References of "Pierard, Luc"
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See detailOutcomes of Patients With Asymptomatic Aortic Stenosis Followed Up in Heart Valve Clinics.
Lancellotti, Patrizio ULiege; Magne, Julien; DULGHERU, Raluca Elena ULiege et al

in JAMA Cardiology (2018)

Importance: The natural history and the management of patients with asymptomatic aortic stenosis (AS) have not been fully examined in the current era. Objective: To determine the clinical outcomes of ... [more ▼]

Importance: The natural history and the management of patients with asymptomatic aortic stenosis (AS) have not been fully examined in the current era. Objective: To determine the clinical outcomes of patients with asymptomatic AS using data from the Heart Valve Clinic International Database. Design, Setting, and Participants: This registry was assembled by merging data from prospectively gathered institutional databases from 10 heart valve clinics in Europe, Canada, and the United States. Asymptomatic patients with an aortic valve area of 1.5 cm2 or less and preserved left ventricular ejection fraction (LVEF) greater than 50% at entry were considered for the present analysis. Data were collected from January 2001 to December 2014, and data were analyzed from January 2017 to July 2018. Main Outcomes and Measures: Natural history, need for aortic valve replacement (AVR), and survival of asymptomatic patients with moderate or severe AS at entry followed up in a heart valve clinic. Indications for AVR were based on current guideline recommendations. Results: Of the 1375 patients included in this analysis, 834 (60.7%) were male, and the mean (SD) age was 71 (13) years. A total of 861 patients (62.6%) had severe AS (aortic valve area less than 1.0 cm2). The mean (SD) overall survival during medical management (mean [SD] follow up, 27 [24] months) was 93% (1%), 86% (2%), and 75% (4%) at 2, 4, and 8 years, respectively. A total of 104 patients (7.6%) died under observation, including 57 patients (54.8%) from cardiovascular causes. The crude rate of sudden death was 0.65% over the duration of the study. A total of 542 patients (39.4%) underwent AVR, including 388 patients (71.6%) with severe AS at study entry and 154 (28.4%) with moderate AS at entry who progressed to severe AS. Those with severe AS at entry who underwent AVR did so at a mean (SD) of 14.4 (16.6) months and a median of 8.7 months. The mean (SD) 2-year and 4-year AVR-free survival rates for asymptomatic patients with severe AS at baseline were 54% (2%) and 32% (3%), respectively. In those undergoing AVR, the 30-day postprocedural mortality was 0.9%. In patients with severe AS at entry, peak aortic jet velocity (greater than 5 m/s) and LVEF (less than 60%) were associated with all-cause and cardiovascular mortality without AVR; these factors were also associated with postprocedural mortality in those patients with severe AS at baseline who underwent AVR (surgical AVR in 310 patients; transcatheter AVR in 78 patients). Conclusions and Relevance: In patients with asymptomatic AS followed up in heart valve centers, the risk of sudden death is low, and rates of overall survival are similar to those reported from previous series. Patients with severe AS at baseline and peak aortic jet velocity of 5.0 m/s or greater or LVEF less than 60% have increased risks of all-cause and cardiovascular mortality even after AVR. The potential benefit of early intervention should be considered in these high-risk patients. [less ▲]

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See detailAngioedema: a rare and sometimes delayed side effect of angiotensin-converting enzyme inhibitors.
DAVIN, Laurent ULiege; MARECHAL, Patrick ULiege; LANCELLOTTI, Patrizio ULiege et al

in Acta Cardiologica (2018)

The effects of angiotensin converting enzyme (ACE) inhibitors result from the inhibition of the ACE (kininase II) to ultimately influence both the renin-angiotensin system and the degradation of the ... [more ▼]

The effects of angiotensin converting enzyme (ACE) inhibitors result from the inhibition of the ACE (kininase II) to ultimately influence both the renin-angiotensin system and the degradation of the bradykinin (BK) metabolism. ACE inhibitors block the degradation of BK and substance P by ACE. In addition, an active metabolite of BK (Des-Arg9-BK) is catalysed by kininase I and its degradation is controlled in part by the conversion enzyme. These molecules have been associated with increased plasma extravasation associated with ACE inhibitors. ACE inhibitors are the leading cause of drug-induced Angioedema (AE). Symptoms of AE mainly occur after the first month of treatment by ACE. However, very late onset cases, sometimes after several years of stable therapy, are also described in the literature. It has been observed that patients previously stable under ACE inhibitor will most likely develop AE soon after the addition of another medication, including the combination of aspirin or non-steroid anti-inflammatory drugs with ACE inhibitor which has proved to be the most common cause, accounting for close to 50% of all AE cases related to ACE inhibitors. This side effect of ACE inhibitors, sometimes very late and rare, deserves to be recalled. [less ▲]

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See detailMultiple and Mixed Valvular Heart Diseases.
Unger, Philippe; Pibarot, Philippe; Tribouilloy, Christophe et al

in Circulation: Cardiovascular Imaging (2018), 11(8), 007862

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See detailGuía ESC/EACTS 2017 sobre el tratamiento de las valvulopatías
Baumgartner, A. D. G. D. T. H.; Falk, V.; Bax, J. J. et al

in Revista Espanola de Cardiologia (2018), 71(2), 117-118

[No abstract available]

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See detailMaladie coronaire et pratique sportive
ANCION, Arnaud ULiege; KAUX, Jean-François ULiege; PIERARD, Luc ULiege et al

in Revue Médicale de Liège (2017), 72(6), 281-287

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See detailPlace du traitement médical bradycardisant dans l’insuffisance cardiaque
tridetti, j; KRZESINSKI, François ULiege; D'ORIO, Virginie ULiege et al

in Revue Médicale de Liège (2017), 72

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See detailEndocardite à aggregatibacter aphrophilus sur prothèses valvulaires
Deleixhe, Benjamin ULiege; FRIPPIAT, Frédéric ULiege; Léonard, Philippe ULiege et al

in Revue Médicale de Liège (2017), 72(12), 522-528

We present the case of an acute endocarditis of mitral and aortic prosthetic heart valves caused by Aggregatibacter aphrophilus (Haemophilus aphrophilus-paraphrophilus). This third report in the ... [more ▼]

We present the case of an acute endocarditis of mitral and aortic prosthetic heart valves caused by Aggregatibacter aphrophilus (Haemophilus aphrophilus-paraphrophilus). This third report in the literature emphasizes the diagnostic work-up and the role of positron emission tomography combined with computed tomography in this setting. The specificities of endocarditis due to the HACEK group (Haemophilus spp., Aggregatibacter, Cardiobacterium hominis, Eikenella corrodens and Kingella spp.) and the specific microbiological data and therapeutic options pertinent to this germ are discussed. [less ▲]

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See detailSerum albumin level and hospital mortality in acute non-ischemic heart failure.
ANCION, Arnaud ULiege; Allepaerts, Sophie; Oury, Cécile ULiege et al

in ESC Heart Failure (2017), 4(2), 138-145

AIMS: Hypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic significance of ... [more ▼]

AIMS: Hypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic significance of serum albumin level in the prediction of hospital mortality in patients admitted for acute non-ischemic HF. METHODS AND RESULTS: We examined the association between albumin and hospital mortality in a cohort of 546 patients admitted for acute non-ischemic HF. None of the patients had infectious disease, severe arrhythmias (atrial fibrillation, ventricular tachycardia, ventricular fibrillation), required invasive ventilation, or presented with acute coronary syndrome or primary valvular disease. Thirty-six patients (7%) died during the hospital stay. These patients were significantly older (78 +/- 9 vs. 72 +/- 12 years; P = 0.006), had higher heart rate (P < 0.0001), increased creatinine level (P = 0.01), lower systolic and diastolic blood pressures (P < 0.05), elevated leucocyte count (P = 0.001), and lower albumin levels (31.3 +/- 5.6 g/L vs. 36.9 +/- 4.1 g/L; P < 0.001). With multivariable analysis, age (P = 0.01), heart rate (P < 0.0003), diastolic blood pressure (P < 0.01), leukocyte count (P = 0.009), and serum albumin level (P < 0.0001) emerged as independent predictors of hospital mortality. Hypoalbuminemia (<34 g/L) yielded the best sensitivity (78.8%) and specificity (75%) for predicting hospital death. CONCLUSIONS: Serum albumin level measured at admission can serve as a simple prognostic factor in acute non-ischemic HF. Hypoalbuminemia is associated with increased risk of hospital mortality, especially in elderly patients. [less ▲]

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See detailRatio of high-sensitivity troponin to creatine kinase-MB in takotsubo syndrome.
Pirlet, Charles; Pierard, Luc ULiege; Legrand, Victor ULiege et al

in International Journal of Cardiology (2017)

BACKGROUND: Takotsubo syndrome (TT) and myocardial infarction (MI) share numerous similarities in clinical presentation, ECG modifications and biomarker elevation. We sought to determine whether the ratio ... [more ▼]

BACKGROUND: Takotsubo syndrome (TT) and myocardial infarction (MI) share numerous similarities in clinical presentation, ECG modifications and biomarker elevation. We sought to determine whether the ratio of high-sensitivity cardiac troponin T (hs-TnT) to the myocardial fraction of creatine kinase (CKMB) could be a potent discriminator between TT and MI patients. METHODS: We separately present analysis of data from retrospective files and prospectively recruited patients presenting with TT (35 retrospective and 42 prospective), NSTEMI (48 retrospective and 75 prospective) and STEMI (20 retrospective and 39 prospective). We compared ratios of hs-TnT to CKMB on admission to the hospital between TT, NSTEMI and STEMI patients. Receiver operating characteristic (ROC) curves were analysed to determine optimal cut-off values. RESULTS: On admission, hs-TnT/CKMB ratio was significantly higher in TT patients than in NSTEMI and STEMI patients in both the retrospective phase (median and interquartile range, TT 0.024 [0.018-0.047] vs NSTEMI 0.009 [0.006-0.022], p<0.0001; TT vs STEMI 0.011 [0.006-0.016], p=0.0002) and the prospective cohort (median and interquartile range, TT 0.032 [0.018-0.040] vs NSTEMI 0.009 [0.006-0.015], p<0.0001; TT vs STEMI 0.009 [0.005-0.017], p<0.0001). A cut-off hs-TnT/CKMB ratio of 0.015 distinguished TT from MI with a sensitivity of 85.7% and a specificity of 67.6% (AUC 0.796; 95%CI: 0.71-0.89) in the retrospective phase. In the prospective phase, a ratio of 0.017 distinguished TT from MI with a sensitivity of 83.3% and a specificity of 78.1% (AUC 0.88; 95%CI: 0.83-0.94). CONCLUSION: hs-TnT/CKMB ratio is a novel, readily available parameter that could be used alongside clinical risk scores, other biomarkers and ECG findings to discriminate between TT and MI. [less ▲]

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See detailStandards defining a 'Heart Valve Centre': ESC Working Group on Valvular Heart Disease and European Association for Cardiothoracic Surgery Viewpoint.
Chambers, John B.; Prendergast, Bernard; Iung, Bernard et al

in European Journal of Cardio - Thoracic Surgery (2017), 52(3), 418-424

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See detailManagement of tricuspid valve regurgitation: Position statement of the European Society of Cardiology Working Groups of Cardiovascular Surgery and Valvular Heart Disease.
Antunes, Manuel J.; Rodriguez-Palomares, Jose; Prendergast, Bernard et al

in European Journal of Cardio - Thoracic Surgery (2017)

Tricuspid regurgitation (TR) is a very frequent manifestation of valvular heart disease. It may be due to the primary involvement of the valve or secondary to pulmonary hypertension or to the left-sided ... [more ▼]

Tricuspid regurgitation (TR) is a very frequent manifestation of valvular heart disease. It may be due to the primary involvement of the valve or secondary to pulmonary hypertension or to the left-sided heart valve disease (most commonly rheumatic and involving the mitral valve). The pathophysiology of secondary TR is complex and is intrinsically connected to the anatomy and function of the right ventricle. A systematic multimodality approach to diagnosis and assessment (based not only on the severity of the TR but also on the assessment of annular size, RV function and degree of pulmonary hypertension) is, therefore, essential. Once considered non-important, treatment of secondary TR is currently viewed as an essential concomitant procedure at the time of mitral (and, less frequently, aortic valve) surgery. Although the indications for surgical management of severe TR are now generally accepted (Class I), controversy persists concerning the role of intervention for moderate TR. However, there is a trend for intervention in this setting, especially at the time of surgery for left-sided heart valve disease and/or in patients with significant tricuspid annular dilatation (Class IIa). Currently, surgery remains the best approach for the interventional treatment of TR. Percutaneous tricuspid valve intervention (both repair and replacement) is still in its infancy but may become a reliable option in future, especially for high-risk patients with isolated primary TR or with secondary TR related to advanced left-sided heart valve disease. [less ▲]

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See detailRevalidation cardiaque, etat des lieux en 2017.
Lancellotti, Patrizio ULiege; ANCION, Arnaud ULiege; Pierard, Luc ULiege

in Revue Médicale de Liège (2017), 72(11), 481-487

Cardiovascular disease remains the leading cause of death in western countries. Despite advances in acute management of patients, secondary prevention remains essential and should include cardiac ... [more ▼]

Cardiovascular disease remains the leading cause of death in western countries. Despite advances in acute management of patients, secondary prevention remains essential and should include cardiac rehabilitation. Recent data have confirmed the interest of this management in the various conventional indications : coronary disease, valvular heart disease, heart failure and heart transplantation. New indications emerge with some benefit that should be evaluated : ventricular assistance, pulmonary hypertension, trans-catheter aortic valve implantation. However, the different rehabilitation programs proposed are still too uneven in content and duration and the number of patients participating in these programs remains low. Home based cardiac rehabilitation technologies have already shown some effectiveness and could improve some of the weaknesses of rehabilitation programs. Again protocols and tools need to be improved and standardized. The budgetary impact will also have to be studied further. [less ▲]

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See detail2017 ESC/EACTS Guidelines for the management of valvular heart disease
Baumgartner, H.; Falk, V.; Bax, J. J. et al

in European Heart Journal (2017), 38(36), 2739-2786

[No abstract available]

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See detailAppropriateness criteria for the use of cardiovascular imaging in heart valve disease in adults: a European Association of Cardiovascular Imaging report of literature review and current practice
Chambers, JB; Garbi, M; Nieman, K et al

in European Heart Journal - Cardiovascular Imaging (2017)

Heart valve disease is common and a major indication for imaging. Echocardiography is the first-line imaging technique for diagnosis, assessment, and serial surveillance. However, other modalities ... [more ▼]

Heart valve disease is common and a major indication for imaging. Echocardiography is the first-line imaging technique for diagnosis, assessment, and serial surveillance. However, other modalities, notably cardiac magnetic resonance imaging and computerized tomography, are used if echocardiographic imaging is suboptimal or to obtain complementary information, particularly to aid risk assessment in individual patients. This review is a summary of current evidence for state-of-the-art clinical practice to inform appropriateness criteria for heart valve disease. It is divided according to common clinical scenarios: detection of valve disease, assessment of the valve and other cardiac structures, risk assessment, screening, and intervention. [less ▲]

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See detailStandards defining a 'Heart Valve Centre': ESC Working Group on Valvular Heart Disease and European Association for Cardiothoracic Surgery Viewpoint.
Chambers, John B.; Prendergast, Bernard; Iung, Bernard et al

in European Heart Journal (2017), 38(28), 2177-2183

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See detailProtection cardiovasculaire et rénale du patient diabétique de type 2 : le point après EMPA-REG OUTCOME et LEADER
SCHEEN, André ULiege; PIERARD, Luc ULiege; KRZESINSKI, Jean-Marie ULiege et al

in Revue Médicale de Liège (2016), 71(09), 376-381

Summary : Type 2 diabetes (T2D), often associated with arterial hypertension, represents a high risk of cardiovascular disease and nephropathy. Two clinical trials demonstrate the superiority versus a ... [more ▼]

Summary : Type 2 diabetes (T2D), often associated with arterial hypertension, represents a high risk of cardiovascular disease and nephropathy. Two clinical trials demonstrate the superiority versus a placebo of two antidiabetic drugs in patients with T2D and high cardiovascular risk : empagliflozin, an inhibitor of sodium-glucose type 2 (SGLT2) cotransporters, in EMPA-REG OUTCOME and liraglutide, an agonist of glucagon-like peptide-1 (GLP-1) receptors, in LEADER. Both medications showed a significant reduction in major cardiovascular events (-14 and -13 %, respectively), cardiovascular mortality (-38 and -22%), all-cause mortality (-32 and -15 %) and renal events (-39 et -22 %). The underlying protective mechanisms remain controverted. Ongoing studies should allow to decide whether the benefits are specific to each molecule or may be attributed to a class effect. [less ▲]

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See detailHeart Team Liege - Session Video Link
PIERARD, Luc ULiege; vahanian, Alec; LANCELLOTTI, Patrizio ULiege et al

Conference (2016, September)

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See detailHeart Team Session
PIERARD, Luc ULiege; LANCELLOTTI, Patrizio ULiege; PETERMANS, Jean ULiege et al

Conference (2016, August)

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See detailComment je traite... la sténose aortique asymptomatique
MEURICE, Caroline ULiege; DULGHERU, Raluca Elena ULiege; PIERARD, Luc ULiege

in Revue Médicale de Liège (2016), (71), 6-10

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