Atlas-Based Quantification of Myocardial Motion Abnormalities: Added-Value for Understanding the Effect of Cardiac Resynchronization Therapy

International audienc

An Eight-Year Followup Study after Heart Transplantation: The Relevance of Psychosocial and Psychiatric Background

A heart transplantation (HT) is performed when a patient’s heart health has been severely compromised. However, the health care needs of a patient throughout the transplantation process are also significant. In order to investigate these postoperative heart transplant challenges, this study has two objectives: to find which psychosocial and psychiatric variables relate to good prognosis at the end of the followup period and to assess cognitive status and quality of life at the end of the study. Therefore, we divided the sample according to the completion success and then studied and compared the differences in participants’ personality, coping mechanisms, locus of control, clinical, and epidemiological information. Cognitive function and quality of life assessments were also undertaken for participants who completed their followup period. Higher significant differences were found in openness to experience (personality), self-perceived support (locus of control), and positive reinterpretation (coping) among those who completed the followup period. On the other hand, a higher age and current or historical psychiatric diagnoses were more prevalent in the group who did not complete the followup period. Our assessment of the participants after the followup period showed normal levels of cognitive function and quality of life

An Eight-Year Followup Study after Heart Transplantation: The Relevance of Psychosocial and Psychiatric Background

A heart transplantation (HT) is performed when a patient’s heart health has been severely compromised. However, the health care needs of a patient throughout the transplantation process are also significant. In order to investigate these postoperative heart transplant challenges, this study has two objectives: to find which psychosocial and psychiatric variables relate to good prognosis at the end of the followup period and to assess cognitive status and quality of life at the end of the study. Therefore, we divided the sample according to the completion success and then studied and compared the differences in participants’ personality, coping mechanisms, locus of control, clinical, and epidemiological information. Cognitive function and quality of life assessments were also undertaken for participants who completed their followup period. Higher significant differences were found in openness to experience (personality), self-perceived support (locus of control), and positive reinterpretation (coping) among those who completed the followup period. On the other hand, a higher age and current or historical psychiatric diagnoses were more prevalent in the group who did not complete the followup period. Our assessment of the participants after the followup period showed normal levels of cognitive function and quality of life

Heart transplantation as salvage treatment of intractable infective endocarditis

International audienceBackgroundFor infective endocarditis (IE) with extensive perivalvular lesions or end-stage cardiac failure, heart transplantation (HT) may be the last resort.MethodsWe retrospectively collected all cases of HT for IE within the International Collaboration on Endocarditis (ICE) network.ResultsBetween 1991 and 2021, 20 patients (5 women, 15 men), median age 50 years [interquartile range, 29-61], underwent HT for IE in Spain (n = 9), France (n = 6), Switzerland (n = 2), Colombia, Croatia, and USA (n = 1). IE affected prosthetic (n = 10), and native valves (n = 10), primarily aortic (n = 11) and mitral (n = 6). The main pathogens were oral streptococci (n = 8), Staphylococcus aureus (n = 5), and Enterococcus faecalis (n = 2). The major complications included heart failure (n = 18), peri-annular abscess (n = 10), and prosthetic valve dehiscence (n = 4). Eighteen patients had previous cardiac surgery for this episode of IE, and four were on circulatory support before HT (left ventricular assist-device and extra-corporeal membrane oxygenation, 2 patients each). The median time interval between first symptoms of IE and HT was 44.5 days [22-91.5]. The main post-HT complication was acute rejection (n = 6). Seven patients died (35%), four during the first month post-HT. Thirteen (81%) of the 16 patients discharged from the hospital survived with a median follow-up of 35.5 months [4-96.5] after HT, and no relapse of IE.ConclusionsIE is not an absolute contraindication for HT: Our case series and the literature review support that HT may be considered as a salvage treatment in highly-selected patients with intractable IE

Chronic vagal stimulation for the treatment of low ejection fraction heart failure : results of the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) randomized controlled trial

AIM: The neural cardiac therapy for heart failure (NECTAR-HF) was a randomized sham-controlled trial designed to evaluate whether a single dose of vagal nerve stimulation (VNS) would attenuate cardiac remodelling, improve cardiac function and increase exercise capacity in symptomatic heart failure patients with severe left ventricular (LV) systolic dysfunction despite guideline recommended medical therapy. METHODS: Patients were randomized in a 2 : 1 ratio to receive therapy (VNS ON) or control (VNS OFF) for a 6-month period. The primary endpoint was the change in LV end systolic diameter (LVESD) at 6 months for control vs. therapy, with secondary endpoints of other echocardiography measurements, exercise capacity, quality-of-life assessments, 24-h Holter, and circulating biomarkers. RESULTS: Of the 96 implanted patients, 87 had paired datasets for the primary endpoint. Change in LVESD from baseline to 6 months was -0.04 ± 0.25 cm in the therapy group compared with -0.08 ± 0.32 cm in the control group (P = 0.60). Additional echocardiographic parameters of LV end diastolic dimension, LV end systolic volume, left ventricular end diastolic volume, LV ejection fraction, peak V02, and N-terminal pro-hormone brain natriuretic peptide failed to show superiority compared to the control group. However, there were statistically significant improvements in quality of life for the Minnesota Living with Heart Failure Questionnaire (P = 0.049), New York Heart Association class (P = 0.032), and the SF-36 Physical Component (P = 0.016) in the therapy group. CONCLUSION: Vagal nerve stimulation as delivered in the NECTAR-HF trial failed to demonstrate a significant effect on primary and secondary endpoint measures of cardiac remodelling and functional capacity in symptomatic heart failure patients, but quality-of-life measures showed significant improvement