Publications by authors named "Guillaume Schurtz"
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 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.
Background: 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.
View Article and Find Full Text PDFBackground: Intensive cardiac care units (ICCUs) were created to manage ventricular arrhythmias after acute coronary syndromes, but have diversified to include a more heterogeneous population, the characteristics of which are not well depicted by conventional methods.
Aims: To identify ICCU patient subgroups by phenotypic unsupervised clustering integrating clinical, biological, and echocardiographic data to reveal pathophysiological differences.
Methods: During 7-22 April 2021, we recruited all consecutive patients admitted to ICCUs in 39 centers.
Background: Evaluation of the residual risk in patient with chronic coronary syndrome is challenging in daily practice. Several types of events (myocardial infarction, ischemic stroke, bleeding, and heart failure [HF]) may occur, and their impact on subsequent mortality is unclear in the era of modern evidence-based pharmacotherapy.
Methods: CORONOR (Suivi d'une cohorte de patients Coronariens stables en région Nord-pas-de-Calais) is a prospective multicenter cohort that enrolled 4184 consecutive unselected outpatients with chronic coronary syndrome.
Tricuspid annular plane systolic excursion over systolic pulmonary artery pressure prognostic value for in-hospital adverse events in patients hospitalized for acute coronary syndrome.
Eur Heart J Cardiovasc Imaging
August 2024
Article Synopsis
- 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.
Background: Cardiovascular diseases (CVDs) are currently the leading cause of maternal death in Western countries. Although multidisciplinary cardio-obstetric teams are recommended to improve the management of pregnant women with CVD, data supporting this approach are scarce.
Aims: To describe the characteristics and outcomes of pregnant patients with CVD managed within the cardio-obstetric programme of a tertiary centre.
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 PDFUnlabelled: We report the case of a redo Ross surgery complicated by an ostial left circumflex occlusion requiring emergent percutaneous coronary intervention. The latter was complicated by coronary perforation treated by two covered stents with V-stenting technique. After immediate success, the clinical course was marked by acute stent thrombosis requiring emergent coronary bypass.
View Article and Find Full Text PDFPurpose: The severity of bleeding events is heterogeneously defined during peripheral veno-arterial extracorporeal membrane oxygenation (pVA-ECMO). We studied three bleeding definitions in pVA-ECMO: the Extracorporeal Life Support Organization (ELSO)-serious bleeding, the Bleeding Academic Research Consortium (BARC), and the universal definition of postoperative bleeding (UPDB) classifications.
Methods: We included consecutive adult patients supported by pVA-ECMO for refractory cardiogenic shock admitted to Lille academic hospitals between January 2013 and December 2019.
Article Synopsis
- - The study investigated the use of the TAPSE/sPAP ratio, measured by echocardiography, to predict in-hospital major adverse cardiovascular events (MACEs) in patients hospitalized for acute heart failure (AHF) across multiple French hospitals.
- - A total of 333 patients were included, revealing that a TAPSE/sPAP ratio of less than 0.40 mm/mmHg was independently linked to a higher risk of in-hospital MACEs, which occurred in 15% of patients studied.
- - The findings suggest that early assessment of TAPSE/sPAP can improve risk stratification in AHF patients and may prompt closer monitoring and intervention strategies.
Article Synopsis
- Intensive cardiac care units (ICCU) in France have diversified from monitoring arrhythmias post-heart attack to treating various cardiac conditions, with acute coronary syndromes (ACS) being the most common cause for admission.
- A study of 1499 patients revealed that many have additional health concerns, with a significant portion requiring advanced therapies but a majority not needing invasive procedures.
- Overall, patients tend to have brief hospital stays with a low rate of major adverse events, although acute heart failure (AHF) patients face higher risks and resource use.
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 study evaluated the prognostic significance of non-invasive parameters related to ventricular-arterial coupling (VAC) in patients with left ventricular ejection fraction (LVEF) ≥40% after a myocardial infarction (MI).
- Using echocardiography and arterial tonometry, researchers measured VAC parameters during rest and a handgrip test in 374 patients, tracking major adverse cardiovascular events (MACE) over a median of 32 months.
- Results indicated that the PWV/GLS ratio was the most useful parameter for identifying high-risk patients for MACE after MI, suggesting it adds valuable information beyond traditional assessment methods.
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.
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 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.
View Article and Find Full Text PDFArticle Synopsis
- 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
- Despite advancements in treating acute myocardial infarction complicated by cardiogenic shock (AMICS), patients still face high incidence and mortality rates, prompting investigation into better treatment options.
- The ULYSS trial plans to evaluate the effectiveness of the IMPELLA CP device in enhancing patient outcomes compared to standard treatment during percutaneous coronary intervention.
- This study will focus on short-term outcomes like death and the need for advanced support at one month, while also reviewing long-term safety, efficacy, and costs of the treatment.