References of "PIERARD, Luc"
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See detailAdhesion aux recommandations pour la prise en charge de l'insuffisance cardiaque chronique.
Nellessen, E.; LANCELLOTTI, Patrizio ULg; Pierard, Luc ULg

in Revue Médicale de Liège (2010), 65(5-6), 285-9

Chronic heart failure is a growing public health problem with a bad prognosis. Despite the seriousness of this syndrome and the well defined therapeutic approach, adherence to guidelines remains poor ... [more ▼]

Chronic heart failure is a growing public health problem with a bad prognosis. Despite the seriousness of this syndrome and the well defined therapeutic approach, adherence to guidelines remains poor. After briefly recalling the main points of these guidelines, we present statistical data regarding therapeutic care of these patients. We then present factors influencing prescription or non prescription of heart failure drugs and emphasize the importance of a team management programme and patients pathways. [less ▲]

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See detailAdhesion aux regles du traitement anti-thrombotique dans la fibrillation auriculaire.
MELON, Pierre ULg; GARWEG, Christophe ULg; LANCELLOTTI, Patrizio ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 299-303

Adherence to the rules for antithrombotic ment in atrial fibrillation patients significantly reduces the risk of stroke. We review the criteria for the use of anti-vitamin K as well as its daily ... [more ▼]

Adherence to the rules for antithrombotic ment in atrial fibrillation patients significantly reduces the risk of stroke. We review the criteria for the use of anti-vitamin K as well as its daily management in patients with atrial fibrillation. [less ▲]

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See detailEuropean Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease).
LANCELLOTTI, Patrizio ULg; Moura, Luis; Pierard, Luc ULg et al

in European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology (2010), 11(4), 307-32

Mitral and tricuspid are increasingly prevalent. Doppler echocardiography not only detects the presence of regurgitation but also permits to understand mechanisms of regurgitation, quantification of its ... [more ▼]

Mitral and tricuspid are increasingly prevalent. Doppler echocardiography not only detects the presence of regurgitation but also permits to understand mechanisms of regurgitation, quantification of its severity and repercussions. The present document aims to provide standards for the assessment of mitral and tricuspid regurgitation. [less ▲]

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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

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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 ▲]

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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 ▲]

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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 ▲]

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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

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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)

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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 ▲]

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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 ▲]

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