Publications of Patrizio LANCELLOTTI
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See detailSystème rénine-angiotensine-aldostérone:bref historique et questionnements face à la pandémie COVID-19
VALDES SOCIN, Hernan Gonzalo ULiege; JOURET, François ULiege; VROONEN, Laurent ULiege et al

in Revue Médicale de Liège. Supplément (2020), 75

The breakthrough of the secrets of hypertension and the renin-angiotensin-aldosterone system (RAAS) is one of the legends of medicine. The first chapter is the one of Tigerstedt’s experiments about renin ... [more ▼]

The breakthrough of the secrets of hypertension and the renin-angiotensin-aldosterone system (RAAS) is one of the legends of medicine. The first chapter is the one of Tigerstedt’s experiments about renin, and Loesch and Gollblatt’s model of renal hypertension. The race to elucidate the mechanisms of angiotensin, angiotensinogen and the angiotensin conversion enzyme cascade, by Braun Menéndez and Page teams, is a second chapter. The puzzle of this elegant cascade is completed by aldosterone isolation by the collaboration of Tait spouses and Tadeus Rechstein. As a corollary of these findings, Conn made the first description of primary hyperaldosteronism. The elucidation of RAAS pathophysiology naturally led to the synthesis of the antihypertensive captopril by Ondetti and Cushman, thereby opening the modern era of ACE inhibitors and ARII blockers. In March 2020, a viral pandemic caused by SARS-Cov-2 ignites the entire planet. This new coronavirus uses the RAAS angiotensin conversion enzyme type 2 (ACE-2) as a gateway. The SARS-CoV-2/ ACE-2 signalling pathway and its pathological effects on the cardio-respiratory and renal system of these patients initiate a new chapter. The interaction of SARS-Cov-2/ ACE-2 axis with anti-hypertensive agents, as well as with ACE-2 activators and ACE-2 homologs, takes a part of an active international study searching for therapeutic targets. This modern research, summarized in this article, will further develop our knowledge of RAAS and, hopefully, will improve the management of COVID-19 patients. [less ▲]

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See detailCorrelation between non-invasive myocardial work indices and main parameters of systolic and diastolic function: results from the EACVI NORRE study.
Manganaro, Roberta; MARCHETTA, Stella ULiege; DULGHERU, Raluca Elena ULiege et al

in European Heart Journal - Cardiovascular Imaging (2020), 21

AIMS: The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and ... [more ▼]

AIMS: The present study sought to evaluate the correlation between indices of non-invasive myocardial work (MW) and left ventricle (LV) size, traditional and advanced parameters of LV systolic and diastolic function by 2D echocardiography (2DE). METHODS AND RESULTS: A total of 226 (85 men, mean age: 45 +/- 13 years) healthy subjects were enrolled at 22 collaborating institutions of the Normal Reference Ranges for Echocardiography (NORRE) study. Global work index (GWI), global constructive work (GCW), global work waste (GWW), and global work efficiency (GWE) were estimated from LV pressure-strain loops using custom software. Peak LV pressure was estimated non-invasively from brachial artery cuff pressure. LV size, parameters of systolic and diastolic function and ventricular-arterial coupling were measured by echocardiography. As advanced indices of myocardial performance, global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained. On multivariable analysis, GWI was significantly correlated with GLS (standardized beta-coefficient = -0.23, P < 0.001), ejection fraction (EF) (standardized beta-coefficient = 0.15, P = 0.02), systolic blood pressure (SBP) (standardized beta-coefficient = 0.56, P < 0.001) and GRS (standardized beta-coefficient = 0.19, P = 0.004), while GCW was correlated with GLS (standardized beta-coefficient = -0.55, P < 0.001), SBP (standardized beta-coefficient = 0.71, P < 0.001), GRS (standardized beta-coefficient = 0.11, P = 0.02), and GCS (standardized beta-coefficient = -0.10, P = 0.01). GWE was directly correlated with EF and inversely correlated with Tei index (standardized beta-coefficient = 0.18, P = 0.009 and standardized beta-coefficient = -0.20, P = 0.004, respectively), the opposite occurred for GWW (standardized beta-coefficient =--0.14, P = 0.03 and standardized beta-coefficient = 0.17, P = 0.01, respectively). CONCLUSION: The non-invasive MW indices show a good correlation with traditional 2DE parameters of myocardial systolic function and myocardial strain. [less ▲]

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See detailEvolution of the slopes of ST2 and galectin-3 during marathon and ultratrail running compared to a control group
LE GOFF, Caroline ULiege; Kaux, Jean-François ULiege; Farre Segura, Jordi ULiege et al

in Clinical Chemistry and Laboratory Medicine (2020), 58(2), 314-321

Background Previous studies have suggested that exercising may induce cardiac damage. Galectin-3 (Gal-3) and soluble suppression of tumorigenicity 2 (ST2) are very interesting biomarkers for heart failure ... [more ▼]

Background Previous studies have suggested that exercising may induce cardiac damage. Galectin-3 (Gal-3) and soluble suppression of tumorigenicity 2 (ST2) are very interesting biomarkers for heart failure and myocardial fibrosis. We aimed to compare the kinetics of emerging fibrosis cardiac biomarkers as Gal-3 and ST-2 in endurance runners, and recreational runners before and after a running event represented by a marathon and an ultratrail event. Methods Blood samples were taken from 19 healthy non-elite marathon runners (42 km), 27 ultratour runners (67 km), and 14 recreational runners who represented the control group (10 km) just before the run (T0), just after (T1) and 3 h after (T2), in order to analyze Gal-3, ST2, hsTnT, NT-proBNP, CKMB and hsCRP. We compared the percentage of evolution and the slopes obtained from T0 to T1 (pT0T1) and from T1 to T2 (pT1T2), between the different groups of runners participating in three different races. Results Plasma cardiac biomarker concentrations increased significantly from baseline to immediately post-exercise and most of the time decreased over the subsequent 3-h period. For pT0T1 and pT1T2, the markers Gal-3 and ST2 showed a significant difference between types of run (p < 0.05 and p < 0.0001, respectively). During the recovery time, Gal-3 returned to the baseline values but not ST2 which continued to increase. Conclusions Gal-3 and ST2 are considered as a reflection of cardiac fibrosis and remodeling. The evolution of both was different, particularly after the recovery time. ST2 values exceeding cutoff values at any time. [less ▲]

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See detailSummary of 2019 ESC Guidelines on chronic coronary syndromes, acute pulmonary embolism, supraventricular tachycardia and dislipidaemias.
Claeys, Marc J.; Vandekerckhove, Yves; Cosyns, Bernard et al

in Acta Cardiologica (2020), 10

During the ESC congress in September 2019 in Paris, the new ESC guidelines were presented and are now available on the ESC website. The new guidelines describe management recommendations on following ... [more ▼]

During the ESC congress in September 2019 in Paris, the new ESC guidelines were presented and are now available on the ESC website. The new guidelines describe management recommendations on following cardiovascular diseases: chronic coronary syndromes, acute pulmonary embolism, supraventricular tachycardia and dislipidaemias. The present document gives a summary of these guidelines and highlights the most important recommendations and changes in the management of these diseases. It will help to increase awareness about the new guidelines and may stimulate to consult the full document for specific items. Ultimately, the authors hope that this document will enhance implementation of new ESC guidelines in daily clinical practice. [less ▲]

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See detailComment je traite... par anticoagulants la thrombose veineuse profonde des membres inferieurs apres la phase aigue.
GIRBEA, Alexandra ULiege; SPRYNGER, Muriel ULiege; MOONEN, Marie ULiege et al

in Revue medicale de Liege (2020), 75(4), 203-209

Treatment of lower-limb deep vein thrombosis comprises three phases : the initial phase that includes the first 5 to 21 days, the long-term phase that includes the following 3 to 6 months and a potential ... [more ▼]

Treatment of lower-limb deep vein thrombosis comprises three phases : the initial phase that includes the first 5 to 21 days, the long-term phase that includes the following 3 to 6 months and a potential extended phase (indefinite duration). After 3 to 6 months of anticoagulation, the treatment must be re-evaluated. Full or reduced dosage or complete cessation of anticoagulants can be proposed according to the individual benefit-risk balance. Risk assessment of recurrence may be challenging in the case of unprovoked venous thrombosis. Similarly, risk assessment of bleeding may be difficult. Consequently, a personalized decision must be made and regularly reassessed. As far as possible, it should also take into account the patient's preferences and lifestyle (dangerous sports, sedentary lifestyle, drug adherence,...). Further studies are still needed in order to better assess the individual risks and adapt the treatment. [less ▲]

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See detailWhen your heart depends on your gut feelings.
Musumeci, Lucia ULiege; Oury, Cécile ULiege; Lancellotti, Patrizio ULiege

in Revista espanola de cardiologia (English ed.) (2020)

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See detailIntervention In Severe Aortic Stenosis: It May Be Time When the Left Ventricle Says So.
Vannan, Mani A.; TRIDETTI, Julien ULiege; Lancellotti, Patrizio ULiege

in Journal of the American College of Cardiology (2020), 75(19), 2459-2462

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See detailTiming of Intervention in Aortic Stenosis.
Lancellotti, Patrizio ULiege; Vannan, Mani A.

in The New England journal of medicine (2020), 382(2),

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See detailL'etude clinique du mois. PARAGON-HF : sacubitril/valsartan (Entresto(R)) dans l'insuffisance cardiaque a fraction d'ejection preservee (HFpEF).
TRIDETTI, Julien ULiege; NGUYEN TRUNG, Mai-Linh ULiege; ANCION, Arnaud ULiege et al

in Revue medicale de Liege (2020), 75(2), 130-135

The <<Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction>> (PARAGON HF) trial is a multicenter, randomized, double-blind study comparing the incidence of heart ... [more ▼]

The <<Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction>> (PARAGON HF) trial is a multicenter, randomized, double-blind study comparing the incidence of heart failure hospitalization and cardiovascular mortality in patients with heart failure with preserved ejection fraction (HFpEF) treated with sacubitril/valsartan (Entresto(R)) versus valsartan alone. After a median follow-up of 35 months, the primary endpoint was reduced by 13 % in the sacubitril/valsartan group compared to the valsartan group (relative risk: 0.87, 95 % IC: 0.753-1.005, p = 0.058). Despite this lack of significance, the incidence of hospitalizations for heart failure was reduced (RR 0.85, 95 % CI: 0.72-1.00), whereas no benefit was observed on cardiovascular mortality. A subgroup analysis suggested that women and patients with an intermediate ejection fraction could get more benefit from the treatment. Concerning secondary criteria, a significant improvement in quality of life and in heart failure symptoms was observed in the group sacubitril/valsartan. There was a greater incidence of arterial hypotension and angioneurotic edema, but a lower incidence of hyperkalemia in the group sacubitril/valsartan. [less ▲]

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See detailEndocardite infectieuse a Streptococcus agalactiae.
Tajildin; MARCHETTA, Stella ULiege; FRIPPIAT, Frédéric ULiege et al

in Revue medicale de Liege (2020), 75(2), 94-99

Infectious endocarditis is a rare pathology whose mortality is high and whose diagnosis is still difficult by the usual clinical, biological and ultrasound tools. We report the case of a patient, drug ... [more ▼]

Infectious endocarditis is a rare pathology whose mortality is high and whose diagnosis is still difficult by the usual clinical, biological and ultrasound tools. We report the case of a patient, drug addict, suffering from an infectious endocarditis of the aortic valve at Streptococcus agalactiae. This germ is rarely at the origin of cardiac infection but it is responsible for quickly destructive lesion by its pathophysiological mechanisms. In this case, the infection unfortunately caused the death of the patient. [less ▲]

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See detailAortic Stenosis
LANCELLOTTI, Patrizio ULiege; SUGIMOTO, Tadafumi; DULGHERU, Raluca Elena ULiege

in 3D ECHOCARDIOGRAPHY THIRD EDITION (2020)

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See detailCOVID-19 et maladies cardiovasculaires.
HAECK, Gaëlle ULiege; ANCION, Arnaud ULiege; MARECHAL, Patrick ULiege et al

in Revue medicale de Liege (2020), 75(4), 226-232

COVID-2019 disease mainly affects the respiratory tract and can progress in severe cases to pneumonia, acute respiratory distress syndrome and multi-organ failure. Patients with prior cardiovascular ... [more ▼]

COVID-2019 disease mainly affects the respiratory tract and can progress in severe cases to pneumonia, acute respiratory distress syndrome and multi-organ failure. Patients with prior cardiovascular disease are at higher risk of developing an infection and progressing to a severe form of the disease. Also, due to the growing number of infected cases, it is clear that, in addition to the typical respiratory symptoms caused by the infection, some patients suffer from cardiovascular damage. This condition can, in fact, cause significant myocardial damage, which worsens the disease and affects the prognosis. Based on the results of currently published research, it seems important to discuss the manifestations and characteristics of myocardial damage induced by COVID-19 and its impact on patient prognosis. [less ▲]

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See detailPeptides natriurétiques dans l’insuffisance cardiaque.
NGUYEN TRUNG, Mai-Linh ULiege; TRIDETTI, Julien ULiege; ANCION, Arnaud ULiege et al

in Revue medicale de Liege (2020), 75(10), 644-648

The diagnosis of heart failure can sometimes be challenging for the clinician because presentation circumstances and heart failure phenotypes are varied. The identification and validation of sensitive and ... [more ▼]

The diagnosis of heart failure can sometimes be challenging for the clinician because presentation circumstances and heart failure phenotypes are varied. The identification and validation of sensitive and specific biomarkers for this condition are still a subject of intensive research. Among them, natriuretic peptides (ANP, BNP, NTproBNP) are widely used and validated as markers of heart failure. Their appropriate use and correct interpretation, however, require knowledge of their indications, specificities and limitations. The European Society of Cardiology has recently issued recommendations in this regard. This article summarizes them in order to facilitate the understanding and the use of natriuretic peptides in clinical practice. It also discusses their use in the etiological diagnosis of pleural effusions caused by heart failure. [less ▲]

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See detailRecommandations dans le diagnostic et la prise en charge de la syncope sur hypotension orthostatique
ANTOLE, Nathalie ULiege; Scheen, André ULiege; ANCION, Arnaud ULiege et al

in Revue medicale de Liege (2020), 75(3), 154-158

Syncope is a frequent reason for admission to emergency department or consultations. The common pathophysiological mechanism is a drop in systemic blood pressure leading to cerebral hypoperfusion, and ... [more ▼]

Syncope is a frequent reason for admission to emergency department or consultations. The common pathophysiological mechanism is a drop in systemic blood pressure leading to cerebral hypoperfusion, and ultimately to total loss of consciousness. The causes are multiple, with varying degrees of severity, classified into three main types : reflex syncope, syncope due to orthostatic hypotension and cardiac syncope. Among these, orthostatic hypotension can be easily detected, particularly by performing an orthostatic challenge with active standing, which is recommended in the presence of any syncope. Simple measures can reduce the recurrence of this type of syncope, even if sometimes drug treatments are necessary. In this article, we will detail the characteristics, diagnostic methods and therapies recommended by the latest guidelines of the European Society of Cardiology.Les syncopes sont un motif fréquent d’admission aux urgences ou de consultation. Le mécanisme physiopathologique commun est une chute de la pression artérielle systémique conduisant à une hypoperfusion cérébrale, et, in fine, à une perte de connaissance. Les causes sont multiples, avec une gravité variable, classées en trois grands types : les syncopes réflexes, les syncopes dues à une hypotension orthostatique et les syncopes d’origine cardiaque. Parmi celles-ci, l’hypotension orthostatique peut être facilement dépistée, notamment via la réalisation d’un test d’orthostatisme, qui est recommandé face à toute syncope. Des mesures simples permettent de réduire la récurrence de ce type de syncope, même si, parfois, le recours à des traitements médicamenteux est nécessaire. Dans cet article, nous résumons les caractéristiques cliniques, les méthodes diagnostiques et la prise en charge recommandées récemment par la Société Européenne de Cardiologie. [less ▲]

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See detailSecondary Mitral Regurgitation
LANCELLOTTI, Patrizio ULiege; GO, Yun Yun; DULGHERU, Raluca Elena ULiege

in 3D ECHOCARDIOGRAPHY THIRD EDITION (2020)

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See detailThe Belgian Society of Cardiology in Perspective.
Lancellotti, Patrizio ULiege; De Pauw, Michel; Claeys, Marc

in European Heart Journal (2020), 41(31), 2932-2933

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See detailSynthesis of ticagrelor analogues belonging to 1,2,3-triazolo[4,5-d]pyrimidines and study of their antiplatelet and antibacterial activity.
Goffin, Eric ULiege; Jacques, Nicolas ULiege; Musumeci, Lucia ULiege et al

in European journal of medicinal chemistry (2020), 208

Based on the recent observation that the antiplatelet agent ticagrelor and one of its metabolite exert bactericidal activity against gram-positive bacteria, a series of 1,2,3-triazolo[4,5-d]pyrimidines ... [more ▼]

Based on the recent observation that the antiplatelet agent ticagrelor and one of its metabolite exert bactericidal activity against gram-positive bacteria, a series of 1,2,3-triazolo[4,5-d]pyrimidines structurally related to ticagrelor were synthesized and examined as putative antiplatelet and antibacterial agents. The aim was to assess the possibility of dissociating the two biological properties and to find novel 1,2,3-triazolo[4,5-d]pyrimidines expressing antiplatelet activity and devoid of in vitro antibacterial activity. The new compounds synthesized were known metabolites of ticagrelor as well as structurally simplified analogues. Some of them were found to express antiplatelet activity and to lose the antibacterial activity, supporting the view that the two activities were not necessarily linked. [less ▲]

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See detailCardio-oncology: where do we stand for in Belgium?
Lancellotti, Patrizio ULiege; De Pauw, Michel; Claeys, Marc

in Acta Cardiologica (2020)

Cardiovascular disease (CVD) and cancer represent the two main causes of death in industrialised countries. Both share common risk factors (diabetes, obesity, hypertension, diet, smoking, etc.). The ... [more ▼]

Cardiovascular disease (CVD) and cancer represent the two main causes of death in industrialised countries. Both share common risk factors (diabetes, obesity, hypertension, diet, smoking, etc.). The associated timing of CVD and cancer onset is thus largely influenced by modifiable risk factors. Advances in cancer treatment have extended the lives of patients with cancer, but for some at the cost of adverse cardiovascular events. The rapidly growing number of patients surviving cancer, often in the setting of advanced age, new or pre-existing CV disease and risk factors, the management of these patients has become the concern of experts in cardio-oncology. The goal of cardio-oncology is to provide optimal care for patients with cancer and/or at risk of cardiovascular disease. To date, no specific cardio-oncology teaching programme is available in Belgium. The present paper reports the results of the Belgian Society of Cardiology (BSC) survey on cardio-oncology. The vast majority of respondents (154/159, 97%) are in favour of organising courses or educational meetings on cardio-oncology. A dedicated cardio-oncology clinic was present in only 40% of the hospitals that participated in the survey. Compared to the data collected by the European Society of Cardiology, the number of respondents considering themselves as experts in the management of left ventricular dysfunction or atrial fibrillation complicating cancer treatment was much lower in Belgium (11% vs. 30%). [less ▲]

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See detailPourquoi et comment traiter la carence martiale du patient insuffisant cardiaque ?
TRIDETTI, Julien ULiege; NGUYEN TRUNG, Mai-Linh ULiege; ANCION, Arnaud ULiege et al

in Revue medicale de Liege (2020), 75(1), 23-28

Anemia and iron deficiency are two common comorbidities in heart failure with reduced ejection fraction (HFrEF) and are associated with a poor prognosis. In contrast to iron oral supplementation ... [more ▼]

Anemia and iron deficiency are two common comorbidities in heart failure with reduced ejection fraction (HFrEF) and are associated with a poor prognosis. In contrast to iron oral supplementation, administration of intravenous ferric carboxymaltose (Injectafer(R)) improves quality of life, exercise capacity, and seems to reduce hospitalizations for heart failure. Unfortunately, although anaphylactic reactions are extremely rare, it is recommended to administer Injectafer(R) in a suitable medical environment. This limitation hinders Injectafer(R) administration and may cause reluctance from both physician and patient. The aim of this article is to optimize and harmonize management of iron deficiency in heart failure, by proposing a simple solution for the patient and the practitioner. [less ▲]

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