Publications by authors named "Biere L"

Background: The anomalous origin of the left circumflex artery from the pulmonary artery (ACXAPA) is a very rare coronary anomaly. Only a few cases have been reported until today, from incidental findings to autopsy reports after sudden cardiac death.

Case Summary: We report here for the first time the case of a man, previously monitored for asymptomatic left ventricular non-compaction cardiomyopathy, who presented with non-ST myocardial infarction and was diagnosed with ACXAPA.

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Importance: Evidence is scarce on the effectiveness of simulation-based training in transesophageal echocardiography (TEE).

Objective: To assess the effectiveness of simulation-based teaching vs traditional teaching of TEE knowledge and skills of cardiology fellows.

Design, Setting, And Participants: Between November 2020 and November 2021, all consecutive cardiology fellows inexperienced in TEE from 42 French university centers were randomized (1:1; n = 324) into 2 groups with or without simulation support.

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Background Following myocardial infarction, left ventricular remodeling (LVR) is associated with heart failure and cardiac death. At the same time, left atrial (LA) remodeling (LAR) is an essential part of the outcome of a wide spectrum of cardiac conditions. The authors sought to evaluate the correlates of LAR and its relationships with LVR after myocardial infarction.

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  • Heart failure (HF) and arrhythmia-related complications significantly impact patients with nonischemic dilated cardiomyopathy (NIDCM), and this study investigates the prognostic value of cardiovascular magnetic resonance (CMR) imaging metrics like T1 and extracellular volume (ECV) for predicting these events.
  • Analyzing 225 NIDCM patients over two years, the study found 26% experienced major adverse cardiovascular events (MACE), with a notable association between increased ECV and HF-related events, while higher T1 Z-scores and ECV values correlated with arrhythmia-related events.
  • The study concluded that specific cutoffs for ECV and T1 Z-scores can be important independent predictors of both
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  • Researchers aimed to enhance predictions for left ventricular remodeling (LVR) within three months post-myocardial infarction (MI) by utilizing machine learning techniques.
  • A study involved 443 ST-elevation MI patients at Angers University Hospital, collecting various clinical, biological, and CMR imaging data to analyze the incidence of LVR using advanced algorithms.
  • The most effective machine learning model, a neural network using seven key variables, achieved a higher accuracy (AUC of 0.78) and sensitivity (92%) compared to conventional models, highlighting the benefits of data-driven approaches in predicting LVR.
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Background: Near-peer tutoring appears to be an efficient approach for teaching clinical skills. However, the clinical experience gained in the form of student medical internships may offset any interest in such tutoring programme. We then investigated the long-term benefits of this programme.

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Aims: Tricuspid regurgitation (TR) is associated with significant morbidity and mortality. Its independent prognostic role has been repeatedly demonstrated. However, this valvular heart condition is largely undertreated because of the increased risk of surgical repair.

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  • This study investigated if colchicine, an anti-inflammatory medication, could reduce heart damage and remodeling after a ST-segment-elevation myocardial infarction (a type of heart attack) by comparing it to a placebo in a double-blind trial.
  • The trial included 192 patients, with no significant differences in heart damage or remodeling observed between the colchicine and placebo groups at both 5 days and 3 months post-treatment.
  • However, patients taking colchicine experienced higher rates of gastrointestinal side effects compared to those on the placebo, suggesting a potential drawback of the treatment.
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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.

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Simulation-based training in transesophageal echocardiography (TEE) seems promising. However, data are limited to non-randomized or single-center studies. To assess the impact of simulation-based vs.

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Introduction: Despite suffering a severe aortic stenosis, some patients are denied either surgical or transcatheter aortic valve implantation (TAVI) therapy because of a frail condition. We aimed to identify whether a comprehensive geriatric assessment (CGA) might be useful to predict the prognosis of presumably frail patients with severe aortic stenosis.

Material And Methods: Between March 2011 and July 2016, 818 patients were consecutively and prospectively enrolled.

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  • Inflammatory processes significantly worsen myocardial damage during ischemia-reperfusion injury in STEMI, leading to serious complications like heart failure and poor recovery.
  • Colchicine, known for its strong anti-inflammatory effects, has shown a promising 50% reduction in infarct size in a phase II trial, compared to placebo, for acute STEMI patients undergoing primary percutaneous coronary intervention (PPCI).
  • The ongoing COVERT-MI trial aims to confirm these findings by comparing a short course of colchicine treatment to placebo in STEMI patients, measuring infarct size and other cardiac health indicators over 5 days.
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In our healthcare system, mindful of patient safety and the reduction of medical errors, simulation-based training has emerged as the cornerstone of medical education, allowing quality training in complete safety for patients. Initiated by anaesthesiologists, this teaching mode effectively allows a gradual transfer of learning, and has become an essential tool in cardiology teaching. Cardiologists are embracing simulation to master complex techniques in interventional cardiology, to manage crisis situations and unusual complications and to develop medical teamwork.

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Background: Postinfarction adverse left ventricular (LV) remodelling is strongly associated with heart failure events. Conicity index, sphericity index and LV global functional index (LVGFI) are new LV remodelling indexes assessed by cardiac magnetic resonance (CMR).

Aim: To assess the predictive value of the new indexes for 1-year adverse LV remodelling in patients with anterior ST-segment elevated myocardial infarction (STEMI).

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This study sought to identify parameters that could guide towards an ischemic origin in patients hospitalized for myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA). MINOCA is challenging in clinical practice, as the pathophysiology is multifaceted. A total of 135 patients with MINOCA who underwent cardiovascular magnetic resonance imaging (CMR) in a single tertiary University Hospital, were retrospectively included.

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Objectives: The aim of this study was to determine the prevalence of myocarditis among patients presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA) in relation to the angiographic severity of nonobstructive coronary artery disease (CAD).

Background: MINOCA represents about 6% of all cases of acute myocardial infarction. Myocarditis is a diagnosis that may be identified by cardiac magnetic resonance (CMR) imaging in patients with a provisional diagnosis of MINOCA.

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Aims: Fifteen to thirty percentage of patients with severe aortic stenosis (AS) have preserved left ventricular ejection fraction (LVEF) and a discordant AS pattern at Doppler echocardiography, which is characterized by a small (<1 cm2) aortic area and low mean aortic gradient (<40 mmHg). The 'Randomized study for the Optimal Treatment of symptomatic patients with low-gradient severe Aortic Stenosis and preserved left ventricular ejection fraction' (ROTAS trial) aims at demonstrating the superiority of aortic valve replacement vs. a 'watchful waiting strategy' in symptomatic patients with low-gradient (LS), severe AS, and preserved LVEF, stratified according to indexed stroke volume, in terms of all-cause mortality or cardiovascular-related hospitalization during follow-up (FU).

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Background: ST-elevation myocardial infarction (STEMI) remains a major cause of mortality despite early revascularization and optimal medical therapy. Tailoring individual management by considering patients' specificities may help in improving post-STEMI survival.

Aim: To evaluate whether in-hospital bleeding complications may be involved in post STEMI prognosis among overweight patients.

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Myocarditis encompasses a wide range of myocardial inflammatory diseases, including acute myocarditis, chronic myocarditis and inflammatory cardiomyopathies, and myocardial inflammation associated with other cardiomyopathies. Because of this heterogeneity in clinical presentation, and the infrequent use of endomyocardial biopsy, cardiac imaging has gradually acquired a key role in the non-invasive detection of myocardial inflammation, the assessment of aetiology and the management of specific therapies. This article summarizes the issue of myocarditis and myocardial inflammation in clinical practice, and reviews the role of different non-invasive imaging techniques in the exploration of myocardial inflammation.

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The ability of remote ischemic preconditioning (RIPC) to prevent contrast-induced nephropathy (CIN) following percutaneous coronary angiography in at-risk patients is controversial. No evidence exists regarding potential RIPC positive effects on renal function and clinical outcomes in the long-term. The PREPARE study was a randomized, prospective, multicenter, and double-blinded trial.

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Presentation of myocarditis in athletes is heterogeneous and establishing the diagnosis is challenging with no current uniform clinical gold standard. The combined information from symptoms, electrocardiography, laboratory testing, echocardiography, cardiac magnetic resonance imaging, and in certain cases endomyocardial biopsy helps to establish the diagnosis. Most patients with myocarditis recover spontaneously; however, athletes may be at higher risk of adverse cardiac events.

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Background: Atrial fibrillation (AF) is common in ST-segment elevation myocardial infarction (STEMI), but its influence on prognosis remains controversial.

Aim: We examined the 1-year prognostic value of AF in STEMI, distinguishing patients with prior AF from patients with de novo AF.

Methods: Between January 2004 and December 2015, 3173 STEMI patients were enrolled in the RIMA registry (Registre des Infarctus en Maine Anjou).

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Background: Although the presence of late gadolinium enhancement (LGE) using cardiovascular magnetic resonance imaging (CMR) is a significant discriminator of events in patients with suspected myocarditis, no data are available on the optimal LGE quantification method.

Methods: Six hundred seventy consecutive patients (48 ± 16 years, 59% male) with suspected myocarditis were enrolled between 2002 and 2015. We performed LGE quantitation using seven different signal intensity thresholding methods based either on 2, 3, 4, 5, 6, 7 standard deviations (SD) above remote myocardium or full width at half maximum (FWHM).

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