References of "Lancellotti, Patrizio"
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See detailDeterminants of exercise-induced pulmonary arterial hypertension in systemic sclerosis.
Voilliot, Damien; Magne, Julien ULg; Dulgheru, Raluca et al

in International journal of cardiology (2014)

BACKGROUND: Exercise-induced pulmonary arterial hypertension (EIPH) in systemic sclerosis (SSc) has already been observed but its determinants remain unclear. The aim of this study was to determine the ... [more ▼]

BACKGROUND: Exercise-induced pulmonary arterial hypertension (EIPH) in systemic sclerosis (SSc) has already been observed but its determinants remain unclear. The aim of this study was to determine the incidence and the determinants of EIPH in SSc. METHODS AND RESULTS: We prospectively enrolled 63 patients with SSc (age 54+/-3years, 76% female) followed in CHU Sart-Tilman in Liege. All patients underwent graded semi-supine exercise echocardiography. Systolic pulmonary arterial pressure (sPAP) was derived from the peak velocity of the tricuspid regurgitation jet and adding the estimation of right atrial pressure, both at rest and during exercise. Resting pulmonary arterial hypertension (PH) was defined as sPAP >35mmHg and EIPH as sPAP >50mmHg during exercise. The following formulas were used: mean PAP (mPAP)=0.61xsPAP+2, left atrial pressure (LAP)=1.9+1.24xleft ventricular (LV) E/e' and pulmonary vascular resistance (PVR)=(mPAP-LAP)/LV cardiac output (CO) and slope of mPAP-LVCO relationship=changes in mPAP/changes in LVCO. Resting PH was present in 3 patients (7%) and 21 patients developed EIPH (47%). Patients with EIPH had higher resting LAP (10.3+/-2.2 versus 8.8+/-2.3mmHg; p=0.03), resting PVR (2.6+/-0.8 vs. 1.4+/-1.1Woods units; p=0.004), exercise LAP (13.3+/-2.3 vs. 9+/-1.7mmHg; p<0.0001), exercise PVR (3.6+/-0.7 vs. 2.1+/-0.9 Woods units; p=0.02) and slope of mPAP-LVCO (5.8+/-2.4 vs. 2.9+/-2.1mmHg/L/min; p<0.0001). After adjustment for age and gender, exercise LAP (beta=3.1+/-0.8; p=0.001) and exercise PVR (beta=7.9+/-1.7; p=0.0001) were independent determinants of exercise sPAP. CONCLUSION: EIPH is frequent in SSc patients and is mainly related to both increased exercise LV filling pressure and exercise PVR. [less ▲]

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See detailExercise testing in asymptomatic severe aortic stenosis.
Magne, Julien ULg; Lancellotti, Patrizio ULg; Pierard, Luc ULg

in JACC. Cardiovascular imaging (2014), 7(2), 188-99

The management and the clinical decision making in asymptomatic patients with aortic stenosis are challenging. An "aggressive" management, including early aortic valve replacement, is debated in these ... [more ▼]

The management and the clinical decision making in asymptomatic patients with aortic stenosis are challenging. An "aggressive" management, including early aortic valve replacement, is debated in these patients. However, the optimal timing for surgery remains controversial due to the lack of prospective data on the determinants of aortic stenosis progression, multicenter studies on risk stratification, and randomized studies on patient management. Exercise stress testing with or without imaging is strictly contraindicated in symptomatic patients with severe aortic stenosis. Exercise stress test is now recommended by current guidelines in asymptomatic patients and may provide incremental prognostic value. Indeed, the development of symptoms during exercise or an abnormal blood pressure response are associated with poor outcome and should be considered as an indication for surgery, as suggested by the most recently updated European Society of Cardiology 2012 guidelines. Exercise stress echocardiography may also improve the risk stratification and identify asymptomatic patients at higher risk of a cardiac event. When the test is combined with imaging, echocardiography during exercise should be recommended rather than post-exercise echocardiography. During exercise, an increase >18 to 20 mm Hg in mean pressure gradient, absence of improvement in left ventricular ejection fraction (i.e., absence of contractile reserve), and/or a systolic pulmonary arterial pressure >60 mm Hg (i.e., exercise pulmonary hypertension) are suggestive signs of advanced stages of the disease and impaired prognosis. Hence, exercise stress test may identify resting asymptomatic patients who develop exercise abnormalities and in whom surgery is recommended according to current guidelines. Exercise stress echocardiography may further unmask a subset of asymptomatic patients (i.e., without exercise stress test abnormalities) who are at high risk of reduced cardiac event free survival. In these patients, early surgery could be beneficial, whereas regular follow-up seems more appropriate in patients without echocardiographic abnormalities during exercise. [less ▲]

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See detailBrain natriuretic peptide release in patients with aortic stenosis: Resting and exercise echocardiographic determinants.
Henri, Christine; Magne, Julien ULg; Dulgheru, Raluca et al

in International journal of cardiology (2014), 172(3), 611-3

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See detailUsefulness of Serial B-type Natriuretic Peptide Assessment in Asymptomatic Aortic Stenosis.
Henri; Magne; DULGHERU, Raluca Elena ULg et al

in The American journal of cardiology (2014)

B-type natriuretic peptide (BNP) level may be a useful prognostic marker for the management of asymptomatic patients with aortic stenosis (AS). The aim of this study was to identify the echocardiographic ... [more ▼]

B-type natriuretic peptide (BNP) level may be a useful prognostic marker for the management of asymptomatic patients with aortic stenosis (AS). The aim of this study was to identify the echocardiographic determinants of BNP changes during follow-up in AS. We studied 61 asymptomatic patients with greater than moderate AS and preserved left ventricular (LV) ejection fraction who underwent rest and exercise Doppler echocardiography with concomitant BNP level measurement at baseline. BNP measurement was repeated after inclusion every 6 months. Patients were divided into 2 groups according to the median of BNP changes during follow-up. According to parameters at rest, patients in the high BNP changes group had significantly higher E/e' ratio. Statistically significant correlations were found between BNP changes and E/e' ratio and indexed left atrial area. According to exercise parameters, patients in the high BNP changes group had significantly lower exercise-induced increase in LV ejection fraction. Statistically significant correlations were found between BNP changes and exercise-induced changes in LV ejection fraction. After adjustment for age, mean aortic pressure gradient, and BNP level at baseline, multivariate analysis identified indexed left atrial area, E/e' at rest, and exercise-induced increase in ejection fraction as independent determinants of BNP changes during follow-up. In conclusion, this study shows that, in asymptomatic patients with preserved LV function and moderate AS, serial BNP measurements may widely vary. Subclinical LV diastolic and systolic dysfunctions are frequently present in patients with higher serial BNP changes. [less ▲]

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See detailEuropean multicentre validation study of the accuracy of E/e' ratio in estimating invasive left ventricular filling pressure: EURO-FILLING study.
Galderisi, Maurizio; Lancellotti, Patrizio ULg; Donal, Erwan et al

in European Heart Journal - Cardiovascular Imaging (2014)

AIMS: The non-invasive estimation of left ventricular filling pressures (LVFPs) represents a main goal in the clinical setting. Current recommendations encourage the use of pulsed-wave Tissue Doppler for ... [more ▼]

AIMS: The non-invasive estimation of left ventricular filling pressures (LVFPs) represents a main goal in the clinical setting. Current recommendations encourage the use of pulsed-wave Tissue Doppler for calculating the ratio between the preload-dependent transmitral E velocity and the average of septal and lateral early diastolic velocities (e') of the mitral annulus. Despite its wide use, real utility of the E/e' ratio has been recently challenged in patients with either very advanced heart failure or preserved left ventricular (LV) ejection fraction. However, only few studies performed the invasive and non-invasive estimation of LVFP simultaneously. The EURO-FILLING Study will validate the E/e' ratio (and additional non-invasive estimates) against simultaneously measured LVFP obtained by left heart catheterization in a multicentre study involving reference European echo laboratories collecting a wide population sample size of cardiac patients with and without heart failure. METHODS AND RESULTS: The EURO-FILLING study is a large, prospective observational study in which simultaneous assessment of invasive and non-invasive measurements of LVFP will be acquired in eight reference European centres. Centralized reading of the collected parameters will be performed in a core laboratory. Not only standardized echo Doppler measurements but also novel echo parameters such as LV global longitudinal strain and global atrial strain (obtainable by two-dimensional speckle tracking echocardiography) will be tested for predicting invasive measurements of LVFP. CONCLUSIONS: The EURO-FILLING study is expected to provide important information on non-invasive assessment of LVFP and to contribute to the standardization of this assessment in clinical practice. [less ▲]

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See detailEuroEcho-Imaging 2013: highlights.
Lancellotti, Patrizio ULg; Magne, Julien ULg; Cosyns, Bernard et al

in European Heart Journal - Cardiovascular Imaging (2014), 15(5), 483-488

The annual meeting of the European Association of Echocardiography (EuroEcho-Imaging) was held in Istanbul, Turkey. In the present paper, we present a summary of the 'Highlights' session.

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See detailEchocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study.
Kou, Seisyou; Caballero, Luis; Dulgheru, Raluca et al

in European heart journal cardiovascular Imaging (2014), 15(6), 680-690

AIMS: Availability of normative reference values for cardiac chamber quantitation is a prerequisite for accurate clinical application of echocardiography. In this study, we report normal reference ranges ... [more ▼]

AIMS: Availability of normative reference values for cardiac chamber quantitation is a prerequisite for accurate clinical application of echocardiography. In this study, we report normal reference ranges for cardiac chambers size obtained in a large group of healthy volunteers accounting for gender and age. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following chamber quantitation protocols approved by the European Association of Cardiovascular Imaging. METHODS: A total of 734 (mean age: 45.8 +/- 13.3 years) healthy volunteers (320 men and 414 women) were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was performed on all subjects following pre-defined protocols. There were no gender differences in age or cholesterol levels. Compared with men, women had significantly smaller body surface areas, and lower blood pressure. Quality of echocardiographic data sets was good to excellent in the majority of patients. Upper and lower reference limits were higher in men than in women. The reference values varied with age. These age-related changes persisted for most parameters after normalization for the body surface area. CONCLUSION: The NORRE study provides useful two-dimensional echocardiographic reference ranges for cardiac chamber quantification. These data highlight the need for body size normalization that should be performed together with age-and gender-specific assessment for the most echocardiographic parameters. [less ▲]

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See detailThe appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular Imaging, Percutaneous Cardiovascular Interventions and Electrophysiology.
Picano, Eugenio; Vano, Eliseo; Rehani, Madan M. et al

in European heart journal (2014), 35(10), 665-72

The benefits of cardiac imaging are immense, and modern medicine requires the extensive and versatile use of a variety of cardiac imaging techniques. Cardiologists are responsible for a large part of the ... [more ▼]

The benefits of cardiac imaging are immense, and modern medicine requires the extensive and versatile use of a variety of cardiac imaging techniques. Cardiologists are responsible for a large part of the radiation exposures every person gets per year from all medical sources. Therefore, they have a particular responsibility to avoid unjustified and non-optimized use of radiation, but sometimes are imperfectly aware of the radiological dose of the examination they prescribe or practice. This position paper aims to summarize the current knowledge on radiation effective doses (and risks) related to cardiac imaging procedures. We have reviewed the literature on radiation doses, which can range from the equivalent of 1-60 milliSievert (mSv) around a reference dose average of 15 mSv (corresponding to 750 chest X-rays) for a percutaneous coronary intervention, a cardiac radiofrequency ablation, a multidetector coronary angiography, or a myocardial perfusion imaging scintigraphy. We provide a European perspective on the best way to play an active role in implementing into clinical practice the key principle of radiation protection that: 'each patient should get the right imaging exam, at the right time, with the right radiation dose'. [less ▲]

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See detailCarotid artery and aortic stiffness evaluation in aortic stenosis.
Weisz, Sara Hana; Magne, Julien ULg; Dulgheru, Raluca et al

in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography (2014), 27(4), 385-92

BACKGROUND: In aortic stenosis (AS), the combination of risk factors can progressively lead to an increased arterial rigidity, which can be evaluated by the carotid artery and aortic stiffness (beta index ... [more ▼]

BACKGROUND: In aortic stenosis (AS), the combination of risk factors can progressively lead to an increased arterial rigidity, which can be evaluated by the carotid artery and aortic stiffness (beta index). The aim of this study was to investigate the relationship between carotid and aortic beta index, left ventricular (LV) function, plasma brain natriuretic peptide (BNP) level, and symptoms in patients with AS. METHODS: Comprehensive echocardiography including Doppler tissue imaging of the mitral annulus was performed in 53 patients with AS (aortic valve area < 1.2 cm(2)) and preserved LV ejection fractions (>/=50%). Carotid beta index was automatically derived from ultrasound wall tracking of the right carotid artery. The mitral E/e' ratio was used to estimate LV filling pressures. RESULTS: Carotid beta index was higher in women than in men and was significantly correlated with age (P < .0001), diastolic arterial pressure (P = .046), pulse pressure (P = .006), and systemic arterial compliance (P = .001). Interestingly, carotid beta index was significantly correlated with E/e' ratio (P < .0001) and plasma BNP level (P = .011). In multivariate regression analysis, carotid beta index was an independent predictor of E/e' ratio (P < .0001) and of BNP level (P = .02). Moreover, carotid beta index was significantly higher in symptomatic patients (P = .009). Aortic beta index was significantly correlated with carotid beta index (P < .0001), E/e' ratio (P = .004), and BNP (P < .001) and was significantly higher in symptomatic patients (P = .037). CONCLUSIONS: In patients with moderate to severe AS and preserved LV ejection fractions, the presence of increased carotid artery and aortic stiffness, assessed using carotid and aortic beta index, is independently associated with elevated LV filling pressures, BNP level, and symptoms. [less ▲]

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See detailExercise Echocardiography in Asymptomatic Patients with Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction.
Henri, Christine; Lancellotti, Patrizio ULg

in Journal of cardiovascular ultrasound (2014), 22(1), 1-5

The management of asymptomatic patients with severe aortic stenosis (AS) remains controversial. Recent series reported that early aortic valve replacement might be associated with improved clinical ... [more ▼]

The management of asymptomatic patients with severe aortic stenosis (AS) remains controversial. Recent series reported that early aortic valve replacement might be associated with improved clinical outcomes. However, the risk-benefit ratio should be carefully evaluated and early surgery only be proposed to a subset of asymptomatic patients considered at higher risk. Exercise echocardiography can help unmask symptomatic patients combined with assessment of the hemodynamic consequences of AS. Recent studies have demonstrated that exercise echocardiography can provide incremental prognostic value to identify patients who may benefit most from early surgery. In "truly" asymptomatic patients, an increase in mean aortic gradient >/= 18-20 mmHg, a limited left ventricular contractile reserve or a pulmonary hypertension during exercise are predictive parameters of adverse cardiac events. Exercise echocardiography is low-cost, safe and available in many referral centers, and does not expose patients to radiation. The purpose of this article is to describe the role of exercise testing and echocardiography in the management of asymptomatic patients with severe AS and preserved left ventricular ejection fraction. [less ▲]

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See detailNormal reference ranges for echocardiography: do we really need more?
Lancellotti, Patrizio ULg

in European heart journal cardiovascular Imaging (2014), 15(3), 253-4

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See detailRecommendations for transoesophageal echocardiography: EACVI update 2014.
Flachskampf, Frank A.; Wouters, Patrick F.; Edvardsen, Thor et al

in European heart journal cardiovascular Imaging (2014), 15(4), 353-65

With this document, we update the recommendations for transoesophageal echocardiography (TOE) of the European Association of Cardiovascular Imaging. The document focusses on the areas of interventional ... [more ▼]

With this document, we update the recommendations for transoesophageal echocardiography (TOE) of the European Association of Cardiovascular Imaging. The document focusses on the areas of interventional TOE, in particular transcatheter aortic, mitral, and left atrial appendage interventions, as well as on the role of TOE in infective endocarditis, adult congenital heart disease, and aortic disease. [less ▲]

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See detailAppropriateness criteria for cardiovascular imaging use in clinical practice: a position statement of the ESC/EACVI taskforce.
Garbi, Madalina; Habib, Gilbert; Plein, Sven et al

in European heart journal cardiovascular Imaging (2014), 15(5), 477-182

There is a growing interest from the scientific community in the appropriate use of cardiovascular imaging techniques for diagnosis and decision making in Europe. To develop appropriateness criteria for ... [more ▼]

There is a growing interest from the scientific community in the appropriate use of cardiovascular imaging techniques for diagnosis and decision making in Europe. To develop appropriateness criteria for cardiovascular imaging use in clinical practice in Europe, a dedicated taskforce has been appointed by the European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging (EACVI). The present paper describes the appropriateness criteria development process. [less ▲]

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See detailUpdated standards and processes for accreditation of echocardiographic laboratories from The European Association of Cardiovascular Imaging.
Popescu, Bogdan A.; Stefanidis, Alexandros; Nihoyannopoulos, Petros et al

in European heart journal cardiovascular Imaging (2014)

Standards for echocardiographic laboratories were proposed by the European Association of Echocardiography (now the European Association of Cardiovascular Imaging) 7 years ago in order to raise standards ... [more ▼]

Standards for echocardiographic laboratories were proposed by the European Association of Echocardiography (now the European Association of Cardiovascular Imaging) 7 years ago in order to raise standards of practice and improve the quality of care. Criteria and requirements were published at that time for transthoracic, transoesophageal, and stress echocardiography. This paper reassesses and updates the quality standards to take account of experience and the technical developments of modern echocardiographic practice. It also discusses quality control, the incentives for laboratories to apply for accreditation, the reaccreditation criteria, and the current status and future prospects of the laboratory accreditation process. [less ▲]

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See detailRecommadantions européennes concernant la thérapie de resynchronisation cardiaque
ROBINET, Sébastien ULg; DELCOUR, Alexandre ULg; LANCELLOTTI, Patrizio ULg

in Revue Médicale de Liège (2014), 69(4), 180-187

La thérapie de resynchronisation cardiaque (CRT) est l'une des plus grandes avancées thérapeutiques depuis ces 25 dernières années dans le domaine de l'insuffisance cardiaque. Elle est applicable chez ... [more ▼]

La thérapie de resynchronisation cardiaque (CRT) est l'une des plus grandes avancées thérapeutiques depuis ces 25 dernières années dans le domaine de l'insuffisance cardiaque. Elle est applicable chez plus de 25-30% des patients décompensés cardiaques symptomatiques. Dans cet article, nous détaillons les recommandations de la Société Européenne de Cardiologie 2013 concernant la thérapie de resynchronisation cardiaque. [less ▲]

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See detailRECOMMANDATIONS EUROPÉENNES POUR LA PRISE EN CHARGE DU DIABÈTE, DU PRÉ-DIABÈTE ET DES MALADIES CARDIO-VASCULAIRES 2ème partie. Gestion des complications cardiaques, cérébro-vasculaires et artériopathiques périphériques
SCHEEN, André ULg; LANCELLOTTI, Patrizio ULg

in Revue Médicale de Liège (2013), 68(12), 617-624

Summary : Patients with prediabetes (dysglycaemia) or diabetes present accelerated atherosclerosis that predisposes them to multiple cardiovascular complications. We summarize here the joint ... [more ▼]

Summary : Patients with prediabetes (dysglycaemia) or diabetes present accelerated atherosclerosis that predisposes them to multiple cardiovascular complications. We summarize here the joint recommendations recently published by the European Society of Cardiology and the European Society for the Study of Diabetes. The management of main risk factors, aiming to optimize primary or secondary prevention, has been developed in a first article. This second article is focusing on the management of cardiac, cerebrovascular and peripheral arteriopathic complications. The importance of an individualized patient-centered strategy is emphasized, including the management of microangiopathies and, ideally, within a multidisciplinary approach. [less ▲]

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See detailRecommandations Europeennes pour la prise en charge des cardiopathies congenitales de l'adulte.
Miltner, B.; Seghaye, Marie-Christine ULg; Lancellotti, Patrizio ULg

in Revue medicale de Liege (2013), 68(9), 450-7

Improved survival of patients with congenital heart disease has increased the number of these patients at adulthood. In 2010, the European Society of Cardiology has published new guidelines for the ... [more ▼]

Improved survival of patients with congenital heart disease has increased the number of these patients at adulthood. In 2010, the European Society of Cardiology has published new guidelines for the management of grown-up congenital heart disease. They provide more detailed information on specific defects in adults. This article summarizes the guidelines for the management of the most common adult congenital heart diseases. [less ▲]

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See detailESC working group on valvular heart disease position paper-heart valve clinics: organization, structure, and experiences
LANCELLOTTI, Patrizio ULg; Rosenhek, R; Pibarot, P et al

in European Heart Journal (2013)

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See detailPulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases.
Lewis, Gregory D.; Bossone, Eduardo; Naeije, Robert et al

in Circulation (2013), 128(13), 1470-9

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