References of "Pierard, L. A"
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See detailDoes treatment with erythropoietin improve left ventricular systolic performance and mitral regurgitation in patients with heart failure and chronic kidney disease?
Cosyns, B.; Lancellotti, Patrizio ULg; Velez-Roa, S. et al

in European Heart Journal (2006, August), 27(Suppl. 1), 339

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See detailElectrocardiographic changes during dobutamine stress testing in patients with recent myocardial infarction: relation with residual infarct artery stenosis and contractile recovery
Lancellotti, Patrizio ULg; Mipinda, J. B.; Pierard, L. A.

in Acta Cardiologica (2004), 59(1), 11-16

OBJECTIVE: The identification of viable but jeopardized myocardium after acute myocardial infarction (AMI) is of great importance for selecting patients who could benefit from a revascularization ... [more ▼]

OBJECTIVE: The identification of viable but jeopardized myocardium after acute myocardial infarction (AMI) is of great importance for selecting patients who could benefit from a revascularization procedure. The aim of the study was to determine the accuracy of the dobutamine stress electrocardiogram (ECG) 1) for detecting significant stenosis of the infarct-related artery and 2) for predicting the occurrence of contractile recovery. METHODS AND RESULTS: Ninety-four patients underwent dobutamine stress ECG and quantitative angiography within the first week after AMI. A follow-up resting echocardiogram was obtained in all patients at 1 month. Significant stenosis of the infarct-related artery was detected in 76 patients and functional recovery occurred in 56 patients. Dobutamine stress induced ST-segment elevation in 44 patients, ST-segment depression in 17 and T-wave normalization in 34. Increase in QT dispersion and dobutamine ST elevation were more sensitive than chest pain and ST-segment depression (79% and 53% vs. 24% and 17%, respectively; p<0.05) for detecting significant infarct-related artery stenosis. Four independent variables were selected for predicting contractile recovery: > or = 20 ms increase in QT dispersion from baseline to low-dose dobutamine (p = 0.00016), dobutamine-induced ST-segment elevation (p = 0.0009), elective angioplasty of the infarct-related artery (p = 0.001) and T-wave normalization (p = 0.005). CONCLUSIONS: The analysis of predischarge dobutamine stress ECG is useful for predicting residual stenosis of the infarct-related artery and contractile recovery in the affected area. QT dispersion changes during the test are the most accurate parameter. [less ▲]

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See detailPrognostic importance of exercise-induced changes in mitral regurgitation in patients with chronic ischemic left ventricular dysfunction
Lancellotti, Patrizio ULg; Troisfontaines, P.; Toussaint, A. C. et al

in Circulation (2003), 108(14), 1713-1717

Background-In the post-myocardial infarction phase, mortality risk is related to the severity of mitral regurgitation (MR). Ischemic MR is a dynamic condition that can be studied during exercise. Whether ... [more ▼]

Background-In the post-myocardial infarction phase, mortality risk is related to the severity of mitral regurgitation (MR). Ischemic MR is a dynamic condition that can be studied during exercise. Whether the assessment of exercise-induced changes in the degree of MR provides prognostic information is unknown. Methods and Results-Ninety-eight consecutive patients with chronic ischemic left ventricular dysfunction and at least mild MR who prospectively underwent quantitative measurement of the regurgitant volume and the effective regurgitant orifice (ERO) of MR at rest and during semisupine exercise test were followed up for 19+/-8 months. The 16 patients who underwent surgery were censored at the time of operation. Of the 82 patients who were medically treated, 9 (11%) died. No clinical data demonstrated a distinction between survivors and nonsurvivors. By multivariate Cox regression analysis, independent predictors of cardiac death were an increase in ERO by greater than or equal to13 mm(2) (P=0.0045) during exercise, an ERO >20 mm(2) at rest (P=0.01), and a shorter mitral deceleration time (P=0.044). Half of the patients with exercise-induced significant increases in MR who died had moderate MR at rest. In contrast, none of the 14 patients with a decrease in MR at exercise displayed cardiac death. Conclusions-In patients with ischemic MR and left ventricular dysfunction, quantitative assessment of exercise-induced changes in the degree of MR provides independent prognostic information. Significant exercise-induced increases in MR unmask patients at high risk of poor outcome. [less ▲]

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See detailDetection and clinical usefulness of a biphasic response during exercise echocardiography early after myocardial infarction
Lancellotti, Patrizio ULg; Hoffer, E. P.; Pierard, L. A.

in Journal of the American College of Cardiology (2003), 41(7), 1142-1147

OBJECTIVES The aim of this study was to determine the accuracy of exercise echocardiography (EE) for detecting infarct-related artery (IRA) stenosis and predicting functional recovery early after acute ... [more ▼]

OBJECTIVES The aim of this study was to determine the accuracy of exercise echocardiography (EE) for detecting infarct-related artery (IRA) stenosis and predicting functional recovery early after acute myocardial infarction (AMI). BACKGROUND Dobutamine stress echocardiography is widely used for identifying jeopardized myocardium. The clinical usefulness of a biphasic response detected during EE has never been investigated. METHODS A total of 114 consecutive patients with a first AMI and greater than or equal to2 dyssynergic segments in the infarct-related territory underwent semi-supine continuous EE 6 +/- 2 days after AMI. Quantitative coronary angiography was performed in all patients after EE. A follow-up echocardiogram was obtained one month later. RESULTS Ninety-seven patients had significant (greater than or equal to50%) IRA stenosis, and 26 had multivessel disease. Residual ischemia was identified in 77 patients (biphasic response in 62 and worsening response in 15). The sensitivity and specificity of ischemia during EE for predicting IRA stenosis were 75% and 76%, respectively. The sensitivity of a biphasic response was higher than the sensitivity of a worsening response (61% vs. 14%, p < 0.0001). Wall motion abnormalities induced in other vascular territories were specific (97%) and moderately sensitive (62%) for the detection of multivessel disease. Functional recovery was observed in 75 patients. Two independent variables predicted contractile recovery: contractile reserve during EE (p < 0.0001) and elective angioplasty of the IRA (p = 0.002). A biphasic response, but not sustained improvement, predicted reversible dysfunction (73% vs. 9%, p < 0.0001). CONCLUSIONS A biphasic response can be detected during exercise. Exercise echocardiography is an accurate tool for detecting IRA stenosis and predicting functional improvement early after AMI. [less ▲]

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See detailEchocardiographie dynamique dans l'insuffisance mitrale
Lancellotti, Patrizio ULg; Pierard, L. A.

in Archives des Maladies du Coeur et des Vaisseaux (2002), 95(9), 793-8

Mitral insufficiency can have a dynamic character, correlating to an intermittent increase in the area of the regurgitant orifice and the regurgitant volume. Among the various stress methods ... [more ▼]

Mitral insufficiency can have a dynamic character, correlating to an intermittent increase in the area of the regurgitant orifice and the regurgitant volume. Among the various stress methods, echocardiography during effort on a bicycle in the semisitting position appears to be the technique of choice for evaluating this dynamic character. Thanks to the improvement of the Doppler signal quality, quantification of the regurgitant volume variations can be obtained in a reproducible manner at rest and during effort by applying the "PISA" method. [less ▲]

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See detailSignificance of Dobutamine-Induced Changes in Qt Dispersion Early after Acute Myocardial Infarction
LANCELLOTTI, Patrizio ULg; Bilge, A. R.; Mipinda, J. B. et al

in American Journal of Cardiology (2001), 88(9), 939-43

This study sought to examine the effects of graded dobutamine infusion on QT dispersion early after acute myocardial infarction (AMI) and to investigate the relation of dobutamine-induced changes in QT ... [more ▼]

This study sought to examine the effects of graded dobutamine infusion on QT dispersion early after acute myocardial infarction (AMI) and to investigate the relation of dobutamine-induced changes in QT dispersion to wall motion responses. Seventy-eight patients with a first AMI underwent dobutamine-atropine stress echocardiography 5 +/- 2 days after admission. Contractile reserve was identified in 45 patients and ischemic myocardium in 40. Sixteen patients had persistent akinesia. The best cut-off value of QT dispersion on the baseline electrocardiogram for predicting myocardial viability was 65 ms (sensitivity and specificity of 68%). Dobutamine infusion increased QT dispersion only in patients with viable myocardium (61 +/- 18 to 83 +/- 19 ms, p = 0.003) and/or ischemia (72 +/- 16 to 112 +/- 25 ms, p < 0.0001). No change was observed in patients with persistent akinesia (84 +/- 10 to 87 +/- 15 ms, p = NS). QT dispersion increased by 22 +/- 12 ms with administration of low-dose dobutamine in patients who had viable myocardium and by 47 +/- 21 ms with administration of low- to high-dose dobutamine in patients with ischemic myocardium. An increase in QT dispersion of > or = 20 ms from at rest to low-dose dobutamine infusion was associated with myocardial viability with a sensitivity of 78% and a specificity of 79%, whereas an increase in QT dispersion of > or = 10 ms from low- to high-dose dobutamine infusion predicted ischemic myocardium with a sensitivity of 85% and a specificity of 82%. In conclusion, (1) low QT dispersion on the baseline electrocardiogram is determined by the presence of viable myocardium, (2) a dobutamine-induced increase in QT dispersion is associated with viable and jeopardized myocardium, and (3) unchanged QT dispersion during dobutamine stress is a simple marker of extensive necrosis. [less ▲]

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See detailShort- and Long-Term Prognostic Importance of Complete Bundle-Branch Block Complicating Acute Myocardial Infarction
Dubois, Colette ULg; Pierard, L. A.; Smeets, J. P. et al

in Clinical Cardiology : International Journal for Cardiovascular Diseases (1988), 11(5), 292-6

Among 1013 consecutive patients with acute myocardial infarction (AMI), 104 (10%) developed complete bundle-branch block (BBB). The clinical characteristics and the short- and long-term prognosis were ... [more ▼]

Among 1013 consecutive patients with acute myocardial infarction (AMI), 104 (10%) developed complete bundle-branch block (BBB). The clinical characteristics and the short- and long-term prognosis were similar in the 53 patients with right and the 51 patients with left BBB. Compared to the 909 patients without this conduction disturbance, these 104 patients were older (64 +/- 9 vs. 58 +/- 10 years, p less than 0.001), more frequently women (26 vs. 17%, p less than 0.05), had a larger infarct (peak CK 1672 +/- 1124 vs. 1356 +/- 1089 IU/l, p less than 0.001), more frequently anterior (60 vs. 37%, p less than 0.001). They had a higher incidence of Killip class greater than 1 (63 vs. 38%, p less than 0.001), pericarditis (40 vs. 23%, p less than 0.001), atrial fibrillation or flutter (22 vs. 12%, p less than 0.01), ventricular fibrillation (15 vs. 9%, p less than 0.05), and atrioventricular block (23 vs. 11%, p less than 0.001). Both hospital mortality (32 vs 10%, p less than 0.001) and 3-year posthospital mortality (37 vs. 18%, p less than 0.001) were much higher among patients with complete BBB. Transient BBB had the same deleterious prognosis as BBB persistent at discharge (mortality 33 vs. 39%, NS). The prognostic importance of BBB was more prominent during the first 6 months after infarction (mortality between 6 and 36 months: 18% with BBB vs. 11% without BBB, NS). [less ▲]

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