non invasive estimation of left atrial pressure and mitral valve area waveforms during an entire cardiac cycle
Paeme, Sabine ; Pironet, Antoine ; LANCELLOTTI, Patrizio et al
in proceeding of 11th national day of the National Committee on Biomedical Engineering (2012, December 07)Detailed reference viewed: 19 (3 ULg)
structural model of the mitral valve included in a cardiovascular closed loop model. Static and dynamic validation
Paeme, Sabine ; Pironet, Antoine ; et al
Conference (2012, August 31)Detailed reference viewed: 16 (4 ULg)
Structural model of the mitral valve included in a cardiovascular closed loop model. Static and dynamic validation
Paeme, Sabine ; Pironet, Antoine ; et al
in proceedings of 8th IFAC Symposium on Biological and Medical Systems, Budapest 29-31 août 2012 (2012, August 31)Detailed reference viewed: 23 (4 ULg)
Papillary muscle relocation in conjunction with valve annuloplasty improve repair results in severe ischemic mitral regurgitation.
; Lancellotti, Patrizio ; et al
in Journal of Thoracic and Cardiovascular Surgery (The) (2012), 143(6), 1352-5
OBJECTIVE: the incidence of recurrent mitral regurgitation (MR) after restrictive annuloplasty (RA) was 5% to 20% in several reports. There are many opinions in favor of adding subvalvular procedures to ... [more ▼]
OBJECTIVE: the incidence of recurrent mitral regurgitation (MR) after restrictive annuloplasty (RA) was 5% to 20% in several reports. There are many opinions in favor of adding subvalvular procedures to RA to reduce the tenting forces and improve the repair results. METHODS: From March 2003 to May 2010, 55 patients with severe ischemic MR who had undergone papillary muscle (PPM) relocation in conjunction with mitral annuloplasty in our institutions were enrolled. The patients were matched 1:1 with those who underwent isolated RA using the propensity score. The mean left ventricular ejection fraction was 42% ± 6%. The mean tenting area and coaptation depth was 3.2 ± 0.6 cm(2) and 1.3 ± 0.2 cm, respectively. The study endpoints were early mortality and clinical and echocardiographic outcomes, freedom from cardiac-related deaths, and cardiac-related events. RESULTS: In-hospital death occurred in 5 patients (4.5%), without a statistically significant difference between the 2 groups (P = .72). The 5-year freedom from cardiac-related deaths and cardiac-related events in the PPM relocation group versus the RA group was 90.9% ± 1.8% versus 89% ± 1.6% (P = .82) and 83% ± 2.1% versus 65.4% ± 1.2% (P < .001), respectively. Recurrent MR equal to or greater than moderate occurred in 2 (3.7%) and 6 (11.5%) patients in the PPM relocation group and RA group (P = .01), respectively. Moreover, we found statistically significant differences for the postoperative mean tenting area and coaptation depth in both groups (P < .001). CONCLUSIONS: PPM relocation in conjunction to mitral annuloplasty is an easy and safe method and can be performed without an increase in-hospital mortality. This technique reduced the tenting area and coaptation depth compared with isolated RA, leading to improvement in the incidence of recurrent MR. The PPM group of patients experienced fewer cardiac-related events. [less ▲]Detailed reference viewed: 14 (2 ULg)
Seguimiento prospectivo ecocardiografico de 104 pacientes con enffermedades endocrinologicas tratados con cabergolina
Daly, Adrian ; VROONEN, Laurent ; Lancellotti, Patrizio et al
in Abstract book - 54 Congreso Sociedad Espanola de Endocrinologia y nutrition (2012, May 23)Detailed reference viewed: 12 (0 ULg)
A prospective study of cardiac valvular status in patients treated with cabergoline for Endocrine Disease
VROONEN, Laurent ; LANCELLOTTI, Patrizio ; et al
in Endocrine abstracts - May 2012, volume 29 (2012, May)Detailed reference viewed: 17 (5 ULg)
A prospective study of cardiac valvular status in patients treated with cabergoline for Endocrine Disease
VROONEN, Laurent ; Lancellotti, Patrizio ; et al
in Annales d'Endocrinologie (2012, April), 73(2), 148Detailed reference viewed: 20 (2 ULg)
Low-Flow, Low-Gradient Severe Aortic Stenosis Despite Normal Ejection Fraction Is Associated With Severe Left Ventricular Dysfunction as Assessed by Speckle-Tracking Echocardiography: A Multicenter Study.
; ; et al
in Circulation: cardiovascular imaging (2012)
Background- Low-flow low-gradient (LFLG) is sometimes observed in severe aortic stenosis (AS) despite normal ejection fraction, but its frequency and mechanisms are still debated. We aimed to describe the ... [more ▼]
Background- Low-flow low-gradient (LFLG) is sometimes observed in severe aortic stenosis (AS) despite normal ejection fraction, but its frequency and mechanisms are still debated. We aimed to describe the characteristics of patients with LFLG AS and assess the presence of longitudinal left ventricular dysfunction in these patients. Methods and Results- In a multicenter prospective study, 340 consecutive patients with severe AS and normal ejection fraction were studied. Longitudinal left ventricular function was assessed by 2D-strain and global afterload by valvulo-arterial impedance. Patients were classified according to flow and gradient: low flow was defined as a stroke volume index ≤35 mL/m(2), low gradient as a mean gradient ≤40 mm Hg. Most patients (n=258, 75.9%) presented with high-gradient AS, and 82 patients (24.1%) with low-gradient AS. Among the latter, 52 (15.3%) presented with normal flow and low gradient and 30 (8.8%) with LFLG. As compared with normal flow and low gradient, patients with LFLG had more severe AS (aortic valve area=0.7±0.12 cm(2) versus 0.86±0.14 cm(2)), higher valvulo-arterial impedance (5.5±1.1 versus 4±0.8 mm Hg/mL/m(2)), and worse longitudinal left ventricular function (basal longitudinal strain=-11.6±3.4 versus -14.8±3%; P<0.001 for all). Conclusions- LFLG AS is observed in 9% of patients with severe AS and normal ejection fraction and is associated with high global afterload and reduced longitudinal systolic function. Patients with normal-flow low-gradient AS are more frequent and present with less severe AS, normal afterload, and less severe longitudinal dysfunction. Severe left ventricular longitudinal dysfunction is a new explanation to the concept of LFLG AS. [less ▲]Detailed reference viewed: 14 (0 ULg)
Grading aortic stenosis severity when the flow modifies the gradientvalve area correlation.
in Cardiovascular diagnosis and therapy (2012), 2(1), 6-9Detailed reference viewed: 4 (0 ULg)
Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.
LAYIOS, Nathalie ; LAMBERMONT, Bernard ; CANIVET, Jean-Luc et al
in Critical Care Medicine (2012), 40(8), 2304-9
OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled ... [more ▼]
OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled study. SETTING: : Five intensive care units from a tertiary teaching hospital. PATIENTS: : All consecutive adult patients hospitalized for > 48 hrs in the intensive care unit during a 9-month period. INTERVENTIONS: : Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay. The use of antibiotics was more or less strongly discouraged or recommended according to the Muller classification. Patients were randomized into two groups: one using the procalcitonin results (procalcitonin group) and one being blinded to the procalcitonin results (control group). The primary end point was the reduction of antibiotic use expressed as a proportion of treatment days and of daily defined dose per 100 intensive care unit days using a procalcitonin-guided approach. Secondary end points included: a posteriori assessment of the accuracy of the infectious diagnosis when using procalcitonin in the intensive care unit and of the diagnostic concordance between the intensive care unit physician and the infectious-disease specialist. MEASUREMENTS AND MAIN RESULTS: : There were 258 patients in the procalcitonin group and 251 patients in the control group. A significantly higher amount of withheld treatment was observed in the procalcitonin group of patients classified by the intensive care unit clinicians as having possible infection. This, however, did not result in a reduction of antibiotic consumption. The treatment days represented 62.6 +/- 34.4% and 57.7 +/- 34.4% of the intensive care unit stays in the procalcitonin and control groups, respectively (p = .11). According to the infectious-disease specialist, 33.8% of the cases in which no infection was confirmed, had a procalcitonin value >1microg/L and 14.9% of the cases with confirmed infection had procalcitonin levels <0.25 microg/L. The ability of procalcitonin to differentiate between certain or probable infection and possible or no infection, upon initiation of antibiotic treatment was low, as confirmed by the receiving operating curve analysis (area under the curve = 0.69). Finally, procalcitonin did not help improve concordance between the diagnostic confidence of the infectious-disease specialist and the ICU physician. CONCLUSIONS: : Procalcitonin measuring for the initiation of antimicrobials did not appear to be helpful in a strategy aiming at decreasing the antibiotic consumption in intensive care unit patients. [less ▲]Detailed reference viewed: 49 (6 ULg)
Le cas clinique du mois: Implantation fortuite d'une sonde de defibrillation dans le ventricule gauche au travers d'un foramen ovale permeable.
; ; LANCELLOTTI, Patrizio et al
in Revue Médicale de Liège (2012), 67(2), 58-60
Inadvertent insertion of a defibrillation lead in the left ventricle is a rare complication generally underdiagnosed after device implantation. Management is not strictly codified due to the small number ... [more ▼]
Inadvertent insertion of a defibrillation lead in the left ventricle is a rare complication generally underdiagnosed after device implantation. Management is not strictly codified due to the small number of observed cases. We report the case of a 78 year-old man in whom the diagnosis has been performed lately during an echocardiography. [less ▲]Detailed reference viewed: 11 (4 ULg)
Clinical outcome in asymptomatic severe aortic stenosis: Insights from the new proposed aortic stenosis grading classification
Lancellotti, Patrizio ; Magne, Julien ; et al
in Journal of the American College of Cardiology (2012), 59(3), 235-243Detailed reference viewed: 16 (3 ULg)
EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography.
; ; et al
in Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography (2012), 25(1), 3-46Detailed reference viewed: 17 (0 ULg)
Heart rate and use of beta-blockers in stable outpatients with coronary artery disease.
; ; et al
in PLoS ONE (2012), 7(5), 36284
BACKGROUND: Heart rate (HR) is an emerging risk factor in coronary artery disease (CAD). However, there is little contemporary data regarding HR and the use of HR-lowering medications, particularly beta ... [more ▼]
BACKGROUND: Heart rate (HR) is an emerging risk factor in coronary artery disease (CAD). However, there is little contemporary data regarding HR and the use of HR-lowering medications, particularly beta-blockers, among patients with stable CAD in routine clinical practice. The goal of the present analysis was to describe HR in such patients, overall and in relation to beta-blocker use, and to describe the determinants of HR. METHODS AND FINDINGS: CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable CAD, defined as prior myocardial infarction or revascularization procedure, evidence of coronary stenosis of >50%, or chest pain associated with proven myocardial ischemia. A total of 33,438 patients from 45 countries in Europe, the Americas, Africa, Middle East, and Asia/Pacific were enrolled between November 2009 and July 2010. Most of the 33,177 patients included in this analysis were men (77.5%). Mean (SD) age was 64.2 (10.5) years, HR by pulse was 68.3 (10.6) bpm, and by electrocardiogram was 67.2 (11.4) bpm. Overall, 44.0% had HR >/= 70 bpm. Beta-blockers were used in 75.1% of patients and another 14.4% had intolerance or contraindications to beta-blocker therapy. Among 24,910 patients on beta-blockers, 41.1% had HR >/= 70 bpm. HR >/= 70 bpm was independently associated with higher prevalence and severity of angina, more frequent evidence of myocardial ischemia, and lack of use of HR-lowering agents. CONCLUSIONS: Despite a high rate of use of beta-blockers, stable CAD patients often have resting HR >/= 70 bpm, which was associated with an overall worse health status, more frequent angina and ischemia. Further HR lowering is possible in many patients with CAD. Whether it will improve symptoms and outcomes is being tested. [less ▲]Detailed reference viewed: 2 (0 ULg)
Prasugrel versus clopidogrel for acute coronary syndromes without revascularization.
; ; et al
in New England Journal of Medicine [=NEJM] (2012), 367(14), 1297-309
BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been ... [more ▼]
BACKGROUND: The effect of intensified platelet inhibition for patients with unstable angina or myocardial infarction without ST-segment elevation who do not undergo revascularization has not been delineated. METHODS: In this double-blind, randomized trial, in a primary analysis involving 7243 patients under the age of 75 years receiving aspirin, we evaluated up to 30 months of treatment with prasugrel (10 mg daily) versus clopidogrel (75 mg daily). In a secondary analysis involving 2083 patients 75 years of age or older, we evaluated 5 mg of prasugrel versus 75 mg of clopidogrel. RESULTS: At a median follow-up of 17 months, the primary end point of death from cardiovascular causes, myocardial infarction, or stroke among patients under the age of 75 years occurred in 13.9% of the prasugrel group and 16.0% of the clopidogrel group (hazard ratio in the prasugrel [less ▲]Detailed reference viewed: 10 (0 ULg)
L'atherosclerose: une maladie complexe.
Kulbertus, Henri ; LANCELLOTTI, Patrizio
in Revue Médicale de Liège (2012), 67(5-6), 273-8
Atherosclerosis is a complex disease resulting from an interaction between environmental risk factors (diet, smoking habit, lack of exercise, stress) and a favourable genetic profile. In the recent past ... [more ▼]
Atherosclerosis is a complex disease resulting from an interaction between environmental risk factors (diet, smoking habit, lack of exercise, stress) and a favourable genetic profile. In the recent past, the analysis of the genetic factors involved has considerably progressed. A significant number of genetic variants associated with the various phenotypes of atherosclerosis or its risk factors have been identified. Each, taken individually, only exerts a modest influence, but as a group, they play a significant role, albeit as yet not precisely quantified, in the aetiology of atherosclerosis. The individual response to various therapies prescribed in atherosclerosis can also be significantly influenced by genetic factors. In the next future, genetics and pharmacogenetics will represent major determinants of our approach to the prevention and individualized treatment of atherosclerosis and its complications. [less ▲]Detailed reference viewed: 4 (0 ULg)
Ticagrelor (brilique"): puissant antagoniste oral de l'activite plaquettaire.
in Revue Médicale de Liège (2012), 67(9), 485-91
Dual antiplatelet therapy with clopidogrel combined with aspirin reduces ischemic events in acute coronary syndromes (ACS). The individual response to clopidogrel is, however, very variable from one ... [more ▼]
Dual antiplatelet therapy with clopidogrel combined with aspirin reduces ischemic events in acute coronary syndromes (ACS). The individual response to clopidogrel is, however, very variable from one subject to another, and the risk of events seems higher when platelet inhibition is insufficient. Ticagrelor is a potent oral inhibitor of platelet activity. It binds reversibly to the P2Y12 adenosine diphosphate. The platelet inhibition that it induces is faster and more pronounced than that of clopidogrel. In patients who have an ACS (PLATO study) with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke, without an increase in the rate of overall major bleeding but with an increase in the rate of non-procedure-related bleeding. In Belgium, Brilique is currently indicated in combination with aspirin for the prevention of atherothrombotic events in patients with ACS. [less ▲]Detailed reference viewed: 13 (0 ULg)
The quest for evidence "Beauty is truth, truth beauty"--that is all ye know on earth, and all ye need to know.
; LANCELLOTTI, Patrizio
in Acta Cardiologica (2012), 67(1), 1-2Detailed reference viewed: 2 (0 ULg)
Recurrent stress cardiomyopathy with variable pattern of left ventricle contraction abnormality.
; ; Pierard, Luc et al
in Journal of the American College of Cardiology (2012), 60(3), 5Detailed reference viewed: 9 (3 ULg)
Recommandations Europeennes 2011 pour la prise en charge des maladies cardiovasculaires pendant la grossesse. Partie 1: valvulopathies et anticoagulation.
; Moonen, Marie ; LANCELLOTTI, Patrizio
in Revue Médicale de Liège (2012), 67(9), 452-7
In this article, we describe the 2011 European guidelines on the management of cardiovascular diseases during pregnancy, with particular attention to the management of valvular heart disease and ... [more ▼]
In this article, we describe the 2011 European guidelines on the management of cardiovascular diseases during pregnancy, with particular attention to the management of valvular heart disease and anticoagulation.We will also describe cardiologic conditions in which pregnancy is contraindicated and the preferred way of delivery. [less ▲]Detailed reference viewed: 5 (1 ULg)