Publications by authors named "Gerbaud E"
Article Synopsis
- The study focused on the use of a machine learning model using initial transthoracic echocardiography (TTE) to predict in-hospital major adverse events (MAEs) in patients admitted to intensive cardiac care units (ICCU).
- A total of 1,499 patients were evaluated, and the model showed significant accuracy, highlighting five key TTE parameters that contributed to its predictions.
- The machine learning model outperformed traditional scoring methods, indicating it could serve as a better tool for risk stratification in heart patients.
Background: Despite improvement in devices, in-stent restenosis remains a frequent and challenging complication of percutaneous coronary interventions.
Methods And Results: The RESTO (Morphological Parameters of In-Stent Restenosis Assessed and Identified by OCT [Optical Coherence Tomography]; study NCT04268875) was a prospective multicenter registry including patients presenting with coronary syndromes related to in-stent restenosis. All patients underwent preintervention OCT analysis, which led to analysis of in-stent restenosis phenotype, number of strut layers, and presence of stent underexpansion.
Background: Despite scarce data, invasive mechanical ventilation (MV) is widely suggested as first-line ventilatory support in cardiogenic shock (CS) patients. We assessed the real-life use of different ventilation strategies in CS and their influence on short and mid-term prognosis.
Methods: FRENSHOCK was a prospective registry including 772 CS patients from 49 centers in France.
Different types of macrophages (Mφ) are involved in atherogenesis, including inflammatory Mφ and foamy Mφ (FM). Our previous study demonstrated that two-photon excited fluorescence (TPEF) imaging of NADH and FAD autofluorescence (AF) could distinguish experimental models that mimic the different atherosclerotic Mφ types. The present study assessed whether optical differences correlated with phenotypic and functional differences, potentially guiding diagnostic and therapeutic strategies.
View Article and Find Full Text PDFBackground: Cardiogenic shock and sepsis are severe haemodynamic states that are frequently present concomitantly, leading to substantial mortality. Despite its frequency and clinical significance, there is a striking lack of literature on the outcomes of combined sepsis and cardiogenic shock.
Methods: FRENSHOCK was a prospective registry including 772 patients with cardiogenic shock from 49 centres.
Inflammatory processes are involved not only in coronary artery disease but also in heart failure (HF). Cardiogenic shock (CS) and septic shock are classically distinct although intricate relationships are frequent in daily practice. The impact of admission inflammation in patients with CS is largely unknown.
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- The study investigated the prognostic value of the TAPSE/sPAP ratio in patients hospitalized for acute coronary syndrome (ACS), focusing on its link to in-hospital major adverse cardiovascular events (MACEs).
- In a cohort of 481 patients, a TAPSE/sPAP ratio below 0.55 was found to significantly predict the occurrence of MACEs, with odds ratios indicating a very strong association even after accounting for other health factors.
- The findings highlight that a lower TAPSE/sPAP ratio improves risk assessment beyond conventional factors, suggesting it could serve as a critical marker for patient prognosis during hospitalization for ACS.
Article Synopsis
- * In a study involving 772 patients with cardiogenic shock, 21.3% had CKD, and these patients were generally older and had more health issues, which contributed to increased mortality.
- * Renal replacement therapy (RRT) was associated with a higher risk of death regardless of CKD status, highlighting the need for collaborative care between cardiac and kidney specialists to better manage these patients.
Background: Cardiogenic shock (CS) is the most severe form of acute heart failure. Discrepancies have been reported between sexes regarding delays, pathways and invasive strategies in CS complicating acute myocardial infarction. However, effect of sex on the prognosis of unselected CS remains controversial.
View Article and Find Full Text PDFBackground: Myocarditis is commonly diagnosed in the intensive care cardiology unit (ICCU). No current recommendation nor guideline aids exist for aetiological assessments.
Methods: From September 2021 to October 2023, 84 patients with acute myocarditis underwent thorough and systematic serum and blood cell panel evaluations to determine the most common causes of myocarditis.
Background: The effects of pharmacological therapy on cardiogenic shock (CS) survivors have not been extensively studied. Thus, this study investigated the association between guideline-directed heart failure (HF) medical therapy (GDMT) and one-year survival rate in patients who are post-CS.
Methods And Results: FRENSHOCK (French Observatory on the Management of Cardiogenic Shock in 2016) registry was a prospective multicenter observational survey, conducted in metropolitan French intensive care units and intensive cardiac care units.
Article Synopsis
- Smoking cigarettes leads to elevated carbon monoxide (CO) levels in the blood, which can reduce oxygen capacity and potentially worsen outcomes for smokers experiencing acute cardiac events.
- A study of 1,379 patients in France found that 27% were active smokers and those with CO levels above 11 parts per million (ppm) had a significantly higher risk of death and major adverse cardiac events (MAE).
- Elevated CO levels were shown to be independently linked to a 6-fold increase in one-year mortality and a 10-fold increase in in-hospital MAE among smokers, regardless of other health factors.
Background: Beta blockers (BBs) are a cornerstone for patients with heart failure (HF) and ventricular dysfunction. However, their use in patients recovering from a cardiogenic shock (CS) remains a bone of contention, especially regarding whether and when to reintroduce this class of drugs.
Methods: FRENSHOCK is a prospective multicenter registry including 772 CS patients from 49 centers.
Article Synopsis
- - The beta-adrenergic signaling pathway is crucial in managing heart failure (HF), with beta-blockers (BBs) being the first-line treatment for patients with HF and reduced ejection fraction (HFrEF).
- - In cases of severe acute heart failure (AHF), particularly those recovering from cardiogenic shock, starting BB therapy can be risky due to a lack of comprehensive data.
- - An expert consensus has been developed to review existing studies on BB use in severe decompensated AHF and offers a practical algorithm for prescribing and monitoring BB therapy in critical conditions.
(1) Background: Percutaneous coronary interventions (PCI) in patients with acute coronary syndrome (ACS) are performed with titanium-nitride-oxide-coated stents (TiNOSs) or drug-eluting stents (DESs). The initial completion of this prospective systematic literature review (SLR) of prospective randomized controlled trials (RCTs) showed that TiNOSs are non-inferior to DESs in major adverse cardiac event (MACE) rates and present a lower risk of recurrent myocardial infarction (MI) at 1-year follow-up. This iteration of the SLR protocol performs the critical assessment of 5-year follow-up outcomes with clinical validity and generalizability assessments.
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- The study examines heart failure and cardiogenic shock (CS) in older adults, highlighting that the incidence is rising due to an aging population, with limited data available on this demographic.
- The research involved a registry called FRENSHOCK, which included 772 CS patients, revealing that 30.6% were over 75 years old, with higher comorbidities and lower treatment intensity compared to younger patients.
- Results indicated that older adults have more than double the risk of death at 1 month and 1 year post-CS, emphasizing the need for targeted research to determine effective treatment strategies for this age group.
Background: Cardiogenic shock (CS) is the most severe form of heart failure (HF), resulting in high early and long-term mortality. Characteristics of CS secondary to supraventricular tachycardia (SVT) are poorly reported. Based on a large registry of unselected CS, we aimed to compare 1-year outcomes between SVT-triggered and non-SVT-triggered CS.
View Article and Find Full Text PDFAims: Short-term mechanical circulatory support (STMCS) may be used as an intentional escalation strategy to treat refractory cardiogenic shock (rCS). However, with growing technical possibilities, making the right choice at the right time can be challenging. We established a shock team in January 2013 comprising a cardiac anaesthetist-intensivist, an interventional cardiologist, and a cardiac surgeon.
View Article and Find Full Text PDFIdiopathic dilated cardiomyopathy (IDCM) is one of the most common forms of nonischemic cardiomyopathy worldwide, possibly leading to cardiogenic shock (CS). Despite this heavy burden, the outcomes of CS in IDCM are poorly reported. Based on a large registry of unselected CS, our aim was to shed light on the 1-year outcomes after CS in patients with and without IDCM.
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- The study investigates the impact of skin mottling on patients with cardiogenic shock, finding that nearly 39% of patients showed mottling at admission, which is linked to worse outcomes.
- In a cohort of 772 patients, those with mottling had higher rates of invasive support, longer hospital stays, and increased mortality at both 30 days and 1 year compared to those without mottling.
- The study concludes that skin mottling can be a valuable assessment tool in guiding therapy for cardiogenic shock patients, indicating the need for more aggressive treatment to improve survival chances.
Article Synopsis
- Cardiogenic shock is a rare condition in adults with congenital heart disease (ACHD), making up only 0.9% of cases in a nationwide registry study in France.
- The study found that ACHD patients were younger and had fewer risk factors for cardiovascular issues compared to non-ACHD patients, but they still experienced a high rate of severe outcomes after one year, similar to non-ACHD patients.
- Management strategies differed significantly, with ACHD patients more likely to receive catheterizations and device implantations while less likely to use temporary circulatory support or invasive ventilation.
Characteristics, management, and outcomes of active cancer patients with cardiogenic shock.
Eur Heart J Acute Cardiovasc Care
October 2023
Article Synopsis
- This study explored the characteristics, management, and outcomes of patients with active cancer who were admitted for cardiogenic shock, finding that they made up about 6.6% of the 772 enrolled patients.
- Although active cancer patients had similar initial in-hospital outcomes as non-cancer patients, they required more intensive drug management but received less mechanical support.
- While both groups had similar 30-day mortality rates, the active cancer group had significantly higher long-term mortality rates at 1 year, indicating that active cancer dramatically impacts survival after initial treatment for cardiogenic shock.