Atrial arrhythmia in adults with sickle cell anemia: a missing link toward understanding and preventing strokes.

Autor:	d'Humières T; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.; INSERM IMRB U955, Université Paris Est, Créteil, France.; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, Université Paris Est, FHU SENEC, CHU Henri Mondor Assistance Publique Hôpitaux de Paris, Créteil, France.; Paris Cardiovascular Research Center-PARCC, Inserm, Université Paris Cité, Paris, France., Sadraoui Z; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Savale L; Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris; Le Kremlin-Bicêtre, France.; Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.; INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, France., Boyer L; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.; INSERM IMRB U955, Université Paris Est, Créteil, France., Guillet H; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, Université Paris Est, FHU SENEC, CHU Henri Mondor Assistance Publique Hôpitaux de Paris, Créteil, France.; Department of Internal Medicine, Henri Mondor University Hospital, Université Paris Est/Assistance Publique Hôpitaux de Paris, Créteil, France., Alassaad L; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.; INSERM IMRB U955, Université Paris Est, Créteil, France., de Luna G; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, Université Paris Est, FHU SENEC, CHU Henri Mondor Assistance Publique Hôpitaux de Paris, Créteil, France.; Department of Internal Medicine, Henri Mondor University Hospital, Université Paris Est/Assistance Publique Hôpitaux de Paris, Créteil, France., Iles S; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Balfanz P; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.; INSERM IMRB U955, Université Paris Est, Créteil, France., Habibi A; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, Université Paris Est, FHU SENEC, CHU Henri Mondor Assistance Publique Hôpitaux de Paris, Créteil, France.; Department of Internal Medicine, Henri Mondor University Hospital, Université Paris Est/Assistance Publique Hôpitaux de Paris, Créteil, France., Martino S; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, Université Paris Est, FHU SENEC, CHU Henri Mondor Assistance Publique Hôpitaux de Paris, Créteil, France.; Department of Internal Medicine, Henri Mondor University Hospital, Université Paris Est/Assistance Publique Hôpitaux de Paris, Créteil, France., Amorouayeche Z; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Dang TL; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Pham Hung d'Alexandry d'Orengiani AL; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, Université Paris Est, FHU SENEC, CHU Henri Mondor Assistance Publique Hôpitaux de Paris, Créteil, France., Rideau D; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Train L; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Simon T; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Ibrahim C; Paris Cardiovascular Research Center-PARCC, Inserm, Université Paris Cité, Paris, France., Messonnier LA; Inter-university Laboratory of Human Movement Sciences EA 7424, Université Savoie Mont Blanc, Chambéry, France.; Institut Universitaire de France, Paris, France., Audureau E; INSERM IMRB U955, Université Paris Est, Créteil, France.; Biostatistics Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Derbel H; Radiology Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.; School of Medicine, Université Paris Est, Créteil, France., Calvet D; Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Université Paris Cité, FHU Neurovasc, INSERM 1266, Paris, France., Lellouche N; School of Medicine, Université Paris Est, Créteil, France.; Cardiology Department, Rhythmology unit, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France., Derumeaux G; Physiology Department, FHU SENEC, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France.; INSERM IMRB U955, Université Paris Est, Créteil, France., Bartolucci P; Sickle Cell Referral Center-UMGGR, Plateforme d'expertise Maladies Rares Grand Paris Est, Université Paris Est, FHU SENEC, CHU Henri Mondor Assistance Publique Hôpitaux de Paris, Créteil, France.; Department of Internal Medicine, Henri Mondor University Hospital, Université Paris Est/Assistance Publique Hôpitaux de Paris, Créteil, France.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2024 Nov 12; Vol. 8 (21), pp. 5625-5638.
DOI:	10.1182/bloodadvances.2024013208
Abstrakt:	Abstract: Although patients with homozygous sickle cell anemia (SCA) carry both significant left atrial (LA) remodeling and an increased risk of stroke, the prevalence of atrial arrhythmia (AA) has never been prospectively evaluated. The aim of this study was to identify the prevalence and predictors of atrial arrhythmia in SCA. From 2018 to 2022, consecutive adult patients with SCA were included in the DREPACOEUR prospective registry and referred to the physiology department for cardiac evaluation, including a 24-hour electrocardiogram monitoring (ECG-Holter). The primary endpoint was the occurrence of AA, defined by the presence of excessive supraventricular ectopic activity (ESVEA) on ECG-Holter (ie >720 premature atrial contractions [PACs] or any run ≥ 20 PACs) or any recent history of atrial fibrillation. Overall, 130 patients with SCA (mean age: 45±12 years, 48% of male) were included. AA was found in 34 (26%) patients. Age (52±9 vs. 42±12 years, P=0,002), LA dilation (LAVi, 71±24 vs. 52±14 mL/m², P<0.001) and history of stroke without underlying cerebral vasculopathy (26% vs. 5%, P=0.009, OR=6.6 (95%CI 1.4-30.3]) were independently associated with AA. Age and LAVi correlated with PAC load per 24 hours on ECG-Holter. An age over 47 years or a LAVi >55mL/m² could predict AA with a PPV of 33% and a NPV of 92%. AAs are frequent in middle-aged patients with SCA and increase with age and LA remodeling, leading to a major additional risk factor for ischemic stroke. This study provides arguments and means to early screen for AA and potentially prevent cerebral complications. (© 2024 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
Databáze:	MEDLINE
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