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2. Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance

Author

Mebazaa, A., Tolppanen, H., Mueller, C., Lassus, J., DiSomma, S., Baksyte, G., and Cecconi, M.

Subjects
Medical research -- Health aspects, Medicine, Experimental -- Health aspects, Mortality -- France -- Canada, Cardiogenic shock -- Diagnosis, Vasodilators -- Health aspects, Natriuretic peptides -- Health aspects, Medical colleges -- Health aspects, Heart -- Health aspects, Evidence-based medicine -- Health aspects, Heart failure -- Diagnosis, Diuretics -- Health aspects, Health care industry
Abstract

Purpose Acute heart failure (AHF) causes high burden of mortality, morbidity, and repeated hospitalizations worldwide. This guidance paper describes the tailored treatment approaches of different clinical scenarios of AHF and CS, focusing on the needs of professionals working in intensive care settings. Results Tissue congestion and hypoperfusion are the two leading mechanisms of end-organ injury and dysfunction, which are associated with worse outcome in AHF. Diagnosis of AHF is based on clinical assessment, measurement of natriuretic peptides, and imaging modalities. Simultaneously, emphasis should be given in rapidly identifying the underlying trigger of AHF and assessing severity of AHF, as well as in recognizing end-organ injuries. Early initiation of effective treatment is associated with superior outcomes. Oxygen, diuretics, and vasodilators are the key therapies for the initial treatment of AHF. In case of respiratory distress, non-invasive ventilation with pressure support should be promptly started. In patients with severe forms of AHF with cardiogenic shock (CS), inotropes are recommended to achieve hemodynamic stability and restore tissue perfusion. In refractory CS, when hemodynamic stabilization is not achieved, the use of mechanical support with assist devices should be considered early, before the development of irreversible end-organ injuries. Conclusion A multidisciplinary approach along the entire patient journey from pre-hospital care to hospital discharge is needed to ensure early recognition, risk stratification, and the benefit of available therapies. Medical management should be planned according to the underlying mechanisms of various clinical scenarios of AHF., Author(s): A. Mebazaa [sup.1] [sup.2] [sup.3], H. Tolppanen [sup.1] [sup.4], C. Mueller [sup.5], J. Lassus [sup.4], S. DiSomma [sup.6], G. Baksyte [sup.7], M. Cecconi [sup.8], D. J. Choi [sup.9], A. [...]

Published
2016
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3. Soluble triggering receptor expressed on myeloid cells-1 is a marker of organ injuries in cardiogenic shock: results from the CardShock Study

Author

Kimmoun, A, Duarte, K, Harjola, VP, Tarvasmaki, T, Levy, B, Mebazaa, A, Gibot, S, Koniari, K, Voumvourakis, A, Karavidas, A, Parissis, J, Sans-Rosello, J, Vila, M, Duran-Cambra, A, Sionis, A, Parenica, J, Stipal, R, Ludka, O, Palsuva, M, Ganovska, E, Kubena, P, Spinar, J, Lindholm, MG, Hassager, C, Kober, L, Backlund, T, Lassus, J, Jurkko, R, Tolppanen, H, Nieminen, MS, Jarvinen, K, Nieminen, T, Pulkki, K, Soininen, L, Sund, R, Tierala, I, Tolonen, J, Varpula, M, Korva, T, Pietila, M, Pitkala, A, Marino, R, Di Somma, S, Metra, M, Bulgari, M, Lazzarini, V, Carubelli, V, Sousa, A, Silva-Cardoso, J, Sousa, C, Paiva, M, Rangel, I, Almeida, R, Pinho, T, Maciel, MJ, Banaszewski, M, Stepinska, J, Skrobisz, A, Goral, P, Zeymer, U, and Thiele, H

Subjects
Cardiogenic Shock, STREM, Biomarkers, Outcome
Abstract

Aims Optimal outcome after cardiogenic shock (CS) depends on a coordinated healing response in which both debris removal and extracellular matrix tissue repair play a crucial role. Excessive inflammation can perpetuate a vicious circle, positioning leucocytes as central protagonists and potential therapeutic targets. High levels of circulating Triggering Receptor Expressed on Myeloid cells-1 (TREM-1), were associated with death in acute myocardial infarction confirming excessive inflammation as determinant of bad outcome. The present study aims to describe the association of soluble TREM-1 with 90-day mortality and with various organ injuries in patients with CS. Methods and results This is a post-hoc study of CardShock, a prospective, multicenter study assessing the clinical presentation and management in patients with CS. At the time of this study, 87 patients had available plasma samples at either baseline, and/or 48 h and/or 96-120 h for soluble TREM-1 (sTREM-1) measurements. Plasma concentration of sTREM-1 was higher in 90-day non-survivors than survivors at baseline [median: 1392 IQR: (724-2128) vs. 621 (525-1233) pg/mL, p = 0.008), 48 h (p = 0.019) and 96-120 h (p = 0.029). The highest tertile of sTREM-1 at baseline (threshold: 1347 pg/mL) was associated with 90-day mortality with an unadjusted HR 3.08 CI 95% (1.48-6.42). sTREM-1 at baseline was not associated to hemodynamic parameters (heart rate, blood pressure, use of vasopressors or inotropes) but rather with organ injury markers: renal (estimated glomerular filtration rate, p = 0.0002), endothelial (bio-adrenomedullin, p = 0.018), myocardial (Suppression of Tumourigenicity 2, p = 0.002) or hepatic (bilirubin, p = 0.008). Conclusion In CS patients TREM-1 pathway is highly activated and gives an early prediction of vital organ injuries and outcome. [GRAPHICS] .

Published
2022

16. Circulating levels of microRNA 423-5p are associated with 90 day mortality in cardiogenic shock

Author

Jantti, T, Segersvard, H, Tolppanen, H, Tarvasmaki, T, Lassus, J, Devaux, Y, Vausort, M, Pulkki, K, Sionis, A, Bayes-Genis, A, Tikkanen, I, Lakkisto, P, Harjola, VP, HUS Heart and Lung Center, Kardiologian yksikkö, Department of Medicine, Faculty of Medicine, Clinicum, University of Helsinki, HUS Abdominal Center, Nefrologian yksikkö, HUSLAB, Department of Clinical Chemistry and Hematology, Medicum, HUS Emergency Medicine and Services, and Department of Diagnostics and Therapeutics

Subjects
MIR-423-5P, BIOMARKER, microRNA, HEART-FAILURE, Acute coronary syndrome, Mortality, 3126 Surgery, anesthesiology, intensive care, radiology, miR-423-5p, Prognosis, Cardiogenic shock
Abstract

Aims The role of microRNAs has not been studied in cardiogenic shock. We examined the potential role of miR-423-5p level to predict mortality and associations of miR-423-5p with prognostic markers in cardiogenic shock. Methods and results We conducted a prospective multinational observational study enrolling consecutive cardiogenic shock patients. Blood samples were available for 179 patients at baseline to determine levels of miR-423-5p and other biomarkers. Patients were treated according to local practice. Main outcome was 90 day all-cause mortality. Median miR-423-5p level was significantly higher in 90 day non-survivors [median 0.008 arbitrary units (AU) (interquartile range 0.003-0.017) vs. 0.004 AU (0.002-0.009), P = 0.003]. miR-423-5p level above median was associated with higher lactate (median 3.7 vs. 2.4 mmol/L, P = 0.001) and alanine aminotransferase levels (median 68 vs. 35 IU/L, P

Published
2019

17. Hypoalbuminemia is a frequent marker of increased mortality in cardiogenic shock

Author

Jantti, T, Tarvasmaki, T, Harjola, VP, Javanainen, T, Tolppanen, H, Hongisto, M, Kataja, A, Banaszewski, M, Kober, L, Lassus, J, Mebazaa, A, Parissis, J, Silva-Cardoso, J, Sionis, A, Di Somma, S, Spinar, J, Koniari, K, Voumvourakis, A, Karavidas, A, Sans-Rosello, J, Vila, M, Duran-Cambra, A, Metra, M, Bulgari, M, Lazzarini, V, Parenica, J, Stipal, R, Ludka, O, Palsuva, M, Ganovska, E, Kubena, P, Lindholm, MG, Hassager, C, Backlund, T, Jurkko, R, Jarvinen, K, Nieminen, T, Pulkki, K, Soininen, L, Sund, R, Tierala, I, Tolonen, J, Varpula, M, Korva, T, Pitkala, A, Marino, R, Sousa, ASC, Paiva, M, Rangel, I, Almeida, R, Pinho, T, Maciel, MJ, Stepinska, J, Skrobisz, A, and Goral, P

Abstract

Introduction The prevalence of hypoalbuminemia, early changes of plasma albumin (P-Alb) levels, and their effects on mortality in cardiogenic shock are unknown. Materials and methods P-Alb was measured from serial blood samples in 178 patients from a prospective multinational study on cardiogenic shock. The association of hypoalbuminemia with clinical characteristics and course of hospital stay including treatment and procedures was assessed. The primary outcome was all-cause 90-day mortality. Results Hypoalbuminemia (P-Alb < 34g/L) was very frequent (75%) at baseline in patients with cardiogenic shock. Patients with hypoalbuminemia had higher mortality than patients with normal albumin levels (48% vs. 23%, p = 0.004). Odds ratio for death at 90 days was 2.4 [95% CI 1.5-4.1] per 10 g/L decrease in baseline P-Alb. The association with increased mortality remained independent in regression models adjusted for clinical risk scores developed for cardiogenic shock (CardShock score adjusted odds ratio 2.0 [95% CI 1.1-3.8], IABP-SHOCK II score adjusted odds ratio 2.5 [95% CI 1.2-5.0]) and variables associated with hypoalbuminemia at baseline (adjusted odds ratio 2.9 [95% CI 1.2-7.1]). In serial measurements, albumin levels decreased at a similar rate between 0h and 72h in both survivors and nonsurvivors (Delta P-Alb -4.6 g/L vs. 5.4 g/L, p = 0.5). While the decrease was higher for patients with normal P-Alb at baseline (p

Published
2019

18. Supplement II: Abstracts of the international symposium on Skin Carcinogenesis in man and in experimental models. Heidelberg, 29–31 October 1991 (pp S61–S88)

Author

Barrett, J. C., Afshari, C. A., Annab, L. A., Burkhart, B. A., Boyd, J. A., Owen, R. D., Futreal, P. A., Richter, K. H., Moses, H. L., Lavker, R. M., Miller, Stanley, Sun, T. -T., Stingl, G., Bianchi, A. B., Navone, N. M., Conti, C. J., Spencer, James M., Kahn, S., Weinstein, I. B., Silvers, D. S., DeLeo, V. A., Larcher, F., Bauluz, C., Quintanilla, M., Ballestin, C., Jorcano, J. L., Schön, M., Haas, M., Klein, C. E., Weber, L., Cerri, A., Tadini, G., Gitto, R., Berti, E., Cano, A., Caulín, C., Gómez, M., Gandarillas, A., Martín, M., Montes, A., Navarro, P., Bastian, B. C., Van der Piepen, U., Römisch, J., Pâques, E., Hartmann, A. A., Krieg, P., Schnapke, R., Feil, S., Fürstenberger, G., Marks, F., Missero, C., Cajal, S. Ramon y, Filvaroff, E., Dotto, G. P., Sherman, J., Albert, R. E., Baxter, C. S., Bauer, G., Höfler, P., Götschl, M., Viesel, E., Jürgensmeier, J., Schaefer, D., Picht, G., Grande, T., Real, A., Rünqer, T. M., Möller, K., Fuchs, P., Bauer, C., Epe' B., Gruner, S., Diezel, W., Macejewski, J., Weber, H., Eckert, R., Volk, H. D., Sönnichsen, N., Bavinck, Jan N. Bouwes, Vermeer, Bert J., Van Der Woude, Fokko J., Vandenbroucke, Jan P., Claas, Frans H. J., Griffin, E. F., Harris, H., Tilgen, W., Garbe, C., Østerlind, Anne, Weiss, J., Jung, E. G., Ruiter, D. J., Danen, E., Broecker, E. -B., Johnson, J. P., van Muijen, G. N. P., Halaban, R., Krüger-Krasagakes, S., Orfanos, C. E., Newton, J. A., Bataille, V., Cuzick, J., Bishop, T., Schwaaf, A., Azizi, E., Bröcker, E. B., Eberlein, B., Froschermaier, S., Gollhausen, R., Przybilla, B., Krasagakis, K., Abdel-Naser, M. B., Lopez-Bran, E., Robledo, A., Lopez-Bran, E., Heine, H., Hennig, B., Graf, G., Nährig, J., Niedner, R., Schöpf, E., Mailhammer, R., Reisbach, G., Kempkes, B., Hültner, L., Thalmeier, K., Anders, F., Zechel, C., Schleenbecker, U., Leers, J., Smith, A., Wagner, E., Burcin, U., Hug, H., Fiebich, B., Anders, A., Gröger, H., Schlatterer, B., Moll, I., Wollina, U., Leigh IM, Purkis PE, Markey A., Neill S., Proby C., Glover M., Lane EB, Klein-Szanto, A. J. P., Yaar, M., Garmyn, M., Gilani, A., Gilchrest, B. A., Bowden, G. T., Nelson, M., Levy, J., Tanooka, Hiroshi, Ootsuyama, Akira, Urbach, F., van der Leun, J. C., de Gruijl, F. R., Kripke, Margaret L., Yuspa, S. H., Glick, A., Lee, E., Diugosz, A., Balmain, A., Bums, P., Kemp, C. J., Stoler, A. B., Harks, F., Boukamp, P., Pascheberg, U., Breitkreutz, D., Hülsen, A., Altmeier, S., Tomakidi, P., Fusenig, N. E., Lowy, Douglas R., Sedman, Sylvia A., Cohen, Bruce D., Schiller, John T., Kricker, A., Armstrong, B. K., English, D., Heenan, P. J., Randell, P. L., de Gruijl, F. R., Kelfkens, G., van Weelden, H., van der Leun, J. C., Grabbe, S., Bruvers, S., Granstein, R. D., Albert, R., Miller, M., Cody, T., Baxter, C., Shukla, R., Ueda, M., Ichihashi, M., Yamamura, K., Hayashibe, K., Funasaka, Y., Mishima, Y., Fujiwara, Y., Ichihashi, M., Jimbo, T., Mishima, Y., Popanda, O., Thielmann, H. W., Jahrens, D., Edler, L., Ootsuyama, A., Tanooka, H., Sutter, C., Mukhtar, H., Strickland, P. T., Winter, H., Schweizer, J., Schmidt, R., Weber, E., Rippmann, F., Hecker, E., Kopp-Schneider, A., Lehmann, W. D., Stephan, M., Troll, W., Wei, H., Fujiki, H., Garte, S. J., Frenkel, K., Svetek, J., Schara, M., Pečar, S., Hergenhahn, M., Kinzel, V., Richards, J., Plein, P., Schiess, K., Kaszkin, M., Yamamoto, S., Wang, J. C., Kato, R., Kuroki, T., Hashimoto, Y., Osada, S., Ohno, S., Gilles, C., Piette, M., Foidart, J. -M., Ranki, A., Lassus, J., Lehmus, A., Niemi, K. -M., Friesel, H., Schneider, T., Steinbauer, B., Sorg, B., Winter, A., Krauter, G., Krauß, R., Roeser, H., Unger, Sylvia, Janiaud, Paul, Rueß, Doris, Mechler, Bernard M., Stanbridge, Eric J., Gross, Monika M., Buček, M., Klein-Bauernschmitt, P., Schlehofer, J. R., Kosters, R., Stark, H. -J., Okulov, V. B., Elgjo, K., Ushmorov, A. G., Danilov, A. O., Zubova, S. G., Furstenberger, G., and Faissner, A.

Published
1991
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21. Rationale and design of the ADVOR (Acetazolamide in Decompensated Heart Failure with Volume Overload) trial

Author

Mullens, W. Verbrugge, F.H. Nijst, P. Martens, P. Tartaglia, K. Theunissen, E. Bruckers, L. Droogne, W. Troisfontaines, P. Damman, K. Lassus, J. Mebazaa, A. Filippatos, G. Ruschitzka, F. Dupont, M.

Abstract

Aims: Decisive evidence on the optimal diuretic agent, dosing schedule, and administration route is lacking in acute heart failure (AHF) with congestion. The Acetazolamide in Decompensated heart failure with Volume OveRload (ADVOR) trial is designed to test the hypothesis that the carbonic anhydrase inhibitor acetazolamide, a potent inhibitor of proximal tubular sodium reabsorption, improves decongestion when combined with loop diuretic therapy in AHF, potentially leading to better clinical outcomes. Methods: The ADVOR trial is set up as a multicentre, randomized, double-blind, placebo-controlled study, aiming to recruit 519 patients with AHF and clinically evident volume overload. All study participants receive high-dose intravenous loop diuretics as background therapy and are randomized towards intravenous acetazolamide at a dose of 500 mg once daily vs. placebo, stratified according to including study centre and ejection fraction (< 40% vs. ≥ 40%). The primary endpoint is successful decongestion with no more than trace oedema assessed on the third morning after hospital admission, with good diuretic efficacy defined as a urine output > 3.5 L during the first 30–48 h of decongestive treatment. Secondary endpoints include all-cause mortality or heart failure readmission after 3 months, length of hospital stay for the index admission, and longitudinal changes in the EuroQol-5 dimensions questionnaire. Conclusion: ADVOR will investigate if acetazolamide combined with loop diuretic therapy improves decongestion in AHF with volume overload. © 2018 The Authors. European Journal of Heart Failure © 2018 European Society of Cardiology

Published
2018

22. Acute kidney injury in cardiogenic shock. definitions, incidence, haemodynamic alterations, and mortality

Author

Tarvasmäki, T., Haapio, M., Mebazaa, A., Sionis, A., Silva-Cardoso, J., Tolppanen, H., Lindholm, M. G., Pulkki, K., Parissis, J., Harjola, V. -P., Lassus, J., Banaszewski, M., Kober, L., Metra, M., Di Somma, S., Spinar, J., Koniari, K., Voumvourakis, A., Karavidas, A., Sans-Rosello, J., Vila, M., Duran-Cambra, A., Bulgari, M., Lazzarini, V., Parenica, J., Stipal, R., Ludka, O., Palsuva, M., Ganovska, E., Kubena, P., Hassager, C., Bäcklund, T., Jurkko, R., Järvinen, K., and Nieminen, T.

Subjects
haemodynamics, acute kidney injury, cardiogenic shock, urine output, kdigo, mortality
Published
2018

23. Prevalence, Temporal Evolution, and Impact on Survival of Ventricular Conduction Blocks in Patients With Acute Coronary Syndrome and Cardiogenic Shock

Author

Tolppanen, H, Javanainen, T, Sans-Rosello, J, Parenica, J, Nieminen, T, Pavlusova, M, Masip, J, Kober, L, Banaszewski, M, Sionis, A, Spinar, J, Harjola, VP, Jurkko, R, Lassus, J, CardShock Study Investigators, and GREAT Network

Abstract

Changes in QRS duration and pattern are regarded to reflect severe ischemia in acute coronary syndromes (ACS), and ventricular conduction blocks (VCBs) are recognized high-risk markers in both ACS and acute heart failure. Our aim was to evaluate the prevalence, temporal evolution, association with clinical and angiographic parameters, and impact on mortality of VCBs in ACS-related cardiogenic shock (CS). Data of 199 patients with ACS-related CS from a prospective multinational cohort were evaluated with electrocardiogram data from baseline and day 3. VCBs including left or right bundle branch block, right bundle branch block and hemiblock, isolated hemiblocks, and unspecified intraventricular conduction delay were assessed. Fifty percent of patients had a VCB at baseline; these patients were older, had poorer left ventricular function and had more often left main disease compared with those without VCB. One-year mortality was over 2-fold in patients with VCB compared with those without VCB (68% vs 32%, p

Published
2018

24. P6354Decreased beneficial effects of oral heart failure medications in patients with acute decompensated heart failure and hyperglycemia: results from an international observational cohort

Author

Akiyama, E, primary, Cinotti, R, additional, Arrigo, M, additional, Lassus, J, additional, Miro, O, additional, Celutkiene, J, additional, Cohen-Solal, A, additional, Maggioni, A P, additional, Mueller, C, additional, Parenica, J, additional, Spinar, J, additional, Sato, N, additional, Tamura, K, additional, Kimura, K, additional, and Mebazaa, A, additional

Published
2019
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25. Association of myocardial edema, hemorrhage and persistent microvascular obstruction with circulating inflammatory biomarkers in acute myocardial infarction patient

Author

Paccalet, A., primary, Bochaton, T., additional, Lassus, J., additional, Derimay, F., additional, Rioufol, G., additional, Prieur, C., additional, Bonnefoy-Cudraz, E., additional, Crola Da Silva, C., additional, Amaz, C., additional, Jossan, C., additional, Monneret, G., additional, Ovize, M., additional, and Mewton, N., additional

Published
2019
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26. Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)

Author

Harjola, V.-P. Mullens, W. Banaszewski, M. Bauersachs, J. Brunner-La Rocca, H.-P. Chioncel, O. Collins, S.P. Doehner, W. Filippatos, G.S. Flammer, A.J. Fuhrmann, V. Lainscak, M. Lassus, J. Legrand, M. Masip, J. Mueller, C. Papp, Z. Parissis, J. Platz, E. Rudiger, A. Ruschitzka, F. Schäfer, A. Seferovic, P.M. Skouri, H. Yilmaz, M.B. Mebazaa, A.

Abstract

Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology

Published
2017

27. Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

Author

Ridker, P. M., Revkin, J., Amarenco, P., Brunell, R., Civeira, F., Flather, M., Glynn, R. J., Gregoire, J., Jukema, J. W., Karpov, Y., Kastelein, J. J. P., Koenig, W., Lorenzatti, A., Manga, P., Masiukiewicz, U., Miller, M., Mosterd, A., Murin, J., Nicolau, J. C., Nissen, S., Ponikowski, P., Santos, R. D., Schwartz, P. F., Soran, H., White, H., Wright, R. S., Vrablik, M., Yunis, C., Shear, C. L., Tardif, Conde D, J. -C., Colquhoun, D, Missault, L, Grégoire, J, Gao, R, Urina, M, Solar, M, Jensen, Hk, Grobbee, D, Savolainen, M, Schiele, Fn, Montalescot, G, Edes, I, Blake, G, Lotan, C, Maggioni, A, Savonitto, S, Lee, Cw, Leiva Pons JL, Dan, Ga, Cortada, Jb, Mellbin, L, Kahan, T, Noble, S, Hwang, Jj, Sritara, P, Tökgozoğlu, L, Tarasenko, L, Borer, Js, Black, H, Carmena, R, Furie, Kl, Mcmurray, J, Neaton, J, Zannad, F, O’Neill, B, Welty, F, Mcnamara, R, Chun, H, Abbott, Jd, Jacoby, D, Mcpherson, C, Jadbabaie, F, Pinto, D, Mccullough, L, Silverman, Ie, Sansing, Lh, Dearborn-Tomazos, J, Foody, J, Schindler, J, Piazza, G, Chakrabarti, A, Pride, Y, Gelfand, E, Baultrukonis, D, Chaudhuri, S, Frederich, R, Johnson, M, Mridha, K, Powell, C, Wang, E, Wei, C, Anderson, P, Buonanno, M, Epsley, C, Evans, B, Frolova, M, Goetsch, M, Hessinger, D, Ikehara, E, Ivanac, K, Kizko, J, Le, K, McNally-Dufort, C, Morocco, T, Nadkarni, S, Nissen, T, Nye, R, Pak, R, Pence, D, Redifer, P, Schwartz, W, Sattler, C, Schade, R, Sullivan, B, Wegner, J, Alvarez, Ca, Budassi, N, Vogel, Dr, Avaca, H, Conde, Dg, Estol, Cc, Gelersztein, E, Glenny, Ja, Hershson, Ar, Bruno, Rl, Maffei, Le, Soler, Jm, Zaidman, Cj, Carnero, Gs, Colombo, Hr, Jure, Ho, Luquez, Ha, Ramos, Hr, Resk, Jh, Rusculleda, Mm, Ulla, Mr, Caccavo, A, Farias, Ef, Wenetz, Lm, Cabella, Pr, Cuadrado, Ja, Chahin, M, Mackinnon, Ij, Zarandon, Rb, Schmidberg, J, Fernandez, Aa, Montana, O, Codutti, Or, Gorosito, Vm, Maldonado, N, Sala, J, De La Fuente RA, Casabella, Te, Di Gennaro JP, Guerrero, Ra, Alvarez, Ms, Berli, M, Botta, Ce, Montenegro, Ee, Vico, Ml, Begg, A, Lehman, R, Gilfillan, Cp, D'Emden, M, Markovic, Tp, Sullivan, D, Aroney, C, Stranks, Sn, Crimmins, Ds, Arstall, M, Van Gaal, W, Davis, T, Aylward, Pe, Amerena, J, William, M, Proietto, J, Purnell, Pw, Singh, B, Arya, Kw, Dart, Am, Thompson, P, Davis, Sm, Carroll, Pa, De Looze, F, Jayasinghe, R, Bhindi, R, Buysschaert, I, Sarens, T, van de Borne, P, Scott, Bp, Roosen, J, Cools, F, Missault, Lh, Debroye, C, Schoors, Df, Hollanders, G, Schroe, Hh, De Sutter, J, Hermans, K, Carlier, M, van Landegem, P, Verwerft, J, Mulleners, T, Delforge, Md, Soufflet, V, Elegeert, I, Descamps, Os, Janssens, S, Lemmens, Rc, Desfontaines, P, Scheen, A, Heijmans, S, Capiau, L, Vervoort, G, Carlier, Sg, Faes, D, Alzand, B, Keuleers, S, De Wolf, L, Thoeng, J, De Bruyne, L, de Santos MO, Felicio, Js, Areas, Ca, Figueiredo, El, Michalaros, Yl, Neuenschwander, Fc, Reis, G, Saad, Ja, Kormann, Ap, Nascimento, Cv, Precoma, Db, Abib, E Jr, dos Santos FR, Mello, Yg, Saraiva, Jf, Rech, Rl, Cerci, R, Fortes, Ja, Rossi, Pr, de Lima, e Silva FA, Hissa, M, Silva, Rp, de Souza WK, Guimarães Filho FV, Mangili, Oc, de Oliveira Paiva MS, Tumelero, R, Abrantes, Ja, Caramori, Pr, Dutra, Op, Leaes, Pe, Manenti, Er, Polanczyk, Ca, Bandeira, e Farias FA, de Moraes Junior JB, Russo, La, Alves AR Jr, Dracoulakis, Md, Ritt, Le, Saporito, Wf, Herdy, Ah, Maia, Ln, Sternieri, Mv, Ayoub, Jc, Bianco, Ht, 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Kotek, Lw, Changlani, M, Zavaro, Sh, Munoz, F, Mehta, Pm, Helm, Rj, Farhat, Nz, Farsad, R, Raoof, Tj, Shultz, Jh, Geohas, Jg, Allaw, Ma, Dela Llana, A, Gutmann, Je, Inzerello, At, Alappat, P, George, Ar, Haddad, Tm, Lillestol, Mj, Grodman, R, Peniston, Jh, Wadud, K, Garcia, B, Hamilton, Me, Lerman, S, Perloff, De, Graff, A, Saxena, S, Alvarado, Op, Malik, A, Reddy, Rd, Kinzfogl, G, Cornett, Gm, Norwood, Pc, Gilbert, Jm, Willis, Jg, Mcgrew, F, Sharma, S, Castro, Ma, Cucher, Fh, Altafullah, Im, Khurana, S, Knutson, Tj, Kinnaman, Sj, Stuckey, T, Pudi, Kk, Mayfield, Rk, Funk, Gs, Nixon, Wa, Dor, I, Boyett, Be, Srivastava, S, Elosegui, Am, Isserman, Sm, Cheek, Hb, Promisloff, Sd, Tami, Lf, Zeig, S, fitz-Patrick, D, Dave, Kn, Ahmad, A, Arain, S, Ballantyne, Cm, Doshi, A, El Hafi SE, Feldman, J, Fragoso, Vg, Gilford, T, Hoffman, As, Pouzar, Je, Vivekananthan, K, Ansari, Sh, Strzinek, Ra, Crater, Ta, Robinson, Jg, Fulmer, Jj, Patel, Am, Pereira, Es, Stich, Ma, Sultan, S, Geskin, G, Ruoff, Ge, Gillespie, E, Bybee, Ka, Moriarty, Pm, Savin, V, Agaiby, Jm, Melucci, Mb, Jantzi, Cm, Davidson, E, Smith, Wb, Treasure, Cb, Wakefield, Ph, Deck, K, Edris, Ma, Gilmore, Rm, Seep, Mk, Andersen, Jl, Detweiler, Ro, Rosenfeld, Jc, Strobl, Dj, Steinhoff, Jp, Adams, A, Estevez, R, Molin, Cj, Kim, Cy, Dy, J, Fox, Ke, Farris, Nr, Wayne, Jd, Whitney, Rt, Randhawa, Pm, Mego, Dm, Macdolnald, L, Caputo, Rp, Rigolosi, R, Vannatta, B, Pacheco, Tr, El-Shahawy, M, Gonzalez, Ej, Guice, Mj, Cherlin, Rs, Bays, He, Shoukfeh, M, Morris, Fh, Loy, J, Vora, Sk, Staab, Pk, Frisoli, A, Kimmel, Ma, Cohen, Aj, Green, Cb, Whitlock, L, Butuk, Dj, Mccartney, Mj, Ables, Lr, Acosta, R, Alvarez, Jg, Barrera, Cm, Benitez, O, Berenguer, Ra, Breton, Cf, Chiong, R, Delgado, Mi, Dufreny, A, Fialkow, Ja, Franczek, S, Frias, Jj, Iglesias, C, Landron-Garcia, L, Llerena, Sn, Martinez, Rf, Miranda, Aa, Morytko, Ja, Rodriguez, Ij, Sotolongo, R, Suarez-Sarmiento, A, Terrelonge, Ae, Vaca, Ce, Venereo, Jm, Verdeza, C, Zeno, Ml, Chilka, S, Felten, Wr, Hartman, An, Shayani, Ss, Duprez, D, Knickelbine, T, Chambers, Jd, Cone, Cl, Broughton, R, Napoli, Mc, Seaton, Bl, Smith, Sk, Reedy, Ma, Kesani, Mk, Nicol, Pr, Stringam, So, Talano, Jv, Barnum, O, Desai, V, Montero, M, Jacks, Rk, Kostis, Jb, Owen, Jg, Makam, Sk, Grosman, I, Underberg, Ja, Masri, Be, Peters, Ss, Serje, J, Lenhard, Mj, Glover, R, Paraboschi, Cf, Lim, Eh, Connery, L, Kipgen, W, Bravo, P, Digiovanna, Mj, Tayoum, H, Gabriel, Jd, Ariani, Mk, Robinson, Mf, Clemens, Pc, Corder, Cn, Schifferdecker, B, Tahirkheli, Nk, Hurling, Rt, Rendell, Ms, Shivaswamy, V, Madu, Ij, Dahl, Cf, Ayesu, K, Kim, C, Barettella, Mb, Jamidar, Ha, Bloom, Sa, Vora, Kn, Ong, St, Aggarwala, G, Sack, G, Blaze, K, Krichmar, P, Murcia, A, Teltser, M, Villaman-Bencosme, Y, Fahdi, Ie, Williams, Dg, Lain, El, Garcia, Hl, Karim, Sn, Francyk, Dm, Gordon, Mb, Palchick, Ba, Mckenzie, Me, Gimness, Mp, Greiff, J, Ruiz-R, L, Vazquez-Tanus, Jb, Schlager, D, Connelly, T, Soroka, E, Hastings, Wl, O’Dea, Dj, Purdy, Da, Jackson, B, Arcanese, Ml, Strain, Je, Schmedtje JF Jr, Jrdavis, Mg, A, A, Prasada, S, Scott, Dl, Vukotic, G, Akhtar, N, Larsen, Dc, Rhudy, Jm, Zebrack, Js, Bailey, Sr, Grant, Dc, Mora, A, Perez, Ja, Reyes, Rg, Sutton, Jc, Brandon, Dm, First, Bp, Risser, Ja, Claudio, J, Figueroa-Cruz, Wl, Sosa-Padilla, Ma, Tan, Ae, Traboulssi, Ma, Morcos, Nc, Glaser, La, Bredlau, Ce, El Shahawy, M, Ramos, Mj, Kandath, Dd, Kaluski, E, Akright, L, Rictor, Kw, Pluto, Tm, Hermany, Pr, Bellingar, B, Clark, Gb, Herrod, Jn, Goisse, M, Hook, M, Barrington, P, Lentz, Jd, Singal, Dk, Gleason, Gp, Lipetz, Rs, Schuchard, Tn, Bonner, Jh, Forgosh, Lb, Lefebvre, Gc, Pierpoint, Be, Radin, Dm, Stoller, Sr, Segall, N, Shah, Sa, Ramstad, Ds, Nisnisan, Jm, Trippett, Jm, Benjamin, Sa, Labissiere, Jc, Nashed, An, Maaieh, M, Aslam, Aa, Mandviwala, M, Budoff, Mj, French, Wj, Vlach, Jj, Destefano, P, Bayron, Cj, Fraser, Nj, Sandberg, Jh, Fagan, Tc, Peart, Bc, Suryanarayana, Pg, Gupta, Dk, Lee, Mw, Bertolet, Bd, Hartley, Pa, Kelberman, M, Behmanesh, B, Buynak, Rj, Chochinov, Rh, Steinberg, Aa, Chandna, H, Bjasker, Kr, Perlman, Rl, Ball, Em, Pock, J, Singh, S, Baldari, D, Kaster, S, Lovell, Jp, Horowitz, Bs, Gorman, Ta, Pham, Dn, Landzberg, Js, Mootoo, Ki, Moon, E, Krawczyk, J, Alfieri, Ad, Janik, Mj, Herrington, Dm, Koilpillai, Rn, Waxler, Ar, Hoffman, Da, Sahul, Zh, Gumbiner, B, Cropp, A, Fujita, K, Garzone, P, Imai, K, Levisetti, M, Plowchalk, D, Sasson, S, Skaggs, J, Sweeney, K, Vincent, J., Curto, M, Ridker, P., Revkin, J., Amarenco, P., Brunell, R., Curto, M., Civeira, F., Flather, M., Glynn, R., Gregoire, J., Jukema, J., Karpov, Y., Kastelein, J., Koenig, W., Lorenzatti, A., Manga, P., Masiukiewicz, U., Miller, M., Mosterd, A., Murin, J., Nicolau, J., Nissen, S., Ponikowski, P., Santos, R., Schwartz, P., Soran, H., White, H., Wright, R., Vrablik, M., Yunis, C., Shear, C., Tardif, J., SPIRE Cardiovascular Outcome Investigators, Averna, M., Brigham and Women's Hospital [Boston], Université Paris Diderot - Paris 7 (UPD7), Université Sorbonne Paris Cité (USPC), RS: CARIM - R3.02 - Hypertension and target organ damage, MUMC+: MA Alg Interne Geneeskunde (9), Interne Geneeskunde, Ridker, P. M., Glynn, R. J., Jukema, J. W., Kastelein, J. J. P., Nicolau, J. C., Santos, R. D., Schwartz, P. F., Wright, R. S., Shear, C. L., Tardif, J. -C., SPIRE Cardiovascular Outcome Investigator, Perrone, Filardi, P, Vascular Medicine, ACS - Amsterdam Cardiovascular Sciences, ACS - Pulmonary hypertension & thrombosis, and ACS - Atherosclerosis & ischemic syndromes

Subjects
Male, STATIN THERAPY, Anticholesteremic Agents/adverse effects, Antibodie, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Injections, Subcutaneous/adverse effects, 030204 cardiovascular system & hematology, Bococizumab, law.invention, PCSK9, 0302 clinical medicine, Randomized controlled trial, law, Risk Factors, GENETIC-VARIANTS, Cardiovascular Disease, Monoclonal, Anticholesteremic Agent, 030212 general & internal medicine, Myocardial infarction, Treatment Failure, Humanized, Proprotein Convertase 9/antagonists & inhibitors, Medicine(all), Antibodies, Antibodies, Monoclonal, Humanized, Anticholesteremic Agents, Cardiovascular Diseases, Cholesterol, LDL, Double-Blind Method, Female, Follow-Up Studies, Humans, Hypercholesterolemia, Injections, Subcutaneous, Lipids, Middle Aged, Proprotein Convertase 9, Medicine (all), PCSK9 Inhibitors, antibodies monoclonal humanized, anticholesteremic agents, cardiovascular diseases, cholesterol, LDL, double-blind method, female, follow-up studies, humans, hypercholesterolemia, injections, subcutaneous, lipids, male, middle aged, proprotein convertase 9, risk factors, treatment failure, medicine (all), Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16], General Medicine, Lipid, 3. Good health, LDL/blood, Multicenter Study, Cholesterol, TRIALS, Cholesterol, LDL/blood, Antibodies, Monoclonal, Humanized/adverse effects, Randomized Controlled Trial, subcutaneous, lipids (amino acids, peptides, and proteins), Cardiovascular Diseases/prevention & control, REDUCING LIPIDS, Human, medicine.medical_specialty, animal structures, Hypercholesterolemia/drug therapy, Placebo, Injections, Subcutaneou, LDL, Injections, Follow-Up Studie, EVENTS, 03 medical and health sciences, Internal medicine, medicine, Journal Article, Comparative Study, METAANALYSIS, Alirocumab, business.industry, Unstable angina, Lipids/blood, Risk Factor, fungi, Antibodies/blood, ta3121, medicine.disease, Surgery, Evolocumab, REDUCTION, Humanized/adverse effects, Subcutaneous/adverse effects, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Item does not contain fulltext BACKGROUND: Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and reduces levels of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the efficacy of bococizumab in patients at high cardiovascular risk. METHODS: In two parallel, multinational trials with different entry criteria for LDL cholesterol levels, we randomly assigned the 27,438 patients in the combined trials to receive bococizumab (at a dose of 150 mg) subcutaneously every 2 weeks or placebo. The primary end point was nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina requiring urgent revascularization, or cardiovascular death; 93% of the patients were receiving statin therapy at baseline. The trials were stopped early after the sponsor elected to discontinue the development of bococizumab owing in part to the development of high rates of antidrug antibodies, as seen in data from other studies in the program. The median follow-up was 10 months. RESULTS: At 14 weeks, patients in the combined trials had a mean change from baseline in LDL cholesterol levels of -56.0% in the bococizumab group and +2.9% in the placebo group, for a between-group difference of -59.0 percentage points (P/=70 mg per deciliter [1.8 mmol per liter] and the median follow-up was 7 months), major cardiovascular events occurred in 173 patients each in the bococizumab group and the placebo group (hazard ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P=0.94). In the higher-risk, longer-duration trial (in which the patients had a baseline LDL cholesterol level of >/=100 mg per deciliter [2.6 mmol per liter] and the median follow-up was 12 months), major cardiovascular events occurred in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to 0.97; P=0.02). The hazard ratio for the primary end point in the combined trials was 0.88 (95% CI, 0.76 to 1.02; P=0.08). Injection-site reactions were more common in the bococizumab group than in the placebo group (10.4% vs. 1.3%, P

Published
2017

29. Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Author

Harjola, V-P, Mebazaa, A, Celutkiene, J, Bettex, D, Bueno, H, Chioncel, O, Crespo-Leiro, MG, Falk, V, Filippatos, G, Gibbs, S, Leite-Moreira, A, Lassus, J, Masip, J, Mueller, C, Mullens, W, Naeije, R, Nordegraaf, AV, Parissis, J, Riley, JP, Ristic, A, Rosano, G, Rudiger, A, Ruschitzka, F, Seferovic, P, Sztrymf, B, Vieillard-Baron, A, Yilmaz, MB, Konstantinides, S, University of Zurich, Harjola, Veli-Pekka, [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Dept Emergency Med & Serv, Emergency Med, Helsinki, Finland -- [Mebazaa, Alexandre] Univers Paris Diderot, Sorbonne Paris Cite, Paris, France -- [Mebazaa, Alexandre] AP HP, Inserm U942, Paris, France -- [Mebazaa, Alexandre] Hop Univ St Louis Lariboisiere, AP HP, Dept Anaesthesia & Crit Care, Paris, France -- [Celutkiene, Jelena] Vilnius Univ, Fac Med, Clin Cardiac & Vasc Dis, Vilnius, Lithuania -- [Bettex, Dominique] Univ Zurich Hosp, Inst Anaesthesiol, Zurich, Switzerland -- [Bueno, Hector] Hosp Univ 12 Octubre, CNIC, Madrid, Spain -- [Bueno, Hector] Hosp Univ 12 Octubre, Inst Invest I 12, Madrid, Spain -- [Bueno, Hector] Hosp Univ 12 Octubre, Dept Cardiol, Madrid, Spain -- [Bueno, Hector] Univ Complutense Madrid, E-28040 Madrid, Spain -- [Chioncel, Ovidiu] Univ Med & Pharm Carol Davila, Inst Emergency Cardiovasc Dis, Bucharest, Romania -- [Crespo-Leiro, Maria G.] CHUAC, Complexo Hosp Univ A Coruna, Unidad Insuficiencia Cardiaca Avanzada & Trasplan, La Coruna, Spain -- [Falk, Volkmar] Deutsch Herzzentrum Berlin, Dept Cardiothorac & Vasc Surg, Berlin, Germany -- [Filippatos, Gerasimos] Athens Univ Hosp Attikon, Athens, Greece -- [Gibbs, Simon -- Riley, Jillian P.] Univ London Imperial Coll Sci Technol & Med, London, England -- [Leite-Moreira, Adelino] Univ Porto, Fac Med, Dept Fisiol & Cirurgia Cardiotorac, Rua Campo Alegre 823, P-4100 Oporto, Portugal -- [Lassus, Johan] Univ Helsinki, Helsinki Univ Hosp, Cardiol, Helsinki, Finland -- [Masip, Josep] Univ Barcelona, Hosp St Joan Despi Moises Broggi, Barcelona, Spain -- [Masip, Josep] Univ Barcelona, Hosp Gen Hosp, Barcelona, Spain -- [Mueller, Christian] Univ Basel Hosp, Dept Cardiol, CH-4031 Basel, Switzerland -- [Mueller, Christian] Univ Basel Hosp, CRIB, CH-4031 Basel, Switzerland -- [Mullens, Wilfried] Hasselt Univ, Fac Med & Life Sci, Genk Biomed Res Inst, Dept Cardiol,Ziekenhuis Oost Limburg, Diepenbeek, Belgium -- [Nordegraaf, Anton Vonk] Free Univ Brussels, Dept Phys, Fac Med, 808 Route Lennik, Brussels, Belgium -- [Parissis, John] Vrije Univ Amsterdam, Medisch Centrum, Amsterdam, Netherlands -- [Parissis, John] Attikon Univ Hosp, Athens, Greece -- [Ristic, Arsen] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia -- [Ristic, Arsen] Univ Belgrade, Sch Med, Belgrade, Serbia -- [Rosano, Giuseppe] IRCCS San Raffaele Hosp Roma, Rome, Italy -- [Rosano, Giuseppe] St Georges Univ London, Cardiovasc & Cell Sci Inst, London, England -- [Rudiger, Alain] Univ Hosp, Cardiosurg Intens Care Unit, Zurich, Switzerland -- [Ruschitzka, Frank] Univ Heart Ctr Zurich, Dept Cardiol Heart Failure Clin & Transplantat, Zurich, Switzerland -- [Seferovic, Petar] Univ Belgrade, Sch Med, Dept Internal Med, Belgrade, Serbia -- [Seferovic, Petar] Univ Belgrade, Heart Failure Ctr, Med Ctr, Belgrade, Serbia -- [Sztrymf, Benjamin] Hop Univ Paris Sud, AP HP, Hop Antoine Beclere, Reanimat Polyvalente, Clamart, France -- [Vieillard-Baron, Antoine] INSERM U 1018, CESP, UVSQ, Team 5,EpReC Renal & Cardiovasc Epidemiol, Villejuif, France -- [Vieillard-Baron, Antoine] Univ Hosp Ambroise Pare, AP HP, Boulogne, France -- [Yilmaz, Mehmet Birhan] Cumhuriyet Univ, Fac Med, Dept Cardiol, Sivas, Turkey -- [Konstantinides, Stavros] Univ Med Ctr Mainz, CTH, Mainz, Germany -- [Konstantinides, Stavros] Democritus Univ Thrace, Dept Cardiol, Alexandroupolis, Greece, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, Lamonaca, Palma -- 0000-0003-4891-2255, Celutkiene, Jelena -- 0000-0003-3562-9274, Chioncel, Ovidiu -- 0000-0002-3197-3628, Bueno, Hector -- 0000-0003-0277-7596, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Rudiger, Alain -- 0000-0001-7943-7624, Leite-Moreira, Adelino -- 0000-0001-7808-3596, Mebazaa, Alexandre -- 0000-0001-8715-7753, and Falk, Volkmar -- 0000-0002-7911-8620

Subjects
Pulmonary Circulation, Cardiac & Cardiovascular Systems, INTENSIVE-CARE-UNIT, 10216 Institute of Anesthesiology, Ventricular Dysfunction, Right, RESPIRATORY-DISTRESS-SYNDROME, Heart failure, 610 Medicine & health, TROPONIN-T ASSAY, 1102 Cardiovascular Medicine And Haematology, 2705 Cardiology and Cardiovascular Medicine, ASSIST DEVICE, Humans, cardiovascular diseases, Right ventricular dysfunction, Cardiogenic shock, INFERIOR MYOCARDIAL-INFARCTION, Heart Failure, Science & Technology, Right ventricular function, ACUTE COR-PULMONALE, Cardiovascular System & Hematology, CARDIOVASCULAR-DISEASE, Echocardiography, Intensive care, CARDIOGENIC-SHOCK, Cardiovascular System & Cardiology, cardiovascular system, 10209 Clinic for Cardiology, ARTERIAL-HYPERTENSION, Life Sciences & Biomedicine, TASK-FORCE
Abstract

WOS: 000373160000002, PubMed ID: 26995592, Acute right ventricular (RV) failure is a complex clinical syndrome that results from many causes. Research efforts have disproportionately focused on the failing left ventricle, but recently the need has been recognized to achieve a more comprehensive understanding of RV anatomy, physiology, and pathophysiology, and of management approaches. Right ventricular mechanics and function are altered in the setting of either pressure overload or volume overload. Failure may also result from a primary reduction of myocardial contractility owing to ischaemia, cardiomyopathy, or arrhythmia. Dysfunction leads to impaired RV filling and increased right atrial pressures. As dysfunction progresses to overt RV failure, the RV chamber becomes more spherical and tricuspid regurgitation is aggravated, a cascade leading to increasing venous congestion. Ventricular interdependence results in impaired left ventricular filling, a decrease in left ventricular stroke volume, and ultimately low cardiac output and cardiogenic shock. Identification and treatment of the underlying cause of RV failure, such as acute pulmonary embolism, acute respiratory distress syndrome, acute decompensation of chronic pulmonary hypertension, RV infarction, or arrhythmia, is the primary management strategy. Judicious fluid management, use of inotropes and vasopressors, assist devices, and a strategy focusing on RV protection for mechanical ventilation if required all play a role in the clinical care of these patients. Future research should aim to address the remaining areas of uncertainty which result from the complexity of RV haemodynamics and lack of conclusive evidence regarding RV-specific treatment approaches.

Published
2016

30. Clinical picture and risk prediction of short-term mortality in cardiogenic shock

Author

Harjola V.-P., Lassus J., Sionis A., Køber L., Tarvasmäki T., Spinar J., Parissis J., Banaszewski M., Silva-Cardoso J., Carubelli V., Di Somma S., Tolppanen H., Zeymer U., Thiele H., Nieminen M.S., and Mebazaa A.

Subjects
cardiovascular risk, Male, angiocardiography, hypotension, systolic blood pressure, glomerulus filtration rate, heart infarction, Shock, Cardiogenic, Heart Valve Diseases, heart failure, complication, fluid resuscitation, Coronary Angiography, Article, acute coronary syndrome, cardiovascular mortality, Risk Factors, middle aged, Humans, human, Prospective Studies, lactate blood level, coronary artery bypass surgery, intensive care, CardShock risk score, ST segment elevation myocardial infarction, cardiogenic shock, lactic acid, risk assessment, clinical trial, prediction, major clinical study, mortality, aged, multicenter study, confusion, female, priority journal, risk factor, valvular heart disease, mean arterial pressure, medical decision making, observational study, disease severity, patient selection, prospective study
Abstract

Aims The aim of this study was to investigate the clinical picture and outcome of cardiogenic shock and to develop a risk prediction score for short-term mortality. Methods and results The CardShock study was a multicentre, prospective, observational study conducted between 2010 and 2012. Patients with either acute coronary syndrome (ACS) or non-ACS aetiologies were enrolled within 6 h from detection of cardiogenic shock defined as severe hypotension with clinical signs of hypoperfusion and/or serum lactate >2 mmol/L despite fluid resuscitation (n = 219, mean age 67, 74% men). Data on clinical presentation, management, and biochemical variables were compared between different aetiologies of shock. Systolic blood pressure was on average 78 mmHg (standard deviation 14 mmHg) and mean arterial pressure 57 (11) mmHg. The most common cause (81%) was ACS (68% ST-elevation myocardial infarction and 8% mechanical complications); 94% underwent coronary angiography, of which 89% PCI. Main non-ACS aetiologies were severe chronic heart failure and valvular causes. In-hospital mortality was 37% (n = 80). ACS aetiology, age, previous myocardial infarction, prior coronary artery bypass, confusion, low LVEF, and blood lactate levels were independently associated with increased mortality. The CardShock risk Score including these variables and estimated glomerular filtration rate predicted in-hospital mortality well (area under the curve 0.85). Conclusion Although most commonly due to ACS, other causes account for one-fifth of cases with shock. ACS is independently associated with in-hospital mortality. The CardShock risk Score, consisting of seven common variables, easily stratifies risk of short-term mortality. It might facilitate early decision-making in intensive care or guide patient selection in clinical trials. Trial registration NCT01374867. © 2015 The Authors. European Journal of Heart Failure © 2015 European Society of Cardiology.

Published
2015

31. Body mass index and mortality in acutely decompensated heart failure across the world: a global obesity paradox

Author

Shah, R, Gayat, E, Januzzi JL Jr, Sato, N, Cohen Solal, A, DI SOMMA, Salvatore, Fairman, E, Harjola, Vp, Ishihara, S, Lassus, J, Maggioni, A, Metra, M, Mueller, C, Mueller, T, Parenica, J, Pascual Figal, D, Peacock, Wf, Spinar, J, van Kimmenade, R, Mebazaa, A, and Great, Network

Subjects
Heart Failure, Male, obesity, Internationality, heart failure, obesity paradox, Acute Disease, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Middle Aged, Obesity, Prospective Studies, Registries, Body Mass Index, Global Health, 80 and over
Published
2014

33. The COACH risk engine: a multistate model for predicting survival and hospitalization in patients with heart failure

Author

Postmus, D., van Veldhuisen, D.J., Jaarsma, T., Luttik, M.L., Lassus, J., Mebazaa, A., Nieminen, M.S., Harjola, V.P., Lewsey, J., Buskens, E., and Hillege, H.L.

Abstract

Aims: Several models for predicting the prognosis of heart failure (HF) patients have been developed, but all of them focus on a single outcome variable, such as all-cause mortality. The purpose of this study was to develop a multistate model for simultaneously predicting survival and HF-related hospitalization in patients discharged alive from hospital after recovery from acute HF.\ud \ud Methods and results: The model was derived in the COACH (Coordinating Study Evaluating Outcomes of Advising and Counseling in Heart Failure) cohort, a multicentre, randomized controlled trial in which 1023 patients were enrolled after hospitalization because of HF. External validation was attained with the FINN-AKVA (Finish Acute Heart Failure Study) cohort, a prospective, multicentre study with 620 patients hospitalized due to acute HF. The observed vs. predicted 18-month survival was 72.1% vs. 72.3% in the derivation cohort and 71.4% vs. 71.2% in the validation cohort. The corresponding values of the c statistic were 0.733 [95% confidence interval (CI) 0.705–0.761] and 0.702 (95% CI 0.663–0.744), respectively. The model's accuracy in predicting HF hospitalization was excellent, with predicted values that closely resembled the values observed in the derivation cohort.\ud \ud Conclusion: The COACH risk engine accurately predicted survival and various measures of recurrent hospitalization in (acute) HF patients. It may therefore become a valuable tool in improving and personalizing patient care and optimizing the use of scarce healthcare resources.

Published
2012

34. Acute heart failure and cardiogenic shock: a multidisciplinary practical guidance

Author

Mebazaa, A., primary, Tolppanen, H., additional, Mueller, C., additional, Lassus, J., additional, DiSomma, S., additional, Baksyte, G., additional, Cecconi, M., additional, Choi, D. J., additional, Cohen Solal, A., additional, Christ, M., additional, Masip, J., additional, Arrigo, M., additional, Nouira, S., additional, Ojji, D., additional, Peacock, F., additional, Richards, M., additional, Sato, N., additional, Sliwa, K., additional, Spinar, J., additional, Thiele, H., additional, Yilmaz, M. B., additional, and Januzzi, J., additional

Published
2015
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35. Influence of ventilation on ignition risk of unburnt gases in the extraction duct of an underventilated compartment fire

Author

Lassus, J., Garo, Jean-Pierre, Vantelon, J.P., Jourda, P., Aine, P., Laboratoire de combustion et de détonique (LCD), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), Langrené, Elsa, and Dupuy, Monique

Subjects
[SPI.FLUID]Engineering Sciences [physics]/Reactive fluid environment, [SPI.FLUID] Engineering Sciences [physics]/Reactive fluid environment, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2009

36. Determination of ignition risk of unburnt gases in the extraction duct of an underventilated compartment fire

Author

Lassus, J., Studer, Etienne, Garo, Jean-Pierre, Vantelon, J.P., Jourda, P., Aine, P., Arnould, F., Laboratoire de combustion et de détonique (LCD), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), Service de Thermo-hydraulique et de Mécanique des Fluides (STMF), Département de Modélisation des Systèmes et Structures (DM2S), CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay

Published
2009

38. Risk of hazardous ignition of unburnt gases in the extraction duct of an underventilated compartment fire

Author

Lassus, J., Studer, Etienne, Garo, Jean-Pierre, Vantelon, J.P., Lamuth, P., Jourda, P., Aine, P., Arnould, F., Laboratoire de combustion et de détonique (LCD), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), Service de Thermo-hydraulique et de Mécanique des Fluides (STMF), Département de Modélisation des Systèmes et Structures (DM2S), CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), and Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay

Published
2008

39. Work in Progress Poster Session

Author

Lassus, J., Studer, E., Garo, Jean-Pierre, Vantelon, Jean-Pierre, Lamuth, P., Jourda, P., Aine, P., Arnould, F., Dupuy, Monique, Laboratoire de combustion et de détonique (LCD), and Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SPI.FLUID]Engineering Sciences [physics]/Reactive fluid environment, [SPI.FLUID] Engineering Sciences [physics]/Reactive fluid environment, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2008

40. Fire of electic/electronic cabinets

Author

Lassus, J., Lamuth, P., Vantelon, J.P., Laboratoire de combustion et de détonique (LCD), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), and Drillaud-Leduc, Sandra

Subjects
ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2007

41. Simulation of ignition of unburnt gases in the extraction vent of a room fire

Author

Lassus, J., Lamuth, P., Gautier, Bertrand, Garo, J.P., Vantelon, J.P., Laboratoire de combustion et de détonique (LCD), Université de Poitiers-ENSMA-Centre National de la Recherche Scientifique (CNRS), Hélium : du fondamental aux applications (HELFA), Institut Néel (NEEL), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), and Drillaud-Leduc, Sandra

Subjects
ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2007

44. Pharmacological management of cardiorenal syndromes.

Author

House, AA, Haapio, M, Lassus, J, Bellomo, R, Ronco, C, House, AA, Haapio, M, Lassus, J, Bellomo, R, and Ronco, C

Abstract

Cardiorenal syndromes are disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The pharmacological management of Cardiorenal syndromes may be complicated by unanticipated or unintended effects of agents targeting one organ on the other. Hence, a thorough understanding of the pathophysiology of these disorders is paramount. The treatment of cardiovascular diseases and risk factors may affect renal function and modify the progression of renal injury. Likewise, management of renal disease and associated complications can influence heart function or influence cardiovascular risk. In this paper, an overview of pharmacological management of acute and chronic Cardiorenal Syndromes is presented, and the need for high-quality future studies in this field is highlighted.

Published
2011

45. Avoidance of dermal exposure to preservatives by packaging

Author

Henricson, Joakim, Lassus, J., Eklund, J., Lassus, S., Anderson, Chris, Henricson, Joakim, Lassus, J., Eklund, J., Lassus, S., and Anderson, Chris

Abstract

Dermal exposure to chemicals in cosmetics and hygiene products (e.g. moisturising creams, soaps, shampoos) is increasingly recognized as an important area for risk assessment and regulation. The contents of such products is regulated by classification of exposure types (e.g. stay on/wash off) and regulatory concepts based on toxicological studies and manufacturing or market experience. Positive lists, negative lists or establishment of recommendations on concentration and exposure form a basis for consumer safety. Common problem areas are perfumes, preservatives and the formation of oxidation products after manufacture. A new patented system, suitable for packages from 100 ml to 5 l, with collapsible plastic bags and unique dosage valves prevents bacteria and air from entering the packaging. Thus the use of preservatives can be avoided. This may lead to a reduced risk of individual reactions to specific preservatives as well as cross-allergy reactions. The consumer no longer needs to hunt for strange names on small ingredient labels. Also, it could prevent the prospective development of allergy. The avoidance of oxidation products is another advantage.

Published
2010

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