1
|
Marut B, Donal E. The computer is fantastic for our daily echocardiography practice. Int J Cardiol 2024; 407:132013. [PMID: 38582241 DOI: 10.1016/j.ijcard.2024.132013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 03/30/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024]
Affiliation(s)
- Benjamin Marut
- Department of Cardiology, University of Rennes, CHU Rennes, Inserm, LTSI - UMR, 1099 Rennes, France
| | - Erwan Donal
- Department of Cardiology, University of Rennes, CHU Rennes, Inserm, LTSI - UMR, 1099 Rennes, France.
| |
Collapse
|
2
|
Myon F, Marut B, Kosmala W, Auffret V, Leurent G, L'official G, Curtis E, Le Breton H, Oger E, Donal E. Transcatheter aortic valve implantation impact on left ventricular myocardial damage: long term follow-up. Eur Heart J Cardiovasc Imaging 2024:jeae017. [PMID: 38236150 DOI: 10.1093/ehjci/jeae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Aortic stenosis (AS) is causing myocardial damages and replacement is mainly indicated based on symptoms. Non-invasive estimation of myocardial work (MW) provide a less afterload dependent tool that, we sought to look at the impact of transcatheter aortic valve implantation (TAVI) on the myocardium at long-term follow-up and according to current indications. METHODS We conducted an observational, cross-sectional, single-center study. Patients were selected based on the validated indication for a TAVI. Standardized echocardiographies were repeated. RESULTS 102 patients were included. Mean age was 85-year-old, 45% were female, 68% get high-blood pressure and 52% had a coronary disease. One fifth was suffering from low-flow low-gradient aortic stenosis. Follow-up was performed at 22 ± 9.5 months after the TAVI. No TAVI-dysfunction was observed. LVEF was stable (62 ± 8%), and global longitudinal strain get improved (-14.0% ± 3.7 vs -16.0% ± 3.6, p-value <0.0001). No improvement of the MW-parameters was noticed (Global Work Index (LV GWI) 2099 ± 692mmHg% vs 2066 ± 706mmHg%, p=0.8, Global Constructive (LV GCW) 2463 ± 736mmHg% vs 2463 ± 676mmHg%, p=0.8). Global Wasted Work increased (214 [149; 357] mmHg% vs 247 [177; 394] mmHg%, p= 0.0008). CONCLUSION In a population of severe symptomatic AS-patients who had undergone a TAVI, the non-invasive myocardial indices that assess the LV performance at long term follow-up did not improve. These results are questioning the timing of the intervention and the need for a more attention in the pharmacological management of these AS-patients.
Collapse
Affiliation(s)
- Frederic Myon
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| | - Benjamin Marut
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| | | | - Vincent Auffret
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| | - Guillaume Leurent
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| | - Guillaume L'official
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| | - Elizabeth Curtis
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| | - Herve Le Breton
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| | - Emmanuel Oger
- EA Reperes, CHU Rennes, University Rennes, Rennes, France
| | - Erwan Donal
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France
| |
Collapse
|
3
|
Pierre-Jean M, Marut B, Curtis E, Galli E, Cuggia M, Bouzillé G, Donal E. Phenotyping of heart failure with preserved ejection faction using electronic health records and echocardiography. Eur Heart J Open 2024; 4:oead133. [PMID: 38196848 PMCID: PMC10775683 DOI: 10.1093/ehjopen/oead133] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 01/11/2024]
Abstract
Aims Patients presenting symptoms of heart failure with preserved ejection fraction (HFpEF) are not a homogenous population. Different phenotypes can differ in prognosis and optimal management strategies. We sought to identify phenotypes of HFpEF by using the medical information database from a large university hospital centre using machine learning. Methods and results We explored the use of clinical variables from electronic health records in addition to echocardiography to identify different phenotypes of patients with HFpEF. The proposed methodology identifies four phenotypic clusters based on both clinical and echocardiographic characteristics, which have differing prognoses (death and cardiovascular hospitalization). Conclusion This work demonstrated that artificial intelligence-derived phenotypes could be used as a tool for physicians to assess risk and to target therapies that may improve outcomes.
Collapse
Affiliation(s)
- Morgane Pierre-Jean
- CHU Rennes, Inserm, University of Rennes, LTSI—UMR 1099, hopital Pontchaillou, rue Henri Le Guillou, 35000 Rennes, France
| | - Benjamin Marut
- CHU Rennes, Inserm, University of Rennes, LTSI—UMR 1099, hopital Pontchaillou, rue Henri Le Guillou, 35000 Rennes, France
| | - Elizabeth Curtis
- CHU Rennes, Inserm, University of Rennes, LTSI—UMR 1099, hopital Pontchaillou, rue Henri Le Guillou, 35000 Rennes, France
| | - Elena Galli
- CHU Rennes, Inserm, University of Rennes, LTSI—UMR 1099, hopital Pontchaillou, rue Henri Le Guillou, 35000 Rennes, France
| | - Marc Cuggia
- CHU Rennes, Inserm, University of Rennes, LTSI—UMR 1099, hopital Pontchaillou, rue Henri Le Guillou, 35000 Rennes, France
| | - Guillaume Bouzillé
- CHU Rennes, Inserm, University of Rennes, LTSI—UMR 1099, hopital Pontchaillou, rue Henri Le Guillou, 35000 Rennes, France
| | - Erwan Donal
- CHU Rennes, Inserm, University of Rennes, LTSI—UMR 1099, hopital Pontchaillou, rue Henri Le Guillou, 35000 Rennes, France
| |
Collapse
|
4
|
Marut B, Charbonneau E, Curtis E, Donal E. Will computerised medical records and statistical tools really help us move towards precision medicine of heart failure with preserved ejection fraction? Heart 2023:heartjnl-2023-322475. [PMID: 37068925 DOI: 10.1136/heartjnl-2023-322475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Affiliation(s)
- Benjamin Marut
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| | - Etienne Charbonneau
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| | - Elizabeth Curtis
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| | - Erwan Donal
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| |
Collapse
|