References of "PHILIPS, Jean-Christophe"
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See detailRelations entre neuropathie autonome cardiaque (NAC), pression pulsée (PP) et insuffisance rénale chronique (IRC) chez le patient diabétique de type 2 (DT2)
PHILIPS, Jean-Christophe ULg; MARCHAND, Monique ULg; SCHEEN, André ULg

Poster (2016, March)

Objectifs : Ce travail étudie les relations entre trois complications diabétiques, la NAC, l’élévation de PP (marqueur de rigidité artérielle) et la diminution du débit de filtration glomérulaire (DFG ... [more ▼]

Objectifs : Ce travail étudie les relations entre trois complications diabétiques, la NAC, l’élévation de PP (marqueur de rigidité artérielle) et la diminution du débit de filtration glomérulaire (DFG) chez le patient DT2. Patients et méthodes : L’étude comprend 79 patients DT2 (53H/26F; 56±8 années; 11±8 années de DT2; IMC 28,4±4,6 kg/m²) analysés par enregistrement continu de la pression artérielle (PA) et de la fréquence cardiaque (appareil Finapres) lors d’un test postural standardisé. Le gain baro-réflexe (GBR, indice de NAC) correspond à la pente de la relation entre les espaces R-R et PA systolique (PAS) lors du redressement accroupi-debout. PP est analysée pendant tout le test et par son augmentation durant l’accroupissement (delta PP). DFG est estimé par la formule MDRD au début puis après un suivi moyen de 12±5 ans. Résultats : Les valeurs initiales sont : HbA1c : 8,8± 1,7%; DFG : 86±25 ml/min ; PP : 62±10 mmHg; BRG : 1,8±1,4 msec/mmHg. DFG est inversement corrélé à l’âge (r=-0,317; p=0,020), très positivement corrélé avec GBR (r=0,453; p=0,008), sans corrélation significative avec HbA1c (r=-0,023; p=0,935) ni avec PAS, PP ou encore delta PP (r=-0,206; p=0,114; NS). La diminution de DFG (-12±23 ml/min) lors du suivi de 12 ans n’a pu être corrélée de façon significative aux valeurs initiales et finales d’HbA1c, ni aux valeurs initiales de GBR (et d’autres marqueurs de NAC) ou de PA, même si la relation est proche de la signification pour delta PP (r=0,20; p=0,060). Conclusion : La forte relation initiale entre DFG et GBR suggère que IRC et NAC sont aggravées de façon conjointe et, possiblement, qu’une des deux complications influence l’autre. L’absence de toute corrélation entre la chute ultérieure de DFG et les autres paramètres initiaux peut s’expliquer par l’origine multifactorielle de la progression de l’IRC chez le patient DT2. [less ▲]

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See detailAnalyse rétrospective des données concernant les patientes avec diabète gestationnel au CHU de Liège
RADERMECKER, Régis ULg; PHILIPS, Jean-Christophe ULg; Sepulchre, E

in Diabètes & Métabolism (2015, March), 41

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See detailRelations entre gain baro-réflexe et autres marqueurs de risque chez le patient diabétique de type 2
SCHEEN, André ULg; MARCHAND, Monique ULg; PHILIPS, Jean-Christophe ULg

in Annales de Cardiologie et d'Angeiologie (2015), 64(s1),

André J. Scheen, Monique Marchand, Jean-Christophe Philips (1) (1) Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Sart Tilman, Université de Liège, Liège, Belgique. Relations entre gain ... [more ▼]

André J. Scheen, Monique Marchand, Jean-Christophe Philips (1) (1) Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Sart Tilman, Université de Liège, Liège, Belgique. Relations entre gain baro-réflexe et autres marqueurs de risque chez le patient diabétique de type 2 Relationships between baroreflex gain and other risk markers in patients with type 2 diabetes Objectifs : Le gain baro-réflexe (GBR) est un marqueur de la neuropathie autonome cardiovasculaire (NAC) qui s’avère plus discriminant que le classique R-R E/I ratio. Le but du travail est d’étudier les relations entre le GBR et d’autres marqueurs de risque comme la pression pulsée (PP) et la diminution du débit de filtration glomérulaire (DFG) chez le patient diabétique de type 2 (DT2). Méthodes : Au total, 64 patients DT2 ont été étudiés par enregistrement continu de la pression artérielle (PA) et de la fréquence cardiaque (FC) lors d’un test postural standardisé (test de «squatting» : 1min debout – 1min accroupi – 1min debout). GBR est calculé par la pente de la relation entre les espaces R-R et PA systolique lors du redressement. PP (PAS-PAD) est analysée pendant tout le test et par son augmentation durant l’accroupissement (delta PP). Le DFG est calculé par la formule MDRD avant et après un suivi moyen de 12±5 années. Résultats : Les patients ont été séparés en deux groupes en fonction de la valeur médiane du GBR : G1 (n=34) : </=1,36 msec/mm Hg (moyenne ± SD : 0,77±0,40) vs G2 (n=30) : >1,36 (3,05±0,35). Les sujets de G1 sont légèrement plus âgés (58±7 vs 54±8 ans; p=0,04), mais ont un sexe ratio, une durée du DT2, un taux d’HbA1c et des valeurs de PA comparables aux valeurs de G2. Les patients de G1 ont une FC de base plus élevée (88±15 vs 82±14 bpm; p=0,0462) et un DFG plus bas (79±19 vs 95±19 ml/min; p=0,0479). Si la PP en position debout est comparable (59±15 vs 54±15 mmHg; p=0,1983), elle devient plus élevée en position accroupie (73±18 vs 65±16 mmHg; p=0,0395) chez G1 que chez G2. Lors du redressement, la chute de PA moyenne est significativement plus importante (-46±12 vs -38±12 mmHg; p=0,0079), avec un retard à la récupération des valeurs de base (29±19 vs 21±19 sec; p=0,0107) et une tachycardisation moindre (17±8 vs 23±9 bpm; p=0,0359) chez G1. Par contre, la diminution du DFG durant le suivi est comparable chez G1 vs G2 (-13±21 vs -13±21 ml/min; p=0,8561). Conclusion : Un GBR abaissé, marqueur de la NAC, est associé à une PP élevée en position accroupie (un marqueur indirect de rigidité artérielle) et une diminution du DFG. Par contre, la seule valeur de GBR ne permet pas de prédire l’ampleur de la dégradation de la fonction rénale lors d’un suivi ultérieur de 12 années [less ▲]

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See detailRelations entre marqueurs de neuropathie autonome, pression pulsée et insuffisance rénale chronique chez le patient diabétique de type 2
SCHEEN, André ULg; MARCHAND, Monique ULg; PHILIPS, Jean-Christophe ULg

in Annales de Cardiologie et d'Angeiologie (2015), 64(s1), 23-361-09

Relations entre marqueurs de neuropathie autonome, pression pulsée et insuffisance rénale chronique chez le patient diabétique de type 2 Relationships between markers of autonomic neuropathy, pulse ... [more ▼]

Relations entre marqueurs de neuropathie autonome, pression pulsée et insuffisance rénale chronique chez le patient diabétique de type 2 Relationships between markers of autonomic neuropathy, pulse pressure and chronic kidney disease in patients with type 2 diabetes Objectifs : Le patient diabétique de type 2 (DT2) est exposé à un risque accru de neuropathie autonome cardiovasculaire (NAC), de rigidité artérielle et d’insuffisance rénale chronique (IRC). Le but du travail est d’étudier les relations entre la NAC, PP et le débit de filtration glomérulaire (DFG) chez le patient DT2. Méthodes : L’étude comprend 79 patients DT2 (53H, 26F; âge initial : 56±8 années; durée connue du DT2 : 11±8 années; IMC : 28,4±4,6 kg/m²) analysés par enregistrement continu de la pression artérielle (PA) et de la fréquence cardiaque lors d’un test postural standardisé (test de «squatting» : 1min debout – 1min accroupi – 1min debout). Le gain baro-réflexe (GBR) est calculé par la pente de la relation entre les espaces R-R et PA systolique lors du redressement. La pression pulsée (PP = PAS-PAD) est analysée pendant tout le test et par son augmentation durant l’accroupissement (delta PP). DFG est estimé par la formule MDRD au début et après un suivi moyen de 12±5 ans. Résultats : Les valeurs initiales sont : HbA1c : 8,8± 1,7%; DFG : 86±25 ml/min ; PP : 62±10 mmHg; BRG : 1,8±1,4 msec/mmHg. DFG est inversement corrélé à l’âge (r=-0,317; p=0,020), sans relation avec HbA1c (r=-0,023; p=0,935). DFG est fortement corrélé avec GBR (r=0,453; p=0,008) et, moins, avec SqTs (un autre indice d’atteinte sympathique) (r=0,213; p=0,020), mais pas avec le classique indice de NAC R-R E/I ratio (r=0,092 ; p=0,262). Il n’y a pas de corrélation significative entre DFG et PA moyenne, PAS, PP ou encore delta PP. La diminution de DFG (-12±23 ml/min) lors du suivi de 12 ans n’a pu être corrélée de façon significative aux valeurs initiales et finales d’HbA1c, aux trois marqueurs initiaux de NAC (GBR, RR E/I ratio et SqTs) ou aux divers paramètres initiaux évaluant la PA, même si la relation est proche de la signification pour delta PP, un marqueur de la rigidité artérielle (r= 0,20 p= 0,060). Conclusion : La forte relation inverse initiale entre DFG et GBR suggère que IRC et NAC sont aggravées de façon conjointe et, possiblement, qu’une des deux complications influence l’autre. L’absence de corrélations avec HbA1c et les paramètres PA ou PP pourraient s’expliquer par les interférences liées au traitement en cours. L’absence de toute corrélation entre la chute ultérieure de DFG et les autres paramètres initiaux peut s’expliquer par l’origine multifactorielle de la progression de l’IRC chez le patient DT2. [less ▲]

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See detailTraitement de maladie de longue durée, l’exemple du Diabète de Type 2
Pétré, Benoît ULg; PHILIPS, Jean-Christophe ULg

Conference given outside the academic context (2015)

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See detailRecommandations europeennes pour la prise en charge du diabete, du pre-diabete et des maladies cardio-vasculaire. 1ere partie. Gestion du diabete et des facteurs de risque cardio-vasculaire.
Scheen, André ULg; RADERMECKER, Régis ULg; PHILIPS, Jean-Christophe ULg et al

in Revue medicale de Liege (2013), 68(11), 585-92

The patient with prediabetes or diabetes has a high or very high risk of cardiovascular diseases.We summarize the recent guidelines jointly published by the European Society of Cardiology and the European ... [more ▼]

The patient with prediabetes or diabetes has a high or very high risk of cardiovascular diseases.We summarize the recent guidelines jointly published by the European Society of Cardiology and the European Society for the Study of Diabetes. In this first article, we focus mainly on the preventive approaches of cardiovascular diseases in patients with prediabetes or (type 1 or type 2) diabetes. The crucial importance of a global multifactorial strategy is emphasized and the target levels of various risk factors are updated. The management of these cardiovascular complications in presence of diabetes will be considered in a second article. [less ▲]

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See detailL'Hypotension orthostatique: 1ere partie: definition, symptomatologie, evaluation et physiopathologie.
Tyberghein, Maelle; PHILIPS, Jean-Christophe ULg; Krzesinski, Jean-Marie ULg et al

in Revue Médicale de Liège (2013), 68(2), 65-73

Orthostatic hypotension (OH) is defined by a drop in arterial blood pressure (BP) of at least 20 mmHg for systolic BP and 10 mmHg for diastolic BP after standing. Symptoms are generally quite typical, but ... [more ▼]

Orthostatic hypotension (OH) is defined by a drop in arterial blood pressure (BP) of at least 20 mmHg for systolic BP and 10 mmHg for diastolic BP after standing. Symptoms are generally quite typical, but may also be rather vague. Diagnosis may be easily made by the physician in his/ her office, and confirmed, if necessary, by more sophisticated measurements. Pathophysiology is generally rather complex, but mostly involves a defect in the autonomic nervous system, in its sympathetic component. Failure of peripheral vasoconstriction seems to play a more important role than the defect in reflex tachycardia. Causes of OH are multiples. OH may occur in healthy subjects, when exposed to exceptional circumstances, but is more generally associated with various diseases, either neurological disorders or pathologies characterized by hypovolemia. Medications can also aggravate the risk of OH, among which some antihypertensive or psychotropic agents. Elderly people, especially frailty subjects, are exposed to a high risk of OH, whose origin is often multifactorial, and this complication may have serious medical consequences. [less ▲]

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See detailLe diabète de type 1: de la prédisposition génétique à un contexte environnemental hypothétique
PHILIPS, Jean-Christophe ULg; RADERMECKER, Régis ULg

in Revue de l'Association Belge du Diabète/ Supplément médical (2012), 55

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See detailRelations entre gain baroreflexe et stress pulsatile chez le patient diabetique de type 1.
SCHEEN, André ULg; MARCHAND, Monique ULg; PHILIPS, Jean-Christophe ULg

in Annales de Cardiologie et d'Angeiologie (2012)

AIM OF THE STUDY: Cardiovascular autonomic neuropathy (CAN) and early arterial stiffness are frequent complications in type 1 diabetes. The aim of our work is to study the relationships between CAN ... [more ▼]

AIM OF THE STUDY: Cardiovascular autonomic neuropathy (CAN) and early arterial stiffness are frequent complications in type 1 diabetes. The aim of our work is to study the relationships between CAN (estimated by baroreflex gain calculation) and arterial stiffness (estimated by pulsatile stress) in type 1 diabetic patients. PATIENTS AND METHODS: In a cross-sectional study, we calculated baroreflex gain and pulsatile stress in 167 type 1 diabetic patients and 160 matched non-diabetic subjects whose blood pressure was continuously monitored with a Finapres((R)) device in a postural test (squatting test). The baroreflex gain was calculated by plotting the pulse intervals (R-R) against systolic blood pressure values during the transition phase from squatting to standing. Pulsatile stress was estimated by the pulse pressurexheart rate product. In a longitudinal study, the baroreflex gain and pulsatile stress were calculated before and after a mean follow-up of 79+/-33 months in type 1 diabetic patients. RESULTS: Cross-sectional data showed a decrease in baroreflex gain and an increase in pulsatile stress in type 1 diabetic patients versus the matched non-diabetic subjects. A significant correlation between the baroreflex gain and pulsatile stress was present. Type 1 diabetic patients with lower baroreflex gain had a higher value of pulsatile stress when compared to those with higher baroreflex gain. During follow-up, a significant reduction in baroreflex gain (but without significantly increased pulsatile stress) was observed. A univariate analysis showed that the decrease of the baroreflex gain is not correlated with the time interval between the two tests, neither type 1 diabetes duration nor mean glycated hemoglobin values, but significantly with the pulsatile stress increase. CONCLUSION: In type 1 diabetic patients, the baroreflex gain is decreased and the pulsatile stress is increased when these markers are compared to age-matched non-diabetic subjects. There is a relationship between indices of CAN and arterial stiffness. Nevertheless, the baroreflex gain (marker of CAN) is impaired earlier than the pulsatile stress in this type 1 diabetic population with inadequate glycaemic control. [less ▲]

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See detailSquatting, a posture test for studying cardiovascular autonomic neuropathy in diabetes.
PHILIPS, Jean-Christophe ULg; MARCHAND, Monique ULg; SCHEEN, André ULg

in Diabètes & Métabolism (2011), 37(6), 489-496

Cardiovascular autonomic neuropathy (CAN) is a frequent complication of diabetes mellitus, which is associated with increased morbidity and mortality. It involves both the parasympathetic and sympathetic ... [more ▼]

Cardiovascular autonomic neuropathy (CAN) is a frequent complication of diabetes mellitus, which is associated with increased morbidity and mortality. It involves both the parasympathetic and sympathetic nervous systems, and may be diagnosed by classical dynamic tests with measurements of heart rate (HR) and/or arterial blood pressure (BP). An original squat test (1-min standing, 1-min squatting, 1-min standing) was used with continuous monitoring of HR and BP, using a Finapres((R)) device. This active test imposes greater postural stress than the passive head-up tilt test, and provokes large changes in BP and HR that can be analyzed to derive indices of CAN. In healthy subjects, squatting is associated with BP increases and HR decreases (abolished by atropine: SqTv index), whereas the squat-stand transition is accompanied by a deep but transient drop in BP associated with sympathetic-driven tachycardia (abolished by propranolol: SqTs index). In diabetic patients with CAN, BP increases are accentuated during squatting whereas reflex bradycardia is reduced. When standing from squatting position, the fall in BP tends to be more pronounced and orthostatic hypotension more prolonged, while reflex tachycardia is markedly dampened. The baroreflex gain, similar to that calculated during pharmacological testing with vasodilator/vasopressor agents, can be derived by plotting pulse intervals (R-R) against systolic BP levels during the biphasic response following the squat-stand transition. The slope, which represents baroreflex sensitivity, is significantly reduced in patients with CAN. This discriminatory index allows study of the natural history of CAN in a large cohort of diabetic patients. [less ▲]

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See detailSquatting test: a dynamic postural manoeuvre to study baroreflex sensitivity.
SCHEEN, André ULg; PHILIPS, Jean-Christophe ULg

in Clinical autonomic research : official journal of the Clinical Autonomic Research Society (2011)

INTRODUCTION: Squatting is an active posture test that can be used to assess baroreflex sensitivity. Indeed, the shift from squatting to standing imposes a major orthostatic stress leading to rapid and ... [more ▼]

INTRODUCTION: Squatting is an active posture test that can be used to assess baroreflex sensitivity. Indeed, the shift from squatting to standing imposes a major orthostatic stress leading to rapid and large changes in arterial blood pressure (BP) and heart rate (HR) allowing precise baroreflex assessment. MATERIAL AND METHODS: BP and HR can be continuously and non-invasively monitored with a Finapres device. RESULTS: The standing to squatting transition is accompanied by rises in BP, pulse pressure and cardiac output, mainly due to increased venous return, and by a secondary reduction in HR. Conversely, the squatting to standing transition is associated with an immediate drop in BP and both reflex tachycardia and vasoconstriction. This mirror changes in BP and HR, mimicking those observed with the classical pharmacological approach using vasopressor/vasodilating agents, allows the calculation of the so-called baroreflex gain. DISCUSSION: The present review describes the haemodynamic changes occurring in normal subjects during the shifts from standing to squatting and from squatting to standing and discusses the underlying cardiovascular and autonomic mechanisms. CONCLUSION: This careful analysis in healthy individuals should help in the understanding of disturbances that may be observed in patients with autonomic dysfunction, such as in diabetic patients with cardiovascular autonomic neuropathy. [less ▲]

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See detailHaemodynamic changes during a squat test, pulsatile stress and indices of cardiovascular autonomic neuropathy in patients with long-duration type 1 diabetes.
PHILIPS, Jean-Christophe ULg; MARCHAND, Monique ULg; SCHEEN, André ULg

in Diabètes & Métabolism (2011)

AIM: Cardiovascular autonomic neuropathy (CAN) and pulsatile stress are considered to be independent cardiovascular risk factors. This study compared haemodynamic changes during an active orthostatic test ... [more ▼]

AIM: Cardiovascular autonomic neuropathy (CAN) and pulsatile stress are considered to be independent cardiovascular risk factors. This study compared haemodynamic changes during an active orthostatic test in adult patients with type 1 diabetes (T1DM), using low versus high RR E/I ratios as a marker of CAN. METHODS: A total of 20 T1DM patients with low RR E/I ratios were compared with 20 T1DM patients with normal RR E/I ratios, matched for gender (1/1 ratio), age (mean: 46years) and diabetes duration (22-26years); 40 matched healthy subjects served as controls. All subjects were evaluated by continuous monitoring of arterial blood pressure (Finapres((R))) and heart rate using a standardized posture test (1-min standing, 1-min squatting, 1-min standing), thus allowing calculation of baroreflex gain. RESULTS: Compared with controls, T1DM patients showed lower RR E/I ratios, reduced baroreflex gains, higher pulsatile stress (pulse pressurexheart rate), greater squatting-induced pulse pressure rises, orthostatic hypotension and reduced reflex tachycardia. Compared with T1DM patients with preserved RR E/I ratios, T1DM patients with low RR E/I ratios showed reduced post-standing reflex tachycardia and baroreflex gain, and delayed blood pressure recovery, but no markers of increased pulsatile stress. Interestingly, decreased baroreflex gain was significantly associated with both pulsatile stress and microalbuminuria. CONCLUSION: The use of RR E/I ratios to separate T1DM patients allows the detection of other CAN markers during an orthostatic posture test, but with no significant differences in pulsatile stress or microalbuminuria. In this context, squatting-derived baroreflex gain appears to be more informative. [less ▲]

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See detailRELATIONS ENTRE GAIN BARO-REFLEXE ET STRESS PULSATILE CHEZ LE PATIENT DIABETIQUE DE TYPE 1
SCHEEN, André ULg; MARCHAND, Monique ULg; PHILIPS, Jean-Christophe ULg

in Archives des Maladies du Coeur et des Vaisseaux (2011), hors série 3

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See detailDiagnostic differentiel d'un malaise: hypoglycemie, hypotension ou spasmophilie?
SCHEEN, André ULg; PHILIPS, Jean-Christophe ULg; Krzesinski, Jean-Marie ULg

in Revue Médicale de Liège (2011), 66(1), 48-54

The consultation for dizziness is a common problem in clinical practice. Because of the apparent lack of specificity of the complaints, there is a rather high risk to prescribe a variety of sophisticated ... [more ▼]

The consultation for dizziness is a common problem in clinical practice. Because of the apparent lack of specificity of the complaints, there is a rather high risk to prescribe a variety of sophisticated exams, which will not be very helpful in absence of a well oriented anamnesis and a pertinent clinical examination. The present paper aims at describing a global medical approach, essentially based upon a detailed anamnesis (semiological, chronological and therapeutical arguments), to which may be added a few simple clinical and technical complementary data. This strategy should allow obtaining quite easily pertinent arguments for a differential diagnosis between reactive hypoglycaemia, (orthostatic) hypotension, and hyperventilation crisis (spasmophilia). [less ▲]

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