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Grygorowicz C, Benali K, Serzian G, Mouhat B, Duloquin G, Pommier T, Didier R, Laurent G, Béjot Y, Maille B, Vuillier F, Badoz M, Guenancia C. Value of HAVOC and Brown ESUS-AF scores for atrial fibrillation on implantable cardiac monitors after embolic stroke of undetermined source. J Stroke Cerebrovasc Dis 2024; 33:107451. [PMID: 37995501 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/13/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVES Up to 20 % of ischemic strokes are associated with overt atrial fibrillation (AF). Furthermore, silent AF was detected by an implantable cardiac monitor (ICM) in 1 in 3 cryptogenic strokes in the CRYSTAL AF study. An ESC position paper has suggested a HAVOC score ≥ 4 or a Brown ESUS-AF score ≥ 2 as criteria for ICM implantation after cryptogenic stroke, but neither of these criteria has been developed or validated in ICM populations. We assessed the performance of HAVOC and Brown ESUS-AF scores in a cohort of ICM patients implanted after embolic stroke of undetermined source (ESUS). METHODS All patients implanted with an ICM for ESUS between February 2016 and February 2022 at two French University Hospitals were retrospectively included. Demographic data, cardiovascular risk factors, and clinical and biological data were collected after a review of electronic medical records. HAVOC and Brown ESUS-AF scores were calculated for all patients. FINDINGS Among the 384 patients included, 106 (27 %) developed AF during a mean follow-up of 33 months. The scores performances for predicting AF during follow-up were: HAVOC= AUC: 68.5 %, C-Index: 0.662, and Brown ESUS-AF=AUC: 72.9 %, C-index 0.712. Compared with the CHA2DS2-VASc score, only the Brown ESUS-AF score showed significant improvement in NRI/IDI. Furthermore, classifying patients according to the suggested HAVOC and Brown ESUS-AF thresholds, only 24 % and 31 % of the cohort, respectively, would have received an ICM, and 58 (55 %) and 47 (44 %) of the AF patients, respectively, would not have been implanted with an ICM. CONCLUSION HAVOC and Brown ESUS-AF scores showed close and moderate performance in predicting AF on ICM after cryptogenic stroke, with a significant lack of sensitivity. Specific risk scores should be developed and validated in large ICM cohorts.
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Affiliation(s)
| | - Karim Benali
- Cardiology Department, University Hospital, Saint-Etienne, France
| | | | - Basile Mouhat
- Cardiology Department, University Hospital, Besançon, France
| | - Gauthier Duloquin
- PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - Thibaut Pommier
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Romain Didier
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Gabriel Laurent
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France
| | - Yannick Béjot
- PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France; Neurology Department, University Hospital, Dijon, France
| | - Baptiste Maille
- Cardiology Department, University Hospital, Marseille, France
| | | | - Marc Badoz
- Cardiology Department, University Hospital, Besançon, France
| | - Charles Guenancia
- Cardiology Department, University Hospital, Dijon, France; PEC2 EA7460, University of Burgundy and Franche-Comté, Dijon, France.
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Badoz M, Derimay F, Serzian G, Besutti M, Rioufol G, Frey P, Guenancia C, Ecarnot F, Meneveau N, Chopard R. Incidence of atrial fibrillation in cryptogenic stroke with patent foramen ovale closure: protocol for the prospective, observational PFO-AF study. BMJ Open 2023; 13:e074584. [PMID: 37699623 PMCID: PMC10503323 DOI: 10.1136/bmjopen-2023-074584] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION After closure of patent foramen ovale (PFO) due to stroke, atrial fibrillation (AF) occurs in up to one in five patients. However, data are sparse regarding the possible pre-existence of AF in these patients prior to PFO closure, and about recurrence of AF in the long term after the procedure. No prospective study to date has investigated these topics in patients with implanted cardiac monitor (ICM). The PFO-AF study (registered with ClinicalTrials.gov under the number NCT04926142) will investigate the incidence of AF occurring within 2 months after percutaneous closure of PFO in patients with prior stroke. AF will be identified using systematic ICM. Secondary objectives are to assess incidence and burden of AF in the 2 months prior to, and up to 2 years after PFO closure. METHODS AND ANALYSIS Prospective, multicentre, observational study including 250 patients with an indication for PFO closure after stroke, as decided by interdisciplinary meetings with cardiologists and neurologists. Patients will undergo implantation of a Reveal Linq device (Medtronic). Percutaneous PFO closure will be performed 2 months after device implantation. Follow-up will include consultation, ECG and reading of ICM data at 2, 12 and 24 months after PFO closure. The primary endpoint is occurrence of AF at 2 months, defined as an episode of AF or atrial tachycardia/flutter lasting at least 30 s, and recorded by the ICM and/or any AF or atrial tachycardia/flutter documented on ECG during the first 2 months of follow-up. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee 'Comité de Protection des Personnes (CPP) Sud-Méditerranéen III' on 2 June 2021 and registered with ClinicalTrials.gov (NCT04926142). Findings will be presented in national and international congresses and peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04926142.
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Affiliation(s)
- Marc Badoz
- Department of Cardiology, Besançon Regional University Hospital Center, Besancon, Bourgogne-Franche-Comté, France
- Université de Franche-Comté, Besancon, Bourgogne-Franche-Comté, France
| | - François Derimay
- Interventional Cardiology, Hospices Civils de Lyon, Lyon, France
| | - Guillaume Serzian
- Department of Cardiology, Besançon Regional University Hospital Center, Besancon, Bourgogne-Franche-Comté, France
| | - Matthieu Besutti
- Department of Cardiology, Besançon Regional University Hospital Center, Besancon, Bourgogne-Franche-Comté, France
| | - Gilles Rioufol
- Interventional Cardiology, Hospices Civils de Lyon, Lyon, France
| | - Pierre Frey
- Department of Cardiology, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy, France
| | | | - Fiona Ecarnot
- Department of Cardiology, Besançon Regional University Hospital Center, Besancon, Bourgogne-Franche-Comté, France
- Université de Franche-Comté, Besancon, Bourgogne-Franche-Comté, France
| | - Nicolas Meneveau
- Department of Cardiology, Besançon Regional University Hospital Center, Besancon, Bourgogne-Franche-Comté, France
- Université de Franche-Comté, Besancon, Bourgogne-Franche-Comté, France
| | - Romain Chopard
- Department of Cardiology, Besançon Regional University Hospital Center, Besancon, Bourgogne-Franche-Comté, France
- Université de Franche-Comté, Besancon, Bourgogne-Franche-Comté, France
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Massoullié G, Ploux S, Souteyrand G, Mondoly P, Pereira B, Amabile N, Jean F, Irles D, Mansourati J, Combaret N, Mechulan A, Badoz M, Da Costa A, Defaye P, Motreff P, Clerfond G, Bordachar P, Eschalier R. Incidence and management of atrioventricular conduction disorders in new-onset left bundle branch block after TAVI: A prospective multicenter study. Heart Rhythm 2023; 20:699-706. [PMID: 36646235 DOI: 10.1016/j.hrthm.2023.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 08/24/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND New-onset left bundle branch block (LBBB) is one of the most frequent complications after transcatheter aortic valve implantation (TAVI) and is associated with delayed high degree atrioventricular (AV) block. OBJECTIVES The objectives of this study were to determine the incidence of AV block in such a population and to assess the performance and safety of a risk stratification algorithm on the basis of electrophysiology study (EPS) followed by implantation of a pacemaker or implantable loop recorder (ILR). METHODS This was a prospective open-label study with 12-month follow-up. From June 8, 2015, to November 8, 2018, 183 TAVI recipients (mean age 82.3 ± 5.9 years) were included at 10 centers. New-onset LBBB after TAVI persisting for >24 hours was assessed by electrophysiology study during initial hospitalization. High-risk patients (His-ventricle interval ≥70 ms) were implanted with a dual-chamber pacemaker recording AV conduction disturbance episodes. Patients at lower risk were implanted with an ILR with automatic remote monitoring. RESULTS A high-grade AV conduction disorder was identified in 56 patients (30.6%) at 12 months. Four subjects were symptomatic, all in the ILR group. No complications were associated with the stratification procedure. Patients with His-ventricle interval ≥70 ms displayed more high-grade AV conduction disorders (53.2% [25 of 47] vs 22.8% [31 of 136]; P < .001). In a multivariate analysis, His-ventricle interval ≥70 ms was independently associated with the occurrence of a high-grade conduction disorder (subdistribution hazard ratio 2.4; 95% confidence interval 1.2-4.8; P = .010). CONCLUSION New-onset LBBB after TAVI was associated with high rates of high-grade AV conduction disturbances. The stratification algorithm provided safe and valuable aid to management decisions and reliable guidance on pacemaker implantation.
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Affiliation(s)
- Grégoire Massoullié
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France; Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
| | - Sylvain Ploux
- Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Bordeaux, IHU LIRYC, Bordeaux, France
| | - Géraud Souteyrand
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France; Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
| | - Pierre Mondoly
- Federation of Cardiology, University Hospital Rangueil, Toulouse cedex, France
| | - Bruno Pereira
- Biostatistics Unit (Clinical Research and Innovation Direction), CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Frédéric Jean
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - Nicolas Combaret
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France; Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
| | - Alexis Mechulan
- Ramsay Générale de Santé, Hôpital Privé de Clairval, Marseille, France
| | - Marc Badoz
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France
| | | | - Pascal Defaye
- Arrhythmia Unit, Cardiology Department, University Hospital, Grenoble, France
| | - Pascal Motreff
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France; Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
| | - Guillaume Clerfond
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France; Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France
| | - Pierre Bordachar
- Hôpital Cardiologique du Haut-Lévêque, CHU Bordeaux, Université Bordeaux, IHU LIRYC, Bordeaux, France
| | - Romain Eschalier
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France; Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, Clermont-Ferrand, France.
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Grygorowicz C, Badoz M, Garnier L, Serzian G, Duloquin G, Fichot M, Vergely C, Laurent G, Bejot Y, Guenancia C. Incidence and predictors of atrial fibrillation in a large cohort of implantable cardiac monitors after cryptogenic stroke. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.184] [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: 12/31/2022]
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Artus A, Mansourati J, Fatemi M, Pierre B, Schatz A, Badoz M, Laurent G, Guenancia C, Garnier F. Efficacy and safety of the new TightRail™ mechanical sheath for transvenous lead extraction: Results of a French multicenter study. J Cardiovasc Electrophysiol 2022; 33:731-737. [PMID: 35138039 DOI: 10.1111/jce.15399] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/30/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to assess the safety and efficacy of the TightRail™ sheath for pacemaker/defibrillator transvenous lead extraction (TLE). METHODS Multicenter observational study including patients who underwent a TLE with the TightRail™ sheath in five French university hospitals from September 2014 to January 2020. RESULTS Two hundred and twenty-five patients (76% males, 71 ± 12 years) underwent a TLE procedure with the TightRail™. A total of 438 leads were extracted using the TightRail™, and the mean age of the extracted leads was 128 ± 85 months; of these, 344 (79%) were pacing leads and 94 (21%) were implantable cardioverter defibrillator leads. The overall clinical success of the extraction procedures was 93%. Overall, 410 of the 438 leads (95%) were extracted (complete or incomplete removal). After multilevel mixed-effects logistic regression model, we found that lead age (odds ratio [OR], 95% confidence interval [CI] for a 1 year increase: 1.11 [1.07-1.15], p < .001) and number of leads extracted (OR, 95% CI: 2.09 [1.50-2.96], p < .001) were the two independent factors associated with complete lead removal failure. Finally, there were 7 (3%) cases of major complications but no per-procedural death. CONCLUSION This is the first large-scale survey assessing the efficacy and safety profile of the Tightrail™ mechanical sheath. The clinical success rate was 93%, and the lead removal failure was dependent on the age and number of leads. We show a satisfactory safety profile in this cohort of patients from primarily low-volume centers with older leads.
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Affiliation(s)
- Adrien Artus
- Cardiology Department, Dijon Bourgogne University Hospital, Dijon, France
| | | | - Marjaneh Fatemi
- Cardiology Department, University Hospital of Brest, Brest, France
| | - Bertrand Pierre
- Cardiology Department, Trousseau Hospital-University of Tours, Chambray les Tours, France
| | | | - Marc Badoz
- Cardiology Department, University Hospital Center Jean Minjoz, Besançon, France
| | - Gabriel Laurent
- Cardiology Department, Dijon Bourgogne University Hospital, Dijon, France
| | - Charles Guenancia
- Cardiology Department, Dijon Bourgogne University Hospital, Dijon, France
| | - Fabien Garnier
- Cardiology Department, Dijon Bourgogne University Hospital, Dijon, France
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6
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Massoullié G, Ploux S, Mondoly P, Souteyrand G, Pereira B, Jean F, Amabile N, Irles D, Mansourati J, Combaret N, Mechulan X, Badoz M, Da Costa A, Defaye P, Clerfond G, Bordachar P, Eschalier R. Occurrence of high-grade conduction disorder after the onset of left bundle branch block in post-TAVI. The French multicenter LBBB-TAVI study. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.170] [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: 11/29/2022]
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Chopard R, Piazza G, Falvo N, Ecarnot F, Besutti M, Capellier G, Schiele F, Badoz M, Meneveau N. An original risk score to predict early major bleeding in acute pulmonary embolism: the Syncope, Anemia, Renal Dysfunction (PE-SARD) bleeding score. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Improved prediction of the risk of early major bleeding in pulmonary embolism (PE) is needed to optimize acute management.
Methods
Using data from a multicenter prospective registry including 2,754 patients, we performed multivariable logistic regression analysis to build a risk score to predict early (up to hospital discharge) major bleeding events. We validated the endpoint model internally using bootstrapping in the derivation dataset by sampling with replacement for 500 iterations. We compared the performance of this novel score to that of the VTE-BLEED and RIETE models.
Results
Multivariate regression identified three predictors for the occurrence of 82 major bleeds (3.0%): Syncope (+1.5 points), Anemia defined by a hemoglobin level <12 g/dL (+2.5 points), and Renal Dysfunction defined by a glomerular filtration rate <60 mL/min (+1 point). The PE-SARD bleeding score was calculated by summing all the components. Overall, 52.2% of patients were classified as low bleeding-risk (score, 0 point), 35.2% intermediate-risk (score, 1–2.5 points), and 12.6% high-risk (score >2.5 points). Cumulative observed bleeding rates increased with increasing risk group, from 0.9% in the low-risk group to 9.0% in the high-risk group. The C-index was 0.744 (95% CI, 0.73–0.76) and Brier score 0.028 in the derivation cohort. Similar values were calculated from internal bootstrapping. Performance of the PE-SARD score was better than that observed with the VTE-BLEED and RIETE scores (figure).
Conclusions
The PE-SARD bleeding risk score is an original, user-friendly score to estimate the risk of early major bleeding in patients with acute PE.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- R Chopard
- University Hospital of Besancon, Besancon, France
| | - G Piazza
- Brigham and Women'S Hospital, Harvard Medical School, Boston, United States of America
| | - N Falvo
- University Hospital of Dijon, Dijon, France
| | - F Ecarnot
- University Hospital of Besancon, Besancon, France
| | - M Besutti
- University Hospital of Besancon, Besancon, France
| | - G Capellier
- University Hospital of Besancon, Besancon, France
| | - F Schiele
- University Hospital of Besancon, Besancon, France
| | - M Badoz
- University Hospital of Besancon, Besancon, France
| | - N Meneveau
- University Hospital of Besancon, Besancon, France
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Mathonier C, Badoz M, Besutti M, Schiele F, Meneveau N, Guillon B, Chopard R. Available bleeding scoring systems poorly predict major bleeding in the acute phase of pulmonary embolism. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1925] [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: 11/15/2022] Open
Abstract
Abstract
Background
Bleeding prediction scores may help to guide acute management of patients with pulmonary embolism (PE). However, existing scoring systems have not been validated for in-hospital assessment. We aimed to compare 6 available bleeding scores, in a real-life cohort for the prediction of major in-hospital bleeding.
Methods
We recorded in-hospital characteristics of 2,754 PE patients included in a prospective observational multicenter cohort study contributing 18,028 person-days of follow-up. We assessed the VTE-BLEED, RIETE, ORBIT, HEMORRA2HAGES, ATRIA, and HAS-BLED scores at baseline. ISTH-defined bleeding events were independently adjudicated. The accuracy of the scores for the prediction of in-hospital bleeding was evaluated and compared.
Results
We observed 82 first in-hospital major bleeding events (3.0% (95% CI, 2.4–3.7)). Overall, the predictive power of bleeding scores was poor, with a C index ranging from 0.57 to 0.69 (Figure 1). The RIETE score had the numerically highest model fit and best discriminatory capacity, but without reaching statistical significance versus the ORBIT, HEMORR2HAGES, and ATRIA scores. The VTE-BLEED and HAS-BLED scores had significantly lower C indices, integrated discrimination improvement, and net reclassification improvement compared to the four others.
Conclusion
Currently available scoring systems have insufficient accuracy for the prediction of in-hospital major bleeding in patients with acute PE. The development of acute-PE-specific risk scores is needed to optimally target patients that warrant bleeding-prevention strategies.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- C Mathonier
- University Hospital of Besancon, Besancon, France
| | - M Badoz
- University Hospital of Besancon, Besancon, France
| | - M Besutti
- University Hospital of Besancon, Besancon, France
| | - F Schiele
- University Hospital of Besancon, Besancon, France
| | - N Meneveau
- University Hospital of Besancon, Besancon, France
| | - B Guillon
- University Hospital of Besancon, Besancon, France
| | - R Chopard
- University Hospital of Besancon, Besancon, France
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Chopard R, Piazza G, Falvo N, Ecarnot F, Besutti M, Capellier G, Schiele F, Badoz M, Meneveau N. An Original Risk Score to Predict Early Major Bleeding in Acute Pulmonary Embolism: The Syncope, Anemia, Renal Dysfunction (PE-SARD) Bleeding Score. Chest 2021; 160:1832-1843. [PMID: 34217683 DOI: 10.1016/j.chest.2021.06.048] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 02/18/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Improved prediction of the risk of early major bleeding in pulmonary embolism (PE) is needed to optimize acute management. RESEARCH QUESTION Does a simple scoring system predict early major bleeding in acute PE patients, identifying patients with either high or low probability of early major bleeding? STUDY DESIGN AND METHODS From a multicenter prospective registry including 2,754 patients, we performed post hoc multivariable logistic regression analysis to build a risk score to predict early (up to hospital discharge) major bleeding events. We validated the endpoint model internally, using bootstrapping in the derivation dataset by sampling with replacement for 500 iterations. Performances of this novel score were compared with that of the VTE-BLEED, RIETE, and BACS models. RESULTS Multivariable regression identified three predictors for the occurrence of 82 major bleeds (3.0%; 95% CI, 2.39%-3.72%): Syncope (+1.5); Anemia, defined as hemoglobin <12 g/dL (+2.5); and Renal Dysfunction, defined as glomerular filtration rate <60 mL/min (+1 point) (SARD). The PE-SARD bleeding score was calculated by summing all the components. Overall, 52.2% (95% CI; 50.29%-54.11%) of patients were classified as low bleeding-risk (score, 0 point), 35.2% (95% CI, 33.39%-37.04%) intermediate-risk (score, 1-2.5 points), and 12.6% (95% CI, 9.30%-16.56%) high-risk (score >2.5 points). Observed bleeding rates increased with increasing risk group, from 0.97% (95% CI, 0.53%-1.62%) in the low-risk to 8.93% (95% CI, 6.15%-12.44%) in the high-risk group. C-index was 0.74 (95% CI, 0.73-0.76) and Brier score 0.028 in the derivation cohort. Similar values were calculated from internal bootstrapping. Performance of the PE-SARD score was better than that observed with the VTE-BLEED, RIETE, and BACS scores, leading to a high proportion of bleeding-risk reclassification in patients who bled and those who did not. INTERPRETATION The PE-SARD bleeding risk score is an original, user-friendly score to estimate risk of early major bleeding in patients with acute PE.
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Affiliation(s)
- Romain Chopard
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France; EA3920, University of Burgundy Franche-Comté, Besançon, France; F-CRIN, INNOVTE network, France.
| | - Gregory Piazza
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Nicolas Falvo
- Department of Internal Medicine, University Hospital Dijon-Bourgogne, Dijon, France
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France; EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Mathieu Besutti
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France
| | - Gilles Capellier
- EA3920, University of Burgundy Franche-Comté, Besançon, France; Medical Intensive Care Unit, University Hospital Jean Minjoz, Besançon, France
| | - François Schiele
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France; EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Marc Badoz
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France; EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Nicolas Meneveau
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France; EA3920, University of Burgundy Franche-Comté, Besançon, France; F-CRIN, INNOVTE network, France
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Badoz M, Serzian G, Favoulet B, Sellal JM, De Chillou C, Hammache N, Laurent G, Mebazaa A, Ecarnot F, Bardonnet K, Seronde MF, Schiele F, Meneveau N. Impact of Midregional N-Terminal Pro-Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study. J Am Heart Assoc 2021; 10:e020917. [PMID: 34187182 PMCID: PMC8403329 DOI: 10.1161/jaha.121.020917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P<0.0001), as was sST2 (median, 30.3 [quartile 1–quartile 3, 23.3–39.3] versus 23.4 [95% CI, 17.4–33.0] ng/mL; P=0.0033). In the atria, MRproANP was significantly higher than in peripheral blood and was higher during AF than during sinus rhythm. Receiver operating characteristic curve analysis identified a threshold of MRproANP>107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP<107.9 pmol/L identified subjects at very low risk of recurrence (negative predictive value >95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03351816.
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Affiliation(s)
- Marc Badoz
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Guillaume Serzian
- Department of CardiologyUniversity Hospital Besançon Besançon France
| | - Baptiste Favoulet
- Department of CardiologyUniversity Hospital Besançon Besançon France
| | - Jean-Marc Sellal
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France.,IADIINSERM U1254Université de Lorraine Nancy France
| | - Christian De Chillou
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France
| | - Néfissa Hammache
- Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France.,IADIINSERM U1254Université de Lorraine Nancy France
| | - Gabriel Laurent
- Department of Cardiology University Hospital François Mitterand Dijon France
| | - Alexandre Mebazaa
- INSERM UMR-S 942 Paris France.,Department of Anesthesiology and Critical Care Medicine Assistance Publique - Hôpitaux de ParisSaint Louis Lariboisière University Hospitals Paris France
| | - Fiona Ecarnot
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Karine Bardonnet
- Department of BiochemistryUniversity Hospital Besançon Besançon France
| | - Marie-France Seronde
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - François Schiele
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
| | - Nicolas Meneveau
- Department of CardiologyUniversity Hospital Besançon Besançon France.,EA3920University of Burgundy Franche-Comté Besançon France
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11
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Badoz M, Favoulet B, Serzian G, Ecarnot F, Guillon B, Chopard R, Meneveau N. Impact of early (<7 days) pacemaker implantation after cardiac surgery on long-term pacemaker dependency. Pacing Clin Electrophysiol 2021; 44:1018-1026. [PMID: 33969505 DOI: 10.1111/pace.14260] [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] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/19/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We aimed to investigate pacemaker dependency after at least 1 year in patients with early (<7 days) implantation, compared to those who received a pacemaker ≥7 days after cardiac surgery. Secondary endpoints were length of hospital stay and in-hospital complications. METHODS Retrospective analysis of 108 consecutive patients who received a pacemaker after cardiac surgery between 06/2012 and 06/2018. Characteristics and outcomes were compared between patients with early (<7 days) and late (≥7 days) implantation. Patients were followed up with evaluation of pacemaker dependency between April and June 2019. We identified predictors of dependency by logistic regression. RESULTS In total, 63.9% were men, average age 71.9 ± 11.8 years; 32 (29.6%) had early implantation, and 76 (70.4%) late implantation. After a median 3.2 years [IQR 1.9, 4.5] of follow-up, 30 patients (27.8%) had died, and there was no difference in pacemaker dependency among survivors (66.7% vs. 46.5%, early vs. late respectively, p = .15). Patients in the early group had a shorter length of stay (11.5 [9.0, 14.0] vs. 15.0 [11.5, 20] days, p = .002) and less often had new-onset atrial fibrillation (AF) post-surgery (22.7% vs. 47.8%, p = .05). The only significant predictor of dependency was aortic valve replacement surgery (OR = 4.70, 95% CI [1.36 to 16.24]). CONCLUSION Early implantation of a permanent pacemaker (<7 days after cardiac surgery) does not impact on the proportion of patients with long-term (>12 months) pacemaker dependency, but is associated with shorter length of stay and less frequent new-onset AF. These findings warrant prospective confirmation in randomized trials.
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Affiliation(s)
- Marc Badoz
- Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France.,EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Baptiste Favoulet
- Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France
| | - Guillaume Serzian
- Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France
| | - Fiona Ecarnot
- Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France.,EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Benoit Guillon
- Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France
| | - Romain Chopard
- Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France.,EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Nicolas Meneveau
- Department of Cardiology, University Hospital Besançon, Boulevard Fleming, Besançon, France.,EA3920, University of Burgundy Franche-Comté, Besançon, France
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12
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Chopard R, Badoz M, Eveno C, Ecarnot F, Falvo N, Kalbacher E, Capellier G, Guillon B, Schiele F, Meneveau N. Early prescription of direct oral anticoagulant for the treatment of intermediate-high risk pulmonary embolism: a multi-center, observational cohort study. Thromb Res 2020; 196:476-482. [PMID: 33091699 DOI: 10.1016/j.thromres.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The safety and efficacy of direct oral anticoagulants (DOACs) in intermediate-high risk pulmonary embolism (PE) are unknown. The aims of the present study were to describe outcomes of patients receiving early apixaban or rivaroxaban prescription rather than the recommended delayed prescription strategy. METHODS Retrospective post-hoc analysis based on prospectively collected data from a multicenter cohort including all consecutive PE patients stratified as intermediate-high risk. Group definitions were: early group with DOAC prescription <72 h after admission; delayed group with DOAC prescription between 72 h and discharge. The 30-day primary efficacy outcome was a clinical composite of all-cause death and hemodynamic decompensation. The 30-day primary safety outcome was major bleeding. RESULTS Among 2411 patients admitted with PE, 302 were treated with a DOAC for an intermediate-high risk PE: 34.2% in the early group and 65.9% in the delayed group. The primary outcome occurred in 4.8% (including 1 death and 4 hemodynamic decompensations) in the early DOAC group and in 9.0% in the delayed DOAC group (OR, 0.44, 95% CI 0.15-1.30). The rate of major bleeding did not differ between groups (OR, 0.99; 95% CI 0.45-2.18). The length of stay was numerically shorter in the early group whereas the other outcomes did not differ significantly. CONCLUSION The rate of 30-day outcomes was low in patients receiving a DOAC earlier after admission. Patients in the early DOAC group had a numerically shorter length of stay, with similarly low rates of death and bleeding, and similar RV function recovery compared to the delayed strategy.
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Affiliation(s)
- Romain Chopard
- Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France.
| | - Marc Badoz
- Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
| | - Charly Eveno
- Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
| | - Fiona Ecarnot
- Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
| | - Nicolas Falvo
- Department of Internal Medicine, University Hospital, 2 Boulevard du Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Elsa Kalbacher
- Medical Oncology Unit, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
| | - Gilles Capellier
- Medical Intensive Care Unit, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
| | - Benoit Guillon
- Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
| | - François Schiele
- Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
| | - Nicolas Meneveau
- Department of Cardiology, EA3920, University Hospital Besançon, Boulevard Fleming, 25030 Besançon, France
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13
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Akiyama E, Cinotti R, Čerlinskaitė K, Van Aelst LNL, Arrigo M, Placido R, Chouihed T, Girerd N, Zannad F, Rossignol P, Badoz M, Launay JM, Gayat E, Cohen-Solal A, Lam CSP, Testani J, Mullens W, Cotter G, Seronde MF, Mebazaa A. Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study. ESC Heart Fail 2020; 7:996-1006. [PMID: 32277607 PMCID: PMC7261539 DOI: 10.1002/ehf2.12645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/27/2019] [Accepted: 01/22/2020] [Indexed: 12/20/2022] Open
Abstract
Aims Changes in echocardiographic parameters and biomarkers of cardiac and venous pressures or estimated plasma volume during hospitalization associated with decongestive treatments in acute heart failure (AHF) patients with either preserved left ventricular ejection fraction (LVEF) (HFPEF) or reduced LVEF (HFREF) are poorly assessed. Methods and results From the metabolic road to diastolic heart failure: diastolic heart failure (MEDIA‐DHF) study, 111 patients were included in this substudy: 77 AHF (43 HFPEF and 34 HFREF) and 34 non‐cardiac dyspnea patients. Echocardiographic measurements and blood samples were obtained within 4 h of presentation at the emergency department and before hospital discharge. In AHF patients, echocardiographic indices of cardiac and venous pressures, including inferior vena cava diameter [from 22 (16–24) mm to 13 (11–18) mm, P = 0.009], its respiratory variability [from 32 (8–44) % to 43 (29–70) %, P = 0.04], medial E/e' [from 21.1 (15.8–29.6) to 16.6 (11.7–24.3), P = 0.004], and E wave deceleration time [from 129 (105–156) ms to 166 (128–203) ms, P = 0.003], improved during hospitalization, similarly in HFPEF and HFREF patients. By contrast, no changes were seen in non‐cardiac dyspnea patients. In AHF patients, all plasma biomarkers of cardiac and venous pressures, namely B‐type natriuretic peptide [from 935 (514–2037) pg/mL to 308 (183–609) pg/mL, P < 0.001], mid‐regional pro‐atrial natriuretic peptide [from 449 (274–653) pmol/L to 366 (242–549) pmol/L, P < 0.001], and soluble CD‐146 levels [from 528 (406–654) ng/mL to 450 (374–529) ng/mL, P = 0.003], significantly decreased during hospitalization, similarly in HFPEF and HFREF patients. Echocardiographic parameters of cardiac chamber dimensions [left ventricular end‐diastolic volume: from 120 (76–140) mL to 118 (95–176) mL, P = 0.23] and cardiac index [from 2.1 (1.6–2.6) mL/min/m2 to 1.9 (1.4–2.4) mL/min/m2, P = 0.55] were unchanged in AHF patients, except tricuspid annular plane systolic excursion (TAPSE) that improved during hospitalization [from 16 (15–19) mm to 19 (17–21) mm, P = 0.04]. Estimated plasma volume increased in both AHF [from 4.8 (4.2–5.6) to 5.1 (4.4–5.8), P = 0.03] and non‐cardiac dyspnea patients (P = 0.01). Serum creatinine [from 1.18 (0.90–1.53) to 1.19 (0.86–1.70) mg/dL, P = 0.89] and creatinine‐based estimated glomerular filtration rate [from 59 (40–75) mL/min/1.73m2 to 56 (38–73) mL/min/1.73m2, P = 0.09] were similar, while plasma cystatin C [from 1.50 (1.20–2.27) mg/L to 1.78 (1.33–2.59) mg/L, P < 0.001] and neutrophil gelatinase associated lipocalin (NGAL) [from 127 (95–260) ng/mL to 167 (104–263) ng/mL, P = 0.004] increased during hospitalization in AHF. Conclusions Echocardiographic parameters and plasma biomarkers of cardiac and venous pressures improved during AHF hospitalization in both acute HFPEF and HFREF patients, while cardiac chamber dimensions, cardiac output, and estimated plasma volume showed minimal changes.
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Affiliation(s)
- Eiichi Akiyama
- Inserm UMR-S 942, Paris, France.,Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Raphaël Cinotti
- Inserm UMR-S 942, Paris, France.,Department of Anesthesia and Critical care, Hôtel Dieu, University hospital of Nantes, Nantes, France
| | - Kamilė Čerlinskaitė
- Inserm UMR-S 942, Paris, France.,Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lucas N L Van Aelst
- Inserm UMR-S 942, Paris, France.,Department of Cardiology, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hopitaux de Paris, Paris, France.,Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium
| | - Mattia Arrigo
- Inserm UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisiere, Assistance Publique des Hopitaux de Paris, Paris, France.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Rui Placido
- Cardiology Department, Santa Maria University Hospital (CHLN), Lisbon Academic Medical Centre, and Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Lisbon, Portugal
| | - Tahar Chouihed
- Inserm UMR-S 942, Paris, France.,Emergency Department, University Hospital of Nancy; University of Lorraine, INSERM U1116, Nancy, France; University Paris Diderot, Paris, France
| | - Nicolas Girerd
- INSERM Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, INSERM U1116, Nancy, France.,F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Faiez Zannad
- INSERM Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, INSERM U1116, Nancy, France.,F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Patrick Rossignol
- INSERM Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, CHRU de Nancy, INSERM U1116, Nancy, France.,F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Marc Badoz
- Department of Cardiology, University Hospital Jean Minjoz, Besancon, France
| | - Jean-Marie Launay
- Inserm UMR-S 942, Paris, France.,Department of Medical Biochemistry and Molecular Biology, Hôpital Lariboisière, Paris, France.,Center for Biological Resources BB-033-00064, Hôpital Lariboisière, Paris, France
| | - Etienne Gayat
- Inserm UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisiere, Assistance Publique des Hopitaux de Paris, Paris, France.,F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Alain Cohen-Solal
- Inserm UMR-S 942, Paris, France.,Department of Cardiology, Hôpitaux Universitaires Saint Louis-Lariboisière, Assistance Publique des Hopitaux de Paris, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Carolyn S P Lam
- National Heart Centre Singapore and Duke-National University of Singapore, Singapore, Singapore.,University Medical Centre Groningen, Groningen, Netherlands
| | - Jeffrey Testani
- Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Wilfried Mullens
- Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Gad Cotter
- Momentum Research Inc., Durham, NC, 27707, USA
| | - Marie-France Seronde
- Inserm UMR-S 942, Paris, France.,Department of Cardiology, University Hospital Jean Minjoz, Besancon, France
| | - Alexandre Mebazaa
- Inserm UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisiere, Assistance Publique des Hopitaux de Paris, Paris, France.,F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France
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14
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Badoz M, Arrigo M, Mogenet AC, Sadoune M, Meneveau N, Mebazaa A, Seronde MF. Assessment of successful percutaneous mitral commissurotomy by MRproANP and sCD146. BMC Cardiovasc Disord 2020; 20:157. [PMID: 32248819 PMCID: PMC7132872 DOI: 10.1186/s12872-020-01435-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/13/2020] [Indexed: 12/20/2022] Open
Abstract
Background We studied the course of plasma concentrations of 4 cardiovascular biomarkers: natriuretic peptides (BNP, NT-proBNP; mid-regional (MR) pro-atrial NP); and soluble endothelial CD146 (sCD146), in patients with severe mitral valve stenosis undergoing percutaneous mitral commissurotomy (PMC) to identify potential markers of procedural success. Methods Biomarkers were tested in 40 patients the day before and the day after PMC. Success was defined as mitral valve area ≥ 1.5 cm2; or an increase of ≥0.5 cm2 in mitral valve area associated with echocardiographic mitral regurgitation <grade 3–4 post-PMC. Results Average age was 63.5 ± 12.7 years; 32(80%) were female. Before PMC, mean valve area was 1.1 ± 0.2 cm2, mean gradient 9.1 ± 3.5 mmHg. PMC was successful in 30 (75%) and unsuccessful in 10 (25%). PMC yielded a significant reduction in MR-proANP and sCD146, driven by a significant reduction in these biomarkers in patients with successful procedure, whereas no reduction was observed in patients with unsuccessful procedure. A significant correlation was found between changes in plasma sCD146 and the relative change in mitral valve area. Elevated pre-procedural sPAP correlated with high sCD146, and accordingly, a significant correlation between the decrease in sPAP and sCD146 after PMC was shown. Conclusions MR-proANP and plasma sCD146 decreased significantly immediately after successful PMC. They appear to be markers of immediate success of PMC and of the hemodynamic improvement achieved by this procedure in patients with MS. Trial registration This study is part of the cohorts registered with ClinicalTrials.gov on June 16, 2011 under the number NCT01374880.
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Affiliation(s)
- Marc Badoz
- Besancon University Hospital, and EA3920, University of Burgundy Franche-Comté, Besancon, France.
| | - Mattia Arrigo
- INSERM UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.,Department of Cardiology, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Anne-Claire Mogenet
- Besancon University Hospital, and EA3920, University of Burgundy Franche-Comté, Besancon, France
| | | | - Nicolas Meneveau
- Besancon University Hospital, and EA3920, University of Burgundy Franche-Comté, Besancon, France
| | - Alexandre Mebazaa
- INSERM UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France
| | - Marie-France Seronde
- Besancon University Hospital, and EA3920, University of Burgundy Franche-Comté, Besancon, France
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15
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Rosier L, Zouaghi A, Barré V, Martins R, Probst V, Marijon E, Sadoul N, Chauveau S, Da Costa A, Badoz M, Peyrol M, Barraud J, Massoullie G, Eschalier R, Espinosa M, Lesaffre F, Garcia R, Degand B, Noël A, Mansourati J, Extramiana F, Algalarrondo V, Devilliers H, Cottin Y, Gandjbakhch E, Guenancia C. High Risk of Sustained Ventricular Arrhythmia Recurrence After Acute Myocarditis. J Clin Med 2020; 9:jcm9030848. [PMID: 32244983 PMCID: PMC7141537 DOI: 10.3390/jcm9030848] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/10/2020] [Accepted: 03/19/2020] [Indexed: 12/26/2022] Open
Abstract
Acute myocarditis is associated with cardiac arrhythmia in 25% of cases; a third of these arrhythmias are ventricular tachycardia (VT) or ventricular fibrillation (VF). The implantation of a cardiac defibrillator (ICD) following sustained ventricular arrhythmia remains controversial in these patients. We sought to assess the risk of major arrhythmic ventricular events (MAEs) over time in patients implanted with an ICD following sustained VT/VF in the acute phase of myocarditis compared to those implanted for VT/VF occurring on myocarditis sequelae. Our retrospective observational study included patients implanted with an ICD following VT/VF during acute myocarditis or VT/VF on myocarditis sequelae, from 2007 to 2017, in 15 French university hospitals. Over a median follow-up period of 3 years, MAE occurred in 11 (39%) patients of the acute myocarditis group and 24 (60%) patients of the myocarditis sequelae group. Kaplan–Meier MAE rate estimates at one and three years of follow-up were 19% and 45% in the acute group, and 43% and 64% in the sequelae group. Patients who experienced sustained ventricular arrhythmias during acute myocarditis had a very high risk of VT/VF recurrence during follow-up. These results show that the risk of MAE recurrence remains high after resolution of the acute episode.
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Affiliation(s)
- Laurent Rosier
- Cardiology Department, Dijon Bourgogne University Hospital, 21000 Dijon, France; (L.R.); (Y.C.)
| | - Amir Zouaghi
- Cardiology Department, Hôpitaux Universitaires Pitié Salpêtrière, APHP, 75013 Paris, France; (A.Z.); (E.G.)
| | - Valentin Barré
- Cardiology Department, University Hospital, 35000 Rennes, France; (V.B.); (R.M.)
| | - Raphaël Martins
- Cardiology Department, University Hospital, 35000 Rennes, France; (V.B.); (R.M.)
| | - Vincent Probst
- Institut du thorax, Service de Cardiologie and INSERM 1087, 44000 Nantes, France;
| | - Eloi Marijon
- Cardiology Department, European Georges Pompidou Hospital and Paris Descartes University, 75015 Paris, France;
| | - Nicolas Sadoul
- Cardiology Department, University Hospital, 54511 Nancy, France
| | - Samuel Chauveau
- Cardiology Department, University Hospital Louis Pradel, 69500 Lyon, France;
| | - Antoine Da Costa
- Cardiology Department, University Hospital, 42055 Saint-Etienne, France;
| | - Marc Badoz
- Cardiology Department, University Hospital, 25030 Besançon, France;
| | - Michael Peyrol
- Aix-Marseille University, Assistance Publique–Hôpitaux de Marseille (APHM), Department of Cardiology, Nord Hospital, 13000 Marseille, France; (M.P.); (J.B.)
| | - Jérémie Barraud
- Aix-Marseille University, Assistance Publique–Hôpitaux de Marseille (APHM), Department of Cardiology, Nord Hospital, 13000 Marseille, France; (M.P.); (J.B.)
| | - Grégoire Massoullie
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France and Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France; (G.M.); (R.E.)
| | - Romain Eschalier
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France and Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, 63000 Clermont-Ferrand, France; (G.M.); (R.E.)
| | - Madeline Espinosa
- Cardiology Department, University Hospital, 51100 Reims, France; (M.E.); (F.L.)
| | - François Lesaffre
- Cardiology Department, University Hospital, 51100 Reims, France; (M.E.); (F.L.)
| | - Rodrigue Garcia
- CHU Poitiers, Centre Cardiovasculaire, 86000 Poitiers, France; (R.G.) ; (B.D.)
| | - Bruno Degand
- CHU Poitiers, Centre Cardiovasculaire, 86000 Poitiers, France; (R.G.) ; (B.D.)
| | - Antoine Noël
- Cardiology Department, University Hospital, 29200 Brest, France; (A.N.); (J.M.)
| | - Jacques Mansourati
- Cardiology Department, University Hospital, 29200 Brest, France; (A.N.); (J.M.)
| | - Fabrice Extramiana
- Department of Cardiology, Bichat Claude Bernard Hospital, University Paris Diderot, 75018 Paris, France; (F.E.); (V.A.)
| | - Vincent Algalarrondo
- Department of Cardiology, Bichat Claude Bernard Hospital, University Paris Diderot, 75018 Paris, France; (F.E.); (V.A.)
| | - Hervé Devilliers
- Internal Medicine 2 Department, Dijon Bourgogne University Hospital, 21000 Dijon, France;
| | - Yves Cottin
- Cardiology Department, Dijon Bourgogne University Hospital, 21000 Dijon, France; (L.R.); (Y.C.)
- PEC 2, Univ. Bourgogne Franche–Comté, 21000 Dijon, France
| | - Estelle Gandjbakhch
- Cardiology Department, Hôpitaux Universitaires Pitié Salpêtrière, APHP, 75013 Paris, France; (A.Z.); (E.G.)
| | - Charles Guenancia
- Cardiology Department, Dijon Bourgogne University Hospital, 21000 Dijon, France; (L.R.); (Y.C.)
- PEC 2, Univ. Bourgogne Franche–Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-380293536; Fax: +33-380293879
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16
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Rosier L, Zouaghi A, Barre V, Martins R, Probst V, Marijon E, Sadoul N, Chauveau S, Da Costa A, Badoz M, Barraud J, Eschalier R, Garcia R, Espinosa M, Mansourati J, Extramiana F, Algalarrondo V, Cottin Y, Gandjbakhch E, Guenancia C. High risk of sustained ventricular arrhythmia recurrence after acute myocarditis. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Pastissier A, Humbert S, Naudion P, Meaux-Ruault N, Badoz M, Magy-Bertrand N. Severe Sinus Bradycardia in Puumala virus infection. Int J Infect Dis 2018; 79:75-76. [PMID: 30503652 DOI: 10.1016/j.ijid.2018.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/17/2018] [Revised: 11/25/2018] [Accepted: 11/26/2018] [Indexed: 11/19/2022] Open
Abstract
Puumala orthohantavirus (PUUV) is the most prevalent of the four species of zoonotic hantaviruses found in Europe, causing nephropathia epidemica, a mild form of hemorrhagic fever with acute kidney injury that presents with elevated serum creatinine level, proteinuria and hematuria. The febrile phase of the infection begins with flu-like syndrome and visual disturbance. Laboratory results can show thrombocytopenia. The oliguric phase with elevated serum creatinine level then occurs. Cardiac involvement is sometimes observed, especially ECG abnormality: transient T-waves inversion, generally in the lateral or inferior leads. Marked bradycardia has been exceptionally described. We report the case of a 36-year-old woman with acute PUUV infection. Two days after admission, the patient presented a sinus bradycardia at 25/min. The bradycardia was asymptomatic, persisted one week and resolved spontaneously. Cardiac involvement in Puumala virus infection seems not to be associated with a bad prognosis. Bradycardia in the course of an influenza-like illness in endemic areas should suggest several pathogens such as legionella, Q fever or PUUV virus infection.
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Affiliation(s)
| | | | - Pauline Naudion
- Service de Médecine Interne, CHRU de Besançon, Besançon, France.
| | | | - Marc Badoz
- Service de Cardiologie, CHRU de Besançon, Besançon, France.
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18
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Chopard R, Cart L, Badoz M, Ecarnot F, Schiele F, Meneveau NF. NON-COMPLIANCE WITH GUIDELINES FOR THE MANAGEMENT OF PULMONARY EMBOLISM: PREDICTORS AND IMPACT ON CLINICAL OUTCOME. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32469-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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19
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Van Aelst LNL, Arrigo M, Placido R, Akiyama E, Girerd N, Zannad F, Manivet P, Rossignol P, Badoz M, Sadoune M, Launay JM, Gayat E, Lam CSP, Cohen-Solal A, Mebazaa A, Seronde MF. Acutely decompensated heart failure with preserved and reduced ejection fraction present with comparable haemodynamic congestion. Eur J Heart Fail 2017; 20:738-747. [PMID: 29251818 DOI: 10.1002/ejhf.1050] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [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: 07/14/2017] [Revised: 09/18/2017] [Accepted: 09/26/2017] [Indexed: 02/06/2023] Open
Abstract
AIMS Congestion is a central feature of acute heart failure (HF) and its assessment is important for clinical decisions (e.g. tailoring decongestive treatments). It remains uncertain whether patients with acute HF with preserved ejection fraction (HFpEF) are comparably congested as in acute HF with reduced EF (HFrEF). This study assessed congestion, right ventricular (RV) and renal dysfunction in acute HFpEF, HFrEF and non-cardiac dyspnoea. METHODS AND RESULTS We compared echocardiographic and circulating biomarkers of congestion in 146 patients from the MEDIA-DHF study: 101 with acute HF (38 HFpEF, 41 HFrEF, 22 HF with mid-range ejection fraction) and 45 with non-cardiac dyspnoea. Compared with non-cardiac dyspnoea, patients with acute HF had larger left and right atria, higher E/e', pulmonary artery systolic pressure and inferior vena cava (IVC) diameter at rest, and lower IVC variability (all P < 0.05). Mid-regional pro-atrial natriuretic peptide (MR-proANP) and soluble CD146 (sCD146), but not B-type natriuretic peptide (BNP), correlated with echocardiographic markers of venous congestion. Despite a lower BNP level, patients with HFpEF had similar evidence of venous congestion (enlarged IVC, left and right atria), RV dysfunction (tricuspid annular plane systolic excursion), elevated MR-proANP and sCD146, and renal impairment (estimated glomerular filtration rate; all P > 0.05) compared with HFrEF. CONCLUSION In acute conditions, HFpEF and HFrEF presented in a comparable state of venous congestion, with similarly altered RV and kidney function, despite higher BNP in HFrEF.
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Affiliation(s)
- Lucas N L Van Aelst
- Department of Cardiovascular Sciences KU Leuven, Campus Gasthuisberg O&N1, Leuven, Belgium.,Department of Cardiology, Hôpital Lariboisière, Paris, France.,U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Mattia Arrigo
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Division of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.,Department of Anesthesia and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisière, Paris, France
| | - Rui Placido
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Hospital Santa Maria, Serv Cardiologia I, Lisbon Academic Medical Centre, CCUL, Lisbon, Portugal
| | - Eiichi Akiyama
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Division of Cardiology, Yokohama City University Medical Center, Minamiku, Yokohama, Japan
| | - Nicolas Girerd
- INSERM, Centre d'Investigations Cliniques Plurithématique, CHRU de Nancy, Université de Lorraine, CHRU de Nancy, and F-CRIN INI-CRCT, Nancy, France
| | - Faiez Zannad
- INSERM, Centre d'Investigations Cliniques Plurithématique, CHRU de Nancy, Université de Lorraine, CHRU de Nancy, and F-CRIN INI-CRCT, Nancy, France
| | - Philippe Manivet
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Department of Medical Biochemistry and Molecular Biology, Hôpital Lariboisière, Paris, France.,Biossip Analytical Platform, Center for Biological Resources, Lariboisière Hospital, Paris, France
| | - Patrick Rossignol
- INSERM, Centre d'Investigations Cliniques Plurithématique, CHRU de Nancy, Université de Lorraine, CHRU de Nancy, and F-CRIN INI-CRCT, Nancy, France
| | - Marc Badoz
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France
| | - Malha Sadoune
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-Marie Launay
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Department of Medical Biochemistry and Molecular Biology, Hôpital Lariboisière, Paris, France.,Biossip Analytical Platform, Center for Biological Resources, Lariboisière Hospital, Paris, France
| | - Etienne Gayat
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Department of Anesthesia and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisière, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Carolyn S P Lam
- National Heart Centre Singapore and Duke-National University of Singapore, Singapore
| | - Alain Cohen-Solal
- Department of Cardiology, Hôpital Lariboisière, Paris, France.,U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Alexandre Mebazaa
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Department of Anesthesia and Critical Care, Hôpitaux Universitaires Saint Louis-Lariboisière, Paris, France.,University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Marie-France Seronde
- U942 INSERM, Assistance Publique - Hôpitaux de Paris, Paris, France.,Department of Cardiology, University Hospital Jean Minjoz, Besançon, France
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Nardin C, Colas M, Badoz M, Roche-Kubler B, Méneveau N, Puzenat E, Aubin F. Syndrome de Brugada induit par l’association anti-BRAF et anti-MEK au cours d’un mélanome métastatique. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nardin C, Colas M, Badoz M, Roche-Kubler B, Meneveau N, Puzenat E, Aubin F. Brugada syndrome induced by BRAF and MEK inhibitors in a melanoma patient. Eur Heart J 2017; 38:2151. [DOI: 10.1093/eurheartj/ehx133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Badoz M, Arrigo M, Iung B, Amioglu G, Yilmaz MB, Meneveau N, Sadoune M, Brunette A, Mebazaa A, Seronde MF. Role of cardiovascular biomarkers for the assessment of mitral stenosis and its complications. Eur J Intern Med 2016; 34:58-62. [PMID: 27236297 DOI: 10.1016/j.ejim.2016.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/21/2016] [Accepted: 05/11/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Marc Badoz
- Besancon University Hospital, Besancon, France
| | - Mattia Arrigo
- INSERM UMR-S 942, Paris, France; Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France; Department of Cardiology, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France; Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Bernard Iung
- Department of Cardiology, AP-HP, Bichat University Hospitals, Paris, France
| | | | | | | | | | | | - Alexandre Mebazaa
- INSERM UMR-S 942, Paris, France; Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.
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Badoz M, Chatot M, Hechema R, Chopard R, Meneveau N, Schiele F. Effect of Fractional Flow Reserve (≤0.90 vs >0.90) on Long-Term Outcome (>10 Years) in Patients With Nonsignificant Coronary Arterial Narrowings. Am J Cardiol 2016; 118:465-72. [PMID: 27448943 DOI: 10.1016/j.amjcard.2016.05.037] [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: 01/29/2016] [Revised: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 11/30/2022]
Abstract
We assessed the long-term (>10 years) clinical course of patients with documented coronary lesions deemed nonsignificant according to fractional flow reserve (FFR) assessment and investigated whether the initial FFR value impacted on prognosis. From January 2000 to October 2003, all patients submitted to coronary angiography with FFR measurement were included in a single-center, prospective registry. Patients with an FFR value >0.80 were treated medically without revascularization. Major adverse cardiac events (MACE) (death, acute coronary syndrome (ACS), or coronary revascularization) were compared according to initial FFR value (absolute value and by category, ≤0.90 vs >0.90). Analyses were performed using a multivariable Cox model and propensity score matching. Among 257 patients (332 lesions) treated medically initially, 131 (51%, 143 lesions) had FFR ≤0.90 and 126 (49%, 189 lesions) >0.90. During follow-up (median duration, 11.6 years), 82 (31.9%) had a MACE, 38 (14.8%) died, 17 (6.6%) had ACS, 93 (36.2%) had repeat coronary angiography, and 27 (10.5%) had revascularization. There was no clinical, biologic or angiographic difference between patients with initial FFR value ≤0.90 versus >0.90. Adjusted Cox model showed no difference in relative risk of MACE, death, ACS, or revascularization. Coronary angiographies were numerically more frequent in patients with FFR ≤0.90, versus FFR >0.90. These findings were confirmed by propensity score-matched comparison. In patients with coronary narrowings left unrevascularized based on FFR, an FFR value between 0.80 and 0.90 has no impact on long-term outcome compared with those with FFR >0.90. In conclusion, patients with high FFR values should not be considered as having a lower risk of coronary event.
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Affiliation(s)
- Marc Badoz
- Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France
| | - Marion Chatot
- Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France
| | - Rémy Hechema
- Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France
| | - Romain Chopard
- Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France
| | - Nicolas Meneveau
- Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France
| | - François Schiele
- Department of Cardiology, EA3920, University Hospital Jean Minjoz, Besançon, France.
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Chopard R, Genet B, Badoz M, Ecarnot F, Bonnet B, Seronde MF, Schiele F, Meneveau N. LONG-TERM CLINICAL IMPLICATIONS OF RESIDUAL PULMONARY VASCULAR OBSTRUCTION AFTER PULMONARY EMBOLISM: A VENTILATION-PERFUSION LUNG SCAN FOLLOW-UP STUDY AT TWO TIMEPOINTS. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32047-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Genet B, Chopard R, Chatot M, Badoz M, Bonnet B, Schiele F, Meneveau N. 0300: Course of vascular obstruction after pulmonary embolism as assessed by ventilation-perfusion lung scan follow-up. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30231-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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26
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Crouzet J, Bertrand X, Venier A, Badoz M, Husson C, Talon D. Control of the duration of urinary catheterization: impact on catheter-associated urinary tract infection. J Hosp Infect 2007; 67:253-7. [DOI: 10.1016/j.jhin.2007.08.014] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2006] [Accepted: 08/17/2007] [Indexed: 11/26/2022]
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