Author: "Gilles, Rioufol" - Searchworks@Jio Institute Digital Library Search Results

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1. Incidence of atrial fibrillation in cryptogenic stroke with patent foramen ovale closure: protocol for the prospective, observational PFO-AF study

Author: Fiona Ecarnot, Nicolas Meneveau, Gilles Rioufol, Charles Guenancia, Romain Chopard, Marc Badoz, François Derimay, Guillaume Serzian, Matthieu Besutti, and Pierre Frey
Subjects: Medicine
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.
Published: 2023
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2. Serum Soluble Tumor Necrosis Factor Receptors 1 and 2 Are Early Prognosis Markers After ST-Segment Elevation Myocardial Infarction

Author: Alexandre Paccalet, Claire Crola Da Silva, Laura Mechtouff, Camille Amaz, Yvonne Varillon, Charles de Bourguignon, Regine Cartier, Cyril Prieur, Danka Tomasevic, Nathalie Genot, Simon Leboube, François Derimay, Gilles Rioufol, Eric Bonnefoy-Cudraz, Nathan Mewton, Michel Ovize, Gabriel Bidaux, and Thomas Bochaton
Subjects: myocardial infarction, TNF, soluble TNF receptor, biomarker, prognosis, Therapeutics. Pharmacology, RM1-950
Abstract: Background: As inflammation following ST-segment elevation myocardial infarction (STEMI) is both beneficial and deleterious, there is a need to find new biomarkers of STEMI severity.Objective: We hypothesized that the circulating concentration of the soluble tumor necrosis factor α receptors 1 and 2 (sTNFR1 and sTNFR2) might predict clinical outcomes in STEMI patients.Methods: We enrolled into a prospective cohort 251 consecutive STEMI patients referred to our hospital for percutaneous coronary intervention revascularization. Blood samples were collected at five time points: admission and 4, 24, 48 h, and 1 month after admission to assess sTNFR1 and sTNFR2 serum concentrations. Patients underwent cardiac magnetic resonance imaging at 1 month.Results: sTNFR1 concentration increased at 24 h with a median of 580.5 pg/ml [95% confidence interval (CI): 534.4–645.6]. sTNFR2 increased at 48 h with a median of 2,244.0 pg/ml [95% CI: 2090.0–2,399.0]. Both sTNFR1 and sTNFR2 peak levels were correlated with infarct size and left ventricular end-diastolic volume and inversely correlated with left ventricular ejection fraction. Patients with sTNFR1 or sTNFR2 concentration above the median value were more likely to experience an adverse clinical event within 24 months after STEMI [hazards ratio (HR): 8.8, 95% CI: 4.2–18.6, p < 0.0001 for sTNFR1; HR: 6.1, 95% CI: 2.5 –10.5, p = 0.0003 for sTNFR2]. Soluble TNFR1 was an independent predictor of major adverse cardiovascular events and was more powerful than troponin I (p = 0.04 as compared to the troponin AUC).Conclusion: The circulating sTNFR1 and sTNFR2 are inflammatory markers of morphological and functional injury after STEMI. sTNFR1 appears as an early independent predictor of clinical outcomes in STEMI patients.
Published: 2021
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3. Percutaneous atrial septal defect occlusion through thrombosed inferior vena cava filter

Author: Radotseheno Rolland Rakotonoel, Gilles Rioufol, William Uhlrich, and François Derimay
Subjects: atrial septal defect, IVC filter, mini TEE, Medicine, Medicine (General), R5-920
Abstract: Abstract Thrombosed inferior vena cava (IVC) should not be considered as a limitation to femoral access for cardiac structural procedures. Reopening by angioplasty in the same procedural step is feasible and safe.
Published: 2021
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4. Association of myocardial hemorrhage and persistent microvascular obstruction with circulating inflammatory biomarkers in STEMI patients.

Author: Thomas Bochaton, Jules Lassus, Alexandre Paccalet, François Derimay, Gilles Rioufol, Cyril Prieur, Eric Bonnefoy-Cudraz, Claire Crola Da Silva, Hugo Bernelin, Camille Amaz, Sylvie Espanet, Charles de Bourguignon, Nathalie Dufay, Régine Cartier, Pierre Croisille, Michel Ovize, and Nathan Mewton
Subjects: Medicine, Science
Abstract: IntroductionMyocardial hemorrhage (IMH) and persistent microvascular obstruction (MVO) are associated with impaired myocardial recovery and adverse clinical outcomes in STEMI patients. However, their relationship with circulating inflammatory biomarkers is unclear in human patients.Methods and resultsTwenty consecutive patients referred for primary percutaneous coronary intervention of first STEMI were included in a prospective study. Blood sampling was performed at admission, 4, 12, 24, 48 hours, 7 and 30 days after reperfusion for inflammatory biomarker (C reactive protein, fibrinogen, interleukin-6 (IL-6) and neutrophils count) assessment. At seven days, cardiovascular magnetic resonance (CMR) was performed for infarct size, MVO and IMH assessment. Median infarct size was 24.6% Interquartile range (IQR) [12.0-43.5] of LV mass and edema was 13.2% IQR [7.7-36.1] of LV mass. IL-6 reached a peak at H24 (5.6 pg/mL interquartile range (IQR) [2.5-17.5]), CRP at H48 (11.7 mg/L IQR [7.1-69.2]), fibrinogen one week after admission (4.4 g/L IQR [3.8-6.7]) and neutrophils at H12 (9.0 G/L IQR [6.5-12.7]). MVO was present in 11 patients (55% of the study population) and hemorrhage in 7 patients (35%). Patients with IMH had significantly higher IL-6, CRP, fibrinogen, and neutrophils levels compared to patients without IMH. Patients with persistent MVO had significantly higher CRP, fibrinogen and neutrophils level compared to patients without MVO, but identical IL-6 kinetics.ConclusionIn human patients with acute myocardial infarction, intramyocardial hemorrhage appears to have a stronger relationship with inflammatory biomarker release compared to persistent MVO. Attenuating myocardial hemorrhage may be a novel target in future adjunctive STEMI treatments.
Published: 2021
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5. Transcatheter aortic valve implantation using the SAPIEN 3 valve to treat aortic regurgitation: The French multicentre S3AR study

Author: Clémence Delhomme, Marina Urena, Oualid Zouaghi, Francisco Campelo-Parada, Patrick Ohlmann, Gilles Rioufol, Eric Van Belle, Frédéric Pinaud, Nicolas Meneveau, Patrick Staat, Olivier Morel, François Derimay, Flavien Vincent, Frédéric Rouleau, Eric Brochet, Caroline Chong-Nguyen, and Dominique Himbert
Subjects: General Medicine, Cardiology and Cardiovascular Medicine
Published: 2023
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6. Regression of Q waves and clinical outcomes following primary PCI in anterior STEMI

Author: Mathieu Schaaf, Inesse Boussaha, Claire Jossan, Thomas Bochaton, Sophie Pichot-Lamoureux, Denis Angoulvant, Nathan Mewton, Marc J. Claeys, Michel Ovize, Grégoire Rangé, Yuni de Framond, Olivier Dubreuil, David Garcia Dorado, Gilles Rioufol, CHU Tenon [APHP], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Department of Cardiology, Hospices Civils de Lyon (HCL), Johns Hopkins University School of Medicine [Baltimore], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Population, Myocardial Infarction, Left ventricle remodeling, Stunned myocardium, 030204 cardiovascular system & hematology, Lower risk, Infarct size, QT interval, Ventricular Function, Left, Electrocardiography, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, education, Creatine Kinase, Heart Failure, education.field_of_study, Ejection fraction, biology, Anterior ST-elevation myocardial infarction, business.industry, Percutaneous coronary intervention, Stroke Volume, Q wave regression, medicine.disease, 3. Good health, Heart failure, Conventional PCI, biology.protein, Cardiology, ST Elevation Myocardial Infarction, Creatine kinase, Human medicine, Cardiology and Cardiovascular Medicine, business
Abstract: Background: Pathological Q waves are correlated with infarct size, and Q-wave regression is associated with left ventricular ejection fraction improvement. There are limited data regarding the association of Q-wave regression and clinical outcomes. Our main objective was to assess the association of pathological Q wave evolution after re-perfusion with clinical outcomes after anterior STEMI.Methods: Standard 12-lead electrocardiograms (ECGs) were recorded in 780 anterior STEMI patients treated with primary percutaneous coronary intervention (PCI) from the CIRCUS trial. ECGs were recorded before and 90 min following PCI, as well as at hospitalization discharge and 12 months of follow-up. The number of classic ECG criteria Q waves was scored for each ECG. Patients were classified in the Q wave regression group if they had re-gression of at least one Q wave between the post-PCI, the discharge and/or one year ECGs. Patients were classified in the Q wave persistent group if they had the same number or greater between the post-PCI, the discharge and/ or 1 and one year ECGs. All-cause death and heart failure events were assessed for all patients at one year.Results: There were 323(43%) patients with persistent Q waves (PQ group), 378(49%) patients with Q wave re-gression (RQ group) and 60(8%) patients with non-Q wave MI (NQ group). Infarct size as measured by the peak creatine kinase was significantly greater in the PQ group compared to the RQ and NQ groups (4633 +/- 2784 IU/l vs. 3814 +/- 2595 IU/l vs. 1733 +/- 1583 IU/l respectively, p b 0.0001). At one year, there were 22 deaths (7%) in the PQ-group, 15 (4%) in the RQ-group and none in the NQ-group (p = 0.04). There was a 4-fold increase in the risk of death or heart failure in the PQ compared to the NQ group (HR 4.7 [1.1; 19.3]; p = 0.03), but there was no significant difference between NQ and RQ groups (HR 3.3 [0.8; 13.8]; p = 0.09).Conclusion: Ina population of anterior STEMI patients, persistent Q waves defined according to the classic ECG criteria after reperfusion was associated with a 4-fold increase in the risk of heart failure or death compared to non-Q-wave MI, while Q-wave regression was associated with significantly lower risk of events.(c) 2019 Elsevier Inc. All rights reserved.
Published: 2022
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7. Coronary CT Angiography with Photon-counting CT: First-In-Human Results

Author: Salim A. Si-Mohamed, Sara Boccalini, Hugo Lacombe, Adja Diaw, Mohammad Varasteh, Pierre-Antoine Rodesch, Riham Dessouky, Marjorie Villien, Valérie Tatard-Leitman, Thomas Bochaton, Philippe Coulon, Yoad Yagil, Elias Lahoud, Klaus Erhard, Benjamin Riche, Eric Bonnefoy, Gilles Rioufol, Gerard Finet, Cyrille Bergerot, Loic Boussel, Joel Greffier, and Philippe C. Douek
Subjects: Male, Photons, Computed Tomography Angiography, Humans, Female, Radiology, Nuclear Medicine and imaging, Prospective Studies, Middle Aged, Tomography, X-Ray Computed, Retrospective Studies
Abstract: Background Spatial resolution, soft-tissue contrast, and dose-efficient capabilities of photon-counting CT (PCCT) potentially allow a better quality and diagnostic confidence of coronary CT angiography (CCTA) in comparison to conventional CT. Purpose To compare the quality of CCTA scans obtained with a clinical prototype PCCT system and an energy-integrating detector (EID) dual-layer CT (DLCT) system. Materials and Methods In this prospective board-approved study with informed consent, participants with coronary artery disease underwent retrospective electrocardiographically gated CCTA with both systems after injection of 65-75 mL of 400 mg/mL iodinated contrast agent at 5 mL/sec. A prior phantom task-based quality assessment of the detectability index of coronary lesions was performed. Ultra-high-resolution parameters were used for PCCT (1024 matrix, 0.25-mm section thickness) and EID DLCT (512 matrix, 0.67-mm section thickness). Three cardiac radiologists independently performed a blinded analysis using a five-point quality score (1 = insufficient, 5 = excellent) for overall image quality, diagnostic confidence, and diagnostic quality of calcifications, stents, and noncalcified plaques. A logistic regression model, adjusted for radiologists, was used to evaluate the proportion of improvement in scores with the best method. Results Fourteen consecutive participants (12 men; mean age, 61 years ± 17) were enrolled. Scores of overall quality and diagnostic confidence were higher with PCCT images with a median of 5 (interquartile range [IQR], 2) and 5 (IQR, 1) versus 4 (IQR, 1) and 4 (IQR, 3) with EID DLCT images, using a mean tube current of 255 mAs ± 0 versus 349 mAs ± 111 for EID DLCT images (
Published: 2022
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8. Optical coherence tomography in coronary atherosclerosis assessment and intervention

Author: Makoto Araki, Seung-Jung Park, Harold L. Dauerman, Shiro Uemura, Jung-Sun Kim, Carlo Di Mario, Thomas W. Johnson, Giulio Guagliumi, Adnan Kastrati, Michael Joner, Niels Ramsing Holm, Fernando Alfonso, William Wijns, Tom Adriaenssens, Holger Nef, Gilles Rioufol, Nicolas Amabile, Geraud Souteyrand, Nicolas Meneveau, Edouard Gerbaud, Maksymilian P. Opolski, Nieves Gonzalo, Guillermo J. Tearney, Brett Bouma, Aaron D. Aguirre, Gary S. Mintz, Gregg W. Stone, Christos V. Bourantas, Lorenz Räber, Sebastiano Gili, Kyoichi Mizuno, Shigeki Kimura, Toshiro Shinke, Myeong-Ki Hong, Yangsoo Jang, Jin Man Cho, Bryan P. Yan, Italo Porto, Giampaolo Niccoli, Rocco A. Montone, Vikas Thondapu, Michail I. Papafaklis, Lampros K. Michalis, Harmony Reynolds, Jacqueline Saw, Peter Libby, Giora Weisz, Mario Iannaccone, Tommaso Gori, Konstantinos Toutouzas, Taishi Yonetsu, Yoshiyasu Minami, Masamichi Takano, O. Christopher Raffel, Osamu Kurihara, Tsunenari Soeda, Tomoyo Sugiyama, Hyung Oh Kim, Tetsumin Lee, Takumi Higuma, Akihiro Nakajima, Erika Yamamoto, Krzysztof L. Bryniarski, Luca Di Vito, Rocco Vergallo, Francesco Fracassi, Michele Russo, Lena M. Seegers, Iris McNulty, Sangjoon Park, Marc Feldman, Javier Escaned, Francesco Prati, Eloisa Arbustini, Fausto J. Pinto, Ron Waksman, Hector M. Garcia-Garcia, Akiko Maehara, Ziad Ali, Aloke V. Finn, Renu Virmani, Annapoorna S. Kini, Joost Daemen, Teruyoshi Kume, Kiyoshi Hibi, Atsushi Tanaka, Takashi Akasaka, Takashi Kubo, Satoshi Yasuda, Kevin Croce, Juan F. Granada, Amir Lerman, Abhiram Prasad, Evelyn Regar, Yoshihiko Saito, Mullasari Ajit Sankardas, Vijayakumar Subban, Neil J. Weissman, Yundai Chen, Bo Yu, Stephen J. Nicholls, Peter Barlis, Nick E. J. West, Armin Arbab-Zadeh, Jong Chul Ye, Jouke Dijkstra, Hang Lee, Jagat Narula, Filippo Crea, Sunao Nakamura, Tsunekazu Kakuta, James Fujimoto, Valentin Fuster, Ik-Kyung Jang, CarMeN, laboratoire, Massachusetts General Hospital [Boston, MA, USA], Harvard Medical School [Boston] (HMS), Asan Medical Center [Seoul, South Korea] (AMC), University of Vermont [Burlington], Kawasaki Medical School [Okayama, Japan] (KMS), Yonsei University College of Medicine [Seoul, South Korea] (YUCM), Azienda Ospedaliero-Universitaria Careggi [Firenze] (AOUC), University Hospitals Bristol, Azienda Ospedaliera Ospedale Papa Giovanni XXIII [Bergamo, Italy], Technische Universität München = Technical University of Munich (TUM), Munich Heart Alliance [Munich, Allemagne] (MHA), German Heart Center = Deutsches Herzzentrum München [Munich, Germany] (GHC), Aarhus University Hospital [Skejby, Denmark] (AUH), Hospital Universitario de La Princesa, National University of Ireland [Galway] (NUI Galway), University Hospitals Leuven [Leuven], Technische Hochschule Mittelhessen - University of Applied Sciences [Giessen] (THM), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Université de Lyon, Institut Mutualiste de Montsouris (IMM), CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), National Institute of Cardiology [Warsaw, Poland] (NIC), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Massachusetts General Hospital [Boston], Cardiovascular Research Foundation [New York, NY, USA] (CRF), Icahn School of Medicine at Mount Sinai [New York] (MSSM), Barts Health NHS Trust [London, UK], Queen Mary University of London (QMUL), Bern University Hospital [Berne] (Inselspital), Centro Cardiologico Monzino [Milan, Italy] (2CM), Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Mitsukoshi Health and Welfare Foundation [Tokyo, Japan] (MHWF), Yokohama Minami Kyosai Hospital [Kanagawa, Japan] (YMKH), Showa University Hospital [Tokyo, Japan] (SUH), Kyung Hee University [Seoul, South Korea] (KHU), The Chinese University of Hong Kong [Hong Kong], Università degli studi di Genova = University of Genoa (UniGe), Università degli studi di Parma = University of Parma (UNIPR), Catholic University of the Sacred Heart [Rome, Italy] (CUSH), University Hospital [Ioannina, Greece] (UH), New York University School of Medicine (NYU Grossman School of Medicine), Vancouver General Hospital [Vancouver, British Columbia, Canada] (VGH), University of British Columbia (UBC), Brigham and Women’s Hospital [Boston, MA], New York Presbyterian Hospital, Columbia University Medical Center (CUMC), Columbia University [New York], Ospedale San Giovanni Bosco [Turin, Italy] (OSGB), Johannes Gutenberg - Universität Mainz = Johannes Gutenberg University (JGU), National and Kapodistrian University of Athens (NKUA), Tokyo Medical and Dental University [Japan] (TMDU), Kitasato University, Nippon Medical School Chiba Hokusoh Hospital [Chiba, Japan] (NMSC2H), The Prince Charles Hospital, Nara Medical University [Nara, Japan] (NMU), Tsuchiura Kyodo General Hospital [Ibaraki, Japan] (TKGH), Japanese Red Cross Musashino Hospital [Tokyo], St. Marianna University School of Medicine [Kanagawa, Japan], Kyoto University Graduate School of Medicine [Kyoto, Japan] (KUGSM), Jagiellonian University - Medical College (JUMC), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Mazzoni Hospital [Ascoli Piceno, Italy] (MH), Korea Advanced Institute of Science and Technology (KAIST), University of Texas Health Science Center, The University of Texas Health Science Center at Houston (UTHealth), Saint Camillus International University of Health Sciences [Rome, Italy] (SCIUHS), Fondazione IRCCS Policlinico San Matteo [Pavia], Università degli Studi di Pavia = University of Pavia (UNIPV), Universidade de Lisboa = University of Lisbon (ULISBOA), MedStar Washington Hospital Center [Washington, DC, USA] (MedStar WHC), CV Path Institute [Gaithersburg, MD, USA] (CV-PI), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Yokohama City University (YCU), Wakayama University, Tohoku University [Sendai], Mayo Clinic [Rochester, MN, USA], Mayo Clinic [Rochester], University hospital of Zurich [Zurich], Gifu University Graduate School of Medicine, Madras Medical Mission [Chennai, India] (3M), MedStar Health Research Institute [Washington, DC, USA] (MedStar-HRI), Chinese People's Liberation Army General Hospital [Beijing, China] (CPLAGH), Harbin Medical University [China] (HMU), Monash university, University of Melbourne, Royal Papworth Hospital [Cambridge, UK] (RPH), Johns Hopkins University (JHU), Leiden University Medical Center (LUMC), The Open University of Japan [Chiba] (OUJ), and Massachusetts Institute of Technology (MIT)
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], Cardiology and Cardiovascular Medicine
Abstract: Optical coherence tomography (OCT) has been widely adopted in research on coronary atherosclerosis and adopted clinically to optimize percutaneous coronary intervention. In this Review, Jang and colleagues summarize this rapidly progressing field, with the aim of standardizing the use of OCT in coronary atherosclerosis.Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.
Published: 2022
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9. Thrombus burden management during primary coronary bifurcation intervention: a new experimental bench model

Author: Ahmad Hayek, Yassim Dargaud, Luc Maillard, Gerard Finet, Thomas Bochaton, Gilles Rioufol, and François Dérimay
Subjects: General Medicine, Cardiology and Cardiovascular Medicine
Published: 2023
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10. Collaborative work in a complex case of Fontan for treating intra-atrial reentrant tachycardia and severe aortic stenosis: a case report

Author: Camélia Acatrinei, Caroline Martin-Bonnet, Gilles Rioufol, and Francis Bessière
Subjects: Cardiology and Cardiovascular Medicine
Abstract: BackgroundIntra-atrial reentrant tachycardia (IART) is a frequent arrhythmia in patients with Fontan circulation. Although its supraventricular origin, such arrhythmia can be poorly tolerated as it leads to haemodynamic impairment. Concomitant assessment of pressure/volume overload of cardiac chambers due to valvular disease or residual shunts is necessary.Case summaryWe report the case of a 33-year-old male with Fontan extracardiac conduit, suffering from IART with initial poor haemodynamic tolerance. He had a medical history of pulmonary atresia with intact ventricular septum and Type 0 bicuspid aortic valve, with a total of four cardiac surgeries. Echocardiography demonstrated a severe impairment of the univentricular ejection fraction and a critical aortic stenosis. Given the limited medical treatment options of the arrhythmia and the risks of another heart surgery, both IART ablation and transcatheter aortic valve replacement (TAVR) were performed during the same procedure. The IART critical isthmus located in the antero-lateral region of the extracardiac conduit was effectively treated with radiofrequency. Rapid pacing during TAVR was provided by a catheter placed in the unique ventricle via a transconduit puncture. The aortic valve was deployed with minimal para-valvular regurgitation and a satisfactory transvalvular gradient. At follow-up, the univentricular ejection fraction normalized and no arrhythmic episode was recorded in absence of anti-arrhythmic drugs.DiscussionThis case highlights the need of a collaborative approach for treating complex cases of adult congenital heart disease, suffering from both electrophysiological and haemodynamic disorders. This combination offered an elegant and safest solution for treating concomitantly a life-threatening arrhythmia and an aortic stenosis.
Published: 2023
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11. Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease

Author: Gilles Rioufol, François Dérimay, François Roubille, Thibault Perret, Pascal Motreff, Denis Angoulvant, Yves Cottin, Ludovic Meunier, Laura Cetran, Guillaume Cayla, Brahim Harbaoui, Jean-Yves Wiedemann, Éric Van Belle, Christophe Pouillot, Nathalie Noirclerc, Jean-François Morelle, François-Xavier Soto, Christophe Caussin, Bernard Bertrand, Thierry Lefèvre, Patrick Dupouy, Pierre-François Lesault, Franck Albert, Olivier Barthelemy, René Koning, Laurent Leborgne, Pierre Barnay, Philippe Chapon, Sébastien Armero, Antoine Lafont, Christophe Piot, Camille Amaz, Bernadette Vaz, Lakhdar Benyahya, Yvonne Varillon, Michel Ovize, Nathan Mewton, Gérard Finet, Alexandre Fournier, Geneviève Jarry, François Leleu, Dorothée Malaquin, Anfani Mirode, Loïc Belle, Lionel Mangin, Jean-Lou Hirsch, Marc Metge, Michel Pansiery, FrançoisXavier Soto, Antoine Boge, Kamel HadjHamou, Ichem Miliani, Guillaume Molins, Stéphane Mourot, Marion Pelletier, Olivier Ressencourt, Frédéric Schaad, Pierre Coste, Warren Chasseriaud, Pierre Poustis, Jean-Francois Morelle, Thibaud Demicheli, Grégroire Range, Christophe Thuaire, Nicolas Barber-Chamoux, Nicolas Combaret, Guilhem Malclès, Géraud Souteyrand, Philippe Buffet, Aurélie Gudjonvick, Isabelle L’Huillier, Luc Lorgis, Carole Richard, Gilles Baronne-Rochette, Hélène Bouvaist, Stéphanie Marlière, Olivier Ormezzano, Gérald Vanzetto, Charlotte Trouillet, Yann Valy, Eric VanBelle, Christophe Bauters, Cédric Delhaye, Gilles Lemesle, Riadh Rihani, Pierre Graux, Jean-Michel Lemahieu, Cyril Besnard, Pierre-Yves Courand, Raphaël Dauphin, Pierre Lantelme, Jean-Raymond Caignault, Olivier Dubreuil, Sylvain Ranc, Bernard Ritz, Cyrille Bergerot, Thomas Bochaton, Eric Bonnefoy-Cudraz, Didier Bresson, Julie Dementhon, François Derimay, Lisa Green, Cyril Prieur, Ingrid Sanchez, Oualid Zouaghi, Sébastien Arméro, Hakim Ben-Amer, Bernard Chevalier, Philippe Garot, Thomas Hovasse, Yves Louvard, Marie-Claude Morice, Oscar Tavolaro, Thierry Unterseeh, DinhThienTri Cung, Jean-Christophe Macia, Gilles Levy, Olivier Roth, Laurent Jacquemin, Luc Cornillet, Bertrand Ledermann, Laurent Schmutz, Nicole Karam, Saliha Rahal, Nicolas Amabile, Philippe Girard, Aurélie Veugeois, Olivier Barthélémy, Jean-Philippe Collet, Gilles Montalescot, Jacques Berland, Matthieu Godin, Quentin Landolff, Bilel Zoghlami, Karim Bougrini, Christophe Geyer, Jens Glanenapp, Patrick Mascarel, Geoffray Rambaud, Richard ViFane, Bernard Desveaux, Fabrice Ivanes, Gérard Pacouret, Laurent-Emmanuel Quilliet, Christophe SaintEtienne, Christophe Bretelle, Stanislas Champin, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Long Term Adverse Effects, Coronary Artery Disease, Fractional flow reserve, 030204 cardiovascular system & hematology, Coronary Angiography, Revascularization, Risk Assessment, Severity of Illness Index, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, Postoperative Complications, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, Clinical endpoint, Humans, Medicine, 030212 general & internal medicine, Coronary Artery Bypass, ComputingMilieux_MISCELLANEOUS, Aged, Intention-to-treat analysis, business.industry, Hazard ratio, Coronary Stenosis, Percutaneous coronary intervention, medicine.disease, Coronary Vessels, 3. Good health, Fractional Flow Reserve, Myocardial, Coronary arteries, medicine.anatomical_structure, Early Termination of Clinical Trials, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract: Background There is limited evidence that fractional flow reserve (FFR) is effective in guiding therapeutic strategy in multivessel coronary artery disease (CAD) beyond prespecified percutaneous coronary intervention or coronary graft surgery candidates. Objectives The FUTURE (FUnctional Testing Underlying coronary REvascularization) trial aimed to evaluate whether a treatment strategy based on FFR was superior to a traditional strategy without FFR in the treatment of multivessel CAD. Methods The FUTURE trial is a prospective, randomized, open-label superiority trial. Multivessel CAD candidates were randomly assigned (1:1) to treatment strategy based on FFR in all stenotic (≥50%) coronary arteries or to a traditional strategy without FFR. In the FFR group, revascularization (percutaneous coronary intervention or surgery) was indicated for FFR ≤0.80 lesions. The primary endpoint was a composite of major adverse cardiac or cerebrovascular events at 1 year. Results The trial was stopped prematurely by the data safety and monitoring board after a safety analysis and 927 patients were enrolled. At 1-year follow-up, by intention to treat, there were no significant differences in major adverse cardiac or cerebrovascular events rates between groups (14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97; 95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P = 0.06), and this was confirmed with a 24 months’ extended follow-up. FFR significantly reduced the proportion of revascularized patients, with more patients referred to exclusively medical treatment (P = 0.02). Conclusions In patients with multivessel CAD, we did not find evidence that an FFR-guided treatment strategy reduced the risk of ischemic cardiovascular events or death at 1-year follow-up. (Functional Testing Underlying Coronary Revascularisation; NCT01881555 )
Published: 2021
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12. Effect and Safety of Morphine Use in Acute Anterior ST‐Segment Elevation Myocardial Infarction

Author: Mickael Bonin, Nathan Mewton, Francois Roubille, Olivier Morel, Guillaume Cayla, Denis Angoulvant, Meyer Elbaz, Marc J. Claeys, David Garcia‐Dorado, Céline Giraud, Gilles Rioufol, Claire Jossan, Michel Ovize, and Patrice Guerin
Subjects: clinical, morphine, opioid, percutaneous coronary intervention, pharmaceutical safety, ST‐segment elevation myocardial infarction, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: BackgroundMorphine is commonly used to treat chest pain during myocardial infarction, but its effect on cardiovascular outcome has never been directly evaluated. The aim of this study was to examine the effect and safety of morphine in patients with acute anterior ST‐segment elevation myocardial infarction followed up for 1 year. Methods and ResultsWe used the database of the CIRCUS (Does Cyclosporine Improve Outcome in ST Elevation Myocardial Infarction Patients) trial, which included 969 patients with anterior ST‐segment elevation myocardial infarction, admitted for primary percutaneous coronary intervention. Two groups were defined according to use of morphine preceding coronary angiography. The composite primary outcome was the combined incidence of major adverse cardiovascular events, including cardiovascular death, heart failure, cardiogenic shock, myocardial infarction, unstable angina, and stroke during 1 year. A total of 554 (57.1%) patients received morphine at first medical contact. Both groups, with and without morphine treatment, were comparable with respect to demographic and periprocedural characteristics. There was no significant difference in major adverse cardiovascular events between patients who received morphine compared with those who did not (26.2% versus 22.0%, respectively; P=0.15). The all‐cause mortality was 5.3% in the morphine group versus 5.8% in the no‐morphine group (P=0.89). There was no difference between groups in infarct size as assessed by the creatine kinase peak after primary percutaneous coronary intervention (4023±118 versus 3903±149 IU/L; P=0.52). ConclusionsIn anterior ST‐segment elevation myocardial infarction patients treated by primary percutaneous coronary intervention, morphine was used in half of patients during initial management and was not associated with a significant increase in major adverse cardiovascular events at 1 year.
Published: 2018
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13. Post-infarction inflammation influences diastolic function after STEMI

Author: Simon Leboube, Smaranda Filip, Hélène Thibault, Cyrille Bergerot, Alexandre Paccalet, Ahmad Hayek, Gilles Rioufol, Eric Bonnefoy-Cudraz, Cyril Prieur, Claire Crola Da Silva, Camille Brun, Léa Azar, Iyad Abou Saleh, Nathan Mewton, Laura Mechtouff, and Thomas Bochaton
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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14. The importance of experimental models in interventional cardiology. An illustration in coronary bifurcation stenting

Author: Francois Derimay, Gilles Rioufol, and Gérard Finet
Subjects: General Medicine, Cardiology and Cardiovascular Medicine
Published: 2022

15. TAVR Patients Requiring Anticoagulation

Author: Jean Philippe Verhoye, Thibaut Manigold, Alain Cribier, Nicolas Dumonteil, Patrick Ohlmann, Dominique Himbert, Hervé Le Breton, Frederic Collet, Philippe Guyon, Nicolas Meneveau, Xavier Favereau, Didier Carrié, Stéphane Delépine, Thomas Cuisset, Francois Bourlon, Emmanuel Teiger, Farzin Beygui, Olivier Bar, Bernard Albat, Bernard Bertrand, Martine Gilard, Géraud Souteyrand, Bernard Iung, France-TAVI, Arnaud Sudre, Remi Houel, Vincent Auffret, Philippe Commeau, Romain Didier, Louis Labrousse, Antoine Gommeaux, Guillaume Cayla, Thierry Lefèvre, Jean-Philippe Collet, Hélène Eltchaninoff, Didier Blanchard, Sylvain Beurtheret, Jean-Philippe Claudel, Vincent Doisy, Thibault Lhermusier, Gilles Rioufol, Stop-As, and Said Ghostine
Subjects: medicine.medical_specialty, business.industry, medicine.drug_class, medicine.medical_treatment, Anticoagulant, Hazard ratio, 030204 cardiovascular system & hematology, Vitamin K antagonist, Confidence interval, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, Internal medicine, Propensity score matching, Oral anticoagulant, Medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Major bleeding
Abstract: Objectives Using French transcatheter aortic valve replacement (TAVR) registries linked with the nationwide administrative databases, the study compared the rates of long-term mortality, bleeding, and ischemic events after TAVR in patients requiring oral anticoagulation with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). Background The choice of optimal drug for anticoagulation after TAVR remains debated. Methods Data from the France-TAVI and FRANCE-2 registries were linked to the French national health single-payer claims database, from 2010 to 2017. Propensity score matching was used to reduce treatment-selection bias. Two primary endpoints were death from any cause (efficacy) and major bleeding (safety). Results A total of 24,581 patients who underwent TAVR were included and 8,962 (36.4%) were treated with OAC. Among anticoagulated patients, 2,180 (24.3%) were on DOACs. After propensity matching, at 3 years, mortality (hazard ratio [HR]: 1.37; 95% confidence interval [CI]: 1.12-1.67; P Conclusions In these large multicenter French TAVR registries with an exhaustive clinical follow-up, the long-term mortality and major bleeding were lower with DOACs than VKAs at discharge. The present study supports preferential use of DOACs rather than VKAs in patients requiring oral anticoagulation therapy after TAVR.
Published: 2021
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16. Prognosis After Percutaneous Foramen Ovale Closure Among Patients With Platypnea-Orthodeoxia Syndrome

Author: Gilles Rioufol, Ahmad Hayek, R. Rossi, Nathan Mewton, François Derimay, Eric Bonnefoy-Cudraz, Alexandre Paccalet, Hélène Thibault, Thomas Bochaton, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: Male, Cardiac Catheterization, medicine.medical_specialty, Percutaneous, Septal Occluder Device, [SDV]Life Sciences [q-bio], Foramen Ovale, Patent, Prosthesis Implantation, Postoperative Complications, medicine, Humans, Mortality, Hypoxia, Platypnea orthodeoxia, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, business.industry, Surgery, [SDV] Life Sciences [q-bio], Outcome and Process Assessment, Health Care, Standing Position, Foramen ovale closure, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; No abstract available
Published: 2021
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17. Nonculprit Artery Myocardial Infarction and Complex Coronary Lesions in Anterior ST-Elevated Myocardial Infarction Patients: Data from the CIRCUS Study

Author: Thomas Bochaton, Pierre Croisille, Inesse Boussaha, Gilles Rioufol, François Roubille, Fabien De Poli, Mathieu Schaaf, Olivier Lairez, Nathan Mewton, Agathe Py, Thibault Perret, Loic Belle, Fabrice Prunier, Michel Ovize, Thomas Hovasse, and Loïc Bière
Subjects: medicine.medical_specialty, medicine.medical_treatment, Population, Revascularization, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Pharmacology (medical), cardiovascular diseases, Myocardial infarction, Circumflex, education, education.field_of_study, Ejection fraction, business.industry, Percutaneous coronary intervention, Arteries, medicine.disease, 3. Good health, medicine.anatomical_structure, Conventional PCI, Cardiology, ST Elevation Myocardial Infarction, Cardiology and Cardiovascular Medicine, business, Artery
Abstract: Aims: Periprocedural myocardial infarctions have been reported in the setting of planned percutaneous coronary intervention (PCI). We assessed the prevalence of nonculprit artery acute myocardial infarction (NCAMI) and its relationship with coronary artery characteristics, final infarct size, and 1-year adverse clinical outcomes in a population of anterior ST-elevated myocardial infarction (STEMI) patients. Methods and Results: Late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) studies were performed within 7 days of admission in 129 anterior STEMI patients from the CIRCUS trial treated by primary PCI. Infarct in the noninfarct artery territory (circumflex, right coronary) was assessed on LGE-CMR and T2-weighted images. Eleven (8.5%) patients exhibited NCAMI. The only independent characteristic significantly associated with NCAMI was the presence of multiple complex coronary lesions (odds ratio = 12.9, 95% confidence interval [3.1–53.4]; p < 0.001). There was a significantly increased infarct size in NCAMI patients compared to patients without NCAMI (45.8 ± 20.4% of the left ventricle [LV] vs. 31.0 ± 15.1% of LV, respectively; p = 0.02), with lower LV ejection fraction (46 ± 10% vs. 34 ± 8%, respectively; p < 0.001). Conclusion: NCAMIs are present in 8.5% of anterior STEMI patients and are significantly associated with multiple complex coronary lesions without significant relationship to any revascularization procedural technique. NCAMI was associated with a greater infarct size and reduced LVEF but not worse clinical outcomes at 1 year.
Published: 2021
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18. Procedural and Short-Term Results With the New Watchman FLX Left Atrial Appendage Occlusion Device

Author: Jens Erik Nielsen-Kudsk, Timothy R. Betts, Kasper Korsholm, Gilles Rioufol, Thomas Schmitz, Sven Möbius-Winkler, Boris Schmidt, Jean Benoit Thambo, Blanca Trejo-Velasco, Marcus Sandri, Felix Meincke, Patrizio Mazzone, Marek Grygier, Ignacio Cruz-González, Instituto de Investigación Biomédica de Salamanca (IBSAL), Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Aarhus University Hospital, CHU Bordeaux [Bordeaux], Ospedale San Raffaele, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Poznan University of Medical Sciences [Poland] (PUMS), Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany], Institute of Biomedical Engineering [Oxford] (IBME), University of Oxford, Asklepios Klinikum Uckermark GmbH, Universität Leipzig [Leipzig], Goethe-University Frankfurt am Main, Elisabeth-Krankenhaus Essen [Essen, Germany] (Elisabeth Hospital Essen), CarMeN, laboratoire, and University of Oxford [Oxford]
Subjects: Cardiac Catheterization, medicine.medical_specialty, left atrial appendage occlusion, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030204 cardiovascular system & hematology, Pericardial effusion, Left atrial appendage occlusion, 03 medical and health sciences, 0302 clinical medicine, Left atrial, Interquartile range, Atrial Fibrillation, Occlusion, medicine, Humans, Atrial Appendage, Prospective Studies, 030212 general & internal medicine, Aged, thromboembolic events, Aged, 80 and over, novel devices, business.industry, bleeding, medicine.disease, Thrombosis, 3. Good health, Surgery, [SDV] Life Sciences [q-bio], Stroke, Treatment Outcome, periprocedural complications, Hemorrhagic complication, Cardiology and Cardiovascular Medicine, business, Major bleeding, Boston
Abstract: OBJECTIVES: This study sought to report early experience with the new-generation Watchman FLX device (Boston Scientific, Marlborough, Massachusetts).BACKGROUND: The new-generation Watchman FLX features a reduced height, improved anchoring and fabric coverage, and a closed distal end. These design modifications aim to simplify implantation, allow full recapture and repositioning, and reduce peridevice leak and device-related thrombosis.METHODS: A total of 165 patients undergoing left atrial appendage (LAA) occlusion (LAAO) with Watchman FLX were enrolled in a prospective, multicenter registry at 12 centers participating in the European limited market release program.RESULTS: Mean age was 75.4 ± 8.9 years, and CHA2DS2-VASc score 4.4 ± 1.4. A total of 128 patients (77.6%) had a history of major bleeding, including previous intracranial hemorrhage in 55 cases (33.3%). LAA landing zone minimal and maximal mean diameters were 19.1 ± 3.6 mm and 22.3 ± 3.7 mm, and 24.2% of LAA were considered complex by dimensions. Technical success was achieved in all patients. Successful implantation at first attempt was achieved in 129 cases (78.2%), and a second device was required in 6 cases (3.6%). Procedure-related complications occurred in 3 patients (1.8%): 2 access-related (1.2%) and 1 pericardial effusion (0.6%). No peri-procedural strokes, deaths, or device embolizations occurred. Forty-nine patients (29.7%) were discharged with single antiplatelet therapy, 105 (63.6%) on dual antiplatelet, and 11 (6.7%) on anticoagulation. Imaging follow-up displayed just 1 peridevice leak ≥5 mm and 7 cases of device-related thrombosis (4.7%). During a median follow-up of 55 days (interquartile range: 45 to 148 days), there were 6 hemorrhagic complications (4.8%), 1 patient (0.8%) had an ischemic stroke, and 1 (0.8%) died. No late device embolizations occurred.CONCLUSIONS: LAAO with the Watchman FLX is safe and effective in a wide range of LAA morphologies, with a low procedural complication rate, high degree of LAA sealing, and favorable short-term efficacy.
Published: 2020
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19. Impact of Arterial Blood Pressure on Ultrasound Hemodynamic Assessment of Aortic Valve Stenosis Severity

Author: Hélène Thibault, Marion Rosset, Lisa Green, Gilles Rioufol, Gérard Finet, François Derimay, Ahmad Hayek, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CCSD, Accord Elsevier
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Dimensionless index, Hemodynamics, 030204 cardiovascular system & hematology, Flow rate, Severity of Illness Index, Ventricular Function, Left, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Afterload, Mean transaortic gradient, Internal medicine, Aortic valve area, medicine, Humans, Arterial Pressure, Radiology, Nuclear Medicine and imaging, Prospective Studies, Ejection fraction, business.industry, Aortic stenosis, Ultrasound, afterload, Stroke Volume, Aortic Valve Stenosis, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Stenosis, medicine.anatomical_structure, Blood pressure, Echocardiography, Ventricle, Aortic Valve, Aortic valve stenosis, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; BACKGROUND: Aortic stenosis (AS) severity assessment is based on several indices. Aortic valve area (AVA) is subject to inaccuracies inherent to the measurement method, while velocities and gradients depend on hemodynamic status. There is controversy as to whether blood pressure directly affects common indices of AS severity. OBJECTIVES: The study objective was to assess the effect of systolic blood pressure (SBP) variation on AS indices, in a clinical setting. METHODS: A prospective, single-center study included 100 patients with at least moderately severe AS with preserved left ventricle ejection fraction. Patients underwent ultrasound examination during which AS severity indices were collected, with three hemodynamic conditions: (1) low SBP: \textless120 mm Hg; (2) intermediate SBP: between 120 and 150 mm Hg; (3) high SBP: ≥150 mm Hg. For each patient, SBP profiles were obtained by injection of isosorbide dinitrate or phenylephrine. RESULTS: At baseline state, 59% presented a mean gradient (G(mean)) ≥ 40 mm Hg, 44% a peak aortic jet velocity (V(peak)) ≥4 m/sec, 66% a dimensionless index (DI) ≤0.25, and 87% an indexed AVA (AVAi) ≤ 0.6 cm(2)/m(2). Compared with intermediate and low SBP, high SBP induced a significant decrease in G(mean) (39 ± 12 vs 43 ± 12 and 47 ± 12 mm Hg, respectively; P \textless .05) and in V(peak) (3.8 ± 0.6 vs 4.0 ± 0.6 and 4.2 ± 0.6 mm Hg; P \textless .05). Compared with the baseline measures, in 16% of patients with an initial G(mean)\textless 40 mm Hg, gradient rose above 40 mm Hg after optimization of the afterload (low SBP; P \textless .05). Conversely, DI and AVAi did not vary with changes in hemodynamic conditions. Flow rate, not stroke volume was found to impact G(mean) and V(peak) but not AVA and DI (P \textless .05). CONCLUSIONS: Hemodynamic conditions may affect the AS ultrasound assessment. High SBP, or afterload, leads to an underestimation of AS severity when based on gradients and velocities. Systolic blood pressure monitoring and control are crucial during AS ultrasound assessment.
Published: 2020
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20. Proposal for a standardized discharge letter after hospital stay for acute myocardial infarction

Author: Francois Schiele, Gilles Lemesle, Denis Angoulvant, Michel Krempf, Serge Kownator, Saida Cheggour, Loic Belle, Jean Ferrières, Christophe Bauters, Cyrille Bergerot, Farzin Beygui, Franck Boccara, Eric Bonnefoy, Eric Bruckert, Guillaume Cayla, Jean-Philippe Collet, Pierre Coste, Vincent Descotes-Genon, Gregory Ducrocq, Meyer Elbaz, Michel Farnier, Emile Ferrari, Dominique Guedj, Laszlo Levai, Jacques Mansourati, Nicolas Mansencal, Nicolas Meneveau, Christophe Meune, Olivier Morel, Patrick Ohlmann, Francois Paillard, Christophe Piot, Etienne Puymirat, Gilles Rioufol, François Roubille, Pierre Sabouret, Emmanuel Teiger, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Universitaire de Lille (CHU de Lille), Université Francois Rabelais [Tours], Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA), Centre Cardiologique et Vasculaire, Partenaires INRAE, Centre Hospitalier Henri Duffaut (Avignon), Centre Hospitalier d'Annecy Genevois, Hôpital de Rangueil, and CHU Toulouse [Toulouse]
Subjects: medicine.medical_specialty, Consensus, Primary care, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Antithrombotic, Humans, Medicine, 030212 general & internal medicine, Myocardial infarction, Risk management, communication, business.industry, discharge, primary care, General Medicine, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, medicine.disease, Patient Discharge, 3. Good health, Residual risk, Regimen, Emergency medicine, Cardiology and Cardiovascular Medicine, business, Risk assessment, Fibrinolytic agent
Abstract: In patients admitted for acute myocardial infarction, the communication and transition from specialists to primary care physicians is often delayed, and the information imparted to subsequent healthcare providers (HCPs) may be sub-optimal. A French group of cardiologists, lipidologists and diabetologists decided to establish a consensus to optimize the discharge letter after hospitalization for acute myocardial infarction. The aim is to improve both the timeframe and the quality of the content transmitted to subsequent HCPs, including information regarding baseline assessment, procedures during hospitalization, residual risk, discharge treatments, therapeutic targets and follow-up recommendations in compliance with European Society of Cardiology guidelines. A consensus was obtained regarding a template discharge letter, to be released within two days after patient’s discharge, and containing the description of the patient’s history, risk factors, acute management, risk assessment, discharge treatments and follow-up pathway. Specifically for post acute MI patients, tailored details are necessary regarding the antithrombotic regimen, lipid-lowering and anti-diabetic treatments, including therapeutic targets. Lastly, the follow-up pathway needs to be precisely mentioned in the discharge letter. Additional information such as technical descriptions, imaging, and quality indicators may be provided separately. A template for a standardized discharge letter based on 8 major headings could be useful for implementation in routine practice and help to improve the quality and timing of information transmission between HCPs after acute MI.
Published: 2020
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21. Impact of Age on Systemic Inflammatory Profile of Patients With ST-Segment-Elevation Myocardial Infarction and Acute Ischemic Stroke

Author: Thomas Bochaton, Simon Leboube, Alexandre Paccalet, Claire Crola Da Silva, Marielle Buisson, Nathan Mewton, Camille Amaz, Yvonne Varillon, Eric Bonnefoy-Cudraz, Gilles Rioufol, Tae-Hee Cho, Michel Ovize, Gabriel Bidaux, Norbert Nighoghossian, Laura Mechtouff, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Hôpital Cardiovasculaire Louis Pradel (HCLP), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], and CarMeN, laboratoire
Subjects: Advanced and Specialized Nursing, Interleukin-6, [SDV]Life Sciences [q-bio], Middle Aged, Systemic Inflammatory Response Syndrome, reperfusion, [SDV] Life Sciences [q-bio], Stroke, myocardial infarction, C-Reactive Protein, Percutaneous Coronary Intervention, inflammation, thrombectomy, Humans, ST Elevation Myocardial Infarction, Neurology (clinical), Cardiology and Cardiovascular Medicine, Biomarkers, Aged, Ischemic Stroke
Abstract: Background: Aging is associated with a chronic low-grade inflammatory state. This condition may affect the acute inflammatory response involved in ST-segment–elevation myocardial infarction (STEMI) or acute ischemic stroke (AIS). We sought to compare the profile of a set of circulating inflammatory markers between young and older patients admitted for STEMI or AIS. Methods: HIBISCUS-STEMI (Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in ST Elevation Myocardial Infarction) and HIBISCUS-STROKE (Cohort of Patients to Identify Biological and Imaging Markers of Cardiovascular Outcomes in Stroke) are 2 cohort studies that enrolled patients with STEMI treated with primary percutaneous coronary intervention in the cardiac intensive care unit of Lyon and patients with AIS treated with mechanical thrombectomy in the Lyon Stroke Center, respectively from 2016 to 2019. Patients were classified as older if they were ≥65 years and as young if they were Results: A total of 260 patients with STEMI and 164 patients with AIS were included. Of them, there were 76 (29%) and 105 (64%) older patients with STEMI and AIS, respectively. Following multivariable analysis, a high area under the curve of IL-6 and sTNF-RI, a low lymphocyte count, and a high neutrophil-lymphocyte ratio at 24 hours were associated with older age in patients with STEMI and AIS. Conclusions: Older patients had higher IL-6 and sTFN-RI levels within the first 48 hours associated with a lower lymphocyte count and a higher neutrophil-lymphocyte ratio at 24 hours in both cohorts.
Published: 2022
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22. RANTES (CCL5) as a biomarker of clinical outcomes in STEMI patients

Author: Camille Brun, Florentin Moulin, Simon Leboube, Ahmad Hayek, Abou Saleh Lyad, Alexandre Paccalet, Gilles Rioufol, Cyril Prieur, Eric Bonnefoy-Cudraz, Nathan Mewton, Gabriel Bidaux, Melanie Paillard, Claire Crola Da Silva, Sylvie Ducreux, and Thomas Bochaton
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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23. Reply: Determining Significance in a Prematurely Ceased Trial

Author: Nathan, Mewton, François, Derimay, Pascal, Motreff, Denis, Angoulvant, and Gilles, Rioufol
Published: 2022

24. Percutaneous left ventricular unloading of veno-arterial extracorporeal membrane oxygenation with the atrial flow regulator

Author: Yassine Benseghir, Matteo Pozzi, Jean François Obadia, Gilles Rioufol, Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Hospices Civils de Lyon (HCL), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: Pulmonary and Respiratory Medicine, [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], cardiovascular pathology, Surgery, Cardiology and Cardiovascular Medicine
Abstract: International audience; The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has increased exponentially. Pulmonary congestion is a potentially life-threatening complication of peripheral VA-ECMO. Recently updated guidelines argue for a low threshold of left ventricular (LV) unloading. Although the optimal method of LV unloading is still a matter of debate, the percutaneous approaches became an increasingly used option over time. Here, we present a case of LV unloading with the Atrial Flow Regulator (Occlutech) in a patient supported with peripheral VA-ECMO.
Published: 2022
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25. In-Stent Use of Intravascular Coronary Lithotripsy for Restenosis and Stent Underexpansion: A Multicentre Experience

Author: Vincent Pham, Marc Bonnet, Olivier Varenne, Alexandre Lafont, Arthur Darmon, Laurent Feldman, Gilles Rioufol, François Derimay, Brahim Harbaoui, Fabien Picard, CarMeN, laboratoire, Service de Cardiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Cardiologie [Hôpital Croix- Rousse, HCL] (Centre d'excellence de la Société européenne d'hypertension artérielle), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Alliance française pour les essais cliniques cardio-vasculaires - French Alliance for Cardiovascular Trials (FACT), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Services de Pneumologie, Exploration Fonctionnelle Respiratoire et Cardiologie (Hôpital Louis Pradel), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Coronary Restenosis, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Treatment Outcome, Lithotripsy, Humans, Stents, Vascular Calcification/therapy, Vascular Calcification, Cardiology and Cardiovascular Medicine, Coronary Angiography, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, Coronary Restenosis/diagnosis/therapy
Abstract: International audience; No abstract available
Published: 2022
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26. Ventricular septal rupture: insights into an old disease

Author: Ahmad Hayek, Léa Azar, Matteo Pozzi, Daniel Grinberg, Iyad Abou-Saleh, Héléna Simion, Danka Tomasevic, Cyril Prieur, Flora Kochly, Bertrand Scheppler, Gilles Rioufol, François Derimay, Fadi Farhat, Jean-François Obadia, Nathan Mewton, Eric Bonnefoy-Cudraz, Thomas Bochaton, ROSSI, Sabine, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), and Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Time from myocardial infarction to surgery, Myocardial Infarction, Acute myocardial infarction, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Treatment Outcome, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Humans, ST Elevation Myocardial Infarction, Ventricular septal rupture, Surgery, Cardiology and Cardiovascular Medicine, Aged, Retrospective Studies
Abstract: International audience; Ventricular septal rupture (VSR) is a serious complication of ST-elevation myocardial infarction (STEMI) and surgery is the reference treatment. We aimed at describing trends in management and mortality during the last four decades and reporting mortality predictors in these patients. We conducted a single-center retrospective study of patients sustaining a VSR from 1981 to 2020. We screened 274 patients and included 265 for analysis. The number of patients decreased over the years: 80, 88, 56, and 50 in each 10-year time span. In-hospital mortality decreased significantly since 1990 (logrank 0.007). The median age was 72.0 years IQR [66-78] and 188 patients (70.9%) were operated on. IABP was used more routinely (p < 0.0001). In-hospital mortality was assessed at 66.8% (177 patients) and main predictors of death were a time from MI to surgery < 8 days HR 2.7 IC95% [1.9-3.8] p < 0.0001, a Killip class > 2 HR 2.5 IC [1.9-3.4] p < 0.0001 and Euroscore 2 > 20 HR 2.4 IC [1.8-3.2] p < 0.0001. A "time from MI to surgery" of 8 days offers the best ability to discriminate between patients with or without mortality. The ability of "Euroscore 2 and Killip" to detect the patients most likely to wait 8 days for surgery was at 0.81 [0.73-0.89] p < 0.0001. Mortality remains high over the years. Euroscore 2, Killip class, and time from MI to surgery are the main mortality predictors. Patients with a Killip < 3 and a Euroscore < 20 should be monitored at least 8 days since MI before being referred to surgery.
Published: 2022
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27. ST-segment Elevation Myocardial Infarction and Primary Percutaneous Coronary Intervention: Can We Go Beyond the Clock?

Author: Gilles Rioufol, Francois Derimay, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: Percutaneous Coronary Intervention, Treatment Outcome, myocardial infarction, [SDV.BA] Life Sciences [q-bio]/Animal biology, electrocardiography, [SDV.BA]Life Sciences [q-bio]/Animal biology, Editorials, myocardial reperfusion, Humans, ST Elevation Myocardial Infarction, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, reperfusion injury
Abstract: International audience; No abstract available
Published: 2022
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28. Predictive inflammatory biomarkers for left ventricular thrombus in acute myocardial infarction

Author: Hugo Roccia, Nathan Mewton, Ahmad Hayek, Simon Leboube, Camille Amaz, Maëllia Goninet, Cyril Prieur, Eric Bonnefoy-Cudraz, Cyrille Bergerot, Gilles Rioufol, and Thomas Bochaton
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022
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29. First In-Human Results of Computed Tomography Angiography for Coronary Stent Assessment With a Spectral Photon Counting Computed Tomography

Author: Sara, Boccalini, Salim A, Si-Mohamed, Hugo, Lacombe, Adja, Diaw, Mohammad, Varasteh, Pierre-Antoine, Rodesch, Marjorie, Villien, Monica, Sigovan, Riham, Dessouky, Philippe, Coulon, Yoad, Yagil, Elias, Lahoud, Klaus, Erhard, Gilles, Rioufol, Gerard, Finet, Eric, Bonnefoy-Cudraz, Cyrille, Bergerot, Loic, Boussel, and Philippe C, Douek
Subjects: Male, Photons, Computed Tomography Angiography, Phantoms, Imaging, Humans, Stents, Coronary Angiography, Tomography, X-Ray Computed, Aged, Platinum, Retrospective Studies
Abstract: The aim of this study is to compare the image quality of in vivo coronary stents between an energy integrating detectors dual-layer computed tomography (EID-DLCT) and a clinical prototype of spectral photon counting computed tomography (SPCCT).In January to June 2021, consecutive patients with coronary stents were prospectively enrolled to undergo a coronary computed tomography (CT) with an EID-DLCT (IQon, Philips) and an SPCCT (Philips). The study was approved by the local ethical committee and patients signed an informed consent. A retrospectively electrocardiogram-gated acquisition was performed with optimized matching parameters on the 2 scanners (EID-DLCT: collimation, 64 × 0.625 mm; kVp, 120, automatic exposure control with target current at 255 mAs; rotation time, 0.27 seconds; SPCCT: collimation, 64 × 0.275 mm; kVp, 120; mAs, 255; rotation time, 0.33 seconds). The injection protocol was the same on both scanners: 65 to 75 mL of Iomeron (Bracco) at 5 mL/s. Images were reconstructed with slice thickness of 0.67 mm, 512 matrix, XCB (Xres cardiac standard) and XCD (Xres cardiac detailed) kernel, iDose 3 for EID-DLCT and 0.25-mm slice thickness, 1024 matrix, Detailed 2 and Sharp kernel, and iDose 6 for SPCCT. Two experienced observers measured the proximal and distal external and internal diameters of the stents to quantify blooming artifacts. Regions of interest were drawn in the lumen of the stent and of the upstream coronary artery. The difference (Δ S-C) between the respective attenuation values was calculated as a quantification of stent-induced artifacts on intrastent image quality. For subjective image quality, 3 experienced observers graded with a 4-point scale the image quality of different parameters: coronary wall before the stent, stent lumen, stent structure, calcifications surrounding the stent, and beam-hardening artifacts.Eight patients (age, 68 years [interquartile range, 8]; all men; body mass index, 26.2 kg/m2 [interquartile range, 4.2]) with 16 stents were scanned. Five stents were not evaluable owing to motion artifacts on the SPCCT. Of the remaining, all were drug eluting stents, of which 6 were platinum-chromium, 3 were cobalt-platinum-iridium, and 1 was stainless steel. For 1 stent, no information could be retrieved. Radiation dose was lower with the SPCCT (fixed CT dose index of 25.7 mGy for SPCCT vs median CT dose index of 35.7 [IQ = 13.6] mGy; P = 0.02). For 1 stent, the internal diameter was not assessable on EID-DLCT. External diameters were smaller and internal diameters were larger with SPCCT (all P0.05). Consequently, blooming artifacts were reduced on SPCCT (P0.05). Whereas Hounsfield unit values within the coronary arteries on the 2 scanners were similar, the Δ S-C was lower for SPCCT-Sharp as compared with EID-DLCT-XCD and SPCCT-Detailed 2 (P0.05). The SPCCT received higher subjective scores than EID-DLCT for stent lumen, stent structure, surrounding calcifications and beam-hardening for both Detailed 2 and Sharp (all P ≤ 0.05). The SPCCT-Sharp was judged better for stent structure and beam-hardening assessment as compared with SPCCT-Detailed 2.Spectral photon counting CT demonstrated improved objective and subjective image quality as compared with EID-DLCT for the evaluation of coronary stents even with a reduced radiation dose.
Published: 2021

30. Effect of Colchicine on Myocardial Injury in Acute Myocardial Infarction

Author: Benjamin Alos, Mariama Akodad, Olivier Dubreuil, Didier Bresson, Gilles Rioufol, Cyril Prieur, Charles De Bourguignon, Florent Boutitie, François Derimay, Loïc Bière, Gérard Finet, Rachel Daw, Ahmad Hayek, Fabrice Prunier, Pierre Croisille, Carole Dhelens, Naoual El Jonhy, Nathan Mewton, Eric Bonnefoy-Cudraz, Gabriel Bidaux, Delphine Maucort-Boulch, Claire Bouleti, Denis Angoulvant, Fabrice Ivanes, Lamis Haider, François Roubille, Thomas Bochaton, Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Centre hospitalier universitaire de Poitiers (CHU Poitiers), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Université de Tours (UT), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), ANR-16-RHUS-0009,MARVELOUS,MARVELOUS(2016), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, medicine.medical_specialty, Heart Injury, [SDV]Life Sciences [q-bio], Contrast Media, Inflammation, 030204 cardiovascular system & hematology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Internal medicine, Original Research Articles, medicine, Colchicine, Humans, 030212 general & internal medicine, Myocardial infarction, Ventricular remodeling, Referral and Consultation, ComputingMilieux_MISCELLANEOUS, Aged, Ventricular Remodeling, business.industry, Myocardium, Heart, Heart injuries, Thrombosis, Middle Aged, medicine.disease, 3. Good health, Hospitalization, Clinical trial, chemistry, Ventriculat remodeling, Acute Disease, Cardiology, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, ST Elevation Myocardial Infarction, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Supplemental Digital Content is available in the text., Background: Inflammation is a key factor of myocardial damage in reperfused ST-segment–elevation myocardial infarction. We hypothesized that colchicine, a potent anti-inflammatory agent, may reduce infarct size (IS) and left ventricular (LV) remodeling at the acute phase of ST-segment–elevation myocardial infarction. Methods: In this double-blind multicenter trial, we randomly assigned patients admitted for a first episode of ST-segment–elevation myocardial infarction referred for primary percutaneous coronary intervention to receive oral colchicine (2-mg loading dose followed by 0.5 mg twice a day) or matching placebo from admission to day 5. The primary efficacy outcome was IS determined by cardiac magnetic resonance imaging at 5 days. The relative LV end-diastolic volume change at 3 months and IS at 3 months assessed by cardiac magnetic resonance imaging were among the secondary outcomes. Results: We enrolled 192 patients, 101 in the colchicine group and 91 in the control group. At 5 days, the gadolinium enhancement–defined IS did not differ between the colchicine and placebo groups with a mean of 26 interquartile range (IQR) [16–44] versus 28.4 IQR [14–40] g of LV mass, respectively (P=0.87). At 3 months follow-up, there was no significant difference in LV remodeling between the colchicine and placebo groups with a +2.4% (IQR, –8.3% to 11.1%) versus –1.1% (IQR, –8.0% to 9.9%) change in LV end-diastolic volume (P=0.49). Infarct size at 3 months was also not significantly different between the colchicine and placebo groups (17 IQR [10–28] versus 18 IQR [10–27] g of LV mass, respectively; P=0.92). The incidence of gastrointestinal adverse events during the treatment period was greater with colchicine than with placebo (34% versus 11%, respectively; P=0.0002). Conclusions: In this randomized, placebo-controlled trial, oral administration of high-dose colchicine at the time of reperfusion and for 5 days did not reduce IS assessed by cardiac magnetic resonance imaging. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03156816.
Published: 2021
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31. Percutaneous repair or medical treatment for secondary mitral regurgitation: outcomes at 2 years

Author: Lionel Leroux, Nicolas Piriou, Frédéric Rouleau, Xavier Armoiry, David Messika-Zeitoun, Gilles Rioufol, Sophie Thivolet, Nathan Mewton, Guillaume Bonnet, Bertrand Cormier, Thierry Lefèvre, Florent Boutitie, Guillaume Leurent, Martine Gilard, Delphine Maucort-Boulch, Jean-François Obadia, Gilbert Habib, Mitra-Fr Investigators, Christophe Piot, Didier Carrié, Patrick Ohlmann, Dominique Himbert, Bernard Iung, Patrice Guerin, Mohammed Nejjari, Alec Vahanian, Jean-Noël Trochu, Géraldine Samson, Hélène Thibault, Eric Brochet, Erwan Donal, and Christophe Saint Etienne
Subjects: Male, Cardiac Catheterization, medicine.medical_specialty, Time Factors, Percutaneous, 030204 cardiovascular system & hematology, Effective Regurgitant Orifice Area, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Aged, Retrospective Studies, Heart Failure, Heart Valve Prosthesis Implantation, Mitral regurgitation, Ejection fraction, business.industry, Hazard ratio, Mitral Valve Insufficiency, Stroke Volume, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Surgery, Treatment Outcome, Heart failure, Mitral Valve, Female, Cardiology and Cardiovascular Medicine, business, Echocardiography, Transesophageal, Percutaneous Mitral Valve Repair, Follow-Up Studies
Abstract: Aims The MITRA-FR trial showed that among symptomatic patients with severe secondary mitral regurgitation, percutaneous repair did not reduce the risk of death or hospitalization for heart failure at 12 months compared with guideline-directed medical treatment alone. We report the 24-month outcome from this trial. Methods and results At 37 centres, we randomly assigned 304 symptomatic heart failure patients with severe secondary mitral regurgitation (effective regurgitant orifice area >20 mm2 or regurgitant volume >30 mL), and left ventricular ejection fraction between 15% and 40% to undergo percutaneous valve repair plus medical treatment (intervention group, n = 152) or medical treatment alone (control group, n = 152). The primary efficacy outcome was the composite of all-cause death and unplanned hospitalization for heart failure at 12 months. At 24 months, all-cause death and unplanned hospitalization for heart failure occurred in 63.8% of patients (97/152) in the intervention group and 67.1% (102/152) in the control group [hazard ratio (HR) 1.01, 95% confidence interval (CI) 0.77-1.34]. All-cause mortality occurred in 34.9% of patients (53/152) in the intervention group and 34.2% (52/152) in the control group (HR 1.02, 95% CI 0.70-1.50). Unplanned hospitalization for heart failure occurred in 55.9% of patients (85/152) in the intervention group and 61.8% (94/152) in the control group (HR 0.97, 95% CI 0.72-1.30). Conclusions In patients with severe secondary mitral regurgitation, percutaneous repair added to medical treatment did not significantly reduce the risk of death or hospitalization for heart failure at 2 years compared with medical treatment alone.
Published: 2019
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32. Ticagrelor versus clopidogrel in elective percutaneous coronary intervention (ALPHEUS): a randomised, open-label, phase 3b trial

Author: Johanne Silvain, Benoit Lattuca, Farzin Beygui, Grégoire Rangé, Zuzana Motovska, Jean-Guillaume Dillinger, Ziad Boueri, Philippe Brunel, Thibault Lhermusier, Christophe Pouillot, Elisa Larrieu-Ardilouze, Franck Boccara, Jean-Noël Labeque, Paul Guedeney, Mohamad El Kasty, Mikael Laredo, Raphaëlle Dumaine, Grégory Ducrocq, Jean-Philippe Collet, Guillaume Cayla, Katrien Blanchart, Petr Kala, Eric Vicaut, Gilles Montalescot, Johanne SILVAIN, Jean-Philippe COLLET, Gilles MONTALESCOT, Mathieu KERNEIS, Nassim BRAIK, Olivier BARTHELEMY, Gérard HELFT, Claude LEFEUVRE, Rémi CHOUSSAT, Marie HAUGUEL, Michel ZEITOUNI, Thomas CUISSET, Jean-Louis BONNET, Pierre DEHARO, Benoit LATTUCA, Guillaume CAYLA, Luc CORNILLET, Bertrand LEDERMANN, Clément LONJON, Laurent SCHMUTZ, Grégoire RANGE, Franck ALBERT, Thibault DEMICHELI, Laurent ROUSSEL, Reda BENSAID, Christophe THUAIRE, Jean-Guillaume DILLINGER, Patrick HENRY, Stéphane MANZO-SILBERMAN, Georgios SIDERIS, Damien LOGEART, Vincent SPAGNOLI, Léa CACOUB, Christophe POUILLOT, Jean Richard VI-FANE, Jens GLASENAPP, Karim BOUGRINI, Nicolas COMBARET, Pascal MOTREFF, Géraud SOUTEYRAND, Aimé AMONCHOT, Thomas MOUYEN, Thibault LHERMUSIER, Didier CARRIE, Frédéric BOUISSET, Thomas CHOLLET, Francisco CAMPELO-PARADA, Nicolas DELARCHE, François SCHIELE, Mathieu BESUTTI, Marie HAUGUEL-MOREAU, Rami EL MAHMOUD, Christophe CAUSSIN, Mami ZOHEIR, Aurelie VEUGEOIS, Alain DIBIE, Olivier VARENNE, Fabien PICARD, Alexandre LAFONT, Julien ADJEDJ, Philippe DEGRELL, Farzin BEYGUI, Rémi SABATIER, Vincent ROULE, Mathieux BIGNON, Katrien BLANCHART, Pierre ARDOUIN, Adrien LEMAITRE, Clément BRIET, Ziad BOUERI, Pascal GOUBE, Pierre COSTE, Laura CETRAN, Jérôme CLERC, Hervé LE BRETON, Dominique BOULMIER, Vincent AUFFRET, Jean-Noël LABEQUE, Jean-Luc BONAS, Jean-Louis GEORGES, Bernard LIVAREK, Elodie BLICQ, Nicolas BARON, Géraldine GIBAULT-GENTY, Yves COTTIN, Isabelle LHUILLIER, Carole RICHARD, Luc LORGIS, Philippe BUFFET, Christian SPAULDING, Nicole KARAM, Etienne PUYMIRAT, Marco MENNUNI, Emmanuel POULIDAKIS, Lionel BONNEVIE, Franck BOCCARA, Marion CHAUVET, Laurie DUFOUR, Yann ANCEDY, Stéphane EDERHY, Arnaud ETIENNEY, Anne BELLEMAIN-APPAIX, Nathaniel BITTON, Laurent JACQ, Christophe SAINT-ETIENNE, Florence LECLERCQ, François ROUBILLE, Gilles RIOUFOL, François DERIMAY, Marc GORALSKI, Wael YAFI, Emmanuelle FILIPPI, Alain KERMARREC, Christophe LE RAY, Antoine MERLET, Aurelie LOIRAT, Philippe BRUNEL, Damien BRUNET, Jack RAVISY, Laurent MOCK, Guillaume MOLINS, Max CARRE, Erwan BRESSOLLETTE, Luc CHRISTIAENS, Elisa LARRIEU-ARDILOUZE, Romain CADOR CADOR, Eric VAN BELLE, Gilles LEMESLE, Cédric DELHAYE, Flavien VINCENT, Sina POROUCHANI, Hugues SPILLEMAEKER, Katy PETIT, Olivier RESSENCOURT, Vincent HUMEAU, François JOURDA, Marc-Antoine ARNOULD, Stephen CHASSAING, Karl ISAAZ, Laurent PAYOT, Jacques MONTSEGU, Benjamin FAURIE, Michel PANSIERI, Marc METGE, Karim MOUSSA, Mathieu PANKERT, Olivier MOREL, Sébastien HESS, Luc MAILLARD, Thibault MANIGOLD, Vincent LETOCART, Julien PLESSIS, Pauline BERTHOME, Mickael BONIN, François HUCHET, Emmanuel TEIGER, Romain GALLET, Gauthier MOUILLET, Madjid BOUKANTAR, Mohammed NEJJARI, David ATTIAS, Mathieu STEINECKER, Zuzana MOTOVSKA, Martin KOZEL, Zdenko STELMACH, Ota HLINOMAZ, Michal REZEK, Martin NOVAK, Jan SITAR, Jiri SEMENKA, Petr KALA, Otakar BOCEK, Roman ŠTIPAL, Martin POLOCZEK, Jan KANOVSKÝ, Petr JERABEK, Jiří KARASEK, Sylvie HRUSKOVA, Marian BRANNY, Jan MROZEK, Tomas GREZL, Leos PLEVA, Pavel KUKLA, Martin PORZER, Lesnik, Philippe, Institut de cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service de cardiologie et de pathologie vasculaire [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Louis Pasteur [Chartres], Charles University [Prague] (CU), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier de Bastia (G2HC), Service de Cardiologie [Hôpital privé Dijon Bourgogne], Hôpital privé Dijon Bourgogne, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Clinique Sainte Clotilde, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de Cardiologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Le CHCB, Centre Hospitalier de la Côte Basque, Grand Hôpital de l'Est Francilien (GHEF), Centre de Réadaptation Cardiaque Les Grands Prés [Villeneuve Saint Denis] (CRCLGP), Service de cardiologie [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), University Hospital Brno, Masaryk University [Brno] (MUNI), Hopital Saint-Louis [AP-HP] (AP-HP), Erasmus University Medical Center [Rotterdam] (Erasmus MC), ALPHEUS investigators: Johanne Silvain, Jean-Philippe Collet, Gilles Montalescot, Mathieu Kerneis, Nassim Braik, Olivier Barthelemy, Gérard Helft, Claude Lefeuvre, Rémi Choussat, Marie Hauguel, Michel Zeitouni, Thomas Cuisset, Jean-Louis Bonnet, Pierre Deharo, Benoit Lattuca, Guillaume Cayla, Luc Cornillet, Bertrand Ledermann, Clément Lonjon, Laurent Schmutz, Grégoire Range, Franck Albert, Thibault Demicheli, Laurent Roussel, Reda Bensaid, Christophe Thuaire, Jean-Guillaume Dillinger, Patrick Henry, Stéphane Manzo-Silberman, Georgios Sideris, Damien Logeart, Vincent Spagnoli, Léa Cacoub, Christophe Pouillot, Jean Richard Vi-Fane, Jens Glasenapp, Karim Bougrini, Nicolas Combaret, Pascal Motreff, Géraud Souteyrand, Aimé Amonchot, Thomas Mouyen, Thibault Lhermusier, Didier Carrie, Frédéric Bouisset, Thomas Chollet, Francisco Campelo-Parada, Nicolas Delarche, François Schiele, Mathieu Besutti, Marie Hauguel-Moreau, Rami El Mahmoud, Christophe Caussin, Mami Zoheir, Aurelie Veugeois, Alain Dibie, Olivier Varenne, Fabien Picard, Alexandre Lafont, Julien Adjedj, Philippe Degrell, Farzin Beygui, Rémi Sabatier, Vincent Roule, Mathieux Bignon, Katrien Blanchart, Pierre Ardouin, Adrien Lemaitre, Clément Briet, Ziad Boueri, Pascal Goube, Pierre Coste, Laura Cetran, Jérôme Clerc, Hervé LE Breton, Dominique Boulmier, Vincent Auffret, Jean-Noël Labeque, Jean-Luc Bonas, Jean-Louis Georges, Bernard Livarek, Elodie Blicq, Nicolas Baron, Géraldine Gibault-Genty, Yves Cottin, Isabelle Lhuillier, Carole Richard, Luc Lorgis, Philippe Buffet, Christian Spaulding, Nicole Karam, Etienne Puymirat, Marco Mennuni, Emmanuel Poulidakis, Lionel Bonnevie, Franck Boccara, Marion Chauvet, Laurie Dufour, Yann Ancedy, Stéphane Ederhy, Arnaud Etienney, Anne Bellemain-Appaix, Nathaniel Bitton, Laurent Jacq, Christophe Saint-Etienne, Florence Leclercq, François Roubille, Gilles Rioufol, François Derimay, Marc Goralski, Wael Yafi, Emmanuelle Filippi, Alain Kermarrec, Christophe LE Ray, Antoine Merlet, Aurelie Loirat, Philippe Brunel, Damien Brunet, Jack Ravisy, Laurent Mock, Guillaume Molins, Max Carre, Erwan Bressollette, Luc Christiaens, Elisa Larrieu-Ardilouze, Romain Cador Cador, Eric VAN Belle, Gilles Lemesle, Cédric Delhaye, Flavien Vincent, Sina Porouchani, Hugues Spillemaeker, Katy Petit, Olivier Ressencourt, Max Carre, Vincent Humeau, François Jourda, Marc-Antoine Arnould, Stephen Chassaing, Karl Isaaz, Laurent Payot, Jacques Montsegu, Benjamin Faurie, Michel Pansieri, Marc Metge, Karim Moussa, Mathieu Pankert, Olivier Morel, Sébastien Hess, Luc Maillard, Thibault Manigold, Vincent Letocart, Julien Plessis, Pauline Berthome, Mickael Bonin, François Huchet, Emmanuel Teiger, Romain Gallet, Gauthier Mouillet, Madjid Boukantar, Rami El Mahmoud, Mohammed Nejjari, David Attias, Léa Cacoub, Mathieu Steinecker, François Huchet, Zuzana Motovska, Martin Kozel, Zdenko Stelmach, Ota Hlinomaz, Michal Rezek, Martin Novak, Jan Sitar, Jiri Semenka, Petr Kala, Otakar Bocek, Roman Štipal, Martin Poloczek, Jan KanovskÝ, Petr Jerabek, Jiří Karasek, Sylvie Hruskova, Marian Branny, Jan Mrozek, Tomas Grezl, Leos Pleva, Pavel Kukla, Martin Porzer., Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: Male, Ticagrelor, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, 030204 cardiovascular system & hematology, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, education, ComputingMilieux_MISCELLANEOUS, education.field_of_study, business.industry, Percutaneous coronary intervention, General Medicine, Middle Aged, medicine.disease, Clopidogrel, 3. Good health, [SDV] Life Sciences [q-bio], Treatment Outcome, Action study, Elective Surgical Procedures, Anesthesia, Conventional PCI, Purinergic P2Y Receptor Antagonists, Female, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract: International audience; Background: Percutaneous coronary intervention (PCI)-related myonecrosis is frequent and can affect the long-term prognosis of patients. To our knowledge, ticagrelor has not been evaluated in elective PCI and could reduce periprocedural ischaemic complications compared with clopidogrel, the currently recommended treatment. The aim of the ALPHEUS study was to examine if ticagrelor was superior to clopidogrel in reducing periprocedural myocardial necrosis in stable coronary patients undergoing high-risk elective PCI.Methods: The ALPHEUS study, a phase 3b, randomised, open-label trial, was done at 49 hospitals in France and Czech Republic. Patients with stable coronary artery disease were eligible for the study if they had an indication for PCI and at least one high-risk characteristic. Eligible patients were randomly assigned (1:1) to either ticagrelor (180 mg loading dose, 90 mg twice daily thereafter for 30 days) or clopidogrel (300-600 mg loading dose, 75 mg daily thereafter for 30 days) by use of an interactive web response system, and stratified by centre. The primary outcome was a composite of PCI-related type 4 (a or b) myocardial infarction or major myocardial injury and the primary safety outcome was major bleeding, both of which were evaluated within 48 h of PCI (or at hospital discharge if earlier). The primary analysis was based on all events that occurred in the intention-to-treat population. The trial was registered with ClinicalTrials.gov, NCT02617290.Findings: Between Jan 9, 2017, and May 28, 2020, 1910 patients were randomly assigned at 49 sites, 956 to the ticagrelor group and 954 to the clopidogrel group. 15 patients were excluded from the ticagrelor group and 12 from the clopidogrel group. At 48 h, the primary outcome was observed in 334 (35%) of 941 patients in the ticagrelor group and 341 (36%) of 942 patients in the clopidogrel group (odds ratio [OR] 0·97, 95% CI 0·80-1·17; p=0·75). The primary safety outcome did not differ between the two groups, but minor bleeding events were more frequently observed with ticagrelor than clopidogrel at 30 days (105 [11%] of 941 patients in the ticagrelor group vs 71 [8%] of 942 patients in the clopidogrel group; OR 1·54, 95% CI 1·12-2·11; p=0·0070).Interpretation: Ticagrelor was not superior to clopidogrel in reducing periprocedural myocardial necrosis after elective PCI and did not cause an increase in major bleeding, but did increase the rate of minor bleeding at 30 days. These results support the use of clopidogrel as the standard of care for elective PCI.Funding: ACTION Study Group and AstraZeneca.
Published: 2020
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33. Coronary Steal After Left Internal Thoracic Artery Grafting

Author: François Derimay, Gilles Rioufol, and Ahmad Hayek
Subjects: Left internal thoracic artery, medicine.medical_specialty, Coronary steal, business.industry, Grafting (decision trees), Internal medicine, Cardiology, Medicine, Fractional flow reserve, Cardiology and Cardiovascular Medicine, business, medicine.disease
Published: 2021
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34. Left ventricular assist device percutaneous deactivation with a Watchman device

Author: Jean-François Obadia, Guillaume Baudry, Gilles Rioufol, Tanous Aoun, Matteo Pozzi, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), and CarMeN, laboratoire
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Percutaneous, business.operation, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Percutaneous techniques, 030204 cardiovascular system & hematology, 01 natural sciences, Effective solution, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, In patient, 0101 mathematics, Abbott Laboratories, business.industry, 010102 general mathematics, 3. Good health, [SDV] Life Sciences [q-bio], Ventricular assist device, Cardiology, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract: Myocardial recovery in patients with left ventricular assist devices is a rare event. Surgical explantation remains a risky and challenging procedure. Alternative percutaneous techniques could represent an effective solution. This report describes the clinical use of a Watchman closure device (Boston Scientific Corp, Marlborough, MA) in deactivation of a HeartMate 3 left ventricular assist device (Abbott Laboratories, Abbott Park, IL).
Published: 2021
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35. Sequential technique for the stenting of a coronary bifurcation: the re-proximal optimizing technique strategy

Author: Gérard Finet, Gilles Rioufol, and François Derimay
Subjects: Mathematical optimization, Computer science, medicine.medical_treatment, technology, industry, and agriculture, medicine, Kissing balloon, food and beverages, Balloon, Revascularization, Coronary bifurcation, humanities, Bifurcation
Abstract: Coronary bifurcation revascularization needs to take account of the systematic stepwise relation between the three diameters and to minimize final side-branch (SB) ostial obstruction. Historically, kissing balloon inflation (KBI) was recommended in this indication, but never in fact demonstrated clinical benefit in bifurcation provisional stenting. Thanks to better knowledge of bifurcation pathophysiology and the development of new bench models, a novel sequential technique, without balloon juxtaposition, was developed: the re-proximal optimizing technique (re-POT) strategy. Re-POT consists of a succession of three steps: (1) initial “POT, (2) SB opening, and (3) final POT. Unlike in the case of KBI, the re-POT sequence was assessed progressively, from experimental to clinical studies. The experiments confirmed all the expected benefits of re-POT concerning correction of expected malapposition and SB optimization without deleterious parietal deformation. Thanks to this demonstration, re-POT is now recommended in the European guidelines.
Published: 2021
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36. Percutaneous left ventricular unloading in veno-arterial extracorporeal membrane oxygenation

Author: Gilles Rioufol, Carmen Lab, Team3 Carmen, Daniel GRINBERG, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), and CarMeN, laboratoire
Subjects: medicine.medical_specialty, Percutaneous, business.industry, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], Shock, Cardiogenic, 030204 cardiovascular system & hematology, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Text mining, Extracorporeal Membrane Oxygenation, Internal medicine, Extracorporeal membrane oxygenation, medicine, Cardiology, Humans, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; No abstract available
Published: 2021
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37. First Case of Complete Percutaneous Correction of Isolated Divided Atrium (or Cor Triatriatum) Dexter

Author: Gilles Rioufol, François Derimay, Delphine Gamondes, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service d'hémodynamique et cardiologie interventionnelle [HCL, Lyon] (HCI), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Département de Radiologie [HCL, Lyon], Hospices civils de Lyon (HCL), and CarMeN, laboratoire
Subjects: medicine.medical_specialty, Cardiac Catheterization, Percutaneous, Cor triatriatum dexter, [SDV]Life Sciences [q-bio], Context (language use), 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Cor Triatriatum, Occlusion, medicine, Humans, Heart Atria, cardiovascular diseases, Atrium (heart), Cardiac Surgical Procedures, Aged, 80 and over, business.industry, medicine.disease, 3. Good health, Shunt (medical), [SDV] Life Sciences [q-bio], medicine.anatomical_structure, 030228 respiratory system, Echocardiography, Cor triatriatum, Cardiology, Patent foramen ovale, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Abstract: International audience; Divided atrium (or Cor triatriatum) dexter (DAD) is a rare congenital cardiopathy, usually associated with other anomalies; isolated forms are even rarer. We report the case of an 84-year-old woman presenting with isolated DAD complicated by right-left atrial shunt through patent foramen ovale (PFO), revealed by right cardiac failure and severe hypoxemia. Late destabilization was caused by total superior vena cava thrombosis, related to her pacemaker. Given the overall context, complete percutaneous treatment was performed, associating PFO occlusion and stent implantation in the right atrial membrane, providing total regression of symptoms. Thus, percutaneous correction of DAD appears to be safe and effective.
Published: 2021
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38. The unfinished saga of invasive procedures for secondary mitral regurgitation

Author: Rémi Buzzi, Matteo Pozzi, Sophie Thivolet, Gilles Rioufol, William Uhlrich, Jean-François Obadia, Daniel Grinberg, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: Keynote Lecture Series, medicine.medical_specialty, Percutaneous, [SDV]Life Sciences [q-bio], Disease, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Secondary mitral regurgitation (secondary MR), Materials Chemistry, medicine, percutaneous procedures, MitraClip, mitral valve replacement (MVR), Mitral regurgitation, Ischemic cardiomyopathy, business.industry, valvular heart disease, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Heart failure, Cardiology, Surgery, Cardiology and Cardiovascular Medicine, business, mitral valve repair (MVr)
Abstract: International audience; Secondary mitral regurgitation (MR) is a common valvular heart disease. Its prognostic burden in patients suffering from idiopathic or ischemic cardiomyopathy (ICM) with left ventricular (LV) dysfunction/dilation has been clearly demonstrated. Severe secondary MR is associated with an increased mortality and frequent heart failure hospitalizations. Although guideline-directed medical therapy (GDMT) is the cornerstone of the management of secondary MR, a certain proportion of patients remain symptomatic. For these patients, several surgical techniques have been progressively developed during the last few decades (replacement, repair, sub-valvular apparatus interventions and other ventricular approaches). In the absence of evidence-based medicine, the benefits of these surgical procedures remains controversial, leading to a low level of recommendation in the guidelines. One way to anticipate the future is to look to the past. Recent prospective randomized trials evaluated surgical and percutaneous techniques and led to a better understanding of how best to treat this disease. In this article, we aim to describe the saga of the surgical and percutaneous treatments for secondary MR throughout the previous decades.
Published: 2021
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39. Use All 3 Motor-Driven Axes of Angiocardiographic Systems for Multiple Optimal Fluoroscopic Projections During TAVR

Author: Gérard Finet, Gilles Rioufol, François Derimay, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire
Subjects: business.industry, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Text mining, Medicine, Computer vision, Artificial intelligence, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract available
Published: 2021
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40. Colchicine for Left Ventricular Infarct Size Reduction in Acute Myocardial Infarction: A Phase II, Multicenter, Randomized, Double-Blinded, Placebo-Controlled Study Protocol – The COVERT-MI Study

Author: François Roubille, Loïc Bière, Naoual El Jonhy, Nathan Mewton, Gilles Rioufol, Olivier Dubreuil, Delphine Maucort-Boulch, Thomas Bochaton, Georges Sideris, Fabrice Prunier, Didier Bresson, Charles De Bourguignon, Carole Dhelens, Claire Bouleti, Cyril Prieur, Fabrice Ivanes, Florent Boutitie, Michel Ovize, Denis Angoulvant, Meyer Elbaz, Nathalie Dufay, Pierre Croisille, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Université de Tours (UT), CIC - Poitiers, Université de Poitiers-Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Direction Générale de l'Organisation des Soins (DGOS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre d'Investigation Clinique [Bron] (CIC1407), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupement Hospitalier Est [Bron], Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Neurobiotec [HCL, Lyon], Hospices Civils de Lyon, Departement de Neurologie (HCL), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Hôpital Edouard Herriot [CHU - HCL], Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord (Saint Etienne), and MORNET, Dominique
Subjects: 0301 basic medicine, Adult, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Placebo-controlled study, Myocardial Infarction, Acute myocardial infarction, Placebo, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Clinical Trials, Phase II as Topic, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Multicenter Studies as Topic, Pharmacology (medical), cardiovascular diseases, Myocardial infarction, Prospective Studies, Ventricular remodeling, ComputingMilieux_MISCELLANEOUS, Randomized Controlled Trials as Topic, Inflammation, Ejection fraction, business.industry, Left ventricular remodeling, Percutaneous coronary intervention, Stroke Volume, medicine.disease, Magnetic Resonance Imaging, 3. Good health, ST-segment elevation myocardial infarction, [SDV] Life Sciences [q-bio], 030104 developmental biology, Treatment Outcome, 030220 oncology & carcinogenesis, Heart failure, Cardiology, Cardiology and Cardiovascular Medicine, business, Colchicine, TIMI
Abstract: Inflammatory processes have been identified as key mediators of ischemia-reperfusion injury in ST-segment elevation myocardial infarction (STEMI). They add damage to the myocardium and are associated with clinical adverse events (heart failure and cardiovascular death) and poor myocardial recovery. Colchicine is a well-known alkaloid with potent anti-inflammatory properties. In a proof-of-concept phase II trial, colchicine has been associated with a significant 50% reduction of infarct size (assessed by creatine kinase levels) in comparison to placebo in acute STEMI patients referred for primary percutaneous coronary intervention (PPCI). The Colchicine in STEMI Patients Study (COVERT-MI) is an ongoing confirmative prospective, multicenter, randomized, double-blind trial testing whether a short course oral treatment with colchicine versus placebo decreases myocardial injury in patients presenting with STEMI referred for PPCI. Adult patients, with a first STEMI episode and an initial TIMI flow ≤1, referred for PPCI, will be randomized (n = 194) in a 1:1 ratio to receive an oral bolus of colchicine of 2 mg followed by 0.5 mg b.i.d. treatment during 5 days or matching placebo. The primary endpoint will be the reduction in infarct size as assessed by cardiac magnetic resonance at 5 ± 2 days between both groups. The main secondary endpoints will be tested between groups in hierarchical order with left ventricular ejection fraction at 5 days, microvascular obstruction presence at 5 days, and absolute adverse left ventricular remodeling between 5 days and 3 months. This academic study is being financed by a grant from the French Ministry of Health (PHRCN-16-0357). Results from this study will contribute to a better understanding of the complex pathophysiology underlying myocardial injury after STEMI. The present study describes the rationale, design, and methods of the trial.
Published: 2021
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41. Contributors

Author: Ali C. Akyildiz, Antonios P. Antoniadis, Lambros S. Athanasiou, Hilary E. Barrett, Kristen Billiar, Emmanuelle Canet Soulas, Luis Cardoso, Claire Cawthon, Yiannis S. Chatzizisis, Claudio Chiastra, Myriam Cilla, Guy Cloutier, Ricardo Coppel, Catherine Demos, François Dérimay, Gabriele Dubini, Elazer R. Edelman, Richard L. Ehman, Gérard Finet, Pak-Wing Fok, T. Christian Gasser, Don P. Giddens, Frank J.H. Gijsen, Erin Goerlich, Armida Gómez, Guillaume Goudot, Xiaoya Guo, Allison G. Hays, Ulf Hedin, Gerhard A. Holzapfel, Haibo Jia, Hanjoong Jo, Roger D. Kamm, Ghassan S. Kassab, Arunark Kolipaka, Elisa E. Konofagou, Manuel Lagache, Álvaro T. Latorre, Simon Le Floc'h, Stephanie Lehoux, Genshan Ma, Akiko Maehara, Mauro Malvè, Jean-Louis Martiel, Miguel A. Martínez, Takeo Matsumoto, Mitsuaki Matsumura, Francesco Migliavacca, Gary S. Mintz, Navid Mohammad Mirzaei, David Molony, Farhad Rikhtegar Nezami, Jacques Ohayon, John N. Oshinski, Estefanía Peña, Mathieu Pernot, Roderic I. Pettigrew, William L. Pomeroy, Gilles Rioufol, Joy Roy, Habib Samady, Sarah E. Shelton, Matthias Stuber, Antoine Tacheau, Ian Tamargo, Dalin Tang, Lucas H. Timmins, Emily A. Turner, Liang Wang, Sheldon Weinbaum, Robert G. Weiss, Richard D. White, Chun Yang, Saami K. Yazdani, Jie Zheng, and Jian Zhu
Published: 2021
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42. Coronary intravascular ultrasound and optical coherence tomography imaging and clinical contexts in coronary hemodynamics

Author: Gilles Rioufol and François Derimay
Subjects: Coronary angiography, medicine.medical_specialty, Myocardial ischemia, medicine.diagnostic_test, business.industry, Fractional flow reserve, medicine.disease, Stenosis, Optical coherence tomography, Internal medicine, Intravascular ultrasound, medicine, Cardiology, Coronary hemodynamics, Tomography, business
Abstract: Coronary angiography is the key-procedure for atherosclerosis evaluation, even if it provides only information on the intraluminal stenosis and if it does not analyze the arterial wall or its functional consequences in terms of myocardial ischemia. This chapter aims to describe the place and the input of intracoronary imaging with intravascular ultrasound or optical coronary tomography, and the functional approach of fractional flow reserve, in the cathlab.
Published: 2021
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43. Coronary artery stenosis prediction does not mean coronary artery stenosis obstruction

Author: Gilles Rioufol, Francois Derimay, Carmen Lab, Team3 Carmen, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Cardiovasculaire Louis Pradel (HCLP), Hospices Civils de Lyon (HCL), and CarMeN, laboratoire
Subjects: medicine.medical_specialty, business.industry, [SDV]Life Sciences [q-bio], Coronary stenosis, 030204 cardiovascular system & hematology, 3. Good health, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Text mining, Internal medicine, Cardiology, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; No abstract available
Published: 2021
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44. Life-threatening arrhythmias in anterior ST-segment elevation myocardial infarction patients treated by percutaneous coronary intervention: adverse impact of morphine

Author: François Roubille, Olivier Morel, Annie Trinh, Eric Bonnefoy-Cudraz, David Garcia-Dorado, Camille Amaz, Kensuke Matsushita, Benjamin Marchandot, Patrice Guerin, Denis Angoulvant, Nathan Mewton, Patrick Ohlmann, Marc J. Claeys, François Sauer, Thomas Bochaton, François Derimay, Claire Jossan, Guillaume Cayla, Michel Ovize, Laurence Jesel, Gilles Rioufol, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: Tachycardia, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Myocardial Infarction, 030204 cardiovascular system & hematology, Anterior Descending Coronary Artery, Critical Care and Intensive Care Medicine, Ventricular tachycardia, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Risk Factors, Internal medicine, medicine, ST segment, Humans, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, education, ComputingMilieux_MISCELLANEOUS, education.field_of_study, Morphine, business.industry, Percutaneous coronary intervention, General Medicine, medicine.disease, 3. Good health, Ventricular fibrillation, Ventricular Fibrillation, Cardiology, cardiovascular system, ST Elevation Myocardial Infarction, Human medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Aims Important controversies remain concerning the determinants of life-threatening arrhythmias during ST-segment elevation myocardial infarction (STEMI) and their impact on late adverse events. This study sought to investigate which factors might facilitate ventricular tachycardia (VT) and ventricular fibrillation (VF), in a homogeneous population of anterior STEMI patients defined by abrupt left anterior descending coronary artery (LAD) occlusion and no collateral flow. Methods and results The 967 patients, who entered into the CIRCUS (Does Cyclosporine ImpRove Clinical oUtcome in ST elevation myocardial infarction patients) study, were assessed for further analysis. Acute VT/VF was defined as VT (run of tachycardia >30 s either self-terminated or requiring electrical/pharmacological cardioversion) or VF documented by electrocardiogram or cardiac monitoring, during transportation to the cathlab or initial hospitalization. VT/VF was documented in 136 patients (14.1%). Patients with VT/VF were younger and had shorter time from symptom onset to hospital arrival. Site of LAD occlusion, thrombus burden, area at risk, pre-percutaneous coronary intervention Thrombolysis in Myocardial Infarction flow, and ST-segment resolution were similar to that of patients without VT/VF. There was no impact of VT/VF on left ventricular remodelling or clinical outcomes. By multivariate analysis, the use of morphine (odds ratio 1.71; 95% confidence interval (1.13–2.60); P = 0.012) was the sole independent predictor of VT/VF occurrence. Conclusions In STEMI patients with LAD occlusion, our findings support the view that morphine could favour severe ventricular arrhythmias.
Published: 2020
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45. Association of the PHACTR1/EDN1 Genetic Locus With Spontaneous Coronary Artery Dissection

Author: David Adlam, Timothy M. Olson, Nicolas Combaret, Jason C. Kovacic, Siiri E. Iismaa, Abtehale Al-Hussaini, Megan M. O'Byrne, Sara Bouajila, Adrien Georges, Ketan Mishra, Peter S. Braund, Valentina d’Escamard, Siying Huang, Marios Margaritis, Christopher P. Nelson, Mariza de Andrade, Daniella Kadian-Dodov, Catherine A. Welch, Stephani Mazurkiewicz, Xavier Jeunemaitre, Claire Mei Yi Wong, Eleni Giannoulatou, Michael Sweeting, David Muller, Alice Wood, Lucy McGrath-Cadell, Diane Fatkin, Sally L. Dunwoodie, Richard Harvey, Cameron Holloway, Jean-Philippe Empana, Xavier Jouven, Jeffrey W. Olin, Rajiv Gulati, Marysia S. Tweet, Sharonne N. Hayes, Nilesh J. Samani, Robert M. Graham, Pascal Motreff, Nabila Bouatia-Naji, Loïc Belle, Patrick Dupouy, Pierre Barnay, Nicolas Meneveau, Martine Gilard, Gilles Rioufol, Grégoire Range, Philippe Brunel, Nicolas Delarche, Emmanuelle Filippi, Louis Le Bivic, Brahim Harbaoui, Hakim Benamer, Guillaume Cayla, Olivier Varenne, Stephane Peggy Manzo-Silberman, Johanne Silvain, Christian Spaulding, Christophe Caussin, Edouard Gerbaud, Yann Valy, René Koning, Thibault Lhermusier, Stanislas Champin, Emmanuel Salengro, Arnaud Fluttaz, Amer Zabalawi, Yves Cottin, Emmanuel Teiger, Christophe Saint-Etienne, Grégory Ducrocq, Stéphanie Marliere, Emmanuel Boiffard, Pierre Aubry, Jean Louis Georges, Didier Bresson, Fabien De Poli, Gaëtan Karrillon, Vincent Roule, Laurent Bali, Mathieu Valla, Antoine Gerbay, David Houpe, Olivier Dubreuil, Arsène Monnier, Norbert Mayaud, Aurélie Manchuelle, Philippe Commeau, Marc Bedossa, Majid Nikpay, Anuj Goel, Hong-Hee Won, Leanne M. Hall, Christina Willenborg, Stavroula Kanoni, Danish Saleheen, Theodosios Kyriakou, Jemma C. Hopewell, Thomas R. Webb, Lingyao Zeng, Abbas Dehghan, Maris Alver, Sebastian M. Armasu, Kirsi Auro, Andrew Bjonnes, Daniel I. Chasman, Shufeng Chen, Ian Ford, Nora Franceschini, Christian Gieger, Christopher Grace, Stefan Gustafsson, Jie Huang, Shih-Jen Hwang, Yun Kyoung Kim, Marcus E. Kleber, King Wai Lau, Xiangfeng Lu, Yingchang Lu, Leo P. Lyytikäinen, Evelin Mihailov, Alanna Morrison, Natalia Pervjakova, Liming Qu, Lynda M. Rose, Elias Salfati, Richa Saxena, Markus Scholz, Albert V. Smith, Emmi Tikkanen, Andre Uitterlinden, Xueli Yang, Weihua Zhang, Wei Zhao, Paul S. de Vries, Natalie R. van Zuydam, Sonia S. Anand, Lars Bertram, Frank Beutner, George Dedoussis, Philippe Frossard, Dominique Gauguier, Alison H. Goodall, Omri Gottesman, Marc Haber, Bok-Ghee Han, Jianfeng Huang, Shapour Jalilzadeh, Thorsten Kessler, Inke R. König, Lars Lannfelt, Wolfgang Lieb, Lars Lind, Cecilia M. Lindgren, Maisa Lokki, Patrik K. Magnusson, Nadeem H. Mallick, Narinder Mehra, Thomas Meitinger, Fazal-ur-Rehman Memon, Andrew P. Morris, Markku S. Nieminen, Nancy L. Pedersen, Annette Peters, Loukianos S. Rallidis, Asif Rasheed, Maria Samuel, Svati H. Shah, Juha Sinisalo, Kathleen E. Stirrups, Stella Trompet, Laiyuan Wang, Khan S. Zaman, Diego Ardissino, Eric Boerwinkle, Ingrid B. Borecki, Erwin P. Bottinger, Julie E. Buring, John C. Chambers, Rory Collins, L Adrienne Cupples, John Danesh, Ilja Demuth, Roberto Elosua, Stephen E. Epstein, Tõnu Esko, Mary F. Feitosa, Oscar H. Franco, Maria Grazia Franzosi, Christopher B. Granger, Dongfeng Gu, Vilmundur Gudnason, Alistair S. Hall, Anders Hamsten, Tamara B. Harris, Stanley L. Hazen, Christian Hengstenberg, Albert Hofman, Erik Ingelsson, Carlos Iribarren, J Wouter Jukema, Pekka J. Karhunen, Bong-Jo Kim, Jaspal S. Kooner, Iftikhar J. Kullo, Terho Lehtimäki, Ruth J. Loos, Olle Melander, Andres Metspalu, Winfried März, Colin N. Palmer, Markus Perola, Thomas Quertermous, Daniel J. Rader, Paul M. Ridker, Samuli Ripatti, Robert Roberts, Veikko Salomaa, Dharambir K. Sanghera, Stephen M. Schwartz, Udo Seedorf, Alexandre F. Stewart, David J. Stott, Joachim Thiery, Pierre A. Zalloua, Christopher J. O'Donnell, Muredach P. Reilly, Themistocles L. Assimes, John R. Thompson, Jeanette Erdmann, Robert Clarke, Hugh Watkins, Sekar Kathiresan, Ruth McPherson, Panos Deloukas, Heribert Schunkert, Martin Farrall, Department of Cardiovascular Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, Mayo Clinic [Rochester], Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Icahn School of Medicine at Mount Sinai [New York] (MSSM), Victor Chang Cardiac Research Institute, University of New South Wales [Sydney] (UNSW), St. Vincent’s Clinical School [Sydney, Australia], UNSW Faculty of Medicine [Sydney], University of New South Wales [Sydney] (UNSW)-University of New South Wales [Sydney] (UNSW), Department of Health Sciences Research [Mayo Clinic] (HSR), Mayo Clinic, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de génétique [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Department of Cardiovascular Medicine, Mayo Clinic, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), and Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)
Subjects: Adult, Male, medicine.medical_specialty, Myocardial infarction, Coronary Vessel Anomalies, Fibromuscular dysplasia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Prevalence, Fibromuscular Dysplasia, Humans, 030212 general & internal medicine, Vascular Diseases, Artery dissection, MESH: Australia, United Kingdom, USA, Coronary Vessel Anomalies / epidemiology, Endothelin-1 / genetics, Microfilament proteins / genetics, Genetic association, Aged, Endothelin-1, business.industry, Microfilament Proteins, Australia, Cardiovascular disease in women, Middle Aged, medicine.disease, R1, United States, 3. Good health, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Genetic Loci, Case-Control Studies, Cardiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, Cardiology and Cardiovascular Medicine, Scad, business
Abstract: Background: \ud Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for several vascular diseases, including FMD and coronary artery disease, with the putative causal noncoding variant at the rs9349379 locus acting as a potential enhancer for the endothelin-1 (EDN1) gene.\ud \ud Objectives: \ud This study sought to test the association between the rs9349379 genotype and SCAD.\ud \ud Methods: \ud Results from case control studies from France, United Kingdom, United States, and Australia were analyzed to test the association with SCAD risk, including age at first event, pregnancy-associated SCAD (P-SCAD), and recurrent SCAD.\ud \ud Results: \ud The previously reported risk allele for FMD (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 (95% confidence interval [CI]: 1.50 to 1.86) per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was found to be higher for the association with SCAD in patients without FMD (OR: 1.89; 95% CI: 1.53 to 2.33) than in SCAD cases with FMD (OR: 1.60; 95% CI: 1.28 to 1.99). There was no effect of genotype on age at first event, P-SCAD, or recurrence.\ud \ud Conclusions: \ud The first genetic risk factor for SCAD was identified in the largest study conducted to date for this condition. This genetic link may contribute to the clinical overlap between SCAD and FMD.
Published: 2019
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46. Reply

Author: Nathan Mewton, François Derimay, Pascal Motreff, Denis Angoulvant, and Gilles Rioufol
Subjects: Cardiology and Cardiovascular Medicine
Published: 2022
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47. Sex Differences in Adenosine-Free Coronary Pressure Indexes

Author: Giovanni Esposito, Bernard De Bruyne, Colin Berry, Emanuele Barbato, Nils P. Johnson, Bon-Kwon Koo, Allen Jeremias, Nils Witt, Sonia Shah, William F. Fearon, Seung-Jung Park, Frederik M. Zimmermann, Takeshi Nishi, Contrast Study Investigators, Yuhei Kobayashi, Nico H.J. Pijls, Gilles Rioufol, and Keith G. Oldroyd
Subjects: medicine.medical_specialty, business.industry, media_common.quotation_subject, Fractional flow reserve, 030204 cardiovascular system & hematology, Adenosine, Coronary pressure, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Blood pressure, Internal medicine, Predictive value of tests, Cardiology, Medicine, Contrast (vision), 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Prospective cohort study, Artery, media_common, medicine.drug
Abstract: Objectives The goal of this study was to investigate sex differences in adenosine-free coronary pressure indexes. Background Several adenosine-free coronary pressure wire indexes have been proposed to assess the functional significance of coronary artery lesions; however, there is a theoretical concern that sex differences may affect diagnostic performance because of differences in resting flow and distal myocardial mass. Methods In this CONTRAST (Can Contrast Injection Better Approximate FFR Compared to Pure Resting Physiology?) substudy, contrast fractional flow reserve (cFFR), obtained during contrast-induced submaximal hyperemia, the instantaneous wave-free ratio (iFR), and distal/proximal coronary pressure ratio (Pd/Pa) were compared with fractional flow reserve (FFR) in 547 men and 216 women. Using FFR ≤0.8 as a reference, the diagnostic performance of each index was compared. Results Men and women had similar diameter stenosis (p = 0.78), but women were less likely to have FFR ≤0.80 than men (42.5% vs. 51.5%, p = 0.04). Sensitivity was similar among cFFR, iFR, and Pd/Pa when comparing women and men, respectively (cFFR, 77.5% vs. 75.3%; p = 0.69; iFR, 84.9% vs. 79.4%; p = 0.30; Pd/Pa, 78.8% vs. 77.3%; p = 0.78). cFFR was more specific than iFR or Pd/Pa regardless of sex (cFFR, 94.3% vs. 95.8%; p = 0.56; iFR, 75.6% vs. 80.1%; p = 0.38; Pd/Pa, 80.6% vs. 78.7%; p = 0.69). By receiver-operating characteristic curve analysis, cFFR provided better diagnostic accuracy than resting indexes irrespective of sex (p ≤ 0.0001). Conclusions Despite the theoretical concern, the diagnostic sensitivity and specificity of cFFR, iFR, and Pd/Pa did not differ between the sexes. Irrespective of sex, cFFR provides the best diagnostic performance.
Published: 2018
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48. NEW INSIGHT IN CORONARY VULNERABLE PLAQUE MECHANICAL PROPERTIES

Author: G. Finet, J. Ohayon, and Gilles Rioufol
Subjects: Specialties of internal medicine, RC581-951, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published: 2011
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49. Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve Replacement: A Propensity-Matched Comparison From the FRANCE-TAVI Registry

Author: Hervé Le Breton, Augustin Coisne, Vincent Auffret, Emmanuel Teiger, Dominique Himbert, Jean-Phillipe Collet, Emmanuel Robin, Olivier Bar, Thierry Folliguet, Sina Porouchani, Eric Van Belle, Thomas Cuisset, Patrick Joly, Frédéric Pinaud, Martine Gilard, Cédric Delhaye, Gilles Rioufol, Alessandro Cosenza, Said Ghostine, Florence Leclercq, Thomas Gandet, Nicolas Amabile, M. Richardson, Nicolas Meneveau, Géraud Souteyrand, Bernard Iung, Christian Spaulding, Flavien Vincent, N Debry, Thomas Modine, Pascal Motreff, Guillaume Cayla, Philippe Commeau, T. Lhermusier, Hélène Eltchaninoff, Alain Duhamel, Olivier Darremont, Guillaume Schurtz, René Koning, Gilles Bayet, Julien Labreuche, Thibaut Manigold, Thierry Lefèvre, Patrick Ohlmann, Pascal Leprince, Jean-Phillipe Verhoye, Didier Champagnac, Lionel Leroux, Benoit Lattuca, Récepteurs nucléaires, maladies cardiovasculaires et diabète (EGID), Université de Lille, Droit et Santé-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Santé publique : épidémiologie et qualité des soins-EA 2694 (CERIM), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Pharmacologie des Dysfonctionnements Endotheliaux et Myocardiques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Nutriments Lipidiques et Prévention des Maladies Métaboliques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université de la Méditerranée - Aix-Marseille 2, Image Science for Interventional Techniques (ISIT), Clermont Université-Centre National de la Recherche Scientifique (CNRS)-Université d'Auvergne - Clermont-Ferrand I (UdA), Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (RNMCD), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Lille, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université de la Méditerranée - Aix-Marseille 2-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche de l'institut du thorax (ITX-lab), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale (MITOVASC), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), and Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)
Subjects: Aortic valve, medicine.medical_specialty, medicine.medical_treatment, heart valve disease, aortic valve stenosis, 030204 cardiovascular system & hematology, aortic valve insufficiency, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Interquartile range, Physiology (medical), medicine, 030212 general & internal medicine, business.industry, Hazard ratio, medicine.disease, mortality, 3. Good health, Surgery, Stenosis, medicine.anatomical_structure, Aortic valve stenosis, Relative risk, Propensity score matching, transcatheter aortic valve replacement, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: Background: No randomized study powered to compare balloon expandable (BE) with self expanding (SE) transcatheter heart valves (THVs) on individual end points after transcatheter aortic valve replacement has been conducted to date. Methods: From January 2013 to December 2015, the FRANCE-TAVI nationwide registry (Registry of Aortic Valve Bioprostheses Established by Catheter) included 12 141 patients undergoing BE-THV (Edwards, n=8038) or SE-THV (Medtronic, n=4103) for treatment of native aortic stenosis. Long term mortality status was available in all patients (median 20 months; interquartile range, 14 to 30). Patients treated with BE-THV (n=3910) were successfully matched 1:1 with 3910 patients treated with SE-THV by using propensity score (25 clinical, anatomical, and procedural variables) and by date of the procedure (within 3 months). The first coprimary outcome was ≥ moderate occurrence of paravalvular regurgitation or in-hospital mortality, or both. The second coprimary outcome was 2-year all-cause mortality. Results: In propensity–matched analyses, the incidence of the first coprimary outcome was higher with SE-THV (19.8%) compared with BE-THV (11.9%; relative risk, 1.68 [95% CI, 1.46–1.91]; P P P =0.01). During follow up, all cause mortality occurred in 899 patients treated with SE-THV (2-year mortality, 29.8%) and in 801 patients treated with BE-THV (2-year mortality, 26.6%; hazard ratio, 1.17 [95% CI, 1.06–1.29]; P =0.003). Similar results were found using inverse probability of treatment weighting using propensity score analysis. Conclusion: The present study suggests that use of SE-THV was associated with a higher risk of paravalvular regurgitation and higher in-hospital and 2-year mortality compared with use of BE-THV. These data strongly support the need for a randomized trial sufficiently powered to compare the latest generation of SE-THV and BE-THV. Clinical Trial Registration: https://www.clinicaltrials.gov . Unique identifier: NCT01777828.
Published: 2020
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50. Sequential coronary bifurcation revascularization with the Xposition S™ self-apposing stent: a comparative fractal bench study

Author: Gilles Rioufol, Luc Maillard, Joëlle Veziers, Adel Aminian, Gérard Finet, François Derimay, Patrice Guerin, Géraud Souteyrand, Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), CHU Clermont-Ferrand, Service of Cardiology - CHU Charleroi, Regenerative Medicine and Skeleton research lab (RMeS), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Institut National de la Santé et de la Recherche Médicale (INSERM), French-Clinical Research Infrastructure Network [Lyon] (Cardiovascular & Renal Clinical Trialists - INI-CRCT ), Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RH), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-CHU Saint-Etienne-Hospices Civils de Lyon (HCL)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-CHU Saint-Etienne-Hospices Civils de Lyon (HCL)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Jehan, Frederic, Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Regenerative Medicine and Skeleton (RMeS), École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Unité de recherche de l'institut du thorax (ITX-lab), French-Clinical Research Infrastructure Network / F-CRIN [Lyon] (Cardiovascular & Renal Clinical Trialists - INI-CRCT ), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Université de Lyon-Université de Lyon-CHU Grenoble-Hospices Civils de Lyon (HCL)-CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Grenoble Alpes (UGA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-CHU Grenoble-CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Grenoble Alpes (UGA), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-CHU Saint-Etienne-Hospices Civils de Lyon (HCL)-CHU Grenoble-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-CHU Saint-Etienne-Hospices Civils de Lyon (HCL)-CHU Grenoble-Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS)
Subjects: Nitinol stent, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Prosthesis Design, Revascularization, 03 medical and health sciences, 0302 clinical medicine, Materials Testing, medicine, 030212 general & internal medicine, Angioplasty, Balloon, Coronary, Coronary bifurcation, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Models, Cardiovascular, Stent, X-Ray Microtomography, Vascular surgery, medicine.disease, Cardiac surgery, Surgery, Stenosis, Fractals, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Stents, Cardiology and Cardiovascular Medicine, business, Tomography, Optical Coherence
Abstract: Coronary bifurcation revascularization needs to take account of the diameter differential between vessels and to limit side-branch obstruction (SBO). The self-apposing properties of the Xposition S™ stent (STENTYS, France) seem interesting in this regard. The present experimental fractal bench study determined the best provisional stenting technique using Xposition S™. Three sequential strategies were compared (n = 5/group): implantation alone, side-branch inflation (SBI), and re-POT (initial proximal optimization technique (POT) + SBI + final POT). 2D- and 3D-OCT analyses and micro-CT scan were performed to quantify the main mechanical results at each step. Of the three groups, SBI and re-POT provided better final results than implantation alone in terms of residual SBO (respectively, 24.6 ± 5.6% and 24.8 ± 5.0% vs. 46.5 ± 10.3%, p
Published: 2019
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