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Bohbot Y, Garot J, Hovasse T, Unterseeh T, Di Lena C, Boukefoussa W, Tawa C, Renard C, Limouzineau I, Duhamel S, Garot P, Tribouilloy C, Sanguineti F. Clinical and cardiovascular magnetic resonance predictors of early and long-term clinical outcome in acute myocarditis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.183] [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: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
The natural history of acute myocarditis (AM) remains partially unknown and predictors of outcome are debated.
Purpose
We sought to assess the impact of various cardiac magnetic resonance (CMR) parameters on early and long-term prognosis in a population of patients with AM.
Methods
In a two-centre longitudinal study, we included consecutive patients with diagnosis of AM based on CMR and without haemodynamic compromise. The primary endpoint was the occurrence of an event in the acute phase (≤15 days). Secondary endpoints were the occurrence of major adverse cardiac events (MACE) and recurrence of AM during follow-up.
Results
Three hundred and eighty-eight patients were included (mean age 38.5 years, 77.3% male, mean ejection fraction [EF]:56%) of which 82% (317) presented with chest pain. CMR was performed 4±2 days after index presentation. Overall, 38 patients (9.8%) had an event at the acute phase, 41 (10.6%) presented at least one MACE during follow-up (median 7.5 years, 6.6–8.9) and 30 (7.7%) experienced a recurrence of AM. By multivariate analysis, the independent predictors of initial complications were absence of chest pain (OR [95% CI] = 0.35 [0.15–0.82]), presence of syncope/pre-syncope (OR [95% CI] = 3.56 [1.26–10.02]), lower EF (OR [95% CI] = 0.94 [0.91–0.98] per %), myocardial extent of late gadolinium enhancement (LGE) (OR [95% CI] = 1.05 [1.002–1.100] per %) and absence of edema (OR [95% CI] = 0.44 [0.19–0.97]). Only age (HR [95% CI] = 1.021 [1.001–1.041] per year) and an initial alteration of EF (HR [95% CI] = 0.94 [0.91–0.97] per %) were associated with MACE during follow-up. Factors independently associated with AM recurrence were myocarditis prior to the index episodes (HR [95% CI] = 5.74 [1.72–19.22]) and viral syndrome at the index episode (HR [95% CI] = 4.21 [1.91–9.28]).
Conclusion
In routine consecutive hemodynamically stable patients with diagnosis of AM based on CMR, absence of edema, reduced EF, and extent of LGE were associated with early adverse outcome. Only age and EF were associated with long-term events.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Bohbot
- University Hospital of Amiens , Amiens , France
| | - J Garot
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - T Hovasse
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - T Unterseeh
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - C Di Lena
- University Hospital of Amiens , Amiens , France
| | | | - C Tawa
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - C Renard
- University Hospital of Amiens , Amiens , France
| | | | - S Duhamel
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | - P Garot
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
| | | | - F Sanguineti
- Cardiovascular Institute Paris-Sud (ICPS) , Massy , France
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Mohty D, Duhamel S, Magne J, Lavergne D, Bordessoule D, Aboyans V, Guthrie S, Jaccard A. P1813Incidence and prevalence of light chain amyloidosis: a population-based study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1813] [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: 11/12/2022] Open
Affiliation(s)
- D Mohty
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - S Duhamel
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - J Magne
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - D Lavergne
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | | | - V Aboyans
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
| | - S Guthrie
- Biopharma Consulting, San Fransisco, United States of America
| | - A Jaccard
- University Hospital of Limoges, National Referral Center of Amyloidosis, Limoges, France
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Dauvin JC, Desroy N, Janson AL, Vallet C, Duhamel S. Recent changes in estuarine benthic and suprabenthic communities resulting from the development of harbour infrastructure. Mar Pollut Bull 2006; 53:80-90. [PMID: 16249007 DOI: 10.1016/j.marpolbul.2005.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Using a Before/During/After sampling protocol, the effects of the Le Havre harbour extension, which was started at the end of 2001, on the macrobenthic and suprabenthic communities in the eastern Bay of Seine (English Channel) were examined. As the construction phase has not yet been completed, the results presented here reflect only the data collected before and during the operations (September 2000 and 2002 for benthos sampling and March 2001, September 2001, October 2002 and March 2003 for suprabenthos sampling). Although bio-sedimentary changes did occur at the mouth of the Seine river, an analysis of benthic assemblages reveals that the dredging and construction operations do not seem to have influenced assemblage structure or the spatial distribution of organisms. Comparisons of the suprabenthic assemblages at each sampling date indicate that seasonal dynamics was mainly responsible for determining species distribution. We conclude that, 1 year into the harbour management plan, the observed changes in benthic and suprabenthic assemblage abundance do not exceed the range of spatial variability that exists naturally in the Seine estuary. Despite this compensatory actions designed to protect the aquatic habitats and to preserve a sustainable and healthy ecosystem have been added to the infrastructure development plan.
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Affiliation(s)
- J C Dauvin
- Station Marine de Wimereux, Université des Sciences et Technologies de Lille, CNRS-UMR-8013 ELICO, BP 80, 62930 Wimereux, France.
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Dunscombe P, Duhamel S. A policy for allocating off-site continuing education funds. Leadersh Health Serv 1996; 5:32-5. [PMID: 10154226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Providing support for travel to conferences, workshops and other off-site continuing education activities is an expensive component of a professional development program. The authors describe a policy addressing this issue which was implemented within the multidisciplinary environment of a comprehensive cancer centre. The policy is open, easily adapted to changes in overall funding and can be used to reflect the organization's expectations regarding employee performance in service, academic, management and leadership roles.
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Affiliation(s)
- P Dunscombe
- Northeastern Ontario Regional Cancer Centre, Sudbury, Canada
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Saint-Martin J, Duhamel S, Choulot JJ. [Use of caffeine in apnea in premature infants]. Pediatrie 1980; 35:21-7. [PMID: 7367145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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