Clinical Presentation and Outcomes After Surgery for Mitral Regurgitation: Real-World Insights From the MITRACURE International Registry.

Background: Comprehensive knowledge of the clinical presentation, contemporary management, and outcomes on "allcomer" patients referred for mitral valve surgery (MVS) are critical to evaluate current practice and adherence to guidelines, understand selection biases, and inform key stakeholders on quality improvement.

Methods: MITRACURE is a large international retrospective registry of consecutive adult patients who underwent isolated or combined MVS for mitral regurgitation (MR) in France or Canada in 2019 with in-depth clinical and echocardiographic characterization. Patients operated on for isolated mitral stenosis or who had a prior mitral valve intervention were excluded.

Assessment of cardiopulmonary risk in COPD patients: Expert opinion formalized using the Delphi method.

Background: Cardiovascular (CV) comorbidities are frequent in patients with chronic obstructive pulmonary disease (COPD), increasing individual morbidity and mortality. This observation has given rise to the concept of cardiopulmonary risk. However, assessment and management of CV risk in COPD patients is highly variable in practice.

Characterization of reflex syncope in Brugada syndrome: a literature review.

In Brugada syndrome (BrS), syncope is considered a sign of increased risk for sudden cardiac death (SCD) due to ventricular tachycardia/ventricular fibrillation (VT/VF) episodes. However, arrhythmic syncope in BrS is extremely rare, while nonarrhythmic syncope may occur as in the general active population, mostly from reflex events. Symptomatic patients with BrS show a higher risk profile, requiring a watchful risk stratification.

Vasopressin and its analogues in patients with septic shock: holy Grail or unfulfilled promise?

The Surviving Sepsis Campaign (SSC) recommends norepinephrine as first-line vasopressor in patients with septic shock. For many years, there has been growing evidence that high doses of norepinephrine might have cardiac and immunological adverse effects and be associated with poorer outcomes. Current SSC guidelines therefore suggest adding vasopressin, a non-catecholaminergic vasopressor, as a second-line vasopressor rather than increasing the norepinephrine dose in patients requiring doses of norepinephrine base > 0.

Assessment of chest wall elastance in patients with pulmonary fibrosis waiting for lung transplantation, interest in donor size selection.

Some patients with pulmonary fibrosis (PF) can have severe and fixed chest wall retraction; others regain the shape of their original rib cage once the lungs are removed. These 2 possibilities determine the size of the lung graft to be allocated but are not predictable with classical respiratory tests or computed tomography (CT) scan. We first measured chest wall elastance (E) with esophageal pressure on the day of transplantation (group 1) and then during pretransplant medical check-up, and used for donor selection (group 2).

Effects of the urinary urea excretion index on the decision to wean ICU patients with acute kidney injury from renal replacement therapy: a before-after multicentre study (D-STOP).

Background: The weaning of critical care patients with acute kidney injury (AKI) from renal replacement therapy (RRT) lacks predictive criteria. The urinary urea excretion index (UUEI) based on the urine urea concentration and diuresis may be a relevant prognostic criterion. The aim of this study was to assess the value of utilising a UUEI-based weaning protocol from a RRT catheter.

Home and outpatient versus in-hospital initiation of non-invasive ventilation in people with neuromuscular and restrictive thoracic disorders: a network meta-analysis.

Introduction: There is a growing trend towards outpatient or home initiation of long-term non-invasive ventilation (NIV) instead of in-hospital initiation. However, evidence supporting the non-inferiority of this strategy is limited in people with neuromuscular diseases (NMDs) or restrictive thoracic disorders (RTDs).

Methods: Systematic review and network meta-analysis (NMA) to compare the effect of three NIV initiation settings (home, outpatient and in-hospital) on long-term NIV efficacy in people with NMD or RTD.

Does occupational exposure affect the surgical management of patients with non-small cell lung cancer? A single-center retrospective experience.

Objective: Non-small-cell lung cancer (NSCLC) remains a major public health concern, with tobacco and environmental exposures to carcinogens (such as asbestos, radon, and silica) recognized as major risk factors. This study investigates the impact of occupational exposure, particularly to crystalline silica on peri‑ and postoperative outcomes in patients undergoing surgery for NSCLC.

Methods: A retrospective analysis was performed on 251 patients who underwent lobectomy or segmentectomy between 2018 and 2021, with occupational exposure data collected postoperatively.

Understanding and manipulating morphogenetic processes to generate in vitro models of airways.

Branching morphogenesis, the process by which cells and tissues organize into complex branched tubular structures, is fundamental to the development of functional organs, including the respiratory airways in mammalian lungs. Advances in understanding the molecular and cellular mechanisms driving morphogenetic processes have enabled the development of sophisticated in vitro models that mimic the structure and function of airways. This review recapitulates developmental principles guiding airway morphogenesis, including the key signaling pathways, cellular interactions, and the different biochemical and mechanical cues.

Bronchial smooth muscle extracellular vesicles interfere with bronchial epithelium metabolism and function in asthma.

Bronchial smooth muscle (BSM) remodeling is an important feature of severe asthma pathophysiology. We previously showed that asthmatic BSM is metabolically different and increased rhinovirus (RV) replication rate, the main trigger of severe asthma exacerbations. Extracellular vesicles (EVs) are the key mediator in cell-cell communication, but the role of BSM cells-derived EVs on bronchial epithelial has never been investigated in asthma.

Validity and reliability of anharmonic morphological ventilometry for the characterisation of human breathing.

Diagnosing and monitoring respiratory disorders typically rely on pulmonary function testing, which requires full patient cooperation and trained personnel, limiting its applicability. Analysing natural breathing offers a valuable alternative but requires new methodological approaches. This study introduces anharmonic morphological analysis, a novel technique to characterise breathing cycles, and evaluates its reliability and ability to distinguish healthy individuals from patients with chronic obstructive pulmonary disease (COPD).

Marshall-Plan Ablation Strategy Versus Pulmonary Vein Isolation in Persistent AF: A Randomized Controlled Trial.

Background: Beyond pulmonary vein (PV) isolation, the optimal ablation strategy for persistent atrial fibrillation (AF) remains poorly defined. The purpose of this study was to compare 2 ablation strategies in the treatment of patients with persistent AF: a comprehensive ablation strategy based on anatomic considerations versus PV isolation alone.

Methods: The Marshall-Plan trial is a prospective, randomized, parallel-group, controlled clinical trial of superiority conducted at the Bordeaux University Hospital.

COPD patients with non-small cell lung cancer respond better to anti-PD-(L)1 immune checkpoint inhibitors.

In studies evaluating the efficacy of anti-programmed cell death 1/ligand 1 immune checkpoint inhibitors (anti-PD-(L)1) among patients with non-small cell lung cancer (NSCLC), smokers tend to have better clinical outcomes than non-smokers. However, it is unclear whether NSCLC patients with co-existing chronic obstructive pulmonary disease (COPD) have better clinical outcomes than patients without COPD, regardless of smoking history. The potential correlation of COPD with an improved response to anti-PD-(L)1 was examined in a large cohort of patients with available pulmonary function test results.

Dietary intake remains unchanged while nutritional status improves in children and adults with cystic fibrosis on Elexacaftor/Tezacaftor/Ivacaftor.

Background: Cystic fibrosis (CF) is a genetic disorder involving multi-organ dysfunction, with nutritional status playing a crucial role in disease progression. Cystic Fibrosis Transmembrane conductance Regulator (CFTR) modulator therapy, particularly the combination Elexacaftor/Tezacaftor/Ivacaftor (ETI), has shown numerous clinical benefits, including significant improvements in nutritional status. However, the factors driving this nutritional improvement, especially the potential role of increased dietary intake, remain underexplored.

MR Imaging of Pulmonary Surfactant Distribution in a Preclinical Neonatal Lung Model.

The administration of exogenous surfactant is essential for many premature infants to compensate for pulmonary immaturity and the absence of endogenous surfactant at birth. Exogenous surfactant delivery techniques are continually being refined to improve the management of these infants, with the goal of increasing therapeutic efficacy and decreasing the invasiveness of delivery protocols. Imaging is one of the tools available to achieve these goals.

Severe Haemoptysis due to Pulmonary Artery Agenesis, About Two Rare but Threatening Case Reports.

Unilateral pulmonary artery agenesis (UPAA) is a rare condition that may be asymptomatic or present with recurrent infections and haemoptysis. A 17-year-old patient with severe haemoptysis who was diagnosed with right pulmonary artery agenesis, associated with hypertrophy of the homolateral bronchial arteries and numerous systemic collaterals. Despite three embolisation procedures, a high-risk of recurrence required pneumonectomy.

Access to respiratory rehabilitation in France: Opinions of pulmonologists and people with chronic obstructive pulmonary disease.

Despite its well-known benefits, respiratory rehabilitation (RR) remains underutilized among people with chronic obstructive lung disease (COPD) due to both patient- and physician-related barriers. This qualitative study (October 2023-March 2024) used two questionnaires: one for people with COPD to assess disease severity and access challenges, and another for pulmonologists to identify prescription obstacles. Distributed via associations and mailing lists, the survey reached 3,000 people with COPD and 500 pulmonologists, revealing shared concerns about facility shortages, poor information, and transportation issues.

Propensity score analysis of very long-term outcome after coronary thrombus aspiration in acute myocardial infarction.

Background: The long-term prognostic impact of thrombus aspiration (TA) in acute myocardial infarction (AMI) is unclear.

Aim: To assess the long-term prognostic impact of TA in AMI.

Methods: Data were obtained from three nationwide French surveys (FAST-MI 2005, 2010 and 2015) including consecutive patients with AMI.

Improved and Automated Detection of Papillary Muscle Infarction Using Joint Bright- and Black-Blood Late Gadolinium Enhancement MRI.

Background: Papillary muscle infarction (PMI) has been linked to significantly increased mortality and is associated with ventricular arrhythmias and mitral regurgitation. Reference bright-blood late gadolinium enhancement (LGE) imaging provides poor scar-to-blood contrast, making PMI visualization challenging. Black-blood LGE imaging overcomes this limitation by improving the blood-scar contrast.

CXCR4 Blockade Alleviates Pulmonary and Cardiac Outcomes in Early COPD.

Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory disease lacking effective treatment. Focusing on early COPD should help to discover disease modifying therapies. We examined the role of the CXCL12/CXCR4 axis in early COPD using human samples and murine models.

Guidance for chest-CT in children and adults with cystic fibrosis: A European perspective.

The European Cystic Fibrosis Society-Clinical Trials Network (ECFS-CTN) herein proposes guidance for the use of chest CT-scans for the regular monitoring of lung disease in CF. Statements were completed in a 3-step process: the questions were identified via an anonymous online survey, followed by a comprehensive literature search, and a final Delphi process. The guidance recommends the use of ultra-low dose CT scans (effective radiation dose, 0.

ECG electrode localization using 3D visual reconstruction.

Body surface potential maps (BSPMs) derived from multi-channel ECG recordings enable the detection and diagnosis of electrophysiological phenomena beyond the standard 12-lead ECG. In this work, we developed two AI-based methods for the automatic detection of location of the electrodes used for BSPM: a rapid method using a specialized 3D Depth Sensing (DS) camera and a slower method that can use any 2D camera. Both methods were validated on a phantom model and in 7 healthy volunteers.