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  1. Article ; Online: Systemic Hemodynamics, Cardiac Mechanics, and Signaling Pathways Induced by Extracorporeal Membrane Oxygenation in a Cardiogenic Shock Model.

    Beurton, Antoine / Michot, Maxime / Hérion, François-Xavier / Rienzo, Mario / Oddos, Claire / Couffinhal, Thierry / Imbault, Julien / Ouattara, Alexandre

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2024  Volume 70, Issue 3, Page(s) 177–184

    Abstract: Peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used in patients suffering from refractory cardiogenic shock (CS). Although considered life-saving, peripheral VA-ECMO may also be responsible for intracardiac ... ...

    Abstract Peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used in patients suffering from refractory cardiogenic shock (CS). Although considered life-saving, peripheral VA-ECMO may also be responsible for intracardiac hemodynamic changes, including left ventricular overload and dysfunction. Venoarterial extracorporeal membrane oxygenation may also increase myocardial wall stress and stroke work, possibly affecting the cellular cardioprotective and apoptosis signaling pathways, and thus the infarct size. To test this hypothesis, we investigated the effects of increasing the peripheral VA-ECMO blood flow (25-100% of the baseline cardiac output) on systemic and cardiac hemodynamics in a closed-chest CS model. Upon completion of the experiment, the hearts were removed for assessment of infarct size, histology, apoptosis measurements, and phosphorylation statuses of p38 and protein Kinase B (Akt), and extracellular signal-regulated kinase mitogen-activated protein kinases (ERK-MAPK). Peripheral VA-ECMO restored systemic perfusion but induced a significant and blood flow-dependent increase in left ventricular preload and afterload. Venoarterial extracorporeal membrane oxygenation did not affect infarct size but significantly decreased p38-MAPK phosphorylation and cardiac myocyte apoptosis in the border zone.
    MeSH term(s) Humans ; Shock, Cardiogenic/therapy ; Extracorporeal Membrane Oxygenation ; Hemodynamics ; Myocardium ; Signal Transduction
    Language English
    Publishing date 2024-01-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000002139
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    ab Jg. 2022: Lesesaal (EG)
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Multidisciplinary cardiogenic shock team approach improves the long-term outcomes of patients suffering from refractory cardiogenic shock treated with short-term mechanical circulatory support.

    Hérion, François-Xavier / Beurton, Antoine / Oddos, Claire / Nubret, Karine / Aguerreche, Clément / Quessard, Astrid / Faure, Maxime / Gerbaud, Edouard / Pernot, Mathieu / Imbault, Julien / Ouattara, Alexandre

    European heart journal. Acute cardiovascular care

    2023  Volume 12, Issue 12, Page(s) 821–830

    Abstract: Aims: Short-term mechanical circulatory support (STMCS) may be used as an intentional escalation strategy to treat refractory cardiogenic shock (rCS). However, with growing technical possibilities, making the right choice at the right time can be ... ...

    Abstract Aims: Short-term mechanical circulatory support (STMCS) may be used as an intentional escalation strategy to treat refractory cardiogenic shock (rCS). However, with growing technical possibilities, making the right choice at the right time can be challenging. We established a shock team in January 2013 comprising a cardiac anaesthetist-intensivist, an interventional cardiologist, and a cardiac surgeon. Since then, a diagnosis of rCS has triggered a multidisciplinary team meeting based on a common algorithm. This study aimed to compare the decision-making process for STMCS for rCS before (2007-2013) and after (2013-2019) the creation of the shock team.
    Methods and results: This before-and-after cohort study was conducted over a 156-month period. Post-cardiotomy rCS were excluded. The primary outcome was a 1-year survival rate. In total, 250 consecutive adult patients were included in the analysis (84 in the control group and 166 in the shock team group). At baseline, the CardShock score was not different between the two groups (5[3-5] vs. 5[4-6], P = 0.323). The 1-year survival rate was significantly higher in the shock team group compared with the control group (59% vs. 45%, P = 0.043). After a Cox regression analysis, the shock team intervention was independently associated with a significantly improved 1-year survival rate (HR: 0.592, 95% CI: 0.398-0.880, P = 0.010).
    Conclusion: A multidisciplinary shock team-based decision for STMCS device implantation in rCS is associated with better 1-year survival rates.
    MeSH term(s) Adult ; Humans ; Shock, Cardiogenic ; Cohort Studies ; Treatment Outcome ; Retrospective Studies ; Heart-Assist Devices
    Language English
    Publishing date 2023-09-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2663340-1
    ISSN 2048-8734 ; 2048-8726
    ISSN (online) 2048-8734
    ISSN 2048-8726
    DOI 10.1093/ehjacc/zuad108
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Partial Mural Cell Ablation Disrupts Coronary Vasculature Integrity and Induces Systolic Dysfunction.

    Cornuault, Lauriane / Hérion, François-Xavier / Bourguignon, Célia / Rouault, Paul / Foussard, Ninon / Alzieu, Philippe / Chapouly, Candice / Gadeau, Alain-Pierre / Couffinhal, Thierry / Renault, Marie-Ange

    Journal of the American Heart Association

    2023  Volume 12, Issue 13, Page(s) e029279

    Abstract: Background Although the critical role of pericytes in maintaining vascular integrity has been extensively demonstrated in the brain and the retina, little is known about their role in the heart. We aim to investigate structural and functional ... ...

    Abstract Background Although the critical role of pericytes in maintaining vascular integrity has been extensively demonstrated in the brain and the retina, little is known about their role in the heart. We aim to investigate structural and functional consequences of partial pericyte depletion (≈60%) in the heart of adult mice. Methods and Results To deplete pericytes in adult mice, we used platelet-derived growth factor receptor β-Cre/ERT2; Rosa
    MeSH term(s) Mice ; Animals ; Connexin 43/metabolism ; Stroke Volume ; Ventricular Function, Left ; Cardiomyopathies/metabolism ; Heart ; Pericytes
    Chemical Substances Connexin 43
    Language English
    Publishing date 2023-06-22
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.122.029279
    Database MEDical Literature Analysis and Retrieval System OnLINE

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