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See detailCardiac Performance in Conscious Healthy Dogs During Dobutamine Infusion
Mc Entee, Kathleen ULg; Clercx, Cécile ULg; Pypendop, B. et al

in Research in Veterinary Science (1996), 61(3), 234-9

The aim of this study was to determine the cardiac performance of conscious healthy dogs during stimulation with dobutamine. Eight healthy unsedated beagle dogs were used. Cardiac output was measured by ... [more ▼]

The aim of this study was to determine the cardiac performance of conscious healthy dogs during stimulation with dobutamine. Eight healthy unsedated beagle dogs were used. Cardiac output was measured by the thermodilution technique and blood pressures by extravascular pressure transducers. Dobutamine challenge at a dosage ranging from 27.5 to 50 micrograms kg-1 min-1 induced a significant rise in cardiac power index (CPI), cardiac index (CI), stroke index (SI) and heart rate (HR) and a significant decrease in pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR). The highest CPI was 2.05 times greater than its basal resting value. The CI was primarily responsible for this increase in CPI. The SI and HR contributed approximately 55 per cent and 45 per cent respectively of the maximal increase in CI. [less ▲]

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See detailCardiac Power Output during Dobutamine Stress
Sandersen, Charlotte ULg; Mc Entee, Kathleen ULg; Deleuze, Stefan ULg et al

in Journal of Equine Veterinary Science (2009)

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See detailCardiac pumping reserve measured in healthy horses using a dobutamine stress test
Sandersen, Charlotte ULg; Detilleux, Johann ULg; Art, Tatiana ULg et al

in Proceedings of the 45th Congress of the British Equine Veterinary Association (2006)

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See detailCardiac resynchronisation therapy reduces the incidence of permanent atrial fibrillation in heart failure patients
Cosyns, B.; Lancellotti, Patrizio ULg; Hoffer, E. et al

in European Heart Journal (2006, August), 27(Suppl. 1), 332

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See detailCardiac Risk Assessment before Vascular Surgery: A Prospective Study Comparing Clinical Evaluation, Dobutamine Stress Echocardiography, and Dobutamine Tc-99m Sestamibi Tomoscintigraphy
VAN DAMME, Hendrik ULg; Pierard, Luc ULg; Gillain, Daniel ULg et al

in Cardiovascular Surgery (1997), 5(1), 54-64

Preoperative evaluation for cardiac risk assessment before peripheral vascular surgery remains controversial. Between January and June 1994, a prospective open study was carried out in 156 patients ... [more ▼]

Preoperative evaluation for cardiac risk assessment before peripheral vascular surgery remains controversial. Between January and June 1994, a prospective open study was carried out in 156 patients scheduled for elective vascular procedures (63 carotid endarterectomies, 34 abdominal aortic aneurysms, 29 aortoiliac and 30 infrainguinal reconstructions) to compare the ability of clinical data, dobutamine stress echocardiography, and dobutamine Tc-99m sestamibi tomoscintigraphy to predict postoperative cardiac events. Pharmacological stress testing consisted of incremental dobutamine infusion (+/-1 mg atropine to achieve 85% of age-predicted maximal heart rate, with continuous echocardiographic monitoring, and injection of Tc-99m sestamibi after dobutamine infusion). Dobutamine echocardiography was abnormal in 36 patients (worsening resting wall motion abnormality in 11; new induced wall motion abnormality in 25). Dobutamine Tc-99m sestamibi tomoscintigraphy revealed a reversible perfusion defect in 34 patients, indicating the presence of myocardial ischaemia. As a result, eight patients underwent myocardial revascularization (n = 5) or the proposed operation was cancelled (n = 3). In the remaining 142 vascular procedures, there were eight (5.6%) adverse cardiac events: three myocardial infarctions (two fatal), three prolonged myocardial ischaemia, one acute congestive heart failure and one sustained ventricular arrhythmia in the post operative period. Univariate analysis selected unstable angina (relative risk (RR) 11.6), previous congestive heart failure (RR 6.4), Detsky's score of > or = 15 (RR 3.0), positive dobutamine stress echocardiography (RR 3.7), and positive dobutamine tomoscintigraphy (RR 7.4) as significant predictors of postoperative cardiac events. In patients without clinical markers of coronary artery disease (n = 66), non-invasive cardiac testing did not predict cardiac complications (n = 2; one prolonged myocardial ischaemia; one infarction). In the subset of 76 patients with definite clinical or electrocardiographic evidence of ischaemic heart disease, dobutamine stress testing provided additional information, and optimized risk stratification: five of six patients who suffered a cardiac complication had a pathologic dobutamine stress test. Furthermore, a negative dobutamine stress test was characterized by a high negative predictive value (0.96 for echocardiography; 0.97 for tomoscintigraphy). The study further demonstrated that the cardiac response (ischaemic versus non-ischaemic) to dobutamine stress was concordantly classified by echocardiographic and tomoscintigraphic techniques in 96% of cases. It is concluded that complementary non-invasive cardiac stress testing by dobutamine is indicated only in patients with clinically apparent coronary artery disease. [less ▲]

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See detailCardiac surgery and acute kidney injury.
LAGNY, Marc-Gilbert ULg; BLAFFART, Francine ULg; KOCH, Jean-Noël ULg et al

Conference given outside the academic context (2013)

Lecture about Cardiac surgery and acute kidney injury. Presentations of results about a retrospective study performed in the University Hospital of Liège and presentations about the protocol of a ... [more ▼]

Lecture about Cardiac surgery and acute kidney injury. Presentations of results about a retrospective study performed in the University Hospital of Liège and presentations about the protocol of a prospective study on the same topic. [less ▲]

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See detailCardiac surgery and acute kidney injury: retrospective study
LAGNY, Marc-Gilbert ULg; BLAFFART, Francine ULg; Defraigne, Jean-Olivier ULg et al

Conference (2012, October 27)

Background: In cardiac surgery, acute kidney injury (AKI) is a severe postoperative complication and associated with increased rates of mortality, morbidity, and length of stay in intensive care units ... [more ▼]

Background: In cardiac surgery, acute kidney injury (AKI) is a severe postoperative complication and associated with increased rates of mortality, morbidity, and length of stay in intensive care units (ICU). It occurs in 5% to 30% of patients depending on the definition used [1] [2] [3]. The aim of this study is to present an overview of AKI following cardiac surgery associated or not with cardiopulmonary bypass, in our center. Methods: This retrospective study includes patients treated by cardiac surgery from April 1st, 2008 to March 31th, 2009 in a single center. We selected patients who underwent on-pump coronary artery bypass surgery (CABG), off-pump CABG (OPCAB), aortic valve replacement, mitral valve repair or replacement and aortic valve replacement combined with CABG. Patients undergoing renal replacement therapy preoperatively were excluded. The RIFLE classification (Risk, Injury, Failure, Loss and End stage kidney disease) allowed stratifying the patients into the 3 grades of AKI severity. The stratification was based on the most pejorative element observed within 7 days after surgery: increased serum creatinine level or decreased urine output, or decreased glomerular filtration rate according to criteria of Bellomo [4]. Occurrence of AKI was studied by type of cardiac surgery as its impact on the length of stay in ICU and in the hospital. Proportions were compared by the Chi-square test and median values by the Mann-Whitney U test. Results were considered significant at p < 0.05. Results: Four hundred and thirty-four patients were included: median (IQR) age 69.0(60.0-76.0) year, 30.2% females, 2.76% urgent/emergent cases. Fifty-eight patients (13.4%) underwent OPCAB, 182(41.9%) on-pump CABG, 104(24.0%) aortic valve replacement, 44(10.1%) mitral valve repair or replacement and 46(10.6%) aortic valve replacement combined with CABG. AKI occurred in 213(49.1%) patients: 79(37.1%) “Risk”, 108(50.7%) “Injury” and 26(12,2%) “Failure”. Distribution of AKI by type of surgery was equal to 36.2% among OPCABG, 44.0% on-pump CABG, 49.0% aortic valve replacement, 52.3% mitral valve surgery and 82.6% aortic valve replacement combined with CABG, respectively. AKI occurrences differed significantly according to the type of surgery (p<0.0001). Lengths of stay in ICU were significantly longer (p<0.0001) in AKI group compared with non AKI group: 3(2-4) days versus 2(2-3) days. However, no difference (p = 0.65) was observed between the two (AKI and NON-AKI) groups in hospital length of stay: 13(10-18) days versus 12(10-16) days. Conclusions: The incidence of AKI is very high in this population as compared to the literature. This may be due to the fact that the three elements of the RIFLE classification for all the population studied have been used. This study emphasizes the need for clear definition of AKI in order to compare different studies adequately. AKI after cardiac surgery with cardiopulmonary bypass would be further studied in order to develop more appropriate preventive measures. [less ▲]

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See detailCardiac surgery and acute kidney injury: retrospective study
LAGNY, Marc-Gilbert ULg; BLAFFART, Francine ULg; Defraigne, Jean-Olivier ULg et al

Conference (2012, September 29)

Background: In cardiac surgery, acute kidney injury (AKI) is a severe postoperative complication and associated with increased rates of mortality, morbidity, and length of stay in intensive care units ... [more ▼]

Background: In cardiac surgery, acute kidney injury (AKI) is a severe postoperative complication and associated with increased rates of mortality, morbidity, and length of stay in intensive care units (ICU). It occurs in 5% to 30% of patients depending on the definition used [1] [2] [3]. The aim of this study is to present an overview of AKI following cardiac surgery associated or not with cardiopulmonary bypass. Methods: This retrospective study includes patients treated by cardiac surgery from April 1st, 2008 to March 31th, 2009 in a single center. We selected patients who underwent on-pump coronary artery bypass surgery (CABG), off-pump CABG (OPCAB), aortic valve replacement, mitral valve repair or replacement and aortic valve replacement combined with CABG. Patients undergoing renal replacement therapy preoperatively were excluded. The RIFLE classification (Risk, Injury, Failure, Loss and End stage kidney disease) allowed to stratify the patients into the 3 grades of AKI severity. The stratification was based on the most pejorative element observed within 7 days after surgery: increased serum creatinine level or decreased urine output, or decreased glomerular filtration rate according to criteria of Bellomo [4]. Occurrence of AKI was studied by type of cardiac surgery as its impact on the length of stay in ICU and in the hospital. Proportions were compared by the Chi-square test and median values by the Kruskal-Wallis. Results were considered significant at p < 0.05. Results: Four hundred and thirty four patients were included: median (IQR) age 69.0(60.0-76.0) year, 30.2% females, 2.76% urgent/emergent cases. Fifty-eight patients (13.4%) underwent OPCAB, 182(41.9%) on-pump CABG, 104(24.0%) aortic valve replacement, 44(10.1%) mitral valve repair or replacement and 46(10.6%) aortic valve replacement combined with CABG. AKI occurred in 213(49.1%) patients: 79(37.1%) “Risk”, 108(50.7%) “Injury” and 26(12,2%) “Failure”. Occurrence of AKI after OPCAB was 21(9.86%), CABG 80(37.6%), aortic valve replacement 51(23.9%), mitral valve surgery 23(10.8%) and aortic valve replacement combined with CABG 38(17.8%). AKI occurrences differed significantly between the different groups of surgery (p<0.0001). Lengths of stay in ICU were significantly longer (p<0.0001) in AKI group compared with non AKI group: 3(2-4) days versus 2(2-3) days. No difference (p = 0.65) was observed between the two (AKI and NON-AKI) groups in hospital length of stay: 13(10-18) days versus 12(10-16) days. Conclusions: The incidence of AKI is very high in this population as compared to the literature. This may be due to the fact that the three elements of the RIFLE classification for all the population studied have been used: serum creatinine level, urine output and glomerular filtration rate. This study emphasizes the need for clear definition of AKI in order to compare adequately different studies. AKI after cardiac surgery with cardiopulmonary bypass would be further studied in order to develop more appropriate preventive measures. [less ▲]

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See detailCardiac surgery and shed blood management: one way to improve the quality of cardiopulmonary bypass
LAGNY, Marc-Gilbert ULg; BLAFFART, Francine ULg; KOCH, Jean-Noël ULg et al

Diverse speeche and writing (2012)

Présentation réalisée au cours d'un "work-shop" organisé par la société Eurox, implantée à Bruxelles. Au cours de cette présentation, la gestion du sang épanché durant la circulation extra-corporelle a ... [more ▼]

Présentation réalisée au cours d'un "work-shop" organisé par la société Eurox, implantée à Bruxelles. Au cours de cette présentation, la gestion du sang épanché durant la circulation extra-corporelle a été développée ainsi que la présentation d'un projet d'étude clinique en cours au Centre Hospitalier Universitaire de Liège. [less ▲]

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See detailCardiac surgery in octogenarians: who, when and how?
Pierard, Luc ULg

in European heart journal (2001), 22(14), 1159-61

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See detailCardiac Surgery in Octogenarians; Peri-Operative Outcome and Long-Term Results
Kolh, Philippe ULg; Kerzmann, Arnaud ULg; Lahaye, L. et al

in European Heart Journal (2001), 22(14), 1235-43

AIMS: Because the elderly are increasingly referred for operation, we reviewed the results of cardiac surgery in patients of 80 years or older. METHODS AND RESULTS: Records of 182 consecutive ... [more ▼]

AIMS: Because the elderly are increasingly referred for operation, we reviewed the results of cardiac surgery in patients of 80 years or older. METHODS AND RESULTS: Records of 182 consecutive octogenarians who had had cardiac operations between 1992 and 1998 were reviewed. Follow-up was 100% complete. Seventy patients had coronary grafting (CABG), 70 aortic valve replacement, 30 aortic valve replacement+CABG, and 12 mitral valve repair/replacement. Rates of hospital death, stroke, and prolonged stay (>14 days) were as follows: CABG: 7 (10%), 2 (2.8%) and 41 (58%); aortic valve replacement: 6 (8.5%), 2 (2.8%) and 32 (45.7%); aortic valve replacement+CABG: 8 (26.5%), 1 (3.8%) and 14 (46.6%); mitral valve repair/replacement: 3 (25%), 1 (8.3%) and 5 (41.6%). Multivariate predictors (P<0.05) of hospital death were New York Heart Association functional class, urgent procedure, prolonged cardiopulmonary bypass time, and, after aortic valve replacement, previous percutaneous aortic valvuloplasty. Ascending aortic atheromatous disease was predictive of stroke, while pre-operative myocardial infarction was predictive of prolonged hospital stay. Actuarial 5-year survival was as follows: CABG, 65.8+/-8.8%; aortic valve replacement, 63.6+/-7.1%; aortic valve replacement+CABG, 62.4+/-6.8%; mitral valve repair/replacement, 57.1+/-5.6%; and total, 63.0+/-5.6%. Multivariate predictors of late death were pre-operative myocardial infarction, and urgent procedure. Ninety percent of long-term survivors were in New York Heart Association class I or II, and 87% believed having a heart operation after age 80 years was a good choice. CONCLUSION: Cardiac operations are successful in most octogenarians with increased hospital mortality, and longer hospital stay. Long-term survival and quality of life are good. [less ▲]

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See detailCardiac tamponade and pulmonary compression due to volvulus of oesophageal coloplasty
Canivet, Jean-Luc ULg; Piret, Sonia ULg; Hick, Gaëtane ULg et al

in Acta Anaesthesiologica Belgica (2004), 55(2), 125-127

We describe an unusual case of cardiac tamponade and pulmonary compression due to acute volvulus of colon interposition occuring late after oesophagectomy. Clinical signs were suggestive of cardiac ... [more ▼]

We describe an unusual case of cardiac tamponade and pulmonary compression due to acute volvulus of colon interposition occuring late after oesophagectomy. Clinical signs were suggestive of cardiac tamponade but there was no evidence of pericardial effusion by transthoracic echocardiography. Thoracic-CT provided the diagnostic clue in revealing the extrapericardial nature (a major dilatation of the colonic transplant) of the tamponade. This diagnosis should be considered in case of acute cardiopulmonary distress occuring early or late after oesophagectomy. [less ▲]

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See detailCardiac tamponade as the first manifestation of cardiothoracic malignancy: a study of 10 cases.
el Allaf, D.; Burette, R.; Pierard, Luc ULg et al

in European heart journal (1986), 7(3), 247-53

Ten patients with cardiac tamponade as the first presentation of cardiothoracic malignancy were evaluated from May, 1976 to June, 1982. The best treatment of this particularly rare neoplastic ... [more ▼]

Ten patients with cardiac tamponade as the first presentation of cardiothoracic malignancy were evaluated from May, 1976 to June, 1982. The best treatment of this particularly rare neoplastic manifestation is still being debated. The clinical data of our ten patients were compared to those previously described in the literature. They were first treated by pericardiocentesis and creation of a pericardial window, without recurrence of significant pericardial effusion. Our data suggest that the addition of radiotherapy to the other therapeutic methods (surgery and chemotherapy) may improve survival. [less ▲]

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See detailCardiac Transplantation Beyond 55 Years of Age
Defraigne, Jean-Olivier ULg; Demoulin, J. C.; Beaujean, M. A. et al

in Transplant International (1990), 3(2), 59-61

Between January 1985 and December 1988, 20 patients over the age of 55 years (extremes 56-63 years; 15 men and 5 women) underwent cardiac transplantation. The cause of cardiopathy was ischemic in 70% of ... [more ▼]

Between January 1985 and December 1988, 20 patients over the age of 55 years (extremes 56-63 years; 15 men and 5 women) underwent cardiac transplantation. The cause of cardiopathy was ischemic in 70% of the cases. The immunosuppressive regimen consisted of cyclosporin A, corticoids, and azathioprine. Rejection episodes were monitored by endomyocardial biopsies and treated by pulses of corticoids or monoclonal antibodies (OKT3). The operative mortality was 10% (n = 2). The 1-year survival rate was 70%. The 1-year incidence of infection and/or rejection episodes was 1 and 1.53 episodes/patient, respectively. One patient was successfully retransplanted after 9 months because of intractable rejection. Age beyond 55 years is no longer a contraindication to cardiac transplantation. This change in recipient selection policy should lead to parallel changes in donor selection criteria. [less ▲]

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See detailCardiac Transplantation in Patients Older Than 55 Years
Defraigne, Jean-Olivier ULg; Demoulin, J.C.; VAN DAMME, Hendrik ULg et al

in Acta Chirurgica Belgica (1991), 91(1), 38-42

From 1985 to 1990, 27 patients older than 55 years (extremes 55-65 years; 21 men and 6 women) received a cardiac transplant. The cause of cardiopathy was ischemic in 70%. Postoperative immunosuppressive ... [more ▼]

From 1985 to 1990, 27 patients older than 55 years (extremes 55-65 years; 21 men and 6 women) received a cardiac transplant. The cause of cardiopathy was ischemic in 70%. Postoperative immunosuppressive therapy consisted of Cyclosporin A, steroids, azathioprine and antilymphocytic serum. Rejection episodes were monitored by endomyocardial biopsies and treated by pulses of steroids or monoclonal antibodies (OKT3). The operative mortality is 7.4% (n = 2). The one and two year survivals are 71% and 62% respectively. The incidence of infection and/or rejection were 0.71 +/- 0.4 and 1.4 +/- 0.7 episodes/patient year. Age beyond 55 years does not contraindicate heart transplantation. This change in recipient selection policy should lead to parallel changes in donor selection criteria. [less ▲]

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See detailCardiac troponin and natriuretic peptide in canine emergencies with a systemic inflammatory response syndrome
Gommeren, Kris ULg; Desmas, I.; Garcia, Alexandra ULg et al

in Proceedings of 21st ECVIM Meeting (2011, September 06)

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See detailCardiac Troponin I and Troponin T: Recent Players in the Field of Myocardial Markers
Chapelle, Jean-Paul ULg

in Clinical Chemistry & Laboratory Medicine (1999), 37(1), 11-20

The troponin (Tn) complex consists of three subunits referred to as TnT, TnI and TnC. Myocardium contains TnT and TnI isoforms which are not present in skeletal muscles and which can be separated from the ... [more ▼]

The troponin (Tn) complex consists of three subunits referred to as TnT, TnI and TnC. Myocardium contains TnT and TnI isoforms which are not present in skeletal muscles and which can be separated from the muscular isoforms by immunological techniques. Using commercially available immunoassays, clinical laboratories are able to determine cardiac TnT and TnI (cTnT and cTnI) quickly and reliably as classical cardiac markers. After acute myocardial infarction, cTnT and cTnI concentrations start to increase in serum in a rather similar way than CK-MB, but return to normal after longer periods of time (approximately one week). Because of their excellent cardiac specificity, Tn subunits appear ideally suited for the differential diagnosis of myocardial and muscular damage, for example in noncardiac surgery patients, in patients with muscular trauma or with chronic muscular diseases, or after intense physical exercise. cTnT and cTnI may also be used for detecting evidence of minor myocardial damage: therefore they have found new clinical applications, in particular risk stratification in patients with unstable angina. In spite of the possible reexpression of cTnT in human skeletal muscles, and of the lack of standardization of cTnI assays, Tn subunits are not far to meet the criteria of ideal markers for acute myocardial injury. Only an insufficient sensitivity in the first hours following the acute coronary syndroms requiries to maintain an early myocardial marker in the cardiac panel for routine laboratory testing. [less ▲]

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See detailCardiac troponins and natriuretic peptides in runners: useful for cardiac risk screening ?
LE GOFF, Caroline ULg; Kaux, Jean-François ULg; Fillet, Marianne ULg et al

in British Journal of Sports Medicine (2014, April), 48(7), 173

Background Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. Objective Our aim was to compare ... [more ▼]

Background Cardiac troponins (cTn) are considered as the best biomarkers for detection of myocardial cell injury and NT-proBNP as the best for the cardiac insufficiency. Objective Our aim was to compare cTnT and NT-proBNP levels before and after the stress tests, in sportive subjects. Design Prospective, cohort study. Setting Amateur marathon runners and ultrarunners. Patients 28 subjects (26 men, 42.5±11 yrs) were enrolled. Interventions Subjects ran the Maasmarathon (42.195 kilometers) and 33 subjects (33 men, 45.7±9.3 yrs) ran the Ultratour of Liège (Belgium; 67 km). All subjects gave their informed consent. We took blood sample before (T0), just after (T1) and 3 hours after the race (T3). Main outcome measurements cTnT concentrations were measured by high sensitive methods (hsTnT, Roche Diagnostics) on heparin plasma. The NT-proBNP was also determined with the kit Roche on heparin plasma. All statistical analyses were performed using Medcalc version 8.1 for Windows. P-value <.01 was regarded as statistically significant. Results A significant difference between hsTnT concentrations at T0 and T1 (P<.001), and between T0 and T3 (P<.001) for NT-proBNP have been observed, but not between T1 and T3. This observation appeared only after a strenuous exercise. However, up to now this type of exercise is not reproducible easily in a laboratory. Moreover, nobody knows if these observations would have cardiac consequences at long terms. Conclusion Measurement of cardiac troponins by high sensitive methods allows detecting significant release of biomarkers from the heart during exercise. The value of NT-proBNP are also significant but less than TnThs. We think that the TnThs could be an interesting tool in the future to help sport medicine to detect risk of developing a cardiac problem in the future or a sudden death. [less ▲]

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