Publications by authors named "Baudry G"
Article Synopsis
- - The study evaluated cardiologists' awareness and implementation of advanced heart failure (HF) guidelines, revealing significant knowledge gaps, especially among general cardiologists and other participants compared to heart failure specialists.
- - An online survey collected data from 497 cardiologists across Europe, highlighting that 84% of heart failure cardiologists regularly used ESC/HFA criteria for advanced HF, while only 44% of general cardiologists did.
- - The findings emphasize the need for increased education on advanced HF guidelines and improvements in the referral process to ensure patients receive timely and appropriate care.
Article Synopsis
- Impaired left ventricular-arterial coupling (VAC) is linked to worse outcomes in heart disease and heart failure (HF), and this study seeks to understand its relationship with specific proteins related to HF.
- Researchers examined data from 1,309 participants in the STANISLAS family cohort, analyzing how 32 HF-related proteins correlate with VAC measured through pulse wave velocity (PWV) and global longitudinal strain (GLS).
- Results showed that elevated levels of proteins like MMP-2 and NT-proBNP were associated with better VAC, suggesting that these proteins may play a role in the heart's compensatory mechanisms during cardiac stress.
Article Synopsis
- The HYPO-ECMO trial evaluated the effects of moderate hypothermia (MH) versus normothermia in patients with cardiogenic shock (CS) and cardiac arrest (CA) treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO).
- The study analyzed data from 334 intubated patients and found that 48% had experienced CA; mortality rates were higher in the CA group compared to those without CA.
- Results indicated that MH significantly reduced mortality and improved outcomes for patients with CA, suggesting its potential benefit in this high-risk subgroup, though further research is required for confirmation.
Article Synopsis
- Elevated lactate levels play a critical role in predicting outcomes for patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy, with higher levels consistently linked to increased 30-day mortality.
- A post hoc analysis of the HYPO-ECMO trial highlighted that patients with baseline hyperlactatemia (high lactate) had a significantly increased risk of death and that those who experienced a secondary increase in lactate during their ICU stay faced worse outcomes.
- Despite a general trend of sustained high lactate correlating with mortality, a decrease in lactate levels alone did not guarantee survival, emphasizing the complexity of lactate's role in patient prognosis.
Article Synopsis
- Composite outcomes in critical care trials often treat all events equally, which can misrepresent their clinical importance; for example, death is more significant than organ failure.
- The win ratio (WR) method offers an alternative way to evaluate these outcomes by prioritizing events based on their clinical relevance, making it useful for trials with smaller sample sizes common in critical care.
- While WR has potential benefits for more accurately assessing treatment effects, it also faces challenges like ignoring tied outcomes and difficulties in interpreting clinical significance, which are discussed alongside its application to recent trials like HYPO-ECMO.
Aims: Patients who experience hospitalizations due to heart failure (HF) face a significant risk of readmission and mortality. Our objective was to evaluate whether the risk of hospitalization and mortality following discharge from HF hospitalization differed based on adherence to the outpatient follow-up (FU) protocol comprising an appointment with a general practitioner (GP) within 15 days, a cardiologist within 2 months or both (termed combined FU).
Methods And Results: We studied all adults admitted for a first HF hospitalization from 2016 to 2020 in France's Grand Est region.
Aims: Whether aldosterone levels after myocardial infarction (MI) are associated with mid- and long-term left ventricular (LV) remodelling in the era of systematic use of renin-angiotensin system inhibitors is uncertain. We prospectively investigated the relationship between aldosterone levels and mid- and long-term LV remodelling in patients with acute MI.
Methods And Results: Plasma aldosterone was measured in 119 patients successfully treated by primary percutaneous coronary angioplasty for a first acute ST-elevation MI (STEMI) 2-4 days after the acute event.
Article Synopsis
- A prospective study was conducted to examine the association between three specific circulating microRNAs (10a, 92a, 155) and cardiac rejection in heart transplant recipients across 11 centers from August 2016 to March 2018.
- The study involved 461 patients and 831 biopsies, of which 79 indicated rejection; however, the interim analysis found no significant association between the microRNAs and rejection diagnosis.
- Ultimately, the research concluded that monitoring these microRNAs does not provide clinical utility for heart transplant recipients, leading to the decision to halt further analysis for futility.
Aims: The prognostic value of 'high dose' loop diuretics in advanced heart failure outpatients is unclear. We aimed to assess the prognosis associated with loop diuretic dose in ambulatory patients awaiting heart transplantation (HT).
Methods And Results: All ambulatory patients (n = 700, median age 55 years and 70% men) registered on the French national HT waiting list between 1 January 2013 and 31 December 2019 were included.
Article Synopsis
- Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a critical treatment for patients experiencing severe early graft dysfunction after heart transplant, and the study aims to analyze mortality rates, complications, and prognostic factors associated with its use.
- The research involved a systematic review of 49 studies and included individual patient data from 448 patients, revealing a 30-day mortality rate of 33% and a 1-year mortality rate of 50% in those receiving VA-ECMO.
- The findings highlight the need for further research to improve VA-ECMO strategies, as factors like older age and prior surgeries are linked to higher mortality rates.
Article Synopsis
- Severe primary graft dysfunction is a major cause of death within 30 days after heart transplantation, and this study evaluates the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in these cases.
- Out of 397 heart transplant patients studied, 15.1% experienced severe primary graft dysfunction needing VA-ECMO, with a significant portion (53.3%) surviving to discharge.
- Key factors influencing in-hospital mortality included pre-transplant inotropic support, total ischemic time, and blood transfusion within 48 hours, indicating areas for improving patient outcomes.
Article Synopsis
- The study investigated the relationship between donor-specific antibodies (DSA) and outcomes like cardiac allograft vasculopathy (CAV) and long-term mortality in heart transplant patients.
- Out of 282 patients, 18% developed de novo DSA during follow-up, with those having complement-binding abilities (DSA+C3d+) showing a significantly higher risk for severe CAV or mortality compared to those without DSA.
- The findings suggest that screening for DSA and their ability to bind complement can help improve patient monitoring and outcomes in heart transplant cases.
Article Synopsis
- Heart transplantation remains a critical treatment option but faces challenges due to a shortage of available organs; this study investigates the Forrester classification to predict cardiorenal complications in patients awaiting transplants.
- Analyzing 100 patients, researchers categorized them based on their congestion status, finding that systemic congestion significantly predicts adverse outcomes like cardiogenic shock and acute kidney injury, while pulmonary congestion does not show the same predictive value.
- The results suggest that assessing systemic congestion is vital for forecasting serious events like waitlist death or the need for an emergency heart transplant within a year.
Article Synopsis
- The study evaluates the effectiveness of Forrester's perfusion/congestion profiles in predicting outcomes for non-inotrope advanced heart failure patients on the heart transplant waitlist in France.
- Among the 837 patients assessed, those in 'warm-dry', 'cold-dry', 'warm-wet', and 'cold-wet' categories showed varying rates of adverse outcomes, with 'wet' profiles having significantly worse prognoses.
- The findings highlight that persistent congestion is a critical factor impacting survival and treatment urgency for advanced heart failure patients awaiting transplantation.
Article Synopsis
- There is ongoing debate about the effectiveness of salt-restricted diets in managing heart failure, with current dietary guidelines lacking consistency and supporting evidence.
- The OFICSel observatory collected data from 2822 patients hospitalized for heart failure, examining the relationship between cardiologists' dietary recommendations and patients’ understanding and adherence to these diets.
- Findings reveal that while 90% of patients received a recommendation for a diet with less than 6g of salt per day, only 33% adhered to it, and restrictive diets increased the perceived burden on patients, indicating a need for more evidence-based dietary guidelines.
Article Synopsis
- Abnormal renal function is common in heart transplant patients, and this study focused on identifying the haemodynamic factors linked to low estimated glomerular filtration rate (eGFR) before and after transplantation.
- It analyzed data from 176 adults, revealing that a central venous pressure greater than 10 mmHg significantly increases the risk of poor renal function at the time of heart transplant listing.
- Additionally, patients with low cardiac index before transplant generally experienced better recovery of renal function, especially those with low eGFR initially.*
Article Synopsis
- Advanced heart failure patients often experience delays in being referred for mechanical circulatory support, specifically left ventricular assist devices (LVAD), which raises concerns about their survival rates post-implantation.
- The study analyzed data from the ASSIST-ICD registry involving 303 non-inotrope-dependent patients, discovering that factors like older age and certain surgical procedures significantly increase mortality risk after receiving an LVAD.
- Despite LVAD support, survival rates over five years remain low, highlighting the need for improved patient selection to enhance outcomes in such high-risk individuals.
Article Synopsis
- Cardiovascular issues have been recognized as significant problems in COVID-19 patients, contributing to worse outcomes.
- Proper medical treatments can manage most heart-related symptoms, while severe cases of cardiogenic shock may require advanced support like veno-arterial extracorporeal membrane oxygenation (VA-ECMO).
- The document describes a specific case of a patient suffering from heart injury due to COVID-19, who was treated successfully with VA-ECMO after experiencing severe heart dysfunction.
Article Synopsis
- * A study of 19 dobutamine-dependent patients revealed a one-year survival rate of 32%, with a notable incidence of catheter-related adverse events in 26% of cases.
- * Key biological predictors for survival identified include a glomerular filtration rate greater than 60 mL/min and a brain natriuretic peptide level below 1000 ng/L, helping to guide treatment decisions and potential referrals to palliative care.
Article Synopsis
- Acute heart failure (AHF) is a serious condition that causes about 5% of emergency hospital admissions in Europe, with the study involving 793 patients, mostly men around 72 years old.
- Many patients experienced symptoms like dyspnea and lower limb edema before seeking help, with about half showing symptoms for over 15 days prior to hospitalization.
- Referral methods varied, with emergency services often called during acute symptoms, while cardiologists were typically consulted for longer-standing issues; the study recommends enhancing AHF treatment networks in the French healthcare system for better patient care.