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9 results on '"MESH: Aortic Valve Insufficiency"'

1. Mitral Valve Infective Endocarditis after Trans-Catheter Aortic Valve Implantation

Author

Vassili Panagides, David del Val, Mohamed Abdel-Wahab, Norman Mangner, Eric Durand, Nikolaj Ihlemann, Marina Urena, Costanza Pellegrini, Francesco Giannini, Piotr Scislo, Zenon Huczek, Martin Landt, Vincent Auffret, Jan Malte Sinning, Asim N. Cheema, Luis Nombela-Franco, Chekrallah Chamandi, Francisco Campelo-Parada, Erika Munoz-Garcia, Howard C Herrmann, Luca Testa, Won-Keun Kim, Juan Carlos Castillo, Alberto Alperi, Didier Tchetche, Antonio L. Bartorelli, Samir Kapadia, Stefan Stortecky, Ignacio Amat-Santos, Harindra C. Wijeysundera, John Lisko, Enrique Gutiérrez-Ibanes, Vicenç Serra, Luisa Salido, Abdullah Alkhodair, Ugolino Livi, Tarun Chakravarty, Stamatios Lerakis, Victoria Vilalta, Ander Regueiro, Rafael Romaguera, Utz Kappert, Marco Barbanti, Jean-Bernard Masson, Frédéric Maes, Claudia Fiorina, Antonio Miceli, Susheel Kodali, Henrique B. Ribeiro, Jose Armando Mangione, Fabio Sandoli de Brito, Guglielmo Mario Actis Dato, Francesco Rosato, Maria-Cristina Ferreira, Valter Correia de Lima, Alexandre Siciliano Colafranceschi, Alexandre Abizaid, Marcos Antonio Marino, Vinicius Esteves, Julio Andrea, Roger R. Godinho, Fernando Alfonso, Helene Eltchaninoff, Lars Søndergaard, Dominique Himbert, Oliver Husser, Azeem Latib, Hervé Le Breton, Clement Servoz, Isaac Pascual, Saif Siddiqui, Paolo Olivares, Rosana Hernandez-Antolin, John G. Webb, Sandro Sponga, Raj Makkar, Annapoorna S. Kini, Marouane Boukhris, Philippe Gervais, Axel Linke, Lisa Crusius, David Holzhey, Josep Rodés-Cabau, Université Laval [Québec] (ULaval), Universität Leipzig [Leipzig], Technische Universität Dresden = Dresden University of Technology (TU Dresden), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Rigshospitalet [Copenhagen], Copenhagen University Hospital, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Deutsches Herzzentrum München (DHM), Ospedale San Raffaele, Medical University of Warsaw - Poland, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Rangueil, CHU Toulouse [Toulouse], UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Département cardiovasculaire, Universität Leipzig, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
MESH: Endocarditis, Catheters, MESH: Humans, Endocarditis, MESH: Heart Valve Prosthesis, Aortic Valve Insufficiency, Aortic Valve Stenosis, MESH: Aortic Valve Insufficiency, MESH: Mitral Valve, Transcatheter Aortic Valve Replacement, Treatment Outcome, Risk Factors, MESH: Risk Factors, Aortic Valve, Heart Valve Prosthesis, Humans, Mitral Valve, [SDV.IB]Life Sciences [q-bio]/Bioengineering, MESH: Transcatheter Aortic Valve Replacement, MESH: Catheters, Cardiology and Cardiovascular Medicine, 610 Medicine & health, MESH: Aortic Valve, MESH: Aortic Valve Stenosis, MESH: Treatment Outcome
Abstract

Scarce data exist on mitral valve (MV) infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). This multicenter study included a total of 579 patients with a diagnosis of definite IE after TAVI from the IE after TAVI International Registry and aimed to evaluate the incidence, characteristics, management, and outcomes of MV-IE after TAVI. A total of 86 patients (14.9%) had MV-IE. These patients were compared with 284 patients (49.1%) with involvement of the transcatheter heart valve (THV) only. Two factors were found to be associated with MV-IE: the use of self-expanding valves (adjusted odds ratio 2.49, 95% confidence interval [CI] 1.23 to 5.07, p = 0.012), and the presence of an aortic regurgitation >= 2 at discharge (adjusted odds ratio 3.33; 95% CI 1.43 to 7.73, p < 0.01). There were no differences in IE timing and causative microorganisms between groups, but surgical management was significantly lower in patients with MV-IE (6.0%, vs 21.6% in patients with THV-IE, p = 0.001). All-cause mortality rates at 2-year follow-up were high and similar between patients with MV-IE (51.4%, 95% CI 39.8 to 64.1) and patients with THV-IE (51.5%, 95% CI 45.4 to 58.0) (log-rank p = 0.295). The factors independently associated with increased mortality risk in patients with MV-IE were the occurrence of heart failure (adjusted p < 0.001) and septic shock (adjusted p < 0.01) during the index hospitalization. One of 6 IE episodes after TAVI is localized on the MV. The implantation of a self-expanding THV and the presence of an aortic regurgitation >= 2 at discharge were associated with MV-IE. Patients with MV-IE were rarely operated on and had a poor prognosis at 2-year follow-up. (C) 2022 Elsevier Inc. All rights reserved.

Published
2022
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2. First-phase left ventricular ejection fraction: a small step for myocardial assessment, a big leap for aortic stenosis

Author

Julien Magne, Victor Aboyans, Clinical sciences, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie [CHU Limoges], CHU Limoges, Plate forme de bioinformatique et biostatistique (CEBIMER), and Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST)

Subjects
medicine.medical_specialty, Aortic Valve Stenosis/diagnostic imaging, Aortic Valve Insufficiency, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Phase (matter), Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, AcademicSubjects/MED00200, 030212 general & internal medicine, ejection fraction, ComputingMilieux_MISCELLANEOUS, MESH: Aortic Valve Stenosis, MESH: Humans, Ejection fraction, business.industry, aortic stenosis, MESH: Aortic Valve Insufficiency, General Medicine, Aortic Valve Stenosis, medicine.disease, myocardial function, Stenosis, arterial stiffness, Cardiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Original Article, business, Cardiology and Cardiovascular Medicine
Abstract

Aims First-phase ejection fraction (EF1), the EF at the time to peak aortic jet velocity, has been proposed as a novel marker of peak systolic function in aortic stenosis (AS). This study aimed to explore the association of myocardial contractility and arterial load with EF1 in AS patients. Methods and results Data from a prospective, cross-sectional study of 114 patients with mild, moderate, and severe AS with preserved left ventricular EF (>50%) were analysed. EF1 was measured as the volume change from end-diastole to the time that corresponded to peak aortic jet velocity. Myocardial contractility was assessed by strain rate measured by speckle tracking echocardiography. Arterial stiffness was assessed by central pulse pressure/stroke volume index ratio (PP/SVi). The total study population included 48% women, median age was 73 years, and mean peak aortic jet velocity was 3.47 m/s. In univariable linear regression analyses, lower EF1 was associated with higher age, higher peak aortic jet velocity, lower global EF, lower global longitudinal strain, lower strain rate, and higher PP/SVi. There was no significant association between EF1 and heart rate or sex. In multivariable linear regression analysis, EF1 was associated with lower strain rate and higher PP/SVi, independent of AS severity. Replacing PP/SVi by valvular impedance did not change the results. Conclusion In patients with AS, reduced myocardial contractility and increased arterial load were associated with lower EF1 independent of the severity of valve stenosis.

Published
2020
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3. Value of CMR in quantification of paravalvular aortic regurgitation after TAVI

Author

Alexis Theron, Roch Giorgi, Alexis Jacquier, Marc Lambert, Erwan Salaun, Gilbert Habib, Thomas Cuisset, Dominique Grisoli, Jean-Louis Bonnet, Nicolas Jaussaud, Sandrine Hubert, Frederic Collart, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Marseille (APHM), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre de résonance magnétique biologique et médicale ( CRMBM ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Centre National de la Recherche Scientifique ( CNRS ), Assistance Publique - Hôpitaux de Marseille ( APHM ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Nutrition, obésité et risque thrombotique ( NORT ), Aix Marseille Université ( AMU ) -Institut National de la Recherche Agronomique ( INRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Aix Marseille Université (AMU)-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Radiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Service de chirurgie cardiaque, CUISSET, Thomas, and Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)

Subjects
MESH : Prospective Studies, Severity of Illness Index, MESH : Aortic Valve Insufficiency, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Prospective Studies, Prospective cohort study, MESH: Multidetector Computed Tomography, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, General Medicine, MESH: Aortic Valve Insufficiency, MESH: Magnetic Resonance Imaging, Cine, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Magnetic Resonance Imaging, Cine, MESH : Postoperative Care, MESH: Predictive Value of Tests, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Reproducibility of Results, Echocardiography, Predictive value of tests, Cardiology, cardiovascular system, MESH : Severity of Illness Index, MESH : Multidetector Computed Tomography, MESH : Sensitivity and Specificity, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Transcatheter aortic, Aortic Valve Insufficiency, Magnetic Resonance Imaging, Cine, Regurgitation (circulation), MESH : Transcatheter Aortic Valve Replacement, MESH: Postoperative Care, Sensitivity and Specificity, Transcatheter Aortic Valve Replacement, cardiovascular magnetic resonance, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, medicine.artery, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, MESH: Severity of Illness Index, Severity of illness, Ascending aorta, Multidetector Computed Tomography, medicine, Humans, Radiology, Nuclear Medicine and imaging, MESH : Predictive Value of Tests, transcatheter aortic valve implantation, Postoperative Care, MESH: Humans, business.industry, MESH : Echocardiography, MESH : Reproducibility of Results, MESH : Humans, Reproducibility of Results, aortic stenosis, aortic regurgitation, MESH: Prospective Studies, MESH: Sensitivity and Specificity, Regurgitant fraction, MESH: Echocardiography, MESH: Transcatheter Aortic Valve Replacement, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Edwards sapien
Abstract

To assess the value of cardiac magnetic resonance (CMR) using phase-contrast velocity mapping for paravalvular aortic regurgitation (PAR) quantification., All patients undergoing transcatheter aortic valve implantation (TAVI) in our centre between November 2012 and August 2013, without CMR-contraindication were included. PAR severity was assessed 5 days after TAVI using: transthoracic echocardiography (TTE) and CMR [regurgitant volume (RV), regurgitant fraction (RF)]. Aortic regurgitation (AR) index was obtained during TAVI. Thirty of 51 patients who underwent TAVI were included (COREVALVE, n = 10; or EDWARDS SAPIEN XT, n = 20). At TTE, PAR was mild in 22, moderate in 3, and severe in 5 patients. Reliable phase-contrast images were acquired at the sino-tubular junction for SAPIEN and at the tubular portion of the ascending aorta for COREVALVE. The reproducibility of CMR was high (coefficient of correlation = 0.99 for intra- and inter-operator variability). At CMR, RV, and RF were significantly (P < 0.0005) correlated with AR severity at TTE, with mean RF values at 9.2 ± 7.6% in mild, 20.3 ± 4.2% in moderate, and 46.8 ± 10.8% in severe PAR. A cut-off value of RF < 14% at CMR accurately discriminated mild from moderate/severe (sensitivity: 100%, specificity: 82%). The mean AR index was 29.4 ± 6 for mild and 13.8 ± 5 for moderate/severe PAR. Three patients had a RF > 14% and a low AR index, CMR is a reproducible, accurate, and reliable method to assess PAR severity. CMR may allow correcting an underestimation at TTE when AR index is doubtful.

Published
2017
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4. Ability of the Third-Generation FloTrac/Vigileo Software to Track Changes in Cardiac Output in Cardiac Surgery Patients: A Polar Plot Approach

Author

Olivier Bastien, Roland Henaine, Catherine Koffel, Jean-Jacques Lehot, Lester A. H. Critchley, Olivier Desebbe, Marek Haftek, Hans Garcia, Pascal Rosamel, Jean-François Obadia, Geoffray Keller, Service d'anesthésiologie et de soins intensifs, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Fonctions Normales et Pathologiques de la Barrière Cutanée [Hôpital Edouard Herriot - HCL], Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de chirurgie cardiaque, Hospices Civils de Lyon (HCL)-Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Anaesthesia and Intensive Care, and The Chinese University of Hong Kong [Hong Kong]-Prince of Wales Hospital

Subjects
Adult, Male, medicine.medical_specialty, Cardiac output, MESH: Heart Valve Prosthesis, medicine.medical_treatment, Thermodilution, MESH: Prostheses and Implants, 030204 cardiovascular system & hematology, law.invention, MESH: Marfan Syndrome, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, Monitoring, Intraoperative, Internal medicine, medicine, Humans, Prospective Studies, Polar plot, Cardiac Output, Cardiac Surgical Procedures, Aged, Hetastarch, Aged, 80 and over, MESH: Humans, business.industry, Hemodynamics, Pulmonary artery catheter, Repeated measures design, MESH: Adult, MESH: Aortic Valve Insufficiency, Middle Aged, Intensive care unit, MESH: Male, MESH: Aortic Aneurysm, Cardiac surgery, Anesthesiology and Pain Medicine, ROC Curve, Cardiothoracic surgery, Data Interpretation, Statistical, Anesthesia, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Software, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; OBJECTIVE: To evaluate the ability of the third-generation (3.01) of FloTrac/Vigileo monitor (Edwards Lifesciences, Irvine, CA) to follow variations in cardiac output (∆CO) using the new polar plot approach. DESIGN: Prospective interventional study. SETTING: Single hospital university study. PARTICIPANTS: Twenty-five patients referred for cardiac surgery. INTERVENTIONS: CO was measured simultaneously by 3 to 5 bolus thermodilution (COtd measurements), using a pulmonary artery catheter and by arterial pulse contour analysis, using the FloTrac/Vigileo (COvi). Data were collected at eight time points: before incision, after sternotomy, before and after protamine sulfate infusion, at the start of sternal closure, at the end of surgery, on arrival to intensive care unit, and after a standardized volume expansion with 500 mL of hetastarch 6%. MEASUREMENTS AND MAIN RESULTS: One-hundred thirty-five pairs of CO data were collected; the mean bias of all CO measurements corrected for repeated measures was 0.2 L/min with limits of agreements of -3.3 L/min and +2.9 L/min. The percentage error was 66.5%. The polar plot analysis included 71 significant ∆CO and showed a mean polar angle of -3.4 degrees with 95% polar percentage error equivalent limits of -61 to 55; 69% of analysed data points fell within the 30-degree limits and provided a correct polar concordance rate. CONCLUSIONS: Third-generation FloTrac/Vigileo software still lacks the accuracy to reliably detect changes in cardiac output (∆CO) in cardiac surgery. Improvements to FloTrac/Vigileo CO algorithm and software still are needed in this particular setting.

Published
2013
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5. Cardiac multislice spiral computed tomography as an alternative to coronary angiography in the preoperative assessment of coronary artery disease before aortic valve surgery: A management outcome study

Author

Yves Etienne, Ulric Vinsonneau, Martine Gilard, Virginie Jan, Grégoire Le Gal, Jacques Mansourati, Eric Bezon, Pierre-Yves Pennec, Jacques Boschat, Jean-Christophe Cornily, Jean-Jacques Blanc, Service d'Hémodynamique, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Cardiologie (BREST - Cardio), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, Aortic valve, Valvulopathie aortique, 030204 cardiovascular system & hematology, Coronary Angiography, Coronary artery disease, 0302 clinical medicine, MESH: Child, Image Processing, Computer-Assisted, Prospective Studies, MESH: Coronary Artery Disease, 030212 general & internal medicine, Myocardial infarction, Child, MESH: Aortic Valve Stenosis, MESH: Aged, MESH: Middle Aged, MESH: Aortic Valve Insufficiency, General Medicine, Middle Aged, MESH: Image Processing, Computer-Assisted, Spiral computed tomography, 3. Good health, medicine.anatomical_structure, MESH: Young Adult, Coronaropathie, Cardiology, Female, Radiology, Cardiac multislice spiral computed tomography, Cardiology and Cardiovascular Medicine, Agatston score, Adult, MESH: Preoperative Care, medicine.medical_specialty, Adolescent, Scanner cardiaque, Aortic valve disease, Aortic Valve Insufficiency, Young Adult, 03 medical and health sciences, Internal medicine, Preoperative Care, medicine, Humans, Multislice, Aged, MESH: Adolescent, MESH: Humans, business.industry, MESH: Adult, Aortic Valve Stenosis, Perioperative, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: Coronary Angiography, Confidence interval, MESH: Tomography, Spiral Computed, business, Tomography, Spiral Computed, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; BACKGROUND: Conventional coronary angiography (CA) is still recommended before valvular surgery. Preliminary studies suggest that multislice spiral computed tomography coronary angiography (MSCT-CA) can be used to rule out coronary artery disease (CAD). AIM: To assess prospectively the safety of ruling out CAD before surgery solely on the basis of normal MSCT-CA in patients with severe aortic valve disease. METHODS: We included all consecutive patients scheduled for aortic valve surgery. We first estimated the calcium score (Agatston score equivalent [ASE]). Patients underwent injected MSCT if the ASE was or =1000. Of 136 patients who underwent MSCT-CA, 106 (78%) had a normal MSCT-CA and underwent aortic valve surgery without prior CA; CA was performed in 30 patients because of abnormal (n=18) or bad quality (n=12) MSCT-CA. One patient of the 106 (0.94%, 95% confidence interval 0.17-5.15) had a perioperative myocardial infarction. CONCLUSIONS: When the ASE is

Published
2010
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6. [About the settlement of litigations concerning the harm caused by benfluorex (Mediator®)]

Author

Philippe, Nicot, Irène, Frachon, Catherine, Hill, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Institut Gustave Roussy (IGR)

Subjects
MESH: Mitral Valve Insufficiency, MESH: Expert Testimony, Drug Industry, MESH: Probability, [SDV]Life Sciences [q-bio], Aortic Valve Insufficiency, Eligibility Determination, MESH: Causality, MESH: Fenfluramine, Diagnosis, Differential, MESH: Cross-Sectional Studies, MESH: Eligibility Determination, Risk Factors, MESH: Appetite Depressants, MESH: Risk Factors, MESH: Diagnosis, Differential, Appetite Depressants, Fenfluramine, Drugs, Generic, Humans, Expert Testimony, MESH: Drugs, Generic, Probability, MESH: Humans, MESH: Compensation and Redress, Mitral Valve Insufficiency, MESH: Aortic Valve Insufficiency, Causality, MESH: France, Cross-Sectional Studies, MESH: Drug Industry, Compensation and Redress, France
Abstract

International audience; Since September 1st 2011, the National Bureau for Compensation of Medical Accidents represents a unique portal for out-of-court settlement of litigations concerning the harm caused by benfluorex. In December 2012, its official record is as follows: 7627 patients files have been received, 1378 have been studied, 797 led to a recommendation, and compensation by the drug company Servier has been recommended for 46 cases. The large number of rejections raises a problem which needs to be examined in the light of the available evidence on benfluorex associated heart valve disease. This evidence concerns both the morphological characteristics of the disease and the epidemiology of its association with benfluorex. More than 90% of emergent double valve disease (aortic and mitral regurgitation), of emergent aortic valve regurgitation, and of prevalent grade 2 aortic valve regurgitation are attributable to benfluorex. The proportion of benfluorex-attributable disease is larger than 75% for prevalent double valve disease, or for prevalent aortic valve regurgitation of any grade. This probabilistic information, derived from the available epidemiological studies, needs to be considered as part of the evidence to establish or refute a causal link between benfluorex and valvular disease for a given patient, particularly if the patient has a low grade valvular insufficiency or no morphological anomaly.

Published
2013
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7. Increased risk of left heart valve regurgitation associated with benfluorex use in patients with diabetes mellitus: a multicenter study

Author

Sylvestre Maréchaux, Dan Rusinaru, Pierre-Vladimir Ennezat, Yannick Jobic, Jacques Boulanger, Christophe Tribouilloy, Elise Arnalsteen, Patricia Reant, Stéphane Ederhy, Thierry Garban, Erwan Donal, Antoine Jeu, Pôle cardiovasculaire et thoracique, CHU Amiens-Picardie, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupement Hospitalier de l'Institut Catholique de Lille, Faculté Libre de Médecine de Lille (FLM), Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-Institut Catholique de Lille (ICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL)-UC Lille, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service de Médecine Interne et Cardiologie, Centre Hospitalier de Beauvais, Service de Cardiologie, Centre Hospitalier de Compiègne, Service de cardiologie, Hôpital Cardiologique-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Universitaire G et R Laennec, Département de Cardiologie (CHRU - Cardio), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Faculté Libre de Médecine-UC Lille, Service de Cardiologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
MESH: Mitral Valve Insufficiency, Male, 030204 cardiovascular system & hematology, drugs, MESH: Fenfluramine, Coronary artery disease, chemistry.chemical_compound, MESH: Safety-Based Drug Withdrawals, 0302 clinical medicine, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, MESH: Risk Factors, MESH: Appetite Depressants, Risk Factors, Single-Blind Method, 030212 general & internal medicine, Prospective Studies, MESH: Aged, 2. Zero hunger, Benfluorex, MESH: Middle Aged, Mitral Valve Insufficiency, regurgitation, MESH: Aortic Valve Insufficiency, MESH: Follow-Up Studies, Middle Aged, 3. Good health, Europe, medicine.anatomical_structure, Echocardiography, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Cardiology and Cardiovascular Medicine, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, medicine.medical_specialty, MESH: Diabetes Mellitus, Aortic Valve Insufficiency, valves, 03 medical and health sciences, Safety-Based Drug Withdrawals, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Internal medicine, Diabetes mellitus, Appetite Depressants, Fenfluramine, medicine, Diabetes Mellitus, Product Surveillance, Postmarketing, Humans, MESH: Product Surveillance, Postmarketing, Heart valve, Aged, MESH: Humans, business.industry, MESH: Single-Blind Method, medicine.disease, MESH: Male, MESH: Prospective Studies, chemistry, Propensity score matching, MESH: Echocardiography, Observational study, MESH: Europe, business, MESH: Female, Body mass index, Dyslipidemia, Follow-Up Studies
Abstract

Background— Benfluorex was withdrawn from European markets in June 2010 after reports of an association with heart valve lesions. The link between benfluorex and valve regurgitations was based on small observational studies and retrospective estimations. We therefore designed an echocardiography-based multicenter study to compare the frequency of left heart valve regurgitations in diabetic patients exposed to benfluorex for at least 3 months and in diabetic control subjects never exposed to the drug. Methods and Results— This reader-blinded, controlled study conducted in 10 centers in France between February 2010 and September 2011 prospectively included 376 diabetic subjects previously exposed to benfluorex who were referred by primary care physicians for echocardiography and 376 diabetic control subjects. Through the use of propensity scores, 293 patients and 293 control subjects were matched for age, sex, body mass index, smoking, dyslipidemia, hypertension, and coronary artery disease. The main outcome measure was the frequency of mild or greater left heart valve regurgitations. In the matched sample, the frequency and relative risk (odds ratio) of mild or greater left heart valve regurgitations were significantly increased in benfluorex patients compared with control subjects: 31.0% versus 12.9% (odds ratio, 3.55; 95% confidence interval, 2.03–6.21) for aortic and/or mitral regurgitation, 19.8% versus 4.7% (odds ratio, 5.29; 95% confidence interval, 2.46–11.4) for aortic regurgitation, and 19.4% versus 9.6% (odds ratio, 2.38; 95% confidence interval, 1.27–4.45) for mitral regurgitation. Conclusions— Our results indicate that the use of benfluorex is associated with a significant increase in the frequency of left heart valve regurgitations in diabetic patients. The natural history of benfluorex-induced valve abnormalities needs further research.

Published
2012
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8. [Letter on the article: 'benfluorex and valvular heart disease']

Author

Jobic, Yannick, Etienne, Yves, Tribouilloy, Christophe, Bruneval, Patrick, Frachon, Irène, Département de Cardiologie (CHRU - Cardio), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Picardie Jules Verne (UPJV), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), and Département de Médecine Interne et Pneumologie [Brest] (DMIP - Brest)

Subjects
MESH: Mitral Valve Insufficiency, MESH: Humans, MESH: Appetite Depressants, [SDV]Life Sciences [q-bio], MESH: Norfenfluramine, MESH: Aortic Valve Insufficiency, MESH: Female, ComputingMilieux_MISCELLANEOUS, MESH: Male, MESH: Fenfluramine
Abstract

International audience

Published
2012
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9. [Evaluation after 20 years of a case of Takayasu's disease that presented with aortic regurgitation]

Author

Pierre, B, Machet, M, Marchand, M, Alison, D, Casset-Senon, D, Fauchier, Laurent, Charniot, J, Babuty, D, Cosnay, P, Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), and Dorogoichenko, Aleksandra

Subjects
MESH: Humans, MESH: Middle Aged, MESH: Heart Valve Prosthesis, MESH: Takayasu Arteritis, Aortic Valve Insufficiency, MESH: Aortic Valve Insufficiency, Middle Aged, Takayasu Arteritis, [SHS]Humanities and Social Sciences, Aortic Valve, Heart Valve Prosthesis, cardiovascular system, Humans, Female, [SHS] Humanities and Social Sciences, cardiovascular diseases, MESH: Aortic Valve, MESH: Female
Abstract

International audience; Takayasu's disease is a segmental multifocal affection of medium and large arteries. The diagnosis is based on the association of stenotic and aneurismal lesions of the aorta and its branches secondary to an inflammatory infiltration of the media and adventitia. Cases of aortic regurgitation associated with aneurismal dilatation of the ascending aorta as the presenting features of Takayasu's disease, as in this case, are rare. Histological examination of the aortic wall may help establish the diagnosis by showing signs of aortitis. The other usual arterial lesions are sometimes missing at the initial phase of the disease. A late histological diagnosis may be difficult as the inflammatory lesions tend to be progressively replaced by fibrotic lesions or a banal atheroma.

Published
2005

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