sustained ventricular arrhythmias and acute kidney injury at 1-year follow-up. The quality of life (QOL) and the drug therapy prescription were also assessed. RESULTS At 1 year, 192 patients (101 patients in the colchicine group, 91 in the placebo group) were followed up. Seventy-six (39.6%) MACEs were reported in the study population. There was no significant difference regarding the number of MACEs between groups: 36 (35.6%) in the colchicine group and 40 (44.1%) in the placebo group (p=0.3). There were no differences in the occurrence of ischaemic strokes between the colchicine group and the control group (3 (3%) vs 2 (2.2%), respectively, p=0.99). There was a trend towards fewer heart failure events in the colchicine group compared with the placebo group (12 (11.9%) vs 18 (19.8%), p=0.20). There was no significant difference in QOL scores at 1 year (75.8±15.7 vs 72.7±16.2 respectively, p=0.18). CONCLUSIONS There was no significant difference between the colchicine and placebo groups at 1 year regarding MACEs, especially concerning deaths or ischaemic strokes. No excess of ischaemic adverse events was observed despite the initial increase in LVT in the colchicine group. TRIAL REGISTRATION NUMBER NCT0315681.
Collapse
Affiliation(s)
- Claire Bouleti
- Cardiology, University of Poitiers, Clinical Investigation Center (CIC) INSERM 1402, Poitiers University Hospital, Poitiers, France
| | - Simon Viscogliosi
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Didier Bresson
- Cardiology, Groupe Hospitalier de la Region de Mulhouse et Sud Alsace, Mulhouse, Grand Est, France
| | - Simon Leboube
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Thomas Bochaton
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Naoual El-Jonhy
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Camille Amaz
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
| | - Fabrice Prunier
- Cardiologie, Université Angers, UPRES EA3860, Laboratoire Cardioprotection, Remodelage et Thrombose, CHU Angers, Angers, France
| | | | - Francois Roubille
- Cardiology, Regional University Hospital Center of Montpellier, Montpellier, France
| | - Denis Angoulvant
- Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
| | - Nathan Mewton
- Cardiology, Hospices Civils de Lyon, Clinical Investigation Center Inserm 1407, Université Claude Bernard Lyon 1, Lyon, Auvergne-Rhône-Alpes, France
- IRIS Team, INSERM U1060, Bron, France
| |
Collapse
|
6
|
Serrier H, Rabier H, Fernandez V, Schott AM, Mewton N, Ovize M, Nighoghossian N, Duclos A, Colin C. Comparison of healthcare costs before and after a STEMI: A French national health data system-based cohort study. J Cardiol 2024; 83:44-48. [PMID: 37524298 DOI: 10.1016/j.jjcc.2023.07.010] [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: 11/30/2022] [Revised: 04/11/2023] [Accepted: 07/16/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Few studies have investigated real-world healthcare costs following a myocardial infarction (MI) and, to our knowledge, none after an ST-elevation MI (STEMI) specifically. Producing such data is important in order to help evaluate the economic burden of STEMI, but also to feed economic evaluation models and eventually show the economic interest of reducing STEMI incidence. The aim of this study was to estimate the healthcare cost in the year preceding and the year following a STEMI in France, in order to estimate the surplus in healthcare resource consumption after a STEMI. METHODS This study was conducted from the healthcare system perspective. The individual data from the HIBISCUS-STEMI cohort, which included patients with acute STEMI undergoing primary percutaneous coronary intervention, were matched with the French national health data system (Système National des Données de Santé, SNDS) using a probabilistic method. All expenses (in- and out-hospital) presented for reimbursement were taken into account to estimate a mean annual healthcare cost. RESULTS A total 258 patients from the HIBISCUS-STEMI cohort were included in this economic study. The total mean healthcare cost was estimated at €3516 before the STEMI, and at €9980 after the STEMI. Hospitalizations constituted the largest cost item, 27 % of the total cost before the STEMI and 41.8 % after the STEMI (Δ + 338.8 %). Follow-up and rehabilitative care represented the second largest cost item (25.9 % before and 18 % after the STEMI, Δ + 96.7 %). Treatments represented 19.4 % of the total cost before the STEMI and 17.2 % after (Δ + 150.8 %). CONCLUSIONS This study shows a significant surplus (threefold) of healthcare resource consumption in the year following a STEMI compared to the year preceding the STEMI.
Collapse
Affiliation(s)
- Hassan Serrier
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon cedex F-69424, Université Claude Bernard Lyon 1, INSERM U1290 Reshape, Lyon cedex F-69003, France.
| | - Hugo Rabier
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon cedex F-69424, Université Claude Bernard Lyon 1, INSERM U1290 Reshape, Lyon cedex F-69003, France
| | - Violaine Fernandez
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon cedex F-69424, Université Claude Bernard Lyon 1, INSERM U1290 Reshape, Lyon cedex F-69003, France
| | - Anne-Marie Schott
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon cedex F-69424, Université Claude Bernard Lyon 1, INSERM U1290 Reshape, Lyon cedex F-69003, France
| | - Nathan Mewton
- Hospices Civils de Lyon, Centre d'Investigation Clinique, Bron F-69500, Université Claude Bernard Lyon 1, INSERM U1060 CarMeN, Lyon cedex F-69003, France
| | - Michel Ovize
- Hospices Civils de Lyon, Centre d'Investigation Clinique, Bron F-69500, Université Claude Bernard Lyon 1, INSERM U1060 CarMeN, Lyon cedex F-69003, France
| | | | - Antoine Duclos
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon cedex F-69424, Université Claude Bernard Lyon 1, INSERM U1290 Reshape, Lyon cedex F-69003, France
| | - Cyrille Colin
- Hospices Civils de Lyon, Pôle de Santé Publique, Lyon cedex F-69424, Université Claude Bernard Lyon 1, INSERM U1290 Reshape, Lyon cedex F-69003, France
| |
Collapse
|
7
|
Boccalini S, Teulade M, Paquet E, Si-Mohamed S, Rapallo F, Moreau-Triby C, Charrière S, Mewton N, Boussel L, Bergerot C, Douek P, Moulin P. Silent myocardial infarction fatty scars detected by coronary calcium score CT scan in diabetic patients without history of coronary heart disease. Eur Radiol 2024; 34:214-225. [PMID: 37530810 DOI: 10.1007/s00330-023-09940-2] [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] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES To evaluate the prevalence of intra-myocardial fatty scars (IMFS) most likely indicating previous silent myocardial infarction (SMI), as detected on coronary artery calcium (CAC) computed tomography (CT) scans in diabetic patients without history of coronary heart disease (CHD). METHODS Diabetic patients screened for silent coronary insufficiency in a tertiary-care, university hospital between Jan-2015 and Dec-2016 were categorized according to their CAC score in two groups comprising 242 patients with CACS = 0 and 145 patients with CACS ≥ 300. CAC-CT scans were retrospectively evaluated for subendorcardial and transmural IMFS of the left ventricle. Adipose remodeling, patients' characteristics, cardiovascular risk factors and metabolic profile were compared between groups. RESULTS Eighty-three (21%) patients with IMFS were identified, 55 (37.9%) in the group CACS ≥ 300 and 28 (11.6%) in the CACS = 0 (OR = 4.67; 95% CI = 2.78-7.84; p < 0.001). Total and average surface of IMFS and their number per patient were similar in both groups (p = 0.55; p = 0.29; p = 0.61, respectively). In the group CACS ≥ 300, patients with IMFS were older (p = 0.03) and had longer-lasting diabetes (p = 0.04). Patients with IMFS were older and had longer history of diabetes, reduced glomerular filtration rate, more coronary calcifications (all p < 0.05), and higher prevalence of carotid plaques (OR = 3.03; 95% CI = 1.43-6.39, p = 0.004). After correction for other variables, only a CACS ≥ 300 (OR = 5.12; 95% CI = 2.66-9.85; p < 0.001) was associated with an increased risk of having IMFS. CONCLUSIONS In diabetic patients without known CHD, IMFSs were found in patients without coronary calcifications, although not as frequently as in patients with heavily calcified coronary arteries. It remains to be established if this marker translates in an upwards cardiovascular risk restratification especially in diabetic patients with CACS = 0. CLINICAL RELEVANCE STATEMENT In diabetic patients without history of coronary heart disease, intramyocardial fatty scars, presumably of post-infarction origin, can be detected on coronary artery calcium CT scans more frequently, but not exclusively, if the coronary arteries are heavily calcified as compared to those without calcifications. KEY POINTS • Intramyocardial fatty scars (IMFS), presumably of post-infarction origin, can be detected on coronary artery calcium (CAC) CT scans more frequently, but not exclusively, in diabetic patients with CACS ≥ 300 as compared to patients CACS = 0. • Patients with IMFS were older and had longer history of diabetes, reduced glomerular filtration rate, and more coronary calcifications. • Carotid plaques and CACS ≥ 300 were associated with an increased risk of having IMFS, about three and five folds respectively.
Collapse
Affiliation(s)
- Sara Boccalini
- Department of Cardiovascular Radiology, Hôpital Pradel, Hospices Civils de Lyon, Lyon, France.
- University Claude Bernard Lyon 1, Lyon, France.
| | - Marie Teulade
- University Claude Bernard Lyon 1, Lyon, France
- Department of Endocrinology Louis Pradel University Hospital, Hospices Civils de Lyon, INSERM UMR 1060, Carmen, Lyon, France
| | - Emilie Paquet
- Department of Nuclear Medicine, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Salim Si-Mohamed
- Department of Cardiovascular Radiology, Hôpital Pradel, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon 1, Lyon, France
| | - Fabio Rapallo
- Department of Economics, University of Genova, Genoa, Italy
| | - Caroline Moreau-Triby
- Department of Nuclear Medicine, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Sybil Charrière
- University Claude Bernard Lyon 1, Lyon, France
- Department of Endocrinology Louis Pradel University Hospital, Hospices Civils de Lyon, INSERM UMR 1060, Carmen, Lyon, France
| | - Nathan Mewton
- University Claude Bernard Lyon 1, Lyon, France
- Department of Cardiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Loic Boussel
- Department of Radiology, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Cyrille Bergerot
- Department of Cardiology, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Philippe Douek
- Department of Cardiovascular Radiology, Hôpital Pradel, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon 1, Lyon, France
| | - Philippe Moulin
- University Claude Bernard Lyon 1, Lyon, France
- Department of Endocrinology Louis Pradel University Hospital, Hospices Civils de Lyon, INSERM UMR 1060, Carmen, Lyon, France
| |
Collapse
|
8
|
Schurtz G, Mewton N, Lemesle G, Delmas C, Levy B, Puymirat E, Aissaoui N, Bauer F, Gerbaud E, Henry P, Bonello L, Bochaton T, Bonnefoy E, Roubille F, Lamblin N. Beta-blocker management in patients admitted for acute heart failure and reduced ejection fraction: a review and expert consensus opinion. Front Cardiovasc Med 2023; 10:1263482. [PMID: 38050613 PMCID: PMC10693984 DOI: 10.3389/fcvm.2023.1263482] [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: 07/19/2023] [Accepted: 10/31/2023] [Indexed: 12/06/2023] Open
Abstract
The role of the beta-adrenergic signaling pathway in heart failure (HF) is pivotal. Early blockade of this pathway with beta-blocker (BB) therapy is recommended as the first-line medication for patients with HF and reduced ejection fraction (HFrEF). Conversely, in patients with severe acute HF (AHF), including those with resolved cardiogenic shock (CS), BB initiation can be hazardous. There are very few data on the management of BB in these situations. The present expert consensus aims to review all published data on the use of BB in patients with severe decompensated AHF, with or without hemodynamic compromise, and proposes an expert-recommended practical algorithm for the prescription and monitoring of BB therapy in critical settings.
Collapse
Affiliation(s)
- Guillaume Schurtz
- USICet Centre Hémodynamique, Institut Coeur Poumon, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Nathan Mewton
- Hôpital Cardio-Vasculaire Louis Pradel. Filière Insuffisance Cardiaque, Centre D'Investigation Clinique, INSERM 1407. Unité CarMeN, INSERM 1060, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Gilles Lemesle
- USICet Centre Hémodynamique, Institut Coeur Poumon, Centre Hospitalier Universitaire de Lille, Lille, France
- Institut Pasteur de Lille, Unité INSERM UMR1011, Lille, France
- Faculté de Médecine de l’Université de Lille, Lille, France
- FACT (French Alliance for Cardiovascular Trials), Paris, France
| | - Clément Delmas
- Intensive Cardiac Care Unit, Rangueil University Hospital, Toulouse, France
| | - Bruno Levy
- Service de Réanimation Médicale Brabois, CHRU Nancy, Pôle Cardio-Médico-Chirurgical, Vandoeuvre-les-Nancy, INSERM U1116, Faculté de Médecine, Vandoeuvre-les-Nancy, Université de Lorraine, Nancy, France
| | - Etienne Puymirat
- Department of Cardiology, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Nadia Aissaoui
- Médecine Intensive Réanimation, Cochin, AfterROSC, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Cité, Paris, France
| | - Fabrice Bauer
- Heart Failure Network, Advanced Heart Failure Clinic and Pulmonary Hypertension Department, Cardiac Surgery Department, INSERM U1096, Rouen University Teaching Hospital, Rouen, France
| | - Edouard Gerbaud
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
- Bordeaux Cardio-Thoracic Research Centre, INSERM U1045, Bordeaux University, Bordeaux, France
| | - Patrick Henry
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris, INSERM U942, University of Paris, Paris, France
| | - Laurent Bonello
- Cardiology Department, APHM, Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Centre for CardioVascular and Nutrition Research (C2VN), INSERM 1263, INRA 1260, Aix-Marseille Univ, Marseille, France
| | - Thomas Bochaton
- Intensive Cardiological Care Division, Hospices Civils de Lyon-Hôpital Cardiovasculaire et Pulmonaire, Lyon, France
| | - Eric Bonnefoy
- Intensive Cardiological Care Division, Hospices Civils de Lyon-Hôpital Cardiovasculaire et Pulmonaire, Lyon, France
| | - François Roubille
- Cardiology Department, INI-CRT, CHU de Montpellier, PhyMedExp, INSERM, CNRS, Université de Montpellier, Montpellier, France
| | - Nicolas Lamblin
- Cardiology Department, Heart and Lung Institute, University Hospital of Lille, Lille, France
- INSERM U1167, Institut Pasteur of Lille, Lille, France
| |
Collapse
|
9
|
Mewton N, Donal E, Picard F, Derimay F, Grinberg D, Boulch DM, Bochaton T, Piriou N, De Lorgeril A, Samson G, Rouleau F, Riche B, Trochu JN. Prognostic impact of precipitated cardiac decompensation in symptomatic heart failure with reduced ejection fraction and severe secondary mitral regurgitation. Am Heart J 2023; 265:83-91. [PMID: 37271359 DOI: 10.1016/j.ahj.2023.05.016] [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: 08/24/2022] [Revised: 05/19/2023] [Accepted: 05/28/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Our aim was to assess the distribution of primary (with no trigger) and secondary (with a decompensation trigger) heart failure events in a severe heart failure population and their association with 2-year all-cause mortality in the Mitra.Fr study. METHODS We included 304 patients with symptomatic heart failure, and severe mitral regurgitation and guideline directed medical therapy randomized to medical therapy alone or medical therapy with percutaneous mitral valve repair. According to the follow-up, we defined 3 categories of events: follow-up without any heart failure event, at least 1 decompensation starting with a primary heart failure decompensation or starting with a precipitated secondary heart failure event. The primary outcome was 2-years all-cause mortality. RESULTS A total of 179 patients (59 %) had at least 1 heart failure decompensation within 24-months of follow-up. 129 heart failure decompensations (72%) were a first primary heart failure and 50 (28%) were a first secondary decompensation. Finally, 30 patients had both types of decompensations but these were not taken into account for the comparison of primary and secondary decompensations. Primary decompensations were 3-times more frequent than secondary decompensations, but the mean number of heart failure decompensations was similar in the "Primary heart failure group" compared to the "Secondary heart failure group": (1.94 ± 1.39 vs 1.80 ± 1.07 respectively; P = .480). Compared to patients without heart failure decompensation, patients with "Only primary decompensation" or with "Only secondary decompensation" had a significantly increased risk of death (HR = 4.87, 95% CI [2.86, 8.32] and 2.68 95%CI [1.64, 4.37] respectively). All-cause mortality, was not significantly different between these 2 type of decompensations (HR = 1.82, 95% CI [0.93, 3.58]; P = .082), but each additional heart failure recurrence was associated with a significant increase in mortality risk (HR = 1.27, 95% CI [1.08; 1.50]; P = .005). CONCLUSIONS In heart failure with reduced ejection fraction and severe secondary mitral regurgitation patients, primary heart failure decompensations were 3-times more frequent compared to precipitated decompensations with a nonsignificant trend in increased risk of all-cause mortality. Our results fail to support the differentiation between primary and secondary decompensations as they seem to portend the same outcome impact.
Collapse
Affiliation(s)
- Nathan Mewton
- Heart Failure Department, Centre d'Investigation Clinique, Inserm 1407, CarMeN Inserm 1060, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France.
| | - Erwan Donal
- Cardiology Department, Hospital University Rennes, LTSI UMR1099, INSERM, Rennes, France
| | - François Picard
- Heart Failure Department, Aquitaine Expert Center for Primary Pulmonary Hypertension, University Hospital Bordeaux, Bordeaux, France
| | - François Derimay
- Heart Failure Department, Centre d'Investigation Clinique, Inserm 1407, CarMeN Inserm 1060, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Daniel Grinberg
- Cardiac Surgery Department, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Delphine Maucort Boulch
- Biostatistics Department, Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, F-69003, Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, F-69100, Lyon, France
| | - Thomas Bochaton
- Heart Failure Department, Centre d'Investigation Clinique, Inserm 1407, CarMeN Inserm 1060, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Nicolas Piriou
- Cardiology Department, Clinique cardiologique et des maladies vasculaires Pôle hospitalo-universitaire institut du thorax et du système nerveux CIC INSERM 1413 - Institut du Thorax- UMR INSERM 1087 Université de Nantes, Nantes, France
| | - Amélie De Lorgeril
- Heart Failure Department, Centre d'Investigation Clinique, Inserm 1407, CarMeN Inserm 1060, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Geraldine Samson
- Heart Failure Department, Centre d'Investigation Clinique, Inserm 1407, CarMeN Inserm 1060, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Frédéric Rouleau
- Cardiology department, University Hospital Angers, Angers, France
| | - Benjamin Riche
- Biostatistics Department, Université de Lyon, F-69000, Lyon, France; Université Lyon 1, F-69100, Villeurbanne, France; Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, F-69003, Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, F-69100, Lyon, France
| | - Jean Noël Trochu
- Cardiology Department, Clinique cardiologique et des maladies vasculaires Pôle hospitalo-universitaire institut du thorax et du système nerveux CIC INSERM 1413 - Institut du Thorax- UMR INSERM 1087 Université de Nantes, Nantes, France
| |
Collapse
|
10
|
Fauvel C, Saldarriaga Giraldo CI, Barassa A, Shchendrygina A, Mapelli M, Jakus N, Jobbe-Duval A, Meznar AZ, Harbaoui B, Berthelot E, Roubille F, Rosano G, Mewton N. Differences between heart failure specialists and non-specialists regarding heart failure drug implementation and up-titration. Eur J Heart Fail 2023; 25:1884-1886. [PMID: 37634943 DOI: 10.1002/ejhf.3010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/30/2023] [Revised: 08/05/2023] [Accepted: 08/19/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Charles Fauvel
- Department of Cardiology, University of Rouen Normandie, Inserm U1096, CHU Rouen, Rouen, France
| | | | - Anders Barassa
- Department of Cardiology, Glostrup Hospital, Copenhagen, Denmark
| | | | - Massimo Mapelli
- Heart Failure Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Nina Jakus
- Department of Cardiology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Antoine Jobbe-Duval
- Heart Failure Department, Clinical Investigation Center, INSERM 1060 & 1407, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France
| | | | - Brahim Harbaoui
- Heart Failure Department, Clinical Investigation Center, INSERM 1060 & 1407, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France
| | | | - François Roubille
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, Montpellier, France
| | - Giuseppe Rosano
- Department of Cardiology, IRCCS San Raffaele Pisana, Rome, Italy
| | - Nathan Mewton
- Heart Failure Department, Clinical Investigation Center, INSERM 1060 & 1407, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France
| |
Collapse
|
11
|
Chiari P, Desebbe O, Durand M, Fischer MO, Lena-Quintard D, Palao JC, Samson G, Varillon Y, Vaz B, Joseph P, Ferraris A, Jacquet-Lagreze M, Pozzi M, Maucort-Boulch D, Ovize M, Bidaux G, Mewton N, Fellahi JL. A Multimodal Cardioprotection Strategy During Cardiac Surgery: The ProCCard Study. J Cardiothorac Vasc Anesth 2023; 37:1368-1376. [PMID: 37202231 DOI: 10.1053/j.jvca.2023.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/15/2022] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The ProCCard study tested whether combining several cardioprotective interventions would reduce the myocardial and other biological and clinical damage in patients undergoing cardiac surgery. DESIGN Prospective, randomized, controlled trial. SETTING Multicenter tertiary care hospitals. PARTICIPANTS 210 patients scheduled to undergo aortic valve surgery. INTERVENTIONS A control group (standard of care) was compared to a treated group combining five perioperative cardioprotective techniques: anesthesia with sevoflurane, remote ischemic preconditioning, close intraoperative blood glucose control, moderate respiratory acidosis (pH 7.30) just before aortic unclamping (concept of the "pH paradox"), and gentle reperfusion just after aortic unclamping. MEASUREMENTS AND MAIN RESULTS The primary outcome was the postoperative 72-h area under the curve (AUC) for high-sensitivity cardiac troponin I (hsTnI). Secondary endpoints were biological markers and clinical events occurring during the 30 postoperative days and the prespecified subgroup analyses. The linear relationship between the 72-h AUC for hsTnI and aortic clamping time, significant in both groups (p < 0.0001), was not modified by the treatment (p = 0.57). The rate of adverse events at 30 days was identical. A non-significant reduction of the 72-h AUC for hsTnI (-24%, p = 0.15) was observed when sevoflurane was administered during cardiopulmonary bypass (46% of patients in the treated group). The incidence of postoperative renal failure was not reduced (p = 0.104). CONCLUSION This multimodal cardioprotection has not demonstrated any biological or clinical benefit during cardiac surgery. The cardio- and reno-protective effects of sevoflurane and remote ischemic preconditioning therefore remain to be demonstrated in this context.
Collapse
Affiliation(s)
- Pascal Chiari
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France; Inserm U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France..
| | - Olivier Desebbe
- Service d'Anesthésie-Réanimation, Clinique de la Sauvegarde, Ramsay Générale de Santé, Lyon, France
| | - Michel Durand
- Pole d'Anesthésie-Réanimation, Hôpital Albert Michallon, Centre Hospitalier Universitaire de Grenoble-Alpes, Grenoble, France
| | - Marc-Olivier Fischer
- Service d'Anesthésie-Réanimation, Centre Hospitalier Universitaire de Caen, Université de Normandie, UNICAEN, Caen, France
| | - Diane Lena-Quintard
- Service d'Anesthésie-Réanimation, Institut Arnault Tzanck, Saint Laurent du Var, France
| | - Jean-Charles Palao
- Service d'Anesthésie-Réanimation, Hôpital Nord, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | - Géraldine Samson
- Centre d'Investigation Clinique de Lyon (CIC 1407 Inserm), Hospices Civils de Lyon, Lyon, France
| | - Yvonne Varillon
- Centre d'Investigation Clinique de Lyon (CIC 1407 Inserm), Hospices Civils de Lyon, Lyon, France
| | - Bernadette Vaz
- Centre d'Investigation Clinique de Lyon (CIC 1407 Inserm), Hospices Civils de Lyon, Lyon, France
| | - Pierre Joseph
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Arnaud Ferraris
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Matthias Jacquet-Lagreze
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France; Inserm U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France
| | - Matteo Pozzi
- Service de Chirurgie Cardiaque, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Delphine Maucort-Boulch
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Université de Lyon, Lyon, France; Université Lyon 1, Villeurbanne, France; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, Villeurbanne France
| | - Michel Ovize
- Inserm U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France.; Centre d'Investigation Clinique de Lyon (CIC 1407 Inserm), Hospices Civils de Lyon, Lyon, France
| | - Gabriel Bidaux
- Inserm U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France
| | - Nathan Mewton
- Inserm U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France.; Centre d'Investigation Clinique de Lyon (CIC 1407 Inserm), Hospices Civils de Lyon, Lyon, France; Service d'Insuffisance Cardiaque, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - Jean-Luc Fellahi
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France; Inserm U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France
| |
Collapse
|
12
|
De Angelis E, Bochaton T, Ammirati E, Tedeschi A, Polito MV, Pieroni M, Merlo M, Gentile P, Van De Heyning CM, Bekelaar T, Cipriani A, Camilli M, Sanna T, Marra MP, Cabassi A, Piepoli MF, Sinagra G, Mewton N, Bonnefoy-Cudraz E, Ravera A, Hayek A. Pheochromocytoma-induced cardiogenic shock: A multicentre analysis of clinical profiles, management and outcomes. Int J Cardiol 2023; 383:82-88. [PMID: 37164293 DOI: 10.1016/j.ijcard.2023.05.004] [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: 02/26/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE There is still uncertainty about the management of patients with pheochromocytoma-induced cardiogenic shock (PICS). This study aims to investigate the clinical presentation, management, and outcome of patients with PICS. METHODS We collected, retrospectively, the data of 18 patients without previously known pheochromocytoma admitted to 8 European hospitals with a diagnosis of PICS. RESULTS Among the 18 patients with a median age of 50 years (Q1-Q3: 40-61), 50% were men. The main clinical features at presentation were pulmonary congestion (83%) and cyclic fluctuation of hypertension peaks and hypotension (72%). Echocardiography showed a median left ventricular ejection fraction (LVEF) of 25% (Q1-Q3: 15-33.5) with an atypical- Takotsubo (TTS) pattern in 50%. Inotropes/vasopressors were started in all patients and temporary mechanical circulatory support (t-MCS) was required in 11 (61%) patients. All patients underwent surgical removal of the pheochromocytoma; 4 patients (22%) were operated on while under t-MCS. The median LVEF was estimated at 55% at discharge. Only one patient required heart transplantation (5.5%), and all patients were alive at a median follow-up of 679 days. CONCLUSIONS PICS should be suspected in case of a CS with severe cyclic blood pressure fluctuation and rapid hemodynamic deterioration, associated with increased inflammatory markers or in case of TTS progressing to CS, particularly if an atypical TTS echocardiographic pattern is revealed. T-MCS should be considered in the most severe cases. The main challenge is to stabilize the patient, with medical therapy or with t-MCS, since it remains a reversible cause of CS with a low mortality rate.
Collapse
Affiliation(s)
- Elena De Angelis
- Department of Cardiology and Intensive Care Unit, "S. Anna e SS. Madonna della Neve" Boscotrecase Hospital, Local Health Authority Naples 3 South, Naples, Italy; Intensive Cardiological Care Division, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France.
| | - Thomas Bochaton
- Intensive Cardiological Care Division, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Enrico Ammirati
- "De Gasperis" Cardio Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andrea Tedeschi
- "De Gasperis" Cardio Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Cardiology Division, Parma University, Parma University Hospital, Parma, Italy
| | - Maria Vincenza Polito
- Cardiology Division, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Maurizio Pieroni
- Cardiovascular Department, ASL8 Arezzo, "San Donato Hospital", Arezzo, Italy
| | - Marco Merlo
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria "Giuliano Isontina" (ASUGI), University of Trieste, Trieste, Italy
| | - Piero Gentile
- "De Gasperis" Cardio Center, Niguarda Hospital, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Thalia Bekelaar
- Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium
| | - Alberto Cipriani
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy
| | - Massimiliano Camilli
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Tommaso Sanna
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Martina Perazzolo Marra
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy
| | - Aderville Cabassi
- Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery (DIMEC), University of Parma, Parma, Italy
| | - Massimo F Piepoli
- Cardiology Department, Guglielmo da Saliceto Hospital of Piacenza, Piacenza, Italy
| | - Gianfranco Sinagra
- Cardiothoracovascular Department, Azienda Sanitaria Universitaria "Giuliano Isontina" (ASUGI), University of Trieste, Trieste, Italy
| | - Nathan Mewton
- Clinical Investigation Centre and Heart Failure Department, Hôpital Cardiovasculaire Louis Pradel, Inserm 1407, France
| | - Eric Bonnefoy-Cudraz
- Intensive Cardiological Care Division, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France
| | - Amelia Ravera
- Intensive Cardiac Care Unit, Cardiology Division, Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Ahmad Hayek
- Intensive Cardiological Care Division, Louis Pradel Hospital, Hospices Civils de Lyon, Bron, France; Interventional Department, Montreal heart Institute, Quebec, Canada
| |
Collapse
|
13
|
Duchateau N, Viallon M, Petrusca L, Clarysse P, Mewton N, Belle L, Croisille P. Pixel-wise statistical analysis of myocardial injury in STEMI patients with delayed enhancement MRI. Front Cardiovasc Med 2023; 10:1136760. [PMID: 37396590 PMCID: PMC10313104 DOI: 10.3389/fcvm.2023.1136760] [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: 01/03/2023] [Accepted: 06/06/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives Myocardial injury assessment from delayed enhancement magnetic resonance images is routinely limited to global descriptors such as size and transmurality. Statistical tools from computational anatomy can drastically improve this characterization, and refine the assessment of therapeutic procedures aiming at infarct size reduction. Based on these techniques, we propose a new characterization of myocardial injury up to the pixel resolution. We demonstrate it on the imaging data from the Minimalist Immediate Mechanical Intervention randomized clinical trial (MIMI: NCT01360242), which aimed at comparing immediate and delayed stenting in acute ST-Elevation Myocardial Infarction (STEMI) patients. Methods We analyzed 123 patients from the MIMI trial (62 ± 12 years, 98 male, 65 immediate 58 delayed stenting). Early and late enhancement images were transported onto a common geometry using techniques inspired by statistical atlases, allowing pixel-wise comparisons across population subgroups. A practical visualization of lesion patterns against specific clinical and therapeutic characteristics was also proposed using state-of-the-art dimensionality reduction. Results Infarct patterns were roughly comparable between the two treatments across the whole myocardium. Subtle but significant local differences were observed for the LCX and RCA territories with higher transmurality for delayed stenting at lateral and inferior/inferoseptal locations, respectively (15% and 23% of myocardial locations with a p-value <0.05, mainly in these regions). In contrast, global measurements were comparable for all territories (no statistically significant differences for all-except-one measurements before standardization / for all after standardization), although immediate stenting resulted in more subjects without reperfusion injury. Conclusion Our approach substantially empowers the analysis of lesion patterns with standardized comparisons up to the pixel resolution, and may reveal subtle differences not accessible with global observations. On the MIMI trial data as illustrative case, it confirmed its general conclusions regarding the lack of benefit of delayed stenting, but revealed subgroups differences thanks to the standardized and finer analysis scale.
Collapse
Affiliation(s)
- Nicolas Duchateau
- Univ Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, France
- Institut Universitaire de France (IUF), Paris, France
| | - Magalie Viallon
- Univ Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, France
- Department of Radiology, Hôpital Nord, University Hospital of Saint-Étienne, Saint-Étienne, France
| | - Lorena Petrusca
- Univ Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, France
| | - Patrick Clarysse
- Univ Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, France
| | - Nathan Mewton
- Department of Cardiology, Clinical Investigation Center, INSERM 1407, Hôpital Cardiovasculaire Louis Pradel, Lyon, France
| | - Loic Belle
- Department of Cardiology, Centre Hospitalier Annecy-Genevois, Annecy, France
| | - Pierre Croisille
- Univ Lyon, CREATIS, INSA, CNRS UMR 5220, INSERM U1294, Université Lyon 1, UJM Saint-Etienne, Lyon, France
- Department of Radiology, Hôpital Nord, University Hospital of Saint-Étienne, Saint-Étienne, France
| |
Collapse
|
14
|
Bochaton T, Mewton N. "Outside-the-box" therapeutic solutions for ischemia-reperfusion myocardial protection. Eur Heart J Acute Cardiovasc Care 2023; 12:153-154. [PMID: 36881638 DOI: 10.1093/ehjacc/zuad010] [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] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Thomas Bochaton
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center & Heart Failure Department, INSERM 1407 and INSERM 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | - Nathan Mewton
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center & Heart Failure Department, INSERM 1407 and INSERM 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| |
Collapse
|
15
|
Jacquin L, Battault M, Mewton N, Mantout A, Bergerot C, Tazarourte K, Douplat M. Outcome of patients admitted with oxygen mismatch and myocardial injury or infarction in emergency departments. J Cardiovasc Med (Hagerstown) 2023; 24:159-166. [PMID: 36753723 DOI: 10.2459/jcm.0000000000001443] [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] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
AIMS To describe the outcomes and associated factors in a population of patients admitted to emergency departments with at least one condition of oxygen supply/demand imbalance, regardless of the troponin result or restrictive criteria for type 2 myocardial infarction. METHODS We constituted a retrospective cohort of 824 patients. Medical records of patients having undergone a troponin assay were reviewed for selection and classification, and data including in-hospital stay and readmissions were collected. The reported outcomes are in-hospital mortality, 3-year mortality, and major adverse cardiovascular events. RESULTS Patients with myocardial infarction or injury, either chronic or acute, were older, with more history of hypertension and chronic heart or renal failure but not for other cardiovascular risk factors and medical history. Acute myocardial injury and type 2 myocardial infarction were significantly associated with in-hospital mortality [odds ratio (OR) 3.71 95% confidence interval (CI) 1.90-7.33 and OR 3.15 95% CI 1.59-6.28, respectively]. However, the long-term mortality does not differ in comparison with patients presenting chronic myocardial injury or nonelevated troponin, ranging from 26.9 to 34.3%. Patients with chronic myocardial injury and type 2 myocardial infarction had more long-term major cardiovascular events (39.3 and 38.8%), but only for acute heart failure, and none was associated with this outcome after adjustment. CONCLUSION Among patients admitted to emergency departments with an oxygen supply/demand imbalance, acute myocardial injury and type 2 myocardial infarction are strongly associated with in-hospital mortality. However, they are not associated with higher long-term mortality or major cardiovascular events after discharge, which tend to occur in elderly people with comorbidities.
Collapse
Affiliation(s)
- Laurent Jacquin
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'accueil des urgence.,Université Lyon-1, CarMeN Team 3 Ischemia-Reperfusion Syndromes (IRIS), INSERM UMR 1060
| | - Marion Battault
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'accueil des urgence
| | - Nathan Mewton
- Université Lyon-1, CarMeN Team 3 Ischemia-Reperfusion Syndromes (IRIS), INSERM UMR 1060.,Hospices Civils de Lyon, Hôpital Louis Pradel, Centre d'investigation clinique, INSERM 1407, Lyon.,Hospices Civils de Lyon, Hôpital Louis Pradel, Service de cardiologie, Bron
| | - Adrien Mantout
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'accueil des urgences, Pierre Bénite
| | - Cyrille Bergerot
- Hospices Civils de Lyon, Hôpital Louis Pradel, Centre d'investigation clinique, INSERM 1407, Lyon.,Hospices Civils de Lyon, Hôpital Louis Pradel, Service de cardiologie, Bron
| | - Karim Tazarourte
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'accueil des urgence.,Université Lyon-1, Laboratoire Health Services and Performance Research (HESPER) EA 7425, Lyon, France
| | - Marion Douplat
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'accueil des urgences, Pierre Bénite.,Université Lyon-1, Laboratoire Health Services and Performance Research (HESPER) EA 7425, Lyon, France
| |
Collapse
|
16
|
Enachi S, Schleef M, Hadjseyd CE, Leboube S, Fauvel C, Daniel L, Jobbe-Duval A, Sebbag L, Lemoine S, Mewton N. Challenges and Opportunities in Titrating Disease-Modifying Therapies in Heart Failure with Reduced Ejection Fraction and Chronic Kidney Disease. Curr Heart Fail Rep 2023; 20:101-112. [PMID: 36853555 DOI: 10.1007/s11897-023-00594-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE OF REVIEW Chronic kidney disease (CKD) is highly prevalent in patients with heart failure and reduced ejection fraction (HFrEF), representing a major factor of adverse outcomes. In clinical practice, it is one of the main reasons for not initiating, not titrating, and even withdrawing efficient heart failure drug therapies in patients. RECENT FINDINGS Despite limited data, studies show that HFrEF therapies maintain their benefits on cardiovascular outcomes in patients with CKD. Most HF drugs cause acute renal haemodynamic changes, but with stabilisation or even improvement after the acute phase, thus with no long-term worsening of the renal function. In this expert opinion-based paper, we challenge the pathophysiology misunderstandings that impede HF disease-modifying therapy implementation in this setting and propose a strategy for HF drug titration in patients with moderate, severe, and end-stage chronic kidney disease.
Collapse
Affiliation(s)
- Stefana Enachi
- Heart Failure Department, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Maxime Schleef
- Department of Nephrology and Renal Function, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.,Clinical Investigation Center INSERM 1407, Université Claude Bernard Lyon 1, 69500, Bron, France
| | - Chahr-Eddine Hadjseyd
- Heart Failure Department, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Simon Leboube
- Heart Failure Department, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France.,Clinical Investigation Center INSERM 1407, Université Claude Bernard Lyon 1, 69500, Bron, France
| | - Charles Fauvel
- Department of Cardiology, FHU Carnaval, Rouen University Hospital, Rouen, France
| | - Lucie Daniel
- Heart Failure Department, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Antoine Jobbe-Duval
- Heart Failure Department, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Laurent Sebbag
- Heart Failure Department, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sandrine Lemoine
- Department of Nephrology and Renal Function, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.,Clinical Investigation Center INSERM 1407, Université Claude Bernard Lyon 1, 69500, Bron, France
| | - Nathan Mewton
- Heart Failure Department, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France.,Clinical Investigation Center INSERM 1407, Université Claude Bernard Lyon 1, 69500, Bron, France
| |
Collapse
|
17
|
Fauvel C, Bonnet G, Mullens W, Giraldo CIS, Mežnar AZ, Barasa A, Tokmakova M, Shchendrygina A, Costa FM, Mapelli M, Zemrak F, Tops LF, Jakus N, Sultan A, Bahouth F, Hadjseyd CE, Salvat M, Anselmino M, Messroghli D, Weberndörfer V, Giverts I, Bochaton T, Courand PY, Berthelot E, Legallois D, Beauvais F, Bauer F, Lamblin N, Damy T, Girerd N, Sebbag L, Pezel T, Cohen-Solal A, Rosano G, Roubille F, Mewton N. Sequencing and titrating approach of therapy in heart failure with reduced ejection fraction following the 2021 European Society of Cardiology guidelines: an international cardiology survey. Eur J Heart Fail 2023; 25:213-222. [PMID: 36404398 DOI: 10.1002/ejhf.2743] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/26/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
AIMS In symptomatic patients with heart failure and reduced ejection fraction (HFrEF), recent international guidelines recommend initiating four major therapeutic classes rather than sequential initiation. It remains unclear how this change in guidelines is perceived by practicing cardiologists versus heart failure (HF) specialists. METHODS AND RESULTS An independent academic web-based survey was designed by a group of HF specialists and posted by email and through various social networks to a broad community of cardiologists worldwide 1 year after the publication of the latest European HF guidelines. Overall, 615 cardiologists (38 [32-47] years old, 63% male) completed the survey, of which 58% were working in a university hospital and 26% were HF specialists. The threshold to define HFrEF was ≤40% for 61% of the physicians. Preferred drug prescription for the sequential approach was angiotensin-converting enzyme inhibitors or angiotensin receptor-neprilysin inhibitors first (74%), beta-blockers second (55%), mineralocorticoid receptor antagonists third (52%), and sodium-glucose cotransporter 2 inhibitors (53%) fourth. Eighty-four percent of participants felt that starting all four classes was feasible within the initial hospitalization, and 58% felt that titration is less important than introducing a new class. Age, status in training, and specialization in HF field were the principal characteristics that significantly impacted the answers. CONCLUSION In a broad international cardiology community, the 'historical approach' to HFrEF therapies remains the preferred sequencing approach. However, accelerated introduction and uptitration are also major treatment goals. Strategy trials in treatment guidance are needed to further change practices.
Collapse
Affiliation(s)
- Charles Fauvel
- CHU ROUEN, Department of Cardiology, FHU Carnaval, Rouen University Hospital, Rouen, France
- Internal Medicine Department, Cardiovascular Medicine Section, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Guillaume Bonnet
- Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Unité Médico-Chirurgical de Valvulopathies et Cardiomyopathies, Pessac, France
| | - Wilfried Mullens
- Ziekenhuis Oost-Limburg A.V, Genk, Belgium
- Hasselt University, Hasselt, Belgium
| | | | | | - Anders Barasa
- Department of Cardiology, Glostrup Hospital, Copenhagen, Denmark
| | - Mariya Tokmakova
- Cardiology Department, UMHAT 'Sv. Georgi' EAD Plovdi, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Anastasia Shchendrygina
- Cardiology Department, Department of Hospital Therapy No.2, Sechenov University, Moscow, Russia
| | | | - Massimo Mapelli
- Heart Failure Unit, Centro Cardiologico Monzino IRCCs, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Filip Zemrak
- Department of Cardiac Imaging, Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | - Laurens F Tops
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nina Jakus
- Department of Cardiology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Arian Sultan
- Department of Electrophysiology, Cologne, University Heart Center Cologne, Köln, Germany
| | - Fadel Bahouth
- Cardiology Department, Bnai Zion Hospital, Haifa, Israel
| | - Chahr-Eddine Hadjseyd
- Heart Failure Department and Clinical Investigation Center Inserm 1407, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Claude Bernard University, Lyon, France
| | | | - Matteo Anselmino
- Città della Salute e della Scienza di Torino, Hospital Department of Medical Sciences, University of Turin, Turin, Italy
| | - Daniel Messroghli
- Department of Internal Medicine and Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Vanessa Weberndörfer
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, The Netherlands
| | - Ilya Giverts
- Cardiopulmonary Exercise Core Laboratory, Massachusetts General Hospital, Boston, MA, USA
| | - Thomas Bochaton
- Heart Failure Department and Clinical Investigation Center Inserm 1407, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Claude Bernard University, Lyon, France
| | - Pierre Yves Courand
- Fédération de cardiologie, Hôpital de la Croix-Rousse et Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon
- France; Université de Lyon, CREATIS; CNRS UMR5220; INSERM U1044; INSA-Lyon; Université Claude Bernard Lyon 1, France
| | | | - Damien Legallois
- Service de Cardiologie et de Pathologie Vasculaire, Caen, France
| | - Florence Beauvais
- Inserm UMRS 942, Department of Cardiology, University of Paris, Paris, France
| | - Fabrice Bauer
- Service de Chirurgie Cardiaque, Clinique d'Insuffisance Cardiaque Avancée, Centre de Compétence en Hypertension Pulmonaire 27/76, Centre Hospitalier Universitaire Charles Nicolle, Rouen, France
| | - Nicolas Lamblin
- Université de Lille, Service de Cardiologie, CHU Lille, Institut Pasteur de Lille, Lille, France
| | - Thibaud Damy
- Réseau Cardiogen, Department of Cardiology, Centre Français de Référence de l'Amylose Cardiaque (CRAC), CHU d'Henri-Mondor, Créteil, France
| | - Nicolas Girerd
- Centre d'Investigation Clinique-Plurithématique Inserm CIC-P 1433, Inserm U1116, CHRU Nancy Brabois, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Université de Lorraine, Nancy, France
| | - Laurent Sebbag
- Heart Failure Department and Clinical Investigation Center Inserm 1407, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Claude Bernard University, Lyon, France
| | - Théo Pezel
- Inserm UMRS 942, Department of Cardiology, University of Paris, Paris, France
| | - Alain Cohen-Solal
- Inserm UMRS 942, Department of Cardiology, University of Paris, Paris, France
| | - Giuseppe Rosano
- Department of Cardiology, IRCCS San Raffaele Pisana, Rome, Italy
| | - François Roubille
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, Montpellier, France
| | - Nathan Mewton
- Heart Failure Department and Clinical Investigation Center Inserm 1407, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Claude Bernard University, Lyon, France
| |
Collapse
|
18
|
Louyot C, Portran P, Schweizer R, Glerant JC, Thivolet S, Brassart O, Mewton N, Jacquet-Lagreze M, Fellahi JL. Elaboration of a French version of the Duke Activity Status Index questionnaire and performance to predict functional capacity. Anaesth Crit Care Pain Med 2023; 42:101199. [PMID: 36706990 DOI: 10.1016/j.accpm.2023.101199] [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: 10/03/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Guidelines recommend detecting poor functional capacity (VO2max < 14 ml.kg-1.min-1) to assess preoperative cardiac risk. This screening is performed via a cardiopulmonary exercise test (CPET), the self-reported inability to climb two flights of stairs, or the use of the Duke Activity Status Index (DASI) questionnaire, which has shown a significant correlation with VO2max and postoperative outcomes. The objectives of the present study were: 1) to create a French version of the DASI questionnaire (FDASI); 2) to assess its diagnostic performance in predicting functional capacity. METHODS Consecutive adult patients undergoing CPET for medical or preoperative evaluation were prospectively included between May 2020 and March 2021. All patients were asked to complete FDASI as a self-questionnaire and report their inability to climb two flights of stairs. RESULTS 122 patients were included. Test-retest reliability was 0.88 and 23 (19%) patients experienced a VO2max < 14 ml.kg-1.min-1. There was a significant positive relationship between FDASI and VO2max: r2 = 0.32; p < 0.001. ROCAUC was 0.81 [95%CI: 0.73-0.89]. The best FDASI score threshold was 36 points, leading to sensitivity and specificity values of 87% [74-100] and 68% [56-79], respectively. Besides, sensitivity and specificity were 35% [17-56] and 92% [86-97] for the self-reported inability to climb two flights of stairs. CONCLUSION A FDASI score of 36 represents a reliable threshold the clinicians could routinely use to identify patients with a VO2max < 14 ml.kg-1.min-1. FDASI could advantageously replace the self-reported inability to climb two flights of stairs.
Collapse
Affiliation(s)
- Claire Louyot
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France.
| | - Philippe Portran
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France.
| | - Rémi Schweizer
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France
| | - Jean-Charles Glerant
- Service d'Explorations Fonctionnelles Respiratoires, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France
| | - Sophie Thivolet
- Service d'Explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France
| | - Océane Brassart
- Direction de la Recherche Clinique et de l'Innovation, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France
| | - Nathan Mewton
- Laboratoire CarMeN, Inserm UMR 1060, Université Claude Bernard Lyon 1, France
| | - Matthias Jacquet-Lagreze
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France; Laboratoire CarMeN, Inserm UMR 1060, Université Claude Bernard Lyon 1, France
| | - Jean-Luc Fellahi
- Service d'Anesthésie-Réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, 28 Avenue du Doyen Lépine, 69677 Bron Cedex, France; Laboratoire CarMeN, Inserm UMR 1060, Université Claude Bernard Lyon 1, France
| |
Collapse
|
19
|
Delbaere Q, Chapet N, Huet F, Delmas C, Mewton N, Prunier F, Angoulvant D, Roubille F. Anti-Inflammatory Drug Candidates for Prevention and Treatment of Cardiovascular Diseases. Pharmaceuticals (Basel) 2023; 16:ph16010078. [PMID: 36678575 PMCID: PMC9865197 DOI: 10.3390/ph16010078] [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: 10/09/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/07/2023] Open
Abstract
Incidence and mortality rates for cardiovascular disease are declining, but it still remains a major cause of morbidity and mortality. Drug treatments to slow the progression of atherosclerosis focus on reducing cholesterol levels. The paradigm shift to consider atherosclerosis an inflammatory disease by itself has led to the development of new treatments. In this article, we discuss the pathophysiology of inflammation and focus attention on therapeutics targeting different inflammatory pathways of atherosclerosis and myocardial infarction. In atherosclerosis, colchicine is included in new recommendations, and eight randomized clinical trials are testing new drugs in different inflammatory pathways. After a myocardial infarction, no drug has shown a significant benefit, but we present four randomized clinical trials with new treatments targeting inflammation.
Collapse
Affiliation(s)
- Quentin Delbaere
- Department of Cardiology, Arnaud de Villeneuve University Hospital, 34295 Montpellier, France
| | - Nicolas Chapet
- Department of Cardiology, Arnaud de Villeneuve University Hospital, 34295 Montpellier, France
| | - Fabien Huet
- Department of Cardiology, Arnaud de Villeneuve University Hospital, 34295 Montpellier, France
- Department of Cardiology, Bretagne Atlantique General Hospital, 56000 Vannes, France
| | - Clément Delmas
- Department of Cardiology, Arnaud de Villeneuve University Hospital, 34295 Montpellier, France
| | - Nathan Mewton
- Hôpital Cardiovasculaire Louis Pradel, 69002 Lyon, France
| | - Fabrice Prunier
- Department of Cardiology, CHU Angers, Université d’Angers, 49100 Angers, France
| | - Denis Angoulvant
- Cardiology Department, CHRU de Tours, 37044 Tours, France
- EA 4245 T2I, Université de Tours, 37044 Tours, France
| | - François Roubille
- Department of Cardiology, Arnaud de Villeneuve University Hospital, 34295 Montpellier, France
- Correspondence:
| |
Collapse
|
20
|
Petrusca L, Croisille P, Augeul L, Ovize M, Mewton N, Viallon M. Cardioprotective effects of shock wave therapy: A cardiac magnetic resonance imaging study on acute ischemia-reperfusion injury. Front Cardiovasc Med 2023; 10:1134389. [PMID: 37180809 PMCID: PMC10172681 DOI: 10.3389/fcvm.2023.1134389] [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: 12/30/2022] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Cardioprotection strategies remain a new frontier in treating acute myocardial infarction (AMI), aiming at further protect the myocardium from the ischemia-reperfusion damage. Therefore, we aimed at investigating the mechano-transduction effects induced by shock waves (SW) therapy at time of the ischemia reperfusion as a non-invasive cardioprotective innovative approach to trigger healing molecular mechanisms. Methods We evaluated the SW therapy effects in an open-chest pig ischemia-reperfusion (IR) model, with quantitative cardiac Magnetic Resonance (MR) imaging performed along the experiments at multiple time points (baseline (B), during ischemia (I), at early reperfusion (ER) (∼15 min), and late reperfusion (LR) (3 h)). AMI was obtained by a left anterior artery temporary occlusion (50 min) in 18 pigs (32 ± 1.9 kg) randomized into SW therapy and control groups. In the SW therapy group, treatment was started at the end of the ischemia period and extended during early reperfusion (600 + 1,200 shots @0.09 J/mm2, f = 5 Hz). The MR protocol included at all time points LV global function assessment, regional strain quantification, native T1 and T2 parametric mapping. Then, after contrast injection (gadolinium), we obtained late gadolinium imaging and extra-cellular volume (ECV) mapping. Before animal sacrifice, Evans blue dye was administrated after re-occlusion for area-at-risk sizing. Results During ischemia, LVEF decreased in both groups (25 ± 4.8% in controls (p = 0.031), 31.6 ± 3.2% in SW (p = 0.02). After reperfusion, left ventricular ejection fraction (LVEF) remained significantly decreased in controls (39.9 ± 4% at LR vs. 60 ± 5% at baseline (p = 0.02). In the SW group, LVEF increased quickly ER (43.7 ± 11.4% vs. 52.4 ± 8.2%), and further improved at LR (49.4 ± 10.1) (ER vs. LR p = 0.05), close to baseline reference (LR vs. B p = 0.92). Furthermore, there was no significant difference in myocardial relaxation time (i.e. edema) after reperfusion in the intervention group compared to the control group: ΔT1 (MI vs. remote) was increased by 23.2±% for SW vs. +25.2% for the controls, while ΔT2 (MI vs. remote) increased by +24.9% for SW vs. +21.7% for the control group. Discussion In conclusion, we showed in an ischemia-reperfusion open-chest swine model that SW therapy, when applied near the relief of 50' LAD occlusion, led to a nearly immediate cardioprotective effect translating to a reduction in the acute ischemia-reperfusion lesion size and to a significant LV function improvement. These new and promising results related to the multi-targeted effects of SW therapy in IR injury need to be confirmed by further in-vivo studies in close chest models with longitudinal follow-up.
Collapse
Affiliation(s)
- Lorena Petrusca
- Univ Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, Saint-Etienne, France
| | - Pierre Croisille
- Univ Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, Saint-Etienne, France
- Department of Radiology, Centre Hospitalier Universitaire de Saint- Etienne, Université Jean-Monnet, Saint-Etienne, France
| | - Lionel Augeul
- INSERM UMR 1060, CARMEN Laboratory, Université Lyon 1, Faculté de Medecine, Rockfeller, Lyon, France
| | - Michel Ovize
- INSERM UMR 1060, CARMEN Laboratory, Université Lyon 1, Faculté de Medecine, Rockfeller, Lyon, France
- Heart Failure Department, Clinical Investigation Center, Inserm 1407, HCL—Lyon, France
| | - Nathan Mewton
- INSERM UMR 1060, CARMEN Laboratory, Université Lyon 1, Faculté de Medecine, Rockfeller, Lyon, France
- Heart Failure Department, Clinical Investigation Center, Inserm 1407, HCL—Lyon, France
| | - Magalie Viallon
- Univ Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, Saint-Etienne, France
- Department of Radiology, Centre Hospitalier Universitaire de Saint- Etienne, Université Jean-Monnet, Saint-Etienne, France
- Correspondence: Magalie Viallon
| |
Collapse
|
21
|
Harhous Z, Paccalet A, Badawi S, Ovize M, Augeul L, Pillot B, Gomez L, Bochaton T, Mewton N, da Silva CC, Kurdi M, Bidaux G. Ischemic post-conditioning requires STAT3 pathway to finely-tune early inflammation at reperfusion onset in mouse myocardium. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.028] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
22
|
Badawi S, Leboullenger C, Chourout M, Gouriou Y, Paccalet A, Berd C, Pillot B, Augeul L, Bolbos R, Bongiovani A, Ovize M, Mewton N, Bochaton T, Tardivel M, Canet-Soulas E, da Silva CC, Bidaux G. A novel fluorescence imaging of myoglobin redox STATE reveals early reperfusion-injury in myocardium. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.139] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
23
|
Cour M, Klouche K, Souweine B, Quenot JP, Schwebel C, Perinel S, Amaz C, Buisson M, Ovize M, Mewton N, Argaud L. Remote ischemic conditioning in septic shock: the RECO-Sepsis randomized clinical trial. Intensive Care Med 2022; 48:1563-1572. [PMID: 36100725 DOI: 10.1007/s00134-022-06872-1] [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: 05/31/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine whether remote ischemic conditioning (RECO), compared to standard care, limits the severity and the consequences of multiple organ failure in patients with septic shock. METHODS The RECO-Sepsis trial, a prospective, multicenter, randomized, open-label, parallel group trial with blinded assessment of the outcome, was conducted at six intensive care units in France in adult patients with septic shock. Within 12 h after the onset of septic shock, patients were randomized (1:1 ratio) to receive either RECO applied by inflating/deflating (200/0 mmHg for 5/5 min) 4 times a cuff around an arm or a sham procedure every 12 h for 24 h. The primary endpoint was the severity of multiple organ failure assessed by the mean daily Sequential Organ Failure Assessment (SOFA) score from inclusion to the fourth day after inclusion (day 4). Patients were followed for 90 days. RESULTS Among 180 randomized patients, 178 completed the trial (RECO group: 87; control group: 91) and were included in the intention-to-treat analysis (108 men [60.7%], median age 68 [59-75] years). There was no significant difference in the mean daily SOFA score between the intervention group and the control group (7.2 points [5.2-10.7] versus 7.6 points [4.9-10.7], respectively; p = 0.919). Cumulative mortality within 90 days was 27.6% in the RECO group and 39.6% control group (Log-rank test, p = 0.10; adjusted hazard ratio 0.59, 95% CI, 0.35 to 0.99; p = 0.049). CONCLUSIONS In patients with septic shock, RECO failed to reduce the severity of organ failures assessed by mean daily SOFA score from inclusion to day 4. Adequately powered trials are needed to assess potential delayed benefits of RECO.
Collapse
Affiliation(s)
- Martin Cour
- Médecine Intensive-Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Intensive-Réanimation, 5, Place d'Arsonval, 69437, Lyon Cedex 03, France.
- Faculté de Médecine Lyon-Est, Université de Lyon, Lyon, France.
| | - Kada Klouche
- Service de Médecine Intensive-Réanimation, CHU de Montpellier, Montpellier, France
| | - Bertrand Souweine
- Service de Médecine Intensive-Réanimation, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Jean-Pierre Quenot
- Service de Médecine Intensive-Réanimation, CHU François-Mitterrand, Dijon, France
| | - Carole Schwebel
- Service de Médecine Intensive-Réanimation, CHU Albert Michallon, Grenoble, France
| | - Sophie Perinel
- Service de Médecine Intensive-Réanimation, CHU de Saint-Etienne, Saint-Etienne, France
| | - Camille Amaz
- Centre d'Investigations Cliniques (CIC), Hospices Civils de Lyon, Hôpital Cardiologique Louis Pradel, Bron, France
| | - Marielle Buisson
- Centre d'Investigations Cliniques (CIC), Hospices Civils de Lyon, Hôpital Cardiologique Louis Pradel, Bron, France
| | - Michel Ovize
- Faculté de Médecine Lyon-Est, Université de Lyon, Lyon, France
- Centre d'Investigations Cliniques (CIC), Hospices Civils de Lyon, Hôpital Cardiologique Louis Pradel, Bron, France
| | - Nathan Mewton
- Faculté de Médecine Lyon-Est, Université de Lyon, Lyon, France
- Centre d'Investigations Cliniques (CIC), Hospices Civils de Lyon, Hôpital Cardiologique Louis Pradel, Bron, France
| | - Laurent Argaud
- Médecine Intensive-Réanimation, Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Intensive-Réanimation, 5, Place d'Arsonval, 69437, Lyon Cedex 03, France
- Faculté de Médecine Lyon-Est, Université de Lyon, Lyon, France
| |
Collapse
|
24
|
Mechtouff L, Debs N, Frindel C, Bani-Sadr A, Bochaton T, Paccalet A, Crola Da Silva C, Buisson M, Amaz C, Berthezene Y, Eker OF, Bouin M, de Bourguignon C, Mewton N, Ovize M, Bidaux G, Nighoghossian N, Cho TH. Association of Blood Biomarkers of Inflammation With Penumbra Consumption After Mechanical Thrombectomy in Patients With Acute Ischemic Stroke. Neurology 2022; 99:e2063-e2071. [PMID: 36316128 DOI: 10.1212/wnl.0000000000201038] [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] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The objective of this study was to assess the relationship between blood biomarkers of inflammation and lesion growth within the penumbra in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT). METHODS The HIBISCUS-STROKE cohort enrolled patients admitted in the Lyon Stroke Center for an anterior circulation AIS treated with MT after brain MRI assessment. Lesion growth within the penumbra was assessed on day 6 MRI using a voxel-based nonlinear coregistration method and dichotomized into low and high according to the median value. C-reactive protein, interleukin (IL)-6, IL-8, IL-10, monocyte chemoattractant protein-1, soluble tumor necrosis factor receptor I, soluble form suppression of tumorigenicity 2 (sST2), soluble P-selectin, vascular cellular adhesion molecule-1, and matrix metalloproteinase-9 were measured in sera at 4 time points within the first 48 hours. Reperfusion was considered as successful if Thrombolysis in Cerebral Infarction score was 2b/2c/3. A multiple logistic regression model was performed to detect any association between area under the curve (AUC) of these biomarkers within the first 48 hours and a high lesion growth within the penumbra. RESULTS Ninety patients were included. The median lesion growth within the penumbra was 2.3 (0.7-6.2) mL. On multivariable analysis, a high sST2 AUC (OR 3.77, 95% CI 1.36-10.46), a high baseline DWI volume (OR 3.65, 95% CI 1.32-10.12), and a lack of successful reperfusion (OR 0.19, 95% CI 0.04-0.92) were associated with a high lesion growth within the penumbra. When restricting analyses to patients with successful reperfusion (n = 76), a high sST2 AUC (OR 5.03, 95% CI 1.64-15.40), a high baseline DWI volume (OR 3.74, 95% CI 1.22-11.53), and a high penumbra volume (OR 3.25, 95% CI 1.10-9.57) remained associated with a high lesion growth within the penumbra. DISCUSSION High sST2 levels within the first 48 hours are associated with a high lesion growth within the penumbra.
Collapse
Affiliation(s)
- Laura Mechtouff
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France.
| | - Noelie Debs
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Carole Frindel
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Alexandre Bani-Sadr
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Thomas Bochaton
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Alexandre Paccalet
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Claire Crola Da Silva
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Marielle Buisson
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Camille Amaz
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Yves Berthezene
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Omer Faruk Eker
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Morgane Bouin
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Charles de Bourguignon
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Nathan Mewton
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Michel Ovize
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Gabriel Bidaux
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Norbert Nighoghossian
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| | - Tae-Hee Cho
- From the Stroke Department (L.M., N.N., T.-H.C.), Hospices Civils de Lyon; Univ Lyon (L.M., T.B., A.P., C.C.D.S., M.O., G.B., N.N., T.-H.C.), CarMeN Laboratory, INSERM, INRA, University Lyon 1; CREATIS (N.D., C.F., Y.B.), CNRS UMR 5220, INSERM U1044, University Lyon 1; Neuroradiology Department (A.B.-S., Y.B., O.F.E.), Hospices Civils de Lyon; Cardiac Intensive Care Unit (T.B.), Hospices Civils de Lyon; Clinical Investigation Center (M.B., C.A., C.d.B., N.M., M.O.), INSERM 1407, Hospices Civils de Lyon; and Cellule Recherche Imagerie (M.B.), Hospices Civils de Lyon, France
| |
Collapse
|
25
|
Rajinthan P, Gardey K, Boccalini S, Si-Mohammed S, Dulac A, Berger C, Placide L, Delinière A, Mewton N, Chevalier P, Bessière F. CMR - Late gadolinium enhancement characteristics associated with monomorphic ventricular arrhythmia in patients with non-ischemic cardiomyopathy. Indian Pacing Electrophysiol J 2022; 22:225-230. [PMID: 35931352 PMCID: PMC9463474 DOI: 10.1016/j.ipej.2022.07.007] [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: 03/21/2022] [Revised: 06/27/2022] [Accepted: 07/22/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Priyanka Rajinthan
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Kevin Gardey
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Sara Boccalini
- Radiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue Du Doyen Lépine, 69394 LYON Cedex 03, Hospices Civils de Lyon, France
| | - Salim Si-Mohammed
- Radiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue Du Doyen Lépine, 69394 LYON Cedex 03, Hospices Civils de Lyon, France; Creatis, UMR CNRS 5220, INSERM U 1044, Université Claude Bernard Lyon 1, France
| | - Arnaud Dulac
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Clothilde Berger
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Leslie Placide
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Antoine Delinière
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Nathan Mewton
- Centre d'investigation Clinique, Hôpital Cardiologique Louis Pradel, 28 Avenue Du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Philippe Chevalier
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France
| | - Francis Bessière
- Cardiac Electrophysiology Department, Hôpital Cardiologique Louis Pradel, 28 Avenue du Doyen Lépine, 69394, Lyon Cedex 03, Hospices Civils de Lyon, France; LabTau, INSERM U 1032, Université Claude Bernard Lyon 1, France.
| |
Collapse
|
26
|
Rascle L, Nighoghossian N, Cho TH, Bochaton T, Paccalet A, Da Silva CC, Buisson M, Amaz C, Fontaine J, Ong E, Derex L, Berthezene Y, Eker OF, Mewton N, Ovize M, Mechtouff L. Inflammatory profile and white matter hyperintensity burden in acute ischemic stroke patients. J Neuroimmunol 2022; 371:577934. [DOI: 10.1016/j.jneuroim.2022.577934] [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] [Received: 03/29/2022] [Revised: 07/10/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022]
|
27
|
Goninet M, Bourdin J, Kochly F, Tores C, Prieur C, Scheppler B, Tomasevic D, Roccia H, Mewton N, Bonnefoy-Cudraz E, Bochaton T. Prognostic factors in a contemporary cohort of cardiogenic shocks managed in ICU. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.089] [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: 11/17/2022]
|
28
|
Dietz M, Kamani CH, Dunet V, Fournier S, Rubimbura V, Testart Dardel N, Schaefer A, Jreige M, Boughdad S, Nicod Lalonde M, Schaefer N, Mewton N, Prior JO, Treglia G. Overview of the RGD-Based PET Agents Use in Patients With Cardiovascular Diseases: A Systematic Review. Front Med (Lausanne) 2022; 9:887508. [PMID: 35602497 PMCID: PMC9120643 DOI: 10.3389/fmed.2022.887508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/02/2022] [Accepted: 04/19/2022] [Indexed: 01/02/2023] Open
Abstract
Studies using arginine–glycine–aspartate (RGD)-PET agents in cardiovascular diseases have been recently published. The aim of this systematic review was to perform an updated, evidence-based summary about the role of RGD-based PET agents in patients with cardiovascular diseases to better address future research in this setting. Original articles within the field of interest reporting the role of RGD-based PET agents in patients with cardiovascular diseases were eligible for inclusion in this systematic review. A systematic literature search of PubMed/MEDLINE and Cochrane library databases was performed until October 26, 2021. Literature shows an increasing role of RGD-based PET agents in patients with cardiovascular diseases. Overall, two main topics emerged: the infarcted myocardium and atherosclerosis. The existing studies support that αvβ3 integrin expression in the infarcted myocardium is well evident in RGD PET/CT scans. RGD-based PET radiotracers accumulate at the site of infarction as early as 3 days and seem to be peaking at 1–3 weeks post myocardial infarction before decreasing, but only 1 study assessed serial changes of myocardial RGD-based PET uptake after ischemic events. RGD-based PET uptake in large vessels showed correlation with CT plaque burden, and increased signal was found in patients with prior cardiovascular events. In human atherosclerotic carotid plaques, increased PET signal was observed in stenotic compared with non-stenotic areas based on MR or CT angiography data. Histopathological analysis found a co-localization between tracer accumulation and areas of αvβ3 expression. Promising applications using RGD-based PET agents are emerging, such as prediction of remodeling processes in the infarcted myocardium or detection of active atherosclerosis, with potentially significant clinical impact.
Collapse
Affiliation(s)
- Matthieu Dietz
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
| | - Christel H. Kamani
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Vincent Dunet
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Stephane Fournier
- Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Vladimir Rubimbura
- Cardiology Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Nathalie Testart Dardel
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Ana Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Mario Jreige
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Sarah Boughdad
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Marie Nicod Lalonde
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Niklaus Schaefer
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
| | - Nathan Mewton
- INSERM U1060, CarMeN Laboratory, University of Lyon, Lyon, France
- Cardiovascular Hospital Louis Pradel, Department of Heart Failure, Hospices Civils de Lyon, Lyon, France
- Clinical Investigation Center Inserm 1407, Lyon, France
| | - John O. Prior
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
- *Correspondence: John O. Prior
| | - Giorgio Treglia
- Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne, Lausanne, Switzerland
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Università della Svizzera Italiana, Lugano, Switzerland
| |
Collapse
|
29
|
Legras M, Amaz C, Bochaton T, Mewton N, Soulage C, Guebre-Egziabher F. MO464: Long-Term Renal Outcomes After ST-Elevation Myocardial Infarction Treated by Percutaneaous Coronary Intervention. Nephrol Dial Transplant 2022. [DOI: 10.1093/ndt/gfac070.078] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND AND AIMS
Among patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI), short- and long-term renal function evaluations are of prime importance. Most studies have focused on short-term renal dysfunction and acute kidney injury (AKI) occurrence after STEMI treated by PCI, which is associated with major adverse cardiovascular events (MACE) and especially the occurrence of heart failure. However, few studies have focused on long-term renal outcomes.
We aimed to describe renal function evolution and to determine predictors of estimated glomerular filtration rate (eGFR) decline one year after STEMI is treated by PCI.
METHOD
From May 2016 to July 2020, 322 consecutive patients with STEMI who underwent PCI revascularization were enrolled prospectively.
Serum creatinine (SCr) concentration was routinely measured at patient admission, after 48 h or hospital discharge, then during systematic 1-month and 1-year clinical check-ups, AKI was determined according to the Acute Kidney Injury Network (AKIN) definition. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD EPI) formula. The evolution of renal function was evaluated by the difference between admission and 1-month or 1-year eGFR. Rapid progression was defined as a decline in eGFR of more than 5 mL/min/1.73m² per year. Determinants of eGFR decline ≥ 10 mL/min/1.73m² per year were analyzed with multivariate logistic regressions.
RESULTS
The mean age was 59.6 years, 29.5% of patients had a medical history of hypertension, 13.8% had diabetes and 52.8% presented with anterior myocardial infarction. Median admission SCr concentration was 71 µmol/L, with an eGFR of 96.5 mL/min/1.73m² [inter quartile range (IQR): 84.4–105.1]. A total of 38 patients (11.8%) developed AKI.
In the whole population median eGFR decline was 7.7 mL/min/1.73 m² (1.2–14.4) and 8 mL/min/1.73 m² [1.3–15.9] 1-month and 1-year after STEMI respectively (Figure 1). Rapid eGFR decline was found in 59.7% of the total population and 44.6% of patients presented a 1-year eGFR decline of at least 10 mL/min/1.73 m². AKI patients had significant lower eGFR at 1-month and 1-year follow up (median 1-year eGFR of 74.5 mL/min/1.73m² (52.4–96.4) versus 88.1 mL/min/1.73m² (74.0–100.3) in non-AKI patients, P = 0.01). There was no significant difference between AKI and non-AKI patients regarding rates of eGFR decline at both 1-month and 1-year after inclusion.
Multivariate analysis (Table 1) showed that age and 1-month eGFR decline was significantly associated with 1-year eGFR decline ≥ 10 mL/min/1.73m². Especially, 1-month eGFR decline greater than 10 mL/min/1.73m² was an independent and stratified predictor of 1-year eGFR decline with an odds ratio (OR) of 7.45 [95% confidence interval (CI): 2.76–22.81, P < 0.01). AKI occurrence and peak hs-I troponin were not found as predictors of 1-year eGFR decline.
CONCLUSION
Among STEMI patients treated by PCI, a large majority of patients present a significant decline in renal function 1-year after STEMI, regardless of AKI occurrence or infarct size. One-month eGFR decline is a strong predictor of 1-year eGFR evolution and could help identify high-risk patients and adjust nephrological care. Our findings bear important clinical implications and underline the need for longitudinal follow-up of renal function after STEMI is treated by PCI.
Collapse
Affiliation(s)
- Marie Legras
- Hopital Edouard Herriot, Néphrologie, Lyon, France
- Laboratoire CarMeN, Institution National de la Santé et de la Recherche Médicale 1060 Université Lyon 1, France
| | - Camille Amaz
- Centre d'investigation Clinique Hôpital Louis Pradel, Bron, France
| | - Thomas Bochaton
- Laboratoire CarMeN, Institution National de la Santé et de la Recherche Médicale 1060 Université Lyon 1, France
- Hôpital Louis Pradel, Cardiologie, BRON, France
| | - Nathan Mewton
- Centre d'investigation Clinique Hôpital Louis Pradel, Bron, France
- Hôpital Louis Pradel, Cardiologie, BRON, France
| | - Christophe Soulage
- Laboratoire CarMeN, Institution National de la Santé et de la Recherche Médicale 1060 Université Lyon 1, France
| | - Fitsum Guebre-Egziabher
- Hopital Edouard Herriot, Néphrologie, Lyon, France
- Laboratoire CarMeN, Institution National de la Santé et de la Recherche Médicale 1060 Université Lyon 1, France
| |
Collapse
|
30
|
Girerd N, Mewton N, Tartière JM, Guijarro D, Jourdain P, Damy T, Lamblin N, Bayes-Génis A, Pellicori P, Januzzi J, Rossignol P, Roubille F. Practical outpatient management of worsening chronic heart failure. Eur J Heart Fail 2022; 24:750-761. [PMID: 35417093 PMCID: PMC9325366 DOI: 10.1002/ejhf.2503] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 10/05/2021] [Revised: 04/04/2022] [Accepted: 04/10/2022] [Indexed: 11/12/2022] Open
Abstract
Management of worsening heart failure (WHF) has traditionally been hospital‐based, but with the rising burden of heart failure (HF), the pressure on healthcare systems exerted by this disease necessitates a different strategy than long (and costly) hospital stays. A strategy for outpatient intravenous (IV) diuretic treatment of WHF has been developed in certain American centres in the past 10 years, whereas European centres have been mostly favouring ‘classic’ in‐hospital management of WHF. Embracing novel, outpatient approaches for treating WHF could substantially reduce the burden on healthcare systems while improving patient's satisfaction and quality of life. The present article is intended to provide essential knowledge and practical guidelines aimed at helping clinicians implement these new ambulatory approaches using day hospital and/or at‐home hospitalization. The topics addressed by our group of HF experts include the pathophysiological background of diuretic therapy, the most suitable profile of WHF that may be managed in an ambulatory setting, the pharmacological protocols that can be used, as well as a detailed description of healthcare structures that can be proposed to deliver these ambulatory care interventions. The practical aspects of day hospital and hospital‐at‐home IV diuretic administration are specifically emphasized. The algorithm provided along with the practical IV diuretic protocols should assist HF clinicians in implementing this new approach in their local clinical setting.
Collapse
Affiliation(s)
- Nicolas Girerd
- Université de Lorraine, Centre d'Investigation Clinique- Plurithématique Inserm CIC-P 1433, Inserm U1116, CHRU Nancy Brabois, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Nathan Mewton
- Hôpital Cardiovasculaire Louis Pradel Hospices Civils de Lyon Heart Failure Department Clinical Investigation Center Inserm 1407 CarMeN Inserm 1060, University Claude Bernard Lyon 1 28 Avenue Doyen Lépine 69500, Bron
| | | | - Damien Guijarro
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Patrick Jourdain
- Covidom regional telemedicine platform, Assistance Publique-Hôpitaux de Paris, Paris, France; Cardiology Department, University Hospital of Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin Bicêtre, France
| | - Thibaud Damy
- Réseau cardiogen, Department of Cardiology, centre français de référence de l'amylose cardiaque (CRAC), CHU d'Henri-Mondor, AP-HP, 94000, Créteil, France
| | - Nicolas Lamblin
- Department of Cardiology, Université de Lille, 59000, Lille, France
| | - Antoni Bayes-Génis
- CIBERCV; Servicio de Cardiología. Hospital Germans Trias i Pujol. Universitat Autònoma de Barcelona. Barcelona., Spain
| | - Pierpaolo Pellicori
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - James Januzzi
- Cardiology Division, Massachusetts General Hospital, Baim Institute for Clinical Research, Harvard Medical School, Boston, MA, USA
| | - Patrick Rossignol
- Université de Lorraine, Centre d'Investigation Clinique- Plurithématique Inserm CIC-P 1433, Inserm U1116, CHRU Nancy Brabois, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - François Roubille
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, France
| |
Collapse
|
31
|
Mewton N, Derimay F, Motreff P, Angoulvant D, Rioufol G. Reply. J Am Coll Cardiol 2022; 79:e233. [DOI: 10.1016/j.jacc.2022.01.031] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/29/2022]
|
32
|
Mewton N, Sebbag L. "Don't Be Frail to Optimize Heart Failure Therapies!". JACC Heart Fail 2022; 10:276-277. [PMID: 35361447 DOI: 10.1016/j.jchf.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Nathan Mewton
- Cardiovascular Hospital Louis Pradel, Heart Failure Department and Clinical Investigation Center, Inserm 1407 & Carmen 1060, University Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France.
| | - Laurent Sebbag
- Cardiovascular Hospital Louis Pradel, Heart Failure Department and Clinical Investigation Center, Inserm 1407 & Carmen 1060, University Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
33
|
Bochaton T, Leboube S, Paccalet A, Crola Da Silva C, Buisson M, Mewton N, Amaz C, Varillon Y, Bonnefoy-Cudraz E, Rioufol G, Cho TH, Ovize M, Bidaux G, Nighoghossian N, Mechtouff L. Impact of Age on Systemic Inflammatory Profile of Patients With ST-Segment-Elevation Myocardial Infarction and Acute Ischemic Stroke. Stroke 2022; 53:2249-2259. [PMID: 35354295 DOI: 10.1161/strokeaha.121.036806] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Aging is associated with a chronic low-grade inflammatory state. This condition may affect the acute inflammatory response involved in ST-segment-elevation myocardial infarction (STEMI) or acute ischemic stroke (AIS). We sought to compare the profile of a set of circulating inflammatory markers between young and older patients admitted for STEMI or AIS. METHODS HIBISCUS-STEMI (Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in ST Elevation Myocardial Infarction) and HIBISCUS-STROKE (Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in Stroke) are 2 cohort studies that enrolled patients with STEMI treated with primary percutaneous coronary intervention in the cardiac intensive care unit of Lyon and patients with AIS treated with mechanical thrombectomy in the Lyon Stroke Center, respectively from 2016 to 2019. Patients were classified as older if they were ≥65 years and as young if they were <65 years. In both cohorts, CRP (C-reactive protein), IL (interleukin)-6, IL-8, IL-10, MCP (monocyte chemoattractant protein), sTNF-RI (soluble tumor necrosis factor receptor I), sST2 (soluble form suppression of tumorigenicity 2), and VCAM-1 (vascular cellular adhesion molecule-1) were measured on serum collected at 5 time points using enzyme-linked immunosorbent assay. A multiple logistic regression model was performed to detect an association between area under the curve of circulating inflammatory markers within the first 48 hours and older age. RESULTS A total of 260 patients with STEMI and 164 patients with AIS were included. Of them, there were 76 (29%) and 105 (64%) older patients with STEMI and AIS, respectively. Following multivariable analysis, a high area under the curve of IL-6 and sTNF-RI, a low lymphocyte count, and a high neutrophil-lymphocyte ratio at 24 hours were associated with older age in patients with STEMI and AIS. CONCLUSIONS Older patients had higher IL-6 and sTFN-RI levels within the first 48 hours associated with a lower lymphocyte count and a higher neutrophil-lymphocyte ratio at 24 hours in both cohorts.
Collapse
Affiliation(s)
- Thomas Bochaton
- Cardiac Intensive Care Unit (T.B., E.B.-C.).,Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Simon Leboube
- Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Alexandre Paccalet
- Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Claire Crola Da Silva
- Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Marielle Buisson
- Clinical Investigation Center, INSERM 1407 (M.B., N.M., C.A., Y.V., M.O.)
| | - Nathan Mewton
- Clinical Investigation Center, INSERM 1407 (M.B., N.M., C.A., Y.V., M.O.).,Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Camille Amaz
- Clinical Investigation Center, INSERM 1407 (M.B., N.M., C.A., Y.V., M.O.)
| | - Yvonne Varillon
- Clinical Investigation Center, INSERM 1407 (M.B., N.M., C.A., Y.V., M.O.)
| | - Eric Bonnefoy-Cudraz
- Cardiac Intensive Care Unit (T.B., E.B.-C.).,Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Gilles Rioufol
- Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Tae-Hee Cho
- Louis Pradel Hospital, Stroke Center, Hôpital Pierre Wertheimer (T.-H.C., N.N., L.M.).,Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Michel Ovize
- Clinical Investigation Center, INSERM 1407 (M.B., N.M., C.A., Y.V., M.O.).,Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Gabriel Bidaux
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, F-69500 Bron, France (G.R.)
| | - Norbert Nighoghossian
- Louis Pradel Hospital, Stroke Center, Hôpital Pierre Wertheimer (T.-H.C., N.N., L.M.).,Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| | - Laura Mechtouff
- Louis Pradel Hospital, Stroke Center, Hôpital Pierre Wertheimer (T.-H.C., N.N., L.M.).,Hospices Civils de Lyon, F-69500 Bron, France. INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, F-69500 Bron, France (T.B., S.L., A.P., C.C.D.S., N.M., E.B.-C., T.-H.C., M.O., G.B., N.N., L.M.)
| |
Collapse
|
34
|
Zupan Mežnar A, Žižek D, Mewton N. Atrioventricular dromotropathy: an important substrate for complete resynchronization therapy. Europace 2022; 24:868. [PMID: 35352812 DOI: 10.1093/europace/euac036] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
- Anja Zupan Mežnar
- Cardiology Department, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000Ljubljana, Slovenia
| | - David Žižek
- Cardiology Department, University Medical Centre Ljubljana, Zaloška Cesta 7, 1000Ljubljana, Slovenia
| | - Nathan Mewton
- Heart Failure Department, Hôpital Cardio-Vasculaire Louis Pradel, Clinical Investigation Center Inserm 1407, CarMeN Inserm 1060, Hospices Civils de Lyon, Claude Barnard University Lyon 1, Lyon, France
| |
Collapse
|
35
|
Rascle L, Bani Sadr A, Amaz C, Mewton N, Buisson M, Hermier M, Ong E, Fontaine J, Derex L, Berthezène Y, Eker OF, Cho TH, Nighoghossian N, Mechtouff L. Does the Brush-Sign Reflect Collateral Status and DWI-ASPECTS in Large Vessel Occlusion? Front Neurol 2022; 13:828256. [PMID: 35309551 PMCID: PMC8924293 DOI: 10.3389/fneur.2022.828256] [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] [Received: 12/03/2021] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction The relevance of the brush-sign remained poorly documented in large vessel occlusion (LVO). We aimed to assess the relationship between the brush-sign and collateral status and its potential impact on baseline diffusion-weighted imaging–Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) in acute ischemic stroke (AIS) patients eligible to mechanical thrombectomy (MT). Methods Consecutive patients admitted in the Lyon Stroke Center with anterior circulation AIS due to intracranial internal carotid artery (ICA) and/or M1 or M2 segment of the middle cerebral artery (MCA) occlusion eligible for MT were included. The brush-sign was assessed on T2-gradient-echo MRI. Collateral status was assessed on digital subtraction angiography according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) score. Results In this study, 504 patients were included, among which 171 (33.9%) patients had a brush-sign. Patients with a brush-sign more frequently had a poor collateral status [72 (42.1%) vs. 103 (30.9%); p = 0.017]. In univariable analysis, a DWI-ASPECTS < 7 was associated with a brush sign. Following multivariable analysis, the brush-sign no longer affected DWI-ASPECTS < 7 while the latter remained associated with younger age [odds ratio (OR) 0.97, 95% CI.96–0.99], male sex (OR 1.79, 95% CI 1.08–2.99), a higher National Institutes of Health Stroke Scale (NIHSS) score (OR 1.16, 95% CI 1.1–1.21), a poor collateral status (OR 9.35, 95% CI 5.59-16.02), MCA segment (OR 2.54, 95% CI 1.25–5.38), and intracranial ICA (OR 3.01, 95% CI 1.16–8) occlusion. Conclusions and Relevance The brush-sign may be a marker of poor collateral status but did not independently predict a lower DWI-ASPECTS. Clinical Trial Registration ClinicalTrials.gov, identifier: NCT04620642.
Collapse
Affiliation(s)
- Lucie Rascle
- Department of Stroke, Hospices Civils de Lyon, Lyon, France
| | | | - Camille Amaz
- Clinical Investigation Center, Hospices Civils de Lyon, INSERM, Lyon, France
| | - Nathan Mewton
- Clinical Investigation Center, Hospices Civils de Lyon, INSERM, Lyon, France
| | - Marielle Buisson
- Clinical Investigation Center, Hospices Civils de Lyon, INSERM, Lyon, France
| | - Marc Hermier
- Department of Neuroradiology, Hospices Civils de Lyon, Lyon, France
| | - Elodie Ong
- Department of Stroke, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, INSERM, University Lyon 1, Lyon, France
| | - Julia Fontaine
- Department of Stroke, Hospices Civils de Lyon, Lyon, France
| | - Laurent Derex
- Department of Stroke, Hospices Civils de Lyon, Lyon, France
| | - Yves Berthezène
- Department of Neuroradiology, Hospices Civils de Lyon, Lyon, France
| | - Omer Faruk Eker
- Department of Neuroradiology, Hospices Civils de Lyon, Lyon, France
| | - Tae-Hee Cho
- Department of Stroke, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, INSERM, University Lyon 1, Lyon, France
| | - Norbert Nighoghossian
- Department of Stroke, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, INSERM, University Lyon 1, Lyon, France
| | - Laura Mechtouff
- Department of Stroke, Hospices Civils de Lyon, Lyon, France
- CarMeN Laboratory, INSERM, University Lyon 1, Lyon, France
- *Correspondence: Laura Mechtouff
| |
Collapse
|
36
|
Hayek A, Azar L, Pozzi M, Grinberg D, Abou-Saleh I, Simion H, Tomasevic D, Prieur C, Kochly F, Scheppler B, Rioufol G, Derimay F, Farhat F, Obadia JF, Mewton N, Bonnefoy-Cudraz E, Bochaton T. Ventricular septal rupture: insights into an old disease. Heart Vessels 2022; 37:1305-1315. [PMID: 35133497 DOI: 10.1007/s00380-022-02031-0] [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: 10/06/2021] [Accepted: 01/21/2022] [Indexed: 11/04/2022]
Abstract
Ventricular septal rupture (VSR) is a serious complication of ST-elevation myocardial infarction (STEMI) and surgery is the reference treatment. We aimed at describing trends in management and mortality during the last four decades and reporting mortality predictors in these patients. We conducted a single-center retrospective study of patients sustaining a VSR from 1981 to 2020. We screened 274 patients and included 265 for analysis. The number of patients decreased over the years: 80, 88, 56, and 50 in each 10-year time span. In-hospital mortality decreased significantly since 1990 (logrank 0.007). The median age was 72.0 years IQR [66-78] and 188 patients (70.9%) were operated on. IABP was used more routinely (p < 0.0001). In-hospital mortality was assessed at 66.8% (177 patients) and main predictors of death were a time from MI to surgery < 8 days HR 2.7 IC95% [1.9-3.8] p < 0.0001, a Killip class > 2 HR 2.5 IC [1.9-3.4] p < 0.0001 and Euroscore 2 > 20 HR 2.4 IC [1.8-3.2] p < 0.0001. A "time from MI to surgery" of 8 days offers the best ability to discriminate between patients with or without mortality. The ability of "Euroscore 2 and Killip" to detect the patients most likely to wait 8 days for surgery was at 0.81 [0.73-0.89] p < 0.0001. Mortality remains high over the years. Euroscore 2, Killip class, and time from MI to surgery are the main mortality predictors. Patients with a Killip < 3 and a Euroscore < 20 should be monitored at least 8 days since MI before being referred to surgery.
Collapse
Affiliation(s)
- Ahmad Hayek
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France. .,Claude Bernard University Lyon 1, Villeurbanne, France. .,INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France.
| | - Léa Azar
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Matteo Pozzi
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, 28 Avenue du Doyen Lépine, 69500, Lyon, France
| | - Daniel Grinberg
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, 28 Avenue du Doyen Lépine, 69500, Lyon, France
| | - Iyad Abou-Saleh
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Héléna Simion
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Danka Tomasevic
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Cyril Prieur
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Flora Kochly
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Bertrand Scheppler
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Gilles Rioufol
- Claude Bernard University Lyon 1, Villeurbanne, France.,Department of Cardiology and Interventional Cardiology, Hôpital Cardiologique Louis Pradel, Université Claude-Bernard, Inserm UMR 1060, Lyon, France
| | - François Derimay
- Claude Bernard University Lyon 1, Villeurbanne, France.,Department of Cardiology and Interventional Cardiology, Hôpital Cardiologique Louis Pradel, Université Claude-Bernard, Inserm UMR 1060, Lyon, France
| | - Fadi Farhat
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, 28 Avenue du Doyen Lépine, 69500, Lyon, France
| | - Jean-François Obadia
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, 28 Avenue du Doyen Lépine, 69500, Lyon, France
| | - Nathan Mewton
- Claude Bernard University Lyon 1, Villeurbanne, France.,Centre d'investigation Clinique, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
| | - Eric Bonnefoy-Cudraz
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France
| | - Thomas Bochaton
- Cardiac Intensive Care Unit, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.,Claude Bernard University Lyon 1, Villeurbanne, France.,INSERM U1060, CarMeN laboratory, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
| |
Collapse
|
37
|
Xavier D, Floris C, Fabrice P, Angoulvant D, Mewton N, Roubille F, Pascal R, Marc F, Valérie M, Laurane C, Alain F, Gabriel G, Loïc B, Delphine MP. Post-infarct cardiac remodeling predictions with machine learning. Int J Cardiol 2022; 355:1-4. [DOI: 10.1016/j.ijcard.2022.02.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 11/05/2022]
|
38
|
Facile A, Mewton N, Nguon M, Durand de Gevigney G, Grinberg D, Bodenan E, Samson G, Plattner V, Trochu JN, Cornu C. Primary endpoint adjudication: comparison between the expert committee and the regulatory MedDRA® coding in the MITRA-FR study. Eur J Heart Fail 2021; 24:396-398. [PMID: 34907629 DOI: 10.1002/ejhf.2401] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 12/01/2021] [Accepted: 12/12/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Anthony Facile
- Direction de la Recherche Clinique et de l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Nathan Mewton
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center & Heart Failure Department, INSERM 1407, Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | - Marina Nguon
- Direction de la Recherche Clinique et de l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Guy Durand de Gevigney
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center & Heart Failure Department, INSERM 1407, Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | - Daniel Grinberg
- Cardiovascular Surgery Department, Hôpital Cardiovasculaire Louis Pradel, Lyon, France
| | - Eurielle Bodenan
- Direction de la Recherche Clinique et de l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Geraldine Samson
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center & Heart Failure Department, INSERM 1407, Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | - Valérie Plattner
- Direction de la Recherche Clinique et de l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Jean Noel Trochu
- CIC INSERM 1413, Institut du Thorax, UMR INSERM 1087, University Hospital of Nantes, Nantes, France
| | - Catherine Cornu
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center & Heart Failure Department, INSERM 1407, Hospices Civils de Lyon and Claude Bernard University, Lyon, France.,UMR5558, Université de Lyon, Lyon, France
| |
Collapse
|
39
|
Rioufol G, Dérimay F, Roubille F, Perret T, Motreff P, Angoulvant D, Cottin Y, Meunier L, Cetran L, Cayla G, Harbaoui B, Wiedemann JY, Van Belle É, Pouillot C, Noirclerc N, Morelle JF, Soto FX, Caussin C, Bertrand B, Lefèvre T, Dupouy P, Lesault PF, Albert F, Barthelemy O, Koning R, Leborgne L, Barnay P, Chapon P, Armero S, Lafont A, Piot C, Amaz C, Vaz B, Benyahya L, Varillon Y, Ovize M, Mewton N, Finet G. Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease. J Am Coll Cardiol 2021; 78:1875-1885. [PMID: 34736563 DOI: 10.1016/j.jacc.2021.08.061] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [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: 07/22/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is limited evidence that fractional flow reserve (FFR) is effective in guiding therapeutic strategy in multivessel coronary artery disease (CAD) beyond prespecified percutaneous coronary intervention or coronary graft surgery candidates. OBJECTIVES The FUTURE (FUnctional Testing Underlying coronary REvascularization) trial aimed to evaluate whether a treatment strategy based on FFR was superior to a traditional strategy without FFR in the treatment of multivessel CAD. METHODS The FUTURE trial is a prospective, randomized, open-label superiority trial. Multivessel CAD candidates were randomly assigned (1:1) to treatment strategy based on FFR in all stenotic (≥50%) coronary arteries or to a traditional strategy without FFR. In the FFR group, revascularization (percutaneous coronary intervention or surgery) was indicated for FFR ≤0.80 lesions. The primary endpoint was a composite of major adverse cardiac or cerebrovascular events at 1 year. RESULTS The trial was stopped prematurely by the data safety and monitoring board after a safety analysis and 927 patients were enrolled. At 1-year follow-up, by intention to treat, there were no significant differences in major adverse cardiac or cerebrovascular events rates between groups (14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97; 95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P = 0.06), and this was confirmed with a 24 months' extended follow-up. FFR significantly reduced the proportion of revascularized patients, with more patients referred to exclusively medical treatment (P = 0.02). CONCLUSIONS In patients with multivessel CAD, we did not find evidence that an FFR-guided treatment strategy reduced the risk of ischemic cardiovascular events or death at 1-year follow-up. (Functional Testing Underlying Coronary Revascularisation; NCT01881555).
Collapse
Affiliation(s)
- Gilles Rioufol
- Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France.
| | - François Dérimay
- Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | | | | | | | - Denis Angoulvant
- EA4245 T2i, Hôpital Trousseau, CHRU de Tours, Université de Tours, Tours, France
| | | | | | - Laura Cetran
- Hôpital Cardiologique, Centre Hospitalo-Universitaire de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Guillaume Cayla
- Service de cardiologie, Hôpital Caremeau, Université de Montpellier, Nîmes, France
| | - Brahim Harbaoui
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | | | | - Olivier Barthelemy
- Hôpital de La Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | - Antoine Lafont
- Hôpital Européen George Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Camille Amaz
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Bernadette Vaz
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Lakhdar Benyahya
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Yvonne Varillon
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Michel Ovize
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Nathan Mewton
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Gérard Finet
- Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | | |
Collapse
|
40
|
Hayek A, Rioufol G, Bochaton T, Rossi R, Mewton N, Paccalet A, Bonnefoy-Cudraz E, Thibault H, Derimay F. Prognosis After Percutaneous Foramen Ovale Closure Among Patients With Platypnea-Orthodeoxia Syndrome. J Am Coll Cardiol 2021; 78:1844-1846. [PMID: 34711343 DOI: 10.1016/j.jacc.2021.08.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/29/2022]
|
41
|
Mechtouff L, Paccalet A, Crola Da Silva C, Buisson M, Mewton N, Amaz C, Bonnefoy-Cudraz E, Leboube S, Cho TH, Nighoghossian N, Ovize M, Bochaton T. Prognosis value of serum soluble ST2 level in acute ischemic stroke and STEMI patients in the era of mechanical reperfusion therapy. J Neurol 2021; 269:2641-2648. [PMID: 34694426 DOI: 10.1007/s00415-021-10865-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/18/2021] [Revised: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Soluble form suppression of tumorigenicity 2 (sST2) is known to have prognostic value in ST-elevation myocardial infarction (STEMI) and could impact mortality after acute ischemic stroke (AIS). However, before considering sST2 as a therapeutic target, the kinetics of release and its association with adverse clinical events in both STEMI and AIS patients have to be determined. METHODS We prospectively enrolled 251 STEMI patients, treated with primary percutaneous coronary intervention, and 152 AIS patients treated with mechanical thrombectomy. We evaluated the level of sST2 in patient sera at five time point (admission, 4, 24, 48 h and 1 month from admission for STEMI patients and admission, 6, 24, 48 h and 3 months from admission for AIS patients). Major adverse clinical events (MACE) (all-cause death, acute myocardial infarction, stroke or hospitalization for heart failure) in STEMI patients and all-cause death in AIS patients were recorded during a 12-month follow-up. RESULTS Mean age of the study population was 59 ± 12 and 69 ± 15 years in STEMI and AIS patients, respectively. In STEMI patients, sST2 peaked 24 h after admission (25.5 ng/mL interquartile range (IQR) [14.9-29.1]) whereas an earlier and lower peak was observed in AIS patients (16.8 ng/mL IQR [15.2-18.3] at 6 h). Twenty-five (10.0%) STEMI patients experienced a MACE and 12 (7.9%) AIS patients had all-cause death within the first 12 months. A high level of sST2 at 24 h was associated with MACE in STEMI patients (hazard ratio (HR) = 2.5; 95% confidence interval (CI) [1.1-5.6], p = 0.03) and all-cause death in AIS patients (HR = 11.7; 95% CI [3.8-36.2], p < 0.01) within the first 12 months. CONCLUSIONS The study highlights that sST2 levels at 24 h are associated with an increased risk to adverse clinical events in both diseases.
Collapse
Affiliation(s)
- Laura Mechtouff
- Stroke Center, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France.
| | - Alexandre Paccalet
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
| | - Claire Crola Da Silva
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
| | - Marielle Buisson
- Centre d'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Nathan Mewton
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
- Centre d'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Camille Amaz
- Centre d'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Eric Bonnefoy-Cudraz
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Simon Leboube
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
- Service d'explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Tae-Hee Cho
- Stroke Center, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
| | - Norbert Nighoghossian
- Stroke Center, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
| | - Michel Ovize
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
- Centre d'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
- Service d'explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| | - Thomas Bochaton
- CarMeN Laboratory, INSERM U1060, Université de Lyon, Groupement Hospitalier Est, Bâtiment B13, 59 boulevard Pinel, 69500, Bron, France
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel, Hospices Civils de Lyon, 59 boulevard Pinel, 69500, Bron, France
| |
Collapse
|
42
|
Logeart D, Berthelot E, Bihry N, Eschalier R, Salvat M, Garcon P, Eicher JC, Cohen A, Tartiere JM, Samadi A, Donal E, deGroote P, Mewton N, Mansencal N, Raphael P, Ghanem N, Seronde MF, Chavelas C, Rosamel Y, Beauvais F, Kevorkian JP, Diallo A, Vicaut E, Isnard R. Early and short-term intensive management after discharge for patients hospitalized with acute heart failure: a randomized study (ECAD-HF). Eur J Heart Fail 2021; 24:219-226. [PMID: 34628697 DOI: 10.1002/ejhf.2357] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 08/06/2021] [Revised: 09/06/2021] [Accepted: 10/04/2021] [Indexed: 12/28/2022] Open
Abstract
AIMS Hospitalization for acute heart failure (HF) is followed by a vulnerable time with increased risk of readmission or death, thus requiring particular attention after discharge. In this study, we examined the impact of intensive, early follow-up among patients at high readmission risk at discharge after treatment for acute HF. METHODS AND RESULTS Hospitalized acute HF patients were included with at least one of the following: previous acute HF < 6 months, systolic blood pressure ≤ 110 mmHg, creatininaemia ≥ 180 µmol/L, or B-type natriuretic peptide ≥ 350 pg/mL or N-terminal pro B-type natriuretic peptide ≥ 2200 pg/mL. Patients were randomized to either optimized care and education with serial consultations with HF specialist and dietician during the first 2-3 weeks, or to standard post-discharge care according to guidelines. The primary endpoint was all-cause death or first unplanned hospitalization during 6-month follow-up. Among 482 randomized patients (median age 77 and median left ventricular ejection fraction 35%), 224 were hospitalized or died. In the intensive group, loop diuretics (46%), beta-blockers (49%), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (39%) and mineralocorticoid receptor antagonists (47%) were titrated. No difference was observed between groups for the primary endpoint (hazard ratio 0.97; 95% confidence interval 0.74-1.26), nor for mortality at 6 or 12 months or unplanned HF rehospitalization. Additionally, no difference between groups according to age, previous HF and left ventricular ejection fraction was found. CONCLUSIONS In high-risk HF, intensive follow-up early post-discharge did not improve outcomes. This vulnerable post-discharge time requires further studies to clarify useful transitional care services.
Collapse
Affiliation(s)
- Damien Logeart
- Hôpital Lariboisière Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France
| | | | | | | | | | | | | | - Ariel Cohen
- Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | - Nicolas Mansencal
- Hôpital Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | - Yann Rosamel
- Hôpital Sud-Francilien, Corbeil-Essonnes, France
| | - Florence Beauvais
- Hôpital Lariboisière Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Abdourahmane Diallo
- Hôpital Lariboisière Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Vicaut
- Hôpital Lariboisière Fernand Widal, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France
| | - Richard Isnard
- Hôpital Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
43
|
Paccalet A, Crola Da Silva C, Mechtouff L, Amaz C, Varillon Y, de Bourguignon C, Cartier R, Prieur C, Tomasevic D, Genot N, Leboube S, Derimay F, Rioufol G, Bonnefoy-Cudraz E, Mewton N, Ovize M, Bidaux G, Bochaton T. Serum Soluble Tumor Necrosis Factor Receptors 1 and 2 Are Early Prognosis Markers After ST-Segment Elevation Myocardial Infarction. Front Pharmacol 2021; 12:656928. [PMID: 34539391 PMCID: PMC8440863 DOI: 10.3389/fphar.2021.656928] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 01/25/2021] [Accepted: 07/31/2021] [Indexed: 11/30/2022] Open
Abstract
Background: As inflammation following ST-segment elevation myocardial infarction (STEMI) is both beneficial and deleterious, there is a need to find new biomarkers of STEMI severity. Objective: We hypothesized that the circulating concentration of the soluble tumor necrosis factor α receptors 1 and 2 (sTNFR1 and sTNFR2) might predict clinical outcomes in STEMI patients. Methods: We enrolled into a prospective cohort 251 consecutive STEMI patients referred to our hospital for percutaneous coronary intervention revascularization. Blood samples were collected at five time points: admission and 4, 24, 48 h, and 1 month after admission to assess sTNFR1 and sTNFR2 serum concentrations. Patients underwent cardiac magnetic resonance imaging at 1 month. Results: sTNFR1 concentration increased at 24 h with a median of 580.5 pg/ml [95% confidence interval (CI): 534.4–645.6]. sTNFR2 increased at 48 h with a median of 2,244.0 pg/ml [95% CI: 2090.0–2,399.0]. Both sTNFR1 and sTNFR2 peak levels were correlated with infarct size and left ventricular end-diastolic volume and inversely correlated with left ventricular ejection fraction. Patients with sTNFR1 or sTNFR2 concentration above the median value were more likely to experience an adverse clinical event within 24 months after STEMI [hazards ratio (HR): 8.8, 95% CI: 4.2–18.6, p < 0.0001 for sTNFR1; HR: 6.1, 95% CI: 2.5 –10.5, p = 0.0003 for sTNFR2]. Soluble TNFR1 was an independent predictor of major adverse cardiovascular events and was more powerful than troponin I (p = 0.04 as compared to the troponin AUC). Conclusion: The circulating sTNFR1 and sTNFR2 are inflammatory markers of morphological and functional injury after STEMI. sTNFR1 appears as an early independent predictor of clinical outcomes in STEMI patients.
Collapse
Affiliation(s)
- Alexandre Paccalet
- INSERM U1060, CarMeN Laboratory, Groupement Hospitalier Est, Université de Lyon, Bron, France
| | - Claire Crola Da Silva
- INSERM U1060, CarMeN Laboratory, Groupement Hospitalier Est, Université de Lyon, Bron, France
| | - Laura Mechtouff
- Stroke Department, Hôpital Wertheimer, Hospices Civils de Lyon, Bron, France
| | - Camille Amaz
- Centre D'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Yvonne Varillon
- Centre D'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Charles de Bourguignon
- Centre D'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Regine Cartier
- Centre de Biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Cyril Prieur
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Danka Tomasevic
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Nathalie Genot
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Simon Leboube
- INSERM U1060, CarMeN Laboratory, Groupement Hospitalier Est, Université de Lyon, Bron, France
| | - François Derimay
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, Bron, France
| | - Gilles Rioufol
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, Bron, France
| | - Eric Bonnefoy-Cudraz
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Nathan Mewton
- INSERM U1060, CarMeN Laboratory, Groupement Hospitalier Est, Université de Lyon, Bron, France.,Centre D'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Michel Ovize
- INSERM U1060, CarMeN Laboratory, Groupement Hospitalier Est, Université de Lyon, Bron, France.,Centre D'investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France.,Service D'explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Gabriel Bidaux
- INSERM U1060, CarMeN Laboratory, Groupement Hospitalier Est, Université de Lyon, Bron, France
| | - Thomas Bochaton
- INSERM U1060, CarMeN Laboratory, Groupement Hospitalier Est, Université de Lyon, Bron, France.,Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| |
Collapse
|
44
|
Sokolski M, Trenson S, Sokolska JM, D'Amario D, Meyer P, Poku NK, Biering-Sørensen T, Højbjerg Lassen MC, Skaarup KG, Barge-Caballero E, Pouleur AC, Stolfo D, Sinagra G, Ablasser K, Muster V, Rainer PP, Wallner M, Chiodini A, Heiniger PS, Mikulicic F, Schwaiger J, Winnik S, Cakmak HA, Gaudenzi M, Mapelli M, Mattavelli I, Paul M, Cabac-Pogorevici I, Bouleti C, Lilliu M, Minoia C, Dauw J, Costa J, Celik A, Mewton N, Montenegro CEL, Matsue Y, Loncar G, Marchel M, Bechlioulis A, Michalis L, Dörr M, Prihadi E, Schoenrath F, Messroghli DR, Mullens W, Lund LH, Rosano GMC, Ponikowski P, Ruschitzka F, Flammer AJ. Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry. ESC Heart Fail 2021; 8:4955-4967. [PMID: 34533287 PMCID: PMC8653014 DOI: 10.1002/ehf2.13549] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 04/22/2021] [Revised: 06/29/2021] [Accepted: 07/16/2021] [Indexed: 12/15/2022] Open
Abstract
Aims We assessed the outcome of hospitalized coronavirus disease 2019 (COVID‐19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. Methods and results International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID‐19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF‐COVICAV). The primary endpoint was in‐hospital mortality. Of 1974 patients hospitalized with COVID‐19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62–81] years, 58% male), with HF being present in 256 [20%] patients. Overall in‐hospital mortality was 25% (n = 323/1282 deaths). In‐hospital mortality was higher in patients with a history of HF (36%, n = 92) compared with non‐HF patients (23%, n = 231, odds ratio [OR] 1.93 [95% confidence interval: 1.44–2.59], P < 0.001). After adjusting, HF remained associated with in‐hospital mortality (OR 1.45 [95% confidence interval: 1.01–2.06], P = 0.041). Importantly, 186 of 1282 [15%] patients had an acute HF event during hospitalization (76 [40%] with de novo HF), which was associated with higher in‐hospital mortality (89 [48%] vs. 220 [23%]) than in patients without HF event (OR 3.10 [2.24–4.29], P < 0.001). Conclusions Hospitalized COVID‐19 patients with HF are at increased risk for in‐hospital death. In‐hospital worsening of HF or acute HF de novo are common and associated with a further increase in in‐hospital mortality.
Collapse
Affiliation(s)
- Mateusz Sokolski
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Sander Trenson
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland.,Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
| | - Justyna M Sokolska
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Domenico D'Amario
- Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Philippe Meyer
- Cardiology Service, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland
| | - Nana K Poku
- Cardiology Service, Department of Medicine, University Hospital of Geneva, Geneva, Switzerland
| | - Tor Biering-Sørensen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Mats C Højbjerg Lassen
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kristoffer G Skaarup
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Eduardo Barge-Caballero
- Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.,Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), A Coruña, Spain
| | - Anne-Catherine Pouleur
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc and Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Davide Stolfo
- Cardiovascular Department, University Hospital of Trieste - ASUGI, Trieste, Italy
| | - Gianfranco Sinagra
- Cardiovascular Department, University Hospital of Trieste - ASUGI, Trieste, Italy
| | - Klemens Ablasser
- Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Viktoria Muster
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Peter P Rainer
- Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Markus Wallner
- Division of Cardiology, Medical University of Graz, Graz, Austria.,Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.,Center for Biomarker Research in Medicine, CBmed GmbH, Graz, Austria
| | - Alessandra Chiodini
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Pascal S Heiniger
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Fran Mikulicic
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Judith Schwaiger
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Stephan Winnik
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Huseyin A Cakmak
- Department of Cardiology, Mustafakemalpasa State Hospital, Bursa, Turkey
| | - Margherita Gaudenzi
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | - Massimo Mapelli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
| | | | - Matthias Paul
- Heart Center Lucerne, Luzerner Kantonsspital (LUKS), Luzern, Switzerland
| | - Irina Cabac-Pogorevici
- Department of Cardiology, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Republic of Moldova
| | - Claire Bouleti
- Cardiology Department, Clinical Investigation Center (CIC) INSERM 1402, Poitiers Hospital, Poitiers University, Poitiers, France
| | - Marzia Lilliu
- Division of Infectious Diseases, Azienda ULSS 9, M. Magalini Hospital, Verona, Italy
| | - Chiara Minoia
- Emergency Department, Public Health Company Valle Olona, Busto Arsizio, Italy
| | - Jeroen Dauw
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Doctoral School for Medicine and Life sciences, LCRC, UHasselt, Diepenbeek, Belgium
| | - Jérôme Costa
- Department of Cardiology, Reims University Hospital Centre, Reims, France
| | - Ahmet Celik
- Department of Cardiology, Mersin University Medical Faculty, Mersin, Turkey
| | - Nathan Mewton
- Cardiovascular Hospital Louis Pradel, Department of Heart Failure, Hospices Civils de Lyon, Lyon, France.,Clinical Investigation Center, Inserm 1407, Lyon, France.,CARMEN Inserm 1060, Claude Bernard University Lyon, Lyon, France
| | - Carlos E L Montenegro
- PROCAPE- Pronto Socorro Cardiológico de Pernambuco, Universidade de Pernambuco, Recife, PE, Brazil
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Goran Loncar
- Institute for Cardiovascular Diseases Dedinje, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Michal Marchel
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Aris Bechlioulis
- 2nd Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece
| | - Lampros Michalis
- 2nd Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Greifswald, Greifswald, Germany
| | | | - Felix Schoenrath
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,German Center for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany
| | - Daniel R Messroghli
- German Center for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany.,Department of Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Germany.,Department of Internal Medicine-Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Wilfried Mullens
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Biomedical Research Institute, Faculty of Medicine and Life Sciences, LCRC, UHasselt, Diepenbeek, Belgium
| | - Lars H Lund
- Unit of Cardiology, Department of Medicine, Karolinska Institutet, and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden
| | | | - Piotr Ponikowski
- Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Frank Ruschitzka
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| | - Andreas J Flammer
- Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, Zurich, CH-8091, Switzerland
| |
Collapse
|
45
|
Baudry G, Sebbag L, Bourdin J, Hugon-Vallet E, Jobbe Duval A, Mewton N, Pozzi M, Rossignol P, Girerd N. Haemodynamic parameters associated with renal function prior to and following heart transplantation. ESC Heart Fail 2021; 8:4944-4954. [PMID: 34520113 PMCID: PMC8712911 DOI: 10.1002/ehf2.13534] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022] Open
Abstract
Aims Abnormal renal function is a common feature in patients on heart transplant waiting lists. This study aimed to identify the haemodynamic parameters associated with decreased estimated glomerular filtration rate (eGFR) in patients listed for heart transplantation (HT) and renal function improvement following HT. Methods and results A total of 176 adults (52 years old, 81% men) with available right heart catheterization (RHC) listed in our centre for HT between 2014 and 2019 were studied. Cardiac catheterization measurements were obtained at time of HT listing evaluation. Changes in renal function were assessed between RHC and 6 months after HT. Median eGFR was 63 mL/min/1.73 m2 at time of RHC. Central venous pressure > 10 mmHg was associated with a two‐fold increase in the likelihood of eGFR < 60 mL/min/1.73 m2 at time of RHC (adjusted odd ratio, 2.2; 95% confidence interval, 1.1–4.7; P = 0.04). In the 134 patients (76%) who underwent HT during follow‐up, eGFR decreased by 7.9 ± 29.7 mL/min/1.73 m2 from RHC to 6 months after HT. In these patients, low cardiac index (<2.1 L/min/m2) at initial RHC was associated with a (adjusted) 6 month post‐HT eGFR improvement of 12.2 mL/min/1.73 m2 (P = 0.018). Patients with eGFR < 60 mL/min/1.73 m2 and low cardiac index at time of RHC exhibited the greatest eGFR improvement (delta eGFR = 18.3 mL/min/1.73 m2) while patients with eGFR ≥ 60 mL/min/1.73 m2 and normal cardiac index had a marked decrease in eGFR (delta eGFR = −27.7 mL/min/1.73 m2, P < 0.001). Conclusions Central venous pressure is the main haemodynamic parameter associated with eGFR < 60 mL/min/1.73 m2 in patients listed for HT. Low cardiac index prior to HT is associated with post‐transplant renal function recovery.
Collapse
Affiliation(s)
- Guillaume Baudry
- Service d'insuffisance cardiaque et transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, Bron, France.,Université de Lorraine, Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F-CRIN INI-CRCT, Vandoeuvre-lès-Nancy, 54500, France
| | - Laurent Sebbag
- Service d'insuffisance cardiaque et transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Juliette Bourdin
- Service d'insuffisance cardiaque et transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Elisabeth Hugon-Vallet
- Service d'insuffisance cardiaque et transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Antoine Jobbe Duval
- Service d'insuffisance cardiaque et transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Nathan Mewton
- Centre d'Investigations Clinique, Hôpital Cardiovasculaire Louis Pradel, INSERM 1407, INSERM 1060 Unité Carmen, Université Claude Bernard Lyon 1, Bron, France
| | - Matteo Pozzi
- Service de chirurgie cardiaque, Hôpital Cardiovasculaire Louis Pradel, Bron, France
| | - Patrick Rossignol
- Université de Lorraine, Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F-CRIN INI-CRCT, Vandoeuvre-lès-Nancy, 54500, France
| | - Nicolas Girerd
- Université de Lorraine, Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F-CRIN INI-CRCT, Vandoeuvre-lès-Nancy, 54500, France
| |
Collapse
|
46
|
Mewton N, Roubille F, Bresson D, Prieur C, Bouleti C, Bochaton T, Ivanes F, Dubreuil O, Biere L, Hayek A, Derimay F, Akodad M, Alos B, Haider L, El Jonhy N, Daw R, De Bourguignon C, Dhelens C, Finet G, Bonnefoy-Cudraz E, Bidaux G, Boutitie F, Maucort-Boulch D, Croisille P, Rioufol G, Prunier F, Angoulvant D. Effect of Colchicine on Myocardial Injury in Acute Myocardial Infarction. Circulation 2021; 144:859-869. [PMID: 34420373 PMCID: PMC8462445 DOI: 10.1161/circulationaha.121.056177] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [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] [Indexed: 11/29/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Inflammation is a key factor of myocardial damage in reperfused ST-segment–elevation myocardial infarction. We hypothesized that colchicine, a potent anti-inflammatory agent, may reduce infarct size (IS) and left ventricular (LV) remodeling at the acute phase of ST-segment–elevation myocardial infarction. Methods: In this double-blind multicenter trial, we randomly assigned patients admitted for a first episode of ST-segment–elevation myocardial infarction referred for primary percutaneous coronary intervention to receive oral colchicine (2-mg loading dose followed by 0.5 mg twice a day) or matching placebo from admission to day 5. The primary efficacy outcome was IS determined by cardiac magnetic resonance imaging at 5 days. The relative LV end-diastolic volume change at 3 months and IS at 3 months assessed by cardiac magnetic resonance imaging were among the secondary outcomes. Results: We enrolled 192 patients, 101 in the colchicine group and 91 in the control group. At 5 days, the gadolinium enhancement–defined IS did not differ between the colchicine and placebo groups with a mean of 26 interquartile range (IQR) [16–44] versus 28.4 IQR [14–40] g of LV mass, respectively (P=0.87). At 3 months follow-up, there was no significant difference in LV remodeling between the colchicine and placebo groups with a +2.4% (IQR, –8.3% to 11.1%) versus –1.1% (IQR, –8.0% to 9.9%) change in LV end-diastolic volume (P=0.49). Infarct size at 3 months was also not significantly different between the colchicine and placebo groups (17 IQR [10–28] versus 18 IQR [10–27] g of LV mass, respectively; P=0.92). The incidence of gastrointestinal adverse events during the treatment period was greater with colchicine than with placebo (34% versus 11%, respectively; P=0.0002). Conclusions: In this randomized, placebo-controlled trial, oral administration of high-dose colchicine at the time of reperfusion and for 5 days did not reduce IS assessed by cardiac magnetic resonance imaging. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03156816.
Collapse
Affiliation(s)
- Nathan Mewton
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - François Roubille
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, France (F.R., M.A.)
| | - Didier Bresson
- Cardiology Division, University Hospital of Mulhouse, Hôpital Emile Muller, Mulhouse, France (D.B.)
| | - Cyril Prieur
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Claire Bouleti
- Université de Poitiers, CIC Inserm 1402n CHU de Poitiers, France (C.B., B.A.)
| | - Thomas Bochaton
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Fabrice Ivanes
- Cardiology Department CHRU de Tours and EA4245 T2i Tours University, France (F.I., D.A.)
| | - Olivier Dubreuil
- Centre Hospitalier Saint-Joseph Saint-Luc, Invasive Cardiology Department, Lyon, France (O.D.)
| | - Loïc Biere
- Institut MITOVASC, CNRS 6015 INSERM U1083, Université d'Angers, Cardiology Division, CHU Angers, France (L.B., F.P.)
| | - Ahmad Hayek
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - François Derimay
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Mariama Akodad
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, France (F.R., M.A.)
| | - Benjamin Alos
- Université de Poitiers, CIC Inserm 1402n CHU de Poitiers, France (C.B., B.A.)
| | - Lamis Haider
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Naoual El Jonhy
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Rachel Daw
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Charles De Bourguignon
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Carole Dhelens
- Pharmacy Department, FRIPHARM-RC (C.D.), Hospices Civils de Lyon, France
| | - Gérard Finet
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Eric Bonnefoy-Cudraz
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | | | - Florent Boutitie
- UMR 5558 CNRS UCBL Biostatistics Departement (F.B., D.M.-B.), Hospices Civils de Lyon, France.,INSERM CarMeN 1060, IRIS Team, Claude Bernard University, Lyon, France (F.B.)
| | - Delphine Maucort-Boulch
- UMR 5558 CNRS UCBL Biostatistics Departement (F.B., D.M.-B.), Hospices Civils de Lyon, France
| | - Pierre Croisille
- CREATIS CNRS 5220 INSERM U1206 Research Lab, Radiology Department, University Hospital/CHU Saint Etienne, France (P.C.)
| | - Gilles Rioufol
- Hôpital Cardiovasculaire Louis Pradel, Clinical Investigation Center, INSERM 1407 and INSERM CarMeN 1060, Hospices Civils de Lyon and Claude Bernard University, Lyon, France (N.M., C.P., T.B., A.H., F.D., L.H., N.E.J, R.D., C.D.B., G.F., E.B.-C., G.R.)
| | - Fabrice Prunier
- Institut MITOVASC, CNRS 6015 INSERM U1083, Université d'Angers, Cardiology Division, CHU Angers, France (L.B., F.P.)
| | - Denis Angoulvant
- Cardiology Department CHRU de Tours and EA4245 T2i Tours University, France (F.I., D.A.)
| |
Collapse
|
47
|
Mewton N, Baudry G, Sebbag L. Pneumonia in Chronic Heart Failure: What About a Full Picture of the Puzzle? J Am Coll Cardiol 2021; 78:759. [PMID: 34384557 DOI: 10.1016/j.jacc.2021.04.107] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 04/30/2021] [Indexed: 11/27/2022]
|
48
|
Shchendrygina A, Mewton N, Meznar AZ. Advanced Heart Failure and Angiotensin System Fascinating Complexities. J Am Coll Cardiol 2021; 78:541-542. [PMID: 34325846 DOI: 10.1016/j.jacc.2021.04.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 10/20/2022]
|
49
|
Schaaf M, Croisille P, Py A, Roubille F, Biere L, Bochaton T, Perret T, Belle L, De Poli F, Hovasse T, Lairez O, Boussaha I, Rioufol G, Prunier F, Ovize M, Mewton N. Non-culprit artery myocardial infarction and complex coronary lesions in anterior ST-elevated myocardial infarction patients. Cardiology 2021; 146:728-736. [PMID: 34348264 DOI: 10.1159/000518137] [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: 06/12/2020] [Accepted: 06/02/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Mathieu Schaaf
- CHU de Lyon, Hôpital Cardiovasculaire Louis Pradel, Centre d'Investigation Clinique, INSERM 1407, Hospices Civils de Lyon, Lyon, France
| | - Pierre Croisille
- Radiology Department, Hôpital Nord, CHU Saint-Etienne, Saint Etienne, France
| | - Agathe Py
- CHU de Lyon, Hôpital Cardiovasculaire Louis Pradel, Fédération de Cardiologie, Hospices Civils de Lyon, Lyon, France
| | - François Roubille
- Cardiology Department, Hôpital Arnaud de Villeuneuve, CHU de Montpellier, Montpellier, France
| | - Loic Biere
- Cardiology Department, CHU d'Angers, Angers, France
| | - Thomas Bochaton
- CHU de Lyon, Hôpital Cardiovasculaire Louis Pradel, Centre d'Investigation Clinique, INSERM 1407, Hospices Civils de Lyon, Lyon, France
| | - Thibault Perret
- Cardiology Department, Centre Hospitalier, St Joseph Saint Luc, Lyon, France
| | - Loic Belle
- Cardiology Department, Centre Hospitalier d'Annecy, Annecy, France
| | | | - Thomas Hovasse
- Cardiology Department, Jacques Cartier Institute, Massy, France
| | - Olivier Lairez
- Cardiology Department, Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | - Inesse Boussaha
- CHU de Lyon, Hôpital Cardiovasculaire Louis Pradel, Centre d'Investigation Clinique, INSERM 1407, Hospices Civils de Lyon, Lyon, France
| | - Gilles Rioufol
- CHU de Lyon, Hôpital Cardiovasculaire Louis Pradel, Centre d'Investigation Clinique, INSERM 1407, Hospices Civils de Lyon, Lyon, France
| | | | - Michel Ovize
- CHU de Lyon, Hôpital Cardiovasculaire Louis Pradel, Centre d'Investigation Clinique, INSERM 1407, Hospices Civils de Lyon, Lyon, France
| | - Nathan Mewton
- CHU de Lyon, Hôpital Cardiovasculaire Louis Pradel, Centre d'Investigation Clinique, INSERM 1407, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
50
|
Hayek A, Paccalet A, Mechtouff L, Da Silva CC, Ivanes F, Falque H, Leboube S, Varillon Y, Amaz C, de Bourguignon C, Prieur C, Tomasevic D, Genot N, Derimay F, Bonnefoy‐Cudraz E, Bidaux G, Mewton N, Ovize M, Bochaton T. Kinetics and prognostic value of soluble VCAM-1 in ST-segment elevation myocardial infarction patients. Immun Inflamm Dis 2021; 9:493-501. [PMID: 33559404 PMCID: PMC8127550 DOI: 10.1002/iid3.409] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Soluble vascular cell adhesion molecule-1 (sVCAM-1) is a biomarker of endothelial activation and inflammation. There is still controversy as to whether it can predict clinical outcome after ST-elevation myocardial infarction (STEMI). Our aim was to assess the sVCAM-1 kinetics and to evaluate its prognostic predictive value. METHOD We prospectively enrolled 251 consecutive STEMI patients who underwent coronary revascularization in our university hospital. Blood samples were collected at admission, 4, 24, 48 h and 1 month after admission. sVCAM-1 serum level was assessed using ELISA assay. All patients had cardiac magnetic resonance imaging at 1-month for infarct size (IS) and left ventricular ejection fraction (LVEF) assessment. Clinical outcomes were recorded over 12 months after STEMI. RESULTS sVCAM-1 levels significantly increased from admission up to 1 month and were significantly correlated with IS, LVEF, and LV end-systolic and diastolic volume. (H48 area under curve (AUC) ≥ H48 median) were associated with an increased risk of adverse clinical events during the 12-month follow-up period with a hazard ratio (HR) = 2.6 (95% confidence interval [CI] of ratio = 1.2-5.6, p = .02). The ability of H48 AUC for sVCAM-1 to discriminate between patients with or without the composite endpoint was evaluated using receiver operating characteristics with an AUC at 0.67 (0.57-0.78, p = .004). This ability was significantly superior to H48 AUC creatine kinase (p = .03). CONCLUSIONS In STEMI patients, high sVCAM-1 levels are associated with a poor clinical outcome. sVCAM-1 is an early postmyocardial infarction biomarker and might be an interesting target for the development of future therapeutic strategies.
Collapse
Affiliation(s)
- Ahmad Hayek
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Alexandre Paccalet
- INSERM U1060, CarMeN LaboratoryUniversity of Lyon, Groupement Hospitalier EstBronFrance
| | - Laura Mechtouff
- Department of Neurology and Stroke Center, Hospices Civils de LyonLyon UniversityLyonFrance
| | - Claire C. Da Silva
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Fabrice Ivanes
- Faculty of Medicine, Loire Valley Cardiovascular CollaborationUniversity of ToursToursFrance
- Department of Cardiology and FACTCHRU de ToursToursFrance
| | - Hadrien Falque
- Department of Cardiology, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Simon Leboube
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Yvonne Varillon
- Clinical Investigation Center and Heart Failure Department, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Camille Amaz
- Clinical Investigation Center and Heart Failure Department, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Charles de Bourguignon
- Clinical Investigation Center and Heart Failure Department, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Cyril Prieur
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Danka Tomasevic
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Nathalie Genot
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - François Derimay
- Department of Cardiology, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Eric Bonnefoy‐Cudraz
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Gabriel Bidaux
- INSERM U1060, CarMeN LaboratoryUniversity of Lyon, Groupement Hospitalier EstBronFrance
| | - Nathan Mewton
- Clinical Investigation Center and Heart Failure Department, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Michel Ovize
- INSERM U1060, CarMeN LaboratoryUniversity of Lyon, Groupement Hospitalier EstBronFrance
- Clinical Investigation Center and Heart Failure Department, Louis Pradel HospitalHospices Civils de LyonBronFrance
- Department of Cardiovascular Functional Exploration, Louis Pradel HospitalHospices Civils de LyonBronFrance
| | - Thomas Bochaton
- Intensive Cardiological Care Division, Louis Pradel HospitalHospices Civils de LyonBronFrance
- INSERM U1060, CarMeN LaboratoryUniversity of Lyon, Groupement Hospitalier EstBronFrance
| |
Collapse
|