References of "PIERARD, Luc"
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See detailInertie clinique et observance thérapeutique dans les valvulopathies chroniques du coeur gauche.
Moonen, Marie ULg; Leroux, Aurélia ULg; Lancellotti, Patrizio ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 290-8

Valvular heart diseases are of increasing importance among the general adult population. When compared with other heart diseases, there are few trials in the field of valvular heart disease and randomized ... [more ▼]

Valvular heart diseases are of increasing importance among the general adult population. When compared with other heart diseases, there are few trials in the field of valvular heart disease and randomized clinical trials are particularly scarce. Two sets of guidelines exist: one in the USA and the other in Europe. However, they are not always consistent due to the lack of randomized data and it appears that, frequently, there is a gap between the existing guidelines and their effective application. [less ▲]

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See detailExercise echocardiography in severe asymptomatic aortic stenosis.
O'Connor, K.; LANCELLOTTI, Patrizio ULg; Donal, E. et al

in Archives of Cardiovascular Diseases (2010), 103(4), 262-269

The management of asymptomatic patients with severe aortic stenosis is challenging. Unfortunately, evaluation of symptoms such as dyspnoea remains subjective. The use of exercise echocardiography may help ... [more ▼]

The management of asymptomatic patients with severe aortic stenosis is challenging. Unfortunately, evaluation of symptoms such as dyspnoea remains subjective. The use of exercise echocardiography may help to predict major events in patients with asymptomatic severe aortic stenosis. This article explains how to perform the test and discusses which echocardiographic measurements should be obtained, focusing on the diagnostic and prognostic value of these measurements. An increase in mean transaortic pressure gradient >or= 18 mmHg predicts a worse prognosis in patients with severe aortic stenosis. The absence of left ventricular contractile reserve also has an important prognostic impact. Evaluation of filling pressures and looking for a worsening or a new mitral regurgitation are also part of the exam. Further studies are required to determine whether surgery should be recommended in the presence of an abnormal exercise echocardiogram in severe asymptomatic aortic stenosis. [less ▲]

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See detailImpact of global left ventricular afterload on left ventricular function in asymptomatic severe aortic stenosis: a two-dimensional speckle-tracking study.
Lancellotti, Patrizio ULg; Donal, Erwan; Magne, Julien ULg et al

in European Journal of Echocardiography (2010), 11(6), 537-543

Aims: The present study sought to assess the effect of global left ventricular (LV) afterload on LV myocardial systolic function in patients with aortic stenosis (AS) and preserved LV ejection fraction ... [more ▼]

Aims: The present study sought to assess the effect of global left ventricular (LV) afterload on LV myocardial systolic function in patients with aortic stenosis (AS) and preserved LV ejection fraction. <br />Methods and results: We prospectively examined the LV myocardial deformation (i.e. longitudinal, radial, and circumferential) by two-dimensional speckle tracking in 173 patients with asymptomatic severe AS. Thirty-eight patients (22%) had lowflow as determined by a low stroke volume index (􏰀35 mL/m2). By multivariable analysis, four variables emerged as independently associated with low-flow AS: peak Ea velocity (P 1⁄4 0.01), left atrial area index (P 1⁄4 0.017), global LV afterload (P 1⁄4 0.024), and circumferential myocardial deformation (P 1⁄4 0.04). Forty-nine patients (28%) had an increased global LV afterload (􏰁5 mmHg mL/m2). Systemic arterial compliance (P 1⁄4 0.001), circumferential myocardial deformation (P 1⁄4 0.024), and left atrial area index (P 1⁄4 0.04) were independently associated with increased global LV load in multivariable analysis. <br />Conclusion: In asymptomatic patients with severe AS, LV ejection fraction markedly underestimates the extent of myocardial sys- tolic impairment. Intrinsic myocardial dysfunction is particularly common in patients with increased global LV after- load, and especially in the subset of patients with low-flow AS. [less ▲]

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See detailEffects of eythropoietin administration on mitral regurgitation and left ventricular remodeling in heart failure patients.
Cosyns, B.; Velez-Roa, S.; Droogmans, S. et al

in International Journal of Cardiology (2010), 138(3), 306-307

The effects of erythropoietin administration on mitral regurgitation in patients with congestive heart failure have not yet been examined. After 2 months, erythropoietin treatment results in a significant ... [more ▼]

The effects of erythropoietin administration on mitral regurgitation in patients with congestive heart failure have not yet been examined. After 2 months, erythropoietin treatment results in a significant reduction in left ventricular volumes and mitral regurgitation severity and improves hemodynamics. [less ▲]

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See detailLa vignette therapeutique de l'etudiant. Premier episode de fibrillation auriculaire.
MELON, Pierre ULg; GARWEG, Christophe ULg; Pierard, Luc ULg et al

in Revue Médicale de Liège (2010), 65(4), 224-7

We report the case of a patient seen at the outpatient clinic for a first episode of atrial fibrillation. We discussed the steps of the treatment including anticoagulation, rate and rhythm control.

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See detailLe syndrome du QT long congenital.
Garweg, C.; D'Orio, Vincenzo ULg; MELON, Pierre ULg et al

in Revue Médicale de Liège (2010), 65(11), 628-33

The congenital long QT syndrome (LQTS) is a hereditary cardiac disease characterized by a prolongation of the QT interval > 440 ms at rest ECG associated with a high risk of ventricular arrhythmias ... [more ▼]

The congenital long QT syndrome (LQTS) is a hereditary cardiac disease characterized by a prolongation of the QT interval > 440 ms at rest ECG associated with a high risk of ventricular arrhythmias (torsade de pointe). Clinical manifestations are syncope and sudden cardiac death. The implicated genes encode cardiac ion channel subunits or proteins involved in modulating ionic currents. The diagnosis of LQTS can be complex in borderline cases. Etiology, pathogenesis, diagnosis and treatment are discussed. [less ▲]

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See detailComment je traite...une tachycardie paroxystique a QRS fins par reentree.
GARWEG, Christophe ULg; MELON, Pierre ULg; Pierard, Luc ULg et al

in Revue Médicale de Liège (2010), 65(9), 486-9

Paroxysmal narrow complex QRS tachycardias are a clinical entity characterized by abrupt onset and termination of palpitations, dyspnea, dizziness. They depend on mechanisms of reentry within the atrio ... [more ▼]

Paroxysmal narrow complex QRS tachycardias are a clinical entity characterized by abrupt onset and termination of palpitations, dyspnea, dizziness. They depend on mechanisms of reentry within the atrio-ventricular node or with the participation of an accessory pathway (reciprocating orthodromic tachycardia). We review the clinical and electrocardiographical diagnosis as well as the acute and long term treatment of these tachycardias. [less ▲]

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See detailEuropean Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease).
LANCELLOTTI, Patrizio ULg; Tribouilloy, Christophe; Hagendorff, Andreas et al

in European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology (2010), 11(3), 223-44

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 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 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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