1,044 results match your criteria: "Centre d'Investigations Cliniques[Affiliation]"

Aims: Intravenous (IV) iron increases haemoglobin/haematocrit and improves outcomes in patients with heart failure with reduced ejection fraction (HFrEF) and iron deficiency. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) also increase haemoglobin/haematocrit and improve outcomes in heart failure by mechanisms linked to nutrient deprivation signalling and reduction of inflammation and oxidative stress. The effect of IV iron among patients using SGLT2i has not yet been studied.

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Subcutaneous Implantable Cardioverter-Defibrillators in Patients With Congenital Heart Disease.

J Am Coll Cardiol

August 2023

Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Pediatric and Congenital Medico-Surgical Unit, Necker Hospital, Paris, France.

Article Synopsis
  • 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.
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Background: The presence of ischemic heart disease impacts prognosis in patients affected by heart failure and reduced ejection fraction (HFrEF). It is not well known how the extent of vascular disease impacts prognoses and responses to therapy in this setting.

Methods: In this post hoc analysis of the EMPEROR-Reduced trial, outcomes and the effects of empagliflozin, were assessed in study participants according to the extent (none vs mono vs poly [≥ 2] vascular bed) of vascular disease.

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Background: More than 90% of patients developing heart failure (HF) have an epidemiological background of hypertension. The most frequent concomitant conditions are type 2 diabetes mellitus, obesity, atrial fibrillation, and coronary disease, all disorders/diseases closely related to hypertension.

Methods: HF outcome research focuses on decreasing mortality and preventing hospitalization for worsening HF syndrome.

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Aims: In patients hospitalized for acute heart failure (AHF) empagliflozin produced greater clinical benefit than placebo. Many patients with AHF are treated with mineralocorticoid receptor antagonists (MRAs). The interplay between empagliflozin and MRAs in AHF is yet to be explored.

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GLP-1 Receptor Agonist Therapy With and Without SGLT2 Inhibitors in Patients With Type 2 Diabetes.

J Am Coll Cardiol

August 2023

Cardiovascular R&D Centre-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal; Université de Lorraine, Inserm, Centre d'Investigations Cliniques Plurithématique 14-33, and Inserm U1116, CHRU Nancy, Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France.

Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors and GLP-1 receptor agonists (GLP-1 RAs) reduce adverse cardiovascular outcomes in type 2 diabetes (T2D). However, the efficacy of combination therapy is unclear.

Objectives: The aim of this study was to evaluate the effects of GLP-1 RAs on cardiovascular outcomes in patients with T2D treated with or without SGLT2 inhibitors.

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Aims: Whether aldosterone levels after myocardial infarction (MI) are associated with mid- and long-term left ventricular (LV) remodelling in the era of systematic use of renin-angiotensin system inhibitors is uncertain. We prospectively investigated the relationship between aldosterone levels and mid- and long-term LV remodelling in patients with acute MI.

Methods And Results: Plasma aldosterone was measured in 119 patients successfully treated by primary percutaneous coronary angioplasty for a first acute ST-elevation MI (STEMI) 2-4 days after the acute event.

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'Old-generation' potassium (K) binders [i.e. sodium (SPS) and calcium polystyrene sulfonate] are widely used, but with substantial heterogeneity across countries to treat hyperkalaemia (HK).

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Article Synopsis
  • - The MOMENTUM study successfully showed that momelotinib, compared to danazol, provided significant improvements in symptoms, spleen size, and anemia in myelofibrosis patients at the 24-week mark, and this analysis focuses on outcomes from 24 to 48 weeks.
  • - The study involved 107 international sites with adult patients who had a history of myelofibrosis and were treated with a Janus kinase inhibitor, with participants randomly assigned to receive either momelotinib or danazol for 24 weeks.
  • - After 24 weeks, all patients transitioned to open-label momelotinib, and this updated analysis reports on the duration of responses and additional patient results through week 48
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Patients with polycythemia vera (PV) are at significant risk of thromboembolic events (TE). The PV-AIM study used the Optum de-identified Electronic Health Record dataset and machine learning to identify markers of TE in a real-world population. Data for 82,960 patients with PV were extracted: 3852 patients were treated with hydroxyurea (HU) only, while 130 patients were treated with HU and then changed to ruxolitinib (HU-ruxolitinib).

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Impact of disease duration on proteomic bioprofile and prognosis in rheumatoid arthritis patients.

Clin Exp Rheumatol

November 2023

Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, CHRU de Nancy, Inserm U1116 F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France, and UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Portugal.

Objectives: Cardiovascular disease worsens the prognosis of rheumatoid arthritis (RA) and vice-versa. Inflammation may be a common pathway for both conditions. It is expected that a longer RA duration leads to a greater inflammatory cumulative exposure burden; however, studies on the association between RA disease duration and outcomes are scarce.

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Aims: Left ventricular scar is an arrhythmic substrate that may be missed by echocardiography and diagnosed only by cardiac magnetic resonance (CMR), which is a time-consuming and expensive imaging modality. Premature ventricular complexes (PVCs) with a right-bundle-branch-block (RBBB) pattern are independent predictors of late gadolinium enhancement (LGE) but their positive predictive value is low. We studied which electrocardiographic features of PVCs with an RBBB pattern are associated with a higher probability of the absence of an underlying LGE.

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Glucagon-Like Peptide-1 Receptor Agonists Across the Spectrum of Heart Failure.

J Clin Endocrinol Metab

December 2023

UnIC@RISE, Department of Surgery and Physiology, Cardiovascular Research and Development Center, University of Porto, Porto, Portugal.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been used to reduce body weight in overweight or people with obesity and to improve glycemic control and cardiovascular outcomes among people with type 2 diabetes (T2D) and a high cardiovascular risk. However, the effects of GLP-1 RAs may be modified by the presence of heart failure (HF). In this review, we summarize the evidence for the use of GLP-1 RA across a patient's risk with a particular focus on HF.

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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.

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Malnutrition is the most common comorbidity during the continuum of hematopoietic stem cell transplant (HSCT) and negatively impacts clinical outcomes, response to therapy, quality of life, and costs. The intensive conditioning regimen administered before transplant causes inflammatory damages to the gastrointestinal system, which themselves contribute to trigger graft versus host disease (GvHD) in the allogeneic setting. GvHD and other post-transplant complications such as infections adversely affect food intake and gut absorption of nutrients.

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Ventricular-arterial coupling (VAC) has independent diagnostic and prognostic value for cardiovascular (CV) risk stratification, but studies on its association with anthropometric and CV factors are sparse in young individuals without overt CV disease. We aim to provide descriptive data regarding VAC and its associations with CV risk factors in young adults without overt CV disease. For 631 (mean age, 24 ± 3 yr; 51% female) individuals, VAC was determined by carotid-femoral pulse wave velocity (PWV)/global longitudinal strain (GLS).

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NGAL is a Novel Target in Hypertension by Modulating the NCC-Mediated Renal Na Balance.

Hypertension

September 2023

Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, France (B.B., S.E.M., K.U., L.L., M.S., F.J.).

Background: The expression of NGAL/lcn2 (neutrophil gelatinase-associated lipocalin) is directly modulated by mineralocorticoid receptor activation but its role in blood pressure control is unclear.

Methods: a potential relationship between NGAL plasma levels, systolic blood pressure and urinary Na excretion was assessed in the STANISLAS cohort. The specific role of NGAL/lcn2 in salt-sensitive hypertension was studied using lcn2-knockout mice (lcn2 KO) fed with low-Na diet (0Na).

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Aim: Eplerenone reduces the risk of cardiovascular death or first hospitalization for heart failure (HF) in patients with HF and a reduced ejection fraction (HFrEF), but it is still frequently underused in routine practice. We evaluated the time course of benefits of eplerenone after its initiation in HFrEF patients from the EMPHASIS-HF trial.

Methods And Results: The EMPHASIS-HF trial was a double-blind randomized clinical trial assessing the effect of eplerenone in patients (n = 2737, mean age 68.

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Layer myocardial strain is the most heritable echocardiographic trait.

Eur Heart J Cardiovasc Imaging

September 2023

Université de Lorraine, INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM 1116, CHRU de Nancy, FCRIN INI-CRCT, Nancy, France.

Aims: Myocardial deformation assessed by strain analysis represents a significant advancement in our assessment of cardiac mechanics. However, whether this variable is genetically heritable or whether all/most of its variability is related to environmental factors is currently unknown. We sought to determine the heritability of echocardiographically determined cardiac mechanics indices in a population setting.

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Article Synopsis
  • The study examined the long-term effects of crovalimab in patients with paroxysmal nocturnal hemoglobinuria as an extension of the COMPOSER trial, focusing on safety and drug effects.
  • Out of 44 patients, 43 participated in the open-label extension (OLE) phase, with 32% experiencing treatment-related side effects, but overall, crovalimab's effectiveness was maintained.
  • Findings indicated significant success in managing blood-related issues, such as haemoglobin stabilization and avoiding transfusions, confirming crovalimab's long-term tolerability and efficacy over a median treatment period of three years.
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Aims: To investigate whether a heart failure (HF) hospitalization is associated with initiation/discontinuation of guideline-directed medical HF therapy (GDMT) and consequent outcomes.

Methods And Results: Among patients in the Swedish HF registry with an ejection fraction <50% enrolled in 2009-2018, initiation/discontinuation of GDMT was investigated by assessing dispensations of GDMT in those with versus without a HF hospitalization. Of 14 737 patients, 6893 (47%) were enrolled when hospitalized for HF.

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Article Synopsis
  • Hematological toxicity is the most frequent side effect of CAR T-cell therapy, leading to severe and prolonged cytopenias that increase the risk of infections.
  • An international panel of CAR T-cell experts developed consensus recommendations for grading and managing immune effector cell-associated hematotoxicity (ICAHT) during a series of meetings organized by the European Society for Blood and Marrow Transplantation and the European Hematology Association.
  • The recommendations include a classification system for grading cytopenias, risk factors, diagnostic workups, and management tactics such as growth factor support and prophylaxis against infections.
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