References of "Kulbertus, Henri"
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See detailQuelques considerations generales et rappels historiques a propos de la therapeutique.
Kulbertus, Henri ULg; Scheen, André ULg

in Revue Médicale de Liège (2000), 55(4), 201-5

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See detailDe la medecine factuelle aux recommandations therapeutiques. Epilogue.
Scheen, André ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (2000), 55(5), 476-7

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See detailLa femme et les maladies cardio-vasculaires, en particulier, les coronaropathies
Kulbertus, Henri ULg; Legrand, Victor ULg

in Revue Médicale de Liège (1999), 54(4), 244-50

Cardiovascular diseases represent the major cause of death in women. If women are early in life relatively protected by their hormones, after the menopause heart disease and stroke become their greatest ... [more ▼]

Cardiovascular diseases represent the major cause of death in women. If women are early in life relatively protected by their hormones, after the menopause heart disease and stroke become their greatest health threat. Altogether one in three women will die of cardiovascular disease whereas only one in twenty-two will die of breast cancer. The risk factors for cardiovascular diseases are similar in both sexes. It should be noted however that the impact of diabetes on the development of coronary artery disease is markedly higher in woman than in man. In woman the first presenting symptom of coronary artery disease frequently is angina pectoris. In man it is more often an acute myocardial infarction whether it be symptomatic or silent. The various non invasive techniques used for the diagnosis of coronary artery disease may yield results that pose very difficult problems of differential diagnosis in women. Several studies indicate that in the past, probably because of the ignorance by the public and, perhaps, the medical profession of the high prevalence of cardiovascular and coronary artery diseases in women, the latter have not always received an optimal treatment when they suffered an acute ischemic attack. But, in this decade, they have been dramatic changes in the patents of clinical practice related to coronary heart disease in women. Statistical investigations however indicate that thrombolytic therapy appears less efficacious in women than in men whereas beta-blockers administered early in acute MI are of remarkable efficacy in women. It seems generally agreed that the results of revascularization by coronary artery bypass surgery are poorer in women than in men both in terms of operative mortality and morbidity. Initially, the same pessimism was reported for PTCA. However, recent results allow a much more optimistic view. [less ▲]

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See detailSt-Segment Elevation During Dobutamine Stress Testing Predicts Functional Recovery after Acute Myocardial Infarction
Pierard, Luc ULg; Lancellotti, Patrizio ULg; Kulbertus, Henri ULg

in American Heart Journal (1999), 137(3), 500-11

OBJECTIVES: The aims of this study were (1) to assess the relation between ST-segment elevation and wall motion response occurring during dobutamine testing and (2) to evaluate the usefulness of stress ... [more ▼]

OBJECTIVES: The aims of this study were (1) to assess the relation between ST-segment elevation and wall motion response occurring during dobutamine testing and (2) to evaluate the usefulness of stress-induced ST-segment elevation for predicting functional recovery after acute myocardial infarction. BACKGROUND: Clinical significance of stress-induced ST-segment elevation after acute myocardial infarction remains controversial. According to previous studies, it may reflect a larger infarcted area, depressed left ventricular function, left ventricular aneurysm, stress-induced dyskinesia, residual myocardial ischemia, or viability in the affected region. Whether transient ST-segment elevation occurring during dobutamine testing may predict functional recovery is unknown. METHODS AND RESULTS: We studied 38 patients who underwent dobutamine stress testing early (5 +/- 2 days) after a first acute myocardial infarction. Dobutamine was infused at increasing doses from 5 to a maximum of 40 microg/kg per minute, with the addition of up to 1 mg of atropine if the target rate could not be reached by dobutamine alone. Twelve-lead electrocardiography and cross-sectional echocardiography were continuously monitored throughout the test. Dobutamine-induced ST-segment elevation was defined as a new or worsening >/=1 mm elevation, 80 ms after J point, in >/=2 infarct-related leads. Quantitative angiography was available in all patients before hospital discharge. Follow-up resting echocardiography was recorded in all patients 12 to 18 months after the acute event. ST-segment elevation was observed in 20 of the 38 patients. There were no significant differences between patients with and those without dobutamine-induced ST-segment elevation in age, site of infarction, peak level of total creatine kinase enzyme, and use of thrombolytic therapy, angioplasty, or both. Persistent akinesis without change during dobutamine stress testing was more frequently observed in patients without ST elevation (P <. 05). A biphasic response during dobutamine testing was more frequently observed in patients with ST-segment elevation (P =.01). Multivariate analysis selected 2 independent variables associated with ST-segment elevation: a biphasic response during dobutamine stress (chi-square = 7.3; P =.007) and the minimal lumen diameter of the infarct-related vessel at quantitative angiography (chi-square = 5.5; P <.02). Functional recovery was demonstrated in 26 patients. Sensitivity of ST-segment elevation for the prediction of functional recovery was 69%, specificity 83%, positive predictive value 90%, and accuracy 74%. Two independent variables predicting functional recovery were selected: dobutamine-induced ST-segment elevation (chi-square = 9.1; P =.003) and a biphasic response during stress (chi-square = 6.15; P =.013). CONCLUSIONS: Dobutamine-induced ST-segment elevation in the infarct-related leads is an ancillary sign of viable myocardium in jeopardy. It has a high specificity and an acceptable sensitivity for the prediction of functional recovery after acute myocardial infarction. [less ▲]

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See detailLa stenose sous-valvulaire aortique d'origine membraneuse
Lahaye, L.; Soyeur, D.J.; Limet, Raymond ULg et al

in Revue Médicale de Liège (1999), 54(10), 801-4

We report the case of a 55 year old patient presenting a discrete obstructive sub-aortic membrane. After clinical examination, complete echocardiographic evaluation and cardiac catheterisation, an ... [more ▼]

We report the case of a 55 year old patient presenting a discrete obstructive sub-aortic membrane. After clinical examination, complete echocardiographic evaluation and cardiac catheterisation, an operative procedure was decided and the sub-aortic membrane was resected. The results were satisfactory but the literature reports risks of re-obstruction of the left ventricular outflow tract. The article points out the importance of an early diagnosis and further stresses the major role played by transoesophageal echocardiography in the evaluation of the patient. [less ▲]

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See detailLes etudes cliniques controlees, support incontournable de la medecine basee sur l'evidence.
Scheen, André ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (1999), 54(1), 1

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See detailComment j'explore ... le risque coronarien individuel extrapole a 10 ans.
Scheen, André ULg; Rorive, Georges ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (1999), 54(2), 118-21

The European Societies of Cardiology. Atherosclerosis and Hypertension agreed upon a table allowing to evaluate the coronary risk after 10 years according to five parameters (sex, age, smoking, total ... [more ▼]

The European Societies of Cardiology. Atherosclerosis and Hypertension agreed upon a table allowing to evaluate the coronary risk after 10 years according to five parameters (sex, age, smoking, total cholesterol, arterial blood pressure) and aggravating factors (familial history, diabetes mellitus, low HDL cholesterol, hypertriglyceridaemia). The risk level is based upon the equations of the prospective US study of Framingham. The calculation of such a risk is mainly interesting before considering intensified primary prevention in an individual free of any cardiovascular disease. The efforts should first focus on individuals with a high coronary risk, i.e. > 20% after 10 years. As far as secondary prevention is concerned, the patients should always be considered at high risk and beneficiate of all available therapeutic means. [less ▲]

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See detailSuivi du patient traité par amiodarone
LANCELLOTTI, Patrizio ULg; Melon, Pierre ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (1998), 53(12), 762-5

Amiodarone is a highly effective antiarrhythmic agent. Its iodine content and tissue accumulation are however responsible for various side effects. In this article, we review the various amiodarone ... [more ▼]

Amiodarone is a highly effective antiarrhythmic agent. Its iodine content and tissue accumulation are however responsible for various side effects. In this article, we review the various amiodarone related side effects and propose a monitoring chart for patients treated by this specific agent. [less ▲]

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See detailThe Role of Early Measurement of Nitrogen-13 Ammonia Uptake for Predicting Contractile Recovery after Acute Myocardial Infarction
LANCELLOTTI, Patrizio ULg; Melon, P. G.; de Landsheere, C. M. et al

in International Journal of Cardiac Imaging (1998), 14(4), 261-7269-70

Previous studies have shown that the maintenance of cell membrane integrity and metabolism requires the persistence of residual myocardial blood flow. The purpose of this study was to assess the role of N ... [more ▼]

Previous studies have shown that the maintenance of cell membrane integrity and metabolism requires the persistence of residual myocardial blood flow. The purpose of this study was to assess the role of N-13 ammonia positron emission tomographic (PET) imaging performed early after an acute myocardial infarction for predicting functional recovery. Seventeen patients with an acute myocardial infarction were included in the study. Thirteen received thrombolytic therapy, 2 underwent immediate angioplasty of the infarct-related artery and 2 were treated with heparin. N-13 ammonia imaging was performed 6 +/- 2 days after the acute event and was followed by elective angioplasty in 13 patients. Using a 16-segment polar map display, regional N-13 ammonia uptake was expressed as a percentage of maximal segmental uptake and classified as normal (> 63%), moderately reduced (63-50%) and severely reduced (< 50%) based on values of tracer uptake obtained from healthy subjects. By echocardiographic assessment of regional wall thickening within 96 hours and at 1 month after the infarct, we examined the relationship between blood flow and functional outcome of myocardial segments in the infarct-related area. Regional wall thickening was graded on a 4-point scale: normal (1), hypokinesia (2), akinesia (3) and dyskinesia (4). Of 77 dyssynergic segments at baseline echocardiographic study, 43 had normal flow, 15 moderately reduced flow and 19 severely reduced flow. Segments with N-13 ammonia uptake > or = 50% demonstrated a significant improvement in wall thickening score at follow-up (p < 0.001), whereas segments with N-13 ammonia uptake < 50% showed no improvement in wall thickening scores (p < 0.001). The proportion of segments improving contractility by at least 1 score was significantly higher in the group of segments with N-13 ammonia uptake > 63%. The predictive value for defining functional recovery with segmental N-13 ammonia uptake > 63% was 86%. The predictive value for absence of recovery (uptake < 50%) was 54%. In conclusion, our data showed that early after an acute myocardial infarction N-13 ammonia imaging provides information regarding functional outcome. [less ▲]

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See detailInfo-congrès. Le bisoprolol dans la décompensation cardiaque
Kulbertus, Henri ULg; Pierard, Luc ULg

in Revue Médicale de Liège (1998), 53(4), 223-4

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See detailComment j'explore ... évaluation du risque de mort subite dans le syndrome de Wolff-Parkinson-White
Melon, Pierre ULg; LANCELLOTTI, Patrizio ULg; Kulbertus, Henri ULg

in Revue Médicale de Liège (1998), 53(4), 218-9

The identification of a WPW impose to evaluate the potential risk of sudden cardiac death. The risk depends on the duration of the refractory period of the accessory pathway. If the preexcitation ... [more ▼]

The identification of a WPW impose to evaluate the potential risk of sudden cardiac death. The risk depends on the duration of the refractory period of the accessory pathway. If the preexcitation disappears when the patient is stressed on a treadmill, there is no risk of sudden death. If it does not, an electrophysiological study will have to be performed to measure the refractory period of the accessory pathway. If a risk of sudden death is present (refractory period < 220 ms), the accessory pathway has to be ablated using radiofrequency. [less ▲]

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See detailWiktor stent for treatment of chronic total coronary artery occlusions: short- and long-term clinical and angiographic results from a large multicenter experience.
Anzuini, A.; Rosanio, S.; Legrand, Victor ULg et al

in Journal of the American College of Cardiology (1998), 31(2), 281-8

OBJECTIVES: This study reports the first multicenter experience with the Wiktor coil stent for treatment of chronic total coronary artery occlusions (CTOs). BACKGROUND: Percutaneous transluminal coronary ... [more ▼]

OBJECTIVES: This study reports the first multicenter experience with the Wiktor coil stent for treatment of chronic total coronary artery occlusions (CTOs). BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) of CTO is associated with very high restenosis and reocclusion rates. Coronary stenting has been proposed as a means of improving outcome. However, the Wiktor device for CTOs has never been tested in a large patient sample. METHODS: From January 1993 to December 1996, 89 patients with 91 CTOs underwent Wiktor stent implantation after successful PTCA. The post-stenting regimen consisted of warfarin (Coumadin) plus aspirin in the initial 49 patients (55%) and aspirin plus ticlopidine in 40 patients (45%). RESULTS: Stenting was successful in 87 patients (98%). At 1 month, 6% of patients had subacute stent thrombosis, 3% had a major bleeding event, and 1% had access-site complications. Subacute stent thrombosis showed univariate association with warfarin therapy (p = 0.009). Angiographic follow-up was obtained in 76 (93%) of 82 eligible patients. The restenosis rate was 32%, including 4% reocclusions. By multiple logistic regression analysis, restenosis was independently associated with multiple stents (adjusted odds ratio [OR] 27.67, 95% confidence interval [CI] 4.25 to 79.95, p = 0.0008) and increasing values of occlusion length (adjusted OR 1.23, 95% CI 1.09 to 1.39, p = 0.001). Freedom from death, myocardial infarction or stented vessel revascularization was 87% and 72% at 1 and 3 years, respectively. CONCLUSIONS: Short- and long-term clinical and angiographic outcomes are favorable in patients undergoing Wiktor stent implantation in CTO. Further technical improvement is needed to reduce the restenosis rate in patients with long lesions and multiple stents. [less ▲]

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See detailThe clinical signification of troponin T, troponin I, CK and CK-MB after coronary angioplsaty
Marechal, P.; Legrand, Victor ULg; Chapelle, Jean-Paul ULg et al

in Acta Cardiologica (1998), 53

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See detailEmergency Coronary Stenting with Wiktor Stent N Immediate and Late Results.
Bertrand, Olivier; Legrand, Victor ULg; Bilodeau et al

in The Journal of invasive cardiology (1997), 9(1), 2-9

In case of failed angioplasty, coronary stenting has gradually emerged as a non-surgical method to restore vessel patency and optimize coronary blood flow. There is still little clinical and angiographic ... [more ▼]

In case of failed angioplasty, coronary stenting has gradually emerged as a non-surgical method to restore vessel patency and optimize coronary blood flow. There is still little clinical and angiographic information on the use of radiopaque single loose interdigitating wire stents in angioplasty complicated by threatened or acute closure. Seventy-one patients received Wiktor stents after threatened vessel closure in 53 cases and acute closure in 18 cases. Stent delivery was successful in 98%. In-hospital death occurred in 1 case (1.4%). Stents occlusion were faced in 10 cases (14%), of which 6 presented early and 4 late after the procedure. Urgent bypass surgery was needed in 9 cases (12%) and 7 patients (10%) developed acute myocardial infarction. Serious bleeding complications occurred in 7 cases (10%) and vascular repair was performed in 4 patients (5%). During a follow-up of 20 +/- 10 months, 2 patients died, no myocardial infarction was observed and recurrence of angina was noted in 17 patients (24%). Angiographic analysis showed an acute gain in minimal lumen diameter of 1.71 +/- 0.22 mm and a late loss of 0.63 +/- 0.17 mm. Angiographic restenosis (diameter stenosis > 50%) presented in 20% of patients. Therefore, Wiktor stenting yields similar results than currently used stents in acute closure and strictly defined threatened vessel closure following angioplasty. [less ▲]

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See detailRisultati clinici ed angiografici immediati ed a lungo termine dello stent Wiktor nel trattamento delle occlusioni coronariche croniche.
Anzuini, A.; Rosanio, S.; Legrand, Victor ULg et al

in Giornale italiano di cardiologia (1997), 27(9), 881-91

BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) of chronic total coronary artery occlusions is associated with very high restenosis and reocclusion rates. Coronary stenting has been ... [more ▼]

BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) of chronic total coronary artery occlusions is associated with very high restenosis and reocclusion rates. Coronary stenting has been proposed as a means of improving outcome. However, the Wiktor device for chronic coronary occlusion has never been tested in a large patient sample. This study reports the first multicenter experience with the Wiktor stent for treatment of chronic occlusions. METHODS: From January 1993 to December 1996, 89 consecutive patients with 91 chronic occlusions underwent Wiktor stent implantation after successful PTCA. Post-stenting regimen consisted of coumadin plus aspirin in the first 49 (55%) patients and aspirin plus ticlopidine in the following 40 (45%). RESULTS: Stenting was successful in 87 (98%) patients. At 1 month, 6% of patients had subacute stent thrombosis, 1% access-site complications and 3% major bleeding events. Stent thrombosis showed a univariate association with coumadin therapy (p = 0.009). Angiographic follow-up was obtained in 93% of 82 eligible patients. Restenosis rate was 32%, including 4% reocclusions. Through multiple logistic regression analysis, restenosis was independently associated with multiple stents (odds ratio-OR = 27.67, 95% confidence interval-CI = 4.25 to 79.95, p = 0.0008) and increasing values of occlusion length (OR = 1.23, 95% CI = 1.09 to 1.39, p = 0.001). Freedom from death, myocardial infarction or stented vessel revascularization was 87 and 72% at one and three years, respectively. CONCLUSIONS: Short- and long-term clinical and angiographic outcomes are favorable in patients undergoing Wiktor stent implantation for chronic coronary occlusion. Further technical refinements are needed to reduce restenosis rate in patients with long lesions and multiple stents. [less ▲]

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See detailPercutaneous Balloon Pericardiotomy: A Case Report and Analysis of Mechanism of Action
Bertrand, O.; Legrand, Victor ULg; Kulbertus, Henri ULg

in Catheterization and Cardiovascular Diagnosis (1996), 38(2), 180-2

A 33-year-old man with acquired immunodeficiency syndrome (AIDS) and cardiac tamponade underwent percutaneous balloon pericardiotomy. To elucidate the pathway of fluid elimination, at the end of the ... [more ▼]

A 33-year-old man with acquired immunodeficiency syndrome (AIDS) and cardiac tamponade underwent percutaneous balloon pericardiotomy. To elucidate the pathway of fluid elimination, at the end of the procedure, we injected methylene blue into the pericardial space. Contrary to previous belief, we found no blue discoloration of the pleural fluids, and thus we postulate that most of the fluid was eliminated by peritoneal resorption. [less ▲]

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See detailVariability in Estimation of Coronary Dimensions from 6f and 8f Catheters
Legrand, Victor ULg; Raskinet, B.; Martinez, Christophe ULg et al

in Catheterization and Cardiovascular Diagnosis (1996), 37(1), 39-4546

To investigate the suitability of diagnostic 6F catheters for coronary angiographic measures in the clinical setting, we determined the relative accuracy and reproducibility of the measures obtained with ... [more ▼]

To investigate the suitability of diagnostic 6F catheters for coronary angiographic measures in the clinical setting, we determined the relative accuracy and reproducibility of the measures obtained with these catheters as scaling devices in 59 stenoses. Comparison was made with duplicate injections, obtained before angioplasty, using an 8F guiding catheter as scaling device. Intra- and interobserver variability was evaluated in 15 stenoses. The coefficient of variation averaged 18.3% for the minimal lumen diameter, 10.4% for the percent stenosis, and only 7.4% for the reference diameter. Reproducibility of angiographic measures done with the 6F catheter was similar to that obtained with the 8F catheter, although accuracy was lower with the 6F for the measurement of reference diameter. Thus, quantitative coronary angiography (QCA) measures derived from routine diagnostic angiograms may be suitable for determination of reference diameter, allowing enough precision for determination of the size of a coronary device for intervention, but these measures may lack accuracy for precise determination of minimum diameter and percent stenosis, making their use questionable in studies looking at individual changes in coronary stenosis dimensions. [less ▲]

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