143 results on '"Michel Desnos"'
Search Results
2. Transplantation of Human Embryonic Stem Cell–Derived Cardiovascular Progenitors for Severe Ischemic Left Ventricular Dysfunction
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Alexandre Parouchev, Bernard Cholley, Isabelle Cacciapuoti, Philippe Menasché, Valérie Vanneaux, Nadine Benhamouda, Valérie Bellamy, Hélène Blons, Jean-Hugues Trouvin, Eric Tartour, Michel Desnos, Jean-Roch Fabreguettes, Albert Hagège, Reem Al-Daccak, Gérard Tachdjian, Onnik Agbulut, Alain Bel, Lucie Tosca, Dominique Charron, and Jérôme Larghero
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Male ,0301 basic medicine ,medicine.medical_specialty ,Human Embryonic Stem Cells ,Population ,Myocardial Ischemia ,Cohort Studies ,Ventricular Dysfunction, Left ,03 medical and health sciences ,Interquartile range ,Internal medicine ,Clinical endpoint ,Humans ,Medicine ,Coronary Artery Bypass ,Progenitor cell ,education ,Aged ,education.field_of_study ,Ejection fraction ,business.industry ,Middle Aged ,medicine.disease ,Survival Rate ,Transplantation ,Treatment Outcome ,030104 developmental biology ,medicine.anatomical_structure ,Heart failure ,Cardiology ,Feasibility Studies ,Female ,Cardiology and Cardiovascular Medicine ,business ,Stem Cell Transplantation ,Artery - Abstract
Background In addition to scalability, human embryonic stem cells (hESCs) have the unique advantage of allowing their directed differentiation toward lineage-specific cells. Objectives This study tested the feasibility of leveraging the properties of hESCs to generate clinical-grade cardiovascular progenitor cells and assessed their safety in patients with severe ischemic left ventricular dysfunction. Methods Six patients (median age 66.5 years [interquartile range (IQR): 60.5 to 74.7 years]; median left ventricular ejection fraction 26% [IQR: 22% to 32%]) received a median dose of 8.2 million (IQR: 5 to 10 million) hESC-derived cardiovascular progenitors embedded in a fibrin patch that was epicardially delivered during a coronary artery bypass procedure. The primary endpoint was safety at 1 year and focused on: 1) cardiac or off-target tumor, assessed by imaging (computed tomography and fluorine-18 fluorodeoxyglucose positron emission tomography scans); 2) arrhythmias, detected by serial interrogations of the cardioverter-defibrillators implanted in all patients; and 3) alloimmunization, assessed by the presence of donor-specific antibodies. Patients were followed up for a median of 18 months. Results The protocol generated a highly purified (median 97.5% [IQR: 95.5% to 98.7%]) population of cardiovascular progenitors. One patient died early post-operatively from treatment-unrelated comorbidities. All others had uneventful recoveries. No tumor was detected during follow-up, and none of the patients presented with arrhythmias. Three patients developed clinically silent alloimmunization. All patients were symptomatically improved with an increased systolic motion of the cell-treated segments. One patient died of heart failure after 22 months. Conclusions This trial demonstrates the technical feasibility of producing clinical-grade hESC-derived cardiovascular progenitors and supports their short- and medium-term safety, thereby setting the grounds for adequately powered efficacy studies. (Transplantation of Human Embryonic Stem Cell-derived Progenitors in Severe Heart Failure [ESCORT]; NCT02057900)
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- 2018
3. Heart rate and risk of cancer death in healthy men.
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Xavier Jouven, Sylvie Escolano, David Celermajer, Jean-Philippe Empana, Annie Bingham, Olivier Hermine, Michel Desnos, Marie-Cécile Perier, Eloi Marijon, and Pierre Ducimetière
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Medicine ,Science - Abstract
BackgroundData from several previous studies examining heart-rate and cardiovascular risk have hinted at a possible relationship between heart-rate and non-cardiac mortality. We thus systematically examined the predictive value of heart-rate variables on the subsequent risk of death from cancer.MethodsIn the Paris Prospective Study I, 6101 asymptomatic French working men aged 42 to 53 years, free of clinically detectable cardiovascular disease and cancer, underwent a standardized graded exercise test between 1967 and 1972. Resting heart-rate, heart-rate increase during exercise, and decrease during recovery were measured. Change in resting heart-rate over 5 years was also available in 5139 men. Mortality including 758 cancer deaths was assessed over the 25 years of follow-up.FindingsThere were strong, graded and significant relationships between all heart-rate parameters and subsequent cancer deaths. After adjustment for age and tobacco consumption and, compared with the lowest quartile, those with the highest quartile for resting heart-rate had a relative risk of 2.4 for cancer deaths (95% confidence interval: 1.9-2.9, pInterpretationResting and exercise heart rate had consistent, graded and highly significant associations with subsequent cancer mortality in men.
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- 2011
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4. Éducation thérapeutique du patient insuffisant cardiaque, un facteur de performance
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Michel Desnos, Patrick Jourdain, and Yves Juillière
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medicine.medical_specialty ,business.industry ,General Medicine ,Disease ,030204 cardiovascular system & hematology ,Therapeutic education ,medicine.disease ,Performance factor ,03 medical and health sciences ,0302 clinical medicine ,Heart failure ,medicine ,030212 general & internal medicine ,Intensive care medicine ,business ,General Nursing - Abstract
Heart failure is a little-known disease which is both frequent and serious. It is particularly concerned by therapeutic education as it is linked to a high level of avoidable hospitalisations and requires daily monitoring of simple clinical parameters. It also imposes a change of lifestyle on the patient.
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- 2017
5. Current aspects of the spectrum of acute heart failure syndromes in a real-life setting: the OFICA study
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Logeart, Damien, Isnard, Richard, Resche-Rigon, Matthieu, Seronde, Marie-France, de Groote, Pascal, Jondeau, Guillaume, Galinier, Michel, Mulak, Geneviève, Donal, Erwan, Delahaye, François, Juilliere, Yves, Damy, Thibaud, Jourdain, Patrick, Bauer, Fabrice, Eicher, Jean-Christophe, Neuder, Yannick, Trochu, Jean-Noël, Chantal, Ache Papillon, Nadia, Aissaoudi, François, Aupetit Jean, Christian, Baietto, Noël, Baille, Serge, Baleynaud, Jacques, Ballout, Claude, Barnay, Fabrice, Bauer, Bechetoille, Mohammed, Belhameche, Loïc, Belle, Sandrine, Bentzinger, Alain, Bergere, Philippe, Bernadet, Marie, Perron Jean, François, Bernasconi, Samia, Berranen, Annick, Bineau-Jorisse, Michel, Serrano, Christian, Boureux, Salim, Boutalba, Erik, Bouvier, Marc, Bouvier Jean, Françoise, Bragard Marie, Philippe, Brunel, Roland, Carlioz, Christophe, Charniot Jean, Christophe, Chavelas, Saïda, Cheggour, Pascal, Chevalet, Vlad, Ciobotaru, René, Codjia, Alain, Cohen Solal, Patrick, Coulon, Daniel, Czitrom, Nicolas, Dahdal, Philippe, De Corbiere, Pascal, De Groote, Olivier, De Sauniere, France, Deforet Marie, Alain, Lassabe, Michel, Mansour, François, Delahaye, Michel, Chuzeville, Arnaud, Dellinger, Jacques, Denis, Gilles, Dentan, Michèle, Desruennes, Sylvain, Destrac, Claude, Dib Jean, Rodies, Dimitriou, Philippe, Doazan Jean, Erwan, Donal, Pierre, Matali, Pierre, Dos Santos, Roland, Sananes, Jacques, Dujardin Jean, Hervé, Gallois, Eric, Durand, Michel, Desnos, Sophie, Durand, Florence, Durup, Laurent, Dutoit, J-C, Eicher, Abdellatif, El Hallak, Mariam, Elkohen, Elodie, Faveau, Michèle, Escande, Jean, Ettori, Laurent, Fauchier, François, Maillot, Jean-Pierre, Favier, Bertrand, Fontan, Patrick, Friocourt, Philippe, Fromage, Michel, Galinier, Daniel, Galley, Erik, Garbarz, Philippe, Garcon, Daniel, Garnier, Cédric, Gaxatte, Frédéric, Georger, Renaud, Gervais, Nachwan, Ghanem, Géraldine, Gibault, Clément, Charbonnel, Pierre, Gibelin, Patrice, Brocker, Michel, Gofard, Mohand, Goudjil, Gilbert, Habib, Maryline, Hamdan-Challe, Olivier, Hanon, Michèle, Pinson, Luc, Hittinger, David, Houpe, Agnes, Hyverts, Eva, Inorowicz, Richard, Isnard, Adi, Issa, Muntaser P, Jamal, Luc, Jannin-Manificat, Guillaume, Jondeau, Patrick, Jourdain, Marc, Joussen Jean, Alain, Juillard, Yves, Juilliere, David, Kenizou, Barbara, Lambert, Skander, Khechine, Robin, Zelinsky, Pierre, Lagorce, Maryse, Lescure, Pierre, Lantelme, Thierry, Laperche, Fabrice, Larrazet, Evelyne, Laurent, Philippe, Le Metayer, Patrick, Assyag, Julien, Lemoine, Rémy, Lepori, Benoit, Lequeux, Guillaume, Lhernault, Christine, Machuron, Dominique, Magnin, Nam, Mai, Hamid, Makki, Mounia, Malou, J Jacques, Marier, Jean-Pierre, Maroni, Michel, Martelet, Colette, Matagrin, Nicolas, Coquerel, Mestre-Fernandes, Damien, Metz, Christophe, Meune, Laurent, Michel, Sandrine, Migran, Olivier, Milleron, Catherine, Mimran, Christian, Montagnier, Christophe, Moreau, Yannick, Neuder, Laurent, Orion, Blandine, Ouattara, Joël, Belmin, Eric, Perchicot, Sandrine, Peyrot, Laurent, Poirette, Philippe, Pon-Gabrielsen, Isabelle, Poulain, Fabrice, Prunier, Mamy, Randriamora, Pierre, Raphael, Charles, Raynaud Jean, Guy, Rebuffat, Michel, Remond, Franck, Revel, François, Roubille, Rémi, Sabatier, Raïf, Sader, Robert, Sal, Carole, Saudubray, France, Seronde Marie, François-Xavier, Soto, Jocelyn, Souk Aloun, Benoit, Spillemaecker, Adel, Srour, Yves, Tabet Jean, Michel, Tartiere Jean, Guy, Thourot, Thierry, Tibi, Christophe, Tribouilloy, Noël, Trochu Jean, Eric, Verbrugge, François, Vinchon, and Khelil, Yaici
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- 2013
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6. 256 A dedicated heart failure clinic improves patient management and reduces readmissions
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Patrick, Jourdain, Francois, Funck, Amélie, Boireau, Francois, Alla, Joël, Dagorn, Stéphane, Zuily, and Michel, Desnos
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- 2010
- Full Text
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7. Awareness of Individual Cardiovascular Risk Factors and Self-Perception of Cardiovascular Risk in Women
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Laurence Amar, Corinne Chicheportiche-Ayache, Paul Dardel, Isabelle Weill, Philippe Menasché, Nicole Karam, Tài Pham, Jean-Jacques Monsuez, and Michel Desnos
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Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Psychological intervention ,Blood sugar ,030204 cardiovascular system & hematology ,Overweight ,Contraceptives, Oral, Hormonal ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Patient Education as Topic ,Risk Factors ,Internal medicine ,medicine ,Humans ,Obesity ,030212 general & internal medicine ,Young adult ,Exercise ,Framingham Risk Score ,Cholesterol ,business.industry ,Smoking ,General Medicine ,medicine.disease ,Self Concept ,Blood pressure ,chemistry ,Cardiovascular Diseases ,Physical therapy ,Female ,medicine.symptom ,business ,Biomarkers - Abstract
Cardiovascular risk factors (CVRFs) self-perception by women may be inaccurate.A questionnaire was completed anonymously Online by women who self-reported their personal CVRF levels including age, weight, contraceptive use, menopausal status, smoking, diet and physical activities. Self-perceived risk was matched to actual cardiovascular risk according to the Framingham score.Among 5,240 young and middle-aged women with a high educational level, knowledge of personal CVRFs increased with age, from 51-90% for blood pressure (BP), 22-45% for blood glucose and 15-47% for blood cholesterol levels, between 30 and 65 years, respectively. This knowledge was lower for smoking compared with nonsmoking women: 62.5% vs. 74.5% for BP (P0.001), 22.7% vs. 33.8% for blood glucose (P0.001), 21.9% vs. 32.0% for cholesterol levels (P0.001). Knowledge of BP level was reduced among women using an estrogen-progestogen contraception (56.8% vs. 62.1%, P = 0.0031) and even more reduced among smokers (52.2%, P0.001). Conversely, women with leisure-time physical or sportive activity (60.5%), were less overweight or obese (22.4% vs. 34.2%, P0.001). They reported better knowledge of BP (72.4% vs. 68.3%, P0.001), blood cholesterol (31.1% vs. 26.4%, P0.001) and glucose levels (32.7% vs. 27.8%, P0.001). Self-perceived cardiovascular risk was rated low by 1,279 (20.4%), moderate by 3,710 (63.3%) and high by 893 (16.3%) women. Among 3,386 women tested using the Framingham score, 40.8% were at low, 25.2% at moderate and 33.8% at high risk.Knowledge of CVRFs and self-perception of individual risk are inaccurate in women. Educational interventions should be emphasized.
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- 2017
8. Cardio-oncologie : un partenariat indispensable
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Michel Desnos
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03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,General Medicine ,030204 cardiovascular system & hematology - Abstract
RESUME La cardio-oncologie (ou onco-cardiologie) est un nouveau champ medical a developpement rapide qui a pour but de prevenir et prendre en charge les affections cardiovasculaires chez les patients atteints de cancer, avant pendant et apres leur traitement. L’augmentation de l’incidence des cancers s’accompagne d’une amelioration de leur pronostic, au prix d’une cardiotoxicite frequente liee aux chimiotherapies et a la radiotherapie. Cette nouvelle population grandissante de patients n’est pas aujourd’hui prise en charge de facon optimale et justifie la mise en place d’equipes soignantes dediees avec des programmes de soins et de surveillance communs multidisciplinaires et structures. Cette nouvelle thematique interdisciplinaire medicale et scientifique, genere par ailleurs un inepuisable champ de recherche.
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- 2017
9. [Why the cardio-oncology?]
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Michel, Desnos
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Humans ,Medical Oncology - Published
- 2019
10. [Cardio-oncology: 10 key messages]
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Michel, Desnos
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Humans ,Medical Oncology - Published
- 2019
11. Influence of centre expertise on the diagnosis and management of hypertrophic cardiomyopathy A study from the French register of hypertrophic cardiomyopathy (REMY)
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Claudio Cervino, Gilbert Habib, Thibaud Damy, Lucile Offredo, Muriel Tafflet, Erwan Donal, Patricia Reant, Jean-Christophe Eicher, Mariana Mirabel, Fabien Labombarda, Albert Hagège, Philippe Charron, Geltrude Giura, Xavier Jouven, Marianna Laurito, Xavier Jeunemaitre, Jean-Philippe Empana, Michel Desnos, Olivier Huttin, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Service de cardiologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Sorbonne Paris Cité (USPC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), 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), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Esquirol [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de génétique [CHU HEGP], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance Publique - Hôpitaux de Marseille (APHM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Sanofi Genzyme, Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Paris Descartes - Paris 5 (UPD5)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN)
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Male ,Sarcomeres ,medicine.medical_specialty ,Genotype ,DNA Mutational Analysis ,Magnetic Resonance Imaging, Cine ,Inherited heart disease ,macromolecular substances ,030204 cardiovascular system & hematology ,Gene mutation ,Myosins ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Internal medicine ,Medical practice ,medicine ,In real life ,Humans ,Genetic Predisposition to Disease ,030212 general & internal medicine ,Genetic Testing ,Prospective Studies ,Registries ,cardiovascular diseases ,Cardiac Surgical Procedures ,Genetic testing ,medicine.diagnostic_test ,business.industry ,Hypertrophic cardiomyopathy ,Disease Management ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,Prognosis ,3. Good health ,Current management ,Mutation ,cardiovascular system ,Female ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
International audience; Background - Our knowledge of hypertrophic cardiomyopathy (HCM) mainly originates from quarternary centres. The objective is to assess the current management of HCM patients in a large multicentre French register according to the level of expertise. Methods and results - A total of 1431 HCM patients were recruited across 26 (11 expert and 15 non-expert) centres in REMY, a prospective hospital-based register of adult HCM patients. A sarcomeric origin was suspected in 1284 (89.7%) patients [261 (20.3%) with a reported gene mutation, 242 (18.8%) genotype-negative], while 107 (7.5%) had a diagnosis of non-sarcomeric HCM. Patients managed in non-expert centres were older (P
- Published
- 2019
12. Long-Term Engraftment (16 Years) of Myoblasts in a Human Infarcted Heart
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Gilles Soulat, Marie Crahès, Philippe Menasché, Michel Desnos, Jean-Thomas Vilquin, Jean-Pierre Marolleau, Marie-Cécile Bories, Albert Hagège, Patrick Bruneval, Jérôme Larghero, UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), 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), Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Myologie, Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Association française contre les myopathies (AFM-Téléthon)-Sorbonne Université (SU), CHU Amiens-Picardie, Therapie Cellulaire en Pathologie Cardio-Vasculaire (UMR_S 633), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7), Ecotaxie, microenvironnement et développement lymphocytaire (EMily (UMR_S_1160 / U1160)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de Recherche en Myologie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre de recherche en Myologie – U974 SU-INSERM
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0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Myoblasts, Skeletal ,Muscle Fibers, Skeletal ,Myocardial Infarction ,Heart failure ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Myoblasts ,03 medical and health sciences ,0302 clinical medicine ,Troponin T ,Human Clinical Article ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Fibrosis ,Internal medicine ,medicine ,[SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,Myocyte ,Humans ,Muscle, Skeletal ,Pathological ,Long-term follow-up ,Heart transplantation ,Myosin Heavy Chains ,Myogenesis ,business.industry ,Myocardium ,fungi ,Cell Biology ,General Medicine ,Long‐term follow‐up ,medicine.disease ,Transplantation ,030104 developmental biology ,Cardiology ,Clinical cell transplantation ,Stem cell ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Developmental Biology - Abstract
We report the case of a patient who had undergone injections of myoblasts in an infarct area 16 years before being referred for heart transplantation. The pathological examination of the explanted heart found persisting myotubes embedded in fibrosis. This finding supports the ability of myoblasts to survive in harsh environments, which can make them appealing candidates for transplantation in diseases requiring supply of new myogenic cells.
- Published
- 2018
13. [Therapeutic education for patients with heart failure, a performance factor]
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Patrick, Jourdain, Yves, Juillière, and Michel, Desnos
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Heart Failure ,Patient Education as Topic ,Humans - Abstract
Heart failure is a little-known disease which is both frequent and serious. It is particularly concerned by therapeutic education as it is linked to a high level of avoidable hospitalisations and requires daily monitoring of simple clinical parameters. It also imposes a change of lifestyle on the patient.
- Published
- 2017
14. Patient therapeutic education in cardiology
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François Funck, N. Hryschyschyn, Fanny Bajolle, Michel Desnos, Yves Juillière, and Patrick Jourdain
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Gynecology ,medicine.medical_specialty ,business.industry ,Medicine ,Hematology ,Therapeutic education ,business - Abstract
L’education therapeutique est un element-cle de la prise en charge de tout patient souffrant d’une pathologie chronique. Il existe de nombreuses preuves de son efficacite pour eviter les hospitalisations, reduire les couts, et dans certaines pathologies baisser la mortalite. L’accompagnement therapeutique est une extension du concept d’education therapeutique aux nouvelles technologies qui laisse entrevoir (enfin) la diffusion de cette forme de soins beneficiant de recommandations tres fortes des societes de cardiologie nationale et internationales.
- Published
- 2015
15. Human embryonic stem cell-derived cardiac progenitors for severe heart failure treatment: first clinical case report: Figure 1
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Michel Desnos, Valérie Vanneaux, Isabelle Cacciapuoti, Alexandre Parouchev, Lucie Tosca, Alain Bel, Albert Hagège, Eric Tartour, Jean-Hugues Trouvin, Valérie Bellamy, Gérard Tachdjian, Bernard Cholley, Romain Guillemain, Philippe Menasché, Jean-Roch Fabreguettes, Jérôme Larghero, Nadine Benhamouda, and Caroline Suberbielle Boissel
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Cardiac function curve ,Homeobox protein NANOG ,medicine.medical_specialty ,Pathology ,education.field_of_study ,Ejection fraction ,business.industry ,Population ,medicine.disease ,Embryonic stem cell ,Cell therapy ,Internal medicine ,Heart failure ,cardiovascular system ,Cardiology ,Medicine ,Stem cell ,Cardiology and Cardiovascular Medicine ,business ,education - Abstract
Aims Comparative studies suggest that stem cells committed to a cardiac lineage are more effective for improving heart function than those featuring an extra-cardiac phenotype. We have therefore developed a population of human embryonic stem cell (ESC)-derived cardiac progenitor cells. Methods and results Undifferentiated human ESCs (I6 line) were amplified and cardiac-committed by exposure to bone morphogenetic protein-2 and a fibroblast growth factor receptor inhibitor. Cells responding to these cardio-instructive cues express the cardiac transcription factor Isl-1 and the stage-specific embryonic antigen SSEA-1 which was then used to purify them by immunomagnetic sorting. The Isl-1 + SSEA-1+ cells were then embedded into a fibrin scaffold which was surgically delivered onto the infarct area in a 68-year-old patient suffering from severe heart failure [New York Heart Association [NYHA] functional Class III; left ventricular ejection fraction (LVEF): 26%]. A coronary artery bypass was performed concomitantly in a non-infarcted area. The implanted cells featured a high degree of purity (99% were SSEA-1+), had lost the expression of Sox-2 and Nanog , taken as markers for pluripotency, and strongly expressed Isl-1 . The intraoperative delivery of the patch was expeditious. The post-operative course was uncomplicated either. After 3 months, the patient is symptomatically improved (NYHA functional Class I; LVEF: 36%) and a new-onset contractility is echocardiographically evident in the previously akinetic cell/patch-treated, non-revascularized area. There have been no complications such as arrhythmias, tumour formation, or immunosuppression-related adverse events. Conclusion This observation demonstrates the feasibility of generating a clinical-grade population of human ESC-derived cardiac progenitors and combining it within a tissue-engineered construct. While any conclusion pertaining to efficacy would be meaningless, the patient's functional outcome yet provides an encouraging hint. Beyond this case, the platform that has been set could be useful for generating different ESC-derived lineage-specific progenies.
- Published
- 2015
16. Rupture of mitral valve chordae in hypertrophic cardiomyopathy
- Author
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Elisabeth Riant, Florence Boissier, Anh Tuan Nguyen, Michel Desnos, Patrick Bruneval, Albert Hagège, Guy Achkouty, and Jean-Noël Fabiani
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Male ,Mitral Valve Annuloplasty ,Cardiomyopathie hypertrophique ,medicine.medical_treatment ,Heart Rupture ,Severity of Illness Index ,Plastie mitrale ,Risk Factors ,Mitral valve ,Prevalence ,Heart Valve Prosthesis Implantation ,Hypertrophic cardiomyopathy ,Mitral Valve Insufficiency ,General Medicine ,Middle Aged ,Echocardiography, Doppler ,Treatment Outcome ,medicine.anatomical_structure ,cardiovascular system ,Cardiology ,Chordae Tendineae ,Mitral Valve ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Chordal rupture ,Paris ,medicine.medical_specialty ,Rupture de cordage mitral ,Ventricular outflow tract obstruction ,Myxomatous degeneration ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Mitral regurgitation ,Aged ,Retrospective Studies ,Mitral valve repair ,business.industry ,Insuffisance mitrale ,Cardiomyopathy, Hypertrophic ,medicine.disease ,Aged patients ,Obstructive hypertrophic cardiomyopathy ,business - Abstract
Summary Background While occasional reports of mitral valve chordal rupture have been described in hypertrophic cardiomyopathy, the exact prevalence and characteristics of this event in a large medical cohort have not been reported. Aim To assess the prevalence of mitral valve chordal rupture in hypertrophic cardiomyopathy and the clinical, echocardiographic, surgical and histological profiles of those patients. Methods We searched for patients with mitral valve chordal rupture diagnosed by echocardiography among all electronic files of patients admitted to our centre for hypertrophic cardiomyopathy between 2000 and 2010. Results Among 580 patients admitted for hypertrophic cardiomyopathy, six patients (1%, 5 men, age 68–71 years) presented with mitral valve chordal rupture, symptomatic in five cases, always involving the posterior mitral leaflet. In all cases, echocardiography before rupture showed mitral valve systolic anterior motion, with anterior (and not posterior) leaflet elongation compared with a random sample of patients with non-obstructive hypertrophic cardiomyopathy ( P = 0.006) (and similar to that observed in obstructive hypertrophic cardiomyopathy). Significant resting left ventricular outflow tract obstruction was always present before rupture and disappeared after rupture in the five cases requiring mitral valve surgery for severe mitral regurgitation. Histological findings were consistent with extensive myxomatous degeneration in all cases. Conclusion Mitral valve chordal rupture is: infrequent in hypertrophic cardiomyopathy; occurs in aged patients with obstructive disease; involves, essentially, the posterior mitral leaflet; and causes, in general, severe mitral regurgitation requiring surgery. Myxomatous degeneration may be the substrate for rupture in these patients.
- Published
- 2015
17. Therapeutic patient education in heart failure: Do studies provide sufficient information about the educational programme?
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Michel Desnos, Aukse Domenke, Patrick Jourdain, Jean-François d’Ivernois, Vincent de Andrade, and Maria Grazia Albano
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medicine.medical_specialty ,Teaching Materials ,Cost-Benefit Analysis ,Éducation thérapeutique du patient ,Health literacy ,Educational methodology ,Therapeutic patient education ,Précision des programmes ,Patient Readmission ,Outcomes evaluation ,law.invention ,Revue de littérature ,Patient Education as Topic ,Randomized controlled trial ,law ,Humans ,Medicine ,Degree of precision ,Child ,Aged ,Randomized Controlled Trials as Topic ,Literature review ,Heart Failure ,Medical education ,business.industry ,Teaching ,General Medicine ,Middle Aged ,medicine.disease ,Health Literacy ,Insuffisance cardiaque ,Description of programmes ,Patient Satisfaction ,Heart failure ,Physical therapy ,Patient Compliance ,Female ,Cardiology and Cardiovascular Medicine ,business ,Psychosocial ,Program Evaluation - Abstract
SummaryTherapeutic patient education programmes on heart failure have been widely proposed for many years for heart failure patients, but their efficiency remains questionable, partly because most articles lack a precise programme description, which makes comparative analysis of the studies difficult. To analyse the degree of precision in describing therapeutic patient education programmes in recent randomized controlled trials. Three major recent recommendations on therapeutic patient education in heart failure inspired us to compile a list of 23 relevant items that an ‘ideal’ description of a therapeutic patient education programme should contain. To discover the extent to which recent studies into therapeutic patient education in heart failure included these items, we analysed 19 randomized controlled trials among 448 articles published in this field from 2005 to 2012. The major elements required to describe a therapeutic patient education programme were present, but some other very important pieces of information were missing in most of the studies we analysed: the patient's educational needs, health literacy, projects, expectations regarding therapeutic patient education and psychosocial status; the educational methodology used; outcomes evaluation; and follow-up strategies. Research into how therapeutic patient education can help heart failure patients will be improved if more precise descriptions of patients, educational methodology and evaluation protocols are given by authors, ideally in a standardized format.
- Published
- 2014
18. Heart failure and telemedicine, a new model?
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Patrick Jourdain, Michel Desnos, Yves Juillière, Natalya Hrychischin, and François Funck
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Hematology ,business - Abstract
L’insuffisance cardiaque chronique est une maladie frequente et grave. Malgre les progres des derniers annees avec l’emergence de nouvelles therapeutiques, de nouveaux biomarqueurs et l’amelioration de nos possibilites diagnostiques en particulier en echographie, le taux de rehospitalisation et de deces reste particulierement eleve. Une autre specificite de cette maladie est que plus de 50 % des patients presentent des signes cliniques devant alerter celui-ci 5 jours avant son passage aux urgences. Tous ces elements font de l’insuffisance cardiaque une cible de choix pour la telemedecine. Dans le cadre de cette pathologie, la telemedecine s’est preferentiellement orientee, d’une part, vers le suivi de protheses electriques (pacemakers, defibrillateurs) et, d’autre part, vers le suivi de signes de decompensation, que ce soit au moyen de protheses embarquees (implantees) ou bien de modules externes connectes. Cependant, les resultats des etudes publiees ont ete tres variables et discutes. Actuellement, une nouvelle generation de dispositifs de telemedecine voit le jour, integrant non seulement des parametres cliniques, mais aussi des parametres biologiques, mais cette generation comme les autres doit prouver son utilite et sa population cible avant son deploiement.
- Published
- 2014
19. Thérapie cellulaire et insuffisance cardiaque : ombres et lumières
- Author
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Michel Desnos
- Subjects
medicine.medical_treatment ,Mesenchymal stem cell ,Clinical uses of mesenchymal stem cells ,General Medicine ,Stem-cell therapy ,Biology ,Embryonic stem cell ,Cell therapy ,Immunology ,Cancer research ,medicine ,Induced pluripotent stem cell ,Adult stem cell ,Stem cell transplantation for articular cartilage repair - Abstract
Despite therapeutic advances, heart failure remains a common and serious event characterized by initial and progressive loss of cardiac myocytes, a loss that is currently untreatable. Cell therapy has emerged as a promising new approach to the treatment of heart failure, with very encouraging experimental results. Since 2000, when human stem cell therapy was first attempted in France, clinical trials with adult stem cells (myoblasts, bone-marrow derived cells, mesenchymal stem cells) have given variable results. The inconsistent and modest therapeutic benefit observed in these studies is due more to paracrine effects than to the hoped-for cell replacement, as adult stem cells do not turn into cardiomyocytes and their survival rate after transplantation is very low. In order to be effective, cell therapy should use heart muscle cells derived from pluri- or multipotent cells (human embryonic stem cells, induced pluripotent stem cells, resident cardiac cells), which are likely to have a higher survival rate in a hostile biological environment and deteriorated tissue scaffold. Cardiac tissue engineering assisted by nanotechnologies may eventually help to meet this challenge.
- Published
- 2014
20. Major regional disparities in outcomes after sudden cardiac arrest during sports
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Jean-Philippe Empana, Christof Prugger, Christian Spaulding, Nicole Karam, Eloi Marijon, Florence Dumas, Lionel Lamhaut, Jean-Pierre Rifler, Paul Avillach, Jean-Yves Le Heuzey, Michel Desnos, Marie-Cécile Perier, Muriel Tafflet, Xavier Jouven, David S. Celermajer, Hazrije Mustafic, Nordine Benameur, Wulfran Bougouin, and Alain Cariou
- Subjects
medicine.medical_specialty ,Resuscitation ,business.industry ,medicine.medical_treatment ,Basic life support ,Poison control ,Sudden cardiac arrest ,medicine.disease ,Confidence interval ,Sudden cardiac death ,Internal medicine ,medicine ,Cardiopulmonary resuscitation ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,Survival rate - Abstract
Aims Characteristics of sudden cardiac arrest (SCA) during sports offers a novel (and unexplored) setting to assess factors associated with disparities in outcomes across regions. Methods and results From a prospective 5-year community-based French registry concerning SCA during sports in 10–75 year-olds, we evaluated whether outcomes differed significantly between geographic regions. We then determined the extent to which variations in community-related early interventions were associated with regional variations in survival. Among 820 SCA cases studied, overall survival at hospital discharge was 15.7% (95% confidence interval, 13.2–18.2%), with considerable regional disparities (from 3.4 to 42.6%, P < 0.001). Major differences were noted regarding bystander initiation of cardiopulmonary resuscitation (15.3–80.9%, P < 0.001) and presence of initial shockable rhythm (28.6–79.1%, P < 0.001), with higher values of these being associated with better survival rates. The proportion of survivors with favourable neurological outcome at discharge was fairly uniform among survival groups (CPC–1/2, varying from 77.4 to 90.0%, P = 0.83). No difference was observed regarding subjects' characteristics and circumstances of SCA occurrence, including delays in resuscitation (collapse-to-call period). With a comparable in-hospital mortality ( P = 0.44), survival at hospital discharge was highly correlated with that at hospital admission (regional variations from 7.4 to 75.0%, P < 0.001). Conclusion Major regional disparities exist in survival rates (up to 10-fold) after SCA during sports. SCA cases from regions with the highest levels of bystander resuscitation had the best survival rates to hospital admission and discharge.
- Published
- 2013
21. High prevalence of arrhythmic and myocardial complications in patients with cardiac glycogenosis due to PRKAG2 mutations
- Author
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Julien Thevenon, Gabriel Laurent, Claire Bonithon-Kopp, Claude Alain Maurage, Laurent Martin, Christel Thauvin-Robinet, Denis Duboc, Didier Klug, Patricia Reant, Elodie Gautier, François Picard, Michel Desnos, Salem Kacet, Laurence Faivre, Philippe Charron, Juliette Albuisson, Laurent Gouya, Christine Binquet, Pascale Richard, Patrice Bouvagnet, Anju Duva Pentiah, Pascal Laforêt, Jean-Christophe Eicher, Flavie Ader, Eric Bieth, Centre de génétique - Centre de référence des maladies rares, anomalies du développement et syndromes malformatifs (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Laboratoire Electronique, Informatique et Image [UMR6306] (Le2i), Université de Bourgogne (UB)-École Nationale Supérieure d'Arts et Métiers (ENSAM), Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de recherche biomédicale Bichat-Beaujon (CRB3), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Cardiologie [CHU de Dijon], Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiologie et la Radiologie Cardio-vasculaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Génétique [Purpan], CHU Toulouse [Toulouse], Service de Cardiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Service de Pathologie [CHU de Dijon], Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques (CIC-EC), Université de Bourgogne (UB)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Cardiogénétique, CHU de Lyon HCL-GH Est-Hôpital Louis Pradel, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université de Bourgogne (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Arts et Métiers (ENSAM), HESAM Université (HESAM)-HESAM Université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, Université Paris Descartes - Paris 5 (UPD5)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), CHU Pitié-Salpêtrière [APHP], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre de recherche biomédicale Bichat-Beaujon ( CRB3 ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), CRM J-P Aubert INSERM UMR 837, Université de Lille, Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Centre d'Investigation Clinique 1432 (Dijon) - Epidemiologie Clinique/Essais Cliniques ( CIC-EC ), Université de Bourgogne ( UB ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Centre de référence des maladies cardiaques héréditaires, Laboratoire Electronique, Informatique et Image [UMR6303] ( Le2i ), Université de Bourgogne ( UB ) -École Nationale Supérieure d'Arts et Métiers ( ENSAM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Européen Georges Pompidou [APHP] ( HEGP ), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Arts et Métiers Sciences et Technologies, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Therapie Cellulaire en Pathologie Cardio-Vasculaire (UMR_S 633), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Génétique Médicale [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service médico-chirurgical Cardiologie Pédiatrique et Congénitale Adulte (CHU de Lyon - HCL - Hôpital L. Pradel), Hospices Civils de Lyon (HCL), Hôpital Ambroise Paré [AP-HP], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP]
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Heart block ,Cardiomyopathy ,medicine.medical_treatment ,Disease ,030204 cardiovascular system & hematology ,Sudden cardiac death ,Time-to-event study ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Physiology (medical) ,Internal medicine ,Wolff–Parkinson–White ,Ventricular pre-excitation ,medicine ,Heart transplantation ,business.industry ,Incidence (epidemiology) ,Hypertrophic cardiomyopathy ,[ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine.disease ,PRKAG2 ,3. Good health ,030104 developmental biology ,Cohort ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
International audience; AIMS: Mutations in PRKAG2, the gene encoding for the γ2 subunit of 5'-AMP-activated protein kinase (AMPK), are responsible for an autosomal dominant glycogenosis with a cardiac presentation, associating hypertrophic cardiomyopathy (HCM), ventricular pre-excitation (VPE), and progressive heart block. The aim of this study was to perform a retrospective time-to-event study of the clinical manifestations associated with PRKAG2 mutations.METHODS AND RESULTS: A cohort of 34 patients from 9 families was recruited between 2001 and 2010. DNA were sequenced on all exons and flanking sequences of the PRKAG2 gene using Sanger sequencing. Overall, four families carried the recurrent p.Arg302Gln mutation, and the five others carried private mutations among which three had never been reported. In the total cohort, at 40 years of age, the risk of developing HCM was 61%, VPE 70%, conduction block 22%, and sudden cardiac death (SCD) 20%. The global survival at 60 years of age was 66%. Thirty-two per cent of patients (N = 10) required a device implantation (5 pacemakers and 5 defibrillators) at a median age of 66 years, and two patients required heart transplant. Only one patient presented with significant skeletal muscle symptoms. No significant differences regarding the occurrence of VPE, ablation complications, or death incidence were observed between different mutations.CONCLUSION: This study of patients with PRKAG2 mutations provides a more comprehensive view of the natural history of this disease and demonstrates a high risk of cardiac complications. Early recognition of this disease appears important to allow an appropriate management.
- Published
- 2016
22. Cardiomyopathie hypertrophique : aspects actuels et nouveautés
- Author
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Michel Desnos
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,Myocardial disease ,business - Abstract
RESUME La cardiomyopathie hypertrophique est une maladie myocardique caracterisee par une hypertrophie ventriculaire gauche sans cause apparente (c’est-a-dire en l’absence d’une hypertension arterielle severe, d’une stenose valvulaire aortique...) Le diagnostic clinique repose sur l’imagerie cardiaque, habituellement l’echographie et de plus en plus la resonance magnetique nucleaire. La cardiomyopathie hypertrophique est la cause la plus frequente de mort subite chez les jeunes, particulierement lors des competitions athletiques. La majorite des patients reste asymptomatique durant la vie mais d’autres developpent des signes d’insuffisance cardiaque, une fibrillation auriculaire et des accidents vasculaires cerebraux. C’est la maladie cardiovasculaire genetique la plus frequente (a transmission autosomique dominante) avec une penetrance et une expression variables, causee par des mutations des genes codant les proteines sarcomeriques cardiaques. Les conseils genetiques et la stratification du risque sont indispensables chez tous les patients. Le traitement medical avec les betabloqueurs ou le verapamil ameliore les symptomes mais ne modifie pas la progression de la maladie. Les patients ayant une obstruction systolique et des symptomes severes ne repondant pas au traitement medical sont candidats a l’alcoolisation septale ou a la myectomie chirurgicale. L’approche actuelle est focalisee sur la prevention de la mort subite par le defibrillateur implantable indique chez les patients a haut risque.
- Published
- 2012
23. Sports-Related Sudden Death in the General Population
- Author
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Eloi Marijon, Jean-Philippe Empana, David S. Celermajer, Michel Rieu, Hazrije Mustafic, Michel Desnos, Jean-Yves Le Heuzey, Marie-Cécile Perier, Florence Dumas, Nordine Benameur, Muriel Tafflet, Xavier Jouven, Jean-François Toussaint, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut de recherche biomédicale et d’épidémiologie du sport (IRMES - EA 7329), Université Paris Descartes - Paris 5 (UPD5)-Institut national du sport, de l'expertise et de la performance (INSEP), Imaging Sciences and Biomedical Engineering Division [London], Guy's and St Thomas' Hospital [London]-King‘s College London, Université Paris Descartes - Paris 5 (UPD5), Therapie Cellulaire en Pathologie Cardio-Vasculaire (UMR_S 633), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Agence Française de Lutte contre le Dopage (AFLD), INSEP, documentation, 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)
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Male ,Survival ,medicine.medical_treatment ,bystander help ,Poison control ,cardiac arrest ,030204 cardiovascular system & hematology ,0302 clinical medicine ,[SHS.SPORT.SS]Humanities and Social Sciences/Sport/Sport heath ,[SHS.SPORT.SS] Humanities and Social Sciences/Sport/Sport heath ,Prospective Studies ,030212 general & internal medicine ,Child ,physical ,education.field_of_study ,exercise ,Data Collection ,Incidence ,Incidence (epidemiology) ,Age Factors ,Middle Aged ,defibrillation ,3. Good health ,Female ,France ,Cardiology and Cardiovascular Medicine ,Sports ,Adult ,Chest Pain ,medicine.medical_specialty ,Adolescent ,Population ,Electric Countershock ,Context (language use) ,arrhythmia ,cardiopulmonary resuscitation ,Sudden death ,Young Adult ,03 medical and health sciences ,Physiology (medical) ,medicine ,First Aid ,Humans ,Cardiopulmonary resuscitation ,education ,Aged ,business.industry ,Arrhythmias, Cardiac ,Odds ratio ,Confidence interval ,Heart Arrest ,Surgery ,Death, Sudden, Cardiac ,athletes ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Emergency medicine ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
Background— Although such data are available for young competitive athletes, the prevalence, characteristics, and outcome of sports-related sudden death have not been assessed previously in the general population. Methods and Results— A prospective and comprehensive national survey was performed throughout France from 2005 to 2010, involving subjects 10 to 75 years of age. Case detection for sports-related sudden death, including resuscitated cardiac arrest, was undertaken via national ambulance service reporting and Web-based screening of media releases. The overall burden of sports-related sudden death was 4.6 cases per million population per year, with 6% of cases occurring in young competitive athletes. Sensitivity analyses used to address suspected underreporting demonstrated an incidence ranging from 5 to 17 new cases per million population per year. More than 90% of cases occurred in the context of recreational sports. The age of subjects was relatively young (mean±SD 46±15 years), with a predominance of men (95%). Although most cases were witnessed (93%), bystander cardiopulmonary resuscitation was only commenced in 30.7% of cases. Bystander cardiopulmonary resuscitation (odds ratio 3.73, 95% confidence interval 2.19 to 6.39, P P Conclusions— Sports-related sudden death in the general population is considerably more common than previously suspected. Most cases are witnessed, yet bystander cardiopulmonary resuscitation was only initiated in one third of cases. Given the often predictable setting of sports-related sudden death and that prompt interventions were significantly associated with improved survival, these data have implications for health services planning.
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- 2011
24. High on-clopidogrel platelet reactivity: Genotyping Can help to optimize antiplatelet treatment
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Hubert Van Viet, Pascale Gaussem, Jean Szymezak, Marie-Anne Loriot, Caroline Moreau, Eric Durand, and Michel Desnos
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Platelet reactivity ,Antithrombotic Agent ,business.industry ,medicine ,Platelet ,Hematology ,Pharmacology ,Clopidogrel ,business ,Genotyping ,medicine.drug - Published
- 2011
25. Relief of Mitral Leaflet Tethering Following Chronic Myocardial Infarction by Chordal Cutting Diminishes Left Ventricular Remodeling
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Alain Carpentier, Albert Hagège, Philippe Menasché, Alain Bel, Michel Desnos, Iris Cohen, Emmanuel Messas, Bernard Touchot, Robert A. Levine, Mark D. Handschumacher, and Catherine Szymanski
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medicine.medical_specialty ,Heart Ventricles ,Echocardiography, Three-Dimensional ,Myocardial Infarction ,Infarction ,Doppler echocardiography ,Article ,Internal medicine ,Mitral valve ,Animals ,Medicine ,Radiology, Nuclear Medicine and imaging ,Myocardial infarction ,Ventricular remodeling ,Analysis of Variance ,Mitral regurgitation ,Sheep ,Ejection fraction ,Vena contracta ,Ventricular Remodeling ,medicine.diagnostic_test ,business.industry ,Mitral Valve Insufficiency ,medicine.disease ,Echocardiography, Doppler ,Surgery ,Disease Models, Animal ,medicine.anatomical_structure ,Chronic Disease ,Disease Progression ,Cardiology ,Chordae Tendineae ,Mitral Valve ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background— One of the key targets in treating mitral regurgitation (MR) is reducing the otherwise progressive left ventricular (LV) remodeling that exacerbates MR and conveys adverse prognosis. We have previously demonstrated that severing 2 second-order chordae to the anterior mitral leaflet relieves tethering and ischemic MR acutely. The purpose of this study was to test whether this technique reduces the progression of LV remodeling in the chronic ischemic MR setting. Methods and Results— A posterolateral MI was created in 18 sheep by obtuse marginal branch ligation. After chronic remodeling and MR development at 3 months, 6 sheep were randomized to sham surgery (control group) and 12 to second-order chordal cutting (6 each to anterior leaflet [AntL] and bileaflet [BiL] chordal cutting, techniques that are in clinical application). At baseline, chronic infarction (3 months), and follow-up at a mean of 6.6 months post-myocardial infarction (MI) (euthanasia), we measured LV end-diastolic (EDV) and end-systolic volume (ESV), ejection fraction, wall motion score index, and posterior leaflet (PL) restriction angle relative to the annulus by 2D and 3D echocardiography. All measurements were comparable among groups at baseline and chronic MI. At euthanasia, AntL and BiL chordal cutting limited the progressive remodeling seen in controls. LVESV increased relative to chronic MI by 109±8.7% in controls versus 30.5±6.1% with chordal cutting ( P P P P Conclusions— Reduced leaflet tethering by chordal cutting in the chronic post-MI setting substantially decreases the progression of LV remodeling with sustained reduction of MR over a chronic follow-up. These benefits have the potential to improve clinical outcomes.
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- 2010
26. Performance assessment of a chest pain unit: Preliminary 2-year experience in the European Georges Pompidou Hospital
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Marilyse Collin, Antoine Lepillier, Severine Beretti, Jean-François Coeuret, Nicolas Danchin, Aures Chaib, Martine Schachtel, Michel Desnos, Aurélie Delos, Eric Durand, and Jean-Yves Le Heuzey
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Male ,Thorax ,Chest pain unit ,Time Factors ,Epidemiology ,Pilot Projects ,Chest pain ,Coronary artery disease ,Patient Admission ,Risk Factors ,Task Performance and Analysis ,Prevalence ,Medicine ,Prospective Studies ,Program Development ,Prospective cohort study ,Aged, 80 and over ,Unité de douleur thoracique ,General Medicine ,Middle Aged ,Syndrome coronaire aigu ,Épidémiologie ,Outcome and Process Assessment, Health Care ,Treatment Outcome ,Heart Function Tests ,Female ,Cardiology Service, Hospital ,France ,medicine.symptom ,Emergency Service, Hospital ,Cardiology and Cardiovascular Medicine ,Adult ,Chest Pain ,Acute coronary syndrome ,medicine.medical_specialty ,Adolescent ,Patient Readmission ,Risk Assessment ,Young Adult ,Predictive Value of Tests ,Humans ,Organizational Objectives ,Acute Coronary Syndrome ,Quality of care ,Hospitals, Teaching ,Aged ,business.industry ,Coronary Care Units ,Length of Stay ,medicine.disease ,Triage ,Surgery ,Emergency medicine ,business ,Program Evaluation - Abstract
Summary Background Chest pain units (CPUs) are very popular in the USA for the triage of low-to-intermediate-risk chest pains. However, CPUs do not yet exist in France. Aims To determine the prevalence and clinical characteristics of patients admitted to a new CPU in France, and to assess the quality of care with regard to identification and exclusion of an acute coronary syndromes (ACS). Methods This prospective study included 906 consecutive patients with non-traumatic chest pain admitted to our CPU between September 2006 and August 2008. Patients were managed according to their probability of presenting with an ACS. Clinical characteristics, diagnostic tests, final diagnosis, destination and length of stay were recorded. We also assessed the 30-day outcome of patients in whom an ACS was excluded. Results Of the 906 patients, 27.9% had an ACS (1.3% with and 26.6% without ST-segment elevation, respectively). Non-ischaemic cardiac aetiologies and non-cardiac aetiologies were found in 123 (12.6%) and 63 (7.0%) patients, respectively. A final diagnosis of chest pain of undetermined origin was made in 51.5% of patients; among these, 17 (6.5%) patients were re-admitted to the CPU between September 2006 and September 2007. Thirty-day follow-up revealed that only one patient had subsequent confirmation of coronary artery disease requiring further hospitalization. Conclusions This prospective study reports the first experience of a CPU in a cardiology department in France. Our preliminary results suggest that our CPU can exclude an ACS safely. Further studies are warranted to assess the value of CPUs in France.
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- 2009
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27. Excessive heart rate increase during mild mental stress in preparation for exercise predicts sudden death in the general population
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Peter J. Schwartz, Jean Philippe Empana, Céline Straczek, Sylvie Escolano, Xavier Jouven, Muriel Tafflet, Pierre Ducimetière, and Michel Desnos
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Adult ,Male ,medicine.medical_specialty ,Population ,Physical exercise ,Sudden death ,Sudden cardiac death ,Heart Rate ,Predictive Value of Tests ,Risk Factors ,Internal medicine ,Heart rate ,medicine ,Humans ,Prospective Studies ,Risk factor ,education ,education.field_of_study ,business.industry ,Middle Aged ,medicine.disease ,Death, Sudden, Cardiac ,Early Diagnosis ,Relative risk ,Exercise Test ,Physical therapy ,Cardiology ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business ,Stress, Psychological - Abstract
Aims The aim of this study involves the early identification, among apparently healthy individuals, of those at high risk for sudden cardiac death. We tested the hypothesis that individuals who respond to mild mental stress in preparation for exercise test with the largest heart rate increases might be at highest risk. Methods and results Data from 7746 civil servants participating in the Paris Prospective Study I, followed-up for 23 years, allowed to compare heart rate changes between rest and mild mental stress (preparation prior to an exercise test) between subjects who suffered sudden cardiac death ( n = 81), non-sudden ( n = 129) coronary death, or death from any cause ( n = 1306). The mean heart rate increase during mild mental stress was 8.9 ± 10.8 b.p.m. Risk of sudden cardiac death increased progressively with heart rate increase during mental stress and the relative risk of the third vs. the first tertile was 2.09 (95% confidence interval, 1.13–3.86) after adjustment for confounders. This relationship was not observed for non-sudden coronary death. Conclusion An important heart rate increase produced by a mild mental stress predicts long-term risk for sudden cardiac death. Heart rate changes before an exercise test may provide a simple tool for risk stratification.
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- 2009
28. Can Mesenchymal Stem Cells Induce Tolerance to Cotransplanted Human Embryonic Stem Cells?
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Etienne Puymirat, Patrick Bruneval, Michel Desnos, Ludovic Trinquart, Valérie Bellamy, Jérôme Larghero, Michel Pucéat, André Tomescot, Raghed Geha, Albert Hagège, and Philippe Menasché
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Angiogenesis ,Myocardial Infarction ,Apoptosis ,030204 cardiovascular system & hematology ,Biology ,Mesenchymal Stem Cell Transplantation ,Cell Line ,Andrology ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Drug Discovery ,Genetics ,Animals ,Humans ,Rats, Wistar ,Molecular Biology ,Embryonic Stem Cells ,030304 developmental biology ,Stem cell transplantation for articular cartilage repair ,Pharmacology ,0303 health sciences ,Neovascularization, Pathologic ,Mesenchymal stem cell ,FOXP3 ,Mesenchymal Stem Cells ,Original Articles ,Fibrosis ,Immunohistochemistry ,Embryonic stem cell ,Rats ,3. Good health ,Transplantation ,Echocardiography ,Cell culture ,Immunology ,Molecular Medicine ,Female - Abstract
Mesenchymal stem cells (MSCs) are reported to be immune privileged. We assessed whether their transplantation (Tx) could create a suppressive microenvironment mitigating rejection of coinjected human embryonic stem cells (hESCs). Three weeks after ligation-induced myocardial infarction, 40 immunocompetent rats received 150 microl of cardiac-specified hESCs (5 x 10(6)), MSCs (5 x 10(6)), hESC + MSC (5 x 10(6) for each), or control medium. Two months after Tx, left ventricle (LV) function was assessed by echocardiography, and hearts were processed for the detection of human cells by immunostaining and quantitative RT-PCR, patterns of rejection, fibrosis, and angiogenesis. Two months after Tx, LV ejection fraction (LVEF) was significantly higher in the ESC and ESC + MSC groups compared with controls. There were few engrafted cells, which expressed markers of endothelial, smooth muscle, and ventricular cardiac cells, particularly in the MSC group. Hearts of all groups demonstrated a similar infiltration by CD4(+) and CD3(+) cells but MSC-Tx resulted in a greater infiltration of FoxP3 compared with the control and ESC-alone groups. No teratoma was observed. Thus, cotransplantation of ESCs and MSCs provided better functional preservation compared with single-cell treatment alone. However, there was only modest evidence for an immunosuppressive effect of coinjected MSCs and their beneficial effects seemed rather mediated by trophic effects on the host tissue.
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- 2009
29. Relation of Heart Rate at Rest and Long-Term (>20 Years) Death Rate in Initially Healthy Middle-Aged Men
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Jean François Buyck, Michel Desnos, Muriel Tafflet, Xavier Jouven, Pierre Ducimetière, Sylvie Escolano, and Jean Philippe Empana
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Adult ,Male ,medicine.medical_specialty ,Rest ,Asymptomatic ,Heart Rate ,Risk Factors ,Internal medicine ,Heart rate ,medicine ,Humans ,Mortality ,Survival analysis ,Proportional Hazards Models ,Analysis of Variance ,Chi-Square Distribution ,business.industry ,Proportional hazards model ,Mortality rate ,Confounding ,Middle Aged ,Survival Analysis ,Confidence interval ,Cardiology ,France ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Chi-squared distribution - Abstract
The prognostic implications of heart rate (HR) change over years have never been assessed. It was hypothesized that an increase in HR in apparently healthy persons observed over years could be associated with an increase in mortality risk and conversely. A total of 5,139 asymptomatic working men (aged 42 to 53 years) free of clinically detectable cardiovascular disease were recruited from 1967 to 1972 and had their HRs measured at rest in standardized conditions every year for 5 consecutive years. HR change was defined as the difference between HR at examination 5 and HR at inclusion, and subjects were divided into tertiles according to decrease >4 beats/min, unchanged (from -4 to +3 beats/min), and increase >3 beats/min. After >20 years of mortality surveillance, 1,219 deaths were observed. After adjustments were made for confounding factors, including baseline HR at rest, and compared with subjects with unchanged HRs, subjects with decreased HRs during the 5 years had a 14% decreased mortality risk (RR 0.86, 95% confidence interval 0.74 to 1.00, p=0.05), whereas subjects with increased HRs during the 5 years had a 19% increased mortality risk (RR 1.19, and 95% confidence interval 1.04 to 1.37, p
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- 2009
30. [Stem cell therapy and heart failure: hopes and disappointments]
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Michel, Desnos
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Heart Failure ,Pluripotent Stem Cells ,Nuclear Transfer Techniques ,Humans ,Myocytes, Cardiac ,Embryonic Stem Cells ,Stem Cell Transplantation - Abstract
Despite therapeutic advances, heart failure remains a common and serious event characterized by initial and progressive loss of cardiac myocytes, a loss that is currently untreatable. Cell therapy has emerged as a promising new approach to the treatment of heart failure, with very encouraging experimental results. Since 2000, when human stem cell therapy was first attempted in France, clinical trials with adult stem cells (myoblasts, bone-marrow derived cells, mesenchymal stem cells) have given variable results. The inconsistent and modest therapeutic benefit observed in these studies is due more to paracrine effects than to the hoped-for cell replacement, as adult stem cells do not turn into cardiomyocytes and their survival rate after transplantation is very low. In order to be effective, cell therapy should use heart muscle cells derived from pluri- or multipotent cells (human embryonic stem cells, induced pluripotent stem cells, resident cardiac cells), which are likely to have a higher survival rate in a hostile biological environment and deteriorated tissue scaffold. Cardiac tissue engineering assisted by nanotechnologies may eventually help to meet this challenge.
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- 2015
31. Human embryonic stem cell-derived cardiac progenitors for severe heart failure treatment: first clinical case report
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Philippe, Menasché, Valérie, Vanneaux, Albert, Hagège, Alain, Bel, Bernard, Cholley, Isabelle, Cacciapuoti, Alexandre, Parouchev, Nadine, Benhamouda, Gérard, Tachdjian, Lucie, Tosca, Jean-Hugues, Trouvin, Jean-Roch, Fabreguettes, Valérie, Bellamy, Romain, Guillemain, Caroline, Suberbielle Boissel, Eric, Tartour, Michel, Desnos, and Jérôme, Larghero
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Heart Failure ,Ventricular Dysfunction, Left ,Treatment Outcome ,Tissue Scaffolds ,Human Embryonic Stem Cells ,Myocardial Ischemia ,Humans ,Female ,Middle Aged - Abstract
Comparative studies suggest that stem cells committed to a cardiac lineage are more effective for improving heart function than those featuring an extra-cardiac phenotype. We have therefore developed a population of human embryonic stem cell (ESC)-derived cardiac progenitor cells.Undifferentiated human ESCs (I6 line) were amplified and cardiac-committed by exposure to bone morphogenetic protein-2 and a fibroblast growth factor receptor inhibitor. Cells responding to these cardio-instructive cues express the cardiac transcription factor Isl-1 and the stage-specific embryonic antigen SSEA-1 which was then used to purify them by immunomagnetic sorting. The Isl-1(+) SSEA-1(+) cells were then embedded into a fibrin scaffold which was surgically delivered onto the infarct area in a 68-year-old patient suffering from severe heart failure [New York Heart Association [NYHA] functional Class III; left ventricular ejection fraction (LVEF): 26%]. A coronary artery bypass was performed concomitantly in a non-infarcted area. The implanted cells featured a high degree of purity (99% were SSEA-1(+)), had lost the expression of Sox-2 and Nanog, taken as markers for pluripotency, and strongly expressed Isl-1. The intraoperative delivery of the patch was expeditious. The post-operative course was uncomplicated either. After 3 months, the patient is symptomatically improved (NYHA functional Class I; LVEF: 36%) and a new-onset contractility is echocardiographically evident in the previously akinetic cell/patch-treated, non-revascularized area. There have been no complications such as arrhythmias, tumour formation, or immunosuppression-related adverse events.This observation demonstrates the feasibility of generating a clinical-grade population of human ESC-derived cardiac progenitors and combining it within a tissue-engineered construct. While any conclusion pertaining to efficacy would be meaningless, the patient's functional outcome yet provides an encouraging hint. Beyond this case, the platform that has been set could be useful for generating different ESC-derived lineage-specific progenies.
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- 2015
32. Towards a clinical use of human embryonic stem cell-derived cardiac progenitors: a translational experience
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Alain Bel, Michel Desnos, Julia Pouly, Gérard Tachdjian, Jean-Hugues Trouvin, Onnik Agbulut, Valérie Vanneaux, Jérôme Larghero, Valérie Bellamy, Marie-Cécile Perier, Jean-Roch Fabreguettes, Patrick Bruneval, Lucie Tosca, Yohan Farouz, Odile Damour, Albert Hagège, Sylvie Garcia, Philippe Menasché, Cellules Souches et Biothérapies (CSB), Adaptation Biologique et Vieillissement = Biological Adaptation and Ageing (B2A), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Biologie Paris Seine (IBPS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Biologie Paris Seine (IBPS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique-Hopitaux de Paris, LabEx REVIVE, Foundation LeDucq (SHAPE-HEART network), Fondation de France, Fondation Coeur et Arteres, Association Francaise contre les Myopathies [ANR-10-IBHU-0002], Hospices Civils de Lyon, INSERM, University Paris Descartes, Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Biologie Paris Seine (IBPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Biologie Paris Seine (IBPS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Biologie Paris Seine (IBPS), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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Cost effectiveness ,Human Embryonic Stem Cells ,Population ,Cell- and Tissue-Based Therapy ,Heart failure ,Mice, SCID ,Tissue Banks ,Stem cells ,[SDV.BC]Life Sciences [q-bio]/Cellular Biology ,Cell therapy ,Animals ,Humans ,Medicine ,Myocytes, Cardiac ,Tissue engineering ,Progenitor cell ,education ,education.field_of_study ,Clinical Trials, Phase I as Topic ,Tissue Scaffolds ,Immunomagnetic Separation ,business.industry ,Embryonic stem cell ,3. Good health ,Transplantation ,Myocardial infarction ,Evaluation Studies as Topic ,Cytogenetic Analysis ,Immunology ,Cancer research ,Tissue Preservation ,Stem cell ,Cardiology and Cardiovascular Medicine ,business ,Cell bank - Abstract
International audience; Aim This paper describes the multi-step translational approach that has resulted in the generation of clinical-grade human embryonic stem cell-derived cardiac progenitor cells for transplantation in patients with severe ischaemic heart failure. There is now compelling evidence that cells committed to a cardiac lineage are most effective for improving the function of infarcted hearts. This has been confirmed by our pre-clinical studies entailing transplantation of human embryonic stem cell (hESC)-derived cardiac progenitors in rat and non-human primate models of myocardial infarction. These data have paved the way for a translational programme aimed at a phase I clinical trial. Methods and results The main steps of this programme have included (i) the expansion of a clone of pluripotent hESC to generate a master cell bank under good manufacturing practice conditions (GMP); (ii) a growth factor-induced cardiac specification; (iii) the purification of committed cells by immunomagnetic sorting to yield a stage-specific embryonic antigen (SSEA)-1-positive cell population strongly expressing the early cardiac transcription factor Isl-1; (iv) the incorporation of these cells into a fibrin scaffold; (v) a safety assessment focused on the loss of teratoma-forming cells by in vitro (transcriptomics) and in vivo (cell injections in immunodeficient mice) measurements; (vi) an extensive cytogenetic and viral testing; and (vii) the characterization of the final cell product and its release criteria. The data collected throughout this process have led to approval by the French regulatory authorities for a first-in-man clinical trial of transplantation of these SSEA-1(+) progenitors in patients with severely impaired cardiac function. Conclusion Although several facets of this manufacturing process still need to be improved, these data may yet provide a useful platform for the production of hESC-derived cardiac progenitor cells under safe and cost-effective GMP conditions.
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- 2015
33. Myoblast transplantation during cardiac surgery
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Michel Desnos, Albert Hagège, and Philippe Menasché
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medicine.medical_specialty ,business.industry ,Regeneration (biology) ,Scars ,Bioinformatics ,law.invention ,Cardiac surgery ,Contractility ,Transplantation ,Paracrine signalling ,Randomized controlled trial ,law ,Internal medicine ,Cardiology ,Medicine ,Myocyte ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
After a decade of experimental work, skeletal myoblast transplantation has now entered the clinical arena as a potentially new means of improving the function of the chronically infarcted heart through regeneration of fibrotic scars. Because the engrafted myoblasts do not connect with the host cardiomyocytes, it is increasingly considered that the functional benefits of myogenic cell transplantation are more related to limitation of adverse post-infarction remodelling and/or paracrine signalling on recipient tissue rather than to a synchronous contribution of the graft to the heart's systolic function. The initial clinical studies of intra-operative myoblast transplantation have primarily documented the feasibility of the procedure and unravelled a potential pro-arrhythmic risk that needs to be further characterized. It is now critical to assess whether the functional benefits observed in the laboratory setting translate into meaningful improvements in local and global contractility and ultimate patient outcomes. The results of ongoing randomized trials should soon help clarifying this efficacy issue. In parallel, experimental studies need to be actively pursued to address some remaining key issues including the means of optimizing myoblast delivery, engraftment and survival, and the development of a second-line generation of cells featuring the potential of a true electromechanical integration within the recipient myocardium.
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- 2006
34. Clinical profile, contemporary management and one-year mortality in patients with severe acute heart failure syndromes: The EFICA study☆
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Faiez Zannad, Alain Cohen-Solal, Laurence Paolozzi, Alexandre Mebazaa, Louis Guize, Catherine Vincent, François Alla, Pierre Rougé, Michel Desnos, Patrick Blin, Kamran Samii, Yves Juillière, and Marie-Hélène Barlet
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Male ,medicine.medical_specialty ,Acute decompensated heart failure ,Severity of Illness Index ,Internal medicine ,Outcome Assessment, Health Care ,Epidemiology ,Severity of illness ,medicine ,Humans ,Hospital Mortality ,Practice Patterns, Physicians' ,Survival analysis ,Aged ,Heart Failure ,business.industry ,Cardiogenic shock ,Syndrome ,Length of Stay ,medicine.disease ,Survival Analysis ,Clinical trial ,Intensive Care Units ,Heart failure ,Shock (circulatory) ,Emergency medicine ,Cardiology ,Female ,France ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background: Little is known about the epidemiology of acute decompensated heart failure (ADHF) in patients admitted to intensive and coronary care units (ICU/CCU). Observational data may improve disease management and guide the design of clinical trials. Aims: EFICA is an observational study of the clinical profile, management and survival of ADHF patients admitted to ICU/CCU. Methods: The study included 599 patients admitted to 60 ICU/CCUs across France. Relevant data was recorded during hospitalisation. Survival was assessed at 4 weeks and 1 year. Results: The main cause of ADHF was ischaemic heart disease (61%); 29% of patients had cardiogenic shock. Mortality was 27.4% at 4 weeks and 46.5% at 1 year, increasing to 43.2% and 62.5%, respectively, when including pre-admission deaths. Shock patients had the highest [57.8% vs. 15.2% without shock (p
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- 2006
35. Severe dilated cardiomyopathy and quadriceps myopathy due to lamin A/C gene mutation: A phenotypic study
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Michel Desnos, Jean-Paul Albertini, Jean-Yves Artigou, Dominique Bonnefont-Rousselot, Guillaume Bassez, Jeffrey Zaketto Salama, Michel Komajda, Khaled Zerhouni, and Jean-Christophe Charniot
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Adult ,Cardiomyopathy, Dilated ,Male ,medicine.medical_specialty ,Cardiomyopathy ,Neurological examination ,Gene mutation ,Sudden death ,Quadriceps Muscle ,Muscular Diseases ,Internal medicine ,medicine ,Humans ,Myopathy ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,Dilated cardiomyopathy ,Middle Aged ,Lamin Type A ,medicine.disease ,Phenotype ,Heart failure ,Mutation ,cardiovascular system ,Cardiology ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
This study reports a family affected by a new phenotype associated with dilated cardiomyopathy and quadriceps myopathy. 1 Methods: 29 family members underwent a physical and neurological examination, including an electromyogram and biopsy of muscle abnormalities. A cardiac examination was performed in all subjects. 2 Results: The family pedigree (n=72) demonstrated that transmission was autosomal dominant. Eleven subjects had cardiac involvement, only four had quadriceps muscle involvement. Cardiac impairment preceded neurological involvement. The mean age for neurological involvement was 44±0.8 years (range 43–45) and cardiac involvement was 37±7.9 years (range: 24–45). Cardiac involvement consisted of: hypokinetic dilated cardiomyopathy (64%); atrial fibrillation (100%); ventricular arrhythmias (64%); impaired conduction with bundle branch or complete atrio ventricular block (73%). Four patients required pacemakers and anti arrhythmic therapies. Four patients died: two of refractory heart failure and two of sudden death; two patients were resuscitated following cardiac arrest. Three patients required a prophylactic implantable cardiac defibrillator (ICD). Muscle morphological abnormalities were characterized by a variable number of fibers with rimmed vacuoles. The quadriceps deteriorated progressively without impairment of other muscles. Genotypic study showed a lamin A/C gene mutation. 3 Conclusions: This family was affected by a new phenotype composed of an autosomal dominant severe dilated cardiomyopathy with conduction defects or arrhythmias and quadriceps myopathy. Cardiac abnormalities preceded neuromuscular disorders and defined the prognosis of this disease.
- Published
- 2006
36. Skeletal myoblast transplantation through a catheter-based coronary sinus approach: an effective means of improving function of infarcted myocardium
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Camille Brasselet, Miguel Cortes Morichetti, Claire Carrion, Albert Hagège, Emmanuel Messas, Jean-Thomas Vilquin, Antoine Lafont, Patrick Bruneval, Michel Desnos, Philippe Menasché, and Alvine Bissery
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Cardiac Catheterization ,medicine.medical_specialty ,Sheep ,Muscle biopsy ,Ejection fraction ,medicine.diagnostic_test ,Heart disease ,business.industry ,Myoblasts, Skeletal ,Myocardial Infarction ,Recovery of Function ,medicine.disease ,Ventricular Function, Left ,Surgery ,Transplantation ,Catheter ,Internal medicine ,Circulatory system ,medicine ,Cardiology ,Animals ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Coronary sinus - Abstract
Aims This study was designed to assess the functional effects of a transvenous coronary sinus technique of skeletal myoblast delivery in infarcted myocardium. Methods and results An anterior myocardial infarction was created percutaneously in 14 sheep. Simultaneously, a muscle biopsy was harvested and expanded. Two weeks later, sheep were instrumented percutaneously with a dedicated catheter incorporating an extendable needle for puncture of the venous wall and, under endovascular ultrasound guidance, a microcatheter was advanced through the needle into the target scar for cell delivery. Following the baseline echocardiographic assessment of left ventricular (LV) function, sheep were randomly allocated to receive four-staged in-scar injections of either autologous cells (n ¼ 7) or culture medium (n ¼ 7). Two months later, LV function was reassessed blindly and hearts were explanted for subsequent histological and immunohistochemical analysis. There were no acute procedural complications. Baseline LV ejection fraction (EF) was significantly lower in transplanted sheep than in controls [38% (35‐48) vs. 51% (38‐55), respectively, P ¼ 0.03; median (range)]. Two months later, LVEF was significantly higher in the transplanted group than in controls [50% (47‐56) vs. 39% (36‐47), respectively, P ¼ 0.002]. Clusters of myoblasts were identified by histology and immunohistochemistry in three of the seven transplanted sheep. Conclusion These data suggest the functional efficacy of the transvenous coronary sinus technique as a less invasive means of cell delivery to infarcted myocardium.
- Published
- 2005
37. Adenovirus-Mediated Gene Transfer of Superoxide Dismutase and Catalase Decreases Restenosis after Balloon Angioplasty
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Eric Durand, Camille Brasselet, Giuseppina Caligiuri, Patrick Bruneval, Faouzi Addad, François Vinchon, Patricia Lemarchand, Ayman Al Haj Zen, Antoine Lafont, and Michel Desnos
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Pathology ,medicine.medical_specialty ,Arteriosclerosis ,Physiology ,medicine.medical_treatment ,Genetic Vectors ,Myocytes, Smooth Muscle ,Pharmacology ,medicine.disease_cause ,Iliac Artery ,Muscle, Smooth, Vascular ,Adenoviridae ,Superoxide dismutase ,Restenosis ,Angioplasty ,Secondary Prevention ,medicine ,Animals ,Humans ,Aorta ,Cells, Cultured ,Inflammation ,chemistry.chemical_classification ,Reactive oxygen species ,biology ,Superoxide Dismutase ,business.industry ,Genetic transfer ,Gene Transfer Techniques ,Catalase ,medicine.disease ,Oxidative Stress ,chemistry ,biology.protein ,Collagen ,Endothelium, Vascular ,Rabbits ,Reactive Oxygen Species ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon ,Oxidative stress - Abstract
Background: Reactive oxygen species (ROS) production increases after injury and potentially contributes to restenosis after angioplasty. We therefore evaluated the effect of adenovirus-mediated gene transfer (Ad) of superoxide dismutase (SOD) and catalase (CAT) on ROS production and restenosis after balloon angioplasty. Methods: O2– and H2O2 production was quantified in cultured cells after incubation with either LPS or CuSO4. Angioplasty and gene transfer were performed in rabbit atherosclerotic iliac arteries. One artery was injected with AdSOD and AdCAT, while the contralateral artery was injected with an adenovirus carrying no transgene, and served as control. Results: ROS production was significantly decreased after adenovirus-mediated gene transfer of SOD and CAT as compared with control. Treated arteries showed less restenosis (32 ± 27 vs. 63 ± 19%, p = 0.003) and less constrictive remodeling (1.2 ± 0.3 vs. 0.9 ± 0.2, p = 0.02) than control arteries. Arteries injected with AdSOD and AdCAT showed better vasoreactivity to acetylcholine (11 ± 4 vs. –1 ± 6%, p < 0.05), lower collagen density (43 ± 16 vs. 53 ± 23%, p = 0.03), and lower inflammatory cell infiltration (22 ± 6 vs. 36 ± 11%, p = 0.04) than control arteries. Conclusions: Our data suggest that adenovirus-mediated gene transfer of SOD and CAT reduced oxidative stress, restenosis, collagen accumulation, and inflammation and improved endothelial function after angioplasty.
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- 2005
38. Prédiction du risque d’intolérance du traitement bêtabloquant chez l’insuffisant cardiaque chronique par le dosage du BNP
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A. El Hallak, J Loiret, François Funck, E. Hery, N Guillard, M. Bellorini, Patrick Jourdain, B. Thebault, and Michel Desnos
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Decompensation ,Cardiology and Cardiovascular Medicine ,business ,Treatment monitoring - Abstract
Resume Le traitement betabloquant est actuellement recommande par l'ensemble des guidelines concernant le traitement de l'insuffisance cardiaque systolique. Pourtant, leur prescription reste limitee. Une des possibles raisons de cette relative faible prescription est le risque de survenue d'une decompensation cardiaque induite par l'effet a court terme du traitement betabloquant. Parmi les autres elements limitatifs on retrouve l'apparition d'une bradycardie ou d'une hypotension symptomatique. Si les donnees cliniques peuvent permettre d'identifier assez facilement les patients susceptibles de presenter une hypotension ou une bradycardie, ils ne peuvent permettre d'identifier ceux allant presenter une poussee d'insuffisance cardiaque secondaire a l'introduction d'un traitement betabloquant. En revanche l'existence d'un BNP superieur a 490 pg/ml avant l'introduction du traitement betabloquant permet d'identifier ces patients avec une sensibilite de 90 %, un taux de BNP superieur a 1000 pg/ml etant associe a un risque de 40 % de presenter une poussee d'insuffisance cardiaque. A ce titre, il convient d'etre prudent lors de l'introduction d'un traitement betabloquant chez les patients insuffisants cardiaques presentant des taux de BNP eleves.
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- 2004
39. In Vivo Induction of Endothelial Apoptosis Leads to Vessel Thrombosis and Endothelial Denudation
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Massoud Mirshahi, A. Al Hajzen, Antoine Lafont, Alexandra Scoazec, Michel Desnos, Alain Tedgui, Jacques Boddaert, Eric Durand, Faouzi Addad, and Ziad Mallat
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Pathology ,medicine.medical_specialty ,Endothelium ,Arteriosclerosis ,Apoptosis ,Cysteine Proteinase Inhibitors ,Amino Acid Chloromethyl Ketones ,Catheterization ,Thromboplastin ,Tissue factor ,New Zealand white rabbit ,In vivo ,Physiology (medical) ,In Situ Nick-End Labeling ,medicine ,Animals ,Fibrin ,TUNEL assay ,biology ,Platelet Count ,Vascular disease ,business.industry ,Endothelial Cells ,Thrombosis ,Anatomy ,Staurosporine ,medicine.disease ,biology.organism_classification ,Femoral Artery ,medicine.anatomical_structure ,Endothelium, Vascular ,Rabbits ,Tunica Intima ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Background— The mechanisms of thrombosis on plaque erosion are poorly understood. We examined the potential role of endothelial apoptosis in endothelial erosion and vessel thrombosis. Methods and Results— Segments of New Zealand White rabbit femoral arteries were temporarily isolated in vivo. One artery was incubated with staurosporin for 30 minutes, whereas the contralateral artery was incubated with saline and served as control. Three days later, thrombosis was evaluated angiographically and histologically. TUNEL score in the endothelial layer was significantly increased in staurosporin-treated arteries compared with controls (2.43±0.30 versus 0.93±0.44, respectively; P =0.001). Large areas of endothelial denudation were detectable in staurosporin-treated vessels, whereas endothelium integrity was almost preserved in the saline group. Vessel thrombosis occurred in 58% of staurosporin-treated arteries (7 of 12) but in only 8% of saline-treated segments ( P P =0.04). These results were confirmed in balloon-injured atheromatous arteries. Conclusions— In vivo induction of endothelial apoptosis leads to both vessel thrombosis and endothelial denudation. Endothelial apoptosis may be a critical step in the transition from a stable endothelialized plaque to plaque erosion and thrombosis.
- Published
- 2004
40. Éducation des patients concernant l’insuffisance cardiaque en centre hospitalier général : c’est possible…
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A Piccini, N Abdelmoumene, A Astred, B. Thebault, N Guillard, S Neau, Michel Desnos, C. Pege, François Funck, Patrick Jourdain, H Mat, M. Bellorini, and J Loiret
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business.industry ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Humanities - Abstract
Resume L’insuffisance cardiaque est une pathologie grave ou la compliance du patient joue un role crucial. Cette compliance passe par une formation du patient vis-a-vis de sa maladie et de son traitement. Cette formation peut etre realisee au sein d’un centre hospitalier general au prix d’un investissement important en temps et en personnels. L’education therapeutique est neanmoins un element de plus en plus indispensable dans le cadre d’une prise en charge de qualite et est ressentie comme extremement benefique par les patients chez qui elle permet d’ameliorer les connaissances et l’implication d’une part et de diminuer la duree des sejours hospitaliers d’autre part.
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- 2003
41. BNP, insuffisance cardiaque et sujet âgé
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M. Bellorini, B. Thebault, Michel Desnos, J Loiret, François Funck, N Guillard, and Patrick Jourdain
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Gynecology ,medicine.medical_specialty ,business.industry ,medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Resume Les peptides natriuretiques de type B comme le BNP ou le NT Pro BNP sont des marqueurs diagnostiques et pronostiques reconnus et de plus en plus largement utilises en pratique courante. L’âge provoque une augmentation significative de ces peptides en particulier du fait de l’existence de nombreuses co-pathologies comme l’hypertension ou l’insuffisance renale et necessite une adaptation des normes utilisees. La valeur diagnostique et pronostique du BNP semble cependant preservee meme s’il faut rester encore plus prudent que chez le sujet jeune avant d’evoquer le diagnostic d’insuffisance cardiaque en cas de BNP moderement eleve.
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- 2003
42. BNP, insuffisance cardiaque et sujet âgéBNP, heart failure and elderly patients
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François Funck, B. Thebault, Patrick Jourdain, Michel Desnos, J Loiret, M. Bellorini, and N Guillard
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medicine.medical_specialty ,medicine.diagnostic_test ,medicine.drug_class ,business.industry ,medicine.disease ,Brain natriuretic peptide ,Clinical Practice ,Ageing ,Heart failure ,Internal medicine ,Cardiology ,medicine ,Natriuretic peptide ,Elderly people ,Cardiology and Cardiovascular Medicine ,business ,Electrocardiography ,hormones, hormone substitutes, and hormone antagonists ,Cohort study - Abstract
Natriuretic Peptides like BNP or NT Pro BNP are diagnostic and prognostic makers largely used in clinical practice. Ageing may increase these peptides, especially in case of comorbidities like renal failure or hypertension and require adjustment for age. Diagnostic value of natriuretic peptides seems however preserved in elderly people.
- Published
- 2003
43. Functional consequences of anLMNAmutation associated with a new cardiac and non-cardiac phenotype
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Cécile Pascal, Jean-Christophe Charniot, Jean-Yves Artigou, L. Duboscq-Bidot, C. Bouchier, P. Sebillon, Jeffrey Zaketto Salama, Michel Komajda, Michel Desnos, and M. Peuchmaurd
- Subjects
Adult ,Cardiomyopathy, Dilated ,Male ,Pathology ,medicine.medical_specialty ,DNA Mutational Analysis ,Mutation, Missense ,Emerin ,Thymopoietins ,Biology ,Transfection ,Cell Line ,Desmin ,Dystrophin ,LMNA ,Genetics ,medicine ,Animals ,Humans ,Missense mutation ,Emery–Dreifuss muscular dystrophy ,Muscle, Skeletal ,Myopathy ,Genetics (clinical) ,Family Health ,Myocardium ,Membrane Proteins ,Nuclear Proteins ,Dilated cardiomyopathy ,DNA ,Middle Aged ,Lamin Type A ,medicine.disease ,Immunohistochemistry ,Pedigree ,COS Cells ,Mutation ,Female ,medicine.symptom ,Lamin ,Plasmids ,Limb-girdle muscular dystrophy - Abstract
Heritable dilated cardiomyopathy is a genetically highly heterogeneous disease. To date 17 different chromosomal loci have been described for autosomal dominant forms of dilated cardiomyopathy with or without additional clinical manifestations. Among the 10 mutated genes associated with dilated cardiomyopathy, the lamin A/C (LMNA) gene has been reported in forms associated with conduction-system disease with or without skeletal muscle myopathy. For the first time, we report here a French family affected with a new phenotype composed of an autosomal dominant severe dilated cardiomyopathy with conduction defects or atrial/ventricular arrhythmias, and a specific quadriceps muscle myopathy. In all previously reported cases with both cardiac and neuromuscular involvement, neuromuscular disorders preceded cardiac abnormalities. The screening of the coding sequence of the LMNA gene on all family members was performed and we identified a missense mutation (R377H) in the lamin A/C gene that cosegregated with the disease in the family. Cell transfection experiments showed that the R377H mutation leads to mislocalization of both lamin and emerin. These results were obtained in both muscular (C2C12) and non-muscular cells (COS-7). This new phenotype points out the wide spectrum of neuromuscular and cardiac manifestations associated with lamin A/C mutations, with the functional consequence of this mutation seemingly associated with a disorganization of the lamina.
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- 2003
44. Bedside B-type natriuretic peptide and functional capacity in chronic heart failure
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B. Thebault, François Funck, Michel Desnos, N Guillard, J Loiret, M. Bellorini, Patrick Jourdain, and Denis Duboc
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Adrenergic beta-Antagonists ,Carbazoles ,Angiotensin-Converting Enzyme Inhibitors ,Physical examination ,Spironolactone ,Severity of Illness Index ,New york heart association ,Nyha class ,Propanolamines ,Furosemide ,Lisinopril ,Internal medicine ,Natriuretic Peptide, Brain ,medicine ,Natriuretic peptide ,Humans ,In patient ,cardiovascular diseases ,Diuretics ,Aged ,Aged, 80 and over ,Heart Failure ,Ejection fraction ,Dose-Response Relationship, Drug ,medicine.diagnostic_test ,business.industry ,Incidence ,Stroke Volume ,Middle Aged ,medicine.disease ,Treatment Outcome ,Heart failure ,Chronic Disease ,cardiovascular system ,Cardiology ,Carvedilol ,Test performance ,France ,Cardiology and Cardiovascular Medicine ,business ,human activities ,Atrial Natriuretic Factor ,Biomarkers ,Follow-Up Studies ,circulatory and respiratory physiology - Abstract
Objectives: To determine if B-type natriuretic peptide (BNP) measurement could be useful in determination of functional capacity in patients suffering from chronic heart failure. Background: Evaluating functional capacity is a crucial factor in the follow-up of patients with chronic heart failure. There are numerous methods for measuring functional capacity and their relative merits remain under discussion. Clinical classifications are very subjective and other methods are difficult to use in clinical practice. Methods: We evaluated functional capacity in 151 consecutive patients using the 6-min walk test. All patients were clinically classified using the New York Heart Association (NYHA) classification. We measured BNP plasma levels using a bedside BNP test. Results: Six minute walk test performance decreased through NYHA classes 1 to 4 (469±87, 411±82, 325±83 and 196±63 m, respectively, P
- Published
- 2003
45. CHF Patient education to self-management reduces all causes mortality in a long-term perspective
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Yves Juillière, P. Jourdain, J. Dagorn, François Funck, Michel Desnos, N. Hryschyschyn, and G. Roul
- Subjects
medicine.medical_specialty ,Self-management ,Ejection fraction ,business.industry ,Mortality rate ,medicine.disease ,Term (time) ,Patient management ,Heart failure ,medicine ,Physical therapy ,Cardiology and Cardiovascular Medicine ,business ,Ventricular filling ,Patient education - Abstract
Chronic heart failure patients education to self-management is recommended by international guidelines but is still underuse by clinicians. Actually only 5–10% of CHF patients benefit from multidisciplinary education in Europe. Many studies have underline the short- or mild-term impact of education on hospitalization but only few on mortality. The aim of our study was to analyse the long-term impact (8 years) of a structured multidisciplinary education of CHF patients and relatives using simple tools (paperboard, games, quiz) on all causes mortality. Methods We have prospectively included 803 consecutive CHF patients referred to our heart failure center since 2001. Patient education was proposed to all patients and was done only in 264. Education was done on Monday and Tuesday. Some refused and some were referred out of the education days. Education was based on an educational diagnostic done by a nurse, a discussion between doctor and a group of 6 patients and relatives and a discussion between physiotherapist and patients. At the end of the session, patients use a game tool analyzing reactivity and knowledge. We have followed the patients in the same way with the same clinicians in charge of optimizing HF therapy. Mean follow up was 8 ± 4 years. The main end point was all cause mortality. Results The two groups (Education vs no education) were comparable in term of age, LVEF (33 ± 11 vs 38 ± 13%) left ventricular filling (E/A 0,9 ± 0,2 vs 1,31 ± 1) renal function (creatininemia 114 ± 94 vs 116 ± 113 μmol/l) and BNP (313 ± 463 vs 533 ± 770 pg/mL)) and comparable in term of CH F therapies. During follow up, annual mortality rate was 3,19% in therapeutic education group versus 4,8% in the no education group ( p : 0,0369). Conclusion Education of CHF patients is a long-term effective tool in order to reduce long-term mortality. Our HF tool kit using face to face discussions and reactivity based games is not really time consuming (3 hours nurse/1 hour physiotherapist for a group from 6 to 8 patients) and is effective in order to reduce long term all cause mortality by 1/3. Due to its impact in real life, patient education to self-management should be promoted in CHF patient management and done in every HF center.
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- 2015
46. Unités d’insuffisance cardiaque. Concept, organisation, résultats
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C Josset, N Guillard, J Loiret, François Funck, C Piednoir, Patrick Jourdain, N Pons, M. Bellorini, B. Thebault, and Michel Desnos
- Subjects
High rate ,medicine.medical_specialty ,Family education ,Heart disease ,business.industry ,Cardiac Care Facilities ,Heart failure ,medicine ,Health education ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,business ,medicine.disease - Abstract
Chronic heart failure is linked to high rate of death and hospitalization. Some studies have highlighted the beneficial effect of heart failure clinics on morbidity and mortality. We have developed this type of structure at CHR Dubos since 3 years and we have recently created an heart failure clinic (10 beds). It's based on a concept including an experienced medical and nurse team, patient's and patient's family education and evaluation of the structure.
- Published
- 2002
47. Time courses of apoptosis and cell proliferation and their relationship to arterial remodeling and restenosis after angioplasty in an atherosclerotic rabbit model
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Eric Durand, Michel Desnos, Antoine Lafont, Faouzi Addad, Alain Tedgui, Françoise Vilde, Claude Guerot, and Ziad Mallat
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Neointima ,Pathology ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Apoptosis ,Coronary Artery Disease ,Coronary Restenosis ,Restenosis ,Angioplasty ,medicine ,Animals ,Fibromuscular Dysplasia ,Angioplasty, Balloon, Coronary ,Lagomorpha ,TUNEL assay ,biology ,business.industry ,Cell growth ,medicine.disease ,biology.organism_classification ,Coronary Vessels ,Femoral Artery ,Disease Models, Animal ,medicine.anatomical_structure ,Rabbits ,business ,Tunica Intima ,Tunica Media ,Cardiology and Cardiovascular Medicine ,Cell Division ,Artery - Abstract
OBJECTIVES We sought to evaluate whether cellular mass changes (including apoptosis and proliferation) after arterial injury could interact with restenosis and arterial remodeling. BACKGROUND The mechanisms controlling arterial remodeling after angioplasty remain poorly understood. Apoptosis and cell proliferation have been previously described after balloon angioplasty. However, their importance in the occurrence of arterial remodeling and restenosis is unknown. METHODS Atherosclerosis was induced in 48 femoral arteries of New Zealand White rabbits by air-desiccation and a high-cholesterol diet. One month later, angioplasty was performed in 40 arteries. Apoptosis, cell proliferation, residual stenosis and arterial remodeling were evaluated at 2 h and 3, 7, 14, 21 and 28 days after angioplasty. RESULTS Cell proliferation and apoptosis profiles were similar, but the peak in cell proliferation occurred approximately four days earlier than the peak in apoptosis in the neointima and media. Apoptosis density was positively correlated with arterial remodeling in the neointima and media (r = 0.69, p = 0.005 and r = 0.50, p = 0.05, respectively). Moreover, residual stenosis was inversely correlated with apoptosis density in the neointima and media (r = -0.62, p = 0.008 and r = -0.52, p = 0.04, respectively). In contrast, cell proliferation was independent of restenosis and arterial remodeling. CONCLUSIONS In this model, cell proliferation preceded apoptosis throughout the four weeks after angioplasty. Apoptosis was inversely correlated with restenosis. Interestingly, apoptosis was also related to enlargement remodeling after balloon angioplasty.
- Published
- 2002
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48. Survival from sports-related sudden cardiac arrest: In sports facilities versus outside of sports facilities
- Author
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François Carré, Lionel Lamhaut, Jean-Yves Le Heuzey, Guillaume Beal, Christian Spaulding, Nordine Benameur, Florence Dumas, Michel Desnos, Frankie Beganton, David S. Celermajer, Alain Cariou, Muriel Tafflet, Wulfran Bougouin, Nicole Karam, Albert Hagège, Xavier Jouven, Marie-Cécile Perier, and Eloi Marijon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Time Factors ,Sports medicine ,Adolescent ,Population ,Young Adult ,Odds Ratio ,Medicine ,Humans ,Prospective Studies ,Young adult ,Prospective cohort study ,education ,Child ,Survival rate ,Aged ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Sudden cardiac arrest ,Odds ratio ,Middle Aged ,3. Good health ,Survival Rate ,Death, Sudden, Cardiac ,Athletes ,Female ,France ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,human activities ,Demography ,Follow-Up Studies ,Sports - Abstract
We sought to evaluate frequency, characteristics, and outcomes of sudden cardiac arrest (SCA) during sports activities according to the location of occurrence (in sports facilities vs those occurring outside of sports facilities).This is an observational 5-year prospective national French survey of subjects 10 to 75 years old presenting with SCA during sports (2005-2010), in 60 French administrative regions (covering a population of 35 million people). Of the 820 SCA during sports, 426 SCAs (52%) occurred in sports facilities. Overall, a substantially higher survival rate at hospital discharge was observed among SCA in sports facilities (22.8%, 95% CI 18.8-26.8) compared to those occurring outside (8.0%, 95% CI 5.3-10.7) (P.0001). Patients with SCA in sports facilities were younger (42.1 vs 51.3 years, P.0001) and less frequently had known cardiovascular diseases (P.0001). The events were more often witnessed (99.8% vs 84.9%, 0.0001), and bystander cardiopulmonary resuscitation was more frequently initiated (35.4% vs 25.9%, P = .003). Delays of intervention were significantly shorter when SCA occurred in sports facilities (9.3 vs 13.6, P=0.03), and the proportion of initially shockable rhythm was higher (58.8% vs 33.1%, P.0001). Better survival in sports facilities was mainly explained by concomitant circumstances of occurrence (adjusted odds ratio 1.48, 95% CI 0.88-2.49, P = .134).Sports-related SCA is not a homogeneous entity. The 3-fold higher survival rate reported among sports-related SCA is mainly due to cases that occur in sports facilities, whereas SCA during sports occurring outside of sports facilities has the usual very low rate of survival.
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- 2014
49. Population movement and sudden cardiac arrest location
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Florence Dumas, David S. Celermajer, Wulfran Bougouin, Michel Desnos, Christian Spaulding, Eloi Marijon, Patricia Pelloux, Frankie Beganton, Jean-Pierre Tourtier, Nicole Karam, Jean-Yves Le Heuzey, Guillaume Beal, Herve Degrange, Alain Cariou, Muriel Tafflet, Xavier Jouven, Daniel Jost, Lionel Lamhaut, and Albert Hagège
- Subjects
Male ,Paris ,Time Factors ,Urban Population ,medicine.medical_treatment ,Population ,Electric Countershock ,Key issues ,Population density ,Health Services Accessibility ,External defibrillators ,Risk Factors ,Physiology (medical) ,medicine ,Emergency medical services ,Humans ,Cardiopulmonary resuscitation ,Prospective Studies ,Death sudden cardiac ,education ,Aged ,Demography ,education.field_of_study ,business.industry ,Sudden cardiac arrest ,Middle Aged ,Death, Sudden, Cardiac ,Ventricular Fibrillation ,Female ,medicine.symptom ,Public Facilities ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest ,Defibrillators - Abstract
Background— Although the benefits of automatic external defibrillators are undeniable, their effectiveness could be dramatically improved. One of the key issues is the disparity between the locations of automatic external defibrillators and sudden cardiac arrests (SCAs). Methods and Results— From emergency medical services and other Parisian agencies, data on all SCAs occurring in public places in Paris, France, were prospectively collected between 2000 and 2010 and recorded using 2020 grid areas. For each area, population density, population movements, and landmarks were analyzed. Of the 4176 SCAs, 1255 (30%) occurred in public areas, with a highly clustered distribution of SCAs, especially in areas containing major train stations (12% of SCAs in 0.75% of the Paris area). The association with population density was poor, with a nonsignificant increase in SCAs with population density ( P =0.4). Occurrence of public SCAs was, in contrast, highly associated with population movements ( P P P Conclusions— Using a systematic analysis of determinants of SCA in public places, we demonstrated the extent to which population movements influence SCA distribution. Our findings also suggested that beyond this key risk factor, some areas are dramatically associated with a higher risk of SCA.
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- 2014
50. Circulating Nonesterified Fatty Acid Level as a Predictive Risk Factor for Sudden Death in the Population
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Pierre Ducimetière, Michel Desnos, Xavier Jouven, and Marie-Aline Charles
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Adult ,Blood Glucose ,Male ,Risk ,medicine.medical_specialty ,Population ,Myocardial Infarction ,Physical examination ,Comorbidity ,Fatty Acids, Nonesterified ,Sudden death ,Asymptomatic ,Body Mass Index ,Time ,Cohort Studies ,NEFA ,Predictive Value of Tests ,Risk Factors ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Insulin ,Prospective Studies ,Risk factor ,Prospective cohort study ,education ,Triglycerides ,Demography ,Proportional Hazards Models ,Analysis of Variance ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Smoking ,Hemodynamics ,Middle Aged ,Cholesterol ,Death, Sudden, Cardiac ,Endocrinology ,Cardiology ,France ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Cohort study - Abstract
Background In ischemic conditions, concentration of circulating nonesterified fatty acids (NEFA) is increased and has a proarrhythmic effect that is responsible for ventricular tachyarrhythmias. In nonischemic patients, high NEFA plasma concentration has been shown to be associated with frequent premature ventricular complexes and increased familial risk of cardiovascular disease, but its relation to sudden death has not been studied. We assessed the role of circulating NEFA in sudden death in asymptomatic men in a long-term cohort study. Methods and Results A total of 5250 men employed by the city of Paris, aged 42 to 53 in 1967 to 1972, free of known ischemic cardiac disease, and included in the Paris Prospective Study I, completed a second annual examination and had fasting plasma circulating NEFA measured. Each subject underwent a physical examination and ECG, provided blood for laboratory tests, and answered questionnaires administered by trained interviewers. Vital status was obtained for each subject from specific inquiries until he retired; after retirement, it was obtained from death certificates. Body mass index, systolic and diastolic blood pressures, tobacco consumption, parental history of sudden death, fasting cholesterol level, and circulating NEFA concentration were independent factors associated with sudden death during follow up (average, 22 years). When adjusted for confounding factors, circulating NEFA concentration remained an independent risk factor for sudden death (relative risk, 1.70; 95% confidence interval, 1.21 to 2.13) but not for fatal myocardial infarction. Conclusions Circulating NEFA concentration is an independent risk factor for sudden death in middle-aged men. Some form of primary prevention could be envisaged in subjects at high risk of sudden death.
- Published
- 2001
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