Publications by authors named "Jerome Garot"

Article Synopsis
  • This study examined whether an AI-based method for measuring left ventricular ejection fraction (LVEF) during stress tests could better predict death in patients compared to traditional methods.
  • Researchers analyzed data from over 9,700 patients, finding a strong correlation between AI-measured stress LVEF and expert-measured LVEF, as well as a significant association with all-cause mortality.
  • The study concluded that the AI method provides valuable prognostic information that improves risk assessment beyond conventional factors and traditional stress CMR findings.
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Article Synopsis
  • Real-time cardiac magnetic resonance (CMR) allows for detailed imaging of the heart without using contrast agents or X-rays, and CMR-guided right heart catheterization (CMR-RHC) merges this technology with traditional catheterization methods.
  • This study evaluated the feasibility and safety of CMR-RHC in 35 patients needing right heart catheterization from December 2018 to May 2021, finding a high success rate of 91% in obtaining necessary measurements and no adverse effects reported.
  • The procedures averaged 29 minutes for CMR-RHC and 62 minutes total, with good overall comfort reported by both patients and physicians, highlighting the technique's potential for improving cardiac diagnostics.*
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Previous randomized trials have shown a lack of benefits from the addition of revascularization to optimal medical therapy versus optimal medical therapy alone in patients with stable ischaemic heart disease at relatively low risk (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation [COURAGE]), and in diabetic patients with stable ischaemic heart disease (Bypass Angioplasty Revascularization Investigation in Type 2 Diabetics [BARI 2D]). More recently, the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) randomized clinical trial showed similar results in patients with moderate-severe ischaemia on functional testing (imaging or stress electrocardiogram) and at least one significant (> 50%) coronary stenosis in a major epicardial coronary artery on coronarography computed coronary angiography. Although the ISCHEMIA trial adds pivotal knowledge regarding the management of and decision-making in stable patients, this study has prompted a great debate about the role of functional imaging for diagnosis, risk stratification and therapeutic decision-making.

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Article Synopsis
  • A study developed an AI-based system for tracking heart valve motion using cardiac MRI to help diagnose heart dysfunction.
  • The system utilizes two neural networks for locating and tracking key landmarks throughout the cardiac cycle, providing valuable motion parameters such as AVPD, MAPSE, and TAPSE.
  • Results showed high accuracy in measuring motion parameters across a large dataset, indicating the system's effectiveness for analyzing heart valve function.
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  • Cardiovascular disease (CVD) is the leading cause of death in chronic kidney disease (CKD) patients, yet the prognostic value of stress cardiovascular magnetic resonance (CMR) in these patients isn't fully established.
  • * A study analyzed 825 symptomatic CKD patients, focusing on the safety and predictive value of vasodilator stress CMR, while excluding patients with severe kidney impairment due to risks associated with gadolinium.
  • *Results showed that stress CMR was well tolerated and the presence of inducible ischemia significantly increased the risk of major adverse cardiovascular events, highlighting stress CMR as a critical tool for predicting outcomes in CKD patients.
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Background: Capnocytophaga canimorsus is a Gram-negative bacillus commensal of the oral cavities of dogs and cats that can cause human infection after a bite or scratch. Cardiovascular manifestations have included endocarditis, heart failure, acute myocardial infarction, mycotic aortic aneurysm and prosthetic aortitis.

Case Summary: A 37-year-old male presented septic manifestations, ST-segment alterations on the electrocardiogram and troponin rise, 3 days after a dog bite.

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Article Synopsis
  • The study aimed to evaluate if fully automated AI-based global circumferential strain (GCS) measured during stress cardiovascular MRI can provide additional predictive value for major adverse cardiovascular events (MACE).
  • The research involved over 2,100 patients and found that while stress-GCS correlated with MACE in patients with normal stress CMR, it did not predict such events in those with abnormal CMR.
  • The findings suggest that stress-GCS offers better prognostic assessment in individuals with normal CMR compared to traditional methods, despite a low overall event rate among these patients.
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Background: The left atrioventricular coupling index (LACI) is a strong and independent predictor of heart failure (HF) in individuals without clinical cardiovascular disease. Its prognostic value is not established in patients with cardiovascular disease.

Objectives: This study sought to determine in patients undergoing stress cardiac magnetic resonance (CMR) whether fully automated artificial intelligence-based LACI can provide incremental prognostic value to predict HF.

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Introduction: Cardiac lymphoma is a rare but serious disease that is usually located in the right heart. The symptoms (dyspnea, respiratory distress, fatigue, syncope…) are not specific and depend on the mass location. Cardiac magnetic resonance has a crucial role in the diagnostic strategy but biopsy is mandatory to confirm the diagnosis.

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Percutaneous paravalvular leak closure seems a safe alternative to surgery in frail patients. However, it is a challenging procedure that should be tailored to each patient with optimal imaging guidance. Transesophageal echocardiography during the procedure and computed tomography scan/fluoroscopy fusion provide guidance for critical steps, such as PVL localization and crossing.

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Background: Inconclusive non-invasive stress testing is associated with impaired outcome. This population is very heterogeneous, and its characteristics are not well depicted by conventional methods.

Aims: To identify patient subgroups by phenotypic unsupervised clustering, integrating clinical and cardiovascular magnetic resonance data to unveil pathophysiological differences between subgroups of patients with inconclusive stress tests.

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Cardiovascular magnetic resonance has emerged as a very helpful tool for the interventional cardiologists not only in the assessment and treatment of coronary artery disease, but also in the evaluation of various structural cardiac diseases. The main pulse sequences are standardised, acquired during short breath-holds, and include steady-state free precession cines, dynamic myocardial first-pass perfusion imaging during contrast injection, and late enhancement imaging for the identification of myocardial substrates. Less than 30-minute CMR studies are now available for the most common clinical indications.

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Aims: To assess the safety, feasibility, and prognostic value of stress cardiovascular magnetic resonance (CMR) in patients with pacemaker (PM).

Methods And Results: Between 2008 and 2021, we conducted a bi-centre longitudinal study with all consecutive patients with MR-conditional PM referred for vasodilator stress CMR at 1.5 T in the Institut Cardiovasculaire Paris Sud and Lariboisiere University Hospital.

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Background: One-third of ischemic strokes are "cryptogenic" without clearly identified etiology. Although coronary artery disease (CAD) is the main cause of death after stroke, the interest in CAD screening in patients with cryptogenic stroke is still debated.

Aim: The aim of the study was to assess the incremental prognostic value of stress cardiovascular magnetic resonance (CMR) beyond traditional risk factors for predicting cardiovascular events in patients with a prior cryptogenic ischemic stroke.

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Article Synopsis
  • - This study evaluates the prognostic value of stress cardiac magnetic resonance (CMR) imaging for patients with obstructive coronary artery disease (CAD) whose condition is not clearly defined through coronary computed tomography angiography (CTA).
  • - Over a median follow-up of 6.8 years, about 13.8% of the patients experienced major cardiovascular events (MACEs), with factors like inducible ischemia and late gadolinium enhancement showing significant correlations with these events.
  • - The research concluded that stress CMR offers better predictive capabilities for adverse cardiovascular outcomes compared to traditional risk assessments and coronary CTA, highlighting its importance in clinical decision-making for symptomatic patients.
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Background: In patients with suspected or known coronary artery disease, traditional prognostic risk assessment is based on a limited selection of clinical and imaging findings. Machine learning (ML) methods can take into account a greater number and complexity of variables.

Objectives: This study sought to investigate the feasibility and accuracy of ML using stress cardiac magnetic resonance (CMR) and clinical data to predict 10-year all-cause mortality in patients with suspected or known coronary artery disease, and compared its performance with existing clinical or CMR scores.

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The Bifurcation Academic Research Consortium (Bif-ARC) project originated from the need to overcome the paucity of standardization and comparability between studies involving bifurcation coronary lesions. This document is the result of a collaborative effort between academic research organizations and the most renowned interventional cardiology societies focused on bifurcation lesions in Europe, the United States, and Asia. This consensus provides standardized definitions for bifurcation lesions; the criteria to judge the side branch relevance; the procedural, mechanistic, and clinical endpoints for every type of bifurcation study; and the follow-up methods.

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The Bifurcation Academic Research Consortium (Bif-ARC) project originated from the need to overcome the paucity of standardization and comparability between studies involving bifurcation coronary lesions. This document is the result of a collaborative effort between academic research organizations and the most renowned interventional cardiology societies focused on bifurcation lesions in Europe, the United States, and Asia. This consensus provides standardized definitions for bifurcation lesions; the criteria to judge the side branch relevance; the procedural, mechanistic, and clinical endpoints for every type of bifurcation study; and the follow-up methods.

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Introduction: The natural history of acute myocarditis (AM) remains partially unknown and predictors of outcome are debated. We sought to assess the impact of various cardiac magnetic resonance (CMR) parameters on early and long-term prognosis in a population of patients with AM.

Materials And Methods: In a two-center longitudinal study, we included consecutive patients with diagnosis of AM based on CMR and without hemodynamic compromise.

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Background: () is a common cause of mostly self-limiting enterocolitis. Although rare, myocarditis has been increasingly documented as a complication following campylobacteriosis. Such cases have occurred predominantly in younger males and involved a single causative species, namely .

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Objectives: The aim of this study was to compare the costs of a noninvasive cardiac magnetic resonance (CMR)-guided strategy versus 2 invasive strategies with and without fractional flow reserve (FFR).

Background: Coronary artery disease (CAD) is a major contributor to the public health burden. Stress perfusion CMR has excellent accuracy to detect CAD.

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