Intensive therapeutic education strategy for patients with acute heart failure (EduStra-HF): Design of a randomized controlled trial.

Background: Heart failure is associated with reduced quality of life, hospitalizations, death and high healthcare costs. Despite care improvements, the rehospitalization rate after an acute heart failure episode, especially for acute heart failure, remains high.

Methods: The Education Strategy for patients with acute Heart Failure (EduStra-HF; ClinicalTrials.

An education program for risk factor management after an acute coronary syndrome: a randomized clinical trial.

Importance: Lifestyle improvements after an acute coronary syndrome reduce cardiovascular risk but are difficult to achieve.

Objective: To determine whether a nurse-led or dietician-led cardiovascular risk factor education program would improve risk factor reduction over the long term after an acute coronary syndrome.

Design, Setting, And Participants: The Réseau Insuffisance Cardiaque (RESICARD) PREVENTION: study was a 2-arm, parallel-group, multicenter, randomized clinical trial at 6 tertiary care hospitals in France.

Optimization of heart FailUre medical Treatment after hospital discharge according to left ventricUlaR Ejection fraction: the FUTURE survey.

Background: No clinical practice guidelines are available for the treatment of heart failure (HF) in patients with preserved left ventricular ejection fraction (LVEF).

Aims: To determine how cardiologists manage medical treatment in HF patients after hospital discharge, according to LVEF.

Methods: The FUTURE study was a cross-sectional survey conducted in HF outpatients by French private cardiologists between September 2007 and August 2008.

RESICARD: East Paris network for the management of heart failure: absence of effect on mortality and rehospitalization in patients with severe heart failure admitted following severe decompensation.

Background: Heart failure presents a major public health problem due to its high prevalence and the increasing number of hospital admissions for this condition. A coordinated healthcare network involving general practitioners and cardiologists was set up in the east of Paris in an effort to improve the management and outcomes of patients with severe heart failure.

Aims: To reinforce patient education, improve compliance with medications and identify symptoms requiring treatment modification.

Improvement in the management of chronic heart failure since the publication of the updated guidelines of the European Society of Cardiology. The Impact-Reco Programme.

Aims: Recent studies have shown that prescription rates and doses of recommended drugs for chronic heart failure (CHF) are not optimal in daily practice. The aim of the Impact-Reco programme was to analyse prescription rates of CHF drugs in stable outpatients with CHF related to left ventricular (LV) systolic dysfunction in two similar surveys in France.

Methods And Results: The two surveys, which included 1917 and 1974 patients, were performed between September 2004 to March 2005 and September 2005 to May 2006, respectively.

Is the gap between guidelines and clinical practice in heart failure treatment being filled? Insights from the IMPACT RECO survey.

Background: Recent registries have shown that recommended drugs for the treatment of chronic heart failure (CHF) are under-prescribed in daily practice.

Aims: To determine prescription rates of CHF drugs, and to assess predictive factors for drug prescription using data from a large panel of French cardiologists.

Methods And Results: We included 1919 outpatients, with NYHA class II-IV heart failure and a left ventricular ejection fraction <40%.

[Flecainide by the intravenous route: a new method for decreasing auricular fibrillation].

The action of intravenous flecainide was studied in patients presenting a tachyarrhythmia secondary to a permanent atrial fibrillation of recent onset. We obtained 9 improvements in 15 patients included in the protocol which consisted in the intravenous injection of 2 mg/kg of flecainide in 10 minutes. The side effects were minimal: no sign of cardia insufficiency nor alteration of the arterial blood pressure was noted.

[Agranulocytosis caused by captopril].

Captopril, an inhibitor of the conversion enzyme, is a medication with a known efficacy in the treatment of arterial hypertension and congestive cardiac insufficiency. Its side-effects are few. Among them, agranulocytosis is a severe complication, all the more severe and frequent as it occurs in patients with chronic renal insufficiency, collagen disease, or patient treated with medication having a leucopenic potential.

[Myocardiopathies of Friedreich's disease].

Cardiac involvement in Friedreich's disease is classically a hypertrophic myocardiopathy, concentric or assymmetrical with or without dilatation. It has nothing specific in comparison to other myocardiopathies. Nevertheless, forms with a dilated myocardiopathy are also possible, but much more unfrequent.

[Residual arterial hypertension after excision of an extra-adrenal pheochromocytoma].

Residual arterial hypertension after excision of a pheochromocytoma of the Zuckerkandl organ, has brought the problem of its etiology. The short term approach consisted in performing, after specific biochemical dosages, a scintigram with IMBG, a scan and a magnetic resonance imaging, to look for a second pheochromocytoma. A negative workup enabled to conclude to an essential arterial hypertension.

[Left intraventricular thrombosis. From diagnosis to treatment].

Left ventricular thrombi are the source of much concern in numerous conditions affecting the ventricles. Refinement in echocardiographic and isotopic techniques is enabling earlier diagnosis and a more rational approach to therapy. These thrombi occur very frequently, and are most often asymptomatic (more than 2 to 3 times out of 4), and their natural course is not well known.