- Email: [email protected]
Epidemiological profile and pronostic impact of patients with heart failure and atrial fibrillation: Results from the NATURE HF registry
46 ization (2.208 [1.579, 3.089]), and the combined end point of all-cause death or hospitalization (1.654, [1.319, 2.072]). There was an increased risk for a composite of death or HF admissions in diabetic patients with ischemic cardiomyopathy (23.9 vs. 14.1% respectively, P < 0.001). Conclusion The co-existence of heart failure and diabetes has significant impact on outcomes and confers a worse prognosis than heart failure alone, especially in patients with ischemic cardiomyopathy. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.095 546
Epidemiological profile and pronostic impact of patients with heart failure and atrial fibrillation: Results from the NATURE HF registry M. Ben Halima 1,∗ , M. Mechri 1 , K. Sammoud 1 , M.S. Mourali 1 , I. Kammoun 2 , L. Bezdah 3 , K. Mzoughi 4 , W. Sdiri 5 , A. Horchani 6 , S. Milouchi 6 , C. Yousfi 7 , O. Abid 3 , A. Mebazaa 8 , F. Addad 2 , L. Abid 7 1 Explorations fonctionnelles et réanimation cardiologiques, Hôpital la Rabta 2 Cardiology, Abderrahman Mami 3 Cardiology, Charles Nicolle 4 Cardiology, Habib Thameur, Tunis 5 Cardiology, Bougatfa habib, Bizerte 6 Cardiology, Mednine hospital, Mednine 7 Cardiology, Hedi Chaker, Sfax, Tunisie 8 Intensive care, Lariboisière hospital, Paris, France ∗ Corresponding author. E-mail address: [email protected] (M. Ben Halima) Background Atrial fibrillation (AF) and heart failure (HF) often coexist aggravating prognosis and constituting a major public health problem. The prevalence of AF especially in patients with chronic HF remains poorly understood in our country. Aim To assess the prevalence of AF in patients with HF recruited from the prospective NATURE-HF registry (NAtional TUnisian REgistry of Heart Failure).and to determine the clinical profile as well as the evolutionary modalities of this group. Materials and methods Between October and November 2017, we prospectively registered 2040 patients with a history of HF. Patients with AF were picked. Clinical features, etiological characteristics, management as well as outcome were recorded within one year of follow-up. Results Among 2040 patients with HF, 337 patients with a mean age of 65 ± 13 years old presented with AF (16.5%). The frequency of cardiovascular risk factors associated with AF was: hypertension, diabetes, dyslipidemia and tobacco in respectively 42.9%, 29.8%, 20.8% and 19.7% of patients. The causes of underlying heart disease of HF associated with AF were: coronary artery diseases (30.4%), heart valve diseases (30.1%), primitive heart disease (24.7%); rythmic cardiopathy (12.8%) and hypertensive (1.2%). Over a follow-up of 12 months, there was no significant difference in terms of hospitalisation between HF patients with or without associated AF (6.3% vs. 7.5%, P = 0.4). However, the presence of AF was associated with a worse prognosis in terms of mortality (17.9% in patients with AF compared to 12% in patients without AF, P = 0.004) despite comparable clinical features to baseline with patients without AF. Conclusion NATURE HF showed that AF frequently appears in patients with HF and it occurs at an average age lower than that found in the literature. Otherwise, the results of NATURE HF empha-
Heart failure and cardiomyopathies size that AF seems to worsen the prognosis in patients followed for HF. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.096 355
Prevalence of mechanical dyssynchrony in heart failure patients according to QRS width L. Bezdah ∗ , E. Allouche , M. Chebbi , F. El Ayech Boudiche , H. Ben Ahmed , W. Ouchtati Cardiologie, hôpital Charles Nicolle, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (L. Bezdah) Introduction The aim of this study was to define the prevalence of mechanical (atrio-ventricular, interventricular and intraventricular) dyssynchrony in heart failure patients with different QRS durations. Methods A total of 46 patients with heart failure (dilated cardiomyopathy with LVEF < 40%, NYHA II-IV) were prospectively evaluated using 12-lead electrocardiogram and complete echocardiographic examination including tissue Doppler imaging. All the patients had sinus rhythm and the dilated cardiomyopathy was primitive in 37% of patients and ischemic in the others. Results According to QRS duration, 16 patients had QRS ≥ 150 ms (group 1), 15 patients had QRS duration between 120 and 149 ms (group 2) and 15 patients had QRS duration < 120 ms (group 3). Interventricular dyssynchrony (IVD) was present in 62% of group 1, 13% of group 2 and was absent in group 3 (P < 0,001). Intraventricular dyssynchrony (IntraVD) was present respectively in 94%, 40%, 20% of groups 1,2, and 3 (P < 0,001). However, there was no significant difference in the prevalence of atrioventricular dyssynchrony (AVD) between the three groups. A multiparametric approach by focusing on criteria combination found that the association of IVD + IntraVD + AVD was present only in group 1 and the combination of two criteria was seen only in group 1 and 2 with a significantly higher prevalence in group 1 (P < 0,01). Conclusion The prevalence of mechanical dyssynchrony increases with the increasing QRS duration and the combination of criteria is significantly more prevalent when the QRS width is ≥ 150 ms. Intraventricular dyssynchrony can be observed in heart failure patients with a narrow QRS complex and may be useful in predicting left ventricular reverse remodelling after CRT. The lack of dyssynchrony in some patients with standard CRT indication by QRS duration may sometimes explain the non-responder’s rates. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.097 422
An associated tricuspid annuloplasty during mitral valve replacement does not increase surgical risk and in-hospital morbidity and mortality: An observational study B. Kichou ∗ , N. Henine , M. Ait Said , S. Mehlal , S. Brahimi , S. Mokrane CHU de Tizi-Ouzou, Tizi-Ouzou, Algérie ∗ Corresponding author. E-mail address: [email protected] (B. Kichou) Purpose To evaluate the impact of an associated tricuspid annuloplasty on surgical mortality and morbidity in patients who underwent mitral valve replacement.
Epidemiological profile and pronostic impact of patients with heart failure and atrial fibrillation: Results from the NATURE HF registry M. Ben Halima 1,∗ , M. Mechri 1 , K. Sammoud 1 , M.S. Mourali 1 , I. Kammoun 2 , L. Bezdah 3 , K. Mzoughi 4 , W. Sdiri 5 , A. Horchani 6 , S. Milouchi 6 , C. Yousfi 7 , O. Abid 3 , A. Mebazaa 8 , F. Addad 2 , L. Abid 7 1 Explorations fonctionnelles et réanimation cardiologiques, Hôpital la Rabta 2 Cardiology, Abderrahman Mami 3 Cardiology, Charles Nicolle 4 Cardiology, Habib Thameur, Tunis 5 Cardiology, Bougatfa habib, Bizerte 6 Cardiology, Mednine hospital, Mednine 7 Cardiology, Hedi Chaker, Sfax, Tunisie 8 Intensive care, Lariboisière hospital, Paris, France ∗ Corresponding author. E-mail address: [email protected] (M. Ben Halima) Background Atrial fibrillation (AF) and heart failure (HF) often coexist aggravating prognosis and constituting a major public health problem. The prevalence of AF especially in patients with chronic HF remains poorly understood in our country. Aim To assess the prevalence of AF in patients with HF recruited from the prospective NATURE-HF registry (NAtional TUnisian REgistry of Heart Failure).and to determine the clinical profile as well as the evolutionary modalities of this group. Materials and methods Between October and November 2017, we prospectively registered 2040 patients with a history of HF. Patients with AF were picked. Clinical features, etiological characteristics, management as well as outcome were recorded within one year of follow-up. Results Among 2040 patients with HF, 337 patients with a mean age of 65 ± 13 years old presented with AF (16.5%). The frequency of cardiovascular risk factors associated with AF was: hypertension, diabetes, dyslipidemia and tobacco in respectively 42.9%, 29.8%, 20.8% and 19.7% of patients. The causes of underlying heart disease of HF associated with AF were: coronary artery diseases (30.4%), heart valve diseases (30.1%), primitive heart disease (24.7%); rythmic cardiopathy (12.8%) and hypertensive (1.2%). Over a follow-up of 12 months, there was no significant difference in terms of hospitalisation between HF patients with or without associated AF (6.3% vs. 7.5%, P = 0.4). However, the presence of AF was associated with a worse prognosis in terms of mortality (17.9% in patients with AF compared to 12% in patients without AF, P = 0.004) despite comparable clinical features to baseline with patients without AF. Conclusion NATURE HF showed that AF frequently appears in patients with HF and it occurs at an average age lower than that found in the literature. Otherwise, the results of NATURE HF empha-
Heart failure and cardiomyopathies size that AF seems to worsen the prognosis in patients followed for HF. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.096 355
Prevalence of mechanical dyssynchrony in heart failure patients according to QRS width L. Bezdah ∗ , E. Allouche , M. Chebbi , F. El Ayech Boudiche , H. Ben Ahmed , W. Ouchtati Cardiologie, hôpital Charles Nicolle, Tunis, Tunisie ∗ Corresponding author. E-mail address: [email protected] (L. Bezdah) Introduction The aim of this study was to define the prevalence of mechanical (atrio-ventricular, interventricular and intraventricular) dyssynchrony in heart failure patients with different QRS durations. Methods A total of 46 patients with heart failure (dilated cardiomyopathy with LVEF < 40%, NYHA II-IV) were prospectively evaluated using 12-lead electrocardiogram and complete echocardiographic examination including tissue Doppler imaging. All the patients had sinus rhythm and the dilated cardiomyopathy was primitive in 37% of patients and ischemic in the others. Results According to QRS duration, 16 patients had QRS ≥ 150 ms (group 1), 15 patients had QRS duration between 120 and 149 ms (group 2) and 15 patients had QRS duration < 120 ms (group 3). Interventricular dyssynchrony (IVD) was present in 62% of group 1, 13% of group 2 and was absent in group 3 (P < 0,001). Intraventricular dyssynchrony (IntraVD) was present respectively in 94%, 40%, 20% of groups 1,2, and 3 (P < 0,001). However, there was no significant difference in the prevalence of atrioventricular dyssynchrony (AVD) between the three groups. A multiparametric approach by focusing on criteria combination found that the association of IVD + IntraVD + AVD was present only in group 1 and the combination of two criteria was seen only in group 1 and 2 with a significantly higher prevalence in group 1 (P < 0,01). Conclusion The prevalence of mechanical dyssynchrony increases with the increasing QRS duration and the combination of criteria is significantly more prevalent when the QRS width is ≥ 150 ms. Intraventricular dyssynchrony can be observed in heart failure patients with a narrow QRS complex and may be useful in predicting left ventricular reverse remodelling after CRT. The lack of dyssynchrony in some patients with standard CRT indication by QRS duration may sometimes explain the non-responder’s rates. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.097 422
An associated tricuspid annuloplasty during mitral valve replacement does not increase surgical risk and in-hospital morbidity and mortality: An observational study B. Kichou ∗ , N. Henine , M. Ait Said , S. Mehlal , S. Brahimi , S. Mokrane CHU de Tizi-Ouzou, Tizi-Ouzou, Algérie ∗ Corresponding author. E-mail address: [email protected] (B. Kichou) Purpose To evaluate the impact of an associated tricuspid annuloplasty on surgical mortality and morbidity in patients who underwent mitral valve replacement.