Publications by authors named "Katrien Blanchart"
Background: Coronary chronic total occlusions (CTO) are frequent, and coronary angioplasty has been increasingly used in recent years for lesion revascularisation. However, to date, no dedicated multicentric prospective study is available in France.
Aim: To describe the characteristics of CTO patients and to assess current treatment strategies in French catheterisation laboratory practice.
Article Synopsis
- The study evaluated the CardioMEMS™ HF System in 103 French patients to assess its feasibility, safety, and clinical benefits post-implantation.
- Over two years, no device-related complications were reported, and the system showed a 50% reduction in heart failure hospitalizations compared to the year before implantation.
- Additionally, patients experienced lower pulmonary artery pressures and improvements in their functional class and overall quality of life.
Article Synopsis
- Predicting outcomes for patients receiving Left Ventricular Assist Devices (LVADs) is crucial, but current methods focusing on right ventricular function are lacking in prognostic value.
- The study utilized data from the ASSIST-ICD registry to evaluate right ventriculoarterial coupling as a potential predictor of all-cause mortality upon LVAD implantation.
- Findings showed that while some measures like TAPSE/sPAP and PAPi were not linked to long-term survival, the ratio of right atrial pressure to pulmonary capillary wedge pressure (RAP/PCWP) was significantly associated with increased mortality, maintaining its relevance even after adjusting for other risk factors.
Article Synopsis
- A prospective study was conducted to examine the association between three specific circulating microRNAs (10a, 92a, 155) and cardiac rejection in heart transplant recipients across 11 centers from August 2016 to March 2018.
- The study involved 461 patients and 831 biopsies, of which 79 indicated rejection; however, the interim analysis found no significant association between the microRNAs and rejection diagnosis.
- Ultimately, the research concluded that monitoring these microRNAs does not provide clinical utility for heart transplant recipients, leading to the decision to halt further analysis for futility.
Aims: The prognostic value of 'high dose' loop diuretics in advanced heart failure outpatients is unclear. We aimed to assess the prognosis associated with loop diuretic dose in ambulatory patients awaiting heart transplantation (HT).
Methods And Results: All ambulatory patients (n = 700, median age 55 years and 70% men) registered on the French national HT waiting list between 1 January 2013 and 31 December 2019 were included.
Heart transplantation as a rescue strategy for patients with refractory electrical storm.
Raphael P Martins Mathilde Hamel-Bougault Francis Bessière Matteo Pozzi Fabrice Extramiana Katrien Blanchart
Eur Heart J Acute Cardiovasc Care
September 2023
Article Synopsis
- Heart transplantation (HT) may be a lifesaving option for patients experiencing severe refractory electrical storm (ES), a condition characterized by uncontrollable heart arrhythmias, with limited existing data on this approach.
- A retrospective study involving 45 patients from 11 French centers revealed that 28.9% experienced in-hospital mortality, with predictors including kidney function and the need for immediate post-operative support.
- One-year survival after surgery was reported at 68.9%, indicating that while many patients can recover and be discharged, significant risks remain, highlighting the need for larger studies to better understand patient outcomes.
Article Synopsis
- The study evaluates the effectiveness of Forrester's perfusion/congestion profiles in predicting outcomes for non-inotrope advanced heart failure patients on the heart transplant waitlist in France.
- Among the 837 patients assessed, those in 'warm-dry', 'cold-dry', 'warm-wet', and 'cold-wet' categories showed varying rates of adverse outcomes, with 'wet' profiles having significantly worse prognoses.
- The findings highlight that persistent congestion is a critical factor impacting survival and treatment urgency for advanced heart failure patients awaiting transplantation.
Article Synopsis
- Wait times for transcatheter aortic valve replacement (TAVR) are linked to higher one-year mortality rates following the procedure.
- A study of 383 patients revealed an average wait time of 144 days, with 14.4% experiencing death within a year post-TAVR.
- Longer wait times increased the risk of mortality by 2% for each week after referral, highlighting the importance of reducing delays in patient access to TAVR.
Article Synopsis
- The study examines the relationship between first medical contact-to-balloon time and 1-year mortality in patients with ST-elevation myocardial infarction (STEMI), focusing on the effects of direct vs. indirect transfer to cardiac catheterization laboratories (CCLs).
- Out of 2,206 STEMI patients, those indirectly admitted to CCL had a higher mortality rate (14.6%) compared to direct admissions (7.7%), highlighting that indirect admissions correlate with worse outcomes despite similar FMC-to-balloon times.
- Key factors influencing indirect admission included older age and the type of initial medical contact (like paramedic response), indicating a need for better population education and care coordination, especially for elderly
Article Synopsis
- The study investigates the outcomes of cardiogenic shock patients receiving temporary circulatory support (TCS) as a bridge to left ventricular assist device (LVAD) implantation, comparing them to patients without TCS.
- Out of 329 patients analyzed, those under TCS had similar 30-day survival rates to those who had TCS removed or did not use a bridging strategy but experienced longer ICU stays and increased mechanical ventilation time.
- Key predictors of mortality in the TCS group include combined surgery with LVAD, body mass index (BMI), and duration of heart failure, while the use of TCS itself did not significantly impact survival rates.
Article Synopsis
- The study focuses on adults with congenital heart disease (ACHD), who often suffer from heart failure (HF) due to past surgeries and require better treatment data to improve their care.
- Researchers will collect data from a multi-country register, the ARTORIA-R, identifying ACHD patients listed for heart transplantation from 1989-2020, using both retrospective and prospective methods.
- The goal is to track outcomes like clinical worsening, death on the waiting list, and overall mortality after transplantation to enhance understanding and management of advanced heart failure in this population.
Article Synopsis
- Advanced heart failure patients often experience delays in being referred for mechanical circulatory support, specifically left ventricular assist devices (LVAD), which raises concerns about their survival rates post-implantation.
- The study analyzed data from the ASSIST-ICD registry involving 303 non-inotrope-dependent patients, discovering that factors like older age and certain surgical procedures significantly increase mortality risk after receiving an LVAD.
- Despite LVAD support, survival rates over five years remain low, highlighting the need for improved patient selection to enhance outcomes in such high-risk individuals.
Article Synopsis
- The study aimed to evaluate the safety and benefits of adding glycoprotein IIb-IIIa inhibitors (GPIs) to more potent P2Y12 inhibitors in patients with ST-segment elevation myocardial infarction (STEMI).* -
- Researchers analyzed data from a registry of STEMI patients who underwent primary percutaneous coronary intervention and were already on newer P2Y12 inhibitors, finding that 41% of them received GPIs.* -
- The results indicated that using GPIs did not increase mortality or bleeding risks compared to patients who did not receive them, suggesting GPIs can be safely combined with modern treatments for STEMI patients.*
Article Synopsis
- Older patients undergoing PCI face high risks for both bleeding and ischemic events, raising concerns about the duration of dual antiplatelet therapy (DAPT).
- A meta-analysis of four studies with nearly 9,000 older patients showed that short-duration DAPT (≤ 3 months) had similar rates of major bleeding and efficacy compared to standard-duration therapy.
- The findings suggest that short DAPT could be a viable option for older patients after PCI, but more targeted research is needed to determine the best duration of antiplatelet therapy for this group.
Article Synopsis
- LVAD implantation in patients with recently diagnosed cardiomyopathy is under-researched, and this study aims to explore characteristics and outcomes of such patients within 30 days of their diagnosis.
- Out of 652 patients studied, 117 had recently diagnosed cardiomyopathy and experienced LVAD implantation after an average of 15 days, showing they were generally younger and had more severe symptoms compared to those with remote diagnoses.
- Although immediate postoperative survival rates were similar between groups, patients with recently diagnosed cardiomyopathy had improved long-term survival, with certain factors like sudden cardiac arrest identified as risk indicators for higher mortality.
Article Synopsis
- The ALPHEUS study aimed to determine if ticagrelor is more effective than clopidogrel in reducing heart muscle injury during elective PCI in stable coronary patients.
- Conducted across 49 hospitals in France and the Czech Republic, it involved 1910 participants who were randomly assigned to receive either ticagrelor or clopidogrel before the procedure.
- Results showed no significant difference in the primary endpoint of myocardial injury between the two groups, with about 35% in the ticagrelor group and 36% in the clopidogrel group affected, indicating ticagrelor did not outperform clopidogrel in this context.
Article Synopsis
- The study examined how low and high body mass index (BMI) affect survival outcomes in patients who underwent left-ventricular assist device (LVAD) surgery across 19 medical centers from 2006 to 2016.
- Out of 652 patients studied, those with high BMI typically had more co-existing health issues and were mostly male, while underweight patients had the lowest survival rates overall.
- Four key predictors of mortality were identified for patients with abnormal BMI: high total bilirubin levels, hypertension, whether they were receiving LVAD as destination therapy, and previous cardiac surgeries, categorizing patients into low, intermediate, and high risk for 1-year mortality.
Implantable cardiac defibrillator leads dysfunction after LVAD implantation.
Vincent Galand Christophe Leclercq Hamed Bourenane Stéphane Boulé André Vincentelli Katrien Blanchart
Pacing Clin Electrophysiol
November 2020
Article Synopsis
- * Out of 401 patients with an ICD before LVAD, 122 had their ICD checked before and after implantation, with 55% showing significant lead dysfunction, including issues with sensing and pacing.
- * Despite the lead dysfunction observed, it did not result in severe clinical problems, indicating that management of these issues was effective and conservative.
Article Synopsis
- The study aimed to evaluate the quality of optical frequency domain imaging (OFDI) of the left main (LM) artery and identify any potential artifacts in the imaging process.
- Researchers analyzed OFDI images from 42 patients, finding that while overall artifact rates were low (8.9%), most artifacts occurred in the proximal LM area.
- OFDI effectively detected atherosclerotic plaques that weren't visible through traditional angiography, suggesting it provides reliable imaging of the LM despite the presence of some artifacts primarily in its proximal sections.
Article Synopsis
- The study evaluates the effectiveness of a personalized discharge checklist (PCL) for patients hospitalized due to acute heart failure (HF) in terms of mortality, readmission rates, and quality of care.
- The research involved 139 patients who received the PCL and a control group of 182 patients who did not, with a primary endpoint of monitoring mortality or readmission for HF over 6 months.
- Results show that while there was a slight trend toward fewer readmissions in the PCL group, there were no significant differences in mortality or medication usage between the groups, although more patients with the PCL were treated for iron and vitamin D deficiencies.
Article Synopsis
- A study compared platelet reactivity and thrombus burden after primary PCI and a pharmacoinvasive approach (PI) in patients with heart issues.
- Both groups showed high platelet reactivity even after medication, but primary PCI patients had more thrombus and worse blood flow after the procedure.
- The results suggest the benefits of choosing a pharmacoinvasive strategy when primary PCI can't be done quickly.
Article Synopsis
- The study aimed to assess how uncommon etiologies of cardiomyopathy affect patient outcomes in those receiving Left-ventricular assist devices (LVADs) compared to more common ischemic or idiopathic dilated cardiomyopathies.
- Conducted over 19 centers from 2006 to 2016, the research found that out of 652 LVAD recipients, 90.5% had ischemic/idiopathic causes, while 9.5% had uncommon causes like hypertrophic cardiomyopathy, cancer-related cardiac dysfunction, and myocarditis.
- Although both groups had similar survival rates during a 9.1-month follow-up, those with hypertrophic cardiomyopathy,
Article Synopsis
- Patients with cancer admitted for acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) face higher risks of mortality compared to those without cancer, both in-hospital and long-term.
- A systematic review and meta-analysis included data from over 294,000 ACS patients and nearly 40,000 PCI patients, revealing significantly increased rates of all-cause and cardiac death in cancer patients.
- The findings highlight the urgent need for improved management strategies for this high-risk population to address their unique healthcare needs after ACS or PCI.
This report describes the case of a 48-year-old man whose electrocardiogram after cardiopulmonary resuscitation showed up-sloping ST-segment depression at the J point in precordial leads combined with tall symmetrical T waves. This electrocardiographic pattern corresponded to de Winter syndrome and is related to proximal left anterior descending coronary artery occlusion. ().
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- The study investigates how the amount of leftover atherothrombotic burden (ATB) after coronary interventions affects heart recovery, using specific imaging methods to measure ATB in heart attack patients.
- Researchers looked at 60 patients with ST-elevation myocardial infarction who received specific medications prior to the procedure and categorized them based on their myocardial blush grade (MBG).
- Results showed that those with better MBG had significantly lower levels of ATB, indicating that the amount of residual ATB could be linked to how well the heart is able to recover after the procedure.