Publications of Patrizio LANCELLOTTI
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See detailAspirin or Ticagrelor in Staphylococcus aureus Infective Endocarditis: Where Do We Stand?
Leeten, Kirsten ULiege; Jacques, Nicolas; LANCELLOTTI, Patrizio ULiege et al

in Frontiers in Cell and Developmental Biology (2021), 9

Infective endocarditis is a challenging disease with a high mortality and morbidity rate. Antibiotic prophylaxis is currently recommended in high-risk infective endocarditis patients. However, the use of ... [more ▼]

Infective endocarditis is a challenging disease with a high mortality and morbidity rate. Antibiotic prophylaxis is currently recommended in high-risk infective endocarditis patients. However, the use of antibiotics faces the challenge of a low efficacy and contributes further to the emerging infection rate by antibiotic-resistant strains, emphasizing the need for new therapeutic strategies. Platelets are essential in the initial phase of infective endocarditis, acting as first-line immune responders. During the first phase of disease, bacteria can interact with platelets and counteract platelet antimicrobial activities. Mechanistic in vitro and animal studies on the effect of aspirin on bacteria-platelet interactions and the prevention of vegetation development showed promising results. However, data from clinical studies on the outcome of infective endocarditis patients who were receiving medically indicated aspirin therapy remain controversial. Therefore, the benefit of antiplatelet agents in infective endocarditis prevention has been questioned. Besides aspirin, it has been discovered that the platelet P2Y12 receptor antagonist ticagrelor has antibacterial properties in addition to its potent antiplatelet activity. Furthermore, a recent study in mice and a case report remarkably indicated the ability of this drug to eradicate Staphylococcus aureus bacteremia. This review will focus on current knowledge on antibacterial activity of ticagrelor, compared to aspirin, pointing out main unanswered questions. The goal is to provide food for thought as to whether a prior ticagrelor therapy might be beneficial for the prevention of infective endocarditis. [less ▲]

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See detailClinical course and challenging management of early COVID-19 infection after heart transplantation: case report of two patients
TCHANA-SATO, Vincent ULiege; ANCION, Arnaud ULiege; TRIDETTI, Julien ULiege et al

in BMC Infectious Diseases (2021)

Background: There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients, especially in heart transplant recipients, with only a few case reports and case series ... [more ▼]

Background: There are limited data on Coronavirus disease 2019 (COVID-19) in solid organ transplant patients, especially in heart transplant recipients, with only a few case reports and case series described so far. Heart transplant recipients may be at particular high risk due to their comorbidities and immunosuppressed state. Case presentation: This report describes the clinical course and the challenging management of early COVID-19infection in two heart transplant recipients who tested positive for the SARS-CoV-2 virus in the perioperative period of the transplant procedure. The two patients developed a severe form of the disease and ultimately died despite the initiation of an antiviral monotherapy with hydroxychloroquine coupled with the interruption of mycophenolate mofetil. Conclusions: These two cases illustrate the severity and poor prognosis of COVID-19 in the perioperative period of a heart transplant. Thorough screening of donors and recipients is mandatory, and the issue of asymptomatic carriers needs to be addressed. [less ▲]

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See detailEssential Information on Surgical Heart Valve Characteristics for Optimal Valve Prosthesis Selection: Expert Consensus Document From the European Association for Cardio-Thoracic Surgery (EACTS)-The Society of Thoracic Surgeons (STS)-American Association for Thoracic Surgery (AATS) Valve Labelling Task Force.
Durko, Andras P.; Pibarot, Philippe; Atluri, Pavan et al

in The Annals of thoracic surgery (2021), 111(1), 314-326

Comprehensive information on the characteristics of surgical heart valves (SHVs) is essential for optimal valve selection. Such information is also important in assessing SHV function after valve ... [more ▼]

Comprehensive information on the characteristics of surgical heart valves (SHVs) is essential for optimal valve selection. Such information is also important in assessing SHV function after valve replacement. Despite the existing regulatory framework for SHV sizing and labelling, this information is challenging to obtain in a uniform manner for various SHVs. To ensure that clinicians are adequately informed, the European Association for Cardio-Thoracic Surgery (EACTS), The Society of Thoracic Surgeons (STS) and American Association for Thoracic Surgery (AATS) set up a Task Force comprised of cardiac surgeons, cardiologists, engineers, regulatory bodies, representatives of the International Organization for Standardization and major valve manufacturers. Previously, the EACTS-STS-AATS Valve Labelling Task Force identified the most important problems around SHV sizing and labelling. This Expert Consensus Document formulates recommendations for providing SHV physical dimensions, intended implant position and hemodynamic performance in a transparent, uniform manner. Furthermore, the Task Force advocates for the introduction and use of a standardized chart to assess the probability of prosthesis-patient mismatch and calls valve manufacturers to provide essential information required for SHV choice on standardized Valve Charts, uniformly for all SHV models. [less ▲]

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See detailInhibiteurs des SGLT2 : nouvelle option pour prévenir ou traiter l’insuffisance cardiaque.
Scheen, André ULiege; Lancellotti, Patrizio ULiege

in Revue medicale de Liege (2021), 76(4), 248-255

Gliflozins (sodium-glucose cotransporter type 2 inhibitors or SGLT2is) are the only glucose-lowering agents that have proven their ability to reduce major cardiovascular events, hospitalisations for heart ... [more ▼]

Gliflozins (sodium-glucose cotransporter type 2 inhibitors or SGLT2is) are the only glucose-lowering agents that have proven their ability to reduce major cardiovascular events, hospitalisations for heart failure and the progression to end-stage kidney disease in at risk patients with type 2 diabetes (T2D). One of the most marked and reproducible effects is the reduction in hospitalisations for heart failure. This protective effect was observed in all large prospective cardiovascular outcome trials, independently of the presence of heart failure at inclusion, and was confirmed in two dedicated trials that specifically targeted patients with heart failure and reduced left ventricular ejection fraction, with or without diabetes : DAPA-HF with dapagliflozin and EMPEROR-reduced with empagliflozin. The reduction in hospitalisations for heart failure appeared more marked when baseline renal function was impaired, including when estimated glomerular filtration rate (eGFR) was inferior to 45 ml/min/1.73 m². These favourable results contribute to give a privileged position to SGLT2is in more recent international guidelines produced by diabetologists, cardiologists and nephrologists. According to these guidelines, the prescription of SGLT2is should be extended to patients with an eGFR between 30 and 60 ml/min/1.73 m² as well to non-diabetic patients with heart failure and reduced ejection fraction. For other patients with preserved ejection fraction, one has to wait for further results from ongoing large prospective trials. [less ▲]

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See detailCancer and cardiovascular mortality risk: is the die cast?
Lancellotti, Patrizio ULiege; NGUYEN TRUNG, Mai-Linh ULiege; Oury, Cécile ULiege et al

in European Heart Journal (2021), 42(1), 110-112

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See detailCHAPTER 9: AORTIC STENOSIS
LANCELLOTTI, Patrizio ULiege; SUGIMOTO, Tadafumi; DULGHERU, Raluca Elena ULiege

in 3D ECHOCARDIOGRAPHY (2021)

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See detailLe médicament du mois. Combinaison fixe atorvastatine-périndopril (Lipercosyl®) pour le traitement de substitution du risque cardiovasculaire.
Lancellotti, Patrizio ULiege; ANCION, Arnaud ULiege; Scheen, André ULiege

in Revue medicale de Liege (2021), 76(2), 128-133

Fixed combination atorvastatin-perindopril (Lipercosyl®) for substitution treatment of cardiovascular risk management Lipercosyl® is a fixed combination of atorvastatin and perindopril, a cholesterol ... [more ▼]

Fixed combination atorvastatin-perindopril (Lipercosyl®) for substitution treatment of cardiovascular risk management Lipercosyl® is a fixed combination of atorvastatin and perindopril, a cholesterol-lowering and an antihypertensive agent, which allows blood pressure and cholesterol levels to be controlled in hypertensive patients with dyslipidemia : atorvastatin, an inhibitor of HMG-CoA reductase, and perindopril, an angiotensin converting enzyme inhibitor. Six presentations with different dosages of each molecule are available so the treatment can be individualized. Specific precautions of use to each medication must obviously be observed. The use of such a combination helps to ensure a good level of cholesterol while controlling blood pressure. [less ▲]

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See detailAnticoagulation des patients diabétiques avec fibrillation auriculaire non valvulaire.
Scheen, André ULiege; SPRYNGER, Muriel ULiege; Lancellotti, Patrizio ULiege

in Revue medicale de Liege (2021), 76(2), 93-97

Patients with diabetes have a higher risk of nonvalvular atrial fibrillation (NVAF), cerebral embolisms and anticoagulant-related intracranial bleeding when compared to nondiabetic patients. Non-vitamin K ... [more ▼]

Patients with diabetes have a higher risk of nonvalvular atrial fibrillation (NVAF), cerebral embolisms and anticoagulant-related intracranial bleeding when compared to nondiabetic patients. Non-vitamin K oral anticoagulants (NOACs) are progressively replacing antivitamin K agents among patients with NVAF. They are as efficacious as warfarin to reduce the risk of cerebral and systemic embolisms while reducing the risk of both severe and cerebral hemorrhages. Four studies reported results of prespecified subanalyses that compared results of efficacy and safety of NOACs (dabigatran, rivaroxaban, apixaban, edoxaban) in patients with and without diabetes, overall with similar results in both subgroups. ENGAGE AF-TIMI 48 is the only trial that reported a significant reduction of severe hemorrhages with edoxaban compared with warfarin in diabetic patients with NVAF. [less ▲]

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See detailCardio-oncologie, pourquoi est-ce une nouvelle spécialité ?
Moonen, Marie ULiege; NGUYEN TRUNG, Mai-Linh ULiege; Deneye, Manon ULiege et al

in Revue medicale de Liege (2021), 76(5-6), 408-412

Cardio-oncology is a new interdisciplinary specialty that has emerged over the past ten years. With the development of increasingly potent cancer therapies which improve cancer survival, but at the cost ... [more ▼]

Cardio-oncology is a new interdisciplinary specialty that has emerged over the past ten years. With the development of increasingly potent cancer therapies which improve cancer survival, but at the cost of cardiovascular toxicity, the demand for specialized cardio-oncology services has emerged. Also, cardiovascular diseases are more common and more serious in cancer patients than in the general population. Cardio-oncology focuses on the prevention, detection, monitoring, and treatment of cardiovascular diseases in cancer patients, mostly those occurring as a side effect of chemo- and radiotherapy. [less ▲]

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See detailCHAPTER 7B: SECONDARY MITRAL REGURGITATION
LANCELLOTTI, Patrizio ULiege; GO, Yun Yun; DULGHERU, Raluca Elena ULiege

in 3D ECHOCARDIOGRAPHY (2021)

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See detailChoc cardiogénique : étiologie et prise en charge.
Dumont, Romain ULiege; TRIDETTI, Julien ULiege; ANCION, Arnaud ULiege et al

in Revue medicale de Liege (2021), 76(2), 88-92

Cardiogenic shock is one of the four types of circulatory shock (cardiogenic, distributive, hypovolemic and obstructive). It is a serious complication associated with a hypoperfusion state of terminal ... [more ▼]

Cardiogenic shock is one of the four types of circulatory shock (cardiogenic, distributive, hypovolemic and obstructive). It is a serious complication associated with a hypoperfusion state of terminal organs and possible multivisceral failures, with a high mortality rate of nearly 50 %. It is secondary to an acute myocardial infarction in 8 out of 10 cases but only complicates it in 5 to 10 %. It is more frequently encountered in pluri-troncular coronary diseases. Coronary revascularization and supportive care are the main treatments. [less ▲]

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See detailRecommandations européennes concernant le diagnostic de l’embolie pulmonaire.
CAGNINA, Aurélien ULiege; MICHAUX, Sandrine ULiege; ANCION, Arnaud ULiege et al

in Revue medicale de Liege (2021), 76(3), 208-215

Pulmonary embolism (PE) is the third cause of cardiovascular death in industrialized countries. The difficulty lies on the diagnosis and is linked to the clinical pre-sentation which is often non-specific ... [more ▼]

Pulmonary embolism (PE) is the third cause of cardiovascular death in industrialized countries. The difficulty lies on the diagnosis and is linked to the clinical pre-sentation which is often non-specific. The use of diagnostic scores and paraclinical examinations help the clinician in the management and assessment of the risk of death. This article aims to optimize knowledge and management of pulmonary embolism by revising the latest recommendations from the European Society of Cardiology 2019. [less ▲]

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See detailInsuffisance mitrale dynamique et œdème pulmonaire aigu.
DELVENNE, Eléonore ULiege; Khaddi, S.; DULGHERU, Raluca Elena ULiege et al

in Revue medicale de Liege (2021), 76(7-8), 583-587

We report the case of a 61-year old patient with signs and symptoms of heart failure with mid-range left ventricular ejection fraction and moderate mitral regurgitation of mixed etiology (rheumatic heart ... [more ▼]

We report the case of a 61-year old patient with signs and symptoms of heart failure with mid-range left ventricular ejection fraction and moderate mitral regurgitation of mixed etiology (rheumatic heart disease, toxic and ischemic). The dynamic behaviour of the mitral regurgitation was revealed by an acute episode of pulmonary edema in the context of an abrupt elevation of blood pressure inducing an increase in left ventricular afterload. Dynamic mitral regurgitation must be considered in any patient with exercise dyspnea who has a moderate mitral regurgitation in resting conditions or in patients with repeated acute pulmonary edema without an obvious cause. Exercise stress echocardiography is the best diagnostic test to explore the dynamic behaviour of the mitral regurgitation. Surgery or percutaneous treatment may be proposed in severe cases. [less ▲]

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See detailSTRESS ECHOCARDIOGRAPHY FOR VALVE DISEASE : AORTIC REGURGITATION AND MITRAL STENOSIS
LANCELLOTTI, Patrizio ULiege; CHITROCEANU, AM; SPERLONGANO, S et al

in ASE's COMPREHENSIVE ECHOCARDIOGRAPHY Third ediction (2021)

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See detailROLE OF EXERCISE STRESS TESTING IN MITRAL REGURGITATION
LANCELLOTTI, Patrizio ULiege; SPERLONGANO, S; CHITROCEANU, AM et al

in ASE's COMPREHENSIVE ECHOCARDIOGRAPHY Third ediction (2021)

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See detailL’insuffisance cardiaque droite aiguë.
TRIDETTI, Julien ULiege; Dumont, Romain ULiege; NGUYEN TRUNG, Mai-Linh ULiege et al

in Revue medicale de Liege (2021), 76(1), 23-30

Even though, it has long been considered as a passive channel allowing communication between the systemic and pulmonary circulations, it is now clearly established that the right ventricle plays an ... [more ▼]

Even though, it has long been considered as a passive channel allowing communication between the systemic and pulmonary circulations, it is now clearly established that the right ventricle plays an essential role in cardio-pulmonary couple physiology. Its failure results in a clinical presentation that reflects the systemic congestion and reduced cardiac output. It is the consequence of two pathological situations frequently encountered in intensive care including pulmonary vascular resistance increase and right ventricle contraction alteration. Mechanical ventilation, certain drugs and volume overload can also participate. The management of the acute right heart failure is based on the combination of supportive treatment and causal treatment, specific to the etiology. Supportive therapy aims to optimize filling pressures, reduce afterload and support cardiac contractibility. With the growing number of therapeutic options used according to co-morbidities, decision-making by a multidisciplinary heart team seems essential. [less ▲]

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See detailA simple modification of dialysate potassium: its impact on plasma potassium concentrations and the electrocardiogram
DELANAYE, Pierre ULiege; KRZESINSKI, François ULiege; DUBOIS, Bernard ULiege et al

in Clinical Kidney Journal (2021), 14(1), 390-397

Background. Sudden death is frequent in haemodialysis (HD) patients. Both hyperkalaemia and change of plasma potassium(K) concentrations induced by HD could explain this. The impact of increasing ... [more ▼]

Background. Sudden death is frequent in haemodialysis (HD) patients. Both hyperkalaemia and change of plasma potassium(K) concentrations induced by HD could explain this. The impact of increasing dialysate K by 1 mEq/L on plasma K concentrations and electrocardiogram(ECG) results before and after HD sessions was studied. Methods. Patients with pre-dialysis K>5.5 mEq/L were excluded. ECG and K measurements were obtained before and after the first session of the week for 2 weeks. Then, K in the dialysate was increased (from 1 or 3 to 2 or 4 mEq/L, respectively). Blood and ECG measurements were repeated after 2 weeks of this change. Results. Twenty-seven prevalent HD patients were included. As expected, a significant decrease in K concentrations was observed after the dialysis session, but this decrease was significantly lower after the switch to an increased dialysate K. The pre-dialysis K concentrations were not different after changing, but post-dialysis K concentrations were higher after switching (P<0.0001), with a lower incidence of post-dialysis hypokalaemia. Regarding ECG, before switching, the QT interval (QT) dispersion increased during the session, whereas no difference was observed after switching. One week after switching, post-dialysis QT dispersion [38 (34–42) ms] was lower than post-dialysis QT dispersion 2 weeks and 1 week before switching [42 (38–57) ms, P¼0.0004; and 40 (35–50) ms, P¼0.0002]. Conclusions. A simple increase of 1 mEq/L of K in the dialysate is associated with a lower risk of hypokalaemia and a lower QT dispersion after the dialysis session. Further study is needed to determine if such a strategy is associated with a lower risk of sudden death. [less ▲]

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See detailRegular Dietary Intake of Palmitate Causes Vascular and Valvular Calcification in a Rabbit Model.
Donis, Nathalie ULiege; Jiang, Zheshen ULiege; D'Emal, Céline ULiege et al

in Frontiers in Cardiovascular Medicine (2021), 8

Aims: Palmitic acid (PA) and oleic acid (OA) are two main dietary fatty acids. Dietary intake of PA has been associated with cardiovascular disease risk, and the effect of OA remains uncertain. Our study ... [more ▼]

Aims: Palmitic acid (PA) and oleic acid (OA) are two main dietary fatty acids. Dietary intake of PA has been associated with cardiovascular disease risk, and the effect of OA remains uncertain. Our study aimed to assess the effect of a short-term intake of lard, as source of PA and OA, on aorta and aortic valve. Methods and Results: Rabbits were fed with two lard-enriched diets, containing either elevated levels of PA or of both PA and OA as compared to chow diet. After 16 weeks of each diet, calcification was observed in the aortic intima and in the aortic valve. The extent of calcification did not differ between the two diets. In contrast, rabbits fed chow diet did not develop any calcification. In blood, PA enrichment resulted in decreased lymphocyte and monocyte counts and increased levels of hemoglobin and haematocrit. Levels of the calcification inhibitor fetuin-A were also diminished, whereas creatinine levels were raised. Of note, none of the diets changed cholesterol levels in LDL or HDL. Comprehensive quantitative lipidomics analysis identified diet-related changes in plasma lipids. Dietary PA enrichment led to a drop of polyunsaturated fatty acids (PUFA), in particular of linoleic acid in cholesteryl esters, triglycerides and diacylglycerols (DAG). Ratios of PA to 18-carbon PUFA in DAG were positively correlated with the extent of aortic valve calcification, and inversely with monocyte counts. PA content in blood correlated with aorta calcification. Conclusions: Regular dietary PA intake induces vascular and valvular calcification independently of traditional risk factors. Our findings raise awareness about PA-rich food consumption and its potential deleterious effect on cardiovascular health. [less ▲]

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See detailEACVI recommendations on cardiovascular imaging for the detection of embolic sources: endorsed by the Canadian Society of Echocardiography.
Cohen, Ariel; Donal, Erwan; Delgado, Victoria et al

in European Heart Journal - Cardiovascular Imaging (2021)

Cardioaortic embolism to the brain accounts for approximately 15-30% of ischaemic strokes and is often referred to as 'cardioembolic stroke'. One-quarter of patients have more than one cardiac source of ... [more ▼]

Cardioaortic embolism to the brain accounts for approximately 15-30% of ischaemic strokes and is often referred to as 'cardioembolic stroke'. One-quarter of patients have more than one cardiac source of embolism and 15% have significant cerebrovascular atherosclerosis. After a careful work-up, up to 30% of ischaemic strokes remain 'cryptogenic', recently redefined as 'embolic strokes of undetermined source'. The diagnosis of cardioembolic stroke remains difficult because a potential cardiac source of embolism does not establish the stroke mechanism. The role of cardiac imaging-transthoracic echocardiography (TTE), transoesophageal echocardiography (TOE), cardiac computed tomography (CT), and magnetic resonance imaging (MRI)-in the diagnosis of potential cardiac sources of embolism, and for therapeutic guidance, is reviewed in these recommendations. Contrast TTE/TOE is highly accurate for detecting left atrial appendage thrombosis in patients with atrial fibrillation, valvular and prosthesis vegetations and thrombosis, aortic arch atheroma, patent foramen ovale, atrial septal defect, and intracardiac tumours. Both CT and MRI are highly accurate for detecting cavity thrombosis, intracardiac tumours, and valvular prosthesis thrombosis. Thus, CT and cardiac magnetic resonance should be considered in addition to TTE and TOE in the detection of a cardiac source of embolism. We propose a diagnostic algorithm where vascular imaging and contrast TTE/TOE are considered the first-line tool in the search for a cardiac source of embolism. CT and MRI are considered as alternative and complementary tools, and their indications are described on a case-by-case approach. [less ▲]

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