Revascularisation en cas d’artériopathie périphérique du membre inférieur – Résumé.
; ; et al
Report (2014)Detailed reference viewed: 11 (3 ULg)
L'ÉCHO-DOPPLER TRANSCRÂNIEN DANS LA PRISE EN CHARE DES STÉNOSES ARTÉRIELLES CERVICALES ET INTRACRÂNIENNES
SCHOYSMAN, Laurent ; TSHIBANDA, Luaba ; OTTO, Bernard et al
in Revue Médicale de Liège (2014), 69
Le progrès technique en imagerie a permis le développement de l’écho-Doppler transcrânien en mode duplex ou triplex. A côté des autres techniques de neuro-imagerie, son intérêt dans la pathologie ... [more ▼]
Le progrès technique en imagerie a permis le développement de l’écho-Doppler transcrânien en mode duplex ou triplex. A côté des autres techniques de neuro-imagerie, son intérêt dans la pathologie vasculaire cérébrale va grandissant. Le présent article a pour but de présenter cette technique en détaillant ses indications actuelles chez les patients présentant des sténoses artérielles cervicales et intra-crâniennes. [less ▲]Detailed reference viewed: 11 (0 ULg)
Determinants of exercise-induced pulmonary arterial hypertension in systemic sclerosis.
; Magne, Julien ; 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 ▲]Detailed reference viewed: 9 (0 ULg)
ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC).
; ; et al
in European Heart Journal (2011), 32(22), 2851-906Detailed reference viewed: 171 (1 ULg)
UNEXPECTED SOURCE OF CEREBRAL MICROEMBOLISATION INVESTIGATED BY TRANSCRANIAL DOPPLER DUPLEX COLOUR SONOGRAPHY
in fascicule du congrès de la BSTH (2009, December 27)
In case of right-to-left shunts, contrast transcranial color-Doppler (cTCD) can complete contrast transœsphageal echocardiiography with a better sensitivity. It is alson a semi-quantitative method. cTCD ... [more ▼]
In case of right-to-left shunts, contrast transcranial color-Doppler (cTCD) can complete contrast transœsphageal echocardiiography with a better sensitivity. It is alson a semi-quantitative method. cTCD can also detect potential micro-emboli in unexpected cerebral areas and/or explain unexpected strokes. [less ▲]Detailed reference viewed: 29 (5 ULg)
Diagnosis and treatment of peripheral arterial disease: recommendations for the medical practice in Belgium.
; Kolh, Philippe ; et al
in Acta Chirurgica Belgica (2007), 107(6), 595-604Detailed reference viewed: 27 (1 ULg)
Le phenomene de Raynaud
in Revue Médicale de Liège (2004), 59(6), 378-84
Raynaud's phenomenon (RP) is a common vascular disorder characterized by a recurrent transient vasospasm of the fingers and toes on exposure to cold or with emotional stress. Clinical criteria are used to ... [more ▼]
Raynaud's phenomenon (RP) is a common vascular disorder characterized by a recurrent transient vasospasm of the fingers and toes on exposure to cold or with emotional stress. Clinical criteria are used to distinguish patients with primary or idiopathic RP (formely Raynaud's disease) from those with secondary RP (formely Raynaud's syndrome). They include history, general physical examination, capillaroscopy, test for antinuclear antibody and erythrocyte sedimentation rate. More specific exams may be needed in selective cases. Excluding RP of occupational origin, the most common cause of secondary RP is a connective tissue disease (particularly scleroderma). RP may precede other clinical symptoms by several years, but most patients with RP will not progress to systemic disease. Nevertheless, primary RP may cause significant disability. We review the pathophysiology and clinical criteria of the disorder. Unfortunately, management of PR is still empirical and largely supportive. [less ▲]Detailed reference viewed: 46 (2 ULg)
Evaluation, severity and prognostic significance of silent myocardial ischaemia in vascular patients
in Acta Chirurgica Belgica (2003), 103(3), 255-261
This paper intends to make an update of recent publications and guidelines for evaluation in coronary symptom-free patients undergoing vascular surgery. It emphasizes the role of preoperative clinical ... [more ▼]
This paper intends to make an update of recent publications and guidelines for evaluation in coronary symptom-free patients undergoing vascular surgery. It emphasizes the role of preoperative clinical evaluation that should identify the most appropriate testing, and treatment strategies to optimize care of the patient and avoid unnecessary testing in this era of cost containment. Selective preoperative coronary artery disease screening and revascularization achieve excellent perioperative and late results after high-risk vascular surgery. Supplemental preoperative evaluation is discussed (exercise ECG, stress echocardiography and stress tomoscintigraphy). Asymptomatic patients with good functional capacity can undergo intermediate-risk surgery without further non-invasive testing. Conversely, further noninvasive testing is often considered for patients with poor functional capacity or moderate functional capacity but higher-risk surgery especially for patients with 2 or more intermediate risk predictors. Additional testing may be considered on an individual basis for patients without clinical markers but with poor functional capacity prior to vascular surgery, particularly those with several minor clinical risk predictors. Because of a higher prevalence of silent myocardial ischaemia in diabetes mellitus, these patients require specific care. Until further data are available, indications for myocardial revascularization in the perioperative setting are similar to those in the ACC/AHA guidelines for use of myocardial revascularization in general. General practioners, cardiologists, angiologists, vascular surgeons and anaesthesiologists should collaborate and aim to slow down the progression of atherosclerosis by giving their patients an optimum secondary cardiovascular prevention. [less ▲]Detailed reference viewed: 22 (1 ULg)
Echocardiographic prediction of the site of coronary artery obstruction in acute myocardial infarction.
Pierard, Luc ; SPRYNGER, Muriel ; Carlier, Jean-Yves
in European heart journal (1987), 8(2), 116-23
In 49 patients with acute myocardial infarction (AMI), the infarction topography was assessed by cross-sectional echocardiography and the location of coronary artery obstruction were correlated. A ... [more ▼]
In 49 patients with acute myocardial infarction (AMI), the infarction topography was assessed by cross-sectional echocardiography and the location of coronary artery obstruction were correlated. A ventricular segmentation of 5 right and 16 left ventricular segments was used. The site of coronary obstruction was determined in 45 patients by coronary angiography and by necropsy in 4 patients. The exact location of the obstruction could not be found in 4 patients. The infarct related vessel was the left main artery in 1 patient, the left anterior descending artery (LAD) in 19, the left circumflex in 6 and the right coronary artery in 24. Specific segments were identified for each of the 3 coronary arteries: anteroseptal and anterior segments for LAD, right ventricular segments for the right coronary artery and basal anterolateral segment for the left circumflex. Specific segments (specificity 100%) were also identified for the principal coronary branches: basal anterior for the first anterior descending diagonal (sensitivity 71%), basal anteroseptal for the first septal perforator (83%), middle anterior for the second diagonal (100%), middle anteroseptal for the second septal (89%), basal posteroseptal for a dominant right coronary artery (89%), right ventricular anterolateral segment for the right ventricular marginal branch (83%). Echocardiographic identification of the topography of AMI can be useful in recognizing the infarct-related vessel and identifying the site of coronary artery obstruction. [less ▲]Detailed reference viewed: 8 (0 ULg)
Hemodynamic profile of patients with acute myocardial infarction at risk of infarct expansion.
Pierard, Luc ; Albert, Adelin ; et al
in American Journal of Cardiology (1987), 60(1), 5-9
To identify patients at risk of cardiac expansion during hospital stay for a first acute myocardial infarction (AMI), 41 patients underwent right-sided cardiac catheterization soon after admission and ... [more ▼]
To identify patients at risk of cardiac expansion during hospital stay for a first acute myocardial infarction (AMI), 41 patients underwent right-sided cardiac catheterization soon after admission and serial 2-dimensional echocardiography on days 1, 3 or 4 and between days 7 and 10. Infarct expansion was recognized by echocardiography in 11 patients (27%), most often on the second recording (day 3 or 4). Age, sex, time from onset of pain to catheterization, peak levels of creatine kinase and creatine kinase-MB isoenzyme, heart rate, mean pulmonary artery wedge pressure and left ventricular stroke work index were similar in the 2 groups. Patients in whom infarct expansion developed had a higher incidence of previous systemic hypertension (73% vs 27%, p less than 0.01) and anterior AMI (91% vs 30%, p less than 0.001) and a higher mortality rate at 1 year (73 vs 7%, p less than 0.001) than those who did not. They also had higher systolic (139 +/- 24 vs 126 +/- 18 mm Hg, p less than 0.05) and diastolic (91 +/- 14 vs 75 +/- 13 mm Hg, p less than 0.001) arterial pressures, lower stroke volume index (31 +/- 10 vs 40 +/- 10 ml/m2, p less than 0.01) and much higher systemic vascular resistance (SVR) values (1,713 +/- 380 vs 1,253 +/- 264 dynes s cm-5, p less than 0.0001). In the subgroups of patients with anterior AMI, differences were significant for diastolic arterial pressure, stroke volume index, SVR and mortality.(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]Detailed reference viewed: 5 (1 ULg)
Incidence and significance of pericardial effusion in acute myocardial infarction as determined by two-dimensional echocardiography
PIERARD, Luc ; Albert, Adelin ; et al
in Journal of the American College of Cardiology (1986), 8Detailed reference viewed: 5 (0 ULg)