The mutual relationship between heart failure and atrial fibrillation

Atrial fibrillation (AF) and Heart Failure (HF) are evolving epidemies, together responsible for substantial human suffering and health-care expenditure. The simultaneous co-existence of the two conditions is associated with higher mortality rates than those observed in individuals with only one or none of them. Patients with concomitant HF and AF suffer from even worse symptoms and poorer prognosis, yet evidence-based evaluation and management of this group of patients is lacking. In this review, we evaluate the common mechanisms for the development of AF in HF patients and vice versa, focusing on the evidence for potential treatment strategies. Recent data have suggested that these patients may respond differently if compared to those with HF or AF alone. These results highlight the clear clinical need to identify and treat these diseases according to best evidence, in order to prevent adverse outcomes and reduce the huge burden er that HF and AF are expected to have on global healthcare systems in the future

Reverse remodeling and arrhythmic burden reduction in a patient with an implantable cardioverter defibrillator treated with sacubitril/valsartan: Case report

Sacubitril/valsartan has been shown to reduce cardiovascular mortality and hospitalizations in patients with HFrEF when compared to enalapril. There are also some evidences of its potential antiarrhythmic effects. We present a report where we found a relation between reverse ventricular remodeling and arrhythmic reduction in a patient treated with sacubitril/valsartan

Early Detection of Myocardial Damage: A Multimodality Approach

Cardiovascular diseases are possible complications of antineoplastic treatment and may lead to premature morbidity and mortality among cancer survivors. A symptom‑based follow‑up is ineffective, and there are growing evidences that early detection of myocardial damage in patients treated with antineoplastic drugs is the key point to prevent the occurrence of damage and improve the prognosis of these patients. Different techniques have been proposed to monitor cardiac function in oncologic patients such as cardiac imaging (echocardiography, nuclear imaging, and cardiac magnetic resonance) and biomarkers (troponin and natriuretic peptides). The European Association of Cardiovascular Imaging/American Society of Echocardiography consensus document encourages an integrated approach to early detec

Prognostic Role of Late Gadolinium Enhancement in Patients With Hypertrophic Cardiomyopathy and Low-to-Intermediate Sudden Cardiac Death Risk Score

Sudden cardiac death (SCD) is the most life-threating complication of hypertrophic cardiomyopathy. Guidelines of the European Society of Cardiology (ESC) suggest the implantation of an implantable cardioverter defibrillator in primary prevention according to a 5-year risk SCD score 656%. The aim of the study is to evaluate the prognostic role of late gadolinium enhancement (LGE) in patients with a 5-year risk SCD score <6%. In this multicenter study, we performed cardiac magnetic resonance in 354 consecutive hypertrophic cardiomyopathy patients (257 males, range of age 54 \ub1 17) with a risk SCD score <6% (302 with <4% and 52 with 654 and <6% risk). Hard cardiac events, including SCD, resuscitated cardiac arrest, appropriate implantable cardioverter defibrillator interventions, sustained ventricular tachycardia, occurred in 22 patients. LGE was detected in a high proportion (92%) of patients with hard cardiac events (p = 0.002). At receiver-operating characteristic curve analysis, LGE extent 6510% was the best threshold to predict major arrhythmic events (area under the curve: 0.74). Kaplan-Meier curves showed that patients with LGE 6510% had a worse prognosis than those with lower extent (p < 0.0001). LGE extent was the best independent predictor of hard cardiac events (hazard ratio 1.05; 95% confidence interval [CI] 1.03 to 107; p < 0.0001). The estimates 5-year risk of hard cardiac event was 2.5% (95% CI 0.8 to 4.2) in patients with LGE extent <10% and 23.4% (95% CI 10.2 to 36.5) for those with LGE extent 6510%. In conclusion, this study demonstrates as the extent of LGE 6510% is able to recognize additional patients at increased risk for malignant arrhythmic episodes in a population with low-to-intermediate ESC SCD risk score

\uab \u2018Durant\u2019, \u2018pendant\u2019 et l\u2019italien \u2018durante\u2019 : les diff\ue9rentes natures de leurs compl\ue9ments. \uc9tat des lieux contrastif d\u2019une grammaticalisation parall\ue8le \ubb

Paola RUOZZI, \u2018Durant\u2019, \u2018pendant\u2019 et l\u2019italien \u2018durante\u2019 : les diff\ue9rentes natures de leurs compl\ue9ments. Etat des lieux contrastif d\u2019une grammaticalisation parall\ue8le, pp. 28-44. Ruozzi analyse l\u2019\ue9volution diachronique et synchronique des pr\ue9positions fran\ue7aises durant et pendant par rapport \ue0 la pr\ue9position italienne durante. Issues des participes pr\ue9sents des verbes latins durare (pour ce qui est de durant et de durante) et pendere (relativement \ue0 pendant), les trois pr\ue9positions ont beaucoup \ue9volu\ue9 au fil des si\ue8cles dans les deux langues. Si elles partagent des emplois identiques, \ue0 savoir le fait que la t\ueate nominale du compl\ue9ment pr\ue9positionnel est un nom abstrait qui marque un processus ou un nom hybride compatible avec l\u2019\ue9vocation d\u2019un processus, deux autres emplois diff\ue8rent d\u2019une langue \ue0 l\u2019autre. En effet, alors que pendant et durant figurent \ue9galement en pr\ue9sence de noms concrets de lieu, d\u2019espace et de temps, durante pose nombre de probl\ue8mes \ue0 ce propos. C\u2019est ainsi qu\u2019\ue0 l\u2019aide de l\u2019\ue9tude diachronique ponctuelle des trois pr\ue9positions l\u2019auteur aboutit \ue0 la conclusion d\u2019apr\ue8s laquelle durant et pendant gardent, au-del\ue0 de leur statut pr\ue9positionnel, un statut participial. En revanche, durante aurait tout \ue0 fait acquis le statut de pr\ue9position en italien. D\u2019o\uf9 une grammaticalisation et une stratification des pr\ue9positions du fran\ue7ais beaucoup plus floues qu\u2019en italien, mais \ue9galement une grammaticalisation qui, selon Ruozzi, est en tout cas encore inachev\ue9e dans les deux langues

« ‘Durant’, ‘pendant’ et l’italien ‘durante’ : les différentes natures de leurs compléments. État des lieux contrastif d’une grammaticalisation parallèle »

Paola RUOZZI, ‘Durant’, ‘pendant’ et l’italien ‘durante’ : les différentes natures de leurs compléments. Etat des lieux contrastif d’une grammaticalisation parallèle, pp. 28-44. Ruozzi analyse l’évolution diachronique et synchronique des prépositions françaises durant et pendant par rapport à la préposition italienne durante. Issues des participes présents des verbes latins durare (pour ce qui est de durant et de durante) et pendere (relativement à pendant), les trois prépositions ont beaucoup évolué au fil des siècles dans les deux langues. Si elles partagent des emplois identiques, à savoir le fait que la tête nominale du complément prépositionnel est un nom abstrait qui marque un processus ou un nom hybride compatible avec l’évocation d’un processus, deux autres emplois diffèrent d’une langue à l’autre. En effet, alors que pendant et durant figurent également en présence de noms concrets de lieu, d’espace et de temps, durante pose nombre de problèmes à ce propos. C’est ainsi qu’à l’aide de l’étude diachronique ponctuelle des trois prépositions l’auteur aboutit à la conclusion d’après laquelle durant et pendant gardent, au-delà de leur statut prépositionnel, un statut participial. En revanche, durante aurait tout à fait acquis le statut de préposition en italien. D’où une grammaticalisation et une stratification des prépositions du français beaucoup plus floues qu’en italien, mais également une grammaticalisation qui, selon Ruozzi, est en tout cas encore inachevée dans les deux langues

Effect of intravenous iron replacement therapy on exercise capacity in iron deficient anemic patients after cardiac surgery

Iron deficiency (ID) is recognized as an important comorbidity in patients undergoing cardiac surgery; however, it still remains under-diagnosed and under-treated in clinical practice. This study aims at comparing efficacy and the effects on exercise capacity of intravenous ferric carboxymaltose (FCM) versus ferric gluconate (FG) in patients with ID anemia (IDA) resulting from cardiac surgery. We retrospectively analyzed data from our records of in-hospital patients with IDA after cardiac surgery undergoing cardiac rehabilitation. Group I was treated with FG, group II with FCM. Efficacy measures included changes (baseline vs discharge) in hemoglobin (Hb) and in distance traveled at six-minutes walking test (6MWT). Data from 74 in-patients (mean age 67.5±10.4 years, 43% women) were analyzed. At discharge, patients treated with FCM showed higher levels of Hb (11.1±1.2g/dl vs 10.2±1.1 g/dl; p=0.001), greater distance traveled at 6MWT (279.2±108.8 meters vs 236.3±72.7 meters; p=0.048), and lower in-hospital rehabilitation length of stay (20.3±7 vs 25.3±11.7 days; p=0.043) as compared to FG group. At multivariate analysis, the most powerful predictors of Hb increase >1 g/dl at discharge were transferrin levels (p=0.019) and treatment with FCM (p100 meters) at discharge (p=0.13 and p=0.003, respectively). In patients with IDA following cardiac surgery, intravenous FCM is effective in restoring Hb levels and in improving exercise capacity after cardiac surgery