References of "PIERARD, Luc"
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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 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 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 detailRevue de litterature illustree de la Cardiomyopathie du peripartum.
Nyssen, A.; Nellessen, E.; Pierard, Luc ULg

in Revue medicale de Liege (2013), 68(12), 625-30

Peripartum cardiomyopathy is defined by the development of heart failure with left ventricular systolic dysfunction at the end of pregnancy or in the months following childbirth. Its diagnosis remains ... [more ▼]

Peripartum cardiomyopathy is defined by the development of heart failure with left ventricular systolic dysfunction at the end of pregnancy or in the months following childbirth. Its diagnosis remains difficult due to lack of specificity. Its pathophysiology is still imperfectly understood, but involves both genetic and pregnancy related factors. From a therapeutic viewpoint, the recommendations of the European Society of Cardiology on heart failure are used, but the stage of pregnancy must be taken into account for the treatment choice. The chances of recovery are greater than in other non-ischemic cardiomyopathies. However, an early diagnosis remains crucial to increase the probability of recovery particularly with bromocriptine, which has shown positive results in recent years. [less ▲]

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See detailThe role of stress testing in evaluation of asymptomatic patients with aortic stenosis.
Lancellotti, Patrizio ULg; Magne, Julien ULg; Pierard, Luc ULg

in Current opinion in cardiology (2013), 28(5), 531-9

PURPOSE OF REVIEW: The emerging role of exercise and especially exercise echocardiography in aortic stenosis has been recently emphasized. In this clinical setting, stress testing can help identify ... [more ▼]

PURPOSE OF REVIEW: The emerging role of exercise and especially exercise echocardiography in aortic stenosis has been recently emphasized. In this clinical setting, stress testing can help identify patients who are falsely asymptomatic, unmask those who will rapidly become symptomatic and appraise the true haemodynamic consequences of aortic stenosis. RECENT FINDINGS: Both exercise stress test and exercise stress echocardiography are strictly contraindicated in symptomatic patients. In contrast, exercise testing is recommended by current guidelines in asymptomatic patients with aortic stenosis. During exercise, either the development of symptoms or an abnormal blood pressure response is associated with a poor outcome and should be considered as an indication for surgery. Exercise echocardiography permits stratification and identification of asymptomatic patients at a higher risk of a cardiac event: exercise-induced increase of more than 18-20 mmHg in mean pressure gradient, absence of left ventricular contractile reserve and/or exercise pulmonary hypertension are suggestive features of an advanced disease process. SUMMARY: Exercise echocardiography has the advantage of its wide availability, low cost and versatility. In asymptomatic severe aortic stenosis, exercise echocardiography can help unmask patients at a more advanced stage of the disease and could aid in identifying those who may benefit from an early elective aortic valve surgery. [less ▲]

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See detailLe cas clinique du mois. Amyloidose cardiaque, a propos d'un cas atypique.
Falque, B.; Davin, L.; Melon, P. et al

in Revue medicale de Liege (2013), 68(10), 497-503

A 64 year old patient with heart failure due to primary cardiac amyloidosis is described. This case offers the opportunity to review the literature dealing with the cardiac involvement associated with ... [more ▼]

A 64 year old patient with heart failure due to primary cardiac amyloidosis is described. This case offers the opportunity to review the literature dealing with the cardiac involvement associated with this disorder and the differential diagnosis of restrictive heart disease. [less ▲]

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See detailInsuffisance mitrate primaire: indications chirurgicales et dernieres avancees.
Voilliot, D.; Henri, C.; Pierard, Luc ULg

in Revue medicale suisse (2013), 9(395), 1518-21

Mitral regurgitation (MR) is, in Europe, the second most common valvular disease. Primary MR represents 61% of cases. The surgical indications for symptomatic patients with severe primary MR, are subject ... [more ▼]

Mitral regurgitation (MR) is, in Europe, the second most common valvular disease. Primary MR represents 61% of cases. The surgical indications for symptomatic patients with severe primary MR, are subject to a broad consensus with strong levels of recommendations. In asymptomatic patients, levels of recommendations are weaker despite the numerous publications. Exercise echocardiography has emerged as a useful tool for the management of the patients and appeared in the latest European recommendations. It continues to be the subject of numerous studies demonstrating its usefulness for risk stratification in asymptomatic patients. The next advances in this field will probably argue for an earlier surgery in these kinds of patients. [less ▲]

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See detailLinee guida per il trattamento delle valvulopatie (versione 2012). Task Force congiunta per il Trattamento delle Valvulopatie della Societa Europea di Cardiologia (ESC) e dell'Associazione Europea di Chirurgia Cardiotoracica (EACTS).
Vahanian, Alec; Alfieri, Ottavio; Andreotti, Felicita et al

in Giornale Italiano di Cardiologia (2006) (2013), 14(3), 167-214

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See detailAssessment of left ventricular volumes and primary mitral regurgitation severity by 2D echocardiography and cardiovascular magnetic resonance.
Van De Heyning, Caroline M.; Magne, Julien ULg; Pierard, Luc ULg et al

in Cardiovascular ultrasound (2013), 11

BACKGROUND: Two-dimensional transthoracic echocardiography (2DTTE) remains the first-line diagnostic imaging tool to assess primary mitral regurgitation although cardiovascular magnetic resonance (CMR ... [more ▼]

BACKGROUND: Two-dimensional transthoracic echocardiography (2DTTE) remains the first-line diagnostic imaging tool to assess primary mitral regurgitation although cardiovascular magnetic resonance (CMR) has proven to establish left ventricular function more accurately and might evaluate mitral regurgitation severity more reliably. We sought to compare routine evaluation of left ventricular function and mitral regurgitation severity by 2DTTE with assessment by CMR in moderate to severe primary mitral regurgitation without overt left ventricular dysfunction. METHODS: We prospectively included 38 patients (79% of male, age 57 +/- 14 years) with at least moderate primary mitral regurgitation, a left ventricular ejection fraction >/=60% and a left ventricular end-systolic diameter </=45 mm. Patients with evidence of coronary artery disease, arrhythmias or significant concomitant valvular disease were excluded. All patients were scheduled for 2DTTE and CMR. RESULTS: Left ventricular end-diastolic and end-systolic volumes were significantly underestimated by 2DTTE in comparison with CMR, although there was a strong correlation (Pearson r = 0.81, p < 0.00001 and r = 0.7, p < 0.00001, respectively). Measurement of the regurgitant orifice was similar between 2DTTE PISA method and planimetry by CMR (47 +/- 24 vs. 42 +/- 16 mm2, p = 0.12) with a strong correlation between both imaging techniques (Pearson r = 0.76, p < 0.0001). By contrast, assessment of the regurgitant volume by 2DTTE and by phase contrast velocity mapping by CMR showed poor agreement. CONCLUSIONS: In moderate to severe primary mitral regurgitation without overt left ventricular dysfunction, 2DTTE significantly underestimates left ventricular remodelling in comparison to CMR. Measurement of the regurgitant orifice with planimetry by CMR shows good agreement with the PISA method by 2DTTE and thus may be a valuable alternative to assess mitral regurgitation severity. [less ▲]

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See detailA simplified model for mitral valve dynamics.
Moorhead, K. T.; Paeme, Sabine ULg; Chase, J. G. et al

in Computer Methods & Programs in Biomedicine (2013), 109(2),

Located between the left atrium and the left ventricle, the mitral valve controls flow between these two cardiac chambers. Mitral valve dysfunction is a major cause of cardiac dysfunction and its dynamics ... [more ▼]

Located between the left atrium and the left ventricle, the mitral valve controls flow between these two cardiac chambers. Mitral valve dysfunction is a major cause of cardiac dysfunction and its dynamics are little known. A simple non-linear rotational spring model is developed and implemented to capture the dynamics of the mitral valve. A measured pressure difference curve was used as the input into the model, which represents an applied torque to the anatomical valve chords. A range of mechanical model hysteresis states were investigated to find a model that best matches reported animal data of chord movement during a heartbeat. The study is limited by the use of one dataset found in the literature due to the highly invasive nature of getting this data. However, results clearly highlight fundamental physiological issues, such as the damping and chord stiffness changing within one cardiac cycle, that would be directly represented in any mitral valve model and affect behaviour in dysfunction. Very good correlation was achieved between modeled and experimental valve angle with 1-10% absolute error in the best case, indicating good promise for future simulation of cardiac valvular dysfunction, such as mitral regurgitation or stenosis. In particular, the model provides a pathway to capturing these dysfunctions in terms of modeled stiffness or elastance that can be directly related to anatomical, structural defects and dysfunction. [less ▲]

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See detailIdentification of protein biomarkers associated with cardiac ischemia by a proteomic approach.
Fillet, Marianne ULg; Deroyer, Céline ULg; COBRAIVILLE, G. et al

in Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals (2013), 18(7), 614-24

Angina is chest pain induced by ischemia of the heart muscle, generally due to obstruction or spasm of the coronary arteries. People that suffer from average to severe cases of angina have an increased ... [more ▼]

Angina is chest pain induced by ischemia of the heart muscle, generally due to obstruction or spasm of the coronary arteries. People that suffer from average to severe cases of angina have an increased percentage of death before the age of 55, usually around 60%. Therefore, prevention of major complications, optimizing diagnosis, prognosis and therapeutics are of primary importance. The main objective of this study was to uncover biomarkers by comparing serum protein profiles of patients suffering from stable or unstable angina and controls. We identified by non-targeted proteomic approach and confirmed by the means of independent techniques, the differential expression of several proteins indicating significantly increased vascular inflammation response, disturbance in the lipid metabolism and in atherogenic plaques stability. [less ▲]

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See detailSystemic Active and Total Myeloperoxidase Levels in Coronary Artery Disease.
GACH, Olivier ULg; MAGNE, Julien ULg; Franck, Thierry ULg et al

in Cardiology (2013), 126(Suppl. 2), 1-521

Backgound: Measurement of total Myeloperoxidase (MPO) by ELISA is considered as a marker of neutrophil activation but is not the true indicator of the degree of its activity. In a dynamic pathology such ... [more ▼]

Backgound: Measurement of total Myeloperoxidase (MPO) by ELISA is considered as a marker of neutrophil activation but is not the true indicator of the degree of its activity. In a dynamic pathology such as atherosclerosis, it may be important to measure the real active part of MPO because it represents the true witness of the oxidant potential of the enzyme. Aim: To identify the relation between coronary artery disease identified by coronaro-angiography on measured serum total and active MPO levels and evaluate the correlation between these MPO levels and the presence of clinically defined unstable condition. Methods: Prospective analyse of serum samples of patients before (within 30 min) coronaro-angiography. Total and active MPO concentrations were assessed by sandwich Elisa and SIEFED® method’s respectively. Results: Two hundred and twenty patients were included in this study (age: 66.1±10.7 years, 67% of male). Among these, 62% presented significant coronary artery disease (stenosis more than 60% at least in one épicardial coronary artery). Twenty four patients (11%) presented unstable coronary syndrome. Mean active and total MPO in the general population were 50.1±63.5 and 147.6±223.3 ng.mL-1 respectively. In comparison, mean active MPO was 47.1±47.9 ng.mL-1 in stable patients and 75.1±135.2 ng.mL-1 in unstable patients (p=0.04). Mean total MPO was 146.3±224.7 ng.mL-1 in stable patients and 158.2±215.8 ng.mL-1 in the unstable’s one (p=0.8). There was a significant correlation between active MPO levels and instability (r=0.14, p=0.04) not present for total MPO levels (r=0.016, p=0.8). Conclusion: We observed a correlation between active MPO and clinical instability while there was no correlation with total MPO. Our preliminary results suggest that this marker could be a powerful indicator of instability which could possess an important prognostic impact. This hypothesis requires an evaluation in wider population and during a prolonged follow-up. [less ▲]

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See detailL'imagerie cardiovasculaire multimodalites avant l'implantation d'une prothese valvulaire aortique par voie percutanee.
DAVIN, Laurent ULg; BRUYERE, Pierre-Julien ULg; LANCELLOTTI, Patrizio ULg et al

in Revue Médicale de Liège (2013), 68(2), 86-93

Calcified aortic valve stenosis is the most frequent valvular heart disease in developed countries with a very poor outcome when symptoms develop. However, several of these patients are denied for surgery ... [more ▼]

Calcified aortic valve stenosis is the most frequent valvular heart disease in developed countries with a very poor outcome when symptoms develop. However, several of these patients are denied for surgery. The main reasons are their advanced age (elderly patient), co-morbidities, technical limitations and a very high surgical risk. It is currently possible to propose a Transcatheter Aortic Valve Implantation (TAVI). After selection of candidates, the feasibility of the intervention is analysed. The size of the aortic bioprosthesis must be selected according to the cardiac anatomy. Several cardiac imaging modalities (echocardiography, computed tomography and cardiac MRI) can be used to identify unsuitable situations. Heavy calcifications or tortuosity can thwart the retrograde approach use. The sub-clavian arteries (for the CoreValve) and trans-apical approach (for the Edwards-Sapien) constitute alternatives ways. [less ▲]

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See detailStress echocardiography and mitral valvular heart disease.
Magne, Julien ULg; LANCELLOTTI, Patrizio ULg; Pierard, Luc ULg

in Cardiology Clinics (2013), 31(2), 311-21

The European Society of Cardiology's updated guidelines emphasize the usefulness of exercise stress echocardiography in patients with valvular heart disease. Exercise-induced changes in valve hemodynamics ... [more ▼]

The European Society of Cardiology's updated guidelines emphasize the usefulness of exercise stress echocardiography in patients with valvular heart disease. Exercise-induced changes in valve hemodynamics should be assessed in patients with mitral valve disease. In asymptomatic patients with moderate or severe mitral regurgitation without left ventricular dysfunction/dilatation, exercise stress echocardiography may identify a subset of patients with reduced cardiac event-free survival who are at a higher risk of developing symptoms. In patients with mitral stenosis who are asymptomatic, the development of symptoms during exercise is strongly related to the kinetics of the changes in the systolic pulmonary arterial pressure. [less ▲]

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See detailRecommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging.
LANCELLOTTI, Patrizio ULg; Tribouilloy, Christophe; Hagendorff, Andreas et al

in European Heart Journal - Cardiovascular Imaging (2013), 14(7), 611-44

Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Echocardiography has become the primary non-invasive imaging method for the evaluation of valvular ... [more ▼]

Valvular regurgitation represents an important cause of cardiovascular morbidity and mortality. Echocardiography has become the primary non-invasive imaging method for the evaluation of valvular regurgitation. The echocardiographic assessment of valvular regurgitation should integrate the quantification of the regurgitation, assessment of the valve anatomy and function, as well as the consequences of valvular disease on cardiac chambers. In clinical practice, the management of patients with valvular regurgitation thus largely integrates the results of echocardiography. It is crucial to provide standards that aim at establishing a baseline list of measurements to be performed when assessing regurgitation. [less ▲]

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See detailThe year 2012 in the European Heart Journal - Cardiovascular Imaging. Part II.
Plein, Sven; Knuuti, Juhani; Edvardsen, Thor et al

in European Heart Journal - Cardiovascular Imaging (2013), 14(7), 613-7

The part II of the best of the European Heart Journal - Cardiovascular Imaging in 2012 specifically focuses on studies of valvular heart diseases, heart failure, cardiomyopathies, and congenital heart ... [more ▼]

The part II of the best of the European Heart Journal - Cardiovascular Imaging in 2012 specifically focuses on studies of valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases. [less ▲]

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See detailA prospective study of cardiac valvular status in patients treated with cabergoline for endocrine disease
VROONEN, Laurent ULg; LANCELLOTTI, Patrizio ULg; Tome, M et al

in Symposium "Perspectives in Endocrinology" - Congresses Highlights 2012: ECE Firenze, ENDO Houston, ESPE Leipzig, SFE Toulouse, IWMEN Liège (2013)

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See detailImpact of hemodynamic load on exercise capacity in aortic stenosis
Dulgheru, Raluca Elena ULg; Magne, Julien ULg; Capoulade, R et al

in International Journal of Cardiology (2013)

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