Publications by authors named "Theo Pezel"

Background: The prevalence of recreational drug use in myocardial infarction (MI) patients without standard modifiable cardiovascular risk factors (SMuRF) namely hypercholesterolemia, hypertension, diabetes and smoking, remains unknown.

Methods: All patients enrolled in The Addiction in Intensive Cardiac Care Units (ADDICT-ICCU) study, a French multicenter prospective observational study which systematically assessed the use of recreational drug within 2 h of admission, and presenting with MI but without known coronary artery disease were included. We compared patients with and without SMuRF.

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Background: Although recreational drug use is a strong risk factor for acute cardiovascular events, systematic testing is currently not performed in patients admitted to intensive cardiac care units, with a risk of underdetection. To address this issue, machine learning methods could assist in the detection of recreational drug use.

Aims: To investigate the accuracy of a machine learning model using clinical, biological and echocardiographic data for detecting recreational drug use in patients admitted to intensive cardiac care units.

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Objectives: We aimed to assess the additional prognostic value of the concept of "late gadolinium enhancement (LGE) granularity" in non-ischemic dilated cardiomyopathy (DCM) patients to predict all-cause death.

Methods: Between 2008 and 2021, we conducted a bicentric retrospective study including all consecutive DCM patients referred for Cardiovascular Magnetic Resonance (CMR). The primary outcome was all-cause death.

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Auto-immune and inflammatory diseases are heterogenous in their clinical manifestations and prognosis, even among individuals presenting with the same pathology. Understanding the immunological alterations involved in their pathogenesis provides valuable insights in different clinical phenotypes and treatment responses. Immunophenotyping could lead to significant improvements in diagnosis, monitoring, initial treatment decisions and follow-up in autoimmune and inflammatory diseases.

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With this document, the European Association of Cardiovascular Imaging (EACVI) provides an Expert Consensus on the role of multi-modality imaging (MMI) in the management of patients with multiple valvular heart disease (MVD). Emphasis is given to the use of MMI to unravel the diagnostic challenges that characterize these patients and to improve risk stratification. Complementing the last European Society of Cardiology and European Association of Cardio-Thoracic Surgery guidelines on valvular heart disease, this Expert Consensus document also outlines how MMI assessment should form an integral part of the multi-disciplinary heart team discussion for patients with MVD to help with complex decision-making regarding the choice and timing of treatment.

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Objectives: To determine whether plaque composition analysis defined by cardiac CT can provide incremental prognostic value above coronary artery disease (CAD) burden markers in symptomatic patients with obstructive CAD.

Materials And Methods: Between 2009 and 2019, a multicentric registry included all consecutive symptomatic patients with obstructive CAD (at least one ≥ 50% stenosis on CCTA) and was followed for major adverse cardiovascular (MACE) defined by cardiovascular death or nonfatal myocardial infarction. Each coronary segment was scored visually for both the degree of stenosis and composition of plaque, which were classified as non-calcified, mixed, or calcified.

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Although relatively rare, cardiac metastases represent a significant clinical challenge because of their impact on cardiac function and overall patient prognosis. This case presents a rare and atypical presentation of a patient with ventricular arrhythmia revealing a metastatic cancer in the heart. A 59-year-old man with lung cancer was admitted for chest tightness and episodes of syncope.

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Background Multimodality imaging is essential for personalized prognostic stratification in suspected coronary artery disease (CAD). Machine learning (ML) methods can help address this complexity by incorporating a broader spectrum of variables. Purpose To investigate the performance of an ML model that uses both stress cardiac MRI and coronary CT angiography (CCTA) data to predict major adverse cardiovascular events (MACE) in patients with newly diagnosed CAD.

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Background Ischemic late gadolinium enhancement (LGE) assessed with cardiac MRI is a well-established prognosticator in ischemic cardiomyopathy. However, the prognostic value of additional LGE parameters, such as extent, transmurality, location, and associated midwall LGE, remains unclear. Purpose To assess the prognostic value of ischemic LGE features to predict all-cause mortality in ischemic cardiomyopathy.

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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.
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Background: The prevalence and short-term cardiovascular consequences of recent cannabis use in patients admitted to an intensive cardiac care unit for acute coronary syndrome is not well established.

Aims: To assess the prevalence of recent cannabis use detected by prospective systematic screening, and its prognostic value in predicting the occurrence of in-hospital major adverse events in consecutive patients with acute coronary syndrome.

Methods: From 07 to 22 April 2021, all consecutive patients admitted to an intensive cardiac care unit in 39 centres throughout France were studied prospectively.

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Article Synopsis
  • * Despite advancements in understanding and treating aortic stenosis, there are still significant gaps in knowledge about its causes, severity assessment, and treatment strategies.
  • * The review, from the Heart Valve Council of the French Society of Cardiology, highlights these gaps and suggests areas for future research to enhance patient outcomes.
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  • This study evaluated the effectiveness of cardiac magnetic resonance (CMR) imaging compared to other diagnostic markers in predicting mortality in patients with AL cardiac amyloidosis (CA).
  • Conducted on 176 patients with a median age of 68 years, the study found that high levels of NT-proBNP and troponin, along with low heart function measurements, were linked to increased mortality risk.
  • Extracellular volume (ECV) from CMR emerged as a strong independent predictor of all-cause mortality and heart failure hospitalizations, suggesting it can enhance prognostic assessments beyond the established Mayo Clinic staging.
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  • This statement from the European Association of Cardiovascular Imaging (EACVI) outlines key principles for conducting clinical research in cardiovascular imaging.
  • It serves as a useful guide for clinical researchers, cardiology fellows, and Ph.D. students in designing and implementing imaging protocols for clinical trials.
  • While it can't substitute formal research training, it's highly recommended for anyone wanting to learn about or get involved in clinical trials related to cardiovascular imaging.
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  • 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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  • A study investigated how changes in left atrial (LA) function may indicate the risk of developing heart failure (HF) in a diverse group of nearly 2,500 participants over an average of 9 years.
  • The researchers found that a decrease in peak LA strain is closely linked to heart failure with preserved ejection fraction (HFpEF), while a decrease in indexed LA volume is linked to heart failure with reduced ejection fraction (HFrEF).
  • Both LA function metrics significantly improved the prediction models for these conditions, highlighting their potential as early indicators of heart failure in subjects with early signs of cardiovascular disease.
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Background: 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.

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  • 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.
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Aims: To assess the current role of cardiac imaging in the diagnosis, management, and follow-up of patients with acute myocarditis (AM) through a European Association of Cardiovascular Imaging survey.

Methods And Results: A total of 412 volunteers from 74 countries responded to the survey. Most participants worked in tertiary centres (56%).

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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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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.
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