Publications by authors named "Ninni S"
Background: Real-world data regarding clinical outcomes according to aortic stenosis (AS) management are scarce. Therefore, we aimed to investigate long-term management across the spectrum of outpatients with AS.
Methods And Results: Between May 2016 and December 2017, consecutive outpatients with mild (peak aortic velocity, 2.
Background: Cardiac surgery triggers sterile innate immune responses leading to postoperative complications. Clonal hematopoiesis (CH) is associated with short-term inflammation-mediated outcomes after cardiac surgery. The impact of CH on long-term postoperative outcomes remains unknown.
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- SCN5A gene variants are linked to various cardiac electrical disorders, but they can also result in complex phenotypes like overlap syndromes, which haven't been thoroughly studied.
- The study analyzed DNA from over 13,500 patients with a focus on those carrying pathogenic SCN5A variants, finding that most were tied to well-defined conditions like Brugada syndrome and long QT syndrome.
- About 19% of the variants were associated with complex phenotypes, and only a small number (8 out of 9,960 patients) showed a potential link to dilated cardiomyopathies (DCM), suggesting it's a rare association.
Impact of Catheter Ablation of Electrical Storm on Survival: A Propensity Score-Matched Analysis.
JACC Clin Electrophysiol
October 2024
Background: Electrical storm (ES) is a life-threatening condition, associated with substantial early and subacute mortality. Catheter ablation (CA) is a well-established therapy for ES. However, data regarding the impact of CA on the short-term and midterm survival of patients admitted for ES remain unclear.
View Article and Find Full Text PDFBackground: 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
- Heart failure (HF) is associated with chronic inflammation and involves two types of neutrophils: high-density neutrophils (HDNs) and low-density neutrophils (LDNs), with LDNs often increasing in various diseases and releasing inflammatory substances.
- This study isolated and measured these neutrophil subtypes and their activities in individuals with HF, including both HFrEF and HFpEF patients, compared to healthy volunteers.
- Results showed significantly higher counts of both HDNs and LDNs in HF patients, particularly those with HFpEF, linking LDN counts to increased inflammatory markers and the formation of neutrophil extracellular traps (NETs).
Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and is associated with a range of adverse clinical outcomes. Accumulating evidence points to inflammatory processes resulting from innate immune responses as a cornerstone in AF pathogenesis. Genetic and epigenetic factors affecting leukocytes have been identified as key modulators of the inflammatory response.
View Article and Find Full Text PDFAtrial cardiomyopathy is defined as any complex of structural, architectural, contractile or electrophysiological changes affecting atria, with the potential to produce clinically relevant manifestations. Most of our knowledge about the mechanistic aspects of atrial cardiomyopathy is derived from studies investigating animal models of atrial fibrillation and atrial tissue samples obtained from individuals who have a history of atrial fibrillation. Several noninvasive tools have been reported to characterize atrial cardiomyopathy in patients, which may be relevant for predicting the risk of incident atrial fibrillation and its related outcomes, such as stroke.
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- Some patients with serious heart problems were treated with a special radiation therapy for their heart issues, but we didn't know how many of them would survive for a year after the treatment.
- After looking at different studies, researchers found that about 32% of these patients died within a year, with most deaths happening in the first three months.
- The main reason for these deaths was worsening heart failure, but many also died from other health issues, especially in patients over 70 years old.
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.
Atrial cardiomyopathy is a condition that causes electrical and contractile dysfunction of the atria, often along with structural and functional changes. Atrial cardiomyopathy most commonly occurs in conjunction with ventricular dysfunction, in which case it is difficult to discern the atrial features that are secondary to ventricular dysfunction from those that arise as a result of primary atrial abnormalities. Isolated atrial cardiomyopathy (atrial-selective cardiomyopathy [ASCM], with minimal or no ventricular function disturbance) is relatively uncommon and has most frequently been reported in association with deleterious rare genetic variants.
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- Very few studies have explored the effectiveness of subcutaneous implantable cardioverter-defibrillators (S-ICDs) in patients with congenital heart disease (CHD), which this research aims to address.
- In a French cohort study of 4,924 patients implanted with an S-ICD, only 101 were found to have CHD, often presenting at a younger age and more often for secondary prevention compared to non-CHD patients.
- The study found that while patients with CHD had a higher crude risk of receiving appropriate shocks from their S-ICD, this risk was not significant after adjusting for other factors, indicating that complications and inappropriate shocks were similar across both patient groups.
Heart transplantation as a rescue strategy for patients with refractory electrical storm.
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.
Background: Severe aortic stenosis (AS) has been associated with bleeding. However, there is a lack of prospective assessment of bleeding events and their clinical significance in a large population of outpatients with variable degree of AS severity.
Objectives: To assess the incidence, source, determinants, and prognostic impact of major bleeding in patients with variable degree of AS severity.
Background: On-pump cardiac surgery triggers sterile inflammation and postoperative complications such as postoperative atrial fibrillation (POAF). Hematopoietic somatic mosaicism (HSM) is a recently identified risk factor for cardiovascular diseases and results in a shift toward a chronic proinflammatory monocyte transcriptome and phenotype.
Objectives: The aim of this study was to assess the prevalence, characteristics, and impact of HSM on preoperative blood and myocardial myeloid cells as well as on outcomes after cardiac surgery.
Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study.
Circ Arrhythm Electrophysiol
March 2023
Background: Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown.
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- The study investigates patients with right bundle branch block (RBBB)-ventricular tachycardia (VT) and arrhythmogenic cardiomyopathy (ACM) by examining ECG characteristics of sinus rhythm (SR) and VT.
- It included 70 patients, revealing that the most common sites of origin for the VTs were primarily in the inferior and lateral walls of the left ventricle (LV), with a good correlation to electro-anatomic mapping (EAM) data.
- The findings highlight frequent abnormalities in SR depolarization and repolarization, which are associated with clinical implications in patients with ACM and RBBB-VT.
Article Synopsis
- - This study focuses on patients with repaired tetralogy of Fallot, particularly examining characteristics of those experiencing rapid ventricular tachycardia (VT) and the potential progression from nonrapid VT to rapid VT or ventricular fibrillation (VF).
- - Researchers analyzed data from a nationwide registry and found that out of 144 patients, 61 experienced VT or VF episodes, with 28 classified as rapid, revealing distinct clinical differences between the rapid and nonrapid groups, such as age at implantation and cardiac history.
- - The study concludes that patients with rapid VT/VF show specific clinical traits, and the consistent VT cycle lengths over time may indicate a chance for catheter ablation without needing an implantable cardioverter-defibrillator (
Background: Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.
Objectives: The aim of this study was to assess sex-related differences in patients with tetralogy of Fallot (TOF) and implantable cardioverter-defibrillators (ICDs).
Methods: Data were analyzed from the DAI-T4F (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator) cohort study, which has prospectively enrolled all patients with TOF with ICDs in France since 2010.
Multiple Sclerosis (MS) is an autoimmune demyelinating and neurodegenerative disease of the central nervous system (CNS). Current management strategies suppress or modulate immune function, all with consequences and known side effects. They demonstrate a high level of success in limiting new relapses.
View Article and Find Full Text PDFBackground: A number of epidemiological studies have suggested an association between metabolic dysfunction-associated fatty liver disease (MAFLD) and the incidence of atrial fibrillation (AF). However, the pathogenesis leading to AF in the context of MAFLD remains unclear. We therefore aimed at assessing the impact of MAFLD and liver fibrosis status on left atrium (LA) structure and function.
View Article and Find Full Text PDFStereotactic Radioablation for Ventricular Tachycardia in the Setting of Electrical Storm.
Circ Arrhythm Electrophysiol
September 2022
Background: Stereotactic body radiotherapy (SBRT) has been reported as a safe and efficient therapy for treating refractory ventricular tachycardia (VT) despite optimal medical treatment and catheter ablation. However, data on the use of SBRT in patients with electrical storm (ES) is lacking. The aim of this study was to assess the clinical outcomes associated with SBRT in the context of ES.
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- The study examines the prognostic significance of myocardial work parameters in patients after experiencing an acute myocardial infarction (AMI).
- A total of 244 patients were monitored for major cardiac events after receiving specialized care, with findings indicating that those who experienced events had worse overall heart function and were generally older.
- Specifically, the global work efficiency (GWE) was identified as a crucial measure, with a GWE below 91% indicating a significantly increased risk for major events, making it a valuable tool for assessing post-AMI patient risk.
Objective: Current data regarding the impact of diabetes mellitus (DM) on cardiovascular mortality in patients with aortic stenosis (AS) are restricted to severe AS or aortic valve replacement (AVR) trials. We aimed to investigate cardiovascular mortality according to DM across the entire spectrum of outpatients with AS.
Methods: Between May 2016 and December 2017, patients with mild (peak aortic velocity=2.