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Frey S, Caillard C, Mahot P, Pattier S, Volteau C, Knipping G, Lande G, Drui D, Mirallié E. Mortality After Total Thyroidectomy for Amiodarone-Induced Thyrotoxicosis According to Left Ventricular Ejection Fraction. Otolaryngol Head Neck Surg 2023; 169:1542-1549. [PMID: 37317630 DOI: 10.1002/ohn.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/28/2023] [Accepted: 05/13/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To report cardiac outcomes after total thyroidectomy for amiodarone-induced thyrotoxicosis according to the baseline left ventricular ejection fraction in a tertiary referral center. STUDY DESIGN Retrospective, monocentric. SETTING The tertiary health care system. METHODS Patients who underwent total thyroidectomy for amiodarone-induced thyrotoxicosis between 2010 and 2020 with age >18 and available preoperative left ventricular ejection fraction were included in this study. Patients were dichotomized into: group 1 with left ventricular ejection fraction ≥40% (mildly reduced/normal ejection fraction), and group 2 with left ventricular ejection fraction <40% (reduced ejection fraction). RESULTS There were 34 patients in group 1 and 17 to group 2. The latter were younger (median 58.4 [Q1-Q3 48.0-64.9] vs. 69.8 years in group 1 [59.8-78.3], p = .0035) and they presented more cardiomyopathy (58.8 vs. 26.5%, p = .030). Overall, the median time until surgery referral was 3.1 [1.9-7.1] months and 47.1% underwent surgery after restoration of euthyroidism. Surgical complications accounted for 7.8%. In group 2, the median left ventricular ejection fraction was significantly improved after surgery (22.5 [20.0-25.0] vs. 29.0% [25.3-45.5], p = .0078). Five-year cardiac mortality was significantly higher in group 2 (p < .0001): 47.0% died of cardiac causes versus 2.9% in group 1. A baseline left ventricular ejection fraction <40% and a longer time until surgery referral were significantly associated with cardiac mortality (multivariable Cox regression analysis, p = .015 and .020, respectively). CONCLUSION These results reinforce the idea that surgery, if chosen, should be performed quickly in patients with left ventricular ejection fraction <40%.
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Affiliation(s)
- Samuel Frey
- Nantes Université, CHU Nantes, Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, Nantes, France
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
| | - Cécile Caillard
- Nantes Université, CHU Nantes, Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, Nantes, France
| | - Pascale Mahot
- Nantes Université, CHU Nantes, Service d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Nantes, France
| | - Sabine Pattier
- Nantes Université, CHU Nantes, Service de cardiologie, Hôpital Nord Laennec, Nantes, France
| | - Christelle Volteau
- Nantes Université, CHU Nantes, DRCI, Département Promotion, Nantes, Cedex, France
| | - Garance Knipping
- Nantes Université, CHU Nantes, Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, Nantes, France
| | - Gilles Lande
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, France
- Nantes Université, CHU Nantes, Service de cardiologie, Hôpital Nord Laennec, Nantes, France
| | - Delphine Drui
- Nantes Université, CHU Nantes, Service d'Endocrinologie, Diabétologie et Nutrition, l'institut du thorax, Nantes, France
| | - Eric Mirallié
- Nantes Université, CHU Nantes, Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, Nantes, France
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Coutance G, Racapé M, Baudry G, Lécuyer L, Roubille F, Blanchart K, Epailly E, Vermes E, Pattier S, Boignard A, Gay A, Bruneval P, Jouven X, Duong Van Huyen JP, Loupy A. Validation of the clinical utility of microRNA as noninvasive biomarkers of cardiac allograft rejection: A prospective longitudinal multicenter study. J Heart Lung Transplant 2023; 42:1505-1509. [PMID: 37487804 DOI: 10.1016/j.healun.2023.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/30/2023] [Accepted: 07/16/2023] [Indexed: 07/26/2023] Open
Abstract
While studies have shown an association between microRNAs and cardiac rejection, the clinical relevance of a preidentified miRNA signature as a noninvasive biomarker has never been assessed in prospective multicentric unselected cohorts. To address this unmet need, we designed a prospective study (NCT02672683) including recipients from 11 centers between August 2016 to March 2018. The objective was to validate the association between 3 previously identified circulating microRNA (10a, 92a, 155) and the histopathological diagnosis of rejection. Both relative and absolute (sensitivity analysis) quantifications of microRNAs were performed. Overall, 461 patients were included (831 biopsies, 79 rejections). A per-protocol interim analysis (258 biopsies, 49 rejections) did not find any association between microRNA and rejection (microRNA 10a: odds ratio (OR) = 1.05, 95% confidence intervals (CI) = 0.87-1.27, p = 0.61; 92a: OR = 0.98, 95%CI = 0.87-1.10, p = 0.68; 155: OR = 0.91, 95%CI = 0.76-1.10, p = 0.33). These results were confirmed in the sensitivity analysis. The analysis of the remaining sera was stopped for futility. This study shows no clinical utility of circulating microRNAs 10a, 92a, and 155 monitoring in heart allograft recipients.
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Affiliation(s)
- Guillaume Coutance
- University of Paris, INSERM UMR 970, Paris Translational Research Centre for Organ Transplantation, Paris, France; Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University Medical School, Paris, France.
| | - Maud Racapé
- University of Paris, INSERM UMR 970, Paris Translational Research Centre for Organ Transplantation, Paris, France
| | - Guillaume Baudry
- Department of Cardiac Surgery, University Hospital Bichat, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Cité, Paris, France
| | - Lucien Lécuyer
- Cardiology and Heart Transplant Department, Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Roubille
- PhyMedExp, Cardiology Department, University of Montpellier, INSERM U1046, CNRS UMR, 9214; INI-CRT, Montpellier, France
| | - Katrien Blanchart
- Cardiology Department, Caen University Hospital, Côte de Nacre, 14000 Caen, France
| | - Eric Epailly
- Department of Cardiology and Cardiovascular Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Emmanuelle Vermes
- Department of Cardiology and Heart Transplantation Unit, CHRU Tours, France
| | - Sabine Pattier
- Department of Thoracic and Cardiovascular Surgery, Institut du Thorax, University Hospital, Nantes, France
| | - Aude Boignard
- Department of Cardiology and Cardiovascular Surgery Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Arnaud Gay
- Thoracic and Cardiovascular Surgery Department, Rouen University Hospital, Rouen, France
| | - Patrick Bruneval
- University of Paris, INSERM UMR 970, Paris Translational Research Centre for Organ Transplantation, Paris, France; Cardiology and Heart Transplant Department, Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier Jouven
- University of Paris, INSERM UMR 970, Paris Translational Research Centre for Organ Transplantation, Paris, France; Cardiology and Heart Transplant Department, Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Paul Duong Van Huyen
- University of Paris, INSERM UMR 970, Paris Translational Research Centre for Organ Transplantation, Paris, France; Pathology Department, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Alexandre Loupy
- University of Paris, INSERM UMR 970, Paris Translational Research Centre for Organ Transplantation, Paris, France; Kidney Transplant Department, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Baudry G, Coutance G, Dorent R, Bauer F, Blanchart K, Boignard A, Chabanne C, Delmas C, D'Ostrevy N, Epailly E, Gariboldi V, Gaudard P, Goéminne C, Grosjean S, Guihaire J, Guillemain R, Mattei M, Nubret K, Pattier S, Vermes E, Sebbag L, Duarte K, Girerd N. Diuretic dose is a strong prognostic factor in ambulatory patients awaiting heart transplantation. ESC Heart Fail 2023; 10:2843-2852. [PMID: 37408178 PMCID: PMC10567662 DOI: 10.1002/ehf2.14467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 07/07/2023] Open
Abstract
AIMS The prognostic value of 'high dose' loop diuretics in advanced heart failure outpatients is unclear. We aimed to assess the prognosis associated with loop diuretic dose in ambulatory patients awaiting heart transplantation (HT). METHODS AND RESULTS All ambulatory patients (n = 700, median age 55 years and 70% men) registered on the French national HT waiting list between 1 January 2013 and 31 December 2019 were included. Patients were divided into 'low dose', 'intermediate dose', and 'high dose' loop diuretics corresponding to furosemide equivalent doses of ≤40, 40-250, and >250 mg, respectively. The primary outcome was a combined criterion of waitlist death and urgent HT. N-terminal pro-B-type natriuretic peptide, creatinine levels, pulmonary capillary wedge pressure, and pulmonary pressures gradually increased with higher diuretic dose. At 12 months, the risk of waitlist death/urgent HT was 7.4%, 19.2%, and 25.6% (P = 0.001) for 'low dose', 'intermediate dose', and 'high dose' patients, respectively. When adjusting for confounders, including natriuretic peptides, hepatic, and renal function, the 'high dose' group was associated with increased waitlist mortality or urgent HT [adjusted hazard ratio (HR) 2.23, 1.33 to 3.73; P = 0.002] and a six-fold higher risk of waitlist death (adjusted HR 6.18, 2.16 to 17.72; P < 0.001) when compared with the 'low dose' group. 'Intermediate doses' were not significantly associated with these two outcomes in adjusted models (P > 0.05). CONCLUSIONS A 'high dose' of loop diuretics is strongly associated with residual congestion and is a predictor of outcome in patients awaiting HT despite adjustment for classical cardiorenal risk factors. This routine variable may be helpful for risk stratification of pre-HT patients.
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Affiliation(s)
- Guillaume Baudry
- Université de Lorraine, Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F‐CRIN INI‐CRCT, ReicatraVandoeuvre‐lès‐Nancy54500France
| | - Guillaume Coutance
- Department of Cardiac and Thoracic SurgeryCardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique‐Hôpitaux de Paris (AP‐HP). Sorbonne University Medical SchoolParisFrance
| | - Richard Dorent
- Department of Cardiac SurgeryCHU Bichat‐Claude Bernard, AP‐HP, Université Paris VIIParisFrance
| | - Fabrice Bauer
- Department of Cardiology and Cardiovascular SurgeryHospital Charles NicolleRouenFrance
| | - Katrien Blanchart
- Department of Cardiology and Cardiac SurgeryUniversity Hospital of Caen, University of CaenCaenFrance
| | - Aude Boignard
- Department of Cardiology and Cardiovascular SurgeryCHU MichallonGrenobleFrance
| | - Céline Chabanne
- Department of Thoracic and Cardiovascular SurgeryCHU Pontchaillou, Inserm U1099RennesFrance
| | - Clément Delmas
- Department of CardiologyCentre Hospitalier Universitaire de ToulouseToulouseFrance
| | - Nicolas D'Ostrevy
- Department of Cardiology and Cardiac SurgeryCHU Clermont‐FerrandClermont‐FerrandFrance
| | - Eric Epailly
- Department of Cardiology and Cardiovascular SurgeryHôpitaux Universitaires de StrasbourgStrasbourgFrance
| | - Vlad Gariboldi
- Department of Cardiac SurgeryLa Timone HospitalMarseilleFrance
| | - Philippe Gaudard
- Department of Cardiac Surgery, Anesthesiology and Critical Care MedicineArnaud de Villeneuve Hospital, CHRU MontpellierMontpellierFrance
| | - Céline Goéminne
- Department of Cardiac SurgeryCHU Lille, Institut Coeur‐PoumonsLilleFrance
| | - Sandrine Grosjean
- Department of Cardiology and Cardiac SurgeryDijon University HospitalDijonFrance
| | - Julien Guihaire
- Department of Cardiothoracic SurgeryMarie Lannelongue Hospital, University of Paris Sud, Inserm U999 (Pulmonary Hypertension: Pathophysiology and Novel Therapies [PAH])Le Plessis RobinsonFrance
| | - Romain Guillemain
- Department of Cardiology and Cardiac SurgeryEuropean Georges Pompidou HospitalParisFrance
| | - Mathieu Mattei
- Department of Cardiology and Cardiac SurgeryCHU de Nancy, Hopital de BraboisNancyFrance
| | - Karine Nubret
- Department of Thoracic and Cardiovascular SurgeryHôpital Cardiologique du Haut‐Lévêque, Université Bordeaux IIBordeauxFrance
| | - Sabine Pattier
- Department of Cardiology and Heart Transplantation UnitCHU NantesNantesFrance
| | - Emmanuelle Vermes
- Department of Cardiothoracic SurgeryTours University HospitalToursFrance
| | - Laurent Sebbag
- Department of Heart Failure and TransplantationHôpital Cardiovasculaire Louis Pradel, Hospices Civils de LyonBronFrance
| | - Kevin Duarte
- Université de Lorraine, Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F‐CRIN INI‐CRCT, ReicatraVandoeuvre‐lès‐Nancy54500France
| | - Nicolas Girerd
- Université de Lorraine, Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F‐CRIN INI‐CRCT, ReicatraVandoeuvre‐lès‐Nancy54500France
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4
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Coutance G, Tacafred F, Racape M, Dorent R, Battistella P, Guillemain R, Blanchart K, Epailly E, Gay A, Pattier S, Boignard A, Vermes E, Jouven X, Loupy A, Duong-Van-Huyen J. Validation of the Clinical Utility of MicroRNA as Non-Invasive Biomarkers of Cardiac Allograft Rejection Monitoring: A Prospective Longitudinal Multicenter Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1110] [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: 04/05/2023] Open
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5
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Abdoul N, Legeai C, Varnous S, Para M, Goeminne C, Pattier S, Kerbaul F, Dorent R. Sex Differences in Heart Transplantation: A National Cohort Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1258] [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: 04/05/2023] Open
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6
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Bouchand C, Navas D, Corvec S, Pattier S, Roussel JC, Lepoivre T, Bonsergent M, Boutoille D, Bémer P, Lecomte R. Postoperative linezolid-resistant methicillin-resistant Staphylococcus epidermidis mediastinitis in a heart transplant patient: first case of therapeutic success with delafloxacin. J Glob Antimicrob Resist 2023; 32:72-73. [PMID: 36720384 DOI: 10.1016/j.jgar.2023.01.004] [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] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/04/2023] [Accepted: 01/05/2023] [Indexed: 01/30/2023] Open
Affiliation(s)
- Camille Bouchand
- Nantes Université, Centre Hospitalier Universitaire (CHU) Nantes, Service d'Hygiène Hospitalière, France.
| | | | - Stéphane Corvec
- Nantes Université, CHU Nantes, Service de Bactériologie et des Contrôles Microbiologiques, France
| | - Sabine Pattier
- Nantes Université, CHU Nantes, Unité de Transplantation Thoracique, France
| | - Jean-Christian Roussel
- Nantes Université, CHU Nantes, Service de Chirurgie Thoracique et Cardiovasculaire, France
| | - Thierry Lepoivre
- Nantes Université, CHU Nantes, Service d'Anesthésie-Réanimation, France
| | | | - David Boutoille
- Nantes Université, CHU Nantes, Service des Maladies Infectieuses et Tropicales, France
| | - Pascale Bémer
- Nantes Université, CHU Nantes, Service de Bactériologie et des Contrôles Microbiologiques, France
| | - Raphaël Lecomte
- Nantes Université, CHU Nantes, Service des Maladies Infectieuses et Tropicales, France
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7
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Baudry G, Coutance G, Dorent R, Bauer F, Blanchart K, Boignard A, Chabanne C, Delmas C, D'Ostrevy N, Epailly E, Gariboldi V, Gaudard P, Goéminne C, Grosjean S, Guihaire J, Guillemain R, Mattei M, Nubret K, Pattier S, Pozzi M, Rossignol P, Vermes E, Sebbag L, Girerd N. Prognosis value of Forrester's classification in advanced heart failure patients awaiting heart transplantation. ESC Heart Fail 2022; 9:3287-3297. [PMID: 35801277 DOI: 10.1002/ehf2.14037] [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: 02/07/2022] [Revised: 05/04/2022] [Accepted: 06/03/2022] [Indexed: 11/09/2022] Open
Abstract
AIMS The value of Forrester's perfusion/congestion profiles assessed by invasive catheter evaluation in non-inotrope advanced heart failure patients listed for heart transplant (HT) is unclear. We aimed to assess the value of haemodynamic evaluation according to Forrester's profiles to predict events on the HT waitlist. METHODS AND RESULTS All non-inotrope patients (n = 837, 79% ambulatory at listing) registered on the French national HT waiting list between 1 January 2013 and 31 December 2019 with right heart catheterization (RHC) were included. The primary outcome was a combined criteria of waitlist death, delisting for aggravation, urgent HT or left ventricular assist device implantation. Secondary outcome was waitlist death. The 'warm-dry', 'cold-dry', 'warm-wet', and 'cold-wet' profiles represented 27%, 18%, 27%, and 28% of patients, respectively. At 12 months, the respective rates of primary outcome were 15%, 17%, 25%, and 29% (P = 0.008). Taking the 'warm-dry' category as reference, a significant increase in the risk of primary outcome was observed only in the 'wet' categories, irrespectively of 'warm/cold' status: hazard ratios, 1.50; 1.06-2.13; P = 0.024 in 'warm-wet' and 1.77; 1. 25-2.49; P = 0.001 in 'cold-wet'. CONCLUSIONS Haemodynamic assessment of advanced HF patients using perfusion/congestion profiles predicts the risk of the combine endpoint of waitlist death, delisting for aggravation, urgent heart transplantation, or left ventricular assist device implantation. 'Wet' patients had the worst prognosis, independently of perfusion status, thus placing special emphasis on the cardinal prominence of persistent congestion in advanced HF.
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Affiliation(s)
- Guillaume Baudry
- Department of heart failure and transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, 69500, Bron, France.,Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F-CRIN INI-CRCT, Université de Lorraine, 54500, Vandoeuvre-lès-Nancy, Nancy, France
| | - Guillaume Coutance
- Department of Cardiac and Thoracic Surgery, Cardiology Institute, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP). Sorbonne University Medical School, Paris, France
| | - Richard Dorent
- Department of Cardiac Surgery, CHU Bichat-Claude Bernard, AP-HP, Université Paris VII, 75877, Paris, France
| | - Fabrice Bauer
- Department of Cardiology and Cardiovascular Surgery, Hospital Charles Nicolle, Rouen, France
| | - Katrien Blanchart
- Department of Cardiology and Cardiac Surgery, University Hospital of Caen, University of Caen, Caen, France
| | - Aude Boignard
- Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France
| | - Céline Chabanne
- Department of Thoracic and Cardiovascular Surgery, CHU Pontchaillou, Inserm U1099, 35000, Rennes, France
| | - Clément Delmas
- Department of Cardiology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Nicolas D'Ostrevy
- Cardiology and Cardiac Surgery Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Eric Epailly
- Department of Cardiology and Cardiovascular Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Vlad Gariboldi
- Department of Cardiac Surgery, La Timone Hospital, Marseille, France
| | - Philippe Gaudard
- Department of Cardiac Surgery, Anesthesiology and Critical Care Medicine, Arnaud de Villeneuve Hospital, CHRU Montpellier, Montpellier, France
| | - Céline Goéminne
- Department of Cardiac Surgery, CHU Lille, Institut Coeur Poumons, Lille, France
| | - Sandrine Grosjean
- Department of Cardiology and Cardiac Surgery, University Hospital of Dijon, Dijon, France
| | - Julien Guihaire
- Department of Cardiothoracic Surgery, Marie Lannelongue Hospital, University of Paris Sud, Inserm U999 [Pulmonary Hypertension: Pathophysiology and Novel Therapies (PAH)], 92350, Le Plessis Robinson, France
| | - Romain Guillemain
- Cardiology and Cardiac Surgery Department, European Georges Pompidou Hospital, Paris, France
| | - Mathieu Mattei
- Department of Cardiology and Cardiac Surgery, CHU de Nancy, Hopital de Brabois, Nancy, France
| | - Karine Nubret
- Department of Thoracic and Cardiovascular Surgery, Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France
| | - Sabine Pattier
- Department of Cardiology and Heart Transplantation Unit, CHU de Nantes, Nantes, France
| | - Matteo Pozzi
- Department of heart failure and transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, 69500, Bron, France
| | - Patrick Rossignol
- Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F-CRIN INI-CRCT, Université de Lorraine, 54500, Vandoeuvre-lès-Nancy, Nancy, France
| | - Emmanuelle Vermes
- Cardiothoracic Surgery Department, Tours University Hospital, Tours, France
| | - Laurent Sebbag
- Department of heart failure and transplantation, Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, 69500, Bron, France
| | - Nicolas Girerd
- Centre d'Investigations Cliniques Plurithématique 1433, INSERM DCAC, CHRU de Nancy, F-CRIN INI-CRCT, Université de Lorraine, 54500, Vandoeuvre-lès-Nancy, Nancy, France
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Lecomte R, Laine JB, Issa N, Revest M, Gaborit B, Le Turnier P, Deschanvres C, Benezit F, Asseray N, Le Tourneau T, Pattier S, Al Habash O, Raffi F, Boutoille D, Camou F. Long-term Outcome of Patients With Nonoperated Prosthetic Valve Infective Endocarditis: Is Relapse the Main Issue? Clin Infect Dis 2021; 71:1316-1319. [PMID: 31858123 DOI: 10.1093/cid/ciz1177] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/07/2019] [Indexed: 12/19/2022] Open
Abstract
In nonoperated prosthetic valve endocarditis (PVE), long-term outcome is largely unknown. We report the follow-up of 129 nonoperated patients with PVE alive at discharge. At 1 year, the mortality rate was 24%; relapses and reinfection were rare (5% each). Enterococcal PVE was associated with a higher risk of relapse.
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Affiliation(s)
- Raphaël Lecomte
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Jean-Baptiste Laine
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Nahéma Issa
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
| | - Matthieu Revest
- Infectious Diseases and Intensive Care Unit, Rennes University Hospital, Rennes, France.,University of Rennes, Centre d'Investigation Clinique 1414, INSERM, Bacterial Regulatory RNAS and Medicine, Unité Mixte de Recherche 1230, Rennes, France
| | - Benjamin Gaborit
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Paul Le Turnier
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Colin Deschanvres
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - François Benezit
- Infectious Diseases and Intensive Care Unit, Rennes University Hospital, Rennes, France
| | - Nathalie Asseray
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Thierry Le Tourneau
- Department of Cardiology, Institut du Thorax, University Hospital, Nantes, France
| | - Sabine Pattier
- Department of Cardiology, Institut du Thorax, University Hospital, Nantes, France
| | - Ousama Al Habash
- Department of Thoracic and Cardiovascular Surgery, Institut du Thorax, University Hospital, Nantes, France
| | - François Raffi
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - David Boutoille
- Department of Infectious Disease, University Hospital, Nantes, France.,Centre d'Investigation Clinique Unité d'Investigation Clinique 1413 INSERM, University Hospital, Nantes, France
| | - Fabrice Camou
- Intensive Care and Infectious Disease Unit, Groupe Saint-André, University Hospital, Bordeaux, France
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Jasseron C, Legeai C, Cantrelle C, Audry B, Lebreton G, Para M, Vincentelli A, Flecher E, Pattier S, Kerbaul F, Dorent R. Impact of the New French Heart Allocation System on Post-Transplant Mortality. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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10
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David CH, Lacoste P, Nanjaiah P, Bizouarn P, Lepoivre T, Michel M, Pattier S, Toquet C, Périgaud C, Mugniot A, Al Habash O, Petit T, Groleau N, Rozec B, Trochu JN, Roussel JC, Sénage T. A heart transplant after total artificial heart support: initial and long-term results. Eur J Cardiothorac Surg 2020; 58:1175-1181. [PMID: 32830239 DOI: 10.1093/ejcts/ezaa261] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 06/07/2020] [Accepted: 06/11/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES At our centre, the SynCardia temporary Total Artificial Heart (TAH-t) (SynCardia Systems, LLC, Tucson, AZ, USA) is used to provide long-term support for patients with biventricular failure as a bridge to a transplant. However, a heart transplant (HT) after such support remains challenging. The aim of this retrospective study was to assess the immediate and long-term results following an HT in the cohort of patients who had a TAH-t implant. METHODS A total of 73 patients were implanted with the TAH-t between 1988 and 2019 in our centre. Of these 73 consecutive patients, 50 (68%) received an HT and are included in this retrospective analysis of prospectively collected data. RESULTS In the selected cohort, in-hospital mortality after an HT was 10% (n = 5). The median intensive care unit stay was 33 days (range 5-278). The median hospital stay was 41 days (range 28-650). A partial or total pericardiectomy was performed during the HT procedure in 21 patients (42%) due to a severe pericardial reaction. Long-term survival rates after an HT at 5, 10 and 12 years were 79.1 ± 5.9% (n = 32), 76.5 ± 6.3% (n = 22) and 72.4 ± 7.1% (n = 12), respectively, which was similar to the long-term survival for a primary HT without TAH-t during the same period (n = 686). An HT performed within 3-6 months post-TAH-t implantation appeared to provide the best survival (P = 0.007). Eight (16%) patients required chronic dialysis during the subsequent follow-up period, with 3 patients requiring a kidney transplant. CONCLUSIONS The long-term outcomes with the SynCardia TAH-t as a bridge to transplant in patients with severe biventricular failure are very encouraging. Our review noted that an HT following TAH-t can be technically challenging, especially in the case of a severe pericardial reaction, with potential pitfalls that should be recognized preoperatively.
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Affiliation(s)
- Charles-Henri David
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France
| | - Philippe Lacoste
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France
| | - Prakash Nanjaiah
- Department of Cardiac Surgery, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Philippe Bizouarn
- Department of Anesthesiology, Nantes Hospital University, Nantes, France
| | - Thierry Lepoivre
- Department of Anesthesiology, Nantes Hospital University, Nantes, France
| | - Magali Michel
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France.,Thoracic Transplantation Unit, Nantes Hospital University, Nantes, France
| | - Sabine Pattier
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France.,Thoracic Transplantation Unit, Nantes Hospital University, Nantes, France
| | - Claire Toquet
- Department of Cardiology and Vascular Diseases, Institut du thorax, UMR 1087, Clinical Research Unit-INSERM 1413, Teaching Hospital of Nantes, Nantes, France.,Anatomopathology Department, Nantes University Hospital, Nantes, France
| | - Christian Périgaud
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France
| | - Antoine Mugniot
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France
| | - Ousama Al Habash
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France
| | - Thierry Petit
- Thoracic Transplantation Unit, Nantes Hospital University, Nantes, France
| | - Nicolas Groleau
- Department of Anesthesiology, Nantes Hospital University, Nantes, France
| | - Bertrand Rozec
- Department of Anesthesiology, Nantes Hospital University, Nantes, France
| | - Jean Noel Trochu
- Department of Cardiology and Vascular Diseases, Institut du thorax, UMR 1087, Clinical Research Unit-INSERM 1413, Teaching Hospital of Nantes, Nantes, France
| | - Jean Christian Roussel
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France.,Thoracic Transplantation Unit, Nantes Hospital University, Nantes, France
| | - Thomas Sénage
- Department of Thoracic and Cardiovascular Surgery, Nantes Hospital University, Nantes, France.,Thoracic Transplantation Unit, Nantes Hospital University, Nantes, France.,INSERM 1246, Methods in Patients-Centered Outcomes and Health Research - SPHERE, Nantes University, Nantes, France
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11
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Belbachir N, Portero V, Al Sayed ZR, Gourraud JB, Dilasser F, Jesel L, Guo H, Wu H, Gaborit N, Guilluy C, Girardeau A, Bonnaud S, Simonet F, Karakachoff M, Pattier S, Scott C, Burel S, Marionneau C, Chariau C, Gaignerie A, David L, Genin E, Deleuze JF, Dina C, Sauzeau V, Loirand G, Baró I, Schott JJ, Probst V, Wu JC, Redon R, Charpentier F, Le Scouarnec S. RRAD mutation causes electrical and cytoskeletal defects in cardiomyocytes derived from a familial case of Brugada syndrome. Eur Heart J 2020; 40:3081-3094. [PMID: 31114854 DOI: 10.1093/eurheartj/ehz308] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 11/08/2017] [Revised: 04/13/2018] [Accepted: 05/02/2019] [Indexed: 12/19/2022] Open
Abstract
AIMS The Brugada syndrome (BrS) is an inherited cardiac disorder predisposing to ventricular arrhythmias. Despite considerable efforts, its genetic basis and cellular mechanisms remain largely unknown. The objective of this study was to identify a new susceptibility gene for BrS through familial investigation. METHODS AND RESULTS Whole-exome sequencing performed in a three-generation pedigree with five affected members allowed the identification of one rare non-synonymous substitution (p.R211H) in RRAD, the gene encoding the RAD GTPase, carried by all affected members of the family. Three additional rare missense variants were found in 3/186 unrelated index cases. We detected higher levels of RRAD transcripts in subepicardium than in subendocardium in human heart, and in the right ventricle outflow tract compared to the other cardiac compartments in mice. The p.R211H variant was then subjected to electrophysiological and structural investigations in human cardiomyocytes derived from induced pluripotent stem cells (iPSC-CMs). Cardiomyocytes derived from induced pluripotent stem cells from two affected family members exhibited reduced action potential upstroke velocity, prolonged action potentials and increased incidence of early afterdepolarizations, with decreased Na+ peak current amplitude and increased Na+ persistent current amplitude, as well as abnormal distribution of actin and less focal adhesions, compared with intra-familial control iPSC-CMs Insertion of p.R211H-RRAD variant in control iPSCs by genome editing confirmed these results. In addition, iPSC-CMs from affected patients exhibited a decreased L-type Ca2+ current amplitude. CONCLUSION This study identified a potential new BrS-susceptibility gene, RRAD. Cardiomyocytes derived from induced pluripotent stem cells expressing RRAD variant recapitulated single-cell electrophysiological features of BrS, including altered Na+ current, as well as cytoskeleton disturbances.
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Affiliation(s)
- Nadjet Belbachir
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,Division of Cardiovascular Medicine, Department of Medicine, Stanford Cardiovascular Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Vincent Portero
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Zeina R Al Sayed
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Jean-Baptiste Gourraud
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Florian Dilasser
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Laurence Jesel
- CHU Strasbourg, Service de Cardiologie, Strasbourg, France
| | - Hongchao Guo
- Division of Cardiovascular Medicine, Department of Medicine, Stanford Cardiovascular Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Haodi Wu
- Division of Cardiovascular Medicine, Department of Medicine, Stanford Cardiovascular Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nathalie Gaborit
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | | | - Aurore Girardeau
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Stephanie Bonnaud
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Floriane Simonet
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Matilde Karakachoff
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | | | - Carol Scott
- The Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Sophie Burel
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Céline Marionneau
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Caroline Chariau
- INSERM, CNRS, UNIV Nantes, CHU Nantes, SFR François Bonamy, iPSC core facility, Nantes, France
| | - Anne Gaignerie
- INSERM, CNRS, UNIV Nantes, CHU Nantes, SFR François Bonamy, iPSC core facility, Nantes, France
| | - Laurent David
- INSERM, CNRS, UNIV Nantes, CHU Nantes, SFR François Bonamy, iPSC core facility, Nantes, France.,Centre de Recherche en Transplantation et Immunologie UMR 1064, INSERM, UNIV Nantes, Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | | | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de Génomique, CEA, Evry, France
| | - Christian Dina
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Vincent Sauzeau
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Gervaise Loirand
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Isabelle Baró
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
| | - Jean-Jacques Schott
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Vincent Probst
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Joseph C Wu
- Division of Cardiovascular Medicine, Department of Medicine, Stanford Cardiovascular Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Richard Redon
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Flavien Charpentier
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France.,l'institut du thorax, CHU Nantes, Nantes, France
| | - Solena Le Scouarnec
- l'institut du thorax, INSERM, CNRS, UNIV Nantes, 8 quai Moncousu, 44007 Nantes cedex 1, France
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12
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Adam N, Coutance G, Viailly PJ, Drieux F, Ruminy P, Sater AA, Toquet C, Rouvier P, François A, Chenard MP, Epailly E, Guillemain R, Pattier S, Gay A, Varnous S, Taupin JL, Rabant M, Loupy A, Bruneval P, Duong Van Huyen JP. Reverse transcriptase multiplex ligation-dependent probe amplification in endomyocardial biopsies for the diagnosis of cardiac allograft rejection. J Heart Lung Transplant 2020; 39:115-124. [DOI: 10.1016/j.healun.2019.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 11/17/2019] [Accepted: 11/20/2019] [Indexed: 12/29/2022] Open
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13
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Bouttier AL, Jobbe-Duval A, Cueff C, Piriou N, Jaafar P, Pattier S, Capoulade R, Warin-Fresse K, Senage T, Serfaty JM, Roussel JC, Le Tourneau T. 1046 Prognostic value of cardiac magnetic resonance imaging in mitral valve prolapse. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.638] [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 Mitral valve prolapse (MVP) is a frequent pathology that can be complicated by mitral regurgitation, heart failure, rhythm disorders, arterial embolism and death. The aim of this study was to evaluate the prognostic interest of ventricular volumes, right ventricular ejection fraction (RVEF) and late gadolinium enhancement (LGE) assessed by cardiac magnetic resonance (CMR) imaging on cardiovascular morbi-mortality in a cohort of patients with MVP
Methods We examined the prognostic value of CMR imaging in 237 patients with MVP (no to severe mitral regurgitation) included between 2010 and 2019. All patients underwent a comprehensive echocardiography. The main endpoint was a composite endpoint of cardiovascular death, heart failure, new onset atrial fibrillation, arterial embolism.
Results Among the 237 patients (63% male), 97 (41%) had LGE (75 myocardial wall, 10 papillary muscle tip and 12 both locations). Factors associated with LGE in multivariable analysis were age (OR 1.02, P = 0.037), left ventricular (LV) mass (OR 1.01, P = 0.008) and pulmonary artery systolic pressure (PAPS, OR 1.02, P = 0.069). Follow-up was censored at the time of surgery or percutaneous repair. In univariate analysis NYHA class, LV mass, left atrial volume, PAPS, LV end-diastolic and end-systolic volumes, chordal rupture and MR degree were associated with outcome. RVEF and biventricular dysfunction (LV EF < 60% and RV EF < 40%) were also associated with impaired event-free survival (36.0 ± 17.0% vs 65.4± 5.8%, P = 0.019). Finally, LGE was associated with a decreased event-free survival (55.6 ± 9.9% vs 70.7± 6.9%, P = 0.002). In multivariablee analysis, moderate to severe mitral regurgitation (HR : 2.14 [1.44-3.19], P < 0.0001) and the presence of LGE were predictors of impaired event-free survival (HR : 2.12 [1.08-4.16], P = 0.003).
Conclusion CMR imaging provides additional prognostic information to echocardiography in the study of MVP. Myocardial fibrosis of the left ventricle and right ventricular function as assessed by CMR imaging are predictors of cardiovascular morbidity and mortality in MVP.
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Affiliation(s)
- A L Bouttier
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | | | - C Cueff
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | - N Piriou
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | - P Jaafar
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | - S Pattier
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | - R Capoulade
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | | | - T Senage
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | - J M Serfaty
- Institut du Thorax, Inserm UMR 1087, Nantes, France
| | - J C Roussel
- Institut du Thorax, Inserm UMR 1087, Nantes, France
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14
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Vourc'h M, Senage T, Lepoivre T, Volteau C, Fortuit C, Pattier S, Guimbretiere G, Roussel JC, Rozec B. Romiplostim as a transfusion saving strategy in 20 patients after heart or lung transplantation: a single centre before-after pilot study. Perfusion 2019; 35:121-130. [PMID: 31359829 DOI: 10.1177/0267659119864814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Thrombocytopenia is a common disorder after heart or lung transplantation. Platelet transfusion is often required to maintain haemostasis but represents a specific cause of morbidity and mortality in this setting including alloimmunisation and graft rejection. STUDY DESIGN AND METHODS As part of a health-care quality improvement project, in a single-centre before-after pilot study, the relevance of a platelet transfusion saving strategy based on romiplostim administration after transplantation was assessed in patients with platelet count <100 × 109/L. Transfusions on days 28 and 90 were compared using propensity matched score for adjustment of demographic characteristics at baseline. The primary outcome was platelet transfusion until day 28 after transplantation. RESULTS Ninety-three patients were analysed (73 before vs. 20 after). The median [interquartile range] number of platelet concentrate was 1 [0;4.0] before versus 0.5 [0;2.0] in the after period, mean difference 0.5 confidence interval 95% [-0.7 to 1.7], p = 0.39. On day 28, median [interquartile range] red blood cell transfusion was significantly higher in the before versus the after period, 7 [2.0;13.5] versus 6 [1.5;8.5], mean difference 3.2 CI 95% [0.4-6.0], p = 0.02. At 6 months, the rate of patients with de novo anti-human leukocyte antigen alloimmunisation was 45% before versus 53% in the after period (p = 0.56). Deep venous thrombosis was detected in nine patients (12%) before versus seven patients (35%) in the after period (p = 0.04). CONCLUSION Romiplostim did not significantly reduce platelet transfusion after heart or lung transplantation. Its relevance and safety in a global transfusion strategy remains to be studied in this setting in a large randomised study.
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Affiliation(s)
- Mickael Vourc'h
- Intensive Care Unit of Cardiothoracic Surgery, Anesthesia and Critical Care Department, Hôpital Nord Laennec, Nantes University Hospital, Nantes, France.,School of Medicine, UPRES EA 3826, Thérapeutiques Cliniques et Expérimentales des Infections, IRS2 Nantes Biotech, France
| | - Thomas Senage
- Department of Thoracic and Cardiovascular Surgery, Nantes University Hospital, Nantes, France
| | - Thierry Lepoivre
- Intensive Care Unit of Cardiothoracic Surgery, Anesthesia and Critical Care Department, Hôpital Nord Laennec, Nantes University Hospital, Nantes, France
| | - Christelle Volteau
- Biometry Platform, Research Promotion Department, Nantes University Hospital, Nantes, France
| | - Camille Fortuit
- Intensive Care Unit of Cardiothoracic Surgery, Anesthesia and Critical Care Department, Hôpital Nord Laennec, Nantes University Hospital, Nantes, France
| | - Sabine Pattier
- Department of Cardiology, Hôpital Nord Laennec, Nantes University Hospital, Nantes, France
| | - Guillaume Guimbretiere
- Department of Thoracic and Cardiovascular Surgery, Nantes University Hospital, Nantes, France
| | - Jean-Christian Roussel
- Department of Thoracic and Cardiovascular Surgery, Nantes University Hospital, Nantes, France
| | - Bertrand Rozec
- Intensive Care Unit of Cardiothoracic Surgery, Anesthesia and Critical Care Department, Hôpital Nord Laennec, Nantes University Hospital, Nantes, France
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15
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Piriou N, Al Habash O, Donal E, Senage T, Le Tourneau T, Pattier S, Guyomarch B, Roussel JC, Trochu JN, Vahanian A, Obadia JF, Iung B, Guérin P. The MITRA-HR study: design and rationale of a randomised study of MitraClip transcatheter mitral valve repair in patients with severe primary mitral regurgitation eligible for high-risk surgery. EUROINTERVENTION 2019; 15:e329-e335. [DOI: 10.4244/eij-d-18-01086] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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16
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Jobbe Duval A, Poilane M, Thebault O, Cueff C, Piriou N, Al Habash O, Pattier S, Trochu J, Le Tourneau T. Prognostic of the right ventricular strain in organic mitral regurgitation. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.310] [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: 11/28/2022]
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17
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Bosseau C, Lelong B, Pattier S, Trochu JN, Roussel JC, Sirinelli A, Aupart M, Chabanne C, Dorent R, Cantrelle C, Mabo P, Leclercq C, Verhoye JP, Flécher E. Heart transplantation in selected patients aged 60 years and older: a two-decade retrospective and multicentre analysis. Eur J Cardiothorac Surg 2017; 51:893-901. [DOI: 10.1093/ejcts/ezx040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/06/2016] [Indexed: 11/13/2022] Open
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18
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Loupy A, Duong Van Huyen JP, Hidalgo L, Reeve J, Racapé M, Aubert O, Venner JM, Falmuski K, Bories MC, Beuscart T, Guillemain R, François A, Pattier S, Toquet C, Gay A, Rouvier P, Varnous S, Leprince P, Empana JP, Lefaucheur C, Bruneval P, Jouven X, Halloran PF. Gene Expression Profiling for the Identification and Classification of Antibody-Mediated Heart Rejection. Circulation 2017; 135:917-935. [PMID: 28148598 DOI: 10.1161/circulationaha.116.022907] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 01/23/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Antibody-mediated rejection (AMR) contributes to heart allograft loss. However, an important knowledge gap remains in terms of the pathophysiology of AMR and how detection of immune activity, injury degree, and stage could be improved by intragraft gene expression profiling. METHODS We prospectively monitored 617 heart transplant recipients referred from 4 French transplant centers (January 1, 2006-January 1, 2011) for AMR. We compared patients with AMR (n=55) with a matched control group of 55 patients without AMR. We characterized all patients using histopathology (ISHLT [International Society for Heart and Lung Transplantation] 2013 grades), immunostaining, and circulating anti-HLA donor-specific antibodies at the time of biopsy, together with systematic gene expression assessments of the allograft tissue, using microarrays. Effector cells were evaluated with in vitro human cell cultures. We studied a validation cohort of 98 heart recipients transplanted in Edmonton, AB, Canada, including 27 cases of AMR and 71 controls. RESULTS A total of 240 heart transplant endomyocardial biopsies were assessed. AMR showed a distinct pattern of injury characterized by endothelial activation with microcirculatory inflammation by monocytes/macrophages and natural killer (NK) cells. We also observed selective changes in endothelial/angiogenesis and NK cell transcripts, including CD16A signaling and interferon-γ-inducible genes. The AMR-selective gene sets accurately discriminated patients with AMR from those without and included NK transcripts (area under the curve=0.87), endothelial activation transcripts (area under the curve=0.80), macrophage transcripts (area under the curve=0.86), and interferon-γ transcripts (area under the curve=0.84; P<0.0001 for all comparisons). These 4 gene sets showed increased expression with increasing pathological AMR (pAMR) International Society for Heart and Lung Transplantation grade (P<0.001) and association with donor-specific antibody levels. The unsupervised principal components analysis demonstrated a high proportion of molecularly inactive pAMR1(I+), and there was significant molecular overlap between pAMR1(H+) and full-blown pAMR2/3 cases. Endothelial activation transcripts, interferon-γ, and NK transcripts showed association with chronic allograft vasculopathy. The molecular architecture and selective AMR transcripts, together with gene set discrimination capacity for AMR identified in the discovery set, were reproduced in the validation cohort. CONCLUSIONS Tissue-based measurements of specific pathogenesis-based transcripts reflecting NK burden, endothelial activation, macrophage burden, and interferon-γ effects accurately classify AMR and correlate with degree of injury and disease activity. This study illustrates the clinical potential of a tissue-based analysis of gene transcripts to refine diagnosis of heart transplant rejection.
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Affiliation(s)
- Alexandre Loupy
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France.
| | - Jean Paul Duong Van Huyen
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Luis Hidalgo
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Jeff Reeve
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Maud Racapé
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Olivier Aubert
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Jeffery M Venner
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Konrad Falmuski
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Marie Cécile Bories
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Thibaut Beuscart
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Romain Guillemain
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Arnaud François
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Sabine Pattier
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Claire Toquet
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Arnaud Gay
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Philippe Rouvier
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Shaida Varnous
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Pascal Leprince
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Jean Philippe Empana
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Carmen Lefaucheur
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Patrick Bruneval
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Xavier Jouven
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
| | - Philip F Halloran
- From Paris Descartes University and Hôpital Necker, Assistance Publique-Hôpitaux de Paris, France (A.L., J.P.D.V.H., M.R.); Paris Translational Research Centre for Organ Transplantation, INSERM, UMR-S970, France (A.L., J.P.D.V.H., O.A., T.B., J.P.E., C.L., P.B., X.J.); Pathology Department, Necker Hospital, Paris, France (J.P.D.V.H.); Alberta Transplant Applied Genomics Centre; University of Alberta, Edmonton, AB, Canada (L.H., J.R., J.M.V., K.F., P.F.H.); Cardiology Department and Intensive Care (M.C.B.), Cardiology and Heart Transplant Department (R.G., X.J.), and Pathology Department (P.B.), Georges Pompidou Hospital, Paris, France; Pathology (P.R.) and Cardiac Surgery Departments (S.V., P.L.), La Pitié Salpétrière Hospital, Paris; Pathology (C.T.) and Thoracic and Cardiovascular Surgery Departments (S.P), Laennec Hospital, Nantes; Pathology (A.F.) and Cardiovascular Surgery Departments (A.G), Charles Nicolle Hospital, Rouen, France
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Malandain D, Asseray N, Le Tourneau T, Caillon J, Bizouarn P, Al Habash O, Cueff C, Pattier S, Boutoille D. ENDO-06 - Impacts diagnostique et thérapeutique d’un scanner thoraco-abdomino-pelvien systématique dans l’endocardite infectieuse. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30375-4] [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: 11/24/2022]
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Pabois A, Pagie S, Gérard N, Laboisse C, Pattier S, Hulin P, Nedellec S, Toquet C, Charreau B. Notch signaling mediates crosstalk between endothelial cells and macrophages via Dll4 and IL6 in cardiac microvascular inflammation. Biochem Pharmacol 2016; 104:95-107. [PMID: 26826491 DOI: 10.1016/j.bcp.2016.01.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 11/19/2015] [Accepted: 01/22/2016] [Indexed: 12/17/2022]
Abstract
Although short-term outcomes have improved with modern era immunosuppression, little progress has been made in long-term graft survival in cardiac transplantation. Antibody-mediated rejection (AMR) is one of the leading causes of graft failure and contributes significantly to poor long-term outcomes. Endothelial cell (EC) injury, intravascular macrophage infiltrate and microvascular inflammation are the histological features of AMR. Nevertheless, mechanisms of AMR remain unclear and treatment is still limited. Here, we investigated the mechanisms underlying vascular and inflammatory cell network involved in AMR at endothelial and macrophage levels, using endomyocardial transplant biopsies and EC/monocyte cocultures. First, we found that AMR associates with changes in Notch signaling at endothelium/monocyte interface including loss of endothelial Notch4 and the acquisition of the Notch ligand Dll4 in both cell types. We showed that endothelial Dll4 induces macrophage polarization into a pro-inflammatory fate (CD40(high)CD64(high)CD200R(low) HLA-DR(low)CD11b(low)) eliciting the production of IL-6. Dll4 and IL-6 are both Notch-dependent and are required for macrophage polarization through selective down and upregulation of M2- and M1-type markers, respectively. Overall, these findings highlight the impact of the graft's endothelium on macrophage recruitment and differentiation upon AMR via Notch signaling. We identified Dll4 and IL-6 as coregulators of vascular inflammation in cardiac transplantation and as potential targets for immunotherapy.
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Affiliation(s)
- Angélique Pabois
- INSERM UMR1064, Centre de Recherche en Transplantation et Immunologie, LabEx IGO and LabEx Transplantex, Nantes F44000, France; CHU de Nantes, Institut de Transplantation-Urologie-Néphrologie, ITUN, Nantes F44000, France; LUNAM Université de Nantes, Faculté de Médecine, Nantes F44000, France
| | - Sylvain Pagie
- INSERM UMR1064, Centre de Recherche en Transplantation et Immunologie, LabEx IGO and LabEx Transplantex, Nantes F44000, France; CHU de Nantes, Institut de Transplantation-Urologie-Néphrologie, ITUN, Nantes F44000, France; LUNAM Université de Nantes, Faculté de Médecine, Nantes F44000, France
| | - Nathalie Gérard
- INSERM UMR1064, Centre de Recherche en Transplantation et Immunologie, LabEx IGO and LabEx Transplantex, Nantes F44000, France; CHU de Nantes, Institut de Transplantation-Urologie-Néphrologie, ITUN, Nantes F44000, France
| | | | - Sabine Pattier
- Service de transplantation cardiaque, CHU de Nantes, Nantes F44000, France
| | - Philippe Hulin
- LUNAM Université de Nantes, Faculté de Médecine, Nantes F44000, France; Plateforme MicroPICell SFR Santé - IRT, Nantes, France
| | - Steven Nedellec
- LUNAM Université de Nantes, Faculté de Médecine, Nantes F44000, France; Plateforme MicroPICell SFR Santé - IRT, Nantes, France
| | - Claire Toquet
- Service d'Anatomie Pathologique, CHU de Nantes, Nantes F44000, France
| | - Béatrice Charreau
- INSERM UMR1064, Centre de Recherche en Transplantation et Immunologie, LabEx IGO and LabEx Transplantex, Nantes F44000, France; CHU de Nantes, Institut de Transplantation-Urologie-Néphrologie, ITUN, Nantes F44000, France; LUNAM Université de Nantes, Faculté de Médecine, Nantes F44000, France.
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21
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Loupy A, Toquet C, Rouvier P, Beuscart T, Bories MC, Varnous S, Guillemain R, Pattier S, Suberbielle C, Leprince P, Lefaucheur C, Jouven X, Bruneval P, Duong Van Huyen JP. Late Failing Heart Allografts: Pathology of Cardiac Allograft Vasculopathy and Association With Antibody-Mediated Rejection. Am J Transplant 2016; 16:111-20. [PMID: 26588356 DOI: 10.1111/ajt.13529] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [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: 01/09/2015] [Revised: 07/19/2015] [Accepted: 07/20/2015] [Indexed: 01/25/2023]
Abstract
In heart transplantation, there is a lack of robust evidence of the specific causes of late allograft failure. We hypothesized that a substantial fraction of failing heart allografts may be associated with antibody-mediated injury and immune-mediated coronary arteriosclerosis. We included all patients undergoing a retransplantation for late terminal heart allograft failure in three referral centers. We performed an integrative strategy of heart allograft phenotyping by assessing the heart vascular tree including histopathology and immunohistochemistry together with circulating donor-specific antibodies. The main analysis included 40 explanted heart allografts patients and 402 endomyocardial biopsies performed before allograft loss. Overall, antibody-mediated rejection was observed in 19 (47.5%) failing heart allografts including 16 patients (40%) in whom unrecognized previous episodes of subclinical antibody-mediated rejection occurred 4.5 ± 3.5 years before allograft loss. Explanted allografts with evidence of antibody-mediated rejection demonstrated higher endothelitis and microvascular inflammation scores (0.89 ± 0.26 and 2.25 ± 0.28, respectively) compared with explanted allografts without antibody-mediated rejection (0.42 ± 0.11 and 0.36 ± 0.09, p = 0.046 and p < 0.0001, respectively). Antibody-mediated injury was observed in 62.1% of failing allografts with pure coronary arteriosclerosis and mixed (arteriosclerosis and atherosclerosis) pattern, while it was not observed in patients with pure coronary atherosclerosis (p = 0.0076). We demonstrate that antibody-mediated rejection is operating in a substantial fraction of failing heart allografts and is associated with severe coronary arteriosclerosis. Unrecognized subclinical antibody-mediated rejection episodes may be observed years before allograft failure.
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Affiliation(s)
- A Loupy
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France
| | - C Toquet
- Department of Pathology, Hôpital Laennec, Nantes, France
| | - P Rouvier
- Department of Pathology, Hôpital La Pitié, Paris, France
| | - T Beuscart
- Paris Translational Research Center for Organ Transplantation, Paris, France
| | - M C Bories
- Paris Translational Research Center for Organ Transplantation, Paris, France
| | - S Varnous
- Department of Cardiac Surgery, Hôpital La Pitié, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - R Guillemain
- Cardiothoracic Transplantation Unit, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - S Pattier
- Department of Cardiac Surgery, Hôpital Laennec, Nantes, France
| | - C Suberbielle
- Histocompatibility Laboratory, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Leprince
- Department of Cardiac Surgery, Hôpital La Pitié, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Lefaucheur
- Paris Translational Research Center for Organ Transplantation, Paris, France
| | - X Jouven
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France.,Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Bruneval
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France.,Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - J P Duong Van Huyen
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France.,Department of Pathology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France
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22
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Fedrigo M, Leone O, Burke MM, Rice A, Toquet C, Vernerey D, Frigo AC, Guillemain R, Pattier S, Smith J, Lota A, Potena L, Bontadini A, Ceccarelli C, Poli F, Feltrin G, Gerosa G, Manzan E, Thiene G, Bruneval P, Angelini A, Duong Van Huyen JP. Inflammatory cell burden and phenotype in endomyocardial biopsies with antibody-mediated rejection (AMR): a multicenter pilot study from the AECVP. Am J Transplant 2015; 15:526-34. [PMID: 25612500 DOI: 10.1111/ajt.12976] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 07/27/2014] [Accepted: 08/07/2014] [Indexed: 01/25/2023]
Abstract
This multicenter case-controlled pilot study evaluated myocardial inflammatory burden (IB) and phenotype in endomyocardial biopsies (EMBs) with and without pathologic antibody-mediated rejection (pAMR). Sixty-five EMBs from five European heart transplant centers were centrally reviewed as positive (grade 2, n = 28), suspicious (grade 1, n = 7) or negative (n = 30) for pAMR. Absolute counts of total, intravascular (IV) and extravascular (EV) immunophenotyped mononuclear cells were correlated with pAMR grade, capillary C4d deposition, donor specific antibody (DSA) status and acute cellular rejection (ACR). In pAMR+ biopsies, equivalent number of IV CD3+ T lymphocytes (23 ± 4/0.225 mm(2) ) and CD68+ macrophages (21 ± 4/0.225 mm(2) ) were seen. IB and cell phenotype correlated with pAMR grade, C4d positivity and DSA positivity (p < 0.0001). High numbers of IV T lymphocytes were associated with low grade ACR (p = 0.002). In late-occurring AMR EV plasma cells occurring in 34% of pAMR+ EMBs were associated with higher IB. The IB in AMR correlated with pAMR+, C4d positivity and DSA positivity. In pAMR+ equivalent numbers of IV T lymphocytes and macrophages were found. The presence of plasma cells was associated with a higher IB and occurrence of pAMR late after transplantation.
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Affiliation(s)
- M Fedrigo
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
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23
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Sénage T, Le Tourneau T, Foucher Y, Pattier S, Cueff C, Michel M, Serfaty JM, Mugniot A, Périgaud C, Carton HF, Al Habash O, Baron O, Roussel JC. Early Structural Valve Deterioration of Mitroflow Aortic Bioprosthesis. Circulation 2014; 130:2012-20. [DOI: 10.1161/circulationaha.114.010400] [Citation(s) in RCA: 159] [Impact Index Per Article: 15.9] [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: 11/16/2022]
Affiliation(s)
- Thomas Sénage
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Thierry Le Tourneau
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Yohann Foucher
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Sabine Pattier
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Caroline Cueff
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Magali Michel
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Jean-Michel Serfaty
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Antoine Mugniot
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Christian Périgaud
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Hubert François Carton
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Ousama Al Habash
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Olivier Baron
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Jean Christian Roussel
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
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24
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Espitia O, Droy L, Pattier S, Naudin F, Mugniot A, Cavailles A, Hamidou M, Bruneval P, Agard C, Toquet C. A case of aortic and mitral valve involvement in granulomatosis with polyangiitis. Cardiovasc Pathol 2014; 23:363-5. [PMID: 25194969 DOI: 10.1016/j.carpath.2014.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/28/2014] [Accepted: 07/28/2014] [Indexed: 10/24/2022] Open
Abstract
Granulomatosis with polyangiitis (GPA) (Wegener's) is a necrotizing systemic vasculitis of the small-sized blood vessels, affecting kidneys, lungs, upper respiratory tract and skin. Cardiac valvular involvement is an uncommon manifestation of GPA. We report the case of a 60-year-old woman with arthritis and lung nodules due to GPA without antineutrophil cytoplasmic antibodies (ANCA) at time of diagnosis. Remission was obtained with cyclophosphamide and corticosteroid. Azathioprine was then prescribed for 2years. Four years later, she developed severe inflammatory aortic and mitral valvular involvement characterized by GPA typical histopathological valvular lesions. Search for ANCA was positive at this time (anti-myeloperoxidase). Cardiac valvular involvement is a rare and potentially fatal complication of GPA and may misleadingly suggest infectious endocarditis. A review of literature revealed few cases of histologically well-documented cardiac valvular involvement in GPA. Pathologists should be aware of valvular heart diseases in GPA, which usually comprise valvular necrotic lesions without any microbial agents.
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Affiliation(s)
- Olivier Espitia
- Department of Internal Medicine, University Hospital of Nantes, France.
| | - Laure Droy
- Department of Pathology, University Hospital of Nantes, France
| | - Sabine Pattier
- Department of Cardiology, University Hospital of Nantes, France
| | - Frédérique Naudin
- Department of Pulmonary Medicine, University Hospital of Nantes, France
| | - Antoine Mugniot
- Department of Thoracic and Cardio-vascular Surgery, University Hospital of Nantes, France
| | - Arnaud Cavailles
- Department of Pulmonary Medicine, University Hospital of Nantes, France
| | - Mohamed Hamidou
- Department of Internal Medicine, University Hospital of Nantes, France
| | - Patrick Bruneval
- Department of Pathology, Hôpital Européen Georges Pompidou, Paris, France
| | - Christian Agard
- Department of Internal Medicine, University Hospital of Nantes, France
| | - Claire Toquet
- Department of Pathology, University Hospital of Nantes, France
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25
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Janus N, Launay-Vacher V, Sebbag L, Despins P, Epailly E, Pavie A, Obadia JF, Pattier S, Varnous S, Pezzella V, Trillaud L, Deray G, Guillemain R. Renal insufficiency, mortality, and drug management in heart transplant. Results of the CARIN study. Transpl Int 2014; 27:931-8. [DOI: 10.1111/tri.12359] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/12/2013] [Accepted: 05/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Nicolas Janus
- Service ICAR; Nephrology Department; Pitie-Salpetriere Hospital; Paris France
| | | | - Laurent Sebbag
- Heart Transplant Department; Louis Pradel Cardiology Hospital; Lyon France
| | - Philippe Despins
- Thoracic Transplant Department; North Hospital CHU Nantes; Nantes France
| | - Eric Epailly
- Cardiac Surgery Department; Nouvel Hôpital Civil; Strasbourg France
| | - Alain Pavie
- Thorac and Cardiovasculars Surgery Department; Pitie-Salpetriere Hospital; Paris France
| | | | - Sabine Pattier
- Thoracic Transplant Department; North Hospital CHU Nantes; Nantes France
| | - Shaïda Varnous
- Thorac and Cardiovasculars Surgery Department; Pitie-Salpetriere Hospital; Paris France
| | - Veronica Pezzella
- Thoracic Transplant Department; Georges Pompidou European Hospital; Paris France
| | - Laurence Trillaud
- Service ICAR; Nephrology Department; Pitie-Salpetriere Hospital; Paris France
| | - Gilbert Deray
- Nephrology Department; Pitie-Salpetriere Hospital; Paris France
| | - Romain Guillemain
- Thoracic Transplant Department; Georges Pompidou European Hospital; Paris France
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26
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Epailly E, Mattei M, Sebbag L, Kamar N, Guillemain R, Noirclerc M, Lelong B, Pattier S, Redonnet M, Sirinelli A. CNI Free Immunosuppression in Heart Transplant Patients Treated With Everolimus: Results of a Multicenter French Registry. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.743] [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] Open
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27
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Lepelletier D, Bourigault C, Roussel J, Lasserre C, Leclère B, Corvec S, Pattier S, Lepoivre T, Baron O, Despins P. Epidemiology and prevention of surgical site infections after cardiac surgery. Med Mal Infect 2013; 43:403-9. [DOI: 10.1016/j.medmal.2013.07.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 06/20/2013] [Accepted: 07/19/2013] [Indexed: 12/20/2022]
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28
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Fedrigo M, Leone O, Burke M, Rice A, Toquet C, Frigo A, Guillemain R, Pattier S, Smith J, Lota A, Potena L, Bontadini A, Ceccarelli C, Poli F, Feltrin G, Gerosa G, Manzan E, Thiene G, Bruneval P, Angelini A, Duong Van Huyen JP. Inflammatory Cell Burden and Phenotype in Endomyocardial Biopsies from Patients with Antibody-Mediated Rejection (AMR) – An AECVP Multicenter Study. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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29
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Senage T, Gaudin M, Michel M, Mugniot A, Perigaud C, Pattier S, Habash OA, Duveau D, Baron O, Despins P, Roussel JC. [Creation of software to help cardiac surgeons: CordaBase]. Vestn Khir Im I I Grek 2013; 172:91-93. [PMID: 24341256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The writing of surgical and hospitalization reports is time-consuming and does not necessarily enable the increment of a statistical database, tool that is indispensable nowadays to evaluate unit activity or to carry out scientific studies. In order to prevent this double data capture, a computer tool, named CordaBase, has been developed by surgeons and set up in a cardiac surgery unit. MATERIALS AND METHODS CordaBase is an interactive software that stores medical data. Thanks to its intuitive interface, CordaBase stores data which is classified chronologically in the following categories: past medical history, preoperative assessment, operating gesture, stay in intensive care unit, stay in wards and evolution/monitoring after discharge. This date, stored in an Access base, are then used in the creation of personalized surgical and hospitalization reports. All the data is permanently available and can be used for the carrying out of scientific works or for the evaluation of the unit activity. RESULTS From March 2009 to December 2010, 2617 consecutive patients operated on in a Cardiac Surgery Unit were recorded prospectively in the software. All of this stored data assisted the surgeon in his or her administrative tasks, thanks to personalized surgical and hospitalization reports, immediately at the secretariat's disposal. The database, which is requisitely filled by administrative work, enables the carrying out of any statistical study on all unit activity. CONCLUSION With a hindsight of almost 2 years, CordaBase has proven its usefulness in an active cardiac surgery unit, both on an administrative and scientific level. The computerized reports have lightened the medical secretariat's workload and statistical studies have now become possible without having to take the paper medical files out again. In the years to come, the accumulation of medical data prospectively or retrospectively stored will surely confirm the potential of the use of such a software.
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Agard C, Brisseau JM, Grossi O, Pattier S, Espitia-Thibault A, Le Goff B, Audrain M, Ponge T, Hamidou M. Two cases of atypical Whipple's disease associated with cytoplasmic ANCA of undefined specificity. Scand J Rheumatol 2012; 41:246-8. [PMID: 22401599 DOI: 10.3109/03009742.2011.648656] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Agard C, Grossi O, Pattier S, Espitia-Thibault A, Le Goff B, Audrain M, Ponge T, Raoult D, Hamidou M, Pagnoux C. C’est en cas de dyspnée aiguë qu’il est urgent de cesser de végéter…. Rev Med Interne 2010; 31:54-9. [DOI: 10.1016/j.revmed.2009.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 09/14/2009] [Indexed: 11/17/2022]
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Roussel JC, Baron O, Périgaud C, Bizouarn P, Pattier S, Habash O, Mugniot A, Petit T, Michaud JL, Heymann MF, Treilhaud M, Trochu JN, Gueffet JP, Lamirault G, Duveau D, Despins P. Outcome of Heart Transplants 15 to 20 Years Ago: Graft Survival, Post-transplant Morbidity, and Risk Factors for Mortality. J Heart Lung Transplant 2008; 27:486-93. [DOI: 10.1016/j.healun.2008.01.019] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 11/10/2007] [Accepted: 01/13/2008] [Indexed: 10/22/2022] Open
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Boissonnat P, Noel-Baron F, Gaillard S, Mercier C, Roussoulieres A, Sebbag L, Bastien O, Redonnet M, Lelong B, Mattei MF, Mouly-Bandini A, Treilhaud M, Pattier S, Sirinelli A, Epailly E, Thiranos JC, Varnous S, Billes MA. 467: The Impact on Renal Function of an Early Reduction of Cyclosporine in De Novo Cardiac Transplant under MMF: Results of a French Multicenter Prospective Randomized Study. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.480] [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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Agard C, Rendu E, Piriou N, Pattier S, Ponge T, Sagan C, Masseau A, Brisseau JM, Barrier JH, Trochu JN, Hamidou MA. Atteinte cardiaque sévère du syndrome de Churg-Strauss: étude rétrospective de 11 observations. Rev Med Interne 2006. [DOI: 10.1016/j.revmed.2006.10.047] [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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Toquet C, Pattier S, Renaudin K, Treilhaud M, Petit T, Cesbron A, Despins P, Heymann M. Le rejet humoral dans les transplantations cardiaques : à propos de neuf cas. Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)78467-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Probst V, Allouis M, Sacher F, Pattier S, Babuty D, Mabo P, Mansourati J, Victor J, Nguyen JM, Schott JJ, Boisseau P, Escande D, Le Marec H. Progressive cardiac conduction defect is the prevailing phenotype in carriers of a Brugada syndrome SCN5A mutation. J Cardiovasc Electrophysiol 2006; 17:270-5. [PMID: 16643399 DOI: 10.1111/j.1540-8167.2006.00349.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Loss-of-function mutations in the SCN5A gene encoding the cardiac sodium channel are responsible for Brugada syndrome (BS) and also for progressive cardiac conduction disease (inherited Lenègre disease). In an attempt to clarify the frontier between these two entities, we have characterized cardiac conduction defect and its evolution with aging in a cohort of 78 patients carrying a SCN5A mutation linked to Brugada syndrome. METHODS AND RESULTS Families were included in the study if a SCN5A mutation was identified in a BS proband and if at least two family members were mutation carriers. Sixteen families met the study criteria, representing 78 carriers. Resting ECG showed a spontaneous BS ECG pattern in 28 of 78 (36%) gene carriers. Intraventricular conduction anomalies were identified in 59 of 78 gene carriers including complete (17) or incomplete (24) right bundle branch block, right bundle branch block plus hemiblock (6), left bundle branch block (1), hemiblock (1), and parietal block (10). PR and QRS duration were longer in the gene carrier cohort in comparison with their relatives carrying no mutation. Finally, in the gene carrier cohort conduction defect progressively aggravated with aging leading in five occasions to pacemaker implantations. CONCLUSION The present study shows that the most common phenotype of gene carriers of a BS-type SCN5A mutation is progressive cardiac conduction defects similar to the Lenègre disease phenotype. In consequence, we propose that carriers of a SCN5A mutation need a clinical and ECG follow-up because of the risk associated with severe conduction defects.
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Affiliation(s)
- Vincent Probst
- L'Institut du thorax, Service de cardiologie, INSERM U533, Nantes, France.
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Gueffet JP, Bammert A, Pattier S, Baron O, Briec F, Lefevre M, Galmiche L, Heymann MF, Duveau D, Trochu JN. [A rare cause of myocardial infarction: papillary fibroelastoma of the aortic valve]. Arch Mal Coeur Vaiss 2004; 97:1035-8. [PMID: 16008183] [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: 05/03/2023]
Abstract
Papillary fibroelastoma is a rare, benign endocardial tumour usually located on the cardiac valves. Before echocardiography, these tumours were chance findings either at surgery or at autopsy. With the advent of echocardiography, the diagnosis has become commoner and they are often the cause of systemic embolism justifying surgical ablation. In this case, an aortic valve papillary fibroelastoma presented with myocardial infarction in a 78 year old woman with normal coronary angiography. The diagnosis was strongly suspected at echocardiography and confirmed by histological analysis of the surgically excised tumour.
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Affiliation(s)
- J P Gueffet
- Clinique cardiologique et des maladies vasculaires, hôpital Guillaume et René Laennec, Nantes.
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