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Skalidis I, Dayer N, Meier D, Salihu A, Antiochos P, Lu H, Maurizi N, Auberson D, Monney P, Muller O, Rotzinger D, Tzimas G. [Cardiac CT in 2024]. Rev Med Suisse 2024; 20:1020-1025. [PMID: 38783671 DOI: 10.53738/revmed.2024.20.875.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Coronary Computed Tomography Angiography (CCTA) has now become an established tool in the diagnostic process for patients suspected of coronary artery disease. In light of rapid technological development, CCTA has evolved into an imaging modality providing both anatomical and functional information to guide patient management. In this article, we describe the role of cardiac CT in assessing atherosclerotic plaque, chest pain evaluation, cardiovascular risk stratification, planning and guiding coronary intervention, as well as structural heart diseases.
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Affiliation(s)
- Ioannis Skalidis
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Nicolas Dayer
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - David Meier
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Adil Salihu
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Henri Lu
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Niccolo Maurizi
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Denise Auberson
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - David Rotzinger
- Service de radiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Georgios Tzimas
- Service de cardiologie, Département cœur et vaisseaux, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
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Salihu A, Lu H, Maurizi N, Tzimas G, Herrera Siklody C, Le Bloa M, Domenichini G, Teres C, Hugelshofer S, Monney P, Pruvot E, Muller O, Antiochos P, Pascale P. Prevention of esophageal lesions during atrial fibrillation catheter ablation using esophageal temperature monitoring: A systematic review and meta-analysis. Pacing Clin Electrophysiol 2024; 47:614-625. [PMID: 38558218 DOI: 10.1111/pace.14972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION The use of esophageal temperature monitoring (ETM) for the prevention of esophageal injury during atrial fibrillation (AF) ablation is often advocated. However, evidence supporting its use is scarce and controversial. We therefore aimed to review the evidence assessing the efficacy of ETM for the prevention of esophageal injury. METHODS We performed a meta-analysis and systematic review of the available literature from inception to December 31, 2022. All studies comparing the use of ETM, versus no ETM, during radiofrequency (RF) AF ablation and which reported the incidence of endoscopically detected esophageal lesions (EDELs) were included. RESULTS Eleven studies with a total of 1112 patients undergoing RF AF ablation were identified. Of those patients, 627 were assigned to ETM (56%). The overall incidence of EDELs was 9.8%. The use of ETM during AF ablation was associated with a non significant increase in the incidence of EDELs (12.3% with ETM, vs. 6.6 % without ETM, odds ratio, 1.44, 95%CI, 0.49, 4.22, p = .51, I2 = 72%). The use of ETM was associated with a significant increase in the energy delivered specifically on the posterior wall compared to patients without ETM (mean power difference: 5.13 Watts, 95% CI, 1.52, 8.74, p = .005). CONCLUSIONS The use of ETM does not reduce the incidence of EDELs during RF AF ablation. The higher energy delivered on the posterior wall is likely attributable to a false sense of safety that may explain the lack of benefit of ETM. Further randomized controlled trials are needed to provide conclusive results.
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Affiliation(s)
- Adil Salihu
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Henri Lu
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Niccolo Maurizi
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Georgios Tzimas
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Claudia Herrera Siklody
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mathieu Le Bloa
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Giulia Domenichini
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cheryl Teres
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sarah Hugelshofer
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre Monney
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Etienne Pruvot
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Muller
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Panagiotis Antiochos
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrizio Pascale
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Salihu A, Meier D, Noirclerc N, Skalidis I, Mauler-Wittwer S, Recordon F, Kirsch M, Roguelov C, Berger A, Sun X, Abbe E, Marcucci C, Rancati V, Rosner L, Scala E, Rotzinger DC, Humbert M, Muller O, Lu H, Fournier S. A study of ChatGPT in facilitating Heart Team decisions on severe aortic stenosis. EUROINTERVENTION 2024; 20:e496-e503. [PMID: 38629422 PMCID: PMC11017225 DOI: 10.4244/eij-d-23-00643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/01/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Multidisciplinary Heart Teams (HTs) play a central role in the management of valvular heart diseases. However, the comprehensive evaluation of patients' data can be hindered by logistical challenges, which in turn may affect the care they receive. AIMS This study aimed to explore the ability of artificial intelligence (AI), particularly large language models (LLMs), to improve clinical decision-making and enhance the efficiency of HTs. METHODS Data from patients with severe aortic stenosis presented at HT meetings were retrospectively analysed. A standardised multiple-choice questionnaire, with 14 key variables, was processed by the OpenAI Chat Generative Pre-trained Transformer (GPT)-4. AI-generated decisions were then compared to those made by the HT. RESULTS This study included 150 patients, with ChatGPT agreeing with the HT's decisions 77% of the time. The agreement rate varied depending on treatment modality: 90% for transcatheter valve implantation, 65% for surgical valve replacement, and 65% for medical treatment. CONCLUSIONS The use of LLMs offers promising opportunities to improve the HT decision-making process. This study showed that ChatGPT's decisions were consistent with those of the HT in a large proportion of cases. This technology could serve as a failsafe, highlighting potential areas of discrepancy when its decisions diverge from those of the HT. Further research is necessary to solidify our understanding of how AI can be integrated to enhance the decision-making processes of HTs.
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Affiliation(s)
- Adil Salihu
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - David Meier
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Nathalie Noirclerc
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Ioannis Skalidis
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Sarah Mauler-Wittwer
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Frederique Recordon
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Matthias Kirsch
- Department of Cardiovascular Surgery, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Christan Roguelov
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alexandre Berger
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Xiaowu Sun
- Institute of Mathematics and School of Computer and Communication Sciences, EPFL, Lausanne, Switzerland
| | - Emmanuel Abbe
- Institute of Mathematics and School of Computer and Communication Sciences, EPFL, Lausanne, Switzerland
| | - Carlo Marcucci
- Department of Anesthesiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Valentina Rancati
- Department of Anesthesiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Lorenzo Rosner
- Department of Anesthesiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Emanuelle Scala
- Department of Anesthesiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - David C Rotzinger
- Department of Radiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Marc Humbert
- Department of Geriatrics, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Henri Lu
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Salihu A, Rotzinger DC, Fahrni G, Nowacka A, Antiochos P, Fournier S, Muller O, Kirsch M, Lu H. Transcarotid vascular access for transcatheter aortic valve implantation: is choosing the left side always right? J Cardiothorac Surg 2024; 19:196. [PMID: 38600556 PMCID: PMC11008044 DOI: 10.1186/s13019-024-02661-7] [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: 11/21/2023] [Accepted: 03/20/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The transcarotid (TC) vascular access for transcatheter aortic valve implantation (TAVI) has emerged as the first-choice alternative to the transfemoral access, in patients unsuitable for the latter. The use of both the left and right common carotid arteries (CCAs) for TC-TAVI has been described, but the optimal side is subject to debate. We conducted this pilot study to compare the level of vessel tortuosity and plaque burden from either the left CCA to the aortic annulus, or the right CCA to the aortic annulus, considering them as surrogates for technical and procedural complexity. METHODS Consecutive patients who underwent TC-TAVI between 2018 and 2021 in our institution were included. Using three-dimensional reconstruction, pre-TAVI neck and chest computed tomography angiography exams were reviewed to assess the tortuosity index (TI), sum of angles metric, as well as plaque burden, between each CCA and the aortic annulus. RESULTS We included 46 patients who underwent TC-TAVI. No significant difference regarding the mean TIs between the left and right sides (respectively 1.20 and 1.19, p = 0.82), the mean sum of angles (left side: 396°, right side: 384°, p = 0.27), and arterial plaque burden (arterial plaque found in 30% of left CCAs and 45% of right CCAs, p = 0.19) was found. CONCLUSIONS We found no convincing data favoring the use of one particular access side over the other one. The choice of the CCA side in TC-TAVI should to be made on a case-by-case basis, in a multidisciplinary fashion, and may also depend on the operators' experience.
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Affiliation(s)
- Adil Salihu
- Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland
| | - David C Rotzinger
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland
| | - Guillaume Fahrni
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland
| | - Anna Nowacka
- Division of Cardiovascular Surgery, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland
| | - Panagiotis Antiochos
- Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland
| | - Stephane Fournier
- Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland
| | - Olivier Muller
- Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland
| | - Matthias Kirsch
- Division of Cardiovascular Surgery, Lausanne University Hospital and University Hospital, Lausanne, 1011, Switzerland
| | - Henri Lu
- Division of Cardiology, Lausanne University Hospital and University Hospital, Rue du Bugnon 46, Lausanne, 1011, Switzerland.
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Salihu A, Meier D, Kilani N, Burdet O, Tzimas G, Antiochos P, Masi A, Teres C, Ascione C, Rosset S, Daux A, Domenichini G, Ladouceur M, Yerly P, Schwitter J, Monney P, Rutz T, Bouchardy J, Pruvot E, Muller O, Fournier S. [Cardiology: what's new in 2023]. Rev Med Suisse 2024; 20:19-24. [PMID: 38231094 DOI: 10.53738/revmed.2024.20.856-7.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
The year 2023 has been extremely rich in new publications in the various subfields of cardiology. Furthermore, the European Society of Cardiology (ESC) has issued revised guidelines focused on the management of acute coronary syndrome (ACS) and endocarditis, as well as an update on the recommendations for the management of heart failure and cardiovascular prevention. The most significant updates according to the Cardiology Department of CHUV are summarized in this review article.
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Affiliation(s)
- Adil Salihu
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - David Meier
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Nadia Kilani
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Odile Burdet
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Georgios Tzimas
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Ambra Masi
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Cheryl Teres
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Ciro Ascione
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Sabina Rosset
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Aurélien Daux
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Giulia Domenichini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Magalie Ladouceur
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Patrick Yerly
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Juerg Schwitter
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Etienne Pruvot
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Stephane Fournier
- Service de cardiologie, Centre hospitalier universitaire vaudois et Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
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Salihu A, Gadiri MA, Skalidis I, Meier D, Auberson D, Fournier A, Fournier R, Thanou D, Abbé E, Muller O, Fournier S. Towards AI-assisted cardiology: a reflection on the performance and limitations of using large language models in clinical decision-making. EUROINTERVENTION 2023; 19:e798-e801. [PMID: 38050992 PMCID: PMC10687640 DOI: 10.4244/eij-d-23-00461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/18/2023] [Indexed: 12/07/2023]
Affiliation(s)
- Adil Salihu
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Mehdi Ali Gadiri
- MicroBioRobotics Systems Laboratory, Institute of Mechanical Engineering, EPFL, Lausanne, Switzerland
| | - Ioannis Skalidis
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - David Meier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Denise Auberson
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Romain Fournier
- Department of Statistics, University of Oxford, Oxford, United Kingdom
| | - Dorina Thanou
- Department of Mathematical Data Science, EPFL, Lausanne, Switzerland
- LTS4 laboratory, EPFL, Lausanne, Switzerland
| | - Emmanuel Abbé
- Department of Mathematical Data Science, EPFL, Lausanne, Switzerland
- Institute of Mathematics and School of Computer and Communication Sciences, EPFL, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
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Mohammed U, Muhammad SH, Kasimu UA, Salihu A, Ladan A. HISTOPATHOLOGICAL ANALYSIS OF NON-NEOPLASTIC OVARIAN LESIONS SEEN IN A TERTIARY HEALTH CENTRE IN NORTH WESTERN NIGERIA. West Afr J Med 2023; 40:S24. [PMID: 37976344] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Introduction Ovarian lesions may present as enlargements of the ovary and may occur at any age. Non-neoplastic enlargements develop almost exclusively during the childbearing years. They may be asymptomatic or, in rare cases, cause acute symptoms due to complications and account for the most prevalent cause of hospital admissions. They frequently form a pelvic mass and potentially mimic an ovarian neoplasm. Objective To study the frequency and histopathological classification of non-neoplastic ovarian lesions in a tertiary institution in North-western Nigeria. Methodology A retrospective study in which surgical biopsy specimens seen over a 9-year period were reviewed with respect to age and histopathological characteristics. Results A total of 83 non-neoplastic lesions were histologically diagnosed during the period under review. They constitute 5.16 % and 40.9 % of both gynaecological and ovarian samples received respectively. Of which 33.7% were Corpus luteum, 13.3% were both Follicular cysts and simple cysts respectively. Luteoma of pregnancy and Infarction constitute 9.6% each respectively. Endometriosis and no pathology as part of TAH, 6.0% respectively. Ovarian ectopic gestation was 4.8% cases, Nonspecific inflammation (oophoritis) 2.4%, and 1.2% complex cyst. Majority of cases 45.8% occurred among women in the third decade and 26.5% in the fourth decade, cases within the fifth decade were 9.6% and the second decade constituted 8.4% cases. Conclusion Ovarian non-neoplastic lesions are common in our environment; they potentially mimic ovarian neoplasms thereby posing a diagnostic challenge. Proper classifications are important for appropriate management.
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Affiliation(s)
- U Mohammed
- Department of Histopathology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Email
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Skalidis I, Salihu A, Kachrimanidis I, Koliastasis L, Maurizi N, Dayer N, Muller O, Fournier S, Hamilos M, Skalidis E. Meta-CathLab: A Paradigm Shift in Interventional Cardiology Within the Metaverse. Can J Cardiol 2023; 39:1549-1552. [PMID: 37666480 DOI: 10.1016/j.cjca.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/07/2023] [Accepted: 08/29/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
- Ioannis Skalidis
- University of Crete and University Hospital of Heraklion, Heraklion, Greece; Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland.
| | - Adil Salihu
- Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | | | | | - Niccolo Maurizi
- Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Nicolas Dayer
- Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Michalis Hamilos
- University of Crete and University Hospital of Heraklion, Heraklion, Greece
| | - Emmanouil Skalidis
- University of Crete and University Hospital of Heraklion, Heraklion, Greece
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Salihu A, Roguelov C, Fournier S, Coucke P, Eeckhout E. Intracoronary Brachytherapy for Restenosis: 20 Years of Follow-Up. Cardiovasc Revasc Med 2023; 54:1-4. [PMID: 37087307 DOI: 10.1016/j.carrev.2023.04.009] [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: 01/24/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND/PURPOSE Intracoronary brachytherapy (ICB) has mainly been used to treat in-stent restenosis following percutaneous coronary intervention and was virtually abandoned about 20 years ago. However, patients treated with this strategy are still alive and some teams continue to perform this therapy. We aimed to investigate the very long-term clinical outcome of patients treated with ICB. METHODS/MATERIALS A total of 173 consecutive patients who had been treated with ICB at a large tertiary referral centre between 1998 and 2003 were included. The primary endpoint of the study was all-cause mortality. The secondary endpoints were as follows: occurrence of major adverse cardiac events (MACE, defined as all-cause death, non-fatal myocardial infarction, or target vessel revascularization), cardiac death, and presence of angina at the end of follow-up. RESULTS Patients' mean age at the time of ICB was 64 ± 10 years and 77 % were male. Restenosis (bare metal stent vs. balloon angioplasty) was the only indication for ICB. Unstable angina was present in 34 % of the patients. Follow-up was available for 166 patients. After a mean follow-up of 20 ± 1.3 years, 66 % of the patients had died (including 74 patients (67 %) with cardiac death). Cumulative MACE rate at 20 years was 96 %. CONCLUSIONS Very long-term follow-up of patients with in-stent restenosis treated with ICB confirmed a high all-cause mortality rate mainly due to cardiac causes and MACEs.
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Affiliation(s)
- Adil Salihu
- Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Christan Roguelov
- Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | - Eric Eeckhout
- Department of Cardiology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Salihu A, Stadelmann R, Solimando E, Schwitter J. Eosinophilic myocarditis during treatment of acute myeloid leukaemia: cardiac magnetic resonance in the very early phase mimicking triple-vessel coronary artery disease: a case report. Eur Heart J Case Rep 2023; 7:ytad185. [PMID: 37123659 PMCID: PMC10141456 DOI: 10.1093/ehjcr/ytad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 05/02/2023]
Abstract
Background Chemotherapy of acute myeloid leukaemia (AML) can cause a broad spectrum of cardiotoxic effects. Cardiac magnetic resonance (CMR) is key for the diagnosis of eosinophilic myocarditis (EM) defined by the presence of sub-endocardial necrosis and fibrosis. This case report describes the picture of severe triple-vessel ischaemia due to infiltration of eosinophilia without atherosclerotic coronary artery disease (CAD). Case summary A 57-year-old woman was diagnosed with AML requiring chemotherapy. Three days after initiation of chemotherapy, the patient presented with chest pain and new left ventricular (LV) dysfunction and hyper-eosinophilia. A CMR examination initially was compatible with severe triple-vessel ischaemia. Tissue characterization by CMR was not done due to severe dyspnoea promoting the differential diagnosis of triple-vessel CAD or chemotherapy-induced triple-vessel coronary spasm. However, invasive coronary angiography excluded obstructive CAD. Severe LV dysfunction and troponin elevation persisted arguing against coronary vasospasm. Chemotherapy induced a massive increase in blood eosinophils, and EM was considered as most likely diagnosis. Immunosuppressive treatment improved the patient's status and a CMR later on confirmed the diagnosis of EM. Discussion Chemotherapy-induced massive eosinophilia can cause widespread coronary micro-vascular infiltration mimicking severe triple-vessel CAD. Early CMR did not evaluate tissue composition, and EM was not considered which delayed adequate treatment. A complete CMR assessment is key to establish the correct diagnosis.
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Affiliation(s)
- Adil Salihu
- Corresponding author. Tel: +41 79 556 30 32,
| | - Raphael Stadelmann
- Faculty of Biology and Medicine, Lausanne University, UNIL, Quartier Centre, 1015 Lausanne, Switzerland
- Department of Hematology, CHUV, Rue du bugnon 46, 1011 Lausanne, Switzerland
| | - Emilie Solimando
- Department of internal Medicine, CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, Lausanne University, UNIL, Quartier Centre, 1015 Lausanne, Switzerland
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Salihu A, Roux O, Tzimas G, Antiochos P, Le Bloa M, Fournier S, Carron PN, Muller O, Lu H. [An update on some atypical electrocardiographic forms of acute coronary syndrome The "STEMI equivalents"]. Rev Med Suisse 2022; 18:1030-1037. [PMID: 35612475 DOI: 10.53738/revmed.2022.18.783.1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The diagnosis of acute coronary syndrome with ST segment elevation (STEMI) is based on clinical symptoms suggestive of acute myocardial ischemia and precise ECG criteria. STEMI is due to an acute occlusion or subocclusion of a coronary artery, generating a transmural ischaemia, requiring coronary angiography with urgent coronary revascularization. However, some authors consider the current STEMI ECG criteria to be too restrictive: up to 30 % of patients who do not meet these criteria present with critical coronary artery stenosis or acute coronary occlusion. Atypical electrocardiographic patterns, known as "STEMI equivalents", can be found in some cases and justify a rapid cardiological evaluation. We present a pragmatic review of five STEMI equivalents.
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Affiliation(s)
- Adil Salihu
- Service de médecine interne, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Olivier Roux
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Georgios Tzimas
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Mathieu Le Bloa
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Stephane Fournier
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Pierre-Nicolas Carron
- Service des urgences, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Henri Lu
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
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Abdulazeez M, Busari A, Yakubu S, Anigo K, Idris H, Salihu A. Prevalence of Hypertension and Impaired Renal Function in Diabetic Patients Attending Ahmadu Bello University Teaching Hospital (Abuth), Shika, Zaria, Kaduna State, Nigeria. J of Medical Sciences 2013. [DOI: 10.3923/jms.2013.346.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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