References of "Heart"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailLeft atrial function: pathophysiology, echocardiographic assessment, and clinical applications.
Rosca, M.; Lancellotti, Patrizio ULg; Popescu, B. A. et al

in Heart (2011), 97(23), 1982-9

Detailed reference viewed: 13 (5 ULg)
Full Text
Peer Reviewed
See detailRisk stratification in asymptomatic moderate to severe aortic stenosis: the importance of the valvular, arterial and ventricular interplay.
Lancellotti, Patrizio ULg; Donal, Erwan; Magne, Julien ULg et al

in Heart (2010), 96(17), 1364-71

OBJECTIVE: We sought to evaluate prognostic markers of clinical outcome in asymptomatic patients with moderate to severe aortic stenosis (AS). DESIGN: Prospective follow-up of asymptomatic patients with ... [more ▼]

OBJECTIVE: We sought to evaluate prognostic markers of clinical outcome in asymptomatic patients with moderate to severe aortic stenosis (AS). DESIGN: Prospective follow-up of asymptomatic patients with moderate to severe AS. The patients underwent clinical and Doppler echocardiographic evaluation. SETTING: Department of Cardiology. PATIENTS: 163 patients with moderate to severe AS (aortic valve area < or =0.6 cm(2)/m(2)). MAIN OUTCOME MEASURES: Risk stratification. Predefined endpoints for assessing the outcome were the occurrence during follow-up of symptoms, aortic valve replacement or death. RESULTS: During follow-up (mean, 20 (19) months), 11 patients developed symptoms but were not operated on, 57 required aortic valve replacement and six patients died. In multivariable Cox regression analysis, four parameters that were associated with the outcome were identified: peak aortic jet velocity, left ventricular systolic (LV) longitudinal deformation, valvulo-arterial impedance and indexed left atrial area. Using receiver-operator characteristic curve analysis, a peak aortic jet velocity > or =4.4 m/s, a LV longitudinal myocardial deformation < or =15.9%, a valvular-arterial impedance > or =4.9 mm Hg/ml per m(2) and an indexed left atrial area > or =12.2 cm(2)/m(2) were identified as the best cut-off values to be associated with events. CONCLUSIONS: In asymptomatic patients with moderate to severe AS, measurements that integrate the ventricular, vascular and valvular components of the disease improve risk stratification. [less ▲]

Detailed reference viewed: 43 (5 ULg)
Full Text
Peer Reviewed
See detailStress echocardiography for selecting potential responders to cardiac resynchronisation therapy.
Moonen, Marie ULg; O'Connor, Kim; Magne, Julien ULg et al

in Heart (2010), 96(14), 1142-6

In the current ESC/ACC/AHA guidelines, the selection of patients for cardiac resynchronisation therapy (CRT) is based upon the QRS duration, which reflects interventricular dyssynchrony. However, about 30 ... [more ▼]

In the current ESC/ACC/AHA guidelines, the selection of patients for cardiac resynchronisation therapy (CRT) is based upon the QRS duration, which reflects interventricular dyssynchrony. However, about 30% of patients do not respond to CRT. It has previously been demonstrated that the presence of left ventricular mechanical dyssynchrony is predictive of response to CRT after implantation. Most criteria assessing such dyssynchrony were derived from data obtained with resting Doppler echocardiography. The recently published PROSPECT (Predictors of Response to CRT) trial failed to identify echocardiographic measures of dyssynchrony that could routinely be recommended for patient selection before CRT implantation. Therefore, solutions may come from other echocardiographic modalities, such as dobutamine stress echocardiography and exercise echocardiography. The purpose of this review is to evaluate the usefulness of stress echocardiography to predict response to CRT. This review will show how exercise-induced changes in dyssynchrony and severity of mitral regurgitation and the role of preserved contractile reserve may help to better identify potential responders. [less ▲]

Detailed reference viewed: 22 (9 ULg)
Full Text
Peer Reviewed
See detailImpact of prosthesis-patient mismatch on mitral regurgitation after aortic valve replacement
Unger, P.; Magne, Julien ULg; Vanden Eynden, F. et al

in Heart (2010), 96(20), 1627-1632

Full Text
Peer Reviewed
See detailThe role of European national journals in education
Lancellotti, Patrizio ULg

in Heart (2009), 95(24), 3

Detailed reference viewed: 8 (0 ULg)
Full Text
Peer Reviewed
See detailIschaemic mitral regurgitation: mechanisms and diagnosis.
Marwick, Th; Lancellotti, Patrizio ULg; Pierard, Luc ULg

in Heart (2009), 95(20), 1711-8

Detailed reference viewed: 27 (5 ULg)
Full Text
Peer Reviewed
See detailMitral regurgitation in patients with aortic stenosis undergoing valve replacement.
Unger, P.; Dedobbeleer, C.; Van Camp, G. et al

in Heart (2009)

Detailed reference viewed: 16 (1 ULg)
Full Text
Peer Reviewed
See detailEchocardiography in the emergency roon: non-invasive imaging.
Pierard, Luc ULg; Lancellotti, Patrizio ULg

in Heart (2009), 95(2), 164

Detailed reference viewed: 16 (3 ULg)
Full Text
Peer Reviewed
See detailModerate patient-prosthesis mismatch can impact on mortality after aortic valve replacement
Dumesnil, J. G.; Magne, Julien ULg; Girerd, N. et al

in Heart (2009), 95(7), 592

Detailed reference viewed: 2 (0 ULg)
Full Text
Peer Reviewed
See detailHow to manage ischaemic mitral regurgitation.
Lancellotti, Patrizio ULg; Marwick, Thomas; Pierard, Luc ULg

in Heart (2008), 94(11), 1497-502

Detailed reference viewed: 15 (7 ULg)
Full Text
Peer Reviewed
See detailStress testing in valve disease
PIERARD, Luc ULg; Lancellotti, Patrizio ULg

in Heart (2007), 93(6), 766-772

Detailed reference viewed: 3 (1 ULg)
Full Text
Peer Reviewed
See detailDeterminants of persistent negative T waves and early versus late T wave normalisation after acute myocardial infarction
PIERARD, Luc ULg; LANCELLOTTI, Patrizio ULg

in Heart (2005), 91(8), 1008-1012

OBJECTIVE: To determine whether persistent versus early or delayed T wave normalisation of negative T waves after acute myocardial infarction is determined by the myocardial state, the treatment strategy ... [more ▼]

OBJECTIVE: To determine whether persistent versus early or delayed T wave normalisation of negative T waves after acute myocardial infarction is determined by the myocardial state, the treatment strategy, or both. DESIGN: 127 consecutive patients with a first acute myocardial infarction and > or = 2 negative T waves on the 24-36 hour ECG were studied. They underwent dobutamine stress echocardiography and coronary angiography during the first week. ECG was recorded at hospital discharge and at a mean (SD) of 4 (1) months. SETTING: University hospital. RESULTS: T wave normalisation was observed in 88 patients (early at discharge in 19 and delayed at four months in 69). Early T wave normalisation was associated with sustained contractile reserve during dobutamine stress (13 of 19 (68%)), whereas delayed T wave normalisation was observed mainly in patients with an ischaemic response (49 of 69 (71%)). The persistence of negative T waves was associated with an ischaemic response (21 of 39 (54%)) or persistent akinesis (17 of 39 (44%)). Among patients with an ischaemic response to dobutamine, in-hospital elective angioplasty was an independent determinant of delayed T wave normalisation (39 of 49 v 4 of 21 patients with persistent negative T waves at four months, p < 0.0001). CONCLUSIONS: Early T wave normalisation is associated with dobutamine induced, sustained improvement indicating myocardial stunning. Delayed normalisation is observed mainly in patients with ischaemic myocardium who have undergone revascularisation. Persistent negative T waves correspond to either extensive necrosis or non-revascularised, jeopardised myocardium. [less ▲]

Detailed reference viewed: 12 (1 ULg)
Full Text
Peer Reviewed
See detailRepeated beta irradiation for recurrent coronary in-stent restenosis.
Eeckhout, E; Roguelov, C; Berger, A et al

in Heart (2005), 91

Vascular brachytherapy (VBT) is the only proven treatment option for patients with in-stent restenosis. In seven randomised trials with almost 1500 patients that evaluated {gamma} (five studies) and ß ... [more ▼]

Vascular brachytherapy (VBT) is the only proven treatment option for patients with in-stent restenosis. In seven randomised trials with almost 1500 patients that evaluated {gamma} (five studies) and ß (two trials) irradiation, target vessel failure reduction ranged from 73% to 34% by VBT compared with conventional angioplasty.1 However, the reported restenosis rates with the active treatment still varied between 17% and 32%.1 We therefore postulated that repeat VBT is safe and efficacious for preventing refractory in-stent restenosis in high risk patients with failed VBT. METHODS Beginning in January 1999, VBT was applied for all patients with in-stent restenosis. VBT was systematically performed with intravascular ultrasound (IVUS) guidance. The repeat procedure was performed with a strontium/yttrium-90 source train (BetaCath, Novoste, Norcross, Georgia, USA). The design and application of this catheter have been described previously.2 The dosimetry was based on the manufacturer’s recommendations but taking into account not the angiographic vessel reference diameter but the external elastic membrane diameter (as determined by IVUS). The mean dose delivered at 2 mm from the source centre was 23.3 (2.2) Gy during the index procedure and 25.3 (2.2) Gy during the repeat intervention. Percutaneous coronary intervention (PCI) was performed according to standard clinical practice. Failed VBT was defined as angina recurrence combined with target vessel failure (as documented by any repeat angiography: premature depending on early symptom recurrence or at the planned six month control). Repeat VBT was considered for patients estimated to be at high risk for refractory in-stent restenosis or if they had a prognostic risk—that is, diffuse or ostial in-stent restenosis or total occlusion, or proximal left anterior descending artery stenosis. Focal edge effect stenoses and non-prognostic lesion locations in symptomatic patients were treated by conventional PCI. Written informed consent was obtained from all patients before intervention. The study was approved by the hospital ethics committee. All VBT patients were prospectively entered in a dedicated database by a person not taking part in the interventions. A combined antiplatelet treatment (aspirin 100 mg and clopidogrel 75 mg daily) was prescribed for at least six months after the index procedure and for one year after the second VBT. Control angiography was mandatory at six months in all VBT patients and systematic long term clinical follow up was carried out. RESULTS Between July 1998 and March 2003, 251 VBT interventions were performed at our institution: 22 patients were treated for primary restenosis prevention and 229 patients for in-stent restenosis. VBT failed in 34 patients (14.8%): 23 underwent conventional PCI and 11 underwent repeat VBT. The baseline clinical and angiographic demographics were comparable for both groups. Concerning the repeat VBT group, mean (SD) age was 60 (7) years, nine patients were men, and two had diabetes. All patients who underwent a repeat procedure had incapacitating angina pectoris. Angina recurred at 7 (2) months (range 4–10) after the first, failed VBT. The restenosis pattern (table 1Go) was diffuse in the majority of patients at the first presentation and remained diffuse with exacerbation to total occlusion in two patients. In the focal restenosis group, two patients had ostial in-stent restenosis. The cause of recurrent in-stent restenosis was an evident geographical miss in two patients (a focal and a diffuse pattern case). IVUS and angioplasty were successful before irradiation therapy in all patients. During repeat VBT, a 40 mm source train was used in seven patients and a pullback technique was required in two because of the length of the restenotic segment. No additional stents were implanted and no evidence of geographical miss was seen at repeat intervention. Table 1Go shows quantitative coronary angiography and IVUS data. During the index procedure, the minimum in-stent luminal area increased from mean (SD) 5.8 (1.8) to 7.5 (1.4) mm2. This area was maintained at the repeat intervention at 7.8 (2.1) mm2 and further expanded to 8.9 (1.8) mm2. All repeat interventions were technically successful and there were no adverse clinical events during the in-hospital phase. [less ▲]

Detailed reference viewed: 23 (1 ULg)
Full Text
Peer Reviewed
See detailDobutamine Stress Echocardiography Versus Quantitative Technetium-99m Sestamibi Spect for Detecting Residual Stenosis and Multivessel Disease after Myocardial Infarction
LANCELLOTTI, Patrizio ULg; Benoit, T.; Rigo, Pierre ULg et al

in Heart (2001), 86(5), 510-5

OBJECTIVE: To compare the relative accuracy of dobutamine stress echocardiography (DSE) and quantitative technetium-99m sestamibi single photon emission computed tomography (mibi SPECT) for detecting ... [more ▼]

OBJECTIVE: To compare the relative accuracy of dobutamine stress echocardiography (DSE) and quantitative technetium-99m sestamibi single photon emission computed tomography (mibi SPECT) for detecting infarct related artery stenosis and multivessel disease early after acute myocardial infarction. DESIGN: Prospective study. SETTING: University hospital. METHODS: 75 patients underwent simultaneous DSE and mibi SPECT at (mean (SD)) 5 (2) days after a first acute myocardial infarct. Quantitative coronary angiography was performed in all patients after imaging studies. RESULTS: Significant stenosis (> 50%) of the infarct related artery was detected in 69 patients. Residual ischaemia was identified by DSE in 55 patients and by quantitative mibi SPECT in 49. The sensitivity of DSE and mibi SPECT for detecting significant infarct related artery stenosis was 78% and 70%, respectively, with a specificity of 83% for both tests. The combination of DSE and mibi SPECT did not change the specificity (83%) but increased the sensitivity to 94%. Mibi SPECT was more sensitive than DSE for detecting mild stenosis (73% v 9%; p = 0.008). The sensitivity of DSE for detecting moderate or severe stenosis was greater than mibi SPECT (97% v 74%; p = 0.007). Wall motion abnormalities with DSE and transient perfusion defects with mibi SPECT outside the infarction zone were sensitive (80% v 67%; NS) and highly specific (95% v 93%; NS) for multivessel disease. CONCLUSIONS: DSE and mibi SPECT have equivalent accuracy for detecting residual infarct related artery stenosis of >/= 50% and multivessel disease early after acute myocardial infarction. DSE is more predictive of moderate or severe infarct related artery stenosis. Combined imaging only improves the detection of mild stenosis. [less ▲]

Detailed reference viewed: 8 (1 ULg)
Full Text
Peer Reviewed
See detailFull Recovery of Contraction Late after Acute Myocardial Infarction: Determinants and Early Predictors
Lancellotti, Patrizio ULg; Albert, Adelin ULg; Berthe, Christian ULg et al

in Heart (2001), 85(5), 521-6

OBJECTIVES: To assess the relative value of electrocardiographic, echocardiographic, angiographic, and in-hospital therapeutic indices for predicting late functional recovery after acute myocardial ... [more ▼]

OBJECTIVES: To assess the relative value of electrocardiographic, echocardiographic, angiographic, and in-hospital therapeutic indices for predicting late functional recovery after acute myocardial infarction, and to determine the variables associated with absence of recovery, partial recovery, and full recovery. DESIGN: Prospective observational follow up study. SETTING: Teaching hospital. PATIENTS: 74 consecutive patients with a first uncomplicated acute myocardial infarct. INTERVENTIONS: Dobutamine-atropine stress echocardiography was performed mean (SD) 5 (2) days after the acute event. Quantitative angiography was available in all patients before hospital discharge. A follow up resting echocardiogram was obtained 12 (2) months later. RESULTS: Functional recovery (partial, n = 18; full, n = 27) was observed in 45 of the 74 patients. Recovery was associated with earlier thrombolytic treatment (p = 0.008), earlier peak concentration of creatine kinase (p = 0.009), greater contractile reserve (p = 0.0001), non-Q wave acute myocardial infarction (p = 0.002), and more frequent elective angioplasty of the infarct related vessel (p = 0.0004). Three independent variables were selected stepwise from multivariate analysis for predicting late recovery: contractile reserve (chi(2) = 24.2, p < 0.0001); non-Q wave infarction (chi(2) = 15.7, p = 0.0001); and the time from symptom onset to thrombolysis (chi(2) = 4.94, p = 0.026). Three independent variables predicted full recovery: contractile reserve (chi(2) = 17.2, p = 0.0001); non-Q wave infarction (chi(2) = 10.1, p = 0.0016); and elective angioplasty of the infarct related artery (chi(2) = 4.53, p = 0.033). Only contractile reserve (chi(2) = 17.0, p < 0.001) was selected from the multivariate analysis for its ability to distinguish between partial recovery and absence of recovery. CONCLUSIONS: Late recovery of contraction relates to earlier treatment, which is associated with lower infarct size unmasked by a non-Q wave event and the presence of contractile reserve. Elective coronary angioplasty of the infarct related artery before hospital discharge is associated with full recovery. [less ▲]

Detailed reference viewed: 20 (3 ULg)
Full Text
Peer Reviewed
See detailEvaluation of in vivo biocompatibility of different devices for interventional closure of the patent ductus arteriosus in an animal model
Sigler, M.; Handt, S.; SEGHAYE, Marie-Christine ULg et al

in Heart (2000), 83(5), 570-3

OBJECTIVE: To evaluate the in vivo biocompatibility of three different devices following interventional closure of a patent ductus arteriosus (PDA) in an animal model. MATERIALS AND METHODS: A medical ... [more ▼]

OBJECTIVE: To evaluate the in vivo biocompatibility of three different devices following interventional closure of a patent ductus arteriosus (PDA) in an animal model. MATERIALS AND METHODS: A medical grade stainless steel coil (n = 8), a nickel/titanium coil (n = 10), and a polyvinylalcohol foam plug knitted on a titanium wire frame (n = 11) were used for interventional closure of PDA in a neonatal lamb model. The PDA had been maintained by repetitive angioplasty. Between one and 278 days after implantation the animals were killed and the ductal block removed. In addition to standard histology and scanning electron microscopy, immunohistochemical staining for biocompatibility screening was also undertaken. RESULTS: Electron microscopy revealed the growth of a cellular layer in a cobblestone pattern on the implant surfaces with blood contact, which was completed as early as five weeks after implantation of all devices. Immunohistochemical staining of these superficial cells showed an endothelial cell phenotype. After initial thrombus formation causing occlusion of the PDA after implantation there was ingrowth of fibromuscular cells resembling smooth muscle cells. Transformation of thrombotic material was completed within six weeks in the polyvinylalcohol plug and around the nickel/titanium coil, and within six months after implantation of the stainless steel coil. An implant related foreign body reaction was seen in only one of the stainless steel coil specimens and in two of the nickel/titanium coil specimens. CONCLUSION: After implantation, organisation of thrombotic material with ingrowth of fibromuscular cells was demonstrated in a material dependent time pattern. The time it took for endothelium to cover the implants was independent of the type of implant. Little or no inflammatory reaction of the surrounding tissue was seen nine months after implantation. [less ▲]

Detailed reference viewed: 7 (1 ULg)