Publications by authors named "Patrick Jourdain"

Article Synopsis
  • Telemedicine systems for chronic heart failure (CHF) have faced challenges due to inconsistent study results and reliance on hospital-based models, prompting the need for improved out-of-hospital monitoring.* -
  • This study aimed to evaluate the effectiveness of a telemonitoring system in detecting clinical destabilizations in CHF patients at home while minimizing false alerts.* -
  • Among 111 patients studied, 35.1% received alerts for heart failure signs, with a quarter confirmed to have heart failure destabilization, indicating the telemonitoring system's high sensitivity but some issues with false alerts due to inaccurate patient measurements.*
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Article Synopsis
  • The study focuses on finding effective diagnostic thresholds for BNP and NT-proBNP in diagnosing acute heart failure (AHF) in patients over 75 years old, both with and without other health conditions.
  • Data was collected from 12,071 hospitalized patients over a decade, with 65.8% diagnosed with AHF; various NT-proBNP thresholds were identified, showing high positive predictive values (PPV) based on age and specific health conditions.
  • The research concludes that co-morbidities significantly impact natriuretic peptide thresholds for AHF diagnosis in older patients, indicating a need for tailored approaches in this demographic.
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In patients with sickle cell disease (SCD), SCD-related cardiomyopathy may be partly due to repeated ischaemic events related to sickling during vaso-occlusive crises, but few clinical studies support this hypothesis. We evaluated the incidence of acute myocardial ischaemia during vaso-occlusive crises as assessed by the left ventricular global longitudinal strain (LVGLS) and high-sensitive cardiac troponin T (hs-cTnT). We included adult patients with SCD admitted to the intensive care unit (ICU) for vaso-occlusive crisis.

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  • The study investigated the incidence and costs associated with cardiovascular renal diseases (CVRD) among people with type 2 diabetes who did not have a history of CVRD, using a cohort of over 2 million individuals in France for 5 years.
  • Results showed that 15.3% of participants developed a CVRD manifestation within 5 years, with chronic kidney disease (CKD) being the most common (40.6%), followed by heart failure (HF) and peripheral arterial disease (PAD).
  • The total hospitalization costs for CVRD over the 5 years were estimated at 3.9 billion euros, with CKD accounting for the largest share of the costs (2 billion euros), indicating a significant economic burden in
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Heart failure is a chronic condition that affects millions of people worldwide and is associated with high morbidity and mortality. Remote monitoring, which includes the use of non-invasive connected devices, cardiac implantable electronic devices and haemodynamic monitoring systems, has the potential to improve outcomes for patients with heart failure. Despite the conceptual and clinical advantages, there are still limitations in the widespread use of these technologies.

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Objectives: Few is known on pregnant women with mild COVID-19 managed in a community setting with a telemedicine solution, including their outcomes. The objective of this study is to evaluate the adverse fetal outcomes and hospitalization rates of pregnant COVID-19 outpatients who were monitored with the Covidom© telemedicine solution.

Methods: A nested study was conducted on pregnant outpatients with confirmed COVID-19, who were managed with Covidom© between March and November 2020.

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Introduction: The use of telehealth, such as remote patient monitoring (RPM), for chronic heart failure (CHF) impacts patient pathways. Patient-centricity in chronic disease management is valuable. Even though RPM is recommended in practice, the evaluation of patient satisfaction has been limited to date.

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Background: Covidom was a telemonitoring solution for home monitoring of patients with mild to moderate COVID-19, deployed in March 2020 in the Greater Paris area in France to alleviate the burden on the health care system. The Covidom solution included a free mobile application with daily monitoring questionnaires and a regional control center to quickly handle patient alerts, including dispatching emergency medical services when necessary.

Objective: This study aimed to provide an overall evaluation of the Covidom solution 18 months after its inception in terms of effectiveness, safety, and cost.

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Background: French health authorities recommend implementing a strong coordination between general practitioners and office-based cardiologists for the care and management of patients with chronic heart failure. The aim of this study was to describe the characteristics of patients with chronic heart failure who were infrequently referred to an office-based cardiologist (either first time referral or last visit more than 12 months before study inclusion) by a general practitioner or other healthcare professional versus those who were regularly followed by a general practitioner and an office-based cardiologist (at least one visit to an office-based cardiologist in the last 12 months).

Methods: This was a non-interventional, cross-sectional study, conducted among office-based cardiologists in France during a single study visit.

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Article Synopsis
  • This study aimed to clarify the outcomes of asthmatic patients with COVID-19 receiving initial care and monitoring through a telesurveillance solution called Covidom.
  • Researchers analyzed 33,815 patients, finding that 12.6% had asthma, with common comorbidities like obesity and hypertension.
  • Although asthmatic patients showed a higher risk of clinical worsening compared to non-asthmatics, there were no fatalities among asthmatic participants during the 30-day follow-up period.
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Aims: The heart failure (HF) prognosis in older patients remains poor with a high 5-years mortality rate more frequently attributed to noncardiovascular causes. The complex interplay between frailty and heart failure contribute to poor health outcomes of older adults with HF independently of ejection fraction. The aim of this position paper is to propose a practical management of frailty in older patients with heart failure.

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Management of worsening heart failure (WHF) has traditionally been hospital-based, but with the rising burden of heart failure (HF), the pressure on healthcare systems exerted by this disease necessitates a different strategy than long (and costly) hospital stays. A strategy for outpatient intravenous (IV) diuretic treatment of WHF has been developed in certain American centres in the past 10 years, whereas European centres have been mostly favouring 'classic' in-hospital management of WHF. Embracing novel, outpatient approaches for treating WHF could substantially reduce the burden on healthcare systems while improving patient's satisfaction and quality of life.

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Article Synopsis
  • - The study aimed to assess intravascular volume status in patients over 75 years old with acute heart failure to reduce readmission rates by looking at various congestion evaluation methods.
  • - Researchers examined correlations between clinical signs of congestion, ultrasound measurement of inferior vena cava (IVC) diameter, NT-proBNP levels, and estimated plasma volume during treatment in 50 patients.
  • - Results showed strong correlations between IVC measurements and clinical signs of congestion, suggesting that using both assessments can help prevent renal failure related to fluid depletion in these patients.
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Introduction: Patients with established coronary artery disease (CAD) are at very high risk for cardiovascular events.

Methods: The DAUSSET study is a national, multicenter, non-interventional study that included very high-risk CAD patients followed by French cardiologists. It aimed to describe real-life clinical practices for low-density lipoprotein (LDL) cholesterol control in the secondary prevention of CAD.

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Article Synopsis
  • * A study was conducted on 73 patients discharged from the hospital after COVID-19, monitoring their condition through questionnaires and trained physicians for safety and effectiveness of this management strategy.
  • * Results showed no deaths or urgent hospitalizations during remote monitoring, and a follow-up six months later indicated good patient status, with low levels of dyspnea and overall health quality scores.
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Article Synopsis
  • Telemedicine has been acknowledged as an important aspect of healthcare since 2010, but significant national trials only started in 2016 to create a legal framework for its integration.
  • These trials, which concluded in December 2021, successfully involved over 100,000 patients, primarily those with heart conditions.
  • The COVID-19 pandemic highlighted the effectiveness of remote healthcare practices like teleconsultation and telemonitoring, prompting the need for ongoing organizational and technical advancements to integrate telemedicine into everyday healthcare.
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Objectives: To assess the time to resolution of respiratory and systemic symptoms and their associated factors in outpatients during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: Cohort study including adult outpatients, managed with Covidom, a telesurveillance solution, with RT-PCR-confirmed diagnosis, from 9 March 2020 until 23 February 2021. Follow up was 30 days after symptom onset.

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In a large regional observational cohort study of adult (≥ 18 years), outpatients with COVID-19, prevalence, characteristics, and outcome of patients with rash and/or chilblain-like lesions (CLL), compared with population without cutaneous features, were studied. In total, 28,957 outpatients were included; the prevalence of rash and CCL were 9.5% and 3.

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Objectives: Studies on coronavirus disease 2019 (COVID-19) have mainly focused on hospitalized patients or those with severe disease. We aim to assess the clinical characteristics, outcomes and factors associated with hospital admission or death in adult outpatients with COVID-19.

Methods: This is a prospective cohort of outpatients with suspected or confirmed COVID-19, registered in the Covidom telesurveillance solution for home monitoring of patients with COVID-19 in the Greater Paris area, from March to August 2020.

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In a matter of months, COVID-19 has escalated from a cluster of cases in Wuhan, China, to a global pandemic. As the number of patients with COVID-19 grew, solutions for the home monitoring of infected patients became critical. This viewpoint presents a telesurveillance solution-Covidom-deployed in the greater Paris area to monitor patients with COVID-19 in their homes.

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Context: The left ventricular filling pressure (LVFP) is correlated to right atrial pressure (RAP) in heart failure. We compared diagnostic value of the inferior vena cava (IVC) measurements to the one of the 2016 echocardiographic recommendations to estimate LVFP in patients with suspected heart failure with preserved ejection fraction (HFpEF).

Methods: Invasive hemodynamics and echocardiography were obtained within 48 hours in 132 consecutive patients with left ventricular ejection fraction ≥50%, and suspected pulmonary hypertension.

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