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Background: French health authorities recommend implementing a strong coordination between general practitioners and office-based cardiologists for the care and management of patients with chronic heart failure. The aim of this study was to describe the characteristics of patients with chronic heart failure who were infrequently referred to an office-based cardiologist (either first time referral or last visit more than 12 months before study inclusion) by a general practitioner or other healthcare professional versus those who were regularly followed by a general practitioner and an office-based cardiologist (at least one visit to an office-based cardiologist in the last 12 months)., Methods: This was a non-interventional, cross-sectional study, conducted among office-based cardiologists in France during a single study visit. Descriptive statistics were performed., Results: 1460 patients were included in the study with 37.1% in the group infrequently referred to an office-based cardiologist and 62.9% in the regularly followed group. The patients who were infrequently referred to an office-based cardiologist had relatively less heart failure with reduced ejection fraction (29.2% versus 36.6%), less prior chronic heart failure hospitalization (15.9% versus 31.4%), and less atrial fibrillation and ischemic heart failure as comorbidities (40.2% versus 50.5% and 39.3% versus 50.1%, respectively) than patients who were regularly followed by an office-based cardiologist and a general practitioner. They also received less clinical exams (25.5% versus 97.4%) and pharmacological (89.3% versus 98.4%) and non-pharmacological (17.3% versus 27.1%) heart failure treatments before the study visit., Conclusions: This study suggested that patients regularly followed by a general practitioner and an office-based cardiologist had globally a more severe chronic heart failure and a better medical monitoring and follow-up than other patients., Competing Interests: Declaration of interest FM received personal fees from Novartis, Pfizer, Vifor and Boehringer. GH and MT received personal fees from Novartis (Novartis employees). SC received personal fees from Bayer, Alliance BMS Pfizer, Novartis, AstraZeneca, Alliance Boehringer-Lilly, Servier. PJ received personal fees from Novartis, AstraZeneca, Boehringer and Lilly., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Coronary disease results from the slow formation of atherosclerotic plaque, accelerated by plaque ruptures that make it serious. Cardiologists have many explorations, but with a lead time that can take several weeks. The organization of a revascularization can sometimes also be long. The medico-legal analysis reports frequent cases of acceleration of the disease in this interval, which can lead to death. It is then necessary to stratify the individual risk of each patient, if this delay is accepted. However, it is imperative to give instructions in case of the development of symptoms, remembering that at any time, it is sometimes necessary to call the emergency services (911 or others). Care teams must ensure that a process for receiving calls is organized during this period. It is sometimes preferable for the cardiologist to make the appointment personally or for him to opt directly for a coronary angiogram from the outset, if his clinical conviction is strong. It is with a complete strategy that we can reduce the risk of a medical accident and therefore of a complaint., (Copyright © 2022. Published by Elsevier Masson SAS.)

Multiple myeloma is one of the most frequent hematological malignancies in the elderly and corresponds to the presence of a plasma cell clone. Antitumor treatment combines different therapeutics, including alkylating agents, high-dose corticosteroids, immunomodulators and proteasome inhibitors. These treatments can have cardiovascular side effects that are important to be aware of. The role of the cardiologist is essential in preventing, detecting and managing these effects properly in order to improve the cardiological and oncological prognosis of patients., (Copyright © 2022. Published by Elsevier Masson SAS.)

Over the last decade, cancer mortality has decreased considerably, particularly in breast cancer thanks to better screening techniques and better therapeutic management. The significant increase in patient survival has led to the appearance of a certain number of events due to the side effects of the therapies used. Cardiovascular disease is the most frequently observed side effect in breast cancer, due to the direct toxicity of anti-cancer therapies but also due to traditional cardiovascular risk factors common to both of diseases. Anthracyclines, anti-HER2 therapies, chest radiotherapy and hormone therapy are the main causes of cardiotoxicity in breast cancer. It is important to know the rate of follow-up for cardiotoxicity screening and management., Competing Interests: Conflit d'intérêt L'auteur ne déclare aucun conflit d'intérêt., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Introduction: Adherence to guidelines for the management of heart failure (HF) has been shown to be a strong predictor of reduced hospitalisations. The aim of this study was therefore to investigate the adherence of West African cardiologists to guidelines for the management of HF., Methodology: This was a prospective cross-sectional multicentric study (Côte d'Ivoire, Togo, Benin and Burkina-Faso). The "ADDress your Heart" survey developed was administered online to assess cardiologists' adherence to the guidelines for the management of heart failure., Results: 62.3% of the 106 participants reported that they followed the guidelines closely. The therapeutic classes indicated as first-line by the latest guidelines were insufficiently suggested by physicians: 57.5% for mineralocorticoid receptor antagonists, 41.5% for gliflozins and 30.1% for sacubitril-valsartan In univariate logistic regression, affiliation with a teaching hospital OR [95% CI] = 3.0 [1.3-6.8], p < 0.01 ; access to scientific cardiology journals OR [95 % CI] = 3.4 [1.3-8.9], p = 0.01; and frequent attendance at conferences OR [95% CI]=1.8 [1.2-2.9], p < 0.01, were associated with guideline compliance. These factors persisted in multivariate analysis., Conclusion: Adherence of West African cardiologists to guidelines on the management of heart failure was moderate. If affiliation to a university hospital is difficult to apply to all cardiologists, access to scientific cardiology journals and frequent attendance in conference should be encouraged., Competing Interests: Conflit d'intérêts Aucun., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Résumé: Contexte: L’angioplastie des coronaires calcifiées et/ou tortueuses est considérée comme une procédure complexe. Pour surmonter les difficultés techniques plusieurs matériels et stratégies ont été proposés. La technique de « mother and child » utilisant le système « 5-in-6 » a récemment émergé comme un outil efficace pour améliorer le support pendant les interventions coronaires percutanées. Objectifs: L’objectif de cette étude est de rapporter notre expérience concernant l’utilisation du cathéter Heartrail II « 5-in-6 », dans les angioplasties coronaires complexes et d’évaluer son efficacité et sa sécurité d’emploi. Sujets et méthodes: Il s’agit d’une étude rétrospective et descriptive sur des procédures utilisant le système « 5-in-6 » chez des patients admis dans trois centres hospitaliers durant la période de juillet 2009 à septembre 2012. C’est le cardiologue interventionnel qui estimait s’il s’agissait d’une bonne indication de l’utilisation du système « 5-in-6 » pour l’angioplastie coronaire. Résultats: Cent quarante-sept patients ont été inclus dans notre étude. Une majorité masculine : 113 hommes (soit 78 %). L’âge moyen de la population était de 68,5±21,5ans. Cent vingt-huit patient (87 %) ont eu un abord radial, dont 123 par abord radial droit. L’angioplastie a intéressé la coronaire droite dans 82 cas (52 %), l’interventriculaire antérieure dans 35 cas (22 %), la circonflexe dans 18 cas (11,5 %), une artère marginale dans 16 cas (9 %), l’interventriculaire postérieure chez trois patients (0,01 %), la rétroventriculaire chez un patient et un greffon saphène chez deux patients (0,01 %). Les lésions étaient de type (B2 ou C) dans 70 % des cas, avec 50 % de lésions distales, modérément à sévèrement calcifiées dans 62 % des cas, et faisant 16±4mm de longueur moyenne. Il y avait 22 (14 %) procédures de désobstruction chronique dont 18 cas (81 %) ont été traitées avec succès. Le système « 5-in-6 » a été mis avec succès et nous a permis de réussir l’angioplastie chez 139 patients (94 %). Conclusion: Notre travail confirme la faisabilité et la sécurité d’utilisation du dispositif Heartrail II « 5-in-6 » en cas d’angioplastie complexe. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this article is not to present a general academic review on primary angioplasty in patients with ST-elevation myocardial infarction, but rather to focus on some practical points that directly concern cardiologists who perform primary percutaneous interventions in these patients. We detail recent data about the use of the radial artery approach, thromboaspiration, new oral inhibitors of P2Y12, selective use of anti-GPIIb/IIIa, high dose of peri-procedural statin therapy, choice of the best stent, and the best approach for treating non-culprit lesions in patients with multivessel coronary artery disease. The changes observed in the overall management of patients undergoing primary PCI for ST-elevation myocardial infarction are likely to have participated in the decrease in mortality observed in several registries. New European guidelines on the management of STEMI, taking into account these diverse aspects, have just been published. [Copyright &y& Elsevier]

Abstract: Objectives: Patients on antiplatelet therapy have a gastrointestinal bleeding risk. It is increased by risk factors. The frequency of those risk factors, the prevalence of upper digestive symptoms and their management in patients on antiplatelet agents is unknown. Patients and methods: We performed an observational multi-centred prospective survey among 560 French cardiologists with private practice. Each cardiologist completed a questionnaire for the first four patients treated with antiplatelet agents in primary or secondary prevention. Results: Among the 2182 patients included, (age=67±11 years; 74% male), 83% had at least one gastrointestinal bleeding risk factor and 38.9% had a history of upper digestive tract symptom. A history of gastrointestinal bleeding was reported in 3.4% and a history of documented gastro-duodenal ulcer in 5.5%. A proton pump inhibitor was already prescribed in 39% of the patients. At the time of the consultation, upper digestive symptoms were described in 21% of the patients. In those patients with symptoms, 85% had no modification in antiplatelet therapy and 62.7% were prescribed gastro-protective drugs (proton pump inhibitors: 51.8%, H2-blockers 3.6% other anti-acid medication: 7.3%). Conclusion: Among patients on antiplatelet agents, the prevalence of upper digestive symptoms and risk factors for gastrointestinal bleeding is high. Preventative management needs to be clarified in this population. [Copyright &y& Elsevier]

Abstract: Purpose: Patients with permanent cardiac pacemakers occasionally require radiotherapy. Therapeutic irradiation may cause pacemakers to malfunction due to the effects of ionizing radiation or electromagnetic interference. We studied the breast cancer patients who needed breast and/or chest wall and lymph node irradiation to assess the feasibility and tolerance in this population of patients. Patients and methods: From November 2008 to December 2009, more than 900 patients received radiotherapy for their breast cancer in our department using megavoltage linear accelerator (X 4–6 MV and electrons). Among them, seven patients were with permanent pacemaker. All patients have been treated to the breast and chest wall and/or lymph nodes. Total dose to breast and/or chest wall was 50Gy/25 fractions and 46Gy/23 fractions to lymph nodes. Patients who underwent conserving surgery followed by breast irradiation were boosted when indicated to tumour bed with 16Gy/8 fractions. All patients were monitored everyday in presence of radiation oncologist to follow the function of their pacemaker. All pacemakers were controlled before and after radiotherapy by the patients’ cardiologist. Results: Seven patients were referred in our department for postoperative breast cancer radiotherapy. Among them, only one patient was declined for radiotherapy and underwent mastectomy without radiotherapy. In four cases the pacemaker was repositioned before the beginning of radiotherapy. Six patients, aged between 48 and 84years underwent irradiation for their breast cancer. Four patients were treated with conserving surgery followed by breast radiotherapy and two with mastectomy followed by chest wall and internal mammary chain, supra- and infra-clavicular lymph node irradiation. The dose to the pacemaker generator was kept below 2Gy. There was no pacemaker dysfunction observed during the radiotherapy. Conclusion: The multidisciplinary work with position change of the pacemaker before radiotherapy and everyday monitoring permitted the safe treatment of our patients. Updated guidelines are definitely needed with more details about acceptable doses at the different parts of the pacemaker. [Copyright &y& Elsevier]

Résumé: L’objectif était d’évaluer l’intérêt de l’électrocardiogramme (ECG) systématique, comme outil de détection des anomalies cardiaques au cours des spondylarthropathies (SPA) et de la polyarthrite rhumatoïde (PR). Méthodes: Des malades consécutifs atteints de SPA, PR ou maladies articulaires dégénératives (considérés comme témoins) hospitalisés sur une période de six mois et indemnes d’évènement cardiovasculaire ont été inclus. Un ECG – 12 dérivations – était réalisé et interprété par un cardiologue en insu du diagnostic. Résultats: Au total, 108 patients avec SPA (durée moyenne 11±dix ans), 106 malades avec PR (durée moyenne 12±neuf ans) et 74 témoins ont été inclus. Ceux-ci étaient asymptomatiques sur le plan cardiaque et sans antécédent cardiovasculaire. Les populations étaient homogènes, concernant la présence des facteurs de risque cardiovasculaire, hormis pour le diabète, plus fréquent dans les groupes PR et témoin. Les proportions d’extrasystoles, de blocs auriculoventriculaires (2,8 % dans le groupe SPA ; 1,9 % dans le groupe PR ; 2,7 % chez les témoins), de bloc de branche gauche complet ou incomplet (respectivement : 0,9 % ; 0,9 % ; 2,7 %), de bloc de branche droit complet ou de bloc de branche gauche (respectivement : 0,9 % ; 4,7 % ; 4,1 %) et d’anomalie évocatrice d’ischémie myocardique (10,2 % ; 19,8 % ; 17,6 %) étaient similaires chez les patients atteints de PR ou de SPA par comparaison à la population témoin. Conclusion: Chez les patients sans antécédent cardiovasculaire, asymptomatiques, la réalisation d’un ECG systématique ne permet pas de mettre en évidence le risque accru de complications cardiaques spécifiques liées à ces pathologies, chez les patients atteints de SPA et PR. [Copyright &y& Elsevier]

Abstract: Objectives: To describe the management of patients with atrial fibrillation (AF) and to study consistency with guidelines on management of AF. Patients and methods: Observational study on a random sample of cardiologists from a French national database. Each cardiologist had to recruit the first five patients meeting inclusion criteria (patients diagnosed with AF between January 2004 and one month before inclusion and accepting the collection of their medical data). Results: Between December 2006 and January 2207, 1789 patients aged 71 on average have been recruited by 481 cardiologists. Fifty-one percent were diagnosed with paroxysmal, 15% with persistent and 33% with permanent AF. Restoration of sinus rhythm was preferred in forms considered as paroxysmal or persistent forms whereas control of the ventricular rate was more frequent in AF considered as permanent. Overall, therapeutic guidelines are applied in practice, despite a frequent use of amiodarone in patients with no associated heart disease. Prevention of thromboembolism was observed in 88% of the patients. Conclusions: FACTUEL is the biggest observational study on AF ever conducted in France. The therapeutic strategies used by the cardiologists are consistent with the objectives of preventing thromboembolism and controlling heart rhythm and/or rate. In most cases, the treatment used is consistent with the therapeutic guidelines. [Copyright &y& Elsevier]

Abstract: Background: Secondary prevention is a key strategy for reducing levels of coronary heart disease, but a gap between guidelines and practice remains. Objectives: The aim of this double-part survey was to evaluate the improvement in secondary prevention one year after acute coronary syndrome (ACS) in real life, between 1999 and 2005, with respect to the change in guidelines. Methods: Two surveys of almost similar design were performed in 1999 and 2005–2006. In each survey, unselected consecutive patients suffering from ACS (n =112 hospitalized in 1998, and n =110 in 2004) were evaluated at admission, and one year after hospitalization, for the risk factors, lifestyle, and achievement of therapeutic goals recommended by the most recent guidelines. Follow-up (FU) data were obtained by mail and phone contact with patient, general practitioner and cardiologist, and medical laboratory when appropriate. Results: At 1-year FU (n =192 survivors with FU), smoking cessation (87% in 1999 versus 89% in 2005) and obesity (13% versus 19%, respectively) did not vary significantly. Blood pressure was controlled (< 140/90 mmHg, excepted in diabetics in 2005 with less than 130/80 mmHg) in 65% versus 80% (p <0.03). The rate of patients with no or controlled diabetes mellitus decreased from 1999 to 2005 (90% versus 76%), despite more intensive treatment (insuline in 1% versus 20%).The goals for LDL cholesterol were achieved in 47% of patients in 1999 (< 3.4mmol/L) and in 76% in 2005 (< 2.6mmol/L) (p <0.0001). Goals for triglycerides were achieved in 86% in 1999 (< 2g/L), and in 80% in 2005 (< 1.5g/L) (NS). Besides, 63% of patients received an hypolipemic drug in 1999 (a statin in 59%) and 91% in 2005 (a statin in 88%). Mean number of controlled risk factors was 3.96±1.52 in 1999 versus 4.94±1.83 in 2005, and prevalence of pts with more than five controlled risk factors at one year FU increased from 15 to 44% (p <0.0001). Conclusions: These results, drawn from unselected consecutive patients managed in real life, demonstrate an improvement in secondary prevention one year after ACS, between 1999 and 2005, despite strengthened guidelines for blood pressure, triglycerides and LDL cholesterol levels. Control of obesity and diabetes remains unoptimal. [Copyright &y& Elsevier]

Abstract: The coronary stents are widely used to prevent coronary restenosis after percutaneous coronary intervention. Dual antiplatelet therapy (acetyl salicylic acid and a thienopyridine-clopidogrel or ticlopidine) are prescribed at least during six weeks after conventional stent and six months after drug eluting stent insertion to prevent stent thrombosis. When an invasive procedure is required, a risk of stent thrombosis arises after stopping antiplatelet therapy and a risk of bleeding when continuing this treatment. Therefore, cardiologists should choose carefully the type of coronary stent before insertion and concerned physicians (anaesthesiologists, surgeons, cardiologists) should decide a perioperative strategy in these high-risk patients. [Copyright &y& Elsevier]

Abstract: A pharmacoepidemiological cross-sectional observational study was performed among a representative sample of French general practitioners and cardiologists. The aim of this study was to describe the prescription modalities of flecainide acetate, an Ic class antiarrhythmic, and how these modalities match the marketing authorization and the current summary of product characteristics. A total of 941 physicians participated in the study, 496 GPs and 445 cardiologists, and 1116 patients treated with flecainide for more than one month were included. On average, the patients were 68.7-years-old and 54% of them were women. Most of the initial flecainide prescriptions came from cardiologists (96%) and the check-up included an electrocardiogram (98%), a Holter monitoring (56%) and/or an echocardiography (71%). The preferred indication was supraventricular rhythm disorders (95%) and mostly atrial fibrillation (63%). A small proportion of coronary patients (7%) and of patient suffering from cardiac insufficiency (4%) was found. Flecainide was prescribed with a median posology of 150 mg per day, mostly as LP form (64%). Overall, the indications specified in the summary of product characteristics were respected in 90% of the cases, the contraindications in 91% of the cases and the patient follow-up was appropriate in 99% of the cases. In conclusion, the study showed that the prescription''s conditions of flecainide in France complied with the summary of product characteristics data for most of the prescribing physicians with a respect of the indications, contraindications and management recommendations in 84% of the cases. [Copyright &y& Elsevier]

Abstract: Background. – Epidemiological data on heart failure''s epidemiology in France are scarce and mostly hospital based. The present study''s objective is to estimate the prevalence of heart failure (HF) and its management, in subjects aged 60 years and older seen by the French general practitioners (GP). Methods. – A standardised questionnaire was mailed to 900 GPs of the Sentinelles network, requiring answers for any patient aged 60 years and more, seen on a randomly assigned single day of year 2002. National census and health insurance data were used to estimate prevalence. Results. – 434 GPs answered, reporting data for 1797 patients aged 60 years and more. The 214 patients with HF, aged 79 years on average, had been seen by a cardiologist in 95% of cases. Results of an echocardiography was available for 58% of HF patients. Compared to non-HF patients, patients with HF were significantly more dependent, more frequently requiring home visit of the GP and more frequently hospitalised (p < 0.001, age adjusted). All the 42% HF patients with a reported left ventricle ejection fraction lower than 40% were treated with an angiotensin converting enzyme inhibitor or an angiotensin receptor inhibitor. The prevalence of HF among patients aged 60 years and older was estimated at 11.9% in general practice (95% confidence interval: 10.5-13.5), and at 2.19% (1.9-2.5) in the general population. The prevalence increased with age, over 20% in persons aged 80 years and more. Conclusion. – HF in patients aged 60 years and more seen in general practice in France is characterised by a high prevalence and medical consumption in terms of required number of hospitalisation and GP''s home visit. For the GP, the diagnosis of HF relies on the cardiologist more than on an echocardiography. The therapeutic management seems to fit the actual recommendations. [Copyright &y& Elsevier]

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Objectives. – Analyse the modalities of preventive therapy of recurrences of paroxysmal or persistent atrial fibrillation (AF) with Vaughan–Williams (VW) type IC antiarrhythmics.Methods. – Observational study conducted with 326 French cardiologists established in general office practice, involving on the one hand an opinion survey among the cardiologists and on the other hand a cross-sectional observatory of usual medical practice. Each cardiologist was asked to include two patients aged less than 65 with non-permanent (paroxysmal or persistent) AF without left ventricle dysfunction (LVD) and initiated on treatment with a VW type IC antiarrhythmic after cardioversion to sinus rhythm.Results. – The opinion survey among the cardiologists indicates that non-permanent AF constitutes 36.1% of AF cases, of which 57.8% concern LVD-free patients. Most cardiologists (85%) declare to institute a preventive therapy of AF recurrences in 70–100% of these patients after cardioversion to sinus rhythm, with a VW type IC antiarrhythmic in more than 50% of cases. Of the 633 patients included in the FAUVE observatory, mainly men, 409 (64.6%) had paroxysmal AF and 224 (35.4%) had persistent AF. Analysis of therapeutic management shows that both alteration of the previous treatment and the choice of a VW type IC antiarrhythmic are based chiefly on efficacy and on tolerability of the antiarrhythmic therapy.Conclusion. – VW type IC antiarrhythmics constitute a therapy of choice for the maintenance of sinus rhythm in non-aged and LVD-free patients with non-permanent AF. [Copyright &y& Elsevier]

Cardiologist work is undergoing profound changes. He is in charge of the prevention and treatment of atherothrombotic disease. Preoperative evaluation of global cardiovascular risk is of paramount importance to choose between medical, surgical or interventional treatment. Furthermore, because the cardiologist has extensive experience with coronary angioplasty, he will have an essential role in carotid angioplasty. [Copyright &y& Elsevier]

Although indispensable, radiation exposure during cardiac catheterization procedures can cause specific radiation-induced diseases. These affect the patient but also the interventional cardiologist. Exposure to high or repeated radiation doses causes deterministic effects. Moreover, even low-dose exposure, especially when repeated, produces a risk of stochastic effets. In that respect, it is crucial to improve the radiation safety of cardiac angiography and interventions, to promote radiation protection and to maintain this exposure « As Low As Reasonably Achievable ». Thus, there is a necessity to spread knowledge about safety standards and recommandations to reduces the dose among interventionalists. Data collection and comparaison of practices are precious to this quality improvement process. For the year 2020, France-PCI registry had collected dosimetric datas related to 55 783 coronary angiographic and interventional procedures from 30 centers in France. Mean fluoroscopy time was 4,4 minutes for diagnostic procedures. Mean PDS was 1 767cGy.Cm2 and mean Air Kerma de 257Gy. Coronary percutaneous angioplasty procedures were related to approximately two to three times higher mean exposures. Mean exposure related to chronic coronary total occlusion treatment procedures was also two times higher than exposure related to non-CTO interventions. These data also highlighted wide disparities between centers., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

The management of complex cardiovascular disease has changed considerably with the development of new care strategies. In cardiology, the «Heart Team» or literally «Equipe du cœur» occupies a prominent place in the latest European and American recommendations, particularly in the management of complex coronary or valvular diseases and in heart failure patients. The concept of «Heart Team» is based on the need for a multidisciplinary holistic approach based on evidence (respect of the recommendations of the scientific societies), the patient as a whole (comorbidities, preferences), risks and long-term benefits of the treatment selected and performed, as well as on the level of local expertise. It aims to determine the best management strategy for the patient, and perhaps to guarantee a better result (prognosis).

Aim of the Study: To obtain a consensus from a panel of experts (GP and cardiologists) on the elements to appear on the correspondence sent by GP at the patient's first consultation with the cardiologist and on the response of the cardiologist., Method: A list of proposals concerning the content of the exchanges between the GP and the cardiologist was established by a scientific council of three GPs and one cardiologist, based on a review of the literature and their practices. This list was submitted for evaluation to a panel of GP and cardiologists experts using the modified RAND/UCLA Delphi method., Results: Twenty nine experts (16 MG and 13 cardiologists) participated in the two evaluation rounds. For the contents of the letter written by the GP, 11 themes have reached consensus: administrative data, reason for consultation, history of the disease, recent constants, current treatments, current or previous pathologies and cardiovascular risk factors, physical activity, psychosocial context, test results, question asked to the cardiologist, cardiologist's perimeter of action. For the contents of the letter of the cardiologist's response, 11 themes were agreed: administrative data, reason for consultation, previous information, clinical examination, ECG, ultrasound, other complementary examinations, answer to the question asked by the GP, dietary treatments, proposed treatments, proposal for follow-up and management., Conclusion: This study have reached consensus on the elements to appear on the letters exchanged between the GP and the cardiologist., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Background: Transcatheter aortic valve implantation (TAVI) is a treatment for high-risk patients with symptomatic severe aortic stenosis. The aim of the study is to assess results of comprehensive geriatric assessment before TAVI and geriatrician advices about TAVI procedure feasibility. We report one-year outcomes after TAVI procedure., Methods: All patients who underwent comprehensive geriatric assessment in geriatric day hospital before TAVI were prospectively included in Grenoble. We report characteristics of the patients, geriatrician advices about TAVI procedure feasibility and risks, and one year follow-up., Results: Twenty-one frail elderly patients underwent geriatric assessment. The mean age was 85.4; demographics included cognitive impairment (76%), renal dysfunction (81%), NYHA functional class III or IV (48%). Eighteen patients were suitable for TAVI according to geriatric assessment, 8 underwent TAVI. None of the 3 patients who were not candidate for TAVI according to geriatricians were implanted. Cardiologists followed geriatrician advices for 56% of cases. Intensive care unit and cardiology stay were prolonged at 3.5 and 7.9days, respectively. Six out of the 8 patients stayed in rehabilitation unit after TAVI. None of the implanted patients died at one-year follow up, despite of the common periprocedural complications: acute kidney injury, ischemic stroke, delirium, pacemaker, hemorrhage., Conclusions: Cardiologists follow geriatrician advices about TAVI feasibility in frail elderly patients. Comprehensive geriatric assessment also helps preventing complications and providing quick assessment of occurring periprocedural and postprocedural complications. Optimal management of frail elderly patients undergoing TAVI is a multidisciplinary task involving cardiologists, anaesthetists and geriatricians., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Prostate cancer, the most frequent cancer in man, is an adenocarcinoma sensible to chemical castration in more than 80% of cases due to its hormonal dependency. Androgen deprivation is the treatment for advanced cancer and can be associated with radiotherapy locally or in locally advanced situations. Multidisciplinary therapeutic choice depends on patient age and co-morbidities and clinical stage. The impact of hormonal treatment confers varied side effects and cardiovascular effects are now better known. Responsible mechanisms of this cardiotoxicity are at the same time direct but also indirect by metabolic thermogenic effects. Analysis of these clinical or biological effects, their correlations to the used type of hormonal treatment and the possible precautions of prescription will be detailed in this analysis of the literature. The collaboration of the oncologist or the urologist with the cardiologist becomes necessary and the existence of a unit of oncocardiology could improve the evaluation of the risk-benefit balance and the tolerance of the treatment., (Copyright © 2016 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.)