References of "PIERARD, Luc"
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See detailClinical Significance of Exercise Pulmonary Hypertension in Secondary Mitral Regurgitation.
Lancellotti, Patrizio ULg; Magne, Julien; DULGHERU, Raluca Elena ULg et al

in The American journal of cardiology (2015)

In patients with heart failure, exercise echocardiography can help in risk stratification and decision making. The prognostic significance of exercise pulmonary hypertension (PH) in patients with ... [more ▼]

In patients with heart failure, exercise echocardiography can help in risk stratification and decision making. The prognostic significance of exercise pulmonary hypertension (PH) in patients with secondary mitral regurgitation (MR) remains unknown. The aim of the present study was to assess the prognostic value of exercise PH in patients with secondary MR and narrow QRS intervals. From 2005 to 2012, 159 consecutive patients with secondary MR, narrow QRS intervals, left ventricular dysfunction (mean ejection fraction 36 +/- 7%), and measurable systolic pulmonary arterial pressure (SPAP) during exercise echocardiography were included. Resting and exercise PH were defined as SPAP >50 and >60 mm Hg, respectively. Exercise PH was more frequent than resting PH (40% vs 13%, p <0.0001). On multivariate logistic regression, the independent determinants of exercise PH were resting SPAP (p <0.0001), exercise MR severity (p <0.0001), and e'-wave velocity (p = 0.004). The incidence of cardiac events during follow-up was significantly higher in patients with exercise PH compared with those without exercise PH (4 years: 40 +/- 7% vs 20 +/- 5%, p <0.0001). Patients with exercise PH exhibited higher rates of cardiac events and death than those with resting PH. In a multivariate Cox proportional hazards model, exercise PH was independently associated with the occurrence of cardiac events (p <0.0001). In conclusion, in patients with secondary MR, exercise PH is determined mainly by resting SPAP, left ventricular diastolic burden, and exercise MR severity. Exercise PH is a powerful predictor of poor outcomes, with a 5.3-fold increased risk for cardiac-related death during follow-up. These results highlight the added value of exercise echocardiography in secondary MR. [less ▲]

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See detailThe year in cardiology 2014: valvular heart disease.
Pierard, Luc ULg; Vahanian, Alec

in European heart journal (2015)

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See detailPoster session 6: Saturday 6 December 2014, 08:30-12:30Location: Poster area.
Henri, C.; DULGHERU, Raluca Elena ULg; Magne, J. et al

Poster (2014, December)

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See detailPoster session 5: Friday 5 December 2014, 14:00-18:00Location: Poster area.
Henri, C.; DULGHERU, Raluca Elena ULg; Magne, J. et al

Poster (2014, December)

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See detailOral Abstract session: Stress echo in clinical practice: Friday 5 December 2014, 08:30-10:00Location: Agora.
Magne, J.; Donal, E.; Dulgheru, R. et al

Conference (2014, December)

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See detailClub 35 Poster session 2: Thursday 4 December 2014, 08:30-18:00Location: Poster area.
Voilliot, D.; Magne, Jm; DULGHERU, Raluca Elena ULg et al

Poster (2014, December)

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See detail2014 ESC/ESA Guidelines on Non-cardiac Surgery: Cardiovascular Assessment and Management.
Kristensen, Steen Dalby; Knuuti, Juhani; Saraste, Antti et al

in European Heart Journal (2014), 35(35), 2383-431

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See detailAnatomie et physiologie à l'effort
PIERARD, Luc ULg

in Cardio & Sport (2014), 43

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See detailL'insuffisance cardiaque du sujet age.
D'ORIO, Virginie ULg; LANCELLOTTI, Patrizio ULg; Pierard, Luc ULg

in Revue medicale de Liege (2014), 69(5-6), 309-14

Heart failure in the elderly represents a major public health problem.In this population, the general objective of therapy, defined by current guidelines, does not differ from that proposed for younger ... [more ▼]

Heart failure in the elderly represents a major public health problem.In this population, the general objective of therapy, defined by current guidelines, does not differ from that proposed for younger patients: the aims are to decrease symptoms, to improve quality of life, to decrease hospitalizations, and to increase survival. However, in this category of patients, respect for autonomy and quality of life remains a priority, and requires a personalized approach because of the geriatric characteristics of many patients. [less ▲]

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See detailPlace des nouveaux anticoagulants oraux directs.
Pierard, Luc ULg; SPRYNGER, Muriel ULg

in Revue medicale suisse (2014), 10(439), 1562-7

New oral anticoagulants (NOACs) are going to deeply modify the treatment of non valvular atrial fibrillation and thromboembolic disease. They are non-inferior to warfarin and trials show a similar ... [more ▼]

New oral anticoagulants (NOACs) are going to deeply modify the treatment of non valvular atrial fibrillation and thromboembolic disease. They are non-inferior to warfarin and trials show a similar bleeding rate (even lower for some NOACs). Nevertheless one must be cautious when dealing with patients at risk (elderly patients, frail ones, renal or liver impairment...) and practicians must be well aware of doses and contraindications. NOACs' long- term tolerance is not yet well-known. In cancer, their benefit-risk ratio compared to low molecular weight heparin remains to be determined. [less ▲]

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See detailThe year 2013 in the European Heart Journal - Cardiovascular Imaging: Part II.
Plein, Sven; Edvardsen, Thor; Pierard, Luc ULg et al

in European heart journal cardiovascular Imaging (2014), 15(8), 837-841

The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was created in 2012. Here we summarize the most important studies from the journal's second year in ... [more ▼]

The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was created in 2012. Here we summarize the most important studies from the journal's second year in two articles. Part I of the review has summarized studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging. Part II is focussed on valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases. [less ▲]

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See detailRéserve contractile dans l’insuffisance mitrale primaire asymptomatique
PIERARD, Luc ULg; MAGNE, Julien; DULGHERU, Raluca Elena ULg et al

in Revue Médicale de Liège (2014), 69(S2), 8-11

Résumé : L’étude rapportée avait pour but de quantifier la réserve contractile ventriculaire gauche (VG) et d’évaluer son utilité pour la stratification du risque chez les patients asymptomatiques avec ... [more ▼]

Résumé : L’étude rapportée avait pour but de quantifier la réserve contractile ventriculaire gauche (VG) et d’évaluer son utilité pour la stratification du risque chez les patients asymptomatiques avec insuffisance mitrale (IM) primaire. Une échocardiographie au repos et à l’effort, incluant le suivi des marqueurs acoustiques, a été effectuée chez 115 patients consécutifs, présentant une IM primaire modérée ou sévère.La réserve contractile du VG est définie comme une augmentation induite par l’effort de la fraction d’éjection VG ≥ 4% ou de la déformation longitudinale VG ≥ 2%. La réserve contractile VG est absente dans approximativement la moitié de la population. Cette absence est un facteur prédictif indépendant d’événement cardiaque, s’il est évalué par les changements induits par l’effort de la fonction longitudinale VG, mais pas ceux de la fraction d’éjection VG. [less ▲]

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See detailImpact of exercise pulmonary hypertension on postoperative outcome in primary mitral regurgitation.
Magne, Julien; Donal, Erwan; Mahjoub, Haifa et al

in Heart (British Cardiac Society) (2014)

AIMS: The management of asymptomatic patients with mitral regurgitation (MR) remains controversial. Exercise-induced pulmonary hypertension (ExPHT) was recently reported as a strong predictor of rapid ... [more ▼]

AIMS: The management of asymptomatic patients with mitral regurgitation (MR) remains controversial. Exercise-induced pulmonary hypertension (ExPHT) was recently reported as a strong predictor of rapid onset of symptoms. We hypothesised that ExPHT is a predictor of postoperative cardiovascular events in patients with primary MR. METHODS AND RESULTS: One hundred and two patients with primary MR, no or mild symptoms (New York heart association (NYHA) </=2), and no LV dysfunction/dilatation, were prospectively recruited in 3 centres and underwent exercise-stress echocardiography. The presence of ExPHT was defined as an exercise systolic pulmonary arterial pressure >60 mm Hg. All patients were closely followed up and operated on when indication for surgery was reached. Postoperative events were defined as the occurrence of atrial fibrillation (AF), stroke, cardiac-related hospitalisation or death. Among the 102 patients included, 59 developed ExPHT (58%). These patients were significantly older than those without ExPHT (p=0.01). During a mean postoperative follow-up of 50+/-23 months, 28 patients (26%) experienced a predefined cardiovascular event. Patients with ExPHT had significantly higher rate of postoperative events (39% vs 12%, p=0.005); the rate of events was still higher in these patients (32% vs 9%, p=0.013), even when excluding early postoperative AF (ie, within 48 h). Event-free survival was significantly lower in the ExPHT group (all events: 5-year: 60+/-8% vs 88+/-5%, p=0.007, events without early AF: 5-year: 67+/-7% vs 90+/-4%, p=0.02). Using Cox multivariable analysis, ExPHT remained independently associated with higher risk of postoperative events in all models (all p</=0.04). CONCLUSIONS: ExPHT is associated with increased risk of adverse cardiac events following mitral valve surgery in patients with primary MR. [less ▲]

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See detailContribution du scanner coronaire au diagnostic de maladie coronarienne.
PIRLET, Charles ULg; Pierard, Luc ULg; Lancellotti, Patrizio ULg et al

in Revue medicale de Liege (2014), 69(7-8), 422-7

Coronary computed tomography is an emerging technique for the diagnosis of coronary heart disease. Based on a clinical case, we discuss the diagnostic evaluation of chest pain and the role of coronary CT.

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See detailPrognostic value of plasma B-type natriuretic peptide levels after exercise in patients with severe asymptomatic aortic stenosis.
Capoulade, Romain; Magne, Julien; Dulgheru, Raluca et al

in Heart (British Cardiac Society) (2014)

BACKGROUND: Exercise-stress echocardiography is useful in management and risk stratification of patients with asymptomatic aortic stenosis (AS). Resting B-type natriuretic peptide (BNP) level is ... [more ▼]

BACKGROUND: Exercise-stress echocardiography is useful in management and risk stratification of patients with asymptomatic aortic stenosis (AS). Resting B-type natriuretic peptide (BNP) level is associated with increased risk of adverse events. The incremental prognostic value of BNP response during exercise is unknown. OBJECTIVE: The purpose of this study was to assess the usefulness of plasma level of BNP during exercise to predict occurrence of events in asymptomatic patients with severe AS. METHODS: Resting and exercise-stress echocardiographic data and plasma BNP levels were prospectively collected in 211 asymptomatic AS patients in whom 157 had severe AS with preserved LVEF in two centres. The study end-point was the occurrence of death or aortic valve replacement. RESULTS: Plasma BNP level increased from rest to exercise (p<0.0001). During a mean follow-up of 1.5+/-1.2 years, 87 patients with severe AS reached the predefined end-point. Higher peak-exercise BNP level was associated with higher occurrence of adverse events (p<0.0001). In multivariate analysis, second and third tertiles of peak-exercise BNP (T2: HR=2.9; p=0.002 and T3: HR=5.3; p<0.0001, respectively) were powerful predictors of events compared with the first tertile. Further adjustment for resting BNP provided comparable results (T2: HR=2.8; p=0.003 and T3: HR=5.0; p<0.0001). This relationship persisted in both subsets of patients with low or high resting BNP. CONCLUSIONS: This study reports that peak-exercise BNP level provides significant incremental prognostic value beyond what is achieved by demographic and echocardiographic data, as well as resting BNP level. [less ▲]

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See detailLate gadolinium enhancement CMR in primary mitral regurgitation.
Van De Heyning, Caroline M.; Magne, Julien; Pierard, Luc ULg et al

in European journal of clinical investigation (2014), 44(9), 840-7

AIMS: The appropriate timing for surgery in severe asymptomatic primary mitral regurgitation (MR) remains controversial. It has been shown that late gadolinium enhancement on cardiovascular magnetic ... [more ▼]

AIMS: The appropriate timing for surgery in severe asymptomatic primary mitral regurgitation (MR) remains controversial. It has been shown that late gadolinium enhancement on cardiovascular magnetic resonance (LGE CMR), which may identify myocardial fibrosis, is associated with a worse outcome in various cardiomyopathies. We sought to investigate the prevalence and significance of delayed enhancement in primary MR. METHODS: We prospectively included 41 patients with at least moderate primary MR and without overt signs of left ventricular (LV) dysfunction. Patients with evidence of coronary artery disease, arrhythmias or significant concomitant valvular disease were excluded. All patients were scheduled for transthoracic echocardiography and LGE CMR. RESULTS: A total of 39 patients had interpretable LGE CMR images. Among them, 12 (31%) had late contrast uptake of the LV wall. LGE CMR showed an infarct pattern in three patients, a pattern of mid-wall fibrosis in seven patients and two patients had a combined pattern. Patients with delayed enhancement on CMR had significant higher LV diameters (LV end-systolic diameter 39 +/- 4 vs. 34 +/- 5 mm, P = 0.002; LV end-diastolic diameter 57 +/- 5 vs. 50 +/- 5 mm, P = 0.001). There was a trend towards a higher indexed left atrial volume (55 +/- 21 vs. 44 +/- 13 mL/m(2), P = 0.06). By contrast, there was no significant association between myocardial contrast uptake and age, LV ejection fraction and MR severity. CONCLUSION: Left ventricular remodelling seems to be associated with the presence of delayed enhancement on CMR in primary MR. Further data are needed to determine whether LGE CMR can predict a less favourable outcome or could improve risk stratification in asymptomatic primary MR. [less ▲]

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