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See detailCardiac troponins and natriuretic peptides in runners: useful for cardiac risk screening ?
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Fillet, Marianne ULg et al

in British Journal of Sports Medicine (2014, April), 48(7), 173

Background Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. Objective Our aim was to compare ... [more ▼]

Background Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. Objective Our aim was to compare cTnT and NT-proBNP levels before and after the stress tests, in sportive subjects. Design Prospective, cohort study. Setting Amateur marathon runners and ultrarunners. Patients 28 subjects (26 men, 42.5±11 yrs) were enrolled. Interventions Subjects ran the Maasmarathon (42.195 kilometers) and 33 subjects (33 men, 45.7±9.3 yrs) ran the Ultratour of Liège (Belgium; 67 km). All subjects gave their informed consent. We took blood sample before (T0), just after (T1) and 3 hours after the race (T3). Main outcome measurements cTnT concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics) on heparin plasma. The NT-proBNP was also determined with the kit Roche on heparin plasma. All statistical analyses were performed using Medcalc version 8.1 for Windows. P-value <.01 was regarded as statistically significant. Results A significant difference between hsTnT concentrations at T0 and T1 (P<.001), and between T0 and T3 (P<.001) for NT-proBNP have been observed, but not between T1 and T3. This observation appeared only after a strenuous exercise. However, up to now this type of exercise is not reproducible easily in a laboratory. Moreover, nobody knows if these observations would have cardiac consequences at long terms. Conclusion Measurement of cardiac troponins by high sensitive methods allows detecting significant release of biomarkers from the heart during exercise. The value of NT-proBNP are also significant but less than TnThs. We think that the TnThs could be an interesting tool in the future to help sport medicine to detect risk of developing a cardiac problem in the future or a sudden death. [less ▲]

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See detailTwo biomarkers for the screening of cardiac risk among runners ?
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Fillet, Marianne ULg et al

in British Journal of Sports Medicine (2014, April), 48(7), 174

Background Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. Troponin T is a ... [more ▼]

Background Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. Troponin T is a component of the contractile apparatus of the striated musculature. Both are early markers for acute coronary syndrome. Objective The aim of our study was to compare the results obtained with the H-FABP and the highly sensitive cardiac troponins (hsTnT) and to test their cardiospecificity in healthy runners. Design Prospective, cohort study. Setting Amateur marathon runners. Patients 23 runners (marathon) were enrolled. Interventions We drowned blood samples at three times: just before (T0), just after (T1), and three hours after the end of the race (T3). Main outcome measurements H-FABP and hs-TnT were performed according to the manufacturer's instructions. A linear regression was calculated to observe if there is any correlation between the two biomarkers. Values above the 95th percentile for H-FABP (2.5 ng/mL) and the 99th percentile for hsTnT (14 ng/L) were considered as positive. Results At T0, none of the subjects were positive for hsTnT but 35% were positive for H-FABP; at T1, 83% for hsTnT and 100% for H-FABP; at T3, 83% for hsTnT and 96% for H-FABP. At T0, the regression equation was H-FABP T0=3.9454–0.1001×hsTnT T0; at T1: H-FABP T1=51.838–1.7026×hsTnT T1; at T3: H-FABP T3=47.977–1.6193×hsTnT T3. No correlation was observed between the 2 biomarkers. Conclusion We observed a significant increase of H-FABP and hsTnT in runners. These markers are independent to each other. These values could biologically correspond to a heart ischemia. These biomarkers could be helpful for the screening of cardiac risk among runners. [less ▲]

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See detailRunning races: study of the stress and cardiac biomarkers
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; MELON, Pierre ULg et al

in European Journal of Sports Medicine (2013, September), 1(Supplement 1), 212

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured ... [more ▼]

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured by new commercially available high-sensitive methods in subjects undergoing a marathon and an ultra-trail. Our aim was to compare cTnT and NT-proBNP levels before and after the stress tests, in sportive subjects. Materials and Methods: Twenty eight subjects (26 men, 42.5 ± 11 yo) ran the Maasmarathon (42.195 kilometers) between Visé (Belgium) and Maastricht (The Netherlands) and 33 subjects (33 men, 45.7±9.3yo) ran the Ultratour of Liège (Belgium ; 67 km). We took blood sample before (T0), just after (T1) and 3 hours after the race (T3). In all the patients, cTnT concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics) on heparin plasma. The NT-proBNP was also determined with the kit Roche on heparin plasma. The protocol was approved by the Ethics Committee of the University of Liège (Belgium). All subjects gave their informed consent. All statistical analyses were performed using Medcalc version 8.1 for Windows. p-value <0.01 was regarded as statistically significant. Results and discussion: A significant difference between hsTnT concentrations at T0 and T1 (p<0.0001), and between T0 and T3 (p<0.001) for NT-proBNP have been observed, but not between T1 and T3. This observation appeared only after a strenuous exercise. However, up to now this type of exercise is not reproducible easily in a laboratory. Moreover, nobody knows if these observations would have cardiac consequences at long terms. Conclusions: Measurement of cardiac troponins by high sensitive methods allows detecting significant release of biomarkers from the heart during exercise. The value of NT-proBNP are also significant but less than TnThs. We think that the TnThs could be an interesting tool in the future to help sport medicine to detect risk of developing a cardiac problem in the future or a sudden death. [less ▲]

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See detailComparison of the Heart-type fatty acid-binding protein (H-FABP) with the high sensitive cardiac troponin T in healthy runners
LE GOFF, Caroline ULg; MELON, Pierre ULg; BREVERS, Eric ULg et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Background: Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. It is an early marker ... [more ▼]

Background: Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. It is an early marker for acute coronary syndrome. Troponin T (TnT) is a component of the contractile apparatus of the striated musculature. Cardiac TnT is a cardio-specific, highly sensitive marker for myocardial damage. The aim of our study was to compare the results obtained with the H-FABP and the highly sensitive cardiac troponins (hsTnT) and to test their cardiospecificity in healthy runners. Methods: Twenty three runners (marathon) were enrolled. We drowned samples at three times: just before (T0), just after (T1), and three hours after the end of the race (T3). H-FABP was determined with a Randox immunoturbidimetric assay and hs-TnT with a Roche electrochemiluminescence immunoassay, both on Cobas 6000. A linear regression was calculated to observe if there is any correlation between the two biomarkers. Values above the 95th percentile for H-FABP (2.5ng/mL) and the 99th percentile for hsTnT (14ng/L) were considered as positive. Results: At T0, none of the subjects were positive for hsTnT but 35% were positive for H-FABP; at T1, 83% for hsTnT and 100% for H-FABP; at T3, 83% for hsTnT and 96% for H-FABP. At T0, the regression equation was H-FABP T0 = 3.9454 – 0.1001 x hsTnT T0; at T1: H-FABP T1 = 51.838 – 1.7026 x hsTnT T1; at T3: H-FABP T3 = 47.977 – 1.6193 x hsTnT T3. No correlation was observed between the two biomarkers at the different time. Conclusions: We observed a significant increase of H-FABP and hsTnT in runners. These markers are independent to each other. These values could biologically correspond to a heart ischemia. However, we suggested that exercise-induced cardiac hsTnT and H-FABP release is not a marker of exercise-induced pathology but likely a physiologic response to effort or an exercise-induced cardiac remodelling. [less ▲]

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See detailImpact of different endurance races on the heart: the point of view of the biologist
LE GOFF, Caroline ULg; MELON, Pierre ULg; Thébault, Jérémie et al

in Book of abstracts of 18th Annual Congress of the ECSS (2013, June)

Objective The aim of this study was to investigate the impact of intense exercise, represented by different endurance races, in relationship with oxidative stress and cardiac markers. In a second time, we ... [more ▼]

Objective The aim of this study was to investigate the impact of intense exercise, represented by different endurance races, in relationship with oxidative stress and cardiac markers. In a second time, we tried to demonstrate if oxidative stress induced by physical activity is a physiological or pathological process, and to establish some issues to diagnose the risk of sudden death in athletes. Methods Four populations were compared, a control group of 16 participants “sedentary” (37 ± 4,39 years old), a group of 24 semi-marathon runners (41 years ± 8,76 years old), a group of 28 marathon runners (44,1 ± 8,37 years old) and a group of 33 ultra-trail runners (45,8 ± 8,7 years old). Three blood tests were drowned, one just before, one just after, and the last three hours after the end of the race.Different oxidative and stress and cardiac biomarkers were measured. The ultra-trail runners will be subject to an echocardiography and an ECG pre- and post-race. For statistical analysis, STATISTICA 10 software was used. We performed a non-parametric test of Kruskal-Wallis for independent sample and a Friedman ANOVA for paired samples. Results Myeloperoxydase increased during exercise, but the release is less important according to the level of training of the runners. GSH/GSSG ratio seems to remain stable during the race but it could increase during the 24 hours post-race. There is a decrease in lipidic peroxidation during exercise. But, we note an increase of creatine kinase, isoform MB, myoglobin and C-reactive protein during the race. We observe an increase of troponin T and natriuretic peptide but with a different kinetic than the kinetic obtained for a myocardial infarction. Medical imaging in ultra-trail runners present cardiac adaptations to endurance training, as left ventricular hypertrophy (LVH) and incomplete right bundle branch block (IRBBB). A decrease of systolic and diastolic volumes of the left ventricle and a decrease of longitudinal strain were observed by echocardiography at the end of the race. Conclusion Endurance races induce the income of oxidative stress objectified by different biomarkers increase, but a cell necrosis is not specially observed. In fact, the increase of the cardiac markers during endurance races but may be explained by a transient modification of myocyte permeability, with a release of pool cytosolic. These races may induce micro-muscle damages causing the appearance of an inflammatory process explaining our observations of markers of inflammation. For the medical imaging, it was observed a myocardial adaptation to training and a transient impairment of ventricular function due to dehydration. [less ▲]

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See detailImpact of strenuous exercise on the release of cardiac biomarkers
LE GOFF, Caroline ULg; MELON, Pierre ULg; Kaux, Jean-François ULg et al

in Biochimica Clinica (2013, May), 37(SS), 545

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured ... [more ▼]

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured by new commercially available high-sensitive methods in subjects un-dergoing the Maasmarathon. Our aim was to compare cTnT and NT-proBNP levels before and after the stress tests, in sportive subjects. Methods: Twenty eight subjects (26 ♂, 42.5±11yo) underwent a race of 42.195 kilometers be-tween Visé (Belgium) and Maastricht (The Netherlands). We drowned blood sample before (T0), just after (T1) and three hours after the race (T3). In all patients, cTnT concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics) on heparin plasma. The NT-proBNP was also determined with the kit Roche on heparin plasma. The protocol was approved by the ethics committee of the University of Liège (Belgium). All subjects gave their informed consent. All statistical analyses were performed using Medcalc version 8.1 for Windows. p-value <0.01 was regarded as statistically significant. Results: There was a significant difference between hsTnT concentrations at T0 and T1 (p<0.0001), and between T0 and T3 (p<0.001) for NT-proBNP, but not between T1 and T3. This observation appeared only after a strenuous exercise but today this type of exercise is not reproduce easier in a laboratory of sport. Moreover, at this moment, nobody knows if these observations would have cardiac consequences at long terms. Conclusions: Measurement of cardiac troponins by high sensitive methods allows detecting significant release of biomarkers from the heart during exercise. The value of NT-proBNP are also significant but less than TnThs. We think that the TnThs could be an interesting tool in the future to help sport medicine to detect risk of developing a cardiac problem in the future or a sudden death. [less ▲]

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See detailComparison of the Heart-type fatty acid-binding protein (H-FABP) with the high sensitive cardiac troponin T in healthy runners
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; BREVERS, Eric ULg et al

in Biochimica Clinica (2013, May), 37(SS), 544

Background: Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. It is an early marker ... [more ▼]

Background: Heart-type fatty acid-binding protein (H-FABP) is a low molecular weight protein involved in the intracellular uptake and buffering of long chain fatty in the myocardium. It is an early marker for acute coronary syndrome. Troponin T (TnT) is a component of the contractile apparatus of the striated musculature. Cardiac TnT is a cardio-specific, highly sensitive marker for myocardial damage. The aim of our study was to compare the results obtained with the H-FABP and the highly sensitive cardiac troponins (hsTnT) and to test their cardiospecificity in healthy runners. Methods: Twenty three runners (marathon) were enrolled. We drowned samples at three times: just before (T0), just after (T1), and three hours after the end of the race (T3). H-FABP was determined with a Randox immunoturbidimetric assay and hs-TnT with a Roche electrochemiluminescence immunoassay, both on Cobas 6000. A linear regression was calculated to observe if there is any correlation between the two biomarkers. Values above the 95th percentile for H-FABP (2.5ng/mL) and the 99th percentile for hsTnT (14ng/L) were considered as positive. Results: At T0, none of the subjects were positive for hsTnT but 35% were positive for H-FABP; at T1, 83% for hsTnT and 100% for H-FABP; at T3, 83% for hsTnT and 96% for H-FABP. At T0, the regression equation was H-FABP T0 = 3.9454 – 0.1001 x hsTnT T0; at T1: H-FABP T1 = 51.838 – 1.7026 x hsTnT T1; at T3: H-FABP T3 = 47.977 – 1.6193 x hsTnT T3. No correlation was observed between the two biomarkers at the different time. Conclusions: We observed a significant increase of H-FABP and hsTnT in runners. These markers are independent to each other. These values could biologically correspond to a heart ischemia. However, we suggested that exercise-induced cardiac hsTnT and H-FABP release is not a marker of exercise-induced pathology but likely a physiologic response to effort or an exercise-induced cardiac remodelling. [less ▲]

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See detailRace Cycling: biological evolution
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; MELON, Pierre ULg et al

in Biochimica Clinica (2013, May), 37(SS), 544

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and ... [more ▼]

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and metabolic) released during an international cycling race. Methods: Venous blood samples of 15 young men (25.1 ± 6.4 y.o.) were collected just before (T1), just after (T2), 3 hours (T3) after an international cycling race of 179.6 kilometers in Belgium for the determination of cardiac and metabolic biomarkers: red blood cell (RBC), haemoglobin (HgB), creatinin (Cr), highly sensitive troponin T (hsTnT), myoglobin (MYO) and NT-proBNP. All automated assays were performed according to the manufacter’s specifications. For the statistical analysis, an Anova calculated with the Statistica Software version 9.1 was used. Results: RBC and HgB levels varied significantly between T0 and T3 (respectively p=0.0026, and p=0.002). Cr concentration also varied significantly between all times (T0-T1:p<0.0001, T1-T3:p=0.0326 and T0-T3 p=0.0001). These changes might be related to renal flow depletion during exercice. MYO increased significantly between T0 and T1 (p<0.0001), but quickly decreased between T1 and T3, however the T3 level stay higher than T0 (p=0.014). The stress delivered from the physical activity performed during the race induced a significant variation of hsTnT which increased significantly between T0 and T1 (p<0.0001) and stayed higher 3 hours after the end of the exercise (T0-T3: p<0.0001) .The intense exercise delivery by the race induced a significant variation of NT-proBNP, that followed the same kinetic of hsTnT but in smaller proportion. We noticed variations statistically significant between T0 and T1 and between T0 and T3 for NT-proBNP. These increases of cardiac biomarkers were significant but reasonable and could not allow us to talk about cellular necrosis or irreversible injury. Conclusion: Our results show that stress generated by a cycling race could be the cause for the different metabolic variations observed. Troponin T stays without a doubt the most specific marker for stress related to myocardial tissue. Its increase can then be considered as being of interest. [less ▲]

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See detailRace cycling: biological evolution
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Goffaux, Sébastien et al

in Meeusen, R; Duchateau, J; Roelands, B (Eds.) et al Book of Abstracts of the 17th annual Congress of the ECSS (2012, July)

Introduction: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and ... [more ▼]

Introduction: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and metabolic) released during an international cycling race. Materials and methods: Venous blood samples of 15 young men (25.1 ± 6.4 y.o.) were collected just before (T1), just after (T2), 3 hours (T3) after an international cycling race of 179.6 kilometers in Belgium for the determination of cardiac and metabolic biomarkers: red blood cell (RBC), haemoglobin (HgB), creatinin (Cr), highly sensitive troponin T (hsTnT), myoglobin (MYO) and NT-proBNP. All automated assays were performed according to the manufacter’s specifications. For the statistical analysis, an Anova calculated with the Statistica Software version 9.1 was used. Results and discussions: RBC and HgB levels varied significantly between T0 and T3 (respectively p=0.0026, and p=0.002). Cr concentration also varied significantly between all times (T0-T1:p<0.0001, T1-T3:p=0.0326 and T0-T3 p=0.0001). These changes might be related to renal flow depletion during exercice. MYO increased significantly between T0 and T1 (p<0.0001), but quickly decreased between T1 and T3, however the T3 level stay higher than T0 (p=0.014). The stress delivered from the physical activity performed during the race induced a significant variation of hsTnT which increased significantly between T0 and T1 (p<0.0001) and stayed higher 3 hours after the end of the exercise (T0-T3: p<0.0001). The intense exercise delivery by the race induced a significant variation of NT-proBNP, that followed the same kinetic of hsTnT but in smaller proportion. We noticed variations statistically significant between T0 and T1 and between T0 and T3 for NT-proBNP. These increases of cardiac biomarkers were significant but reasonable and could not allow us to talk about cellular necrosis or irreversible injury. Conclusion: Our results show that stress generated by a cycling race could be the cause for the different metabolic variations observed. Troponin T stays without a doubt the most specific marker for stress related to myocardial tissue. Its increase can then be considered as being of interest. [less ▲]

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See detailImpact of strenous exercise on the release of cardiac biomarkers
LE GOFF, Caroline ULg; MELON, Pierre ULg; Kaux, Jean-François ULg et al

in Meeusen, R; Duchateau, J; Roelands, B (Eds.) et al Book of Abstracts of the 17th annual Congress of the ECSS (2012, July)

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured ... [more ▼]

Background: Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. In this study, cTnT was measured by new commercially available high-sensitive methods in subjects undergoing the Maasmarathon. Our aim was to compare cTnT and NT-proBNP levels in sportive subjects before and after a strenuous exercise. Materials and Methods: Twenty eight subjects (26 ♂, 42.5±11yo) underwent a race of 42.195 kilometers between Visé (Belgium) and Maastricht (The Netherlands). We drowned blood samples before (T0), just after (T1) and three hours after the race (T3). For all patients, cTnT concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics) on heparin plasma. The NT-proBNP was also determined with the kit Roche on heparin plasma. The protocol was approved by the ethics committee of the University of Liège (Belgium). All subjects gave their informed consent. All statistical analyses were performed using Medcalc version 8.1 for Windows. p-value <0.01 was regarded as statistically significant. Results and discussion: A significant difference between hsTnT concentrations at T0 and T1 (p<0.0001) was measured as well as between T0 and T3 (p<0.001) for NT-proBNP, but not between T1 and T3. This observation appeared only after a strenuous exercise but today this type of exercise is not reproduce easier in a laboratory of sport. Moreover, at this moment, nobody knows if these observations would have cardiac consequences at long terms. Conclusions: Measurement of cardiac troponins by high sensitive methods allows detecting significant release of biomarkers from the heart during exercise. The levels of NT-proBNP were found significantly increased but in less extent than TnThs. We think that the TnThs could be an interesting marker in the future to help sport medicine to detect risk of developing a cardiac problem. [less ▲]

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See detailBiological variations during a race cycling
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Goffaux, Sébastien et al

in Biomedica 2012 (2012, April)

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and ... [more ▼]

Background: The metabolic and cardiac impact of a cycling effort on blood biology is not very well described in the literature. We aimed to measure the concentration of different biomarkers (cardiac and metabolic) released during an international cycling race. Materials and Methods: Venous blood samples of 15 young men (25.1 ± 6.4 y.o.) were collected just before (T1), just after (T2), 3 hours (T3) after an international cycling race of 176 kilometers in Belgium for the determination of cardiac and metabolic biomarkers: red blood cells (RBC) haemoglobin (HgB) creatinin (Cr) highly sensitive troponin T (hsTnT) myoglobin (MYO) NT-proBNP All automated assays were performed according to the manufacter’s specifications. For the statistical analysis, an Anova calculated with the Statistica Software version 9.1 was used. Results: •RBC and HgB levels varied significantly between T0 and T3 (respectively p=0.0026, and p=0.002) (Fig. 1 and 2). • Cr concentration also varied significantly between all times (T0-T1:p<0.0001, T1-T3:p=0.0326 and T0-T3 p=0.0001)(Fig.3). These changes might be related to renal flow depletion during exercise. •MYO increased significantly between T0 and T1 (p<0.0001), but quickly decreased between T1 and T3, however the T3 level stay higher than T0 (p=0.014) (Fig.4). •The stress delivered from the physical activity performed during the race induced a significant variation of hsTnT which increased significantly between T0 and T1 (p<0.0001) and stayed higher 3 hours after the end of the exercise (T0-T3: p<0.0001) (Fig.5) . •The intense exercise delivery by the race induced a significant variation of NT-proBNP, that followed the same kinetic of hsTnT but in smaller proportion. We noticed variations statistically significant between T0 and T1 and between T0 and T3 for NT-proBNP (Fig.6). •These increases of cardiac biomarkers were significant but reasonable and could not allow us to talk about cellular necrosis or irreversible injury. Conclusions: Our results show that stress generated by a cycling race could be the cause for the different metabolic variations observed. Troponin T stays without a doubt the most specific marker for stress related to myocardial tissue. Its increase can then be considered as being of interest. [less ▲]

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See detailLe cas clinique du mois: Implantation fortuite d'une sonde de defibrillation dans le ventricule gauche au travers d'un foramen ovale permeable.
Bologne, J.C.; Garweg, C.; LANCELLOTTI, Patrizio ULg et al

in Revue Médicale de Liège (2012), 67(2), 58-60

Inadvertent insertion of a defibrillation lead in the left ventricle is a rare complication generally underdiagnosed after device implantation. Management is not strictly codified due to the small number ... [more ▼]

Inadvertent insertion of a defibrillation lead in the left ventricle is a rare complication generally underdiagnosed after device implantation. Management is not strictly codified due to the small number of observed cases. We report the case of a 78 year-old man in whom the diagnosis has been performed lately during an echocardiography. [less ▲]

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See detailImpact d'un exercice intense sur les marqueurs cardiaques et de stess oxydant lors de la course à pieds
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; MELON, Pierre ULg et al

in 4ème Congrès commun SFMS & SFTS (2011, September)

Introduction : Le risque d’évènements cardiaques ou de mort subite après effort physique intense a été décrit dans diverses études. Chez les personnes ne pratiquant pas régulièrement une activité physique ... [more ▼]

Introduction : Le risque d’évènements cardiaques ou de mort subite après effort physique intense a été décrit dans diverses études. Chez les personnes ne pratiquant pas régulièrement une activité physique, l’incidence de décès liée à un exercice physique est plus importante que chez les jeunes sportifs. Ces évènements indésirables se produisent chez des sujets présentant une maladie coronarienne qui leur était inconnue. L’American Heart Association recommande de réaliser un screening cardiovasculaire pour les athlètes de tout âge. Le but de notre étude était de doser des marqueurs cardiaques très sensibles chez des sujets sédentaires soumis à une course à pieds. Méthodes : Nous avons enrôlés 15 sujets sédentaires (<2heures de sport/ semaine) masculins (22.5±2.15ans) dans notre étude. Du sang EDTA et hépariné a été prélevé juste avant la course (T1), juste après (T2), 3 heures après (T3) et 24 heures après la fin de la course (T4). L’exercice consistait en une course d’une heure sur un tapis roulant à 75% de la VO2max. Un test à l’effort a été préalablement réalisé chez chaque participant deux semaines avant le test d’endurance. Des dosages de marqueurs cardiaques tels que la troponine untrasensible (hsTnT), le peptide natriurétique de type B (NT-proBNP), la myéloperoxydase (MPO) et des marqueurs du stress oxydant tels que le glutathion réduit (GSH), le glutathion oxydé (GOX) et les peroxydes lipidiques ont été dosés. Résultats : Après la course, le NT-proBNP, hsTnT, POXL et MPO augmentent durant les 3 heures qui suivent. Le NT-proBNP a augmenté de façon significative de T2 à T4 comparé au T1. Soixante-dix pourcent des sujets dépassent les valeurs de référence pour la hsTnT au T3 et ce, de façon statistiquement significative comparé aux autres temps. La MPO augment légèrement au T2 mais non significativement. Les peroxydes lipidiques montrent une augmentation au T4 mais non significative. Le GOX augmente de façon significative au T2. Il n’y pas de variation du GSH alors que le rapport GSH/GOX est significativement augmenté au T4. Conclusions : Cette étude a permis de mettre en évidence que ce type d’exercice chez des sujets sédentaires produit un stress oxydant quantifiable et continu durant les 24 heures qui suivent l’effort. Nous n’observons pas d’adaptations antixydantes. L’augmentation des marqueurs cardiaques reflètent l’existence d’un stress cardiaque liée à cet exercice. [less ▲]

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See detailLe cas clinique du mois. Péricardite purulente chez un patient atteint de sarcoïdose pulmonaire
NYSSEN, Astrid ULg; MELON, Pierre ULg; GARWEG, Christophe ULg et al

in Revue Médicale de Liège (2011)

We report the case of a patient, suffering from pulmonary sarcoidosis, who developed a purulent pericarditis complicated with a cardiac tamponade. The widespread use of antibiotics has progressively ... [more ▼]

We report the case of a patient, suffering from pulmonary sarcoidosis, who developed a purulent pericarditis complicated with a cardiac tamponade. The widespread use of antibiotics has progressively reduced the number of purulent pericarditis. However, it remains a serious disease that has to be rapidly diagnosed to be treated timely. We will review the required tests for the diagnosis and the treatment of this pathology that leads to death otherwise. The link with pulmonary sardoidosis is uncertain. [less ▲]

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See detailLa Vignette diagnostique de l'étudiant: Critères électrocardiographiques d’une tachycardie ventriculaire
GARWEG, Christophe ULg; BOLOGNE, Jean-Christophe ULg; MELON, Pierre ULg et al

in Revue Médicale de Liège (2011)

Recording of a regular wide QRS tachycardia is often source of panic and anxiety for the young clinician who has to make the differential diagnosis between ventricular tachycardia and supraventricular ... [more ▼]

Recording of a regular wide QRS tachycardia is often source of panic and anxiety for the young clinician who has to make the differential diagnosis between ventricular tachycardia and supraventricular tachycardia with aberration associated with fundamentally different vital prognosis. Most of the time, a rigorous approach and a systematic analysis of the electrocardiogram associated with clinical examination allow to obtain the correct diagnosis. [less ▲]

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See detailComment j'explore... Une arythmie ventriculaire chez le sportif
Tombeux, C.; MELON, Pierre ULg; Close, P. et al

in Revue Médicale de Liège (2011), 66(1), 30-33

How I explore : ventricular arrhythmhmias in athletes <br />SUMMARY : Documented ventricular tachyarrhythmias or related symptoms need meticulous cardiac investigations. The mechanism of ventricular ... [more ▼]

How I explore : ventricular arrhythmhmias in athletes <br />SUMMARY : Documented ventricular tachyarrhythmias or related symptoms need meticulous cardiac investigations. The mechanism of ventricular arrhythmia must be defined. The prognosis is related to underlying cardiac electrical or structural disorders. In the absence of cardiovascular abnormalities, the prognosis is good. No disqualification to competitive activity is required in most cases. Assessment of the risk of sudden death remains a continuing challenge in athletes. This article reviews the diagnostic and therapeutic approaches of ventricular arrhythmias encountered in trained athletes. [less ▲]

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See detailAssessment of high sensitive troponin T and I immunoassays in patients with acute chest
Le Goff, Caroline ULg; Garweg, Christophe ULg; Laurent, Terry et al

in Clinical Chemistry (2010, July), 56(S6), 127

Introduction: Cardiac troponin I and T are specific markers of myocardial injury that are widely used for the diagnosis of acute coronary syndrome (ACS). In acute chest pain without ST-segment elevation ... [more ▼]

Introduction: Cardiac troponin I and T are specific markers of myocardial injury that are widely used for the diagnosis of acute coronary syndrome (ACS). In acute chest pain without ST-segment elevation, they are used to differentiate unstable angina from non ST-segment elevation myocardial infarction (NSTEMI). Recently, troponin assays with higher analytical sensitivities became available to enable the detection of minor myocardial damage and identify individuals at higher risk for ACS. As a result of its high tissue-specificity, cardiac troponin T and I are cardio-specific, highly sensitive markers for myocardial damage. The aim of this study was to evaluate the new higher sensitive troponin (T and I) in patients with stable angina and acute chest pain without ST-segment elevation. Methods: Sixty subjects (mean age : 65.5± 11 years), were included: 20 healthy controls, 20 patients with stable angina, 9 with unstable angina (troponin-) and 18 patients with NSTEMI myocardial infarction (troponin+). The protocol was approved by the ethic committee of the University of Liège (Belgium). High sensitive troponin T (hsTnT) determination was realized on heparin plasma by electrochemiluminescence immunoassay on Modular E (Roche Diagnostic). Troponin I II (TnI II) is a chemiluminescent microparticle immunoassay for the quantitative determination of cardiac troponin-I in heparine plasma on the ARCHITECT i System (Abbott Diagnostic). The lower detection limit of these assays was 0.005μg/L for hsTnT and 0.01μg/L for TnI II. Stastistical analysis was performed using t test. P value <0.05 was considered significant. Results: HsTNT levels were 0.003(0.003, 0.004) [median baseline (1st, 3rd quartile)]ng/ml in controls, 0.0075 (0.00475, 0.014) ng/ml in stable angina, 0.011(0.006, 0.012) ng/ml in unstable angina and 0.3715 (0.1795, 1.00725) ng/ml in NSTEMI ACS. TnI II levels were 0 (0, 0.001) ng/ml in controls and in patients with stable angina, 0.07 (0.005, 0.014) ng/ml in unstable angina and 1.4475 (0.0407, 2.656) ng/ml in NSTEMI. HsTNT and TnI II levels were significantly increased in NSTEMI as compared to control subjects, patients with stable and unstable angina. TnI II levels were also increased in unstable angina as compared to controls. Conclusion: In our population, TnI II was more sensitive than hsTNT to detect minor myocardial damage in patients with unstable angina as compared to controls. Therefore, future studies will have to determine whether TnI II might contribute to better risk stratification and treatment strategy in this group of patients. [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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