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See detailCan Blood Biomarkers Help Predicting Outcome in Transcatheter Aortic Valve Implantation?
Oury, Cécile ULiege; Nchimi Longang, Alain ULiege; Lancellotti, Patrizio ULiege et al

in Frontiers in Cardiovascular Medicine (2018), 5

Transcatheter aortic valve implantation (TAVI) has become the method of choice for patients with severe aortic valve stenosis, who are ineligible or at high risk for surgery. In this high risk patient ... [more ▼]

Transcatheter aortic valve implantation (TAVI) has become the method of choice for patients with severe aortic valve stenosis, who are ineligible or at high risk for surgery. In this high risk patient population, early and late mortality and rehospitalization rates after TAVI are still relatively high. In spite of recent improvements in procedural TAVI, and establishment of risk models for poor outcome, determining individual risk remains challenging. In this context, current data from several small studies strongly suggest that blood biomarkers of myocardial injury, cardiac mechanical stretch, inflammation, and hemostasis imbalance might play an important role by providing informations on patient risk at baseline, and postprocedural progression of patient clinical conditions from days up to years post-TAVI. Although the role of biomarkers for predicting survival post-TAVI remains to be validated in large randomized studies, implementing biomarkers in clinical practice might improve risk stratification, thereby further reducing TAVI-associated morbidity and mortality. [less ▲]

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See detailProsthetic Aortic Valves: Challenges and Solutions.
Musumeci, Lucia ULiege; Jacques, Nicolas; Hego, Alexandre et al

in Frontiers in Cardiovascular Medicine (2018), 5

Aortic Valve Disease (AVD) is the most common Valvular Heart Disease (VHD), affecting millions of people worldwide. Severe AVD is treated in most cases with prosthetic aortic valve replacement, which ... [more ▼]

Aortic Valve Disease (AVD) is the most common Valvular Heart Disease (VHD), affecting millions of people worldwide. Severe AVD is treated in most cases with prosthetic aortic valve replacement, which involves the substitution of the native aortic valve with a prosthetic one. In this review we will discuss the different types of prosthetic aortic valves available for implantation and the challenges faced by patients, medical doctors, researchers and manufacturers, as well as the approaches that are taken to overcome them. [less ▲]

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See detailPredicting Disease Progression and Mortality in Aortic Stenosis: A Systematic Review of Imaging Biomarkers and Meta-Analysis.
Nchimi Longang, Alain ULiege; Dibato, John E.; DAVIN, Laurent ULiege et al

in Frontiers in Cardiovascular Medicine (2018), 5

Background: Detecting among patients with aortic stenosis (AS) those who are likely to rapidly progress, yet potentially benefiting from prophylactic aortic valve replacement, is needed for improved ... [more ▼]

Background: Detecting among patients with aortic stenosis (AS) those who are likely to rapidly progress, yet potentially benefiting from prophylactic aortic valve replacement, is needed for improved patient care. The objective of this study was to evaluate the role of imaging biomarkers in predicting the progression to clinical symptoms and death in patients with AS. Methods: We searched the Pubmed and the International Clinical Trials Registry Platform databases for studies including patients with AS, and investigating imaging techniques, published in any language until Jan 1, 2018. Eligible sets of data include effect of imaging biomarkers relative to: (1) Overall mortality, (2) Cardiac mortality, and (3) Overall events (Symptom onset and Major Adverse Cardiovascular Events). Meta-analysis was used to examine associations between the imaging biomarkers and outcomes of AS using Random Effect models. Results: Eight studies and 1,639 patients were included after systematic review. Four studies investigated aortic valve calcification (AVC) whereas the remaining investigated biomarkers provided by cardiac magnetic resonance (CMR). Four articles investigated the presence of midwall fibrosis on late-gadolinium enhancement imaging, three reported its extent (LGE%) and two, the myocardial extracellular volume (ECV). By decreasing strength of association, there were significant associations between cardiac mortality and LGE% [Relative Risk (RR) = 1.05, 95% Confidence Interval (CI) 1.01-1.10]; overall mortality and AVC (RR = 1.19, 95%CI: 1.05-1.36); overall events and ECV (RR = 1.68, 95%CI: 1.17-2.41); cardiac mortality and midwall fibrosis (RR = 2.88, 95%CI: 1.12-7.39). Conclusion: AVC and myocardial fibrosis imaging biomarkers predict the outcomes in AS, and help understanding AS pathophysiology and setting therapeutic targets. [less ▲]

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See detailEchocardiographic reference ranges for normal left atrial function parameters: results from the EACVI NORRE study.
Sugimoto, Tadafumi; ROBINET, Sébastien ULiege; DULGHERU, Raluca Elena ULiege et al

in European Heart Journal - Cardiovascular Imaging (2018), 19(6), 630-638

Aims: To obtain the normal ranges for echocardiographic measurements of left atrial (LA) function from a large group of healthy volunteers accounting for age and gender. Methods and results: A total of ... [more ▼]

Aims: To obtain the normal ranges for echocardiographic measurements of left atrial (LA) function from a large group of healthy volunteers accounting for age and gender. Methods and results: A total of 371 (median age 45 years) healthy subjects were enrolled at 22 collaborating institutions collaborating in the Normal Reference Ranges for Echocardiography (NORRE) study of the European Association of Cardiovascular Imaging (EACVI). Left atrial data sets were analysed with a vendor-independent software (VIS) package allowing homogeneous measurements irrespective of the echocardiographic equipment used to acquire data sets. The lowest expected values of LA function were 26.1%, 48.7%, and 41.4% for left atrial strain (LAS), 2D left atrial emptying fraction (LAEF), and 3D LAEF (reservoir function); 7.7%, 24.2%, and -0.53/s for LAS-active, LAEF-active, and LA strain rate during LA contraction (SRa) (pump function) and 12.0% and 21.6% for LAS-passive and LAEF-passive (conduit function). Left atrial reservoir and conduit function were decreased with age while pump function was increased. All indices of reservoir function and all LA strains had no difference in both gender and vendor. However, inter-vendor differences were observed in LA SRa despite the use of VIS. Conclusion: The NORRE study provides contemporary, applicable echocardiographic reference ranges for LA function. Our data highlight the importance of age-specific reference values for LA functions. [less ▲]

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See detailP2X1 ion channel regulates neutrophil NETosis in colitis
Wéra, Odile ULiege; Servais, Laurence ULiege; Delierneux, Céline et al

Conference (2017, November)

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See detailStress perfusion CMR: improved correlation with invasive fractional flow reserve after correction for perfusion changes in remote myocardium.
Ghekiere, Olivier; Dacher, Jean-Nicolas; Dewilde, Willem et al

Conference (2017, November)

PURPOSE This study was undertaken, considering fractional flow reserve (FFR) as the reference: (i) to evaluate a predictive model of flow reserve using adenosine cardiac magnetic resonance (CMR) time ... [more ▼]

PURPOSE This study was undertaken, considering fractional flow reserve (FFR) as the reference: (i) to evaluate a predictive model of flow reserve using adenosine cardiac magnetic resonance (CMR) time-signal intensity measurements collected in the area distal to a focal coronary artery stenosis (CAS) and (ii) to assess the incremental value of correcting this model by including similar measurements in remote areas. METHOD AND MATERIALS This retrospective study was approved by the hospital ethics committee. Forty-six patients (mean age 61±9 years; 33 males) who underwent both adenosine first-pass CMR and FFR in the work-up for a focal CAS (n=49) were included after written informed consent. Areas-at-risk (RISK) and remote adenosine/rest time-signal intensity parameters were evaluated. Boosting models were elaborated to predict the FFR value from (i)the whole (extended) and (ii)RISK-only parameters. The relationship between the predictions and FFR value was described with Bland-Altman and summarized with intra-class correlation(ICC). Diagnostic accuracies of the models predicting FFR<=0.80 were calculated. RESULTS The average FFR value was 0.84±0.09 (0.60-0.98 range), 15(31%) were <=0.80. Decreasing FFR was associated with opposite effects on myocardial time-signal intensity responses downstream of the CAS or remotely. Compared to the RISK-only models, the extended models exhibited higher correlations with the FFR value (0.73;95%CI,0.57-0.84 versus 0.25;95%CI,0.03-0.50) and diagnostic accuracy to predict FFR<=0.80 CAS [44/49 (90%; 95%CI,78-98) vs 36/49 (73%;95%CI,55-88)]. CONCLUSION When evaluating the functional significance of a CAS using adenosine first-pass CMR, considering time-signal intensity measurements in remote areas allows a better correlation with invasive FFR and improved diagnostic accuracy for FFR<=0.80. CLINICAL RELEVANCE/APPLICATION To improve the clinical relevance of evaluating coronary stenoses by using adenosine first-pass CMR, each perfusion-related parameter should be corrected by its value in remote segments. Close [less ▲]

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See detailFFRCT and stress perfusion CMR are equally reliable alternatives To invasive FFR measurement in functional significance of intermediate-grade coronary artery stenosis
Ghekiere, Olivier; Bielen, Jurgen; Dewilde, Willem et al

Conference (2017, October)

Purpose: The management of intermediate-grade coronary artery stenoses (CAS) is challenging, often requiring additional invasive work-up with fractional flow reserve (FFR) to guide revascularization. To ... [more ▼]

Purpose: The management of intermediate-grade coronary artery stenoses (CAS) is challenging, often requiring additional invasive work-up with fractional flow reserve (FFR) to guide revascularization. To correlate the FFR estimates derived from computed tomography (FFRCT) and stress perfusion cardiac magnetic resonance (CMR) with invasive FFR, the standard in predicting functional significance of intermediate-grade CAS (i.e.40-70% diameter narrowing). Methods & Materials: Thirty-seven patients (mean age 61±9 years;25 males) who underwent coronary CT angiography, adenosine first-pass CMR, quantitative coronary angiography and FFR in the work-up for intermediate-grade CAS (n=39) were retrospectively evaluated. Blinded FFRCT analysis was computed on each intermediate-grade CAS. Adenosine myocardial perfusion indices (MPI) parameters were evaluated on semi-quantitative CMR in both the subendocardial myocardium supplied by the CAS and in remote (presumed normal) myocardium. Stress subendocardial MPI in RISK segments (RISK) and the correction by including remote subendocardial MPI (RISKcorr) were analyzed and correlated to the FFR and FFRCT values. Differences in correlations with FFR between CMR parameters and FFRCT were tested with z statistics and considered statistically significant different at 0.05 level. Results: The average FFR value was 0.85±0.10(0.60-0.99 range), 28% lesions (n=11) were ≤0.80. FFR value correlated poorly with the RISK MPI (r=0.151;p=0.36), but equally strongly with FFRCT (r=0.675;p<0.001) and the RISKcorr MPI (p-value RISKcorr model versus FFRCT=0.01). Conclusion: Assessment of the functional significance of intermediate-grade CAS estimated from FFRCT and stress perfusion CMR correlates strongly with invasive FFR. Both techniques may be used as equally reliable alternatives to guide patient selection for revascularization. [less ▲]

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See detailPlatelets promote immunosuppression and colorectal tumor formation: inhibition by clopidogrel
Servais, Laurence ULiege; Delierneux, Céline; Wéra, Odile ULiege et al

Poster (2017, July)

Detailed reference viewed: 9 (2 ULiège)
See detailInterplay between platelets, neutrophils and coagulation in bleeding in a mouse model of inflammatory bowel disease
Wéra, Odile ULiege; Delierneux, Céline; Servais, Laurence et al

Poster (2017, July)

Detailed reference viewed: 15 (4 ULiège)
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See detailImage quality in Coronary CT Angiography: Challenges and technical solutions.
Ghekiere, Olivier; Salgado, Rodrigo; Buls, Nico et al

in British Journal of Radiology (2017)

Multidetector CT angiography has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it ... [more ▼]

Multidetector CT angiography has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it remains an often-challenging procedure in which image quality, and hence diagnostic value, is determined by both technical and patient-related factors. Thorough knowledge of these factors is important to obtain high quality examinations. In this review, we discuss several key elements that may adversely affect coronary CT angiography image quality as well as potential measures that can be taken to mitigate their impact. In addition, several recent vendor-specific advances and future directions to improve image quality are discussed. [less ▲]

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See detailThe EACVI Echo Handbook.
Nchimi Longang, Alain ULiege

in European Heart Journal (2017)

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See detailInvited Commentary
Lancellotti, Patrizio ULiege; Nchimi Longang, Alain ULiege

in Annals of Thoracic Surgery (2017), 103(1), 81-82

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See detailP2X1 ion channel is critical for vascular integrity in inflammation
Wéra, Odile ULiege; Delierneux, Céline; Servais, Laurence ULiege et al

Poster (2016, November)

Detailed reference viewed: 15 (1 ULiège)
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 detailP2X1 ion channel is critical for vascular integrity in inflammation
Wéra, Odile ULiege; Delierneux, Céline; Hego, Alexandre ULiege et al

Conference (2016, September)

Detailed reference viewed: 19 (6 ULiège)
See detailHeart Team Session
PIERARD, Luc ULiege; LANCELLOTTI, Patrizio ULiege; PETERMANS, Jean ULiege et al

Conference (2016, August)

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See detailComputed Tomography and Magnetic Resonance Findings in Athletes at Risk for Sudden Cardiac Death
Ghekiere, Olivier; Nchimi Longang, Alain ULiege; Bijnens, Eric et al

in Journal of the Belgian Society of Radiology (2016, February), 1

Detailed reference viewed: 28 (4 ULiège)