Exercice stress echocardiography in secondary mitral regurgitation : impact of pulmonary hypertension
; PIERARD, Luc ; LANCELLOTTI, Patrizio
in Archives of Cardiovascular Diseases (2015, January), 7Detailed reference viewed: 8 (0 ULg)
Prevention of ventilator-associated pneumonia and ventilator-associated conditions: A randomized controlled trial with subglottic secretion suctioning
DAMAS, Pierre ; FRIPPIAT, Frédéric ; ANCION, Arnaud et al
in Critical Care Medicine (2015), 43(1), 22-30Detailed reference viewed: 101 (37 ULg)
Echocardiographic reference ranges for normal cardiac Doppler data: results from the NORRE Study.
; ; et al
in European heart journal cardiovascular Imaging (2015)
AIMS: Reference values for Doppler parameters according to age and gender are recommended for the assessment of heart physiology, specifically for left ventricular (LV) diastolic function. In this study ... [more ▼]
AIMS: Reference values for Doppler parameters according to age and gender are recommended for the assessment of heart physiology, specifically for left ventricular (LV) diastolic function. In this study, we report normal reference ranges for Doppler parameters obtained in a large group of healthy volunteers. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following Doppler acquisition and measurement protocols approved by the European Association of Cardiovascular Imaging. METHODS AND RESULTS: A total of 449 (mean age: 45.8 +/- 13.7 years) healthy volunteers (198 men and 251 women) were enrolled at the collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was obtained from all subjects following predefined protocols. The majority of the Doppler diastolic parameters (e', E/e') as well as right ventricle systolic s' wave velocity were similar in men and women. Left ventricle s' wave velocity was higher in men than in women. E wave and e' were higher in younger subjects and decreased progressively in the older ones. E/e' ratio increased with ageing. Septal e' <8 cm/s was present in 19.7% of the subjects in the 40-60 year group and in 55% of those in the >/=60 year group. However, the cut-off value of average E/e' or lateral E/e' remained <15 or 13, respectively, in the majority of patients. CONCLUSION: The NORRE study provides the reference values for the most useful Doppler parameters in the evaluation of heart physiology. These data highlight the need of using age-specific reference values especially for the diagnosis of LV systolic and diastolic dysfunction and for the estimation of LV filling pressures. [less ▲]Detailed reference viewed: 15 (3 ULg)
Positron Emission Tomography/Computed Tomography Imaging in Device Infective Endocarditis: Ready for Prime Time
Lancellotti, Patrizio ; ; Oury, Cécile et al
in Circulation (2015), 132
Over the last decade there has been a remarkable increase in prosthetic heart valve replacement and cardiac implantable electronic device utilization. Although capable of improving the quality and ... [more ▼]
Over the last decade there has been a remarkable increase in prosthetic heart valve replacement and cardiac implantable electronic device utilization. Although capable of improving the quality and quantity of life of patients suffering from severe valvular heart disease or rhythm disorders, they are both subject to potentially life-threatening infection involving the endocardium, referred to as device infective endocarditis (DIE)1,2. The rate of prosthetic valve endocarditis (PVE) ranges from 1-6% to 15%, being higher in revision surgery1. The infection usually involves the junction between the sewing ring and the annulus, leading to perivalvular abscess, dehiscence, pseudo-aneurysms, and fistulae, or the leaflets of the prosthesis, leading to vegetations, cusp rupture, and perforation. Cardiac device-related infective endocarditis (CDRIE), to be distinguished from local device infection (pocket/generator), is defined as an infection involving the electrode leads, cardiac valve leaflets, or endocardial surface. An incidence of 1.4 per 1000 device-years of definite CDRIE has been reported3. DIE may occur at anytime, being related to surgery only in early cases. [less ▲]Detailed reference viewed: 49 (24 ULg)
2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC)Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM).
; LANCELLOTTI, Patrizio ; et al
in European heart journal (2015), 36(44), 3075-128Detailed reference viewed: 22 (2 ULg)
2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS).
; ; et al
in European heart journal (2015), 36(42), 2921-64Detailed reference viewed: 37 (1 ULg)
Elevated Plasma Soluble ST2 Is Associated with Heart Failure Symptoms and Outcome in Aortic Stenosis.
LANCELLOTTI, Patrizio ; DULGHERU, Raluca Elena ; et al
in PloS one (2015), 10(9), 0138940
B-type natriuretic peptide (BNP) is often used as a complementary finding in the diagnostic work-up of patients with aortic stenosis (AS). Whether soluble ST2, a new biomarker of cardiac stretch, is ... [more ▼]
B-type natriuretic peptide (BNP) is often used as a complementary finding in the diagnostic work-up of patients with aortic stenosis (AS). Whether soluble ST2, a new biomarker of cardiac stretch, is associated with symptomatic status and outcome in asymptomatic AS is unknown. sST2 and BNP levels were measured in 86 patients (74+/-13 years; 59 asymptomatic, 69%) with AS (<1.5 cm2) and preserved left ventricular ejection fraction who were followed-up for 26+/-16 months. Both BNP and sST2 were associated with NYHA class but sST2 (>23 ng/mL, AUC = 0.68, p<0.01) was more accurate to identify asymptomatic patients or those who developed symptoms during follow-up. sST2 was independently related to left atrial index (p<0.0001) and aortic valve area (p = 0.004; model R2 = 0.32). A modest correlation was found with BNP (r = 0.4, p<0.01). During follow-up, 29 asymptomatic patients (34%) developed heart failure symptoms. With multivariable analysis, peak aortic jet velocity (HR = 2.7, p = 0.007) and sST2 level (HR = 1.04, p = 0.03) were independent predictors of cardiovascular events. In AS, sST2 levels could provide complementary information regarding symptomatic status, new onset heart failure symptoms and outcome. It might become a promising biomarker in these patients. [less ▲]Detailed reference viewed: 38 (9 ULg)
New biomarkers for primary mitral regurgitation.
Deroyer, Céline ; ; Moonen, Marie et al
in Clinical proteomics (2015), 12
BACKGROUND: Mitral regurgitation is a frequent valvular heart disease affecting around 2.5 % of the population with prevalence directly related to aging. Degeneration of mitral valve is broadly considered ... [more ▼]
BACKGROUND: Mitral regurgitation is a frequent valvular heart disease affecting around 2.5 % of the population with prevalence directly related to aging. Degeneration of mitral valve is broadly considered as a passive ongoing pathophysiological process and little is known about its physiological deregulation. The purpose of this study was to highlight new biomarkers of mitral regurgitation in order to decipher the underlying pathological mechanism as well as to allow the diagnosis and the monitoring of the disease. RESULTS: Modulation of various blood proteins expression was examined in patients suffering from different grades of mitral regurgitation (mild, moderate and severe) compared to healthy controls. To this end, several routine clinical assays and the multi analyte profile technology targeting 184 proteins were used. High-density lipoprotein, apolipoprotein-A1, haptoglobin and haptoglobin-alpha2 chain levels significantly decreased proportionally to the degree of mitral regurgitation when compared to controls. High-density lipoprotein and apolipoprotein-A1 levels were associated with effective regurgitant orifice area and regurgitant volume. Apolipoprotein-A1 was an independent predictor of severe mitral regurgitation. Moreover, with ordinal logistic regression, apolipoprotein-A1 remained the only independent factor associated with mitral regurgitation. In addition, myxomatous mitral valves were studied by immunocytochemistry. We observed an increase of LC3, the marker of autophagy, in myxomatous mitral valves compared with healthy mitral valves. CONCLUSION: These potential biomarkers of mitral regurgitation highlighted different cellular processes that could be modified in myxomatous degenerescence: reverse cholesterol transport, antioxidant properties and autophagy. [less ▲]Detailed reference viewed: 84 (16 ULg)
2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC)Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC).
; ; et al
in European heart journal (2015), 36(41), 2793-867Detailed reference viewed: 31 (0 ULg)
Cardiovascular outcome in systemic sclerosis.
; ; DULGHERU, Raluca Elena et al
in Acta cardiologica (2015), 70(5), 554-63
OBJECTIVES: Cardiovascular involvement is recognized as a poor prognostic factor in systemic sclerosis (SSc). The aim of this study was to evaluate the usefulness of nailfold video-capillaroscopy (NVC ... [more ▼]
OBJECTIVES: Cardiovascular involvement is recognized as a poor prognostic factor in systemic sclerosis (SSc). The aim of this study was to evaluate the usefulness of nailfold video-capillaroscopy (NVC), brain natriuretic peptide (BNP) blood level and exercise echocardiography to predict the occurrence of cardiovascular events in SSc. METHODS: We prospectively enrolled 65 patients with SSc (age 54+/-14 years, 30% female) followed in CHU Sart-Tilman, Liege, Belgium. All patients underwent graded semi-supine exercise echocardiography. Both baseline resting pulmonary hypertension (PH) and PH during follow-up (FUPH) were defined as systolic pulmonary arterial pressure (sPAP)>35 mmHg, and exercise-induced PH (EIPH) as sPAP>50 mmHg during exercise. RESULTS: EIPH was present in 21 patients. During FU (27+/-18 months), 13 patients developed FUPH and 9 presented cardiovascular complications. Patients with cardiovascular events were significantly older (63+/-14 vs 52+/-13 years; P=0.03), presented more frequently NVC grade>2 (89 vs 43%; P=0.009), had higher resting and exercise sPAP (30+/-6 vs 24+/-6; P=0.007 and 57+/-13 vs 44+/-13 vs mmHg; P=0.01, respectively), and higher BNP blood level (112+/-106 vs 26+/-19 pg/ml; P=0.0001). After adjustment for age and gender, NVC grade>2 (ss=2.4+/-1.1; P=0.03), EIPH (ss=2.30+/-1.13; P=0.04), FUPH (ss=0.24+/-0.09; P=0.01 and ss=3.52+/-1.16; P=0.002, respectively;) and BNP (ss=0.08+/-0.04; P=0.02) were independent predictors of CV events. Beyond age, an incremental value of EIPH, BNP and NVC grade>2 was predictive of cardiovascular events (P<0.001). CONCLUSION: Cardiovascular complications are not rare in SSc (18%). NVC, BNP blood level assessment and exercise echocardiography could be useful tools to identify patients at risk of SSc. [less ▲]Detailed reference viewed: 32 (2 ULg)
Biological Effects of Cardiac Magnetic Resonance on Human Blood Cells.
LANCELLOTTI, Patrizio ; NCHIMI LONGANG, Alain ; Delierneux, Céline et al
in Circulation. Cardiovascular imaging (2015), 8(9),
BACKGROUND: Cardiac magnetic resonance (CMR) is increasingly used for the diagnosis and management of cardiac diseases. Recent studies have reported immediate post-CMR DNA double-strand breaks in T ... [more ▼]
BACKGROUND: Cardiac magnetic resonance (CMR) is increasingly used for the diagnosis and management of cardiac diseases. Recent studies have reported immediate post-CMR DNA double-strand breaks in T lymphocytes. We sought to evaluate CMR-induced DNA damage in lymphocytes, alterations of blood cells, and their temporal persistence. METHODS AND RESULTS: In 20 prospectively enrolled healthy men (31.4+/-7.9 years), blood was drawn before and after (1-2 hours, 2 days, 1 month, and 1 year) unenhanced 1.5T CMR. Blood cell counts, cell death, and activation status of lymphocytes, monocytes, neutrophils, and platelets were evaluated. The first 2-hour post-CMR were characterized by a small increase of lymphocyte B and neutrophil counts and a transient drop of total lymphocytes because of a decrease in natural killer cells. Among blood cells, only neutrophils and monocytes displayed slight and transient activation. DNA double-strand breaks in lymphocytes were quantified through flow cytometric analysis of H2AX phosphorylation (gamma-H2AX). gamma-H2AX intensity in T lymphocytes did not change early after CMR but increased significantly at day 2 </=1 month before returning to baseline levels of 1-year post-CMR. CONCLUSIONS: Unenhanced CMR is associated with minor but significant immediate blood cell alterations or activations figuring inflammatory response, as well as DNA damage in T lymphocytes observed from day 2 until the first month but disappearing at 1-year follow-up. Although further studies are required to definitely state whether CMR can be used safely, our findings already call for caution when it comes to repeat this examination within a month. [less ▲]Detailed reference viewed: 49 (7 ULg)
2015 ESC Guidelines for the Management of Acute Coronary Syndromes in Patients Presenting Without Persistent ST-segment Elevation.
; ; et al
in Revista espanola de cardiologia (English ed.) (2015), 68(12), 1125Detailed reference viewed: 15 (0 ULg)
Young community of EACVI: the transition from EACVI Club 35 to Heart Imagers of Tomorrow: a promising yet challenging step.
; ; et al
in European heart journal cardiovascular Imaging (2015)
The purpose of this review is to summarize the activity and potential of the young community of European Association of Cardiovascular Imaging and to highlight the transition from Club 35 to 'Heart ... [more ▼]
The purpose of this review is to summarize the activity and potential of the young community of European Association of Cardiovascular Imaging and to highlight the transition from Club 35 to 'Heart Imagers of tomorrow'. [less ▲]Detailed reference viewed: 6 (0 ULg)
The European Association of Cardiovascular Imaging/Heart Faiture Association Cardiac Oncology Toxicity Registry : long-term benefits for breast cancer treatment
JERUSALEM, Guy ; MOONEN, Marie ; FRERES, Pierre et al
in Future Oncology (2015), 11(20), 2791-2794Detailed reference viewed: 42 (4 ULg)
The multi-modality cardiac imaging approach to the Athlete's heart: an expert consensus of the European Association of Cardiovascular Imaging.
; ; et al
in European heart journal cardiovascular Imaging (2015)
The term 'athlete's heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athlete's heart aims to differentiate ... [more ▼]
The term 'athlete's heart' refers to a clinical picture characterized by a slow heart rate and enlargement of the heart. A multi-modality imaging approach to the athlete's heart aims to differentiate physiological changes due to intensive training in the athlete's heart from serious cardiac diseases with similar morphological features. Imaging assessment of the athlete's heart should begin with a thorough echocardiographic examination. Left ventricular (LV) wall thickness by echocardiography can contribute to the distinction between athlete's LV hypertrophy and hypertrophic cardiomyopathy (HCM). LV end-diastolic diameter becomes larger (>55 mm) than the normal limits only in end-stage HCM patients when the LV ejection fraction is <50%. Patients with HCM also show early impairment of LV diastolic function, whereas athletes have normal diastolic function. When echocardiography cannot provide a clear differential diagnosis, cardiac magnetic resonance (CMR) imaging should be performed. With CMR, accurate morphological and functional assessment can be made. Tissue characterization by late gadolinium enhancement may show a distinctive, non-ischaemic pattern in HCM and a variety of other myocardial conditions such as idiopathic dilated cardiomyopathy or myocarditis. The work-up of athletes with suspected coronary artery disease should start with an exercise ECG. In athletes with inconclusive exercise ECG results, exercise stress echocardiography should be considered. Nuclear cardiology techniques, coronary cardiac tomography (CCT) and/or CMR may be performed in selected cases. Owing to radiation exposure and the young age of most athletes, the use of CCT and nuclear cardiology techniques should be restricted to athletes with unclear stress echocardiography or CMR. [less ▲]Detailed reference viewed: 33 (2 ULg)
The year 2014 in the European Heart Journal-Cardiovascular Imaging: part II.
; ; Pierard, Luc et al
in European heart journal cardiovascular Imaging (2015), 16(11), 1180-4
The European Heart Journal-Cardiovascular Imaging, created in 2012, has become a reference for publishing multimodality cardiovascular imaging scientific and review papers. The impressive 2014 impact ... [more ▼]
The European Heart Journal-Cardiovascular Imaging, created in 2012, has become a reference for publishing multimodality cardiovascular imaging scientific and review papers. The impressive 2014 impact factor of 4.105 confirms the important position of our journal. In this part, we summarize the most important studies from the journal's third year, with specific emphasis on cardiomyopathies, congenital heart diseases, valvular heart diseases, and heart failure. [less ▲]Detailed reference viewed: 22 (2 ULg)
2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).
; ; et al
in The European respiratory journal (2015), 46(4), 903-75
Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management ... [more ▼]
Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk-benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. [less ▲]Detailed reference viewed: 46 (1 ULg)
Syndrome coronarien aigu et traitement hypolipemiant. L'etude IMPROVE-IT change-t-elle la donne?
Lancellotti, Patrizio ; Pierard, Luc ; Scheen, Andre
in Revue medicale de Liege (2015), 70(9), 450-5
Statins reduce both LDL cholesterol (LDL-C) levels and the risk of cardiovascular events in patients with and without cardiovascular disease. Intensive statin therapy, compared with moderate-dose statin ... [more ▼]
Statins reduce both LDL cholesterol (LDL-C) levels and the risk of cardiovascular events in patients with and without cardiovascular disease. Intensive statin therapy, compared with moderate-dose statin therapy, incrementally lowers LDL-C levels and rates of cardiovascular events in patients presenting with acute coronary syndrome. Ezetimibe, by diminishing the absorption of cholesterol from the intestine, additionally reduces LDL-C when added to statins. In this article, we discuss the potential benefits of the combination of simvastatin and ezetimibe for the long-term management of patients with acute coronary syndrome through an analysis of the IMPROVE-IT results (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial). This randomised double blind trial included 18,144 patients with a LDL-C of 50 to 100 (with statin) or 125 (without statin) mg/dl and had a median follow-up of 6 years. The objective of the study was to test the efficacy of simvastatin 40 mg versus simvastatin 40 mg and 10 mg ezetimibe. The primary endpoint included cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina and coronary revascularization. The addition of ezetimibe to simvastatin resulted in an incremental lowering of LDL-C (reached value 53.2 versus 69.9 mg/dl, p < 0.001) and a further improvement of the patient prognosis (relative reduction of primary endpoint: -6.4%, p = 0.016). In addition, the combined therapy showed no significant adverse effects, particularly regarding the risk of cancers, which confirms the safety of ezetimibe. In acute coronary syndrome, the prescription of ezetimibe should be considered (class HA, level of evidence B) in patients with a LDL-C a 70 mg/dl despite maximally tolerated dose of statin. [less ▲]Detailed reference viewed: 82 (4 ULg)
DETERMINANTS AND PROGNOSTIC IMPACT OF LEFT VENTRICULAR CONTRACTILE RESERVE IN ASYMPTOMATIC AORTIC STENOSIS
; ; DULGHERU, Raluca Elena et al
in Archives of Cardiovascular Diseases (2015), 7Detailed reference viewed: 9 (1 ULg)