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Trimaille A, Matsushita K, Marchandot B, Carmona A, Hess S, Reydel A, Faucher L, Granier A, Mai TA, Diop B, Ohlmann P, Jesel L, Morel O. Outcomes of patients with active cancer undergoing transcatheter aortic valve replacement. Arch Cardiovasc Dis 2023; 116:506-513. [PMID: 37758593 DOI: 10.1016/j.acvd.2023.08.001] [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: 05/16/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Cardiovascular disease and cancer are the two leading causes of mortality worldwide, and their association presents a therapeutic challenge. Current data regarding the prognosis of active cancer in patients undergoing transcatheter aortic valve replacement are conflicting. AIM To determine the impact and prognosis of active cancer in transcatheter aortic valve replacement. METHODS All consecutive patients with severe aortic stenosis treated by transcatheter aortic valve replacement between February 2010 and May 2019 were enrolled in a prospective study. The cohort was divided according to the presence or absence of active cancer at baseline. The primary endpoint was all-cause mortality 1 year after the procedure. RESULTS A total of 1,125 patients were enrolled: 1,037 (92.2%) without and 88 (7.8%) with active cancer. The most frequent cancers were haematological (36.4%), breast (14.8%) and prostate (14.8%), with 79.5% of patients receiving curative treatment and 17.0% receiving palliative treatment. The 1-year mortality rate was higher in patients with active cancer (27.3% vs. 13.9%; P<0.01), mainly driven by non-cardiovascular causes. An increased cardiovascular mortality rate at 2 years was seen in patients with active cancer (27.5% vs. 15.0%; P=0.03) compared with a similar rate at 1-year follow-up. Active cancer was a strong predictor of 1-year all-cause mortality (hazard ratio 2.46, 95% confidence interval 1.19-4.68; P=0.02). Major/life-threatening bleeding events at 1 year were more frequent in patients with active cancer (P=0.02). CONCLUSIONS Among patients who undergo transcatheter aortic valve replacement, 1-year all-cause mortality is higher in those with active cancer. We also observed a trend towards increased long-term bleeding events in case of active cancer.
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Affiliation(s)
- Antonin Trimaille
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France; Inserm (French National Institute of Health and Medical Research), FMTS, Regenerative Nanomedicine, UMR 1260, 67000 Strasbourg, France
| | - Kensuke Matsushita
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France; Inserm (French National Institute of Health and Medical Research), FMTS, Regenerative Nanomedicine, UMR 1260, 67000 Strasbourg, France
| | - Benjamin Marchandot
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Adrien Carmona
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Sebastien Hess
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Antje Reydel
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Loic Faucher
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Amandine Granier
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Trung Anh Mai
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Bamba Diop
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Patrick Ohlmann
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France
| | - Laurence Jesel
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France; Inserm (French National Institute of Health and Medical Research), FMTS, Regenerative Nanomedicine, UMR 1260, 67000 Strasbourg, France
| | - Olivier Morel
- Division of Cardiovascular Medicine, Strasbourg University Hospital, Nouvel Hôpital Civil, 67091 Strasbourg, France; Inserm (French National Institute of Health and Medical Research), FMTS, Regenerative Nanomedicine, UMR 1260, 67000 Strasbourg, France.
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Matsushita K, Marchandot B, Trimaille A, Hmadeh S, Kibler M, Heger J, Carmona A, Hess S, Reydel A, Jesel L, Ohlmann P, Schini-Kerth V, Morel O. Determinants and treatments of heart failure after transcatheter aortic valve implantation: moving up a notch. ESC Heart Fail 2023. [PMID: 37430483 PMCID: PMC10375170 DOI: 10.1002/ehf2.14435] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/26/2023] [Accepted: 05/23/2023] [Indexed: 07/12/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) has become an alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis in elderly and comorbid population. Significant improvement in heart function has been observed in patients undergoing TAVI, but numerous patients are readmitted to hospital for heart failure (HF). Moreover, repeat HF hospitalization is strongly associated with an adverse prognosis and increases the financial burden of health care. Although studies have identified pre-existing and post-procedural factors that contribute to HF hospitalization after TAVI, there is a paucity of data regarding optimal post-procedural pharmacological treatments. This review aims to provide an overview of the current understanding of mechanisms, determinants, and potential treatments of HF following TAVI. We first review the pathophysiology of left ventricular (LV) remodelling, coronary microcirculation disorder, and endothelial dysfunction in patients with aortic stenosis and then examine the impact of TAVI on these conditions. We then present evidence of various factors and complications that may interplay with LV remodelling and contribute to HF events after TAVI. Next, we describe the triggers and predictors of early and late HF rehospitalizations following TAVI. Lastly, we discuss the potential of conventional pharmacological treatments, including renin-angiotensin blockers, beta-blockers, and diuretics in TAVI patients. The paper explores the potential of newer drugs, including sodium-glucose co-transporter 2 inhibitors, anti-inflammatory drugs, and ion supplementation. Comprehensive knowledge in this field may aid in recognizing successful existing therapies, developing effective new treatments, and establishing dedicated patient care strategies during follow-up after TAVI.
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Affiliation(s)
- Kensuke Matsushita
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
- UMR1260 INSERM, Nanomédecine Régénérative, Université de Strasbourg, Strasbourg, France
| | - Benjamin Marchandot
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Antonin Trimaille
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
- UMR1260 INSERM, Nanomédecine Régénérative, Université de Strasbourg, Strasbourg, France
| | - Sandy Hmadeh
- UMR1260 INSERM, Nanomédecine Régénérative, Université de Strasbourg, Strasbourg, France
| | - Marion Kibler
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Joe Heger
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Adrien Carmona
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Sebastien Hess
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Antje Reydel
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Laurence Jesel
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
- UMR1260 INSERM, Nanomédecine Régénérative, Université de Strasbourg, Strasbourg, France
| | - Patrick Ohlmann
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Valerie Schini-Kerth
- UMR1260 INSERM, Nanomédecine Régénérative, Université de Strasbourg, Strasbourg, France
| | - Olivier Morel
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
- UMR1260 INSERM, Nanomédecine Régénérative, Université de Strasbourg, Strasbourg, France
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Matsushita K, Marchandot B, Kibler M, Carmona A, Phi TD, Heger J, Trimaille A, Hess S, Sattler L, Ohana M, Reydel AC, Jesel-Morel L, Ohlmann P, Morel O. Combination of primary hemostatic disorders and atrial fibrillation increases bleeding events following transcatheter aortic valve replacement. TH Open 2023; 7:e117-e127. [PMID: 37180426 PMCID: PMC10174752 DOI: 10.1055/a-2068-5783] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 03/27/2023] [Indexed: 04/07/2023] Open
Abstract
Background Patients with atrial fibrillation (AF) are likely to have a poor prognosis including bleedings following transcatheter aortic valve replacement (TAVR). Closure time of adenosine diphosphate (CT-ADP) is a primary hemostasis point-of-care test and is a predictor of bleeding events following TAVR. We aimed to evaluate the impact of ongoing primary hemostatic disorders on bleeding events in TAVR patients with AF.
Methods We enrolled 878 patients from our prospective registry. The primary endpoint was VARC-2 major/life-threatening bleeding complications (MLBCs) at 1-year after TAVR and secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE) at 1-year, defined as a composite of all-cause death, myocardial infarction, stroke, and heart failure hospitalization. Ongoing primary hemostatic disorder was defined by a post-procedural CT-ADP>180sec.
Results Patients with AF had a higher incidence of MLBCs (20% vs. 12%, p=0.002), MACCE (29% vs. 20%, p=0.002), and all-cause mortality (15% vs. 8%, p=0.002) within 1-year compared to non-AF patients. When the cohort was split into 4 subgroups according to AF and CT-ADP>180sec, patients with AF and CT-ADP>180sec had the highest risk of MLBCs and MACCE. Multivariate Cox regression analysis confirmed that the patients with AF and CT-ADP>180sec had 3.9-fold higher risk of MLBCs, whereas those patients were no longer associated with MACCE after the adjustment.
Conclusions In TAVR patients, AF with post-procedural CT-ADP>180 sec was strongly associated with MLBCs following TAVR. Our study suggests that persistent primary haemostatic disorders contribute to a higher risk of bleeding events particularly in AF patients.
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Affiliation(s)
- Kensuke Matsushita
- Pôle d’Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Strasbourg, France
| | - Benjamin Marchandot
- Pôle d’Activité Médico-Chirurgicale Cardio-Vasculaire, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Marion Kibler
- Pôle d’Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Strasbourg, France
| | - Adrien Carmona
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | | | - Joe Heger
- Pôle d’Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Strasbourg, France
| | - Antonin Trimaille
- Pôle d’Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Strasbourg, France
| | - Sebastien Hess
- Cardiology, Université de Strasbourg, Strasbourg, France
| | - Laurent Sattler
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | | | | | - Laurence Jesel-Morel
- Pôle d’Activité Médico-Chirurgicale Cardio-Vasculaire, Centre Hospitalo Universitaire de Strasbourg, Strasbourg, France
| | - Patrick Ohlmann
- Cardiology department Hautepierre, Fédération de Cardiologie, Strasbourg, France
| | - Olivier Morel
- Cardiology, Hôpiaux Universitaires de Strasbourg, Strasbourg, France
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Mandelli D, Wang C, Hess S. On the Language of Reliability: A System Engineer Perspective. NUCL TECHNOL 2023. [DOI: 10.1080/00295450.2022.2143210] [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] [Indexed: 01/24/2023]
Affiliation(s)
- D. Mandelli
- Idaho National Laboratory, 1955 N. Fremont Avenue, Idaho Falls, Idaho ID 83415
| | - C. Wang
- Idaho National Laboratory, 1955 N. Fremont Avenue, Idaho Falls, Idaho ID 83415
| | - S. Hess
- Jensen Hughes, 158 W. Gay Street, West Chester, Pennsylvania 19380
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Kusk MW, Stowe J, Hess S, Gerke O, Foley S. Low-cost 3D-printed anthropomorphic cardiac phantom, for computed tomography automatic left ventricle segmentation and volumetry - A pilot study. Radiography (Lond) 2023; 29:131-138. [PMID: 36368249 DOI: 10.1016/j.radi.2022.10.015] [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: 08/22/2022] [Revised: 10/04/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Accurate cardiac left ventricle (LV) delineation is essential to CT-derived left ventricular ejection fraction (LVEF). To evaluate dose-reduction potential, an anatomically accurate heart phantom, with realistic X-ray attenuation is required. We demonstrated and tested a custom-made phantom using 3D-printing, and examined the influence of image noise on automatically measured LV volumes METHODS: A single coronary CT angiography (CCTA) dataset was segmented and converted to Standard Tessellation Language (STL) mesh, using open-source software. A 3D-printed model, with hollow left heart chambers, was printed and cavities filled with gelatinized contrast media. This was CT-scanned in an anthropomorphic chest phantom, at different exposure conditions. LV and "myocardium" noise and attenuation was measured. LV volume was automatically measured using two different methods. We calculated Spearmans' correlation of LV volume with noise and contrast-noise ratio respectively om 486 scans of the phantom. Source images were compared to one phantom series with similar parameters. This was done using Dice coefficient on LV short-axis segmentations. RESULTS Phantom "Myocardium" and LV attenuation was comparable to measurements on source images. Automatic volume measurement succeeded, with mean volume deviation to patient images less than 2 ml. There was a moderate correlation of volume with CNR, and strong correlation of volume with image noise. With papillary muscles included in LV volume, the correlation was positive, but negative when excluded. Variation of volumes was lowest at 90-100 kVp for both methods in the 486 repeat scans. The Dice coefficient was 0.87, indicating high overlap between the single phantom series and source scan. Cost of 3D-printer and materials was 400 and 30 Euro respectively. CONCLUSION Both anatomically and radiologically the phantom mimicked the source scans closely. LV volumetry was reliably performed with automatic algorithms. IMPLICATIONS FOR PRACTICE Patient-specific cardiac phantoms may be produced at minimal cost and can potentially be used for other anatomies and pathologies. This enables radiographic phantom studies without need for dedicated 3D-labs or expensive commercial phantoms.
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Affiliation(s)
- M W Kusk
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Ireland; Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Hospital South West Jutland Esbjerg, Denmark; IRIS - Imaging Research Initiative Southwest, Esbjerg, Denmark.
| | - J Stowe
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
| | - S Hess
- Department of Radiology and Nuclear Medicine, University Hospital of Southern Denmark, Hospital South West Jutland Esbjerg, Denmark; IRIS - Imaging Research Initiative Southwest, Esbjerg, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - O Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - S Foley
- Radiography & Diagnostic Imaging, School of Medicine, University College Dublin, Ireland
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Lindena T, Hess S. Is animal welfare better on smaller dairy farms? Evidence from 3,085 dairy farms in Germany. J Dairy Sci 2022; 105:8924-8945. [PMID: 36175235 DOI: 10.3168/jds.2022-21906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
Abstract
The structural change toward larger (dairy) farms is often criticized because it supposedly has a negative effect on farm animal welfare. We investigated this criticism using cross-sectional survey data from 3,085 German dairy farms. Even though our sample was a convenience sample, it closely resembled the diverse structures of dairy farming in Germany and covered a wide range of dairy farm sizes (7 to 2,900 cows per farm, mean 122). We developed an animal welfare index (AWI) in close consultation with experts along the dairy value chain (e.g., farm animal welfare scientists, farmers, dairy representatives). Regression results showed that larger farms tended to achieve a better AWI than smaller farms in our data set. However, the effect size was small. Nevertheless, in contrast to the widespread assumption in public discussion, larger dairy herds are not necessarily associated with poorer animal welfare. In all herd size classes, we found a large variation of AWI between herds. Although this study focused on the effect of herd size, it is not the only factor affecting animal welfare levels on individual farms. Other variables that we included in the regression to describe the AWI indicate that the knowledge and skills of the farm manager and the amount of time that farms can devote to animals have a positive effect on the AWI. However, as with herd size, the effect size of other explanatory variables was small in absolute terms.
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Affiliation(s)
- T Lindena
- Johann Heinrich von Thünen Institute, Institute of Farm Economics, Braunschweig, Lower Saxony, 38116, Germany.
| | - S Hess
- Department of Agricultural Markets, University of Hohenheim, Stuttgart, Baden-Württemberg, 70599, Germany
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Matsushita K, Marchandot B, Hess S, Kibler M, Sato C, Heger J, Truong D, Trimaille A, Sattler L, Grunebaum L, Reydel Dedieu A, Jesel L, Ohlmann P, Morel O. Primary hemostatic disorders drive early and late major bleedings of patients with atrial fibrillation after transcatheter aortic valve replacement. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Trimaille A, Matsushita K, Marchandot B, Carmona A, Hess S, Kibler M, Heger J, Reydel A, Sattler L, Grunebaum L, Jesel L, Ohlmann P, Morel O. Baseline mean platelet volume is a strong predictor of major and life-threatening bleedings after transcatheter aortic valve replacement. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Simon IV, De Poli F, Couppié P, Uhry S, Heyer H, Morel O, Ohlmann P, Hess S, Leddet P. [Challenges of coronary catheterization after TAVR]. Ann Cardiol Angeiol (Paris) 2021; 70:299-307. [PMID: 34635331 DOI: 10.1016/j.ancard.2021.08.008] [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: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Coronary catheterization after transcatheter aortic valve implantation (TAVR) may be challenging. The main objective of the study is to assess the feasibility of coronary catheterization and angioplasty according to each type of valve. PATIENTS AND METHOD We retrospectively studied coronary angiography or percutaneous angioplasty procedures after TAVR in two different centers. The catheterization success of coronary artery was evaluated according to the quality of engagement in ostium and opacification of the artery. Other indicators were collected including catheters used, fluoroscopy and angiography times, DAP and the volume of the contrast agent. RESULTS Among 1512 TAVR procedures, 33 patients were included. The Sapien 3® valve was implanted in 22 patients and the Evolut® in 11 patients (7 Evolut-R® and 4 Evolut Pro®). Coronary angiography with selective or partially selective catheterization has been successfully performed in all patients with a Sapien 3® valve. In the Evolut® group we identified 3 cases of non-selective catheterization for the right coronary and 1 case for the left coronary. Standard Judkins catheters seem to be the most suitable for both types of valve with very good efficiency. CONCLUSION The results of our study is promising for the future of TAVR with a coronary catheterization success rate close to 100% with some difficulties for the Evolut® supra-annular valves. Special attention should be paid to the technique of implantation and orientation of cups in the aortic sinus.
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Affiliation(s)
- I V Simon
- Service de Cardiologie, Centre Hospitalier Haguenau, 67 Avenue du Professeur René Leriche, 67500, Haguenau.
| | - F De Poli
- Service de Cardiologie, Centre Hospitalier Haguenau, 67 Avenue du Professeur René Leriche, 67500, Haguenau
| | - P Couppié
- Service de Cardiologie, Centre Hospitalier Haguenau, 67 Avenue du Professeur René Leriche, 67500, Haguenau
| | - S Uhry
- Service de Cardiologie, Centre Hospitalier Haguenau, 67 Avenue du Professeur René Leriche, 67500, Haguenau
| | - H Heyer
- Service de Cardiologie, Centre Hospitalier Haguenau, 67 Avenue du Professeur René Leriche, 67500, Haguenau
| | - O Morel
- Service de Cardiologie, CHU Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg
| | - P Ohlmann
- Service de Cardiologie, CHU Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg
| | - S Hess
- Service de Cardiologie, CHU Strasbourg, 1 Place de l'Hôpital, 67000 Strasbourg
| | - P Leddet
- Service de Cardiologie, Centre Hospitalier Haguenau, 67 Avenue du Professeur René Leriche, 67500, Haguenau
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Matsushita K, Marchandot B, Hess S, Kibler M, Sato C, Heger J, Truong DP, Trimaille A, Sattler L, Grunebaum L, Reydel A, Jesel L, Ohlmann P, Morel O. Primary hemostatic disorders drive early and late major bleedings of patients with atrial fibrillation after transcatheter aortic valve replacement. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Patients with atrial fibrillation (AF) are likely to have multiple co-morbidities and receive anticoagulants after TAVR, which lead to a poor prognosis including bleeding events. Closure time adenosine diphosphate (CT-ADP) is a primary hemostasis point-of-care test used as a surrogate marker of high molecular weight (HMW) multimers defect of Von Willebrand factor (VWF). Our prior studies suggest that prolongation of CT-ADP (>180 seconds) after TAVR is a major determinant of early and late major/life-threatening bleeding complications (MLBCs).
Purpose
To evaluate the impact of post-procedural CT-ADP >180sec on bleeding events in AF patients.
Methods
We included 878 patients from our prospective TAVR registry between 2010 and 2019. Bleeding complications were assessed according to the VARC-2 (Valve Academic Research Consortium-2) criteria. Major adverse cardiac and cerebrovascular events (MACCE) was defined as a composite of all-cause death, myocardial infarction, stroke, and heart failure hospitalization within 1-year after TAVR. Ongoing primary haemostasis disorder was defined by post-procedure CT-ADP >180sec. Primary endpoint was the occurrence of MLBCs during the first year and the second endpoint was 1-year MACCE.
Results
Patients with AF had a higher incidence of all-cause mortality (15% vs. 8%, p=0.002), MACCE (29% vs. 20%, p=0.002), and MLBCs (20% vs. 12%, p=0.001) within 1-year compared to non-AF patients. When the cohort was split into 4 subgroups according to AF and CT-ADP >180sec, patients with AF and CT-ADP >180sec had the highest risk of MLBCs (log-rank test; p<0.001) (Figure). Multivariate Cox regression analysis confirmed that the patients with AF and CT-ADP >180sec had 4.6-fold higher risk of MLBCs within 1 year compared to non-AF patients with CT-ADP ≤180sec (hazard ratio: 4.60; 95% confidence interval: 2.18 - 9.68; p<0.001).
Conclusion
Among TAVR patients, AF with post-procedural CT-ADP >180 sec was identified as a strong independent predictor of MLBCs at 1-year follow-up. Our study suggest that persistent primary haemostasis disorders contribute to a higher risk of bleeding events particularly in AF patients and may be considered for a tailored and risk-adjusted antithrombotic therapy after TAVR.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Dr Matsushita received a grant from Edwards Lifesciences.
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Affiliation(s)
- K Matsushita
- University Hospital of Strasbourg, Strasbourg, France
| | - B Marchandot
- University Hospital of Strasbourg, Strasbourg, France
| | - S Hess
- University Hospital of Strasbourg, Strasbourg, France
| | - M Kibler
- University Hospital of Strasbourg, Strasbourg, France
| | - C Sato
- University Hospital of Strasbourg, Strasbourg, France
| | - J Heger
- University Hospital of Strasbourg, Strasbourg, France
| | - D P Truong
- University Hospital of Strasbourg, Strasbourg, France
| | - A Trimaille
- University Hospital of Strasbourg, Strasbourg, France
| | - L Sattler
- University Hospital of Strasbourg, Strasbourg, France
| | - L Grunebaum
- University Hospital of Strasbourg, Strasbourg, France
| | - A Reydel
- University Hospital of Strasbourg, Strasbourg, France
| | - L Jesel
- University Hospital of Strasbourg, Strasbourg, France
| | - P Ohlmann
- University Hospital of Strasbourg, Strasbourg, France
| | - O Morel
- University Hospital of Strasbourg, Strasbourg, France
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11
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Burkart P, Bossard M, Moccetti F, Hess S, Jeyarasa M, Madanchi M, Cioffi G, Seiler T, Wolfrum M, Hakimi M, Seelos R, Toggweiler S, Attinger-Toller A, Kobza R, Cuculi F. Utility and safety of the MANTA device for access site closure after removal of the mechanical hemodynamic support device Impella on the intensive care unit. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The percutaneously implanted hemodynamic mechanical support devices Impella are commonly used in patients at risk for or with cardiogenic shock (CS). Impella removal after hemodynamic stabilization on the intensive care unit (ICU) remains a major challenge and is prone to high rates of bleeding and vascular complications.
Purpose
It is unknown if the use of the novel large-bore access closure device MANTA® is safe and facilitates access management compared to manual compression.
Methods
Between January 2017 and December 2020, 172 CS patients were treated with an Impella® device at our centre. Of those, in 89 patients the Impella® was removed on the ICU and access site management occurred with either MANTA® device or manual compression. The criteria for MANTA® 14 french device deployment included: (i) femoral artery Diameter >6mm and (ii) absence of significant peripheral arterial disease (PAD). Bleeding and vascular access site complications were assessed and adjudicated according to the Valve Academic Research Consortium-2 (VARC-2) criteria.
Results
Among the 89 included patients, Impella® removal was performed using the MANTA® device in 31 cases and manual compression in 58 cases. Mean age was 66±11 years, and 50 (56.2%) patients had a CS classified as Society for Cardiovascular Angiography and Interventions (SCAI) D or higher due to myocardial infarction. Median support time was 40 (IQR 24; 69) hours. Baseline characteristics are displayed in Table 1. Immediate haemostasis was more frequently achieved by MANTA® device compared to manual compression (p=0.034). Moreover, we observed significantly less overall (2 (6.5%) vs. 22 (37.9%), p=0.001) and minor bleedings (1 (3.2%) vs. 15 (25.9%), p=0.006) with the MANTA® device when compared to manual compression. Of note, there were no significant differences in vascular complications between the two groups (Table 2).
Conclusions
In patients requiring Impella® support and residing on ICU, the MANTA® device, compared to standard of care manual compression, seems to be a safe and effective option for access site management, especially with regards to the reduction of bleeding events. However, physicians should carefully assess the vascular anatomy and degree of calcification prior to deployment of the MANTA® device. Nevertheless, more prospective data is necessary for evaluating the optimal access closure among CS patients treated with a percutaneously implanted Impella® device.
Funding Acknowledgement
Type of funding sources: None. Table 1. Baseline demographicsTable 2. Outcomes
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Affiliation(s)
- P Burkart
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Bossard
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - F Moccetti
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - S Hess
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Jeyarasa
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Madanchi
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - G Cioffi
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - T Seiler
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Wolfrum
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - M Hakimi
- Luzerner Kantonsspital, Vascular surgery, Luzern, Switzerland
| | - R Seelos
- Luzerner Kantonsspital, Vascular surgery, Luzern, Switzerland
| | - S Toggweiler
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | | | - R Kobza
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
| | - F Cuculi
- Luzerner Kantonsspital, Cardiology, Luzern, Switzerland
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12
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Rombey T, Goossen K, Kugler C, De Santis KK, Breuing J, Mathes T, Hess S, Burchard R, Pieper D. Hospital volume-outcome relationship in total knee arthroplasty: a systematic review and dose-response meta-analysis. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732748] [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] [Indexed: 10/20/2022]
Affiliation(s)
- T Rombey
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
| | - K Goossen
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
| | - C Kugler
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
| | - KK De Santis
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
- Leibniz Institut für Präventiosforschung und Epidemiologie (BIPS)
| | - J Breuing
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
| | - T Mathes
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
| | - S Hess
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
| | - R Burchard
- Klinik für Orthopädie und Unfallchirurgie, Lahn-Dill-Kliniken Dillenburg
- Fakultät für Gesundheit, Universität Witten/Herdecke
- Zentrum für Orthopädie und Unfallchirurgie, Universität Gießen und Marburg
| | - D Pieper
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke
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13
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Peillex M, Marchandot B, Matsushita K, Prinz E, Hess S, Reydel A, Kibler M, Carmona A, Trimaille A, Heger J, Petit-Eisenmann H, Trinh A, Jesel L, Ohlmann P, Morel O. Acute kidney injury and acute kidney recovery following Transcatheter Aortic Valve Replacement. PLoS One 2021; 16:e0255806. [PMID: 34375346 PMCID: PMC8354447 DOI: 10.1371/journal.pone.0255806] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 07/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background Acute kidney injury (AKI) is associated with a dismal prognosis in Transcatheter Aortic Valve replacement (TAVR). Acute kidney recovery (AKR), a phenomenon reverse to AKI has recently been associated with better outcomes. Methods Between November 2012 to May 2018, we explored consecutive patients referred to our Heart Valve Center for TAVR. AKI was defined according to the VARC-2 definition. Mirroring the VARC-2 definition of AKI, AKR was defined as a decrease in serum creatinine (≥50%) or ≥25% improvement in GFR up to 72 hours after TAVR. Results AKI and AKR were respectively observed in 8.3 and 15.7% of the 574 patients included. AKI and AKR patients were associated to more advanced kidney disease at baseline. At a median follow-up of 608 days (range 355–893), AKI and AKR patients experienced an increased cardiovascular mortality compared to unchanged renal function patients (14.6% and 17.8% respectively, vs. 8.1%, CI 95%, p<0.022). Chronic kidney disease, (HR: 3.9; 95% CI 1.7–9.2; p < 0.001) was the strongest independent factor associated with AKI similarly to baseline creatinine level (HR: 1; 95% CI 1 to 1.1 p < 0.001) for AKR. 72-hours post procedural AKR (HR: 2.26; 95% CI 1.14 to 4.88; p = 0.021) was the strongest independent predictor of CV mortality. Conclusions Both AKR and AKI negatively impact long term clinical outcomes of patients undergoing TAVR.
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Affiliation(s)
- Marilou Peillex
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Benjamin Marchandot
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Kensuke Matsushita
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Eric Prinz
- Department of Nephrology, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Sebastien Hess
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Antje Reydel
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Marion Kibler
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Adrien Carmona
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Antonin Trimaille
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Joe Heger
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Hélène Petit-Eisenmann
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Annie Trinh
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Laurence Jesel
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Patrick Ohlmann
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Olivier Morel
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
- * E-mail:
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14
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Berry KLE, Hess S, Clark TD, Wenger AS, Hoogenboom MO, Negri AP. Effects of suspended coal particles on gill structure and oxygen consumption rates in a coral reef fish. Mar Pollut Bull 2021; 169:112459. [PMID: 34022563 DOI: 10.1016/j.marpolbul.2021.112459] [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] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/15/2021] [Accepted: 05/02/2021] [Indexed: 06/12/2023]
Abstract
Large quantities of coal are transported through tropical regions; however, little is known about the sub-lethal effects of coal contamination on tropical marine organisms, including fish. Here, we measured aerobic metabolism and gill morphology in a planktivorous coral reef damselfish, Acanthochromis polyacanthus to elucidate the sub-lethal effects of suspended coal particles over a range of coal concentrations and exposure durations. Differences in the standard oxygen consumption rates (MO2) between control fish and fish exposed to coal particles (38 and 73 mg L-1) were minimal and generally not dose dependent; however, the MO2 of fish exposed to 38 mg coal L-1 (21 days) and 73 mg coal L-1 (31 days) were both significantly higher than the MO2 of control fish. Chronic coal exposure (31 days) altered gill structure in the higher coal treatments (73 and 275 mg L-1), with fish exposed to 275 mg L-1 exhibiting significant reductions in gill mucous and thinning of lamellar and filament epithelium. These findings contribute to our limited understanding of the potential impacts of coal on tropical reef species; however, most of the observed effects occurred at high coal concentrations that are unlikely under most coal spill scenarios. Future studies should investigate other contamination scenarios such as the impacts of chronic exposures to lower concentrations of coal.
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Affiliation(s)
- K L E Berry
- AIMS@JCU, James Cook University, Australian Institute of Marine Science, Townsville, Queensland 4811, Australia; College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia; Australian Institute of Marine Science, Townsville, Queensland 4810, Australia.
| | - S Hess
- College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia
| | - T D Clark
- Deakin University, School of Life and Environmental Sciences, Geelong, Victoria 3216, Australia
| | - A S Wenger
- School of Earth and Environmental Sciences, University of Queensland, St. Lucia, Queensland 4072, Australia
| | - M O Hoogenboom
- College of Science and Engineering, James Cook University, Townsville, QLD 4811, Australia; ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville, Queensland 4811, Australia
| | - A P Negri
- Australian Institute of Marine Science, Townsville, Queensland 4810, Australia
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15
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Lippert RN, Hess S, Klemm P, Burgeno LM, Jahans-Price T, Walton ME, Kloppenburg P, Brüning JC. Maternal high-fat diet during lactation reprograms the dopaminergic circuitry in mice. J Clin Invest 2021; 130:3761-3776. [PMID: 32510473 DOI: 10.1172/jci134412] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [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: 10/21/2019] [Accepted: 03/26/2020] [Indexed: 12/31/2022] Open
Abstract
The maternal perinatal environment modulates brain formation, and altered maternal nutrition has been linked to the development of metabolic and psychiatric disorders in the offspring. Here, we showed that maternal high-fat diet (HFD) feeding during lactation in mice elicits long-lasting changes in gene expression in the offspring's dopaminergic circuitry. This translated into silencing of dopaminergic midbrain neurons, reduced connectivity to their downstream targets, and reduced stimulus-evoked dopamine (DA) release in the striatum. Despite the attenuated activity of DA midbrain neurons, offspring from mothers exposed to HFD feeding exhibited a sexually dimorphic expression of DA-related phenotypes, i.e., hyperlocomotion in males and increased intake of palatable food and sucrose in females. These phenotypes arose from concomitantly increased spontaneous activity of D1 medium spiny neurons (MSNs) and profoundly decreased D2 MSN projections. Overall, we have unraveled a fundamental restructuring of dopaminergic circuitries upon time-restricted altered maternal nutrition to induce persistent behavioral changes in the offspring.
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Affiliation(s)
- R N Lippert
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Cologne, Germany.,National Center for Diabetes Research (DZD), Neuherberg, Germany
| | - S Hess
- Biocenter, Institute for Zoology, and.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - P Klemm
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Cologne, Germany
| | - L M Burgeno
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - T Jahans-Price
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - M E Walton
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - P Kloppenburg
- Biocenter, Institute for Zoology, and.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - J C Brüning
- Department of Neuronal Control of Metabolism, Max Planck Institute for Metabolism Research, Cologne, Germany.,National Center for Diabetes Research (DZD), Neuherberg, Germany.,Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,Center for Endocrinology, Diabetes and Preventive Medicine (CEPD), University Hospital of Cologne, Cologne, Germany
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16
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Kanso M, Kibler M, Hess S, Rischner J, Plastaras P, Kindo M, Hoang M, De Poli F, Leddet P, Petit H, Zeyons F, Trinh A, Matsushita K, Morel O, Ohlmann P. Effective Orifice Area of Balloon-Expandable and Self-Expandable Transcatheter Aortic Valve Prostheses: An Echo Doppler Comparative Study. J Clin Med 2021; 10:jcm10020186. [PMID: 33430206 PMCID: PMC7825656 DOI: 10.3390/jcm10020186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/11/2020] [Accepted: 01/05/2021] [Indexed: 11/16/2022] Open
Abstract
Published data on the size-specific effective orifice area (EOA) of transcatheter heart valves (THVs) remain scarce. Here, we sought to investigate the intra-individual changes in EOA and mean transvalvular aortic gradient (MG) of the Sapien 3 (S3), CoreValve (CV), and Evolut R (EVR) prostheses both at short-term and at 1-year follow-up. The study sample consisted of 260 consecutive patients with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI). EOAs and MGs were measured with Doppler echocardiography for the following prostheses: S3 23 mm (n = 74; 28.5%), S3 26 mm (n = 67; 25.8%), S3 29 mm (n = 20; 7.7%), CV 23 mm (n = 2; 0.8%), CV 26 mm (n = 15; 5.8%), CV 29 mm (n = 24; 9.2%), CV 31 mm (n = 9; 3.5%), EVR 26 mm (n = 22; 8.5%), and EVR 29 mm (n = 27; 10.4%). Values were obtained at discharge, 1 month, 6 months, and 1 year from implantation. At discharge, EOAs were larger and MGs lower for larger-size prostheses, regardless of being balloon-expandable or self-expandable. In patients with small aortic annulus size, the hemodynamic performances of CV and EVR prostheses were superior to those of S3. However, we did not observe significant differences in terms of all-cause mortality according to THV type or size. Both balloon-expandable and self-expandable new-generation THVs show excellent hemodynamic performances without evidence of very early valve degeneration.
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Affiliation(s)
- Mohamad Kanso
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Marion Kibler
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Sebastien Hess
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Jérome Rischner
- Hôpital Albert Schweitzer, 201 Avenue d’Alsace, 68003 Colmar, France; (J.R.); (P.P.)
| | - Philoktimon Plastaras
- Hôpital Albert Schweitzer, 201 Avenue d’Alsace, 68003 Colmar, France; (J.R.); (P.P.)
| | - Michel Kindo
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Minh Hoang
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Fabien De Poli
- Centre Hospitalier d’Haguenau, 64 Avenue Du Professeur Leriche, 67504 Haguenau, France; (F.D.P.); (P.L.)
| | - Pierre Leddet
- Centre Hospitalier d’Haguenau, 64 Avenue Du Professeur Leriche, 67504 Haguenau, France; (F.D.P.); (P.L.)
| | - Hélène Petit
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Floriane Zeyons
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Annie Trinh
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Kensuke Matsushita
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Olivier Morel
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
| | - Patrick Ohlmann
- Pôle d’Activité Médico-Chirurgicale Cardiovasculaire, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (M.K.); (M.K.); (S.H.); (M.K.); (M.H.); (H.P.); (F.Z.); (A.T.); (O.M.)
- Correspondence: ; Tel.: +33-388-695-50953
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17
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Peillex M, Marchandot B, Matsushita K, Prinz E, Hess S, Reydel Dedieu A, Carmona A, Heger J, Trimaille A, Petit-Eisenmann H, Trinh A, Jesel L, Ohlmann P, Morel O. Acute kidney injury and Acute kidney recovery following TAVR: Conflicting results with regards to earlier studies. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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18
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Carmona A, Marchandot B, Matsushita K, Curtiaud A, Elidrissi A, Trimaille A, Kibler M, Cardi T, Heger J, Hess S, Reydel A, Fafi-Kremer S, Schini-Kerth V, Jesel L, Ohlmann P, Morel O. Impact of Covid-19 infection in high-risk coronary patients. Archives of Cardiovascular Diseases Supplements 2021. [PMCID: PMC7803089 DOI: 10.1016/j.acvdsp.2020.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Background Methods Results Conclusions
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19
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Bjerring OS, Hess S, Petersen H, Fristrup CW, Lundell L, Mortensen MB. Value of regular endosonography and [18F]fluorodeoxyglucose PET-CT after surgery for gastro-oesophageal junction, stomach or pancreatic cancer. BJS Open 2020; 5:6044702. [PMID: 33688946 PMCID: PMC7944502 DOI: 10.1093/bjsopen/zraa028] [Citation(s) in RCA: 2] [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: 08/13/2020] [Accepted: 09/28/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Most patients undergo follow-up after surgery for cancers of the gastro-oesophageal junction, stomach or pancreas, but data to support which modalities to use and the frequency of investigation are limited. METHODS Patients in the EUFURO study were randomized to either visits to the outpatient clinic at 3, 6, 9, 12, 18, and 24 months after surgery (standard), or to the addition of [18F]fluorodeoxyglucose (FDG) PET-CT and endoscopic ultrasonography (EUS) with guided fine-needle aspiration biopsy to clinical assessments (intervention). Data from the intervention arm were used to analyse the diagnostic performance of endosonography or [18F]FDG PET-CT in detecting recurrences. RESULTS During the scheduled follow-up, 42 of 89 patients developed recurrence; PET-CT and EUS in combination detected 38 of these recurrences. EUS detected 23 of the 42 patients with recurrent disease during follow-up and correctly diagnosed 17 of 19 locoregional recurrences. EUS was able to detect isolated locoregional recurrence in 11 of 13 patients. In five patients, EUS was false-positive for isolated locoregional recurrence owing to missed distant metastases. PET-CT detected locoregional recurrence in only 12 of 19 patients, and isolated locoregional recurrence in only 7 of 13. False-positive PET-CT results in 23 patients led to a total of 44 futile procedures. CONCLUSION Accuracy in detecting recurrences by concomitant use of PET-CT and EUS was high (90 per cent). PET-CT had moderate to high sensitivity for overall recurrence detection, but low specificity. EUS was superior to PET-CT in the detection of locoregional and isolated locoregional recurrences.
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Affiliation(s)
- O S Bjerring
- Department of Surgery, Odense University Hospital, Odense, Denmark.,OPAC, Odense Pancreas Centre, Odense University Hospital, Odense, Denmark
| | - S Hess
- Department of Physiology and Nuclear Medicine, Odense University Hospital, Odense, Denmark.,Department of Radiology and Nuclear Medicine, Hospital South West Jutland, Esbjerg, Denmark.,Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - H Petersen
- Department of Physiology and Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - C W Fristrup
- Department of Surgery, Odense University Hospital, Odense, Denmark.,OPAC, Odense Pancreas Centre, Odense University Hospital, Odense, Denmark
| | - L Lundell
- Department of Surgery, Odense University Hospital, Odense, Denmark.,CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - M B Mortensen
- Department of Surgery, Odense University Hospital, Odense, Denmark.,OPAC, Odense Pancreas Centre, Odense University Hospital, Odense, Denmark
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Matsushita K, Marchandot B, Carmona A, Curtiaud A, El Idrissi A, Trimaille A, Kibler M, Cardi T, Heger J, Hess S, Reydel A, Jesel L, Ohlmann P, Morel O. Increased susceptibility to SARS-CoV-2 infection in patients with reduced left ventricular ejection fraction. ESC Heart Fail 2020; 8:380-389. [PMID: 33205916 PMCID: PMC7753539 DOI: 10.1002/ehf2.13083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 06/18/2020] [Revised: 09/03/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022] Open
Abstract
Aims Cardiovascular disease has been recognized as a major determinant of coronavirus disease 2019 (COVID‐19) vulnerability and severity. Angiotensin‐converting enzyme (ACE) 2 is a functional receptor for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and is up‐regulated in patients with heart failure. We sought to examine the potential association between reduced left ventricular ejection fraction (LVEF) and the susceptibility to SARS‐CoV‐2 infection. Methods and results Of the 1162 patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention between February 2014 and October 2018, we enrolled 889 patients with available clinical follow‐up data. Follow‐up was conducted by telephone interviews 1 month after the start of the French lockdown which began on 17 March 2020. Patients were divided into two groups according to LVEF <40% (reduced LVEF) (n = 91) or ≥40% (moderately reduced + preserved LVEF) (n = 798). The incidence of COVID‐19‐related hospitalization or death was significantly higher in the reduced LVEF group as compared with the moderately reduced + preserved LVEF group (9% vs. 1%, P < 0.001). No association was found between discontinuation of ACE‐inhibitor or angiotensin‐receptor blockers and COVID‐19 test positivity. By multivariate logistic regression analysis, reduced LVEF was an independent predictor of COVID‐19 hospitalization or death (odds ratio: 6.91, 95% confidence interval: 2.60 to 18.35, P < 0.001). Conclusions In a large cohort of patients with previous ACS, reduced LVEF was associated with increased susceptibility to COVID‐19. Aggressive COVID‐19 testing and therapeutic strategies may be considered for patient with impaired heart function.
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Affiliation(s)
- Kensuke Matsushita
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Benjamin Marchandot
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Adrien Carmona
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Anais Curtiaud
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Anis El Idrissi
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Antonin Trimaille
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Marion Kibler
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Thomas Cardi
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Joe Heger
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Sebastien Hess
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Antje Reydel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Laurence Jesel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Patrick Ohlmann
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Olivier Morel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
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Matsushita K, Hess S, Marchandot B, Sato C, Truong DP, Kim NT, Weiss A, Jesel L, Ohlmann P, Morel O. Clinical features of patients with acute coronary syndrome during the COVID-19 pandemic. J Thromb Thrombolysis 2020; 52:95-104. [PMID: 33200333 PMCID: PMC7668406 DOI: 10.1007/s11239-020-02340-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
Although a reduction in hospital admissions of acute coronary syndromes (ACS) patients has been observed globally during the coronavirus disease 2019 (COVID-19) pandemic, clinical features of those patients have not been fully investigated. The aim of the present analysis is to investigate the incidence, clinical presentation, and outcomes of patients with ACS during the COVID-19 pandemic. We performed a retrospective analysis of consecutive patients who were admitted for ACS at our institution between March 1 and April 20, 2020 and compared with the equivalent period in 2019. Admissions for acute myocardial infarction (AMI) reduced by 39.5% in 2020 compared with the equivalent period in 2019. Owing to the emergency medical services (EMS) of our region, all time components of ST-elevated myocardial infarction care were similar during the COVID-19 outbreak as compared with the previous year’s dataset. Among the 106 ACS patients in 2020, 7 patients tested positive for COVID-19. Higher incidence of type 2 myocardial infarction (29% vs. 4%, p = 0.0497) and elevated D-dimer levels (5650 μg/l [interquartile range (IQR) 1905–13,625 μg/l] vs. 400 μg/l [IQR 270–1050 μg/l], p = 0.02) were observed in COVID-19 patients. In sum, a significant reduction in admission for AMI was observed during the COVID-19 pandemic. COVID-19 patients were characterized by elevated D-dimer levels on admission, reflecting enhanced COVID-19 related thrombogenicity. The prehospital evaluation by EMS may have played an important role for the timely revascularization for STEMI patients.
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Affiliation(s)
- Kensuke Matsushita
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Sebastien Hess
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France
| | - Benjamin Marchandot
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France
| | - Chisato Sato
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Dinh Phi Truong
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France.,Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
| | - Ngoc Thanh Kim
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France.,Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam
| | - Anne Weiss
- Centre Hospitalier Universitaire, SAMU 67, Strasbourg, France
| | - Laurence Jesel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Patrick Ohlmann
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France
| | - Olivier Morel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital, 67091, Strasbourg cedex, France. .,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France.
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22
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Matsushita K, Marchandot B, Kibler M, Trimaille A, Hess S, Grunebaum L, Reydel A, Jesel L, Ohlmann P, Morel O. Predictive Impact of Paravalvular Leak Assessments on Clinical Outcomes Following Transcatheter Aortic Valve Replacement. Am J Cardiol 2020; 135:181-182. [PMID: 32858026 DOI: 10.1016/j.amjcard.2020.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/11/2020] [Accepted: 08/11/2020] [Indexed: 11/24/2022]
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23
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Matsushita K, Marchandot B, Kibler M, Sato C, Heger J, Peillex M, Trimaille A, Hess S, Grunebaum L, Ohana M, Reydel A, Jesel L, Ohlmann P, Morel O. P2Y12 inhibition by clopidogrel increases adverse clinical outcomes in patients undergoing transcatheter aortic valve replacement. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Current recommendations support short-term dual antiplatelet therapy (DAPT) for patients undergoing transcatheter aortic valve replacement (TAVR) despite no relevant study exploring the extent of platelet inhibition by clopidogrel.
Purpose
To assess whether P2Y12 inhibition by clopidogrel as evaluated by vasodilator-stimulated phosphoprotein flow cytometry test (VASP-FCT) impacts 1-year clinical outcomes in patients undergoing TAVR.
Methods
Patients were included in a prospective registry between February 2010 and May 2019. VASP-FCT was assessed 24h after the procedure. Responder to clopidogrel was defined by a platelet reactivity index ≤50%.
Results
Of 640 patients who underwent TAVR with preprocedural clopidogrel therapy, we enrolled 491 patients for whom VASP data were available. Responders were identified in 22% (n=110) of patients and low responders were 78% (n=381) of patients. Low body mass index, active cancer, and clopidogrel on admission were found to be independent predictors of responder. Mean transaortic pressure gradient was lower in the responder group at 1-month post-TAVR (9.9±4.4 mmHg vs. 11.2±5.8 mmHg, p=0.03) but was similar at 1-year (11.5±6.2 mmHg vs. 11.9±7.4 mmHg, p=0.74). By multivariate Cox regression analysis, patients responding to clopidogrel (hazard ratio [HR]: 2.19; 95% confidence interval [CI]: 1.04 to 3.64; p=0.04), prior PCI (HR: 2.12; 95% CI: 1.07 to 4.37; p=0.03), and mean transaortic pressure gradient at baseline (HR: 0.07; 95% CI: 0.01 to 0.70; p=0.02) were identified as independent predictors of 1-year adverse clinical outcomes, including all-cause death, myocardial infarction, stroke, and heart failure hospitalization.
Conclusions
Appropriate P2Y12 inhibition by clopidogrel is a major determinant of adverse clinical events after TAVR. In sum, the present data challenges the need of DAPT as a standard therapy during TAVR.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Matsushita
- University Hospital of Strasbourg, Strasbourg, France
| | - B Marchandot
- University Hospital of Strasbourg, Strasbourg, France
| | - M Kibler
- University Hospital of Strasbourg, Strasbourg, France
| | - C Sato
- University Hospital of Strasbourg, Strasbourg, France
| | - J Heger
- University Hospital of Strasbourg, Strasbourg, France
| | - M Peillex
- University Hospital of Strasbourg, Strasbourg, France
| | - A Trimaille
- University Hospital of Strasbourg, Strasbourg, France
| | - S Hess
- University Hospital of Strasbourg, Strasbourg, France
| | - L Grunebaum
- University Hospital of Strasbourg, Strasbourg, France
| | - M Ohana
- University Hospital of Strasbourg, Strasbourg, France
| | - A Reydel
- University Hospital of Strasbourg, Strasbourg, France
| | - L Jesel
- University Hospital of Strasbourg, Strasbourg, France
| | - P Ohlmann
- University Hospital of Strasbourg, Strasbourg, France
| | - O Morel
- University Hospital of Strasbourg, Strasbourg, France
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24
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Lachmet-Thebaud L, Marchandot B, Matsushita K, Sato C, Dagrenat C, Greciano S, De Poli F, Leddet P, Peillex M, Hess S, Carmona A, Reydel A, Ohlmann P, Jesel L, Morel O. Residual inflammation is a major determinant of myocardial recovery and cardiovascular outcome in takotsubo patients. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent insights have emphasized the importance of myocardial and systemic inflammation in Takotsubo Syndrome (TTS).
Objective
In a large registry of unselected patients, we sought to evaluate whether residual high inflammatory response (RHIR) could impact cardiovascular outcome after TTS.
Methods
Patients with TTS were retrospectively included between 2008 and 2018 in three general hospitals. 385 patients with TTS were split into three subgroups, according to tertiles of C-reactive protein (CRP) levels at discharge (CRP<5.2 mg/l, CRP range 5.2 to 19 mg/l, and CRP>19 mg/L). The primary endpoint was the impact of RHIR, defined as CRP>19 mg/L at discharge, on cardiac death or hospitalization for heart failure.
Results
Follow-up was obtained in 382 patients (99%) after a median of 747 days. RHIR patients were more likely to have a history of cancer or a physical trigger. Left ventricular ejection fraction (LVEF) at admission and at discharge were comparable between groups. By contrast, RHIR was associated with lower LVEF at follow-up (61.7 vs. 60.7 vs. 57.9%; p=0.004) and increased cardiac late mortality (0% vs. 0% vs. 10%; p=0.001). By multivariate Cox regression analysis, RHIR was an independent predictor of cardiac death or hospitalization for heart failure (hazard ratio: 1.97; 95% confidence interval: 1.11 to 3.49; p=0.02).
Conclusions
RHIR was associated with impaired LVEF recovery and was evidenced as an independent factor of cardiovascular events. All together these findings underline RHIR patients as a high-risk subgroup, to target in future clinical trials with specific therapies to attenuate RHIR.
Main results
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): GERCA (Groupe pour l'Enseignement, la prévention et la Recherche Cardiovasculaire en Alsace)
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Affiliation(s)
| | - B Marchandot
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - K Matsushita
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - C Sato
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - C Dagrenat
- Haguenau Hospital Centre, Cardiology, Haguenau, France
| | - S Greciano
- Civil Hospital of Colmar, Colmar, France
| | - F De Poli
- Haguenau Hospital Centre, Cardiology, Haguenau, France
| | - P Leddet
- Civil Hospital of Colmar, Colmar, France
| | - M Peillex
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - S Hess
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - A Carmona
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - A Reydel
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - P Ohlmann
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - L Jesel
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
| | - O Morel
- Civil Hospital/Nouvel Hopital Civil, Strasbourg, France
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Matsushita K, Marchandot B, Kibler M, Sato C, Heger J, Peillex M, Trimaille A, Hess S, Grunebaum L, Ohana M, Reydel A, Jesel L, Ohlmann P, Morel O. Predictive impact of PVL assessments on clinical outcomes in patients undergoing TAVR. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Paravalvular leakage (PVL) following transcatheter aortic valve replacement (TAVR) is associated with greater mortality. In clinical practice, determining PVL severity after TAVR remains challenging and often requires multiparametric assessment.
Purpose
This study sought to evaluate the respective value of various modalities of PVL assessments, including transthoracic echocardiography (TTE), cine-angiography, aortic regurgitation index (ARI), and closure time with adenosine diphosphate (CT-ADP), in the prediction of adverse clinical outcomes.
Methods
We included 1044 patients from our prospective TAVR registry between February 2010 and May 2019. Major adverse cardiac and cerebrovascular events (MACCE) was defined as a composite of all-cause death, myocardial infarction, stroke, and heart failure hospitalization within 1-year. Established cutoff values of ARI (<25) and CT-ADP (>180 sec) were used to assess the presence of PVL after TAVR.
Results
Moderate to severe PVL occurred in 14.2% and 5.2% of patients as measured by TTE and angiography. The rate of patients with ARI <25 and CT-ADP >180 sec were 36.5% and 24.9%, respectively. Among the four modalities, PVL evaluated by angiography predicted poorer clinical outcomes (Log rank test; p=0.001), whereas TTE, ARI <25, and CT-ADP >180 sec were not associated with 1-year MACCE. By multivariate Cox regression analysis, moderate to severe PVL by angiography was an independent predictor of 1-year MACCE (hazard ratio: 1.96; 95% confidence interval: 1.22–3.00; p=0.007).
Conclusions
Paravalvular leakage measured by angiography was evidenced as the most meaningful modality in the prediction of adverse clinical outcomes. Future multicenter studies are warranted to ensure these findings in the current TAVR era.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Matsushita
- University Hospital of Strasbourg, Strasbourg, France
| | - B Marchandot
- University Hospital of Strasbourg, Strasbourg, France
| | - M Kibler
- University Hospital of Strasbourg, Strasbourg, France
| | - C Sato
- University Hospital of Strasbourg, Strasbourg, France
| | - J Heger
- University Hospital of Strasbourg, Strasbourg, France
| | - M Peillex
- University Hospital of Strasbourg, Strasbourg, France
| | - A Trimaille
- University Hospital of Strasbourg, Strasbourg, France
| | - S Hess
- University Hospital of Strasbourg, Strasbourg, France
| | - L Grunebaum
- University Hospital of Strasbourg, Strasbourg, France
| | - M Ohana
- University Hospital of Strasbourg, Strasbourg, France
| | - A Reydel
- University Hospital of Strasbourg, Strasbourg, France
| | - L Jesel
- University Hospital of Strasbourg, Strasbourg, France
| | - P Ohlmann
- University Hospital of Strasbourg, Strasbourg, France
| | - O Morel
- University Hospital of Strasbourg, Strasbourg, France
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Matsushita K, Hess S, Ohlmann P, Morel O. Accordion phenomenon in the descending aorta during transcatheter aortic valve replacement followed by mesenteric ischaemia. Eur Heart J 2020; 41:2819. [PMID: 32738047 DOI: 10.1093/eurheartj/ehz793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kensuke Matsushita
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital - 67091 Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, 74 route du Rhin, Illkirch 67401, France
| | - Sebastien Hess
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital - 67091 Strasbourg, France
| | - Patrick Ohlmann
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital - 67091 Strasbourg, France
| | - Olivier Morel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, 1 place de l'Hôpital - 67091 Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, 74 route du Rhin, Illkirch 67401, France
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Matsushita K, Marchandot B, Trimaille A, Kibler M, Heger J, Peillex M, Hess S, Grunebaum L, Reydel A, Kindo M, Hoang MT, Sato C, De Poli F, Leddet P, Ohana M, Jesel L, Ohlmann P, Susen S, Morel O. Paradoxical Increase of Stroke in Patients with Defect of High Molecular Weight Multimers of the von Willebrand Factors following Transcatheter Aortic Valve Replacement. Thromb Haemost 2020; 120:1330-1338. [PMID: 32726854 DOI: 10.1055/s-0040-1713424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Stroke is a major cause of disability after transcatheter aortic valve replacement (TAVR) and stroke prediction models and data are crucially needed. Following TAVR, high molecular weight (HMW) multimers defect of von Willebrand factor (VWF) as assessed by closure time of adenosine diphosphate (CT-ADP) value > 180 seconds is an independent predictor of bleeding events. This study sought to identify predictors of ischemic neurological events in patients who underwent TAVR and the specific impact of HMW multimers defect of VWF. METHODS Patients were prospectively enrolled between November 2012 and May 2018 at our institution. The CT-ADP, a point-of-care measure of hemostasis, was assessed the day before and 24 hours after the procedures. The rate of ischemic stroke and transient ischemic attack (TIA) was recorded up to 30 days after the procedures. RESULTS Of 565 TAVR patients, ischemic stroke/TIA was observed in 21 (3.7%) patients within 30 days. Ischemic stroke/TIA was associated with major/life-threatening bleeding complications (MLBCs) (9 [43%] vs. 88 [16%], p = 0.002) and postprocedure CT-ADP > 180 seconds (10 [48%] vs. 116 [21%], p = 0.01). By multivariate analysis, MLBCs (odds ratio [OR]: 3.58; 95% confidence interval [CI]: 1.45-8.84; p = 0.006) and postprocedure CT-ADP > 180 seconds (OR: 3.38; 95% CI: 1.38-8.25; p = 0.008) were evidenced as independent predictors of ischemic stroke/TIA. CONCLUSION MLBCs and CT-ADP > 180 seconds were identified as predictors for ischemic stroke or TIA. The present study suggests that the defects of HMW multimers of the VWFs may contribute not only to bleeding events but also to thrombotic events.
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Affiliation(s)
- Kensuke Matsushita
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Benjamin Marchandot
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Antonin Trimaille
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Marion Kibler
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Joe Heger
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Marilou Peillex
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Sebastien Hess
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Lelia Grunebaum
- Department of Haemostasis, Centre Hospitalier Universitaire, Strasbourg, France
| | - Antje Reydel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Michel Kindo
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Minh Tam Hoang
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Chisato Sato
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Fabien De Poli
- Department of Cardiology, Centre Hospitalier de Haguenau, Haguenau, France
| | - Pierre Leddet
- Department of Cardiology, Centre Hospitalier de Haguenau, Haguenau, France
| | - Mickael Ohana
- Department of Radiology, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Laurence Jesel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
| | - Patrick Ohlmann
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France
| | - Sophie Susen
- INSERM U1011 - EGID, Institut Pasteur de Lille, University of Lille, Lille, France.,Hematology Transfusion, CHU Lille, Lille, France
| | - Olivier Morel
- Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Université de Strasbourg, Strasbourg, France.,UMR1260 INSERM, Nanomédecine Régénérative, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France
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Emamifar A, Hess S, Gerke O, Syrak Hansen P, Jensen Hansen IM, Marcussen N, Ellingsen T, Thye-Rønn P. FRI0203 A SINGLE-CENTER INVESTIGATION ON THE PREVALENCE OF MALIGNANCIES IN PATIENTS WITH POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS BY WAY OF 18F-FDG PET/CT: A PROSPECTIVE COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Several chronic inflammatory diseases are associated with a higher risk of cancer.[1] Whether, this is the case in Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA) is still a matter of debate.Objectives:To identify the prevalence of newly diagnosed cancers in patients with PMR and GCA by means of 18F-FDG PET/CT. Moreover, to compare the characteristics of the patients with and without cancer.Methods:Eighty consecutive patients with newly diagnosed PMR/GCA were studied. Diagnosis of PMR/GCA was confirmed by a 40-weeks follow up. A unilateral temporal artery biopsy (TAB) was also performed at the time of diagnosis. All included patients underwent an 18F-FDG PET/CT before, or in case of GCA, within 3 days of initiation of high dose oral glucocorticoid (40-75mg). All cancer-suspicious 18F-FDG-PET/CT findings were assessed thoroughly and malignant diseases were confirmed by histology. Total PMR and GCA scores were defined as the sum of a 4-point visual grading scale in each articular/periarticular site as well as arterial segment.Results:Of the 80 patients, 64 (83.1%) were diagnosed with pure PMR, 10 (13.0%) with concomitant GCA with PMR and 3 (3.9%) with pure GCA. Three patients were diagnosed with rheumatoid arthritis during follow up and excluded from the study. Five types of cancer in 4 (5.2%;95% CI:1.4-12.8%) patients were found. Two patients had breast cancer, one patient had adenocarcinoma of colon and one patient had adenocarcinoma of colon together with skin cancer. Besides, 4 (5.2%;95% CI:1.4-12.8%) patients had Monoclonal Gammopathy of Unknown Significance (MGUS). Age and C-reactive protein were significantly higher among those with solid cancers (p:0.049) and MGUS (p:0.017), respectively (Table1).Table 1.Characteristics of the patients with and without solid cancer ae well as MGUSVariablesCancer –,n=73Cancer +,n=4P-valueMGUS -, n =73MGUS +,n =4P-valueAge, mean±SD71.4±7.879.7±7.50.04971.9±8.070.2±9.20.79Gender, n(%)Female46(59.7%)3(3.9%)0.9947(61.0%)2(2.6%)0.62Constitutional symptoms, n(%)70(90.9%)4(5.2%)0.9970(90.9%)4(5.2%)0.99Shoulder girdle symptoms, n(%)68(88.3%)4(5.2%)0.9968(88.3%)4(5.2%)0.99Hip girdle symptoms, n(%)65(84.4%)3(3.9%)0.4064(83.1%)4(5.2%)0.99Cranial symptoms, n(%)19(24.7%)0(0%)0.5717(22.1%)2(2.6%)0.25Patients pain VAS75(50-85)62.5(50-75)0.5372.5(50 -80)87.5(77.5-95)0.07Patients global VAS80(60-90)62.5(50-75)0.3780(60-90)89.5(79.5-95)0.23Physician global VAS30(25-40)24.5(20-29)0.1530(22.5-40)37.5(32.5-45)0.17Erythrocyte sedimentation rate, mm[2-20]54(38-79)62.5(37.5-76)0.9354(38-77.5)57.5(39 -73.5)0.94C-reactive protein, mg/L[<6.0]37(17-64)34(17.0-76)0.8033(17-60)98(68 -115)0.017TAB positive7(9.1%)0(0%)0.997(9.1%)0(0%)0.99Total PMR score14(10-17)12(5-15)0.3914(10-17)13(6-15.5)0.64Total GCA score0(0-0)0(0-0.5)0.890(0-0)0(0-0)0.34Clinical diagnosis, n(%)0.990.53 Pure PMR60(77.9%)4(5.2%)61(79.2%)3(3.9%) Pure GCA3(3.9%)0(0%)3(3.9%)0(0%) Concomitant PMR and GCA10(13.0%)0(0%)9(11.7%)1(1.3%)VAS: Visual analogue scaleConclusion:The prevalence of cancers in this cohort was higher, compared to the 1-year prevalence of all cancer sites of 1.2% among age-, gender- and region-matched background population in 2016. Occult malignancies are important and relatively prevalent findings in newly diagnosed PMR/GCA patients.References:[1]Hemminki K, et al. Cancer risk in hospitalized rheumatoid arthritis patients. Rheumatology (Oxford) 2008;47:698-701.Disclosure of Interests:None declared
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Ortega Gonzalez M, Gutiérrez Hernández P, Hess S. P-02-74 Do Penile Dimensions Affect Partner's Sexual Pleasure? J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Carmona A, Marchandot B, Kibler M, Trimaille A, Heger J, Peillex M, Matsushita K, Ristorto J, Hoang V, Hess S, Jesel L, Ohlmann P, Morel O. Impact of incomplete coronary revascularization on late ischemic and bleeding events after transcatheter aortic-valve Replacement. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jimenez C, Ohana M, Marchandot B, Kibler M, Carmona A, Peillex M, Heger J, Trimaille A, Matsushita K, Reydel A, Hess S, Jesel L, Ohlmann P, Morel O. Impact of anti-thrombotic regimen and platelet inhibition extent on leaflet thrombosis detected by cardiac MDCT after transcatheter aortic-valve replacement. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Matsushita K, Marchandot B, Kibler M, Trimaille A, Hess S, Grunebaum L, Reydel A, Jesel L, Ohlmann P, Morel O. P2Y12 Inhibition by Clopidogrel Increases Periprocedural Bleeds in Patients Undergoing Transcatheter Aortic Valve Replacement. J Am Coll Cardiol 2019; 74:2707-2708. [DOI: 10.1016/j.jacc.2019.09.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 09/15/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
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Drouelle E, De Poli F, Couppie P, Uhry S, Heyer H, Morel O, Ohlmann P, Hess S, Kibler M, Leddet P. [Common femoral artery bailout stenting with covered stent graft due to TAVR vascular complication: Clinical long term follow-up]. Ann Cardiol Angeiol (Paris) 2019; 68:316-324. [PMID: 31570157 DOI: 10.1016/j.ancard.2019.08.007] [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: 06/29/2019] [Accepted: 08/28/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Vascular complications are frequent in the context of transcatheter aortic valve replacement and may require the implantation of a covered stent graft in the common femforal artery. However, common femoral artery is considered to be at high risk of stent fracture or occlusion due to high mobility of the hip joint. PATIENTS AND METHODS We analyzed medical records of patients with transcatheter aortic valve replacement related vascular complications between 2015 and 2018, treated with commom femoral artery transluminal angioplasty or surgery. Vascular complications or suspect symptoms were followed up by phone calls. RESULTS Among 552 patients, 43 patients were included. Twelve (11.6 %) were managed by prolonged balloon inflation, 5 (11.6 %) by first line surgery and 26 (60.4 %) by the implantation of a covered stent graft. Among the latter group, the covered stent graft was efficient in 24 patients (92.3 %). The median follow-up was 430 days [3-1499]. The first-line surgery group had a higher risk of red blood cell transfusion and all causes mortality. At follow-up, no patient had suspicious symptoms of vascular covered stent complication. Four patients (9.3 %) had US-doppler or CT vascular imaging at follow-up, showing no evidence of stent fracture or occlusion. CONCLUSION In our study, the implantation of a covered stent graft in the common femoral artery was an efficient and safe strategy for the management of transcatheter aortic valve replacement related vascular complications.
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Affiliation(s)
- E Drouelle
- Service de cardiologie, Centre hospitalier Haguenau, 67, avenur du Pr René-Leriche, 67 500 Haguenau.
| | - F De Poli
- Service de cardiologie, Centre hospitalier Haguenau, 67, avenur du Pr René-Leriche, 67 500 Haguenau
| | - P Couppie
- Service de cardiologie, Centre hospitalier Haguenau, 67, avenur du Pr René-Leriche, 67 500 Haguenau
| | - S Uhry
- Service de cardiologie, Centre hospitalier Haguenau, 67, avenur du Pr René-Leriche, 67 500 Haguenau
| | - H Heyer
- Service de cardiologie, Centre hospitalier Haguenau, 67, avenur du Pr René-Leriche, 67 500 Haguenau
| | - O Morel
- Service de cardiologie, CHU de Strasbourg, 1, place de l'Hôpital, 67 000 Strasbourg
| | - P Ohlmann
- Service de cardiologie, CHU de Strasbourg, 1, place de l'Hôpital, 67 000 Strasbourg
| | - S Hess
- Service de cardiologie, CHU de Strasbourg, 1, place de l'Hôpital, 67 000 Strasbourg
| | - M Kibler
- Service de cardiologie, CHU de Strasbourg, 1, place de l'Hôpital, 67 000 Strasbourg
| | - P Leddet
- Service de cardiologie, Centre hospitalier Haguenau, 67, avenur du Pr René-Leriche, 67 500 Haguenau
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Mohammadi-Shemirani P, Chong M, Sjaarda J, Hess S, Gerstein HC, Pare G. P6345Effect of free testosterone levels on cardiovascular outcomes: a Mendelian randomization analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6345] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - M Chong
- McMaster University, Biochemistry and Biomedical Sciences, Hamilton, Canada
| | - J Sjaarda
- McMaster University, Medical Sciences, Hamilton, Canada
| | - S Hess
- Sanofi Aventis Deutschland GmbH, Frankfurt, Germany
| | - H C Gerstein
- Population Health Research Institute, Hamilton, Canada
| | - G Pare
- Population Health Research Institute, Hamilton, Canada
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Gram SB, Hess S, Ahlquist P, Høilund-Carlsen PF, Ellingsen T. [ 18F]Sodium fluoride positron emission tomography/computed tomography: a predictor of early rheumatoid arthritis? A case report. Scand J Rheumatol 2018; 47:425-426. [PMID: 29318921 DOI: 10.1080/03009742.2017.1369153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S B Gram
- a Department of Rheumatology , Odense University Hospital , Odense , Denmark
| | - S Hess
- b Department of Nuclear Medicine , Odense University Hospital , Odense , Denmark.,c Department of Radiology and Nuclear Medicine , Hospital of Southwest Jutland , Esbjerg , Denmark
| | | | - P F Høilund-Carlsen
- b Department of Nuclear Medicine , Odense University Hospital , Odense , Denmark
| | - T Ellingsen
- a Department of Rheumatology , Odense University Hospital , Odense , Denmark
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Birgy C, Messas N, Ristorto J, Hess S, Kayali A, Marchandot B, Cardi T, Jesel L, Ohlmann P, Morel O. Procedural sedation during transradial coronary angiography. Impact of opiod analgesia and inhalation sedation by 50% nitrous oxide/oxygen premix (Kalinox) on pain and radial artery spasm. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.049] [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: 11/15/2022]
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El Ghannudi S, Hess S, Reydel A, Crimizade U, Jesel L, Radulescu B, Wiesel ML, Gachet C, Ohlmann P, Morel O. The extent of P2Y12 inhibition by clopidogrel in diabetes mellitus patients with acute coronary syndrome is not related to glycaemic control: Roles of white blood cell count and body weight. Thromb Haemost 2017; 108:338-48. [DOI: 10.1160/th11-12-0876] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 05/11/2012] [Indexed: 11/05/2022]
Abstract
SummaryIt was the study objective to determine whether glycaemic control affects the extent of platelet inhibition by thienopyridines as assessed by vasodilator-stimulated phosphoprotein flow cytometry (VASP-FCT) in patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) during acute coronary syndrome (ACS). Although the proportion of high on-treatment residual platelet reactivity is higher in DM, the contributions of glycaemic control and other factors associated with DM, such as excess body weight and inflammation, to this impaired platelet inhibition by thienopyridines have not yet been fully characterised. In this study, the extent of P2Y12 ADP receptor pathway inhibition was evaluated by the VASP-FCT. Platelet activation was expressed as the platelet reactivity index (PRI). Low response to clopidogrel (LR) was defined as a PRI of >61%. Four hundred forty-five consecutive ACS patients (DM = 160, NDM = 285) were enrolled. The proportion of LR was higher in DM patients (50 vs. 37.5%). In DM, PRI was not correlated with glycosylated haemoglobin (HbA1c) or glycaemia. In a univariate analysis, LR was associated with age, male sex, overweight, and white blood cell count (WBC). In a multivariate analysis, WBC >10,000 and body weight >80 kg were the sole independent predictors of LR to clopidogrel (hazard ratio (HR) 3.02 [1.36–6.68], p=0.006 and HR 2.47 [1.14–5.35], p = 0.021, respectively). Conversely, in non-DM patients, ST-elevation myocardial infarction was the sole independent predictor of LR. In conclusion, in ACS DM patients undergoing PCI, the extent of P2Y12 inhibition by clopidogrel is not related to glycaemic control but is related to body weight and inflammatory status as assessed by the WBC.
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Hess S, Baker G, Gyenes G, Tsuyuki R, Newman S, Le Melledo JM. Decreased serum L-arginine and L-citrulline levels in major depression. Psychopharmacology (Berl) 2017; 234:3241-3247. [PMID: 28803324 DOI: 10.1007/s00213-017-4712-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 04/18/2017] [Accepted: 08/06/2017] [Indexed: 11/26/2022]
Abstract
RATIONALE It has been suggested that endothelial dysfunction caused by a decreased endothelial production of nitric oxide (NO) may contribute to the consistently observed increased risk of developing cardiovascular disease (CVD) in physically healthy patients suffering from major depression (MD). NO is a gas synthesized from Larginine (a conditionally essential amino acid) and oxygen by endothelial nitric oxide synthase (eNOS). The end products of NO production include both NO and L-citrulline. NO is rapidly reduced to the anions nitrite and nitrate, classically referred to as NO metabolites. Their measurement has been used as a surrogate measurement for endothelial NO production. We and others have shown decreased levels of NO metabolites in the serum of MD patients. The mechanism of this decreased production of NO by the endothelium has not yet been elucidated. OBJECTIVES The purpose of this study is to assess serum levels of L-arginine and L-citrulline in patients with MD. METHODS Levels of L-arginine and L-citrulline were measured in 35 unmedicated physically healthy MD patients and 36 healthy controls (HCs). RESULTS L-arginine and L-citrulline concentrations were significantly lower in MD patients than in healthy controls (L-arginine, 73.54 + 21.53 μmol/L and 84.89 + 25.16, p = 0.04 μmol/L and L-citrulline 31.58 + 6.05 μmol/L and 35.19 + 6.85 μmol/L, p = 0.03, respectively). CONCLUSIONS The decrease in L-arginine levels in MD patients is a possible explanation for the decrease in NO metabolites in MD patients and therefore may contribute, through endothelial dysfunction, to the increased CV risk associated with MD.
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Affiliation(s)
- S Hess
- Department of Psychiatry, University of Alberta, 114th street, Edmonton, AB, T6G 2B7, Canada
| | - G Baker
- Department of Psychiatry, Neurochemical Research Unit, University of Alberta, 114th street, Edmonton, AB, T6G 2B7, Canada
| | - G Gyenes
- Department of Cardiology, University of Alberta, 114th street, Edmonton, AB, T6G 2B7, Canada
| | - R Tsuyuki
- Department of Cardiology, University of Alberta, 114th street, Edmonton, AB, T6G 2B7, Canada
| | - S Newman
- Department of Psychiatry, University of Alberta, 114th street, Edmonton, AB, T6G 2B7, Canada
| | - Jean-Michel Le Melledo
- Department of Psychiatry, University of Alberta, 114th street, Edmonton, AB, T6G 2B7, Canada.
- University of Alberta Hospital, 114th street, Edmonton, AB, T6G 2B7, Canada.
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Akkan D, Jensen L, Veien K, Husain M, Deibjerg L, Junker A, Thomsen K, Rohold A, Hess S, Norgaard B, Sand N. P5864Prediction of standard of care guided coronary revascularisation by FFRct is preserved across a broad range of coronary calcification. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5864] [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: 11/13/2022] Open
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Cardi T, Kayali A, Messas N, Marchandot B, Ristorto J, Hess S, Jesel L, Ohlmann P, Morel O. P6467Prognosis value of incomplete revascularization after PCI following acute coronary syndrome: focus on CKD patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6467] [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: 11/12/2022] Open
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Akkan D, Deibjerg L, Husain M, Veien K, Jensen L, Junker A, Thomsen K, Rohold A, Hess S, Norgaard B, Sand N. P5868FFRct to predict coronary revascularisation - a real-world experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5868] [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: 11/13/2022] Open
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Calcaianu M, Kremer H, Messas N, Zeyons F, Crimizade U, Kindo M, Attali P, Hess S, Morel O, Ohlmann P. Immediate benefit of balloon aortic valvuloplasty in low flow aortic stenosis: hemodynamic echographic assessment in coronary care unit. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30194-5] [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: 11/25/2022]
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Zeyons F, Jesel L, Morel O, Kremer H, Messas N, Hess S, Crimizade U, Reydel P, Tritsch L, Ohlmann P. Out-of-hospital cardiac arrest survivors sent for emergency angiography: a clinical score for predicting acute myocardial infarction. Eur Heart J Acute Cardiovasc Care 2016; 6:103-111. [PMID: 28304194 DOI: 10.1177/2048872616683525] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study. RESULTS A total of 177 patients with complete datasets were included. Significant coronary artery disease was found in 71% of the patients, and 43% presented with AMI. The independent predictors of AMI were ST elevation in any lead including aVR (odds ratio (OR) 18.06; 95% confidence interval (CI) 6.6-49.38), chest pain before cardiac arrest (OR 4.05; 95% CI 1.55-10.54) and an initial shockable rhythm (OR 2.99; 95% CI 1.34-6.45). An additive score that included these three predictors yielded a sensitivity and a specificity for detecting AMI of 93% and 63%, respectively. CONCLUSIONS These data suggest that fewer than half of patients with OHCA undergoing emergency coronary angiography present with AMI. The identification of OHCA patients with AMI might be improved by a simple score using post-resuscitation ECG and simple clinical criteria.
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Affiliation(s)
- Floriane Zeyons
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
| | - Laurence Jesel
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
| | - Olivier Morel
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
| | - Hélène Kremer
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
| | - Nathan Messas
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
| | - Sebastien Hess
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
| | - Ulun Crimizade
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
| | | | | | - Patrick Ohlmann
- 1 Pôle d'Activité Médico-Chirurgicale Cardiovasculaire, Nouvel Hôpital Civil, France
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Messas N, Caspar T, Jesel L, Hess S, Girardey M, Radulescu B, Zupan M, Crimizade U, Kremer H, Ohlmann P, Morel O. Takotsubo cardiomyopathy triggered by ischemic injury: When lateralmyocardial infarction precipitate apical ballooning syndrome. Int J Cardiol 2016; 202:858-60. [DOI: 10.1016/j.ijcard.2015.10.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/04/2015] [Indexed: 11/28/2022]
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Brügger U, Plessow R, Hess S, Caballero A, Eichler K, Meyer V, von Wartburg U. The health technology assessment of the compulsory accident insurance scheme of hand transplantation in Switzerland. J Hand Surg Eur Vol 2015; 40:914-23. [PMID: 25409115 DOI: 10.1177/1753193414559463] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 10/20/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED Recently the decision-making committee of the compulsory Swiss accident insurance scheme needed to make a basic decision as to whether to fund hand transplantation under that scheme or not. A Health Technology Assessment was commissioned to inform decision-making and gain experience with applicability of the method. The following were main findings from various domains. Compared with prosthesis fitting, the outcome of hand transplantation is satisfactory for function and sensibility. Complications due to immunosuppression are frequent, sometimes severe and potentially life-shortening. The direct medical costs over the entire life span calculated for a 35-year-old unilaterally amputated base case patient were CHF 528,600 (EUR 438,500) higher than for a prosthesis. There are challenging ethical, legal and organizational issues. The committee decided not to reimburse hand transplantation for ethical reasons. The Health Technology Assessment has been shown to be a useful tool for decision-making in the context of Swiss accident insurance. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- U Brügger
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - R Plessow
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - S Hess
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - A Caballero
- Medical Tariff Committee for Swiss National Accident Insurance (MTK UVG), Lucerne, Switzerland
| | - K Eichler
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - V Meyer
- Department of Hand-Plastic and Reconstructive Surgery, University Hospital Zurich, Zurich, Switzerland
| | - U von Wartburg
- Division of Hand and Plastic Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
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Turpie A, Amarenco P, Haas S, Hess S, Kirchhof P, Kuhls S, Van Eickels M, Camm A. NON-INTERVENTIONAL STUDY ON THE SAFETY OF RIVAROXABAN FOR STROKE PREVENTION IN NON-VALVULAR ATRIAL FIBRILLATION IN ROUTINE CLINICAL PRACTICE: XANTUS. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Czoski Murray C, Twiddy M, Meads D, Hess S, Wright J, Mitchell ED, Hulme C, Dodd S, Gent H, Gregson A, McLintock K, Raynor DK, Reynard K, Stanley P, Vincent R, Minton J. Community IntraVenous Antibiotic Study (CIVAS): protocol for an evaluation of patient preferences for and cost-effectiveness of community intravenous antibiotic services. BMJ Open 2015; 5:e008965. [PMID: 26297374 PMCID: PMC4550740 DOI: 10.1136/bmjopen-2015-008965] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Outpatient parenteral antimicrobial therapy (OPAT) is used to treat a wide range of infections, and is common practice in countries such as the USA and Australia. In the UK, national guidelines (standards of care) for OPAT services have been developed to act as a benchmark for clinical monitoring and quality. However, the availability of OPAT services in the UK is still patchy and until quite recently was available only in specialist centres. Over time, National Health Service (NHS) Trusts have developed OPAT services in response to local needs, which has resulted in different service configurations and models of care. However, there has been no robust examination comparing the cost-effectiveness of each service type, or any systematic examination of patient preferences for services on which to base any business case decision. METHODS AND ANALYSIS The study will use a mixed methods approach, to evaluate patient preferences for and the cost-effectiveness of OPAT service models. The study includes seven NHS Trusts located in four counties. There are five inter-related work packages: a systematic review of the published research on the safety, efficacy and cost-effectiveness of intravenous antibiotic delivery services; a qualitative study to explore existing OPAT services and perceived barriers to future development; an economic model to estimate the comparative value of four different community intravenous antibiotic services; a discrete choice experiment to assess patient preferences for services, and an expert panel to agree which service models may constitute the optimal service model(s) of community intravenous antibiotics delivery. ETHICS AND DISSEMINATION The study has been approved by the NRES Committee, South West-Frenchay using the Proportionate Review Service (ref 13/SW/0060). The results of the study will be disseminated at national and international conferences, and in international journals.
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Affiliation(s)
- C Czoski Murray
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - M Twiddy
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - D Meads
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - S Hess
- Institute for Transport Studies, University of Leeds, Leeds, UK
| | - J Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - E D Mitchell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - C Hulme
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - S Dodd
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - A Gregson
- Leeds Community Healthcare Trust, Leeds, UK
| | - K McLintock
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - D K Raynor
- School of Healthcare, University of Leeds, Leeds, UK
| | - K Reynard
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - P Stanley
- Bradford Teaching Hospitals NHS Foundation Trust, Leeds, UK
| | - R Vincent
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Minton
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Laustrup H, Velander M, Junker P, Hess S. AB0648 Disease Mapping in Anca Associated Vasculitis (AAV). Yield of FDG-PET/CT Imaging Versus a Conventional Clinico-Pathological Approach,:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2466] [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: 11/04/2022]
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Prado E, Abbeddou S, Adu‐Afarwuah S, Arimond M, Ashorn P, Ashorn U, Brown K, Hess S, Lartey A, Maleta K, Ocansey E, Ouedraogo JB, Phuka J, Somé J, Vosti S, Yakes Jimenez E, Dewey K. Associations between Linear Growth and Language Development in Ghana, Malawi, and Burkina Faso. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.899.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - P Ashorn
- Int Health U of Tampere School of MedicineFinland
| | - U Ashorn
- Int Health U of Tampere School of MedicineFinland
| | | | - S Hess
- Nutr UCDavisUnited States
| | | | - K Maleta
- Comm Health U of Malawi College of MedicineMalawi
| | - E Ocansey
- Nutr UCDavisUnited States
- NutrU of GhanaGhana
| | - JB Ouedraogo
- Inst de Recherche en Sciences de la Santé DROBurkina FASO
| | - J Phuka
- Comm Health U of Malawi College of MedicineMalawi
| | - J Somé
- Nutr UCDavisUnited States
- Inst de Recherche en Sciences de la Santé DROBurkina FASO
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Abstract
The kinetic theory of particles with spin previously developed for a LORENTzian gas is extended to the case of a pure gas. In part A the transport (BOLTZMANN) equation for the one particle distribution operator is stated and discussed (conservation laws, Η-theorem). A magnetic field acting on the magnetic moment of the particles is incorporated throughout. In part B the pertaining linearized collision operator and certain bracket expressions linked with this operator are considered. Part C deals with the expansion of the distribution operator and of the linearized transport equation with respect to a complete set of composite irreducible tensors built from the components of particle velocity and spin. Thus, the distribution operator is replaced by a set of tensors depending only on time and space-coordinates. The physical meaning of these tensors (expansion coefficients) is invoked. They obey a set of coupled first-order differential equations (transport-relaxation equations) . The reciprocity relations for the relaxation matrices are stated. Finally a detailed discussion of angular momentum conservation is given.
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Affiliation(s)
- S. Hess
- Institut für Theoretische Physik der Universität Erlangen-Nürnberg, Erlangen
| | - L. Waldmann
- Institut für Theoretische Physik der Universität Erlangen-Nürnberg, Erlangen
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