References of "LANCELLOTTI, Patrizio"
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See detailRecommandations européennes pour la prise en charge des cardiopathies congénitales complexes de l'adulte
MILTNER, Béatrice ULg; LANCELLOTTI, Patrizio ULg; SEGHAYE, Marie-Christine ULg

in Revue Médicale de Liège (2014), 69(1), 16-25

THe number of patients with Grown-Up Congenital Heart disease (GUCH) consulting adult cardiologists is steadily increasing. These patients have either a non-diagnosed congenital heart disease revealed at ... [more ▼]

THe number of patients with Grown-Up Congenital Heart disease (GUCH) consulting adult cardiologists is steadily increasing. These patients have either a non-diagnosed congenital heart disease revealed at adulthood, or a diagnosed congenital heart disease for which one or multiple interventions have possibly been performed during childhood. In this article, we summarize the recommendations of the European Society of Cardiology of 2010 for complex congenital heart disease. [less ▲]

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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 detailUsefulness of 3D-PISA as compared to guideline endorsed parameters for mitral regurgitation quantification.
Schmidt, Frank P.; Gniewosz, Theresa; Jabs, Alexander et al

in The international journal of cardiovascular imaging (2014)

This study was intended to evaluate the diagnostic value of three dimensional proximal isovelocity surface area (3D PISA) derived effective regurgitant orifice area (EROA) and the accuracy of automatic 3D ... [more ▼]

This study was intended to evaluate the diagnostic value of three dimensional proximal isovelocity surface area (3D PISA) derived effective regurgitant orifice area (EROA) and the accuracy of automatic 3D PISA detection in a population resembling clinical practice. Quantification of mitral regurgitation (MR) remains challenging and 3D PISA EROA is a novel diagnostic tool with promising results. However its' usefulness compared to guideline endorsed parameters has not been shown. In 93 consecutive patients examined in routine practice conventional parameters and 3D-datasets for offline 3D PISA evaluation were recorded. EROA was determined from the largest (peak) PISA and also averaged over systole for meanEROA. Results of 3D PISA calculation were compared with a combination of expert grading by two examiners and two scores for MR grading. In receiver operator characteristic-analysis the meanEROA as determined by 3D PISA had the best diagnostic value (AUC = 0.907 CI 0.832-0.983) as compared to peakEROA (AUC 0.840 CI 0.739-0.941), vena contracta width (AUC 0.831 CI 0.745-0.918) and 2D PISA (AUC 0.747 CI 0.644-0.850). A meanEROA of 0.15 cm2 had a sensitivity of 88.2 % and a specificity of 81.4 % for distinguishing severe from non-severe MR. Semiautomatic 3D PISA detection correlated very well with manually corrected values (r = 0.955). Semiautomatic 3D PISA measurement is feasible in a clinical population and has better diagnostic value compared to 2D PISA. Calculation of mean EROA throughout systole further improves diagnostic value compared to conventional parameters. [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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See detailExercise Testing and Stress Imaging in Valvular Heart Disease.
henri, Christine; Pierard, Luc ULg; Lancellotti, Patrizio ULg et al

in The Canadian journal of cardiology (2014), 30(9), 1012-1026

The role of exercise testing and stress imaging in the management of patients with valvular heart disease (VHD) is reviewed in this article. The American College of Cardiology/American Heart Association ... [more ▼]

The role of exercise testing and stress imaging in the management of patients with valvular heart disease (VHD) is reviewed in this article. The American College of Cardiology/American Heart Association and the European Society of Cardiology/European Association of Cardiothoracic Surgery have recently put emphasis on the role of exercise testing to clarify symptom status and the use of stress imaging to assess the dynamic component of valvular abnormalities and unmask subclinical myocardial dysfunction that could be missed at rest. Recent studies have demonstrated the incremental prognostic value of exercise echocardiography for asymptomatic patients with severe aortic stenosis, moderate-severe mitral stenosis, and severe primary mitral regurgitation. In patients with low-flow, low-gradient aortic stenosis, dobutamine stress echocardiography is recommended to differentiate true severe from pseudosevere aortic stenosis. Data on the prognostic value of stress echocardiography in aortic regurgitation and functional mitral regurgitation are less robust. Data are sparse on the use of stress imaging in right-sided VHD, however recent studies using stress cardiovascular magnetic resonance imaging offer some prognostic information. Although the strongest recommendations for surgical treatment continue to be based on symptom status and resting left ventricular repercussions, stress imaging can be useful to optimize risk stratification and timing of surgery in VHD. Randomized clinical trials are required to confirm that clinical decision-making based on stress imaging can lead to improved outcomes. [less ▲]

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See detailExpert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Plana, Juan Carlos; Galderisi, Maurizio; Barac, Ana et al

in European heart journal cardiovascular Imaging (2014), 15(10), 1063-93

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See detailEuropean Association of Cardiovascular Imaging (EACVI) position paper: multimodality imaging in pericardial disease.
Cosyns, Bernard; Plein, Sven; Nihoyanopoulos, Petros et al

in European heart journal cardiovascular Imaging (2014)

Although pericardial diseases are common in the daily clinical practice and can result in a significant morbidity and mortality, imaging of patients with suspected or known pericardial disorders remain ... [more ▼]

Although pericardial diseases are common in the daily clinical practice and can result in a significant morbidity and mortality, imaging of patients with suspected or known pericardial disorders remain challenging. Multimodality imaging is part of the management of pericardial diseases. Echocardiography, cardiac computed tomography, and cardiovascular magnetic resonance are often used as complementary imaging modalities. The choice of one or multiple imaging modalities is driven by the clinical context or conditions of the patient. The scope of the present document is to highlight the respective role of each technique according to the clinical context in the diagnosis and management of pericardial diseases. [less ▲]

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See detailRecommandations europeennes concernant la therapie de resynchronisation cardiaque.
ROBINET, Sébastien ULg; DELCOUR, Alexandre ULg; Lancellotti, Patrizio ULg

in Revue medicale de Liege (2014), 69(4), 180-7

Cardiac resynchronization therapy (CRT) is one of the most successful heart failure therapies to emerge in the last 25 years; it is applicable to > 25-30% of patients with symptomatic heart failure. In ... [more ▼]

Cardiac resynchronization therapy (CRT) is one of the most successful heart failure therapies to emerge in the last 25 years; it is applicable to > 25-30% of patients with symptomatic heart failure. In this article, we summarize the recommendations of the European Society of Cardiology of 2013 on cardiac resynchronization therapy. [less ▲]

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See detailCardiovascular imaging.
Lancellotti, Patrizio ULg; Habib, Gilbert; Negila, Danilo et al

in European heart journal (2014), 35(18), 1161-2

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See detailHeart Valve Clinic: Rationale and Organization.
Lancellotti, Patrizio ULg; Rosenhek, Raphael; Pibarot, Philippe

in The Canadian journal of cardiology (2014)

With an increasing prevalence of patients with valvular heart disease (VHD), a dedicated management approach delivered in a well-defined structure, namely, the heart valve clinic (HVC), is warranted. The ... [more ▼]

With an increasing prevalence of patients with valvular heart disease (VHD), a dedicated management approach delivered in a well-defined structure, namely, the heart valve clinic (HVC), is warranted. The HVC is made up of a multidisciplinary team with high expertise in the diagnosis, management, treatment, and surveillance of patients with VHD. The aim of the HVC is to provide the highest quality of care to patients with VHD to improve the level of adherence to current evidence and guidelines, quality of life, and short- and long-term outcomes. The HVC also provides help in (1) informing and educating patients to motivate them to take their prescribed medications and look out for signs indicating a worsening of their disease, (2) organizing meetings for updates in knowledge for modern management of patients with VHD, and (3) disseminating protocols of contemporary and good practice in VHD. [less ▲]

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See detailUpdate of the European Association of Cardiovascular Imaging (EACVI) Core Syllabus for the European Cardiovascular Magnetic Resonance Certification Exam.
Petersen, Steffen E.; Almeida, Ana G.; Alpendurada, Francisco et al

in European heart journal cardiovascular Imaging (2014), 15(7), 728-729

An updated version of the European Association of Cardiovascular Imaging (EACVI) Core Syllabus for the European Cardiovascular Magnetic Resonance (CMR) Certification Exam is now available online. The ... [more ▼]

An updated version of the European Association of Cardiovascular Imaging (EACVI) Core Syllabus for the European Cardiovascular Magnetic Resonance (CMR) Certification Exam is now available online. The syllabus lists key elements of knowledge in CMR. It represents a framework for the development of training curricula and provides expected knowledge-based learning outcomes to the CMR trainees, in particular those intending to demonstrate CMR knowledge in the European CMR exam, a core requirement in the CMR certification process. [less ▲]

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See detailFocus cardiac ultrasound: the European Association of Cardiovascular Imaging viewpoint.
Neskovic, Aleksandar N.; Edvardsen, Thor; Galderisi, Maurizio et al

in European heart journal cardiovascular Imaging (2014)

The concept of point-of-care, problem-oriented focus cardiac ultrasound examination (FoCUS) is increasingly applied in the settings of medical emergencies, including cardiac diseases. The European ... [more ▼]

The concept of point-of-care, problem-oriented focus cardiac ultrasound examination (FoCUS) is increasingly applied in the settings of medical emergencies, including cardiac diseases. The European Association of Cardiovascular Imaging (EACVI) recognizes that cardiologists are not the only medical professionals dealing with cardiovascular emergencies. In reality, emergency cardiac diagnostics and treatment are also carried out by a wide range of specialists. For the benefit of the patients, the EACVI encourages any medical professional, sufficiently trained to obtain valuable information from FoCUS, to use it in emergency settings. These medical professionals need to have the necessary knowledge to understand the obtained information entirely, and to use it correctly, thoughtfully and with care. In this document, the EACVI underlines major differences between echocardiography and FoCUS, and underscores the need for specific education and training in order to fully utilize advantages and minimize drawbacks of this type of cardiac ultrasound examination in the critically ill patients. [less ▲]

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See detailLearning from our European imaging colleagues.
Weissman, Neil J.; Lancellotti, Patrizio ULg

in JACC. Cardiovascular imaging (2014), 7(6), 639-40

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See detailThe year 2013 in the European Heart Journal - Cardiovascular Imaging. Part I.
Edvardsen, Thor; Plein, Sven; Saraste, Antti et al

in European heart journal cardiovascular Imaging (2014), 15(7), 730-735

The new multimodality 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 multimodality 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 will focus on studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging, and Part II will focus on valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases. [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)

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 detailDeterminants of exercise-induced pulmonary arterial hypertension in systemic sclerosis.
Voilliot, Damien; Magne, Julien ULg; Dulgheru, Raluca et al

in International journal of cardiology (2014)

BACKGROUND: Exercise-induced pulmonary arterial hypertension (EIPH) in systemic sclerosis (SSc) has already been observed but its determinants remain unclear. The aim of this study was to determine the ... [more ▼]

BACKGROUND: Exercise-induced pulmonary arterial hypertension (EIPH) in systemic sclerosis (SSc) has already been observed but its determinants remain unclear. The aim of this study was to determine the incidence and the determinants of EIPH in SSc. METHODS AND RESULTS: We prospectively enrolled 63 patients with SSc (age 54+/-3years, 76% female) followed in CHU Sart-Tilman in Liege. All patients underwent graded semi-supine exercise echocardiography. Systolic pulmonary arterial pressure (sPAP) was derived from the peak velocity of the tricuspid regurgitation jet and adding the estimation of right atrial pressure, both at rest and during exercise. Resting pulmonary arterial hypertension (PH) was defined as sPAP >35mmHg and EIPH as sPAP >50mmHg during exercise. The following formulas were used: mean PAP (mPAP)=0.61xsPAP+2, left atrial pressure (LAP)=1.9+1.24xleft ventricular (LV) E/e' and pulmonary vascular resistance (PVR)=(mPAP-LAP)/LV cardiac output (CO) and slope of mPAP-LVCO relationship=changes in mPAP/changes in LVCO. Resting PH was present in 3 patients (7%) and 21 patients developed EIPH (47%). Patients with EIPH had higher resting LAP (10.3+/-2.2 versus 8.8+/-2.3mmHg; p=0.03), resting PVR (2.6+/-0.8 vs. 1.4+/-1.1Woods units; p=0.004), exercise LAP (13.3+/-2.3 vs. 9+/-1.7mmHg; p<0.0001), exercise PVR (3.6+/-0.7 vs. 2.1+/-0.9 Woods units; p=0.02) and slope of mPAP-LVCO (5.8+/-2.4 vs. 2.9+/-2.1mmHg/L/min; p<0.0001). After adjustment for age and gender, exercise LAP (beta=3.1+/-0.8; p=0.001) and exercise PVR (beta=7.9+/-1.7; p=0.0001) were independent determinants of exercise sPAP. CONCLUSION: EIPH is frequent in SSc patients and is mainly related to both increased exercise LV filling pressure and exercise PVR. [less ▲]

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See detailExercise testing in asymptomatic severe aortic stenosis.
Magne, Julien ULg; Lancellotti, Patrizio ULg; Pierard, Luc ULg

in JACC. Cardiovascular imaging (2014), 7(2), 188-99

The management and the clinical decision making in asymptomatic patients with aortic stenosis are challenging. An "aggressive" management, including early aortic valve replacement, is debated in these ... [more ▼]

The management and the clinical decision making in asymptomatic patients with aortic stenosis are challenging. An "aggressive" management, including early aortic valve replacement, is debated in these patients. However, the optimal timing for surgery remains controversial due to the lack of prospective data on the determinants of aortic stenosis progression, multicenter studies on risk stratification, and randomized studies on patient management. Exercise stress testing with or without imaging is strictly contraindicated in symptomatic patients with severe aortic stenosis. Exercise stress test is now recommended by current guidelines in asymptomatic patients and may provide incremental prognostic value. Indeed, the development of symptoms during exercise or an abnormal blood pressure response are associated with poor outcome and should be considered as an indication for surgery, as suggested by the most recently updated European Society of Cardiology 2012 guidelines. Exercise stress echocardiography may also improve the risk stratification and identify asymptomatic patients at higher risk of a cardiac event. When the test is combined with imaging, echocardiography during exercise should be recommended rather than post-exercise echocardiography. During exercise, an increase >18 to 20 mm Hg in mean pressure gradient, absence of improvement in left ventricular ejection fraction (i.e., absence of contractile reserve), and/or a systolic pulmonary arterial pressure >60 mm Hg (i.e., exercise pulmonary hypertension) are suggestive signs of advanced stages of the disease and impaired prognosis. Hence, exercise stress test may identify resting asymptomatic patients who develop exercise abnormalities and in whom surgery is recommended according to current guidelines. Exercise stress echocardiography may further unmask a subset of asymptomatic patients (i.e., without exercise stress test abnormalities) who are at high risk of reduced cardiac event free survival. In these patients, early surgery could be beneficial, whereas regular follow-up seems more appropriate in patients without echocardiographic abnormalities during exercise. [less ▲]

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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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