Implementation of FAIR principles in the IPCC: the WGI AR6 Atlas repository

The Sixth Assessment Report (AR6) of the Intergovernmental Panel on Climate Change (IPCC) has adopted the FAIR Guiding Principles. We present the Atlas chapter of Working Group I (WGI) as a test case. We describe the application of the FAIR principles in the Atlas, the challenges faced during its implementation, and those that remain for the future. We introduce the open source repository resulting from this process, including coding (e.g., annotated Jupyter notebooks), data provenance, and some aggregated datasets used in some figures in the Atlas chapter and its interactive companion (the Interactive Atlas), open to scrutiny by the scientific community and the general public. We describe the informal pilot review conducted on this repository to gather recommendations that led to significant improvements. Finally, a working example illustrates the re-use of the repository resources to produce customized regional information, extending the Interactive Atlas products and running the code interactively in a web browser using Jupyter notebooks.Peer reviewe

Valeur pronostique du BNP dans le rétrécissement aortique calcifié du sujet âgé

LE KREMLIN-B.- PARIS 11-BU Méd (940432101) / SudocSudocFranceF

115 Relation between global longitudinal strain in patients with aortic stenosis: relation with severity and symptoms

BackgroundPatient with aortic stenosis (AS) and reduced ejection fraction (EF) should be promptly operated on. Global longitudinal strain (GLS) has been proposed as a subtle subclinical marker of left ventricular (LV) systolic dysfunction and a potential prognostic factor in asymptomatic patients with AS. However, the relation between GLS, AS severity and symptoms has not been fully evaluated.MethodsEighty-six patients (74±11 years, 35% female) with at least mild AS were prospectively enrolled. Clinical evaluation included the assessment of symptoms (angina, syncope, and dyspnea) and a physical examination. All patients had a comprehensive transthoracic echocardiography (TTE). GLS was measured offline using a dedicated station and software (EchoPac, General Electric) blinded of any clinical and TTE information.ResultsForty-three patients (43%) were asymptomatic. AS range was wide with a mean aortic valve area (AVA) of 1.06±0.42cm2 [0.33–2.3] and 55 patients (64%) had a severe AS (AVA<1cm2). Mean EF was 63±6 and 8 patients (9%) and a reduced EF (<60%). We divided our population into 4 subgroups, asymptomatic non-severe AS (group 1), asymptomatic severe AS and normal EF (group 2), symptomatic severe AS and normal EF (group 3) and symptomatic severe AS and reduced EF (group 4). Overall GLS decreased from group 1 to 4 (p<0.0001) (Table) and a correlation between AS severity and GLS was observed (r=−0.40, p=0.0002). However, GLS was not significantly different between patients with symptomatic and asymptomatic severe AS (group 2 and 3, p=0.32).ConclusionsIn the present study we show that GLS was significantly correlated to AS severity and reduced in patients impaired EF. However, GLS was not different between patients with symptomatic and asymptomatic severe AS. These preliminary data deserve further confirmation but raise caution regarding the potential prognostic value of GLS in patients with asymptomatic AS.Group 1 (n=31)Group 2 (n=12)Group 3 (n=35)Group 4 (n=8)P between groupsGLS−19,1±2.9−18,7±4.6−17.5±3.2−12.5±4.0<0.000

Epicardial adipose tissue volume is associated with left ventricular remodelling in calcific aortic valve stenosis

International audienceBackground. - The severity of left ventricular (LV) remodelling is only partially related to the severity of aortic valve stenosis; additional factors, including diabetes, insulin resistance, obesity and metabolic syndrome, may play important roles. Epicardial adipose tissue (EAT), now considered as a metabolically active organ, is also linked to these factors. Aim. - To analyse the association between EAT volume measured using computed tomography and LV remodelling in a prospective cohort of patients with aortic stenosis. Methods. - Consecutive asymptomatic patients with at least mild degenerative aortic stenosis enrolled in a prospective cohort that aimed to assess the determinants of aortic stenosis occurrence and progression constituted our population. Results. - We enrolled 143 patients (78 +/- 5 years; 65% men). Mean LV mass and EAT volume were 219 +/- 64 g and 134 +/- 56 mL, respectively. LV hypertrophy was diagnosed in 86 patients (60%), and concentric hypertrophy (32%) was the main remodelling pattern. EAT was associated with body mass index (P 0.10). EAT was correlated with LV mass (r = 0.41; P < 0.0001), and after adjustment for age, sex, body mass index/body surface area, hypertension, waist circumference, low-density lipoprotein cholesterol and aortic stenosis severity, EAT was independently associated with LV mass (P = 0.01/P = 0.02). Similar results were found when EAT and LV mass index (adjusted for body surface area) were considered instead of absolute values (P = 0.04). Conclusions. - In this prospective cohort of patients with aortic stenosis, EAT volume was independently associated with LV mass. Further studies are warranted to elucidate the underlying mechanisms of this link. (C) 2019 Elsevier Masson SAS. All rights reserved

Influence of metabolic syndrome and diabetes on progression of calcific aortic valve stenosis

Determinants of the progression of aortic stenosis (AS) remained unclear. Metabolic syndrome (MetS) and diabetes are suspected to play an active role but literature is scarce and results conflicting. We sought to assess their impact in an ongoing prospective cohort of asymptomatic patients with at least mild AS

Haemodynamic and anatomic progression of aortic stenosis

Background : Aortic valve stenosis (AS) is a progressive disease, but the impact of baseline AS haemodynamic or anatomic severity on AS progression remains unclear. Methods : In 149 patients (104 mild AS, 36 moderate AS and 9 severe AS) enrolled in 2 ongoing prospective cohorts (COFRASA/GENERAC), we evaluated AS haemodynamic severity at baseline and yearly, thereafter, using echocardiography (mean pressure gradient (MPG)) and AS anatomic severity using CT (degree of aortic valve calcification (AVC)). Results : After a mean follow-up of 2.9±1.0 years, mean MGP increased from 22±11 to 30±16 mm Hg (+3±3 mm Hg/year), and mean AVC from 1108±891 to 1640±1251 AU (arbitrary units) (+188±176 AU/year). Progression of AS was strongly related to baseline haemodynamic severity (+2±3 mm Hg/year in mild AS, +4±3 mm Hg/year in moderate AS and +5±5 mm Hg/year in severe AS (p=0.01)), and baseline haemodynamic severity was an independent predictor of haemodynamic progression (p=0.0003). Annualised haemodynamic and anatomic progression rates were significantly correlated (r=0.55, p<0.0001), but AVC progression rate was also significantly associated with baseline haemodynamic severity (+141±133 AU/year in mild AS, +279±189 AU/year in moderate AS and +361±293 AU/year in severe AS, p<0.0001), and both baseline MPG and baseline AVC were independent determinants of AVC progression (p<0.0001). Conclusions : AS progressed faster with increasing haemodynamic or anatomic severity. Our results suggest that a medical strategy aimed at preventing AVC progression may be useful in all subsets of patients with AS including those with severe AS and support the recommended closer follow-up of patients with AS as AS severity increases

Impact of Fetuin-A on progression of calcific aortic valve stenosis - The COFRASA - GENERAC study

Aortic stenosis (AS) is an active disease, but the determinants of AS progression remain largely unknown. Low levels of Fetuin-A, a powerful inhibitor of ectopic calcification, have been linked to ectopic calcium tissue deposition but its role in AS progression has not been clearly evaluated