Contribution du scanner coronaire au diagnostic de maladie coronarienne.
PIRLET, Charles ; Pierard, Luc ; Lancellotti, Patrizio 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.Detailed reference viewed: 11 (0 ULg)
Usefulness of Serial B-type Natriuretic Peptide Assessment in Asymptomatic Aortic Stenosis.
; ; DULGHERU, Raluca Elena 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 ▲]Detailed reference viewed: 17 (6 ULg)
L'imagerie cardiovasculaire multimodalites avant l'implantation d'une prothese valvulaire aortique par voie percutanee.
DAVIN, Laurent ; BRUYERE, Pierre-Julien ; LANCELLOTTI, Patrizio 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 ▲]Detailed reference viewed: 50 (8 ULg)
Expert consensus for multi-modality imaging evaluation of cardiovascular complications of radiotherapy in adults: a report from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.
LANCELLOTTI, Patrizio ; ; et al
in European Heart Journal - Cardiovascular Imaging (2013), 14(8), 721-40
Cardiac toxicity is one of the most concerning side effects of anti-cancer therapy. The gain in life expectancy obtained with anti-cancer therapy can be compromised by increased morbidity and mortality ... [more ▼]
Cardiac toxicity is one of the most concerning side effects of anti-cancer therapy. The gain in life expectancy obtained with anti-cancer therapy can be compromised by increased morbidity and mortality associated with its cardiac complications. While radiosensitivity of the heart was initially recognized only in the early 1970s, the heart is regarded in the current era as one of the most critical dose-limiting organs in radiotherapy. Several clinical studies have identified adverse clinical consequences of radiation-induced heart disease (RIHD) on the outcome of long-term cancer survivors. A comprehensive review of potential cardiac complications related to radiotherapy is warranted. An evidence-based review of several imaging approaches used to detect, evaluate, and monitor RIHD is discussed. Recommendations for the early identification and monitoring of cardiovascular complications of radiotherapy by cardiac imaging are also proposed. [less ▲]Detailed reference viewed: 39 (5 ULg)
Impact of hemodynamic load on exercise capacity in aortic stenosis
Dulgheru, Raluca Elena ; Magne, Julien ; et al
in International Journal of Cardiology (2013)Detailed reference viewed: 94 (6 ULg)
Clinical outcome in asymptomatic severe aortic stenosis: Insights from the new proposed aortic stenosis grading classification
Lancellotti, Patrizio ; Magne, Julien ; et al
in Journal of the American College of Cardiology (2012), 59(3), 235-243Detailed reference viewed: 17 (3 ULg)
Is left ventricular longitudinal function related to metabolic abnormalities and fat distribution?
; Magne, Julien ; et al
Conference (2010)Detailed reference viewed: 4 (0 ULg)
La tomodensitométrie cardiaque dans la mise au point préopératoire d’une anomalie congénitale d’une artère coronaire
Davin, Laurent ; Gach, Olivier ; Martinez, Christophe et al
in Annales de Cardiologie et d'Angeiologie (2009), 58(2), 122-4Detailed reference viewed: 43 (11 ULg)
Ventricular aneurysm versus pseudoaneurysm: role of multi-imaging modality.
DAVIN, Laurent ; BRUYERE, Pierre-Julien ; LANCELLOTTI, Patrizio
in Archives of Cardiovascular Diseases (2008), 101(2), 135Detailed reference viewed: 3 (1 ULg)
L'image du mois. Les valvules cardiaques en tomodensitometrie multidetecteur et echo 3D.
Davin, Laurent ; Bruyere, Pierre-Julien ; Gach, Olivier et al
in Revue Médicale de Liège (2008), 63(10), 577-8Detailed reference viewed: 12 (1 ULg)
Nouveautes dans la prise en charge des valvulopathies du coeur gauche
Davin, Laurent ; ; Lancellotti, Patrizio
in Revue Médicale Suisse (2007), 3(122), 1870-5
In the last years, the management of left valvular disease has considerably evolved. The American guidelines of 1998 were recently reviewed. Since this year, we have European guidelines which are ... [more ▼]
In the last years, the management of left valvular disease has considerably evolved. The American guidelines of 1998 were recently reviewed. Since this year, we have European guidelines which are different in some points. The place of exercise testing in risk stratification of asymptomatic valvular disease is increasing and helps to make earlier decision regarding the need for surgery. [less ▲]Detailed reference viewed: 4 (2 ULg)
Diagnostic accuracy of computed tomography coronary angiography in routine practice
Davin, Laurent ; LANCELLOTTI, Patrizio ; et al
in Acta Cardiologica (2007), 62(4), 339-344
Objectives - The recent newer advances in computed tomography have dramatically changed our approach to imaging cardiac disease. This study sought to compare the diagnostic value of 16-multi-detector ... [more ▼]
Objectives - The recent newer advances in computed tomography have dramatically changed our approach to imaging cardiac disease. This study sought to compare the diagnostic value of 16-multi-detector spiral computed tomography (MSCT) for detecting coronary artery stenosis. Methods - A total of 88 consecutive patients (52 men, mean age 68 +/- 8 years) with atypical chest pain, stable angina or suspicion of ischaemia at stress test were studied by MSCT and invasive coronary angiography (ICA). The MSCT images and multiplanar reconstructions were analysed regarding the presence of >= 50% coronary artery lesion. Results - All 88 scans obtained at a mean heart rate of 68 8 beats/min were interpretable. Sixteen coronary segments were evaluated in each patient. Of the 1320 segments examined, 148 (11 %) showed poor image quality. A total of 150 significant lesions were detected using ICA, and 80 of 150 (53%) were detected by MSCT Sensitivity, specificity, positive and negative predictive values were as follows: 53%, 97%, 68%, and 94%. Fifty-four patients had >= 50% coronary stenosis. The diagnosis was confirmed by MSCT in 42 patients and correctly ruled out in 30. By patient-based analysis, positive and negative predictive values were 91 % and 71 %. Conclusion - Although its specificity is high, the sensitivity of 16-slice MSCT for detecting 2: 50% coronary stenosis in non-selected patients submitted to ICA is rather low suggesting that for daily practice the diagnostic value of this technique should be improved. [less ▲]Detailed reference viewed: 5 (2 ULg)
Comment j'explore...Les arteres coronaires en 2007: apports de la tomodensitometrie
Davin, Laurent ; ; Lewin, Michel et al
in Revue Médicale de Liège (2007), 62(4), 222-9
Cardiac imaging has always been a challenge because of the continuous movement of the heart. Cardiac computed tomography (CT) has undergone an accelerated progression over the past decade, due to the ... [more ▼]
Cardiac imaging has always been a challenge because of the continuous movement of the heart. Cardiac computed tomography (CT) has undergone an accelerated progression over the past decade, due to the combination of the high-speed rotation of the X-ray tube, the ECG-gating technique and the infra-millimeter spatial resolution. Multidetector CT allows visualisation of the coronary artery lumen and the detection of coronary stenosis after intravenous injection of contrast medium. Studies have demonstrated a high negative predictive value of CT coronary angiography (CTCA). CTCA may be reasonably used for the assessment of symptomatic patients, especially in the setting of equivocal treadmill or functional testing. Also, CTCA allows assessment of coronary bypass graft patency and recognition of aberrant coronary arteries. Limitations in the use of this technique exist: atrial fibrillation and other cardiac arrhythmias remain a contraindication; severe calcifications are the most frequent reason for impaired assessment of coronary arteries. High radiation doses prohibit the use of this test as a screening tool for asymptomatic patients. [less ▲]Detailed reference viewed: 14 (0 ULg)
L'image du mois. Fistule coronaire en imagerie non invasive par CT scanner coronaire
Davin, Laurent ; Lewin, Michel ; BRUYERE, Pierre-Julien et al
in Revue Médicale de Liège (2007), 62(7-8, Jul-Aug), 477-8Detailed reference viewed: 14 (0 ULg)
Non-invasive imaging of a giant right coronary artery due to a coronary fistula
Gach, Olivier ; Davin, Laurent ; Legrand, Victor
in Acta Cardiologica (2006), 61(5), 569-571
Coronary artery fistula is a relatively rare finding in patients undergoing diagnostic cardiac catheterization. Incidence, angiographic characteristics and natural history of coronary fistulas of this ... [more ▼]
Coronary artery fistula is a relatively rare finding in patients undergoing diagnostic cardiac catheterization. Incidence, angiographic characteristics and natural history of coronary fistulas of this type have not been well defined in the literature. We report a case of a 54-year-old man in whom such abnormalities have been diagnosed with invasive and non-invasive coronary imaging and review the epidemiology, treatment and prognosis of coronary fistulas. [less ▲]Detailed reference viewed: 9 (0 ULg)
Tumour Necrosis Factor (Tnf) Gene Polymorphism in Crohn's Disease (Cd): Influence on Disease Behaviour?
Louis, Edouard ; ; et al
in Clinical & Experimental Immunology (2000), 119(1), 64-8
Crohn's disease (CD) is a multifactorial disease with genetic heterogeneity. TNF-alpha plays a key role in the development of the mucosal lesions. The aim of our work was to study a single base pair ... [more ▼]
Crohn's disease (CD) is a multifactorial disease with genetic heterogeneity. TNF-alpha plays a key role in the development of the mucosal lesions. The aim of our work was to study a single base pair polymorphism located in the promoter region of TNF gene, in a large population of CD patients with well defined phenotypes. One hundred and ninety-three patients with CD and 98 ethnically matched controls were studied. The -308 single base pair polymorphism of TNF gene was studied using an allele-specific polymerase chain reaction. Genotype and allelic frequencies were compared between patients and controls and between subgroups of patients defined by sex, age at diagnosis, familial history, location of disease, type of disease, extra-intestinal manifestations, and response to steroid treatment. In 29 patients a measure of TNF-alpha production by colonic biopsies was performed. The frequency of the allele TNF2 as well as the proportion of carriers of the allele TNF2 were slightly but not significantly lower in CD than in controls (11.9% versus 14.8% and 21.5% versus 27.6%, respectively). A more prominent difference in frequencies of allele TNF2 and in proportions of TNF2 carriers was found when comparing subgroups of patients. The frequency of allele TNF2 was significantly higher in steroid-dependent than in non-steroid-dependent disease (28.1% versus 10.3%; Delta = 17.8%, 95% confidence interval (CI) = 6.3-29.5%, P = 0.0027) and tended to be higher in colonic than in small bowel disease and in fistulizing than in stricturing disease. Furthermore, TNF2 carriers tended to be more frequent in patients with steroid-dependent than non-steroid-dependent disease (43.8% versus 19.3%; Delta = 24.5%, 95% CI = 3.6-45.4%, P = 0.022), in patients with fistulizing than stricturing disease (26.5% versus 9.6%; Delta = 16.9%, 95% CI = 1. 1-32.6%, P = 0.036), and in patients with colonic than small bowel disease (26.5% versus 11.1%; Delta = 15.4%, 95% CI = -0.8-31.6%, P = 0.063). Finally, patients carrying at least one copy of allele 2 were found to produce slightly more TNF-alpha at the colonic level. The -308 TNF gene polymorphism may have a slight influence on the behaviour of CD. The carriage of allele 2 may favour steroid-dependent disease and to a lesser extent fistulizing and colonic disease, possibly secondary to a more intense TNF-alpha-driven inflammatory reaction at the mucosal level. [less ▲]Detailed reference viewed: 21 (1 ULg)