24 results on '"Christine, Henri"'
Search Results
2. Right ventricular function and its coupling to pulmonary circulation predicts exercise tolerance in systolic heart failure
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Valéry Legris, Bernard Thibault, Jocelyn Dupuis, Michel White, Anita W. Asgar, Annik Fortier, Céline Pitre, Nadia Bouabdallaoui, Christine Henri, Eileen O'Meara, Anique Ducharme, and EARTH Investigators
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Male ,Pulmonary Circulation ,Stroke Volume ,Original Articles ,RV to pulmonary arterial coupling ,Middle Aged ,Heart failure with reduced ejection fraction ,Right ventricular function ,Ventricular Function, Left ,Exercise tolerance ,Echocardiography ,RC666-701 ,Ventricular Function, Right ,Humans ,Diseases of the circulatory (Cardiovascular) system ,Original Article ,Female ,Cardiology and Cardiovascular Medicine ,Aged ,Heart Failure, Systolic - Abstract
Aims Right ventricular (RV) dysfunction, pulmonary hypertension, and exercise intolerance have prognostic values, but their interrelation is not fully understood. We investigated how RV function alone and its coupling with pulmonary circulation (RV‐PA) predict cardio‐respiratory fitness in patients with heart failure and reduced ejection fraction (HFrEF). Methods and results The Evaluation of Resynchronization Therapy for Heart Failure (EARTH) study included 205 HFrEF patients with narrow (n = 85) and prolonged (n = 120) QRS duration undergoing implantable cardioverter defibrillator implantation. All patients underwent a comprehensive evaluation with exercise tolerance tests and echocardiography. We investigated the correlations at baseline between RV parameters {size, function [tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (RV‐FAC), and RV myocardial performance index (RV‐MPI)], pulmonary artery systolic pressure (PASP), and tricuspid regurgitation}; left ventricular ejection fraction (LVEF), left ventricular end‐diastolic volume index (LVEDVi), and left atrial volume index (LAVi); and cardiopulmonary exercise test (CPET) [peak VO2, minute ventilation/carbon dioxide production (VE/VCO2), 6 min walk distance (6MWD), and submaximal exercise duration (SED)]. We also studied the relationship between RV‐PA coupling (TAPSE/PASP ratio) and echocardiographic parameters in patients with both data available. Univariate and multivariate linear regression models were used. Patients enrolled in EARTH (overall population) were mostly male (73.2%), mean age 61.0 ± 9.8 years, New York Heart Association class II–III (87.8%), mean LVEF of 26.6 ± 7.7%, and reduced peak VO2 (15.1 ± 4.6 mL/kg/min). Of these, 100 had both TAPSE and PASP available (TAPSE/PASP population): they exhibited higher BNP, wider QRS duration, larger LVEDVi, with more having tricuspid regurgitation compared with the 105 patients for whom these values were not available (all P
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- 2022
3. Women and men with coronary heart disease respond similarly to different aerobic exercise training modalities: a pooled analysis of prospective randomized trials
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Annik Fortier, Anil Nigam, Christine Henri, Julie Lalongé, Mathieu Gayda, Maxime Boidin, Martin Juneau, and Lukas Daniel Trachsel
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Male ,medicine.medical_specialty ,Physiology ,Endocrinology, Diabetes and Metabolism ,Diastole ,Blood Pressure ,Coronary Disease ,High-Intensity Interval Training ,030204 cardiovascular system & hematology ,Body Mass Index ,law.invention ,03 medical and health sciences ,Oxygen Consumption ,0302 clinical medicine ,Randomized controlled trial ,law ,Physiology (medical) ,Internal medicine ,Tidal Volume ,medicine ,Humans ,Aerobic exercise ,030212 general & internal medicine ,Randomized Controlled Trials as Topic ,Nutrition and Dietetics ,Ejection fraction ,business.industry ,Resistance Training ,Stroke Volume ,General Medicine ,Middle Aged ,Adaptation, Physiological ,Coronary heart disease ,Exercise Therapy ,Echocardiography ,Cohort ,Exercise Test ,Lean body mass ,Breathing ,Cardiology ,Female ,Pulmonary Ventilation ,business ,Physical Conditioning, Human - Abstract
We aimed to compare cardiopulmonary exercise test (CPET) parameters, cardiac adaptations, and proportion of responders after different aerobic training programs amongst women and men with coronary heart disease (CHD). Patients with CHD were evaluated with a CPET and echocardiography before and after 3 months of aerobic exercise training. Peak oxygen uptake exercise training response was assessed according to the median peak oxygen uptake change for post- versus pretraining in the whole cohort (stratification non/low responders (NLR) vs. high-responders) and normalized for lean body mass (LBM). Eighty-three CHD patients were included (19 women, 64 men; 27 patients with interval, 19 with continuous, and 37 with combination exercises). Peak oxygen uptake, peak workload normalized for LBM, pulmonary variables (i.e., ventilation and oxygen uptake efficiency slope), and O2 pulse were significantly lower in women versus men. These parameters improved similarly with training in both sexes (p < 0.05). There were no differences in the proportion of NLR among women and men with CHD (7/19 (37%) vs. 35/64 (55%), p = 0.1719). Left ventricular ejection fraction and mean peak early diastolic mitral annulus velocity improved similarly with training in both sexes (p < 0.05). Women and men with CHD have a similar exercise training response regarding key CPET and echocardiographic parameters. The proportion of responders is similar. ClinicalTrials.gov: NCT03414996, NCT02048696, NCT03443193. Novelty: Cardiopulmonary adaptations to exercise training are similar among CHD men and women. Proportion of peak oxygen uptake for non/low/high responders is similar in CHD men and women. Left ventricular systolic and diastolic function improved similarly after exercise training in CHD men and women.
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- 2021
4. Age and biomarkers in heart failure: challenging the current model to select patients for clinical trials
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Lisa Mielniczuk, Christine Henri, and Eileen O'Meara
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Heart Failure ,medicine.medical_specialty ,business.industry ,MEDLINE ,Prognosis ,medicine.disease ,Clinical trial ,Troponin T ,Heart failure ,Natriuretic Peptide, Brain ,medicine ,Humans ,Current (fluid) ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Biomarkers - Published
- 2020
5. Impact of aerobic training periodisation on global and regional right ventricular strain in coronary heart disease
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Julie Lalongé, Louis-Philippe David, Martin Juneau, Christine Henri, Maxime Boidin, Lukas Daniel Trachsel, Anil Nigam, and Mathieu Gayda
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Male ,medicine.medical_specialty ,Periodicity ,Physiology ,Endocrinology, Diabetes and Metabolism ,Strain (injury) ,Coronary Disease ,Pilot Projects ,High-Intensity Interval Training ,Physiology (medical) ,Internal medicine ,medicine ,Aerobic exercise ,Humans ,In patient ,Prospective Studies ,Aged ,Nutrition and Dietetics ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Coronary heart disease ,Exercise Therapy ,Echocardiography ,Right heart ,Cardiology ,Ventricular Function, Right ,Female ,business - Abstract
Linear aerobic training periodisation (LP) is recommended for patients with coronary heart disease (CHD). However, the effects of training periodisation on the right heart mechanics in patients with CHD have never been examined. This study aimed to explore the effects of LP and non-linear periodisation (NLP) on right heart mechanics. We prospectively randomised CHD patients to 12 weeks of aerobic training with LP or NLP. While there was a weekly increase in energy expenditure with LP, there was a steeper increase during the first 3 weeks, followed by a decrease in the fourth week with NLP. Echocardiography was performed at baseline and after the training period to assess the right ventricular free wall (RVFW) and right atrial strain. Thirty patients with CHD were included (NLP, n = 16; LP, n = 14). The traditional right and left heart parameters showed no significant time effects. There was a decrease of RVFW strain with time in both groups (+1.3 ± 0.9% with NLP, and +1.5 ± 0.8% with LP; p = 0.033). Mid-ventricular RVFW strain changed significantly with time (+2.0 ± 1.3% with NLP, and from +2.3 ± 1.2% with LP; p = 0.025). There was no time effect on the right atrial strain. In stable CHD patients, LP and NLP resulted in right ventricular strain decrements with a segment-specific pattern. This study was registered at ClinicalTrials.gov (identifier number: NCT03414996). Novelty: In stable coronary heart disease patients, both linear and non-linear aerobic training periodisation programs result in right ventricular strain decrements with time, particularly in the mid-ventricular segment. Traditional right and left heart parameters and right atrial strain showed no significant time effect in both 12 weeks aerobic training periodisation programs.
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- 2021
6. The impact of high‐intensity interval training on ventricular remodeling in patients with a recent acute myocardial infarction—A randomized training intervention pilot study
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Nathalie Thorin-Trescases, Anil Nigam, Julie Lalongé, Eric Thorin, Lukas-Daniel Trachsel, Mariève Cossette, Mathieu Gayda, Louis-Philippe David, Martin Juneau, Christine Henri, D. Hayami, and Mélissa-Anne Blain
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Adult ,Male ,medicine.medical_specialty ,medicine.drug_class ,Clinical Investigations ,Myocardial Infarction ,Pilot Projects ,030204 cardiovascular system & hematology ,High-Intensity Interval Training ,Interval training ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Natriuretic peptide ,Aerobic exercise ,Humans ,030212 general & internal medicine ,Myocardial infarction ,coronary heart disease ,Ventricular remodeling ,interval training secondary prevention ,Aged ,Ventricular Remodeling ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,aerobic exercise ,Treatment Outcome ,Echocardiography ,Heart failure ,Cardiology ,Female ,cardiac remodeling ,Cardiology and Cardiovascular Medicine ,business ,Ventilatory threshold ,High-intensity interval training - Abstract
Background Aerobic exercise training is associated with beneficial ventricular remodeling and an improvement in cardiac biomarkers in chronic stable heart failure. High‐intensity interval training (HIIT) is a time‐efficient method to improve V˙O2peak in stable coronary heart disease patients. This pilot study aimed to compare the effect of HIIT on ventricular remodeling in patients with a recent acute myocardial infarction (AMI). Methods Nineteen post‐AMI patients were randomized to either HIIT (n = 9) or usual care (n = 10). A cardiopulmonary exercise test (CPET), transthoracic echocardiography, and cardiac biomarker assessment (ie, N‐terminal pro B‐type natriuretic peptide levels and G protein‐coupled receptor kinase 2 expression) were performed before and after a 12‐week training intervention. CPET parameters including oxygen uptake efficiency slope (OUES) and V˙O2 at the first ventilatory threshold (V˙O2 VT1) were calculated. left ventricular (LV) structural and functional echocardiographic parameters including myocardial strain imaging were assessed. Results V˙O2peak and OUES improved solely in the HIIT group (P
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- 2019
7. Effects of interval training on risk markers for arrhythmic death: a randomized controlled trial
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Lukas Daniel Trachsel, Florent Besnier, Christine Henri, Martin Juneau, Anil Nigam, Julie Lalongé, Maxime Boidin, Mathieu Gayda, and Doug Hayami
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Male ,medicine.medical_specialty ,Physical Therapy, Sports Therapy and Rehabilitation ,High-Intensity Interval Training ,030204 cardiovascular system & hematology ,Interval training ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,Heart Rate ,law ,Internal medicine ,Secondary Prevention ,Humans ,Medicine ,In patient ,Acute Coronary Syndrome ,Secondary prevention ,business.industry ,Rehabilitation ,Arrhythmias, Cardiac ,030229 sport sciences ,Middle Aged ,Arrhythmic death ,Continuous training ,Coronary heart disease ,Autonomic nervous system ,Cardiology ,Female ,business ,Physical Conditioning, Human - Abstract
Objective: To compare the effects of high-intensity interval training versus moderate-intensity continuous training on risk markers of arrhythmic death in patients who recently suffered from an acute coronary syndrome. Design: Double-blind (patient and evaluator) randomized controlled trial. Setting: Cardiovascular Prevention and Rehabilitation Centre (EPIC Centre) of the Montreal Heart Institute, Montreal, Canada. Subjects: A total of 43 patients were randomized following an acute coronary syndrome. Interventions: Patients were assigned to either high-intensity interval training (n = 18) or isocaloric moderate-intensity continuous training (n = 19), three times a week for a total of 36 sessions. Main measures: Heart rate recovery for 5 minutes, heart rate variability for 24 hours, occurrence of ventricular arrhythmias, and QT dispersion were measured before and after the 36 sessions of training. Results: Among the 43 patients randomized, 6 participants in the high-intensity interval training group stopped training for reasons unrelated to exercise training and were excluded from the analyses. Heart rate recovery improved solely in the high-intensity interval training group, particularly at the end of recovery period ( p < 0.05). There were no differences in heart rate variability, occurrence of ventricular arrhythmias, or QT dispersion parameters between the groups at study end. Conclusion: Despite the lack of power to detect any large difference between the two interventions with respect to risk markers of arrhythmic death, high-intensity interval training appears safe and may be more effective at improving heart rate recovery relative to moderate-intensity continuous training in our patients following acute coronary syndrome.
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- 2019
8. Impact of 2 different aerobic periodization training protocols on left ventricular function in patients with stable coronary artery disease: an exploratory study
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Lukas Daniel Trachsel, Julie Lalongé, Anil Nigam, Martin Juneau, Louis-Philippe David, Maxime Boidin, Christine Henri, Jonathan Tremblay, and Mathieu Gayda
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Cardiac function curve ,Male ,medicine.medical_specialty ,Physiology ,Endocrinology, Diabetes and Metabolism ,CAD ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,High-Intensity Interval Training ,Ventricular Function, Left ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,Physiology (medical) ,Internal medicine ,medicine ,Aerobic exercise ,Humans ,In patient ,030212 general & internal medicine ,Prospective Studies ,Aged ,Nutrition and Dietetics ,Ventricular function ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Coronary heart disease ,Exercise Therapy ,Echocardiography ,Sports periodization ,Cardiology ,Ventricular Function, Right ,Female ,business ,Physical Conditioning, Human - Abstract
We compared the impacts of linear (LP) and nonlinear (NLP) aerobic training periodizations on left ventricular (LV) function and geometry in coronary artery disease (CAD) patients. Thirty-nine CAD patients were randomized to either a 3-month isoenergetic supervised LP or NLP. All underwent standard echocardiography with assessment of 3D LV ejection fraction (LVEF), diastolic function, strain (global longitudinal, radial, and circumferential), and strain rate at baseline and study end. Training was performed 3 times/week and included high-intensity interval and moderate-intensity continuous training sessions. Training load was progressively increased in the LP group, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. For the 34 analyzed patients, we found similar improvements for 3D LVEF (effect size (ES): LP, 0.29; NLP, 0.77), radial strain (ES: LP, 0.58; NLP, 0.48), and radial strain rate (ES: LP, 0.87; NLP, 0.17) in both groups (time for all: p ≤ 0.01). All other parameters of cardiac function remained similar. In conclusion, NLP and LP led to similar improvements in 3D LVEF and radial strain, suggesting a favourable positive cardiac remodelling through myofibers reorganization. These findings must be investigated in patients with more severe cardiac dysfunction. The study was registered on ClinicalTrials.gov (NCT03443193). Novelty: Linear and nonlinear periodization programs improved radial strain, accompanied by improvement of ejection fraction. Both aerobic periodization programs did not negatively impact cardiac function in coronary artery disease patients.
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- 2020
9. Cardiac function during heat stress: impact of short-term passive heat acclimation
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Daniel Gagnon, Parya Behzadi, Christine Henri, Hugo Gravel, Lukas Daniel Trachsel, and Hadiatou Barry
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Cardiac function curve ,Hyperthermia ,Adult ,Male ,Thermotolerance ,Cardiac output ,medicine.medical_specialty ,Hot Temperature ,Time Factors ,Physiology ,Diastole ,030204 cardiovascular system & hematology ,Heat Stress Disorders ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Heat acclimation ,Heart Rate ,Physiology (medical) ,Internal medicine ,Heart rate ,Medicine ,Humans ,Cardiac Output ,Core (anatomy) ,business.industry ,Stroke volume ,medicine.disease ,Echocardiography, Doppler ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Skin Temperature ,030217 neurology & neurosurgery - Abstract
A lower heart rate (HR) during heat exposure is a classic marker of heat acclimation (HA), although it remains unclear whether this adaptation occurs secondary to reduced thermal strain and/or improvements in cardiac function. We evaluated the hypothesis that short-term passive HA reduces HR and improves cardiac function during passive heating. Echocardiography was performed under thermoneutral and hyperthermic conditions in 10 healthy adults (9 men/1 woman, 29 ± 6 yr old), pre and post 7 days of controlled hyperthermia. HR (P = 0.61), stroke volume (P = 0.99), and cardiac output (P = 0.99), were similar on days 1 and 7 of HA. Core (pre: 38.17 ± 0.42, post: 38.15 ± 0.27°C, P = 0.95) and mean skin (pre: 38.24 ± 0.41, post: 38.51 ± 0.29°C, P = 0.17) temperatures were similar during hyperthermic echocardiographic assessments. Cardiac systolic function was unaffected by HA (P ≥ 0.10). HA attenuated the decrease in end-diastolic volume (pre: -18 ± 18, post: -12 ± 19 mL, P = 0.05), accentuated the greater atrial contribution to diastolic filling (pre: +11 ± 5, post: +14 ± 5%, P = 0.02), and attenuated the increase in left atrial reservoir strain rate (pre: +1.5 ± 1.2, post: +0.8 ± 0.8 1/s, P = 0.02) during heating. Nonetheless, there were no differences in HR (pre: 106 ± 12, post: 104 ± 12 beats/min, P = 0.50), stroke volume (pre: 65 ± 15, post: 68 ± 13 mL, P = 0.55), or cardiac output (pre: 6.9 ± 2.0, post: 7.1 ± 1.7 L/min, P = 0.70) during passive heating. Short-term controlled hyperthermia HA results in limited adaptations of cardiac function during passive heating.NEW & NOTEWORTHY A lower heart rate during heat exposure is a classic marker of heat acclimation (HA). It remains unknown if improved cardiac function contributes to this response. A 7-day passive HA protocol did not alter cardiac systolic function during passive heating, whereas it improved some indexes of diastolic function in young adults. Nonetheless, heart rate during heating was unaffected by HA. These results suggest that passive HA induces limited adaptations in cardiac function during passive heating.
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- 2020
10. Care Gaps in Adherence to Heart Failure Guidelines: Clinical Inertia or Physiological Limitations?
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Marilyne, Jarjour, Christine, Henri, Simon, de Denus, Annik, Fortier, Nadia, Bouabdallaoui, Anil, Nigam, Eileen, O'Meara, Charaf, Ahnadi, Michel, White, Patrick, Garceau, Normand, Racine, Marie-Claude, Parent, Mark, Liszkowski, Geneviève, Giraldeau, Jean-Lucien, Rouleau, and Anique, Ducharme
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Cardiac Resynchronization Therapy ,Heart Failure ,Humans ,Patient Compliance ,Stroke Volume ,Registries ,Aged ,Defibrillators, Implantable ,Mineralocorticoid Receptor Antagonists - Abstract
This study evaluated the impact of clinical and physiological factors limiting treatment optimization toward recommended medical therapy in heart failure (HF).Although guidelines aim to assist physicians in prescribing evidence-based therapies and to improve outcomes of patients with HF and reduced ejection fraction (HFrEF), gaps in clinical care persist.Medical records of all patients with HFrEF followed for at least 6 months at the authors' HF clinic (n = 511) allowed for drug optimization and were reviewed regarding the prescription rates of recommended pharmacological agents and devices (implantable cardioverter-defibrillator [ICD] or cardiac resynchronization therapy [CRT]). Then, an algorithm integrating clinical (New York Heart Association [NYHA] functional class, heart rate, blood pressure and biologic parameters (creatinine, serum potassium) based on the inclusion/exclusion criteria of landmark trials guiding these recommendations) was applied for each agent and device to identify potential explanations for treatment gaps.Gross prescription rates were high for beta-blockers (98.6%), mineralocorticoid receptor antagonist (MRA) (93.4%), vasodilators (90.3%), ICDs (75.1%), and CRT (82.1%) among those eligible, except for ivabradine (46.3%, n = 41). However, achievement of target physiological doses was lower (beta-blockers, 67.5%; MRA, 58.9%; and vasodilators, 63.4%), and one-fifth of patient dosages were still being up-titrated. Suboptimal doses were associated with older age (odds ratio [OR]: 1.221; p 0.0001) and history of stroke or transient ischemic attack (TIA) (no vs. yes, OR: 0.264; p = 0.0336).Gaps in adherence to guidelines exist in specialized HF setting and are mostly explained by limiting physiological factors rather than inertia. Older age and history of stroke/TIA, potential markers of frailty, are associated with suboptimal doses of guideline-directed medical therapy, suggesting that an individualized rather than a "one-size-fits-all" approach may be required.
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- 2019
11. Transcatheter Aortic Valve Replacement for Severe Aortic Stenosis in Women: Clinical Characteristics and Outcomes
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Jessica Forcillo, Christine Henri, Anita W. Asgar, and Christine Pacheco
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medicine.medical_specialty ,Poor prognosis ,Standard of care ,Transcatheter aortic ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Severity of Illness Index ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,Internal medicine ,Severity of illness ,medicine ,Humans ,030212 general & internal medicine ,business.industry ,Aortic Valve Stenosis ,Risk adjustment ,medicine.disease ,Surgery ,Stenosis ,Outcome and Process Assessment, Health Care ,Aortic valve stenosis ,Cardiology ,Female ,Risk Adjustment ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aortic stenosis (AS), 1 of the most common valve diseases in developed countries, carries a poor prognosis if left untreated. Transcatheter aortic valve replacement (TAVR) has become the standard of care for high-risk and inoperable patients with severe aortic stenosis (AS). Women represent a significant proportion of patients with severe AS and demonstrate specific clinical, anatomic, and pathophysiological features that are evident both before and after valve replacement. In this review, we discuss these features as well as the outcomes of women undergoing TAVR for AS.
- Published
- 2018
12. Exercise Lowers Plasma Angiopoietin-Like 2 in Men with Post-Acute Coronary Syndrome
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Anil Nigam, Jean-François Larouche, Xiaoyan Luo, Doug Hayami, Eric Thorin, Martin Juneau, Nathalie Thorin-Trescases, André Arsenault, Jean Lambert, Christine Henri, Albert Nguyen, Julie Lalongé, Carol Yu, and Mathieu Gayda
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Male ,Cardiac output ,Physiology ,lcsh:Medicine ,Hemodynamics ,030204 cardiovascular system & hematology ,Cardiovascular Medicine ,Pathology and Laboratory Medicine ,Vascular Medicine ,0302 clinical medicine ,Endocrinology ,Aerobic Exercise ,Medicine and Health Sciences ,Coronary Heart Disease ,Public and Occupational Health ,Endothelial dysfunction ,lcsh:Science ,Immune Response ,Multidisciplinary ,Gated Blood-Pool Imaging ,Sports Science ,Forearm ,C-Reactive Protein ,Physiological Parameters ,Cardiovascular Diseases ,Cardiology ,Female ,Research Article ,Acute coronary syndrome ,medicine.medical_specialty ,Endocrine Disorders ,Immunology ,Physical exercise ,03 medical and health sciences ,Signs and Symptoms ,Diagnostic Medicine ,Internal medicine ,Diabetes mellitus ,medicine ,Diabetes Mellitus ,Aerobic exercise ,Humans ,Obesity ,Exercise physiology ,Acute Coronary Syndrome ,Sports and Exercise Medicine ,Exercise ,Angiopoietin-Like Protein 2 ,Inflammation ,business.industry ,lcsh:R ,Body Weight ,Biology and Life Sciences ,030229 sport sciences ,Physical Activity ,medicine.disease ,Angiopoietin-like Proteins ,Physical Fitness ,Metabolic Disorders ,Physical therapy ,Exercise Test ,lcsh:Q ,business ,Angiopoietins - Abstract
Pro-inflammatory angiopoietin-like 2 (angptl2) promotes endothelial dysfunction in mice and circulating angptl2 is higher in patients with cardiovascular diseases. We previously reported that a single bout of physical exercise was able to reduce angptl2 levels in coronary patients. We hypothesized that chronic exercise would reduce angptl2 in patients with post-acute coronary syndrome (ACS) and endothelial dysfunction. Post-ACS patients (n = 40, 10 women) were enrolled in a 3-month exercise-based prevention program. Plasma angptl2, hs-CRP, and endothelial function assessed by scintigraphic forearm blood flow, were measured before and at the end of the study. Exercise increased VO2peak by 10% (p
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- 2016
13. Prediction of new onset of resting pulmonary arterial hypertension in systemic sclerosis
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Damien Voilliot, Muriel Sprynger, Christine Henri, Patrizio Lancellotti, Seisyou Kou, Luis Caballero, Julien Magne, Carla De Sousa, Luc Pierard, Béatrice Andre, Raluca Elena Dulgheru, GIGA Cardiovascular Sciences [Liège, Belgium] (Department of Cardiology), University Hospital Sart Tilman [Liège, Belgium]-Heart Valve Clinic [Liège, Belgium], Gruppo Villa Maria Care and Research [Bari, Italy], Anthea Hospital [Bari, Italy], CCSD, Accord Elsevier, Cardio-vascular diseases, and Clinical sciences
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Male ,medicine.medical_specialty ,Hypertension, Pulmonary ,030204 cardiovascular system & hematology ,Systemic scleroderma ,Pulmonary arterial hypertension ,Scleroderma ,New onset ,Microscopic Angioscopy ,03 medical and health sciences ,0302 clinical medicine ,Capillaroscopie ,Predictive Value of Tests ,Internal medicine ,Échocardiographie d’effort ,Medicine ,Humans ,Prospective Studies ,Prospective cohort study ,030203 arthritis & rheumatology ,Scleroderma, Systemic ,business.industry ,Nailfold videocapillaroscopy ,Hazard ratio ,Hypertension artérielle pulmonaire ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Pulmonary hypertension ,Confidence interval ,Surgery ,Sclérodermie ,Echocardiography ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Predictive value of tests ,Cardiology ,Exercise Test ,Exercise echocardiography ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business ,Cardiology and Cardiovascular Medicine - Abstract
Background. - Early detection of pulmonary arterial hypertension (PH) is crucial in systemic scleroderma. However, predictors of new onset of resting PH during follow-up (FUPH) have been poorly explored. Aim. - To determine whether nailfold videocapillaroscopy (NVC) grade and exercise echocardiographic variables are predictors of FUPH. Methods. - We prospectively enrolled 40 patients with systemic sclerosis (age 54 13 years; 68% women). All patients underwent graded semisupine exercise echocardiography and NVC. Baseline resting PH and FUPH were defined as systolic pulmonary arterial pressure (sPAP) > 35 mmHg, and exercise-induced PH (EIPH) as exercise sPAP > 50 mmHg. Results. - Seventeen patients developed EIPH (43%). During follow-up (FU) (25 15 months), 11 patients without baseline PH developed FUPH (28%), all from the EIPH group. Patients with FUPH were significantly older (60 +/- 14 vs 50 +/- 12 years; P = 0.04), had higher resting and exercise sPAP (30 +/- 4 vs 22 +/- 5 and 60 +/- 12 vs 40 +/- 11 mmHg, respectively; P < 0.0001) and a higher exercise E/e' ratio (9.4 +/- 0.7 vs 5.8 +/- 0.4; P = 0.0003) and presented more frequently NVC grade > 2 (90% vs 35%; P = 0.0009). After adjustment for age, resting sPAP, exercise sPAP and NVC grade > 2 were associated with maximal resting sPAP during follow-up and FUPH (P < 0.05). Patients with both EIPH and NVC grade > 2 had a very high incidence of FUPH (82%), and both variables remained strongly associated with FUPH after adjustment for age (hazard ratio 11.6, 95% confidence interval 2.4-55.3; P = 0.002). Conclusion. - Exercise echocardiography and NVC can identify a subgroup of patients with systemic sclerosis who are at risk of developing FUPH.
- Published
- 2016
14. Atrial Fibrillation After Pulmonary Transplantation
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Nicolas Noiseux, Marc Dorais, Christine Henri, Pasquale Ferraro, François Girard, Stéphane Rinfret, Geneviève Giraldeau, and Alexis-Simon Cloutier
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Adult ,Lung Diseases ,Male ,medicine.medical_specialty ,Cardiac Resynchronization Therapy ,Postoperative Complications ,Risk Factors ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,Humans ,Medicine ,Sinus rhythm ,Risk factor ,Retrospective Studies ,business.industry ,Incidence ,Hazard ratio ,Quebec ,Retrospective cohort study ,Atrial fibrillation ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Survival Rate ,Transplantation ,Treatment Outcome ,Cardiothoracic surgery ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Lung Transplantation - Abstract
Background— Atrial fibrillation (AF) is common after thoracic surgery. Limited data exist concerning the incidence of AF, its impact on mortality, the effectiveness of therapy, and the risk factors of AF after pulmonary transplantation. Methods and Results— We reviewed the medical files of 224 consecutive lung transplant recipients who underwent surgery over a 10-year period at a large Canadian center. We collected patient characteristics, in-hospital treatments, and outcomes. Time-to-event analysis was used to account for in-hospital follow-up and models generated to assess the impact of AF on mortality and independent risk factors of AF after transplantation. Postoperative AF occurred in 65 patients (29%). AF was more likely to occur with complications such as pneumonia, mediastinitis, and bronchial dehiscence and was not an independent risk factor of mortality (hazard ratio=1.56; 95% confidence interval, 0.52–4.63). Pharmacological or electric therapy for rhythm or rate control of AF was administered to 97% of patients. Intravenous amiodarone was used in 46%, electric cardioversion in 28%, and heparin in 26%. Only 1 patient remained in AF at discharge. Age (hazard ratio=1.08 by year; 95% confidence interval, 1.05–1.12), bilateral transplantation (hazard ratio=1.87; 95% confidence interval, 1.03–3.42), and a history of AF before the transplantation (hazard ratio=4.48; 95% confidence interval, 1.05–19.11) were found to be independently associated with an increased incidence of postoperative AF. Conclusions— AF is fairly common after pulmonary transplantation, transient, and relatively benign. It is not independently associated with increased in-hospital mortality. Most patients return to sinus rhythm before discharge. Age, prior AF, and bilateral transplantation increase the risk of postoperative AF.
- Published
- 2012
15. Acute Pulmonary Edema and Acute Coronary Syndrome: Mostly a Trigger or an Associated Phenomenon?
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Jean-Lucien Rouleau and Christine Henri
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medicine.medical_specialty ,Acute coronary syndrome ,Acute decompensated heart failure ,business.industry ,Volume overload ,Pulmonary Edema ,030204 cardiovascular system & hematology ,Pulmonary edema ,medicine.disease ,Chest pain ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Coronary care unit ,Cardiology ,Humans ,030212 general & internal medicine ,Myocardial infarction ,medicine.symptom ,Acute Coronary Syndrome ,Cardiology and Cardiovascular Medicine ,business - Abstract
Acute decompensated heart failure (ADHF) is the most common cause of hospitalization in North America, and it is associated with high mortality and the need for frequent early rehospitalization. Despite the magnitude of the problem, there have been few advances in its therapy, perhaps because ADHF is the result of the convergence of multiple different factors, including progressive fluid retention, neurohumoral activation, further reduction in cardiac output, vasoconstriction, and hypertension, tachycardia, and impaired coronary perfusion in the face of increased demand (Fig. 1). Therapy is frequently complicated by the presence of comorbidities such as renal dysfunction, mitral regurgitation, supraventricular arrhythmias, and diabetes. The search for a trigger leading to ADHF has generally identified progressive fluid retention and the resultant overactivation of normally compensatory neurohumoral systems as playing a central role in the process, but it may be that progressive volume overload is simply a sign of the convergence of abnormalities that result from the multiple comorbidities that exist in such patients. In search of the precipitating cause of acute pulmonary edema (APE), the article, “Acute Hypertension in Acute Pulmonary Edema: Mostly a Trigger or an Associated Phenomenon?” by Figueras et al., presents a careful documentation of multiple characteristics of 742 patients admitted to their coronary care unit with a particularly severe form of ADHF, ie, APE. In this prospective registry, patients systematically had echocardiographic as well as phenotypic and biomarker assessments, and 468 (63%) patients had coronary angiography. The authors found that 78% of patients had coronary artery disease (CAD) defined as previous myocardial infarction or acute coronary syndrome (ACS) or coronary stenosis 70%; 65% had ACS defined as acute myocardial infarction with increased levels of creatine kinase-MB (CKMB) mass > 10 mg/L with or without chest pain or
- Published
- 2015
16. Elevated Plasma Soluble ST2 Is Associated with Heart Failure Symptoms and Outcome in Aortic Stenosis
- Author
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Arnaud Ancion, Laurent Davin, Julien Magne, Luc Pierard, Nassim Bouznad, Christine Henri, Christophe Martinez, Cécile Oury, Patrizio Lancellotti, Laurence Servais, Raluca Elena Dulgheru, Alain Nchimi, Caroline Le Goff, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Research), Université de Liège, Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, 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, GIGA-Neurosciences, Interdisciplinary Cluster for Applied Genoproteomics (GIGA-R) [Liège], Université de Liège-C.H.U. Sart Tilman [Liège], Service de cardiologie, Centre Hospitalier Universitaire de Liège (CHU-Liège), Cardio-vascular diseases, and Clinical sciences
- Subjects
Aortic valve ,Male ,medicine.medical_specialty ,medicine.drug_class ,lcsh:Medicine ,Receptors, Cell Surface ,030204 cardiovascular system & hematology ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Natriuretic peptide ,Humans ,030212 general & internal medicine ,lcsh:Science ,Aged ,Aged, 80 and over ,Heart Failure ,Multidisciplinary ,Ejection fraction ,business.industry ,lcsh:R ,Aortic Valve Stenosis ,Middle Aged ,medicine.disease ,Interleukin-1 Receptor-Like 1 Protein ,Stenosis ,medicine.anatomical_structure ,Aortic valve stenosis ,Heart failure ,Cardiology ,cardiovascular system ,Biomarker (medicine) ,lcsh:Q ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,medicine.symptom ,business ,Research Article - Abstract
International audience; B-type natriuretic peptide (BNP) is often used as a complementary finding in the diagnostic work-up of patients with aortic stenosis (AS). Whether soluble ST2, a new biomarker of cardiac stretch, is associated with symptomatic status and outcome in asymptomatic AS is unknown. sST2 and BNP levels were measured in 86 patients (74±13 years; 59 asymptomatic, 69%) with AS (23 ng/mL, AUC = 0.68, p
- Published
- 2015
17. Impact of Serial B-Type Natriuretic Peptide Changes for Predicting Outcome in Asymptomatic Patients With Aortic Stenosis
- Author
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Luis Caballero, Cécile Oury, Raluca Elena Dulgheru, Christine Henri, Patrizio Lancellotti, Saloua Laaraibi, Luc Pierard, Damien Voilliot, Laurent Davin, Alain Nchimi, Seisyou Kou, Julien Magne, Cardio-vascular diseases, Clinical sciences, Grelier, Elisabeth, Service de cardiologie [Liège], CHU de Liège-Domaine Universitaire du Sart Tilman, 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, Service de cardiologie, Université de Liège, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Centre Hospitalier Universitaire de Liège (CHU-Liège)
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.drug_class ,030204 cardiovascular system & hematology ,Doppler echocardiography ,Asymptomatic ,Risk Assessment ,Severity of Illness Index ,Disease-Free Survival ,Ventricular Function, Left ,03 medical and health sciences ,0302 clinical medicine ,Aortic valve replacement ,Internal medicine ,Natriuretic Peptide, Brain ,Natriuretic peptide ,Medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Aged ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Stroke Volume ,Stroke volume ,Aortic Valve Stenosis ,medicine.disease ,Prognosis ,Echocardiography, Doppler ,3. Good health ,Stenosis ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Aortic valve stenosis ,Asymptomatic Diseases ,Cardiology ,cardiovascular system ,Disease Progression ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Follow-Up Studies - Abstract
Background: The aim of this study was to determine the impact on the outcome of serial B-type natriuretic peptide (BNP) changes during follow-up in asymptomatic patients with >= moderate aortic stenosis (AS) and preserved left ventricular ejection fraction. Methods: We prospectively screened 69 patients who underwent comprehensive transthoracic echocardiography, BNP level measurement at baseline and after every 6 or 12 months. Annualized BNP changes were calculated as the difference between the last and baseline BNP measurements divided by the duration of follow-up. The primary endpoint was the occurrence of symptoms, aortic valve replacement, or cardiovascular death. Results: During a follow-up of 30 +/- 19 months, 43 patients experienced a cardiac event. These patients were significantly older (73 +/- 9 vs 65 +/- 16 years; P = 0.010), had more often dyslipidemia (79% vs 42%; P = 0.038), more severe AS (peak velocity: 3.9 +/- 0.6 vs 3.5 +/- 0.6 m/s; P = 0.002), larger indexed left atrial area (10.2 +/- 2.5 vs 8.7 +/- 1.9 cm(2)/m(2); P = 0.006), and a higher increase in annualized BNP (+90 +/- 155 vs +7 +/- 49 pg/mL/y; P = 0.010). Patients with higher annualized BNP changes (> 20 pg/mL/y) had a significantly lower cardiac event-free survival (1 year: 63 +/- 8% vs 97 +/- 3%; 3 years: 31 +/- 8% vs 68 +/- 8%; P < 0.001). Using the multivariate Cox proportional hazards model, higher annualized BNP changes were significantly associated with increased risk of cardiac events (hazard ratio: 2.73, 95% confidence interval: 1.27-5.86; P = 0.010) after adjustment for age, dyslipidemia, and echocardiographic parameters. Conclusions: In asymptomatic patients with AS and preserved left ventricular ejection fraction, the use of serial BNP changes may help to anticipate development of class I indication for aortic valve replacement.
- Published
- 2015
18. Brain Natriuretic Peptide Levels and the Occurrence of Subclinical Pulmonary Edema in Healthy Lowlanders at High Altitude
- Author
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Claude Sauvé, Erick Schampaert, Christine Henri, Maude Pagé, and Pierre Pagé
- Subjects
Adult ,Male ,medicine.medical_specialty ,Hypertension, Pulmonary ,Altitude Sickness ,Reference Values ,Internal medicine ,Heart rate ,Natriuretic Peptide, Brain ,Medicine ,Humans ,Exertion ,Subclinical infection ,Oxygen saturation (medicine) ,Aged ,Retrospective Studies ,Lung ,business.industry ,Altitude ,Incidence ,Quebec ,Effects of high altitude on humans ,Middle Aged ,Brain natriuretic peptide ,Pulmonary edema ,medicine.disease ,Endocrinology ,medicine.anatomical_structure ,Echocardiography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
High altitude (HA) pulmonary edema (PE) results from complex and misunderstood interactions between adaptation mechanisms. We assessed the occurrence of subclinical PE and brain natriuretic peptide (BNP) levels among nonacclimatized individuals during an expedition on Mount Elbrus (5642 m).Seven subjects underwent assessment of vital signs, Lake Louise Score, ultrasound lung comets using handheld echography and circulating BNP using capillary testing at different stages of ascension, in addition to baseline echocardiography. Friedman tests were used to compare serial measurements.Heart rate, Lake Louise Score (P0.0001) and blood pressure (P = 0.037) increased during ascension; oxygen saturation decreased (P0.0001). BNP increased (40.7 ± 16.8 vs 19.7 ± 3.04 pg/mL; P0.01) after the summit, as did ultrasound lung comet count throughout ascension (P0.0001), but both parameters were not correlated (r = 0.36; P = 0.42). Post-summit peak BNP correlated with baseline left ventricular mass index (r = -0.79; P = 0.033).This study confirms the high incidence of subclinical PE during subacute exposure to hypobaric hypoxia and enhancement of this phenomenon after exertion. Although not correlated with the degree of PE, BNP levels increased after sustained effort at HA, but not at rest. Further investigation is needed to determine the mechanisms underlying the BNP response at HA and its usefulness as a monitoring tool during expeditions.
- Published
- 2014
19. The left atrium: an old 'barometer' which can reveal great secrets
- Author
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Patrizio, Lancellotti and Christine, Henri
- Subjects
Heart Failure ,Humans ,Atrial Function, Left ,Atrial Remodeling ,Heart Atria ,Cardiac Output ,Ventricular Function, Left - Published
- 2014
20. Usefulness of serial B-type natriuretic peptide assessment in asymptomatic aortic stenosis
- Author
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Damien Voilliot, Cécile Oury, Christine Henri, Alain Nchimi, Laurent Davin, Raluca Elena Dulgheru, Luc Pierard, Patrizio Lancellotti, Seisyou Kou, Julien Magne, and Saloua Laaraibi
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.drug_class ,Diastole ,Doppler echocardiography ,Asymptomatic ,Risk Assessment ,Severity of Illness Index ,Ventricular Function, Left ,Predictive Value of Tests ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Humans ,cardiovascular diseases ,Prospective Studies ,Aged ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Mean Aortic Pressure ,Aortic Valve Stenosis ,medicine.disease ,Prognosis ,Echocardiography, Doppler ,Stenosis ,Aortic valve stenosis ,cardiovascular system ,Cardiology ,Female ,sense organs ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,human activities ,hormones, hormone substitutes, and hormone antagonists ,Biomarkers ,Follow-Up Studies - Abstract
B-type natriuretic peptide (BNP) level may be a useful prognostic marker for the management of asymptomatic patients with aortic stenosis (AS). The aim of this study was to identify the echocardiographic determinants of BNP changes during follow-up in AS. We studied 61 asymptomatic patients with greater than moderate AS and preserved left ventricular (LV) ejection fraction who underwent rest and exercise Doppler echocardiography with concomitant BNP level measurement at baseline. BNP measurement was repeated after inclusion every 6 months. Patients were divided into 2 groups according to the median of BNP changes during follow-up. According to parameters at rest, patients in the high BNP changes group had significantly higher E/e′ ratio. Statistically significant correlations were found between BNP changes and E/e′ ratio and indexed left atrial area. According to exercise parameters, patients in the high BNP changes group had significantly lower exercise-induced increase in LV ejection fraction. Statistically significant correlations were found between BNP changes and exercise-induced changes in LV ejection fraction. After adjustment for age, mean aortic pressure gradient, and BNP level at baseline, multivariate analysis identified indexed left atrial area, E/e′ at rest, and exercise-induced increase in ejection fraction as independent determinants of BNP changes during follow-up. In conclusion, this study shows that, in asymptomatic patients with preserved LV function and moderate AS, serial BNP measurements may widely vary. Subclinical LV diastolic and systolic dysfunctions are frequently present in patients with higher serial BNP changes.
- Published
- 2014
21. Brain natriuretic peptide release in patients with aortic stenosis: resting and exercise echocardiographic determinants
- Author
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Raluca Elena Dulgheru, Saloua Laaraibi, Damien Voilliot, Seisyou Kou, Luc Pierard, Julien Magne, Patrizio Lancellotti, and Christine Henri
- Subjects
Aortic valve ,Adult ,Male ,medicine.medical_specialty ,Severity of Illness Index ,Ventricular Function, Left ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Humans ,In patient ,Heart valve ,Prospective Studies ,Aged ,Aged, 80 and over ,Exercise Tolerance ,business.industry ,Stroke Volume ,Aortic Valve Stenosis ,Middle Aged ,medicine.disease ,Brain natriuretic peptide ,Prognosis ,Stenosis ,medicine.anatomical_structure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Echocardiography, Stress ,Follow-Up Studies - Abstract
Resting and exercise echocardiographic determinants Christine Henri , Julien Magne , Raluca Dulgheru , Saloua Laaraibi , Damien Voilliot , Seisyou Kou , Luc Pierard ⁎, Patrizio Lancellotti a,⁎ a University of Liege Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liege, Belgium b University of Montreal, Department of Medicine, Montreal Heart Institute, Canada
- Published
- 2014
22. Echocardiographic reference ranges for normal cardiac chamber size: Results from the NORRE study
- Author
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Daniele Barone, Monica Baroni, Nico Van de Veire, Krasimira Hristova, Seisyou Kou, Christine Henri, Damien Voilliot, George Kacharava, Julien Magne, Luigi P. Badano, José Juan Gómez de Diego, Ralph Stephan von Bardeleben, Dragos Vinereanu, Alessandro Salustri, Martin Penicka, Jens-Uwe Voigt, Andreas Hagendorff, Jose David Rodrigo Carbonero, Roberto M. Lang, Carla de Sousa, Bogdan A. Popescu, George Athanassopoulos, Patrizio Lancellotti, Tolga Ozyigit, Teresa López, Erwan Donal, Nuno Cardim, Gonzalo de la Morena, José Luis Zamorano, Raluca Elena Dulgheru, Luis Caballero, Kou, S, Caballero, L, Dulgheru, R, Voilliot, D, De Sousa, C, Kacharava, G, Athanassopoulos, G, Barone, D, Baroni, M, Cardim, N, Gomez De Diego, J, Hagendorff, A, Henri, C, Hristova, K, Lopez, T, Magne, J, De La Morena, G, Popescu, B, Penicka, M, Ozyigit, T, Rodrigo Carbonero, J, Salustri, A, Van De Veire, N, Von Bardeleben, R, Vinereanu, D, Voigt, J, Zamorano, J, Donal, E, Lang, R, Badano, L, and Lancellotti, P
- Subjects
Male ,Lower blood pressure ,Sex Factor ,Heart Ventricle ,Cohort Studies ,Chamber size and function ,Reference values ,Two-dimensional echocardiography ,Cardiology and Cardiovascular Medicine ,Radiology, Nuclear Medicine and Imaging ,Medicine (all) ,Nuclear Medicine and Imaging ,Age Factor ,Reference Value ,Young adult ,Body surface area ,Observer Variation ,Age Factors ,General Medicine ,Stroke volume ,Middle Aged ,Echocardiography ,Cardiology ,Female ,Radiology ,Human ,Cohort study ,Adult ,medicine.medical_specialty ,Heart Ventricles ,Reproducibility of Result ,Risk Assessment ,Young Adult ,Sex Factors ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Heart Atria ,Aged ,business.industry ,Reproducibility of Results ,Mean age ,Stroke Volume ,MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Original Articles ,Cardiac chamber ,Cohort Studie ,business - Abstract
AimsAvailability of normative reference values for cardiac chamber quantitation is a prerequisite for accurate clinical application of echocardiography. In this study, we report normal reference ranges for cardiac chambers size obtained in a large group of healthy volunteers accounting for gender and age. Echocardiographic data were acquired using state-of-the-art cardiac ultrasound equipment following chamber quantitation protocols approved by the European Association of Cardiovascular Imaging.MethodsA total of 734 (mean age: 45.8 ± 13.3 years) healthy volunteers (320 men and 414 women) were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. A comprehensive echocardiographic examination was performed on all subjects following pre-defined protocols. There were no gender differences in age or cholesterol levels. Compared with men, women had significantly smaller body surface areas, and lower blood pressure. Quality of echocardiographic data sets was good to excellent in the majority of patients. Upper and lower reference limits were higher in men than in women. The reference values varied with age. These age-related changes persisted for most parameters after normalization for the body surface area.ConclusionThe NORRE study provides useful two-dimensional echocardiographic reference ranges for cardiac chamber quantification. These data highlight the need for body size normalization that should be performed together with age-and gender-specific assessment for the most echocardiographic parameters. © 2014 The Author.
- Published
- 2014
23. Exercise testing and stress imaging in valvular heart disease
- Author
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Patrizio Lancellotti, Arsène Basmadjian, Luc Pierard, Christine Henri, François-Pierre Mongeon, and Philippe Pibarot
- Subjects
medicine.medical_specialty ,Aortic Valve Insufficiency ,Decision Making ,Heart Valve Diseases ,Blood Pressure ,Pulmonary Artery ,Asymptomatic ,Ventricular Function, Left ,Electrocardiography ,Internal medicine ,Dobutamine ,medicine ,Stress Echocardiography ,Humans ,Mitral Valve Stenosis ,Mitral regurgitation ,medicine.diagnostic_test ,business.industry ,valvular heart disease ,Mitral Valve Insufficiency ,Magnetic resonance imaging ,Aortic Valve Stenosis ,medicine.disease ,Prognosis ,Stenosis ,Cardiothoracic surgery ,cardiovascular system ,Cardiology ,Exercise Test ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug ,Echocardiography, Stress - Abstract
The role of exercise testing and stress imaging in the management of patients with valvular heart disease (VHD) is reviewed in this article. The American College of Cardiology/American Heart Association and the European Society of Cardiology/European Association of Cardiothoracic Surgery have recently put emphasis on the role of exercise testing to clarify symptom status and the use of stress imaging to assess the dynamic component of valvular abnormalities and unmask subclinical myocardial dysfunction that could be missed at rest. Recent studies have demonstrated the incremental prognostic value of exercise echocardiography for asymptomatic patients with severe aortic stenosis, moderate-severe mitral stenosis, and severe primary mitral regurgitation. In patients with low-flow, low-gradient aortic stenosis, dobutamine stress echocardiography is recommended to differentiate true severe from pseudosevere aortic stenosis. Data on the prognostic value of stress echocardiography in aortic regurgitation and functional mitral regurgitation are less robust. Data are sparse on the use of stress imaging in right-sided VHD, however recent studies using stress cardiovascular magnetic resonance imaging offer some prognostic information. Although the strongest recommendations for surgical treatment continue to be based on symptom status and resting left ventricular repercussions, stress imaging can be useful to optimize risk stratification and timing of surgery in VHD. Randomized clinical trials are required to confirm that clinical decision-making based on stress imaging can lead to improved outcomes.
- Published
- 2013
24. Determinants of exercise-induced pulmonary arterial hypertension in systemic sclerosis
- Author
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Patrizio Lancellotti, Christine Henri, Seisyou Kou, Julien Magne, Muriel Sprynger, Damien Voilliot, Béatrice Andre, Saloua Laaraibi, Raluca Elena Dulgheru, and Luc Pierard
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cardiac output ,Hypertension, Pulmonary ,Rest ,Regurgitation (circulation) ,Pulmonary arterial pressure ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Exercise ,Aged ,Scleroderma, Systemic ,business.industry ,Central venous pressure ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,Left atrial pressure ,medicine.anatomical_structure ,Peak velocity ,Vascular resistance ,Cardiology ,Exercise Test ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Exercise-induced pulmonary arterial hypertension (EIPH) in systemic sclerosis (SSc) has already been observed but its determinants remain unclear. The aim of this study was to determine the incidence and the determinants of EIPH in SSc.We prospectively enrolled 63 patients with SSc (age 54±3years, 76% female) followed in CHU Sart-Tilman in Liège. All patients underwent graded semi-supine exercise echocardiography. Systolic pulmonary arterial pressure (sPAP) was derived from the peak velocity of the tricuspid regurgitation jet and adding the estimation of right atrial pressure, both at rest and during exercise. Resting pulmonary arterial hypertension (PH) was defined as sPAP35 mmHg and EIPH as sPAP50 mmHg during exercise. The following formulas were used: mean PAP (mPAP) = 0.61 × sPAP + 2, left atrial pressure (LAP)=1.9+1.24 × left ventricular (LV) E/e' and pulmonary vascular resistance (PVR)=(mPAP-LAP)/LV cardiac output (CO) and slope of mPAP-LVCO relationship=changes in mPAP/changes in LVCO. Resting PH was present in 3 patients (7%) and 21 patients developed EIPH (47%). Patients with EIPH had higher resting LAP (10.3 ± 2.2 versus 8.8 ± 2.3 mmHg; p = 0.03), resting PVR (2.6 ± 0.8 vs. 1.4 ± 1.1 Woods units; p=0.004), exercise LAP (13.3 ± 2.3 vs. 9 ± 1.7 mmHg; p0.0001), exercise PVR (3.6 ± 0.7 vs. 2.1 ± 0.9 Woods units; p = 0.02) and slope of mPAP-LVCO (5.8 ± 2.4 vs. 2.9 ± 2.1 mmHg/L/min; p0.0001). After adjustment for age and gender, exercise LAP (β=3.1 ± 0.8; p=0.001) and exercise PVR (β=7.9 ± 1.7; p=0.0001) were independent determinants of exercise sPAP.EIPH is frequent in SSc patients and is mainly related to both increased exercise LV filling pressure and exercise PVR.
- Published
- 2013
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