References of "PIERARD, Luc"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailRisk stratification after myocardial infarction: toward novel quantitative assessment of left ventricular mechanics?
Pierard, Luc ULg; LANCELLOTTI, Patrizio ULg

in Journal of the American College of Cardiology (2010), 56(22), 1823-5

Detailed reference viewed: 3 (1 ULg)
Full Text
Peer Reviewed
See detailStress Doppler echocardiography in valvular heart diseases: utility and assessment.
O'Connor, Kim; LANCELLOTTI, Patrizio ULg; Pierard, Luc ULg

in Future Cardiology (2010), 6(5), 611-25

This article is a review on the role of stress echocardiography in valvular heart diseases, describing what the validated indications are, how to perform the test and the utility of performing this ... [more ▼]

This article is a review on the role of stress echocardiography in valvular heart diseases, describing what the validated indications are, how to perform the test and the utility of performing this examination. Most valve diseases are characteristically dynamic and this dynamic component is best appreciated by exercise Doppler echocardiography. Dobutamine stress echocardiography is also useful in patients with severe aortic stenosis and left ventricular dysfunction. The main advantage of stress echocardiography is to concomitantly allow the evaluation of symptoms, exercise capacity and the hemodynamic consequences of valve diseases, especially in patients with severe valve diseases who deny symptoms or present equivocal symptoms. It also provides important prognostic information and may help to optimize surgical timing in difficult cases. Whether these data should be integrated in the management of patients needs further validation. [less ▲]

Detailed reference viewed: 9 (1 ULg)
Full Text
Peer Reviewed
See detailUsefulness and limitation of dobutamine stress echocardiography to predict acute response to cardiac resynchronization therapy.
Sénéchal, Marie; Lancellotti, Patrizio ULg; Garceau, P. et al

in Echocardiography (2010), 27(1), 50-57

Background: It has been hypothesized that a long-term response to cardiac resynchronization therapy (CRT) could correlate with myocardial viability in patients with left ventricular (LV) dysfunction ... [more ▼]

Background: It has been hypothesized that a long-term response to cardiac resynchronization therapy (CRT) could correlate with myocardial viability in patients with left ventricular (LV) dysfunction. Contractile reserve and viability in the region of the pacing lead have not been investigated in regard to acute response after CRT. Methods: Fifty-one consecutive patients with advanced heart failure, LV ejection fraction ≤ 35%, QRS duration > 120 ms, and intraventricular asynchronism ≥ 50 ms were prospectively included. The week before CRT implantation, the presence of viability was evaluated using dobutamine stress echocardiography. Acute responders were defined as a ≥15% increase in LV stroke volume. Results: The average of viable segments was 5.8 ± 1.9 in responders and 3.9 ± 3 in nonresponders (P = 0.03). Viability in the region of the pacing lead had an excellent sensitivity (96%), but a low specificity (56%) to predict acute response to CRT. Mitral regurgitation (MR) was reduced in 21 patients (84%) with acute response. The presence of MR was a poor predictor of response (sensibility 93% and specificity 17%). However, combining the presence of MR and viability in the region of the pacing lead yields a sensibility (89%) and a specificity (70%) to predict acute response to CRT. Conclusion: Myocardial viability is an important factor influencing acute hemodynamic response to CRT. In acute responders, significant MR reduction is frequent. The combined presence of MR and viability in the region of the pacing lead predicts acute response to CRT with the best accuracy. [less ▲]

Detailed reference viewed: 23 (2 ULg)
Full Text
Peer Reviewed
See detailExercise-induced changes in degenerative mitral regurgitation
Magne, Julien ULg; Lancellotti, Patrizio ULg; Pierard, Luc ULg

in Journal of the American College of Cardiology (2010), 56(4), 300-309

OBJECTIVES: We sought to quantify exercise-induced changes in patients with degenerative mitral regurgitation (MR), to examine the relationship between exercise-induced changes in MR and in systolic ... [more ▼]

OBJECTIVES: We sought to quantify exercise-induced changes in patients with degenerative mitral regurgitation (MR), to examine the relationship between exercise-induced changes in MR and in systolic pulmonary artery pressure (PAP), and to identify their potential impact on symptom-free survival. BACKGROUND: MR severity can change during exercise in patients with functional MR. Quantified changes in MR severity during exercise remain undetermined in patients with degenerative MR. METHODS: Resting and bicycle exercise Doppler-echocardiography were performed in 61 asymptomatic patients (age 62+/-14 years) with moderate to severe degenerative MR (i.e., mitral valve prolapse or flail). Mitral regurgitation was quantified at rest and exercise with effective regurgitant orifice (ERO) area and regurgitant volume calculated with the proximal isovelocity surface area (EROP) and the quantitative Doppler (EROD) methods. RESULTS: At rest, EROP and EROD were well-correlated (r=0.87, p<0.0001), but EROD was larger than EROP (54+/-21 mm2 vs. 42+/-24 mm2, p<0.0001). During exercise, mean ERO and regurgitant volume markedly increased in 32% of patients by >or=10 mm2 and >or=15 ml, respectively. There was good correlation between exercise EROP and EROD (r=0.84, p<0.0001). Changes in systolic PAP were correlated with changes in ERO and regurgitant volume (r=0.59, p=0.02 and r=0.60, p=0.02). Patients with a marked increase in regurgitant volume during exercise had lower symptom-free survival than those in whom MR decreased or remained unchanged (p=0.0015). CONCLUSIONS: Degenerative MR might be dynamic and increases during exercise in one-third of patients. Marked changes in MR severity are associated with exercise-induced changes in systolic PAP and reduced symptom-free survival. [less ▲]

Detailed reference viewed: 11 (1 ULg)
Full Text
Peer Reviewed
See detailUsefulness of cardiac resynchronisation therapy in patients with right bundle branch block: is viability an important piece of the puzzle?
O'Connor, K.; Sénéchal, M.; Lancellotti, Patrizio ULg et al

in International Journal of Cardiology (2010), 145(1), 17-20

Detailed reference viewed: 26 (3 ULg)
Peer Reviewed
See detailIs left ventricular longitudinal function related to metabolic abnormalities and fat distribution?
Laret, V; Magne, Julien ULg; O'Connor, K et al

Conference (2010)

Detailed reference viewed: 1 (0 ULg)
Full Text
Peer Reviewed
See detailIschaemic mitral regurgitation: pathophysiology, outcomes and the conundrum of treatment.
PIERARD, Luc ULg; Carabello, B. A.

in European Heart Journal (2010), 31

Ischaemic mitral regurgitation is a frequent complication of left ventricular global or regional pathological remodelling due to chronic coronary artery disease. It is not a valve disease but represents ... [more ▼]

Ischaemic mitral regurgitation is a frequent complication of left ventricular global or regional pathological remodelling due to chronic coronary artery disease. It is not a valve disease but represents the valvular consequences of increased tethering forces (papillary muscles displacement leading to a more apical position of the leaflets and their coaptation point) and reduced closing forces (reduced contractility, dyssynchrony of the papillary muscles, intra-left ventricular dyssynchrony). Although mitral regurgitation has an unloading effect and reduces impedance, the volume overload begets further left ventricular dilatation, increases ventricular wall stress leading to worsened performance. Ischaemic mitral regurgitation is characteristically dynamic: its severity may vary with haemodynamic conditions. Both the severity of ischaemic mitral regurgitation and its dynamic component worsen prognosis. There are numerous possible treatment modalities, but the management of the individual patient remains difficult. Medical therapy is mandatory; revascularization procedures are frequently not sufficient to reduce mitral regurgitation; the role of combined surgical therapy by mitral valve repair is not yet defined in the absence of large randomized trial. Some patients are good candidates for cardiac resynchronization therapy that may reduce the amount of regurgitation. New therapeutic targets are under investigation. [less ▲]

Detailed reference viewed: 5 (1 ULg)
Full Text
See detailValve aortique percutanée
ERPICUM, Marie ULg; DEFRAIGNE, Jean ULg; LANCELLOTTI, Patrizio ULg et al

in Urgences & Accueil (2010), 11(40), 6-8

Transcatheter aortic valve implantation (TAVI) is increasingly performed and represents a relatively safe alternative treatment for high risk patients denied to surgical aortic valve replacement. TAVI is ... [more ▼]

Transcatheter aortic valve implantation (TAVI) is increasingly performed and represents a relatively safe alternative treatment for high risk patients denied to surgical aortic valve replacement. TAVI is performed at the University Hospital of Liege since July 2008 with the Medtronic CoreValve Revalving® system by femoral or subclavian access. This paper exposed the technique of TAVI and the nursing care required after this procedure. [less ▲]

Detailed reference viewed: 78 (17 ULg)
Full Text
Peer Reviewed
See detailHyperacute graft rejection during heart transplantation for giant cell myocarditis: A case report.
Mutijima, E.; Delbecque, Katty ULg; Defraigne, Jean-Olivier ULg et al

in Pathology - Research & Practice (2010), 15(206), 411-4

We report the case of a patient with giant cell myocarditis who was bridged to transplantation with mechanical circulatory support and developed a fatal perioperative hyperacute rejection. The patient had ... [more ▼]

We report the case of a patient with giant cell myocarditis who was bridged to transplantation with mechanical circulatory support and developed a fatal perioperative hyperacute rejection. The patient had received abundant transfusions that had raised her anti-HLA antibody titers. The cross-match test was positive. No pre-transplantation immunosuppressive therapy had been administered given concomitant infection. The severity and acuteness of the rejection in this case likely reflect the combined effect of preformed anti-HLA antibodies in the context of an active organ-specific immune process at the time of transplantation. This case raises the questions of the need for intensive immunosuppressive therapy before transplantation in giant cell myocarditis and of the management of patients with positive cross-match in the context of a giant cell myocarditis. [less ▲]

Detailed reference viewed: 29 (7 ULg)
Full Text
Peer Reviewed
See detailAre ACE-inhibitors or ARB's still needed for cardiovascular prevention in high risk patients? Insights from PRoFESS and TRANSCEND
Van Mieghem, W.; Billiouw, J.-M.; Brohet, C. et al

in Acta Clinica Belgica (2010), 65-2

The HOPE and EUROPA clinical studies have shown that treatment with the angiotensin-converting enzyme (ACE) inhibitors, ramipril and perindopril, may reduce the occurence of major cardiovascular events in ... [more ▼]

The HOPE and EUROPA clinical studies have shown that treatment with the angiotensin-converting enzyme (ACE) inhibitors, ramipril and perindopril, may reduce the occurence of major cardiovascular events in patients with proven atherosclerotic disease. The recently published results of the PRoFESS and TRANSCEND trials completed the much needed information concerning the use of an angiotensin receptor blocker for patients at high risk of cardiovascular events. PRoFESS compared a therapy of telmisartan 80 mg daily with placebo in patients with a recent ischemic stroke. The difference in the primary outcome of first recurrent stroke was not statistically significant between telmisartan and placebo. The secondary outcome of major cardiovascular events showed a relative risk reduction (RRR) of 7% in favour of telmsartan. This tended to be significant (p=0.06) despite a rather short follow-up period of only 28 months. In TRANSCEND 5,926 patients at high risk for cardiovascular events were randomized to a treatment with telmisartan 80 mg daily or placebo for a mean duration of follow-up of 56 months. The primary composite outcome of cardiovascular death, myocardial infarction, stroke or hospitalization for heart failure showed a non-significant 8% RRR in favour of the telmisartan treated patients. The main secondary outcome of cardiovascular death and myocardial infarction or stroke as used in the HOPE trial showed a non-significant RRR of 13% in favour of telmisartan treated patients (p=0,068 adjusted for multiplicity of comparisons). In comparing the Kaplan-Meier curves for the endpoint of major cardiovascular events used in HOPE, EUROPA, TRANSCEND and PRoFESS, the trends are similar. Results of most of th recently published trials have been neutral. This could partly be explained by major improvements in the optimal background therapy of the patients included. Nevertheless, the results of PRoFESS and TRANSCEND do not contradict the results from previous studies with the ACE inhibitors ramipril and perindopril and the ARB telmisartan. [less ▲]

Detailed reference viewed: 69 (1 ULg)
Full Text
Peer Reviewed
See detailA new look to an old measurement.
Pierard, Luc ULg; Magne, Julien ULg

in Journal of the American College of Cardiology (2009), 54(21), 1969-70

Detailed reference viewed: 5 (1 ULg)