References of "Gérard, Paul"
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See detailDuration perception: A Developmental Semiology from 2:6 to 13 Years, General Population versus Atypical, Assessment by Parental Questionnaire
SCHOLL, Jean-Marc ULg; Philippe, Paule; Gérard, Paul ULg et al

Conference (2012, December 20)

Introduction Perception of duration has a major impact on the child’s ability to manage everyday life. Usually, the perception of time is considered in its sequential component. To our knowledge, possible ... [more ▼]

Introduction Perception of duration has a major impact on the child’s ability to manage everyday life. Usually, the perception of time is considered in its sequential component. To our knowledge, possible semiological markers for the capacity to apprehend temporal duration have not yet been explored. There are thus no existing tools either for its evaluation (in everyday life) or for the description of its development during childhood. We are thus largely in the dark about how the perception of duration develops during childhood. Hypothesis 1) It is possible to track perception of duration using semiological markers in everyday life; 2) Children with developmental disorders can be expected to develop difficulties in this domain. Method We designed a questionnaire for parents using a Likert scale. The questionnaire was administered to 2 samples from 2:6 to 13 years: 827 in a general population and 297 in a mixed-psychopathological population recruited from the Mental Health Services network. We carried out a multinomial logistic regression and used percentiles curves (P5,50,95). Results In the general population, perception of duration is gradually acquired and full competence is attained by 9 years. The apprehension of sequential time is achieved by 4 years. In the psychopathological sample, mean perception of temporal duration is delayed by 18 months and significant difficulties remain even at 13 years. The apprehension of sequential time is also delayed: even at 13 years it remains low (at percentile 95). We have found no sex-related differences. Discussion Perception of duration is an important developmental feature which has not been taken into account until now. Semiological markers can be used to differentiate typically developing children from clinical populations as to their respective capacities to perceive temporal duration. [less ▲]

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See detailPrédiction de l'érosion ravinante en Algérie : vers une nouvelle approche probabiliste à l'aide de données multisources.
Daoudi, Mohamed; Salmon, Marc ULg; Dewitte, Olivier et al

in Journées d’Animation Scientifique (JAS09) de l’AUF (2009, November)

Pour faire face à la complexité de l'érosion ravinante dans la région tellienne, le présent travail propose l'utilisation d'une approche probabiliste basée sur des données multisources dont les images de ... [more ▼]

Pour faire face à la complexité de l'érosion ravinante dans la région tellienne, le présent travail propose l'utilisation d'une approche probabiliste basée sur des données multisources dont les images de télédétection. Un modèle de régression logistique a été élaboré pour la prédiction du processus de ravinement dans le bassin versant de l'oued Isser. Dans un premier temps, il expose les facteurs contrôlant l'érosion linéaire et dans un deuxième temps, il génère des cartes prédictives des zones propices au ravinement. [less ▲]

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See detailShort-term post-dispersal fate of seeds defecated by two small primate species (Saguinus mystax and Saguinus fuscicollis) in the Amazonian forest of Peru
Culot, Laurence ULg; Huynen, Marie-Claude ULg; Gérard, Paul ULg et al

in Journal of Tropical Ecology (2009), 25

Post-dispersal fate of seeds dispersed by large primates is well studied but little is known about this process in small frugivores like tamarins. This study in the Amazonian forest of Peru aimed at ... [more ▼]

Post-dispersal fate of seeds dispersed by large primates is well studied but little is known about this process in small frugivores like tamarins. This study in the Amazonian forest of Peru aimed at investigating if characteristics related to the defecation patterns of tamarins (Saguinus mystax and Saguinus fuscicollis) affected short-term post-dispersal seed fate, through secondary seed dispersal by dung beetles and removal by seed predators. Data on dung beetle activity were based on direct observations of 49 defecations while seed fate was studied using semi-controlled experiments (N = 458 for secondary dispersal and N = 398 for predation). Tamarins produce small defecations with a low number of seeds. Thirty-five per cent of defecations were visited by an average of 1.5 dung beetles that usually transport the faeces as pellets. Twenty-four per cent of seeds were buried by beetles at a mean depth of 3.5 cm. With increasing quantities of faecal matter, the probability of secondary seed dispersal increased but not the depth of burial. Seed predation pressure was low (17.6%) after 4 d and higher in faeces of S. mystax than in faeces of S. fuscicollis. Despite their small size, tamarins could be considered as high-quality seed dispersers, with a potential role for forest regeneration. [less ▲]

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See detailPrédiction des zones propices au ravinement par un modèle de régression logistique intégrant des données de télédétection. Cas du sous-bassin versant de l’oued Alayem - Beni Slimane, Algérie
Daoudi, Mohamed; Ozer, André ULg; Gérard, Paul ULg et al

in Randriamanga, Simone; Rakotoniaina, Solofoarisoa; Auda, Yves (Eds.) et al Les XIèmes Journées Scientifiques du Réseau Télédétection de l'AUF (2008, November 03)

Le sous-bassin versant de l'oued Alayem - Beni Slimane, d’une superficie de 118 km², constitue une zone d'étude d'intérêt particulier en raison des caractéristiques physicoclimatiques représentatives de ... [more ▼]

Le sous-bassin versant de l'oued Alayem - Beni Slimane, d’une superficie de 118 km², constitue une zone d'étude d'intérêt particulier en raison des caractéristiques physicoclimatiques représentatives de la zone tellienne méditerranéenne. Le processus de ravinement y est très répandu et constitue un problème majeur. Les facteurs physiques et anthropiques contribuent à une accélération du phénomène. Le présent travail propose une méthode multivariée, basée sur des données multisources, afin de déterminer les variables indépendantes significatives qui favorisent l’existence de l’érosion ravinante et calculer la probabilité des zones de susceptibilité au processus de ravinement. Des variables explicatives toutes liés aux caractéristiques physico-climatiques sont retenues pour le modèle : il s’agit de la lithologie, la pente, l’orientation des versants, l’altitude (MNT), la morphopédologie, la couverture du sol (PVI) et l’agressivité des précipitations (Indice R). Elles permettent de généraliser le modèle prédictif pour des régions semblables du nord de l’Algérie ou du Maghreb. [less ▲]

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See detailComparison of functional residual capacity and static compliance of the respiratory system during a positive end-expiratory pressure (PEEP) ramp procedure in an experimental model of acute respiratory distress syndrome.
Lambermont, Bernard ULg; Ghuysen, Alexandre ULg; Janssen, Nathalie ULg et al

in Critical Care (2008), 12(4), 91

INTRODUCTION: Functional residual capacity (FRC) measurement is now available on new ventilators as an automated procedure. We compared FRC, static thoracopulmonary compliance (Crs) and PaO2 evolution in ... [more ▼]

INTRODUCTION: Functional residual capacity (FRC) measurement is now available on new ventilators as an automated procedure. We compared FRC, static thoracopulmonary compliance (Crs) and PaO2 evolution in an experimental model of acute respiratory distress syndrome (ARDS) during a reversed, sequential ramp procedure of positive end-expiratory pressure (PEEP) changes to investigate the potential interest of combined FRC and Crs measurement in such a pathologic state. METHODS: ARDS was induced by oleic acid injection in six anesthetised pigs. FRC and Crs were measured, and arterial blood samples were taken after induction of ARDS during a sequential ramp change of PEEP from 20 cm H2O to 0 cm H2O by steps of 5 cm H2O. RESULTS: ARDS was responsible for significant decreases in FRC, Crs and PaO2 values. During ARDS, 20 cm H2O of PEEP was associated with FRC values that increased from 6.2 +/- 1.3 to 19.7 +/- 2.9 ml/kg and a significant improvement in PaO2. The maximal value of Crs was reached at a PEEP of 15 cm H2O, and the maximal value of FRC at a PEEP of 20 cm H2O. From a PEEP value of 15 to 0 cm H2O, FRC and Crs decreased progressively. CONCLUSION: Our results indicate that combined FRC and Crs measurements may help to identify the optimal level of PEEP. Indeed, by taking into account the value of both parameters during a sequential ramp change of PEEP from 20 cm H2O to 0 cm H2O by steps of 5 cm H2O, the end of overdistension may be identified by an increase in Crs and the start of derecruitment by an abrupt decrease in FRC. [less ▲]

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See detailAlteration of Right Ventricular-Pulmonary Vascular Coupling in a Porcine Model of Progressive Pressure Overloading
Ghuysen, Alexandre ULg; Lambermont, Bernard ULg; Kolh, Philippe ULg et al

in Shock (Augusta, Ga.) (2008), 29(2), 197-204

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV ... [more ▼]

In acute pulmonary embolism, right ventricular (RV) failure may result from exceeding myocardial contractile resources with respect to the state of vascular afterload. We investigated the adaptation of RV performance in a porcine model of progressive pulmonary embolism. Twelve anesthetized pigs were randomly divided into two groups: gradual pulmonary arterial pressure increases by three injections of autologous blood clot (n = 6) or sham-operated controls (n = 6). Right ventricular pressure-volume (PV) loops were recorded using a conductance catheter. Right ventricular contractility was estimated by the slope of the end-systolic PV relationship (Ees). Afterload was referred to as pulmonary arterial elastance (Ea) and assessed using a four-element Windkessel model. Right ventricular-arterial coupling (Ees/Ea) and efficiency of energy transfer (from PV area to external mechanical work [stroke work]) were assessed at baseline and every 30 min for 4 h. Eaincreased progressively after embolization, from 0.26 +/- 0.04 to 2.2 +/- 0.7 mmHg mL (P < 0.05). Ees increased from 1.01 +/-0.07 to 2.35 +/- 0.27 mmHg mL (P < 0.05) after the first two injections but failed to increase any further. As a result, Ees/Ea initially decreased to values associated with optimal SW, but the last injection was responsible for Ees/Ea values less than 1, decreased stroke volume, and RV dilation. Stroke work/PV area consistently decreased with each injection from 79% +/- 3% to 39% +/- 11% (P < 0.05). In response to gradual increases in afterload, RV contractility reserve was recruited to a point of optimal coupling but submaximal efficiency. Further afterload increases led to RV-vascular uncoupling and failure. [less ▲]

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See detailEstimation of the comparative therapeutic superiority of QD and BID dosing regimens, based on integrated analysis of dosing history data and pharmacokinetics
Comté, Laetitia ULg; Vrijens, Bernard ULg; Tousset, Eric et al

in Journal of Pharmacokinetics and Pharmacodynamics (2007), 34(4), 549-558

Once-daily dosing almost invariably shows a slightly higher percentage of prescribed doses taken than does twice-daily dosing. Many pharmaceutical scientists, regulators, and prescribers have considered ... [more ▼]

Once-daily dosing almost invariably shows a slightly higher percentage of prescribed doses taken than does twice-daily dosing. Many pharmaceutical scientists, regulators, and prescribers have considered this finding to signify the therapeutic superiority of once-daily dosing. The therapeutically more relevant question, however, is not the percentage of prescribed doses taken but the comparative impact of missed doses on the pharmacologic effects of a drug under the two dosing regimens. A key point in this regard is that the pharmacokinetic equivalent of a single missed once-daily dose is 2-3 sequentially omitted twice-daily doses. Thus, an important parameter in comparing the two regimens is the probability of two or three twice-daily doses being sequentially omitted, versus the probability of missing a single once-daily dose. Our data indicate that the probability of sequential omission of 2-3 twice daily doses is half the probability of omission of a single once-daily dose. For that reason, a twice-daily regimen could prove to be superior to a once-daily regimen in maintaining drug concentrations within a therapeutically desirable range. A more important consideration, however, is to maintain not just the concentration of drug in plasma, but the drug's therapeutic action. The duration of therapeutic drug action following a last-taken dose is not only drug-specific, but also, for some drug, dependent on the pharmacodynamic properties. Judging the comparative superiority of one dosing regimen over another requires knowledge of the drug's duration action after a last-taken dose, plus knowledge of the comparative probabilities of the various patterns of dose omission. When applied to HIV protease inhibitors, a twice-daily regimen appears to be better than an once-daily regimen in maintaining therapeutically effective drug actions. [less ▲]

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See detailRemodelage chirurgical du ventricule gauche par endoventriculoplastie: observation clinique
Radermecker, M. A.; Canivet, J. L.; Roediger, Laurence ULg et al

in Revue Médicale de Liège (2006), 61(9), 649-52

A case of dilated ischemic cardiomyopathy, with severely impaired left ventricular systolic function, treated by endoventriculoplasty and CABG, is reported. The authors discuss the modern concepts ... [more ▼]

A case of dilated ischemic cardiomyopathy, with severely impaired left ventricular systolic function, treated by endoventriculoplasty and CABG, is reported. The authors discuss the modern concepts regarding the surgical treatment of large anterior asynergic scars following occlusion of the LAD. Since there are more similarities between akinesia and dyskinesia than previously thought, the endoventriculoplasty of DOR may constitute a new way to surgically remodel the left ventricle in dilated cardiomyopathies with large anterior akinesia. This surgery significantly improves the ventricular function and the overall patients' prognosis at short and mid term follow up. [less ▲]

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See detailSevere pulmonary embolism: Pulmonary artery clot load scores and cardiovascular parameters as predictors of mortality
Ghaye, Benoît ULg; Ghuysen, Alexandre ULg; Willems, V. et al

in Radiology (2006), 239(3), 884-891

Purpose: To retrospectively evaluate pulmonary artery (PA) clot load scores and computed tomographic (CT) cardiovascular parameters as predictors of mortality in patients with severe pulmonary embolism ... [more ▼]

Purpose: To retrospectively evaluate pulmonary artery (PA) clot load scores and computed tomographic (CT) cardiovascular parameters as predictors of mortality in patients with severe pulmonary embolism (PE). Materials and Methods: Institutional review board approval was obtained with waiver of informed consent. A total of 82 consecutive patients (42 women, 40 men; mean age +/- standard deviation, 61 years +/- 15) were admitted to the intensive care unit for PE-related conditions and were evaluated by using CT pulmonary angiography. Two independent readers who were blinded to clinical outcome quantified PA clot load by using four scoring systems. Cardiovascular measurements included right ventricular (RV) and left ventricular (LV) short-axis measurements; RV short axis to LV short axis (RV/LV) ratios; main PA, ascending aorta, azygos vein, and superior vena cava diameters; and main PA diameter to aorta diameter ratios. Reflux of contrast medium into the inferior vena cava, leftward bowing of the interventricular septum, pleural or pericardial effusion, pulmonary consolidation, infarct, platelike atelectasis, and mosaic ground-glass opacity were also recorded. Results were correlated with patient outcome during hospital stay by using the Wilcoxon rank sum and x(2) tests. Results: Twelve patients died within 1-14 days. RV and LV short axis; RV/LV ratio; azygos vein, superior vena cava, and aorta diameters; and contrast medium reflux into the inferior vena cava were significantly different between survivors and nonsurvivors (P <.05). No significant relationship was found between PA clot load and mortality rate. RV/LV ratio and azygos vein diameter allowed correct prediction of survival in 89% of patients (P <.001). Conclusion: RV/LV ratio and azygos vein diameter are predictors of mortality in patients with severe PE. (c) RSNA, 2006 [less ▲]

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See detailPhysical activity patterns of children after neonatal arterial switch operation.
Massin, Martial M; Hovels-Gurich, Hedwig H; Gérard, Paul ULg et al

in Annals of Thoracic Surgery (2006), 81(2), 665-70

BACKGROUND: Physical inactivity is a major atherosclerosis risk factor. The exercise tolerance is usually excellent after neonatal arterial switch operation, but those patients in whom coronary anomalies ... [more ▼]

BACKGROUND: Physical inactivity is a major atherosclerosis risk factor. The exercise tolerance is usually excellent after neonatal arterial switch operation, but those patients in whom coronary anomalies remain the main late complication, risk developing atherosclerotic coronary disease owing to perceived physical activity restrictions. METHODS: We investigated physical activity patterns of 52 unselected children 7 to 14 years after neonatal arterial switch operation for transposition of the great arteries by 24-hour continuous heart rate monitoring. The percentage of heart rate reserve was used to measure the amounts of activities. Comparisons were made with 35 children with repaired atrial or ventricular septal defect and with 127 age-matched healthy children. RESULTS: Children after arterial switch operation accumulated 167.3 +/- 70.6, 25.3 +/- 12.9, and 15.7 +/- 11.3 minutes a day (mean +/- SD) of light, moderate, and vigorous physical activities, respectively. At the same activity levels, children with repaired septal defect accumulated 165.2 +/- 82.2, 26.2 +/- 11.7, and 16.2 +/- 9.1 minutes a day, and their healthy peers 164.8 +/- 74.5, 31.8 +/- 13.9, and 21.9 +/- 11.3 minutes a day. Both cardiac groups were significantly less active than the control group when considering moderate (p = 0.026) and vigorous activities (p = 0.006). Only 19% and 27% of the children after arterial switch operation engaged, respectively, in more than 30 minutes a day of moderate activity and 20 minutes a day of vigorous activity. CONCLUSIONS: Children after arterial switch operation, just like other cardiac children, do not meet the guidelines for physical activity. We should encourage regular physical activity to offset adult sedentary behavior and to prevent atherosclerotic cardiovascular disease in those patients whose long-term function of the coronary arteries remains a matter of concern. [less ▲]

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See detailA note on the influence of pairwise misclassification in two-way tables
Magis, David ULg; Gérard, Paul ULg

in Journal of Statistical Computation & Simulation (2006), 76

The influence of subject misclassification on log-linear analysis of two-way contingency tables is investigated. We define pairwise misclassification and focus on both deviance and Pearson statistics as ... [more ▼]

The influence of subject misclassification on log-linear analysis of two-way contingency tables is investigated. We define pairwise misclassification and focus on both deviance and Pearson statistics as goodness-of-fit criteria for testing independence between the variables. Attention is paid to the extremal values of the test statistics that can be reached on the basis of the data set. We derive theoretical properties and use them to detect potentially troubling cells in a simple computing routine. Examples illustrate our purpose. [less ▲]

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See detailPatterns of physical activity determined by heart rate monitoring among diabetic children
Massin, M. M.; Lebrethon, M. C.; Brumioul, Danielle ULg et al

in Archives of Disease in Childhood (2005), 90(12), 1223-1226

Background: Children with type 1 diabetes should be encouraged to participate in physical activity because exercise can benefit insulin sensitivity and improve known risk factors for atherosclerosis ... [more ▼]

Background: Children with type 1 diabetes should be encouraged to participate in physical activity because exercise can benefit insulin sensitivity and improve known risk factors for atherosclerosis. Methods: Physical activity patterns of 127 children and adolescents with stable type 1 diabetes were investigated by 24 hour continuous heart rate monitoring. The percentage of heart rate reserve was used to measure the amounts of physical activity at different intensities. The results were compared with normative data. Results: Diabetic preschoolchildren accumulated 192.7 (78.1), 39.1 (24.3), and 21.3 (9.4) minutes/day (mean (SD)) of light, moderate, and vigorous physical activity, respectively. At the same activity levels, diabetic schoolchildren accumulated 168.9 (76.7), 37.9 (15.9), and 19.0 (14.8) minutes/day, and diabetic teenagers accumulated 166.3 (67.5), 45.6 (26.9), and 25.2 (15.3) minutes/day. Diabetic schoolchildren were significantly more active than healthy peers when considering moderate activity; diabetic teenagers were significantly more active when considering moderate and vigorous activity. There was a negative correlation between the most recent glycated haemoglobin and the time spent in light activities in schoolchildren, and a negative correlation between mean glycated haemoglobin for one year and time spent in light and moderate activities in schoolchildren. Conclusion: The majority of our diabetic patients meet the classical paediatric guidelines for physical activity and compare favourably with their healthy peers. [less ▲]

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See detailComputed tomographic pulmonary angiography and prognostic significance in patients with acute pulmonary embolism
Ghuysen, Alexandre ULg; Ghaye, Benoît ULg; Willems, V. et al

in Thorax (2005), 60(11), 956-961

Background: Patients with acute pulmonary embolism (APE) present with a broad spectrum of prognoses. Computed tomographic pulmonary angiography (CTPA) has progressively been established as a first line ... [more ▼]

Background: Patients with acute pulmonary embolism (APE) present with a broad spectrum of prognoses. Computed tomographic pulmonary angiography (CTPA) has progressively been established as a first line test in the APE diagnostic algorithm, but estimation of short term prognosis by this method remains to be explored. Methods: Eighty two patients admitted with APE were divided into three groups according to their clinical presentation: pulmonary infarction (n=21), prominent dyspnoea (n=29), and circulatory failure (n=32). CTPA studies included assessment of both pulmonary obstruction index and right heart overload. Haemodynamic evaluation was based on systolic aortic blood pressure, heart rate, and systolic pulmonary arterial pressure obtained non-invasively by echocardiography at the time of diagnosis of pulmonary embolism. Results: The mortality rate was 0%, 13.8% and 25% in the three groups, respectively. Neither the pulmonary obstruction index nor the pulmonary artery pressure could predict patient outcome. In contrast, a significant correlation with mortality was found using the systolic blood pressure (p<0.001) and heart rate (p<0.05), as well as from imaging parameters including right to left ventricle minor axis ratio (p<0.005), proximal superior vena cava diameter (p<0.001), azygos vein diameter (p<0.001), and presence of contrast regurgitation into the inferior vena cava (p=0.001). Analysis from logistic regression aimed at testing for mortality prediction revealed true reclassification of 89% using radiological variables. Conclusion: These results suggest that CTPA quantification of right ventricular strain is an accurate predictor of in-hospital death related to pulmonary embolism. [less ▲]

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See detailAortic valve replacement in octogenarians: operative outcome and long-term results
Kolh, Philippe ULg; Kerzmann, Arnaud ULg; Jacquart, Julie ULg et al

in European Heart Journal (2005, September), 26(Suppl. 1), 676

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See detailEffects of dobutamine on left ventriculoarterial coupling and mechanical efficiency in acutely ischemic pigs
Kolh, Philippe ULg; Lambermont, Bernard ULg; Ghuysen, Alexandre ULg et al

in Journal of Cardiovascular Pharmacology (2005), 45(2), 144-152

This study investigated the effects of dobutamine on left ventriculoarterial (VA) coupling and mechanical efficiency in acutely ischemic pigs. Experiments were performed in 12 pigs in which vascular ... [more ▼]

This study investigated the effects of dobutamine on left ventriculoarterial (VA) coupling and mechanical efficiency in acutely ischemic pigs. Experiments were performed in 12 pigs in which vascular properties, including peripheral resistance (R-2), compliance (C), and arterial elastance (E-a), were estimated with a windkessel model, and left ventricular (LV) function by the slope (E-es) of the end-systolic pressure-volume relationship (ESPVR) and stroke work (SW). VA coupling was defined as E-es/E-a, and mechanical efficiency as SW/pressure-volume area (PVA). In all animals, the left anterior descending coronary artery was ligated after basal measures. The animals were then randomly divided into 2 groups: group CTRL (n = 6) was followed for 180 minutes without other intervention, whereas group DOBU (n = 6) was infused with dobutamine (5 mug(.)kg(-1.)min(-1)) starting after T60 measures. Coronary occlusion induced a rightward shift of ESPVR and a decrease in E-es from 3.67 +/- 0.33 to 1.92 +/- 0.20 mm Hg(.)mL(-1), while E-a changed from 3.33 +/- 0.56 to 4.65 +/- 0.29 mm Hg(.)mL(-1), R-2 from 1.72 +/- 0.30 to 2.38 +/- 0.16 mm Hg(.)s(.)mL(-1), and C from 0.78 +/- 0.16 to 0.46 +/- 0.08 mL(.)mm Hg-1. This altered VA coupling from 1.22 +/- 0.11 to 0.44 +/- 0.07. SW decreased from 4056 +/- 223 to 2372 +/- 122 mm Hg(.)mL, and PVA and SW/PVA decreased from 5575 +/- 514 to 4830 +/- 3.17 mm Hg(.)mL, and from 0.76 +/- 0.04 to 0.49 +/- 0.03, respectively. In group DOBU, dobutamine restored E-es and the position of ESPVR to baseline values, while E-a decreased to 3.39 +/- 0.34 mm Hg(.)mL(-1) because of an R-2 decrease to 1.60 +/- 0.24 mm Hg(.)s(.)mL(-1). VA coupling was restored. SW and PVA increased to 3833 +/- 180 mm Hg(.)mL and to 7498 +/- 442 mm Hg(.)mL, respectively, while SW/PVA was unchanged. In ischemic pigs, dobutamine restored VA coupling through an increase in LV contractility and decrease in arterial elastance as a result of peripheral vasodilatation. However, myocardial oxygen consumption was increased, and mechanical efficiency impaired. [less ▲]

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See detailLong-term outcome of patients with heart failure and dynamic functional mitral regurgitation.
LANCELLOTTI, Patrizio ULg; Gérard, Paul ULg; Pierard, Luc ULg

in European Heart Journal (2005), 26(15), 1528-32

AIMS: In patients with heart failure and chronic ischaemic mitral regurgitation (MR), the mortality risk is related to the quantified severity of MR at rest and its dynamic changes during exercise. The ... [more ▼]

AIMS: In patients with heart failure and chronic ischaemic mitral regurgitation (MR), the mortality risk is related to the quantified severity of MR at rest and its dynamic changes during exercise. The impact of dynamic MR on long-term mortality, hospital admission for heart failure, and major adverse cardiac events has never been investigated. METHODS AND RESULTS: We prospectively studied 161 patients with chronic ischaemic left ventricular (LV) dysfunction and at least mild MR who underwent quantitative measurement of the effective regurgitant orifice (ERO) of MR at rest and during semi-supine exercise test and who were followed up for 35+/-11 months. The 20 patients who underwent surgery were censored at the time of operation. Of the 141 patients who were treated medically, 23 died, 22 required hospitalization for heart failure, 4 had nonfatal myocardial infarction, and 11 developed unstable angina. By multivariate analysis, an exercise-induced increase in ERO by > or =13 mm(2) and a greater increase in transtricuspid pressure gradient during exercise emerged as predictors of mortality and of hospital admission for heart failure. MR severity under basal conditions (ERO> or =20 mm(2)) was an independent predictor of only cardiac death. Greater LV volumes at rest and lack of contractile reserve during exercise were additional independent markers of poor outcome. CONCLUSION: In patients with ischaemic heart disease and LV dysfunction, large exercise-induced increases in MR identify patients at high risk of morbidity and of death. [less ▲]

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See detailEffects of reperfusion on left ventricular hemodynamics and ventriculo-arterial coupling in acutely ischemic pigs
Lanoye, Lieve; KOLH, Philippe ULg; Rolin, Stéphanie et al

in Computer Methods in Biomechanics & Biomedical Engineering (2005), 8(suppl. 1), 169-170

Rapid restoration of coronary blood flow following a period of myocardial ischemia (due to coronary occlusion) is mandatory to preserve the cardiac muscle. Reperfusion, however, not necessarily restores ... [more ▼]

Rapid restoration of coronary blood flow following a period of myocardial ischemia (due to coronary occlusion) is mandatory to preserve the cardiac muscle. Reperfusion, however, not necessarily restores cardiac function, and cellular damage of the cardiac muscle cells following reperfusion (reperfusion injury) is well documented. The aim of this study was to investigate the effects of reperfusion on left ventricular (LV) hemodynamics and on left ventriculo-arterial (VA) coupling in acutely ischemic pigs. [less ▲]

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See detailComparison of the effects of propofol and pentobarbital on left ventricular adaptation to an increased afterload
Kolh, Philippe ULg; Lambermont, Bernard ULg; Ghuysen, Alexandre ULg et al

in Journal of Cardiovascular Pharmacology (2004), 44(3), 294-301

The purpose of this study was to compare the hemodynamic effects of pentobarbital and propofol and their effects on cardiovascular adaptation to an abrupt increase in left ventricular afterload ... [more ▼]

The purpose of this study was to compare the hemodynamic effects of pentobarbital and propofol and their effects on cardiovascular adaptation to an abrupt increase in left ventricular afterload. Experiments were performed in 12 open-chest pigs instrumented for measurement of aortic pressure and flow, and left ventricular pressure and volume. In one group (n = 6), anesthesia was obtained with sodium pentobarbital (3 mg x kg(-1) x h(-1)), and, in the second group B (n = 6), with propofol (10 mg x kg(-1) x h(-1)). Both groups received sufentanil (0.5 microg x kg(-1) x h(-1)) and pancuronium bromide (0.1 mg x kg(-1)). Left ventricular function was assessed by the slope of end-systolic pressure-volume relationship and stroke work. After baseline recordings, left ventricular afterload was increased by aortic banding. The cardiovascular adaptations triggered by the aortic banding, such as tachycardia, vasoconstriction, and augmentation of myocardial contractility were prevented with propofol, suggesting interference with the baroreflex. Increase in left ventricular afterload decreased mechanical efficiency, regardless of anesthetic agent. These results showed that pentobarbital at 3 mg x kg(-1) x h(-1) has less deleterious hemodynamic effects than propofol at 10 mg x kg(-1) x h(-1). [less ▲]

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See detailPlasmatic cystatin C for the estimation of glomerular filtration rate in intensive care units
Delanaye, Pierre ULg; Lambermont, Bernard ULg; Chapelle, Jean-Paul ULg et al

in Intensive Care Medicine (2004), 30(5), 980-983

OBJECTIVE: To compare the sensitivity of cystatin C and creatinine in detecting decreased glomerular filtration rate. DESIGN: Prospective observational study. SETTING: Medical intensive care unit at a ... [more ▼]

OBJECTIVE: To compare the sensitivity of cystatin C and creatinine in detecting decreased glomerular filtration rate. DESIGN: Prospective observational study. SETTING: Medical intensive care unit at a university hospital. PATIENTS AND PARTICIPANTS: Fourteen patients hospitalised in a medical intensive care unit. INTERVENTIONS: Cystatin C and creatinine plasmatic levels were measured in 40 blood samples taken with an interval of at least 24 h. MEASUREMENTS AND RESULTS: Glomerular filtration rate was estimated by creatinine clearance using 24-h urine collection and the classical Cockcroft-Gault equation. The ability of cystatin C to detect a glomerular filtration rate under 80 ml/min per 1.73 m(2) was significantly better than that of creatinine ( p<0.05). CONCLUSIONS: Cystatin C, a new plasmatic marker of renal function, could be used to detect renal failure in intensive care in the future. [less ▲]

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See detailEffect of a novel thromboxane A(2) inhibitor on right ventricular-arterial coupling in endotoxic shock
Lambermont, Bernard ULg; Kolh, Philippe ULg; Ghuysen, Alexandre ULg et al

in Shock (2004), 21(1), 45-51

We investigated the effects of a dual thromboxane (TX)A(2) synthase inhibitor and TXA(2) receptor antagonist (BM-573) on right ventricular-arterial coupling in a porcine model of endotoxic shock. Thirty ... [more ▼]

We investigated the effects of a dual thromboxane (TX)A(2) synthase inhibitor and TXA(2) receptor antagonist (BM-573) on right ventricular-arterial coupling in a porcine model of endotoxic shock. Thirty minutes before the onset of 0.5 mg/kg endotoxin infusion, six pigs (Endo group) received an infusion with a placebo solution, and six other pigs (Anta group) with BM-573. Right ventricular pressure-volume loops were obtained by the conductance catheter technique. The slope (E-es) of the end-systolic pressure-volume relationship and its volume intercept at 25 mmHg were calculated as measures of right ventricular systolic function. RV afterload was quantified by pulmonary arterial elastance (E-a), and E-es/E-a ratio represented right ventricular-arterial coupling. Mechanical efficiency was defined as the ratio of stroke work and pressure-volume area. In this model of endotoxic shock, BM-573 blunted the early phase of pulmonary hypertension, improved arterial oxygenation, and prevented a decrease in right ventricular myocardial efficiency and right ventricular dilatation. However, the drug could not prevent the loss of homeometric regulation and alterations in right ventricular-arterial coupling. In conclusion, dual TXA(2) synthase inhibitor and receptor antagonists such as BM-573 have potential therapeutic applications, improving right ventricular efficiency and arterial oxygenation in endotoxic shock. [less ▲]

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