Publications by authors named "Florence Beauvais"
Article Synopsis
- The study investigates the use of salt substitutes (saltSubs) for managing sodium intake in patients with chronic heart failure (CHF) in France, focusing on healthcare professional (HCP) recommendations and patient consumption.
- Only 13% of HCPs recommended saltSubs, while 17% of patients and 22% of caregivers reported using them, with those recommended showing a recent hospitalization for acute heart failure.
- The findings revealed that patients advised to use saltSubs were less likely to follow guideline-directed medical therapies (GDMTs), particularly angiotensin-converting enzyme inhibitors and related medications, indicating a potential conflict between saltSubs and standard CHF treatments.
Article Synopsis
- The study aimed to assess the left atrioventricular coupling index (LACI) using cardiac CT as a tool to predict cardiovascular death in patients without known cardiovascular disease.
- Conducted on 1,444 patients over a median follow-up of 6.8 years, results showed that a higher LACI correlates with increased risks of cardiovascular and all-cause death.
- LACI ≥ 25% was identified as a significant predictor for cardiovascular death, demonstrating additional prognostic value beyond traditional risk factors and cardiac CT angiography findings.
Sequencing and titrating approach of therapy in heart failure with reduced ejection fraction following the 2021 European Society of Cardiology guidelines: an international cardiology survey.
Eur J Heart Fail
February 2023
Article Synopsis
- Recent guidelines suggest starting four key heart failure (HF) medications for patients with reduced ejection fraction (HFrEF) at once, but there's uncertainty about how cardiologists view this approach compared to HF specialists.
- A survey with 615 cardiologists globally revealed that most prefer a traditional sequential treatment method, starting with ACE inhibitors or other recommended therapies.
- Although many agree that beginning all four medications during initial hospitalization is doable, there's still a preference for the classic approach, indicating a need for research to alter treatment practices.
Background: Aside from the culprit plaque, the presence of vulnerable plaques in patients with acute coronary syndrome (ACS) may be associated with future cardiac events. A link between calcification and plaque rupture has been previously described.
Aim: To assess whether analysis of the calcium component of coronary plaques using CT angiography, coronary computed tomographic angiography (CCTA) can help to detect additional vulnerable plaques in patients with non-ST elevation myocardial infarction (NSTEMI).
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.
Aims: Hospitalization for acute heart failure (HF) is followed by a vulnerable time with increased risk of readmission or death, thus requiring particular attention after discharge. In this study, we examined the impact of intensive, early follow-up among patients at high readmission risk at discharge after treatment for acute HF.
Methods And Results: Hospitalized acute HF patients were included with at least one of the following: previous acute HF < 6 months, systolic blood pressure ≤ 110 mmHg, creatininaemia ≥ 180 µmol/L, or B-type natriuretic peptide ≥ 350 pg/mL or N-terminal pro B-type natriuretic peptide ≥ 2200 pg/mL.
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.
Introduction: Causes of non-response to cardiac resynchronization therapy (CRT) include mechanical dyssynchrony, myocardial scar, and suboptimal left ventricular (LV) lead location. We aimed to assess the utility of Late Iodine Enhancement Computed Tomography (LIE-CT) with image subtraction in characterizing CRT non-response.
Methods: CRT response was defined as a decrease in LV end-systolic volume > 15% at 6 months.
Article Synopsis
- Transitional care services for patients discharged after acute heart failure aim to reduce rehospitalizations, and smartphone apps present a new way to enhance patient interaction and education.
- A study involving 2822 patients showed that 36% were smartphone users, who tended to be younger, healthier, and more educated than non-users.
- The findings indicate a significant opportunity to create smartphone-based therapeutic education programs to support chronic heart failure patients, as only 22% were actively engaged in existing programs.
Physical activity for patients with heart failure: Position paper from the heart failure (GICC) and cardiac rehabilitation (GERS-P) Working Groups of the French Society of Cardiology.
Arch Cardiovasc Dis
November 2019
Physical activity is important in heart failure to improve functional capacity, quality of life and prognosis, and is a class IA recommendation in the European Society of Cardiology guidelines (Ponikowski et al., 2016). The benefits of exercise training are widely recognized.
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- The use of temporary mechanical circulatory support through venoarterial ECMO is growing for patients with severe acute circulatory failure that doesn't respond to standard treatments.
- Proper implantation and daily management of these devices require specialized expertise and resources.
- The current organization and regulation for managing these patients is unclear, prompting the suggestion for a dedicated territorial structure to enhance care.
Aim: This study aimed at evaluating the effects of sacubitril/valsartan on neprilysin (NEP), and the metabolism of natriuretic peptides in heart failure (HF) and providing additional mechanistic information on the mode of action of the drug.
Methods And Results: We enrolled 73 chronic HF patients who were switched from angiotensin-converting enzyme inhibitor or angiotensin receptor blocker to sacubitril/valsartan. In addition to clinical and echocardiographic assessment, plasma biomarkers were measured at baseline, day 30 and day 90 after initiation of treatment.
Background Cardiac rehabilitation (CR) improves the symptoms, exercise capacity and quality of life of chronic heart failure (CHF) patients. Its effects on new plasma biomarkers of prognostic importance are unknown. The present study aimed at analysing the effects of a structured CR programme on plasma cardiac biomarkers in a large population of patients with CHF and reduced left ventricular ejection fraction (LVEF).
View Article and Find Full Text PDFObjective: Subendocardial viability ratio (SEVR), defined as diastolic to systolic pressure-time integral ratio, is a useful tool reflecting the balance between coronary perfusion and arterial load. Suboptimal SEVR creating a supply-demand imbalance may limit favorable cardiac response to cardiac rehabilitation (CR). To explore this hypothesis, we designed a study to analyze the relationship between baseline SEVR and response to CR in patients with coronary artery disease (CAD).
View Article and Find Full Text PDFValue of Baseline Cardiovascular Mechanics in Predicting Exercise Training Success.
J Cardiopulm Rehabil Prev
December 2017
Purpose: Despite being repeatedly shown that exercise training (ET) increases exercise capacity and decreases mortality in many cardiac conditions, not all patients enjoy the benefits of ET programs. We hypothesized that baseline cardiovascular mechanic properties, including cardiac systolic and diastolic functions, arterial mechanics and ventriculoarterial interaction, may have a role in predicting response to ET.
Methods: Full left ventricular pressure-volume loops were constructed and arterial mechanics were evaluated using echocardiographic and tonometric measurements.
Objective: Functional capacity is one of the cardinal determinants of morbidity and mortality in patients with coronary artery disease (CAD). We hypothesized that baseline cardiovascular mechanics, including cardiac systolic and diastolic functions, arterial mechanics, and ventriculoarterial interaction, may play a role in predicting exercise capacity in patients with CAD.
Methods: Fifty consecutive patients with CAD who were referred to cardiac rehabilitation were prospectively included in the study.
Background: Trans-oesophageal echocardiography (TOE) is one of the major diagnostic tests in cardiovascular medicine, but the procedure is associated with some discomfort for the patient.
Aim: To determine the additive value of hypnosis as a means of improving patient comfort during TOE.
Methods: We randomly assigned 98 patients with non-emergency indications for TOE to a 30-minute hypnosis session combined with topical oropharyngeal anaesthesia (HYP group) or topical oropharyngeal anaesthesia only (CTRL group) before the procedure.
Background: Success of cardiac rehabilitation (CR) is generally assessed by the objective improvement in peak volume of inhaled oxygen (VO2) measured by cardiopulmonary exercise test (CPX). However, cardiac mechanical efficiency and ventricular-arterial coupling (VAC) are the other important dimensions of the heart failure pathophysiology, which are not included in CPX-derived data. The effect of cardiac rehabilitation on left ventricular (LV) efficiency or VAC in unselected heart failure patients has not been studied thus far.
View Article and Find Full Text PDFBackground: A suboptimal ventricular-arterial (VA) interaction may have a prolonged depressing effect on the failing heart after functional reserves forced to their limits under stress conditions such as exercise. The continuation of excessive load in the postexercise period may be more important than the load during exercise, because the sum of postexercise periods generally exceeds exercise time itself. We sought that exercise-induced changes in postexercise VA coupling and pulsatile efficiency in patients with heart failure (HF).
View Article and Find Full Text PDFBackground: Exercise capacity, best reflected by peak exercise oxygen consumption (peak VO(2)), is a powerful prognostic factor in patients with chronic heart failure (CHF). However, the optimal time to assess exercise capacity for prognosis remains unclear and whether an exercise training program (ETP) to improve exercise capacity alters the prognostic value of cardiopulmonary exercise (CPX) testing variables in CHF is unknown.
Methods And Results: CHF patients who underwent an ETP in two cardiac rehabilitation centers between 2004 and 2009 were prospectively included, and CPX testing was performed before and after ETP completion.
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.
Progress in the medical treatment of patients with heart failure with systolic dysfunction, cardiac resynchronization therapy, internal cardiac defibrillators and multidisciplinary management programmes has resulted in dramatic improvements in survival and quality of life; however, this progress has led to an increase in the prevalence of advanced heart failure. In the context of organ shortage for cardiac transplantation, the technological developments in left ventricular assist devices, shown in recent positive clinical studies, provide real hope for patients with advanced heart failure. This article summarizes the most recent clinical studies concerning left ventricular assist devices and discusses for whom and when a left ventricular assist device should be proposed.
View Article and Find Full Text PDFObjectives: This study sought to demonstrate that arterial stiffness is probably underestimated in patients with heart failure with preserved ejection fraction (HFpEF) at rest and may be revealed with moderate exercise.
Background: HFpEF is associated with ventriculoarterial stiffening.
Methods: We compared 23 patients with stable chronic HFpEF, left ventricular ejection fraction >45%, and impaired relaxation with 15 controls without cardiac disease.