Publications of Patrizio LANCELLOTTI
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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 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 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 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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See detailCase report: aortic bioprosthesis marantic endocarditis.
DOUIN, Clara ULiege; Marchetta, Stella; DULGHERU, Raluca Elena ULiege et al

in Acta Cardiologica (2020)

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See detailGrande clinique intégrée. La maladie cardiaque carcinoïde.
Sinatra, T.; Grzesinski, Q.; DULGHERU, Raluca Elena ULiege et al

in Revue medicale de Liege (2020), 75(7-8), 478-483

Carcinoid syndrome is the term applied to a constellation of symptoms mediated by a variety of humoral factors produced by the well-differentiated neuroendocrine tumours (NET) localised usually in the ... [more ▼]

Carcinoid syndrome is the term applied to a constellation of symptoms mediated by a variety of humoral factors produced by the well-differentiated neuroendocrine tumours (NET) localised usually in the gastrointestinal tract and the lungs. This syndrome includes a characteristic triad of diarrhea, flushing and cardiac disease. This cardiopathy occurs in 20 % of the cases and prevails on the right side of the heart. It evolves to a potentially severe heart failure. Therefore, early diagnosis and appropriate cardiac care are crucial to improve the prognosis of these patients. We report a case of a carcinoid syndrome with a trivalvular insufficiency and cardiac decompensation which required surgical replacement of the tricuspid and aortic valves. [less ▲]

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See detailDexfenfluramine and Pergolide Cause Heart Valve Disease via Valve Metabolic Reprogramming and Ongoing Matrix Remodeling.
Oury, Cécile ULiege; MARECHAL, Patrick ULiege; Donis, Nathalie ULiege et al

in International journal of molecular sciences (2020), 21(11),

Several clinical reports indicate that the use of amphetaminic anorectic drugs or ergot derivatives could cause valvular heart disease (VHD). We sought to investigate whether valvular lesions develop in ... [more ▼]

Several clinical reports indicate that the use of amphetaminic anorectic drugs or ergot derivatives could cause valvular heart disease (VHD). We sought to investigate whether valvular lesions develop in response to long-term oral administration of these drugs and to identify drug-targeted biological processes that may lead to VHD. Treatment of New Zealand White rabbits with pergolide, dexfenfluramine, or high-dose serotonin for 16 weeks induced valvular alterations characterized by extracellular matrix remodeling. Transcriptome profiling of tricuspid valves using RNA sequencing revealed distinct patterns of differentially expressed genes (DEGs) that clustered according to the different treatments. Genes that were affected by the three treatments were functionally enriched for reduced cell metabolism processes. The two drugs yielded more changes in gene expression than serotonin and shared most of the DEGs. These DEGs were mostly enriched for decreased biosynthetic processes, increased cell-matrix interaction, and cell response to growth factors, including TGF-β, which was associated with p38 MAPK activation. Treatment with pergolide specifically affected genes involved in homeostasis, which was corroborated by the activation of the master regulator of cell energy homeostasis, AMPK-α, as well as decreased levels of metabolism-related miR-107. Thus, both pergolide and dexfenfluramine may cause VHD through valve metabolic reprogramming and matrix remodeling. [less ▲]

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See detailNeutrophil Phenotypes in Coronary Artery Disease.
Maréchal, Patrick; Tridetti, Julien; Nguyen, Mai-Linh et al

in Journal of clinical medicine (2020), 9(5),

Clinical evidence indicates that innate immune cells may contribute to acute coronary syndrome (ACS). Our prospective study aimed at investigating the association of neutrophil phenotypes with ACS. 108 ... [more ▼]

Clinical evidence indicates that innate immune cells may contribute to acute coronary syndrome (ACS). Our prospective study aimed at investigating the association of neutrophil phenotypes with ACS. 108 patients were categorized into chronic stable coronary artery disease (n = 37), unstable angina (UA) (n = 19), Non-ST-Elevation Myocardial Infarction (NSTEMI) (n = 25), and ST-Elevation Myocardial Infarction (STEMI) (n = 27). At the time of inclusion, blood neutrophil subpopulations were analysed by flow cytometry. Differential blood cell count and plasma levels of neutrophilic soluble markers were recorded at admission and, for half of patients, at six-month follow-up. STEMI and NSTEMI patients displayed higher neutrophil count and neutrophil-to-lymphocyte ratio than stable and UA patients (p < 0.0001), which normalized at six-month post-MI. Atypical low-density neutrophils were detected in the blood of the four patient groups. STEMI patients were characterized by elevated percentages of band cells compared to the other patients (p = 0.019). Multivariable logistic regression analysis revealed that plasma levels of total myeloperoxidase was associated with STEMI compared to stable (OR: 1.434; 95% CI: 1.119-1.837; P < 0.0001), UA (1.47; 1.146-1.886; p = 0.002), and NSTEMI (1.213; 1.1-1.134; p = 0.0001) patients, while increased neutrophil side scatter (SSC) signal intensity was associated with NSTEMI compared to stable patients (3.828; 1.033-14.184; p = 0.045). Hence, changes in neutrophil phenotype are concomitant to ACS. [less ▲]

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See detailLa transplantation cardiaque : indications actuelles et resultats de l'experience liegeoise.
BRULS, Samuel ULiege; Tchana-Sato, Vincent ULiege; LAVIGNE, Jean-Paul ULiege et al

in Revue medicale de Liege (2020), 75(1), 29-36

Heart transplantation remains undoubtedly the most effective treatment for end-stage heart failure, whatever its cause. Last decade has witnessed significant improvements in terms of morbidity and ... [more ▼]

Heart transplantation remains undoubtedly the most effective treatment for end-stage heart failure, whatever its cause. Last decade has witnessed significant improvements in terms of morbidity and mortality following heart transplant. The 5-year survival rate is now beyond 70 %. However, the shortage of potential donors limits its use and requires strict criteria before listing a candidate for heart transplantation. Herein, we present a review of current indications and results of the heart transplantation program at the University hospital of Liege. [less ▲]

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See detailSubclinical impairment of dynamic left ventricular systolic and diastolic function in patients with obstructive sleep apnea and preserved left ventricular ejection fraction.
D'Andrea, Antonello; Canora, Angelo; Sperlongano, Simona et al

in BMC Pulmonary Medicine (2020), 20(1), 76

BACKGROUND: Hypoxia affects myocardial oxygen supply resulting in subclinical cardiac dysfunction in obstructive sleep apnea (OSA) patients, with cardiovascular complications being associated with ... [more ▼]

BACKGROUND: Hypoxia affects myocardial oxygen supply resulting in subclinical cardiac dysfunction in obstructive sleep apnea (OSA) patients, with cardiovascular complications being associated with increased oxidative burst (OB). The aims of our study were to assess left ventricular (LV) dynamic myocardial deformation and diastolic reserve at rest and upon exercise, along with OB determination in this patients subset. METHODS: Conventional echocardiography, Doppler myocardial imaging and LV 2D speckle tracking echocardiography were performed in 55 OSA patients with preserved LV ejection fraction (EF) and 35 age and sex-comparable healthy controls. Peripheral OB levels were evaluated by flow cytometry. RESULTS: Despite comparable LVEF, LV global longitudinal strain (GLS) was significantly reduced in OSA at rest (- 13.4 ± 3.8 vs - 18.4 ± 3.3 in controls, P <  0.001) and at peak exercise (- 15.8 ± 2.6 vs - 23.4 ± 4.3, P <  0.001). Systolic pulmonary artery pressure (sPAP) and E/E' ratios increase during effort were higher in OSA than in controls (ΔsPAP 44.3% ± 6.4 vs 32.3% ± 5.5, P <  0.0001, and ΔE/E' 87.5% ± 3.5 vs 25.4% ± 3.3, P <  0.0001, respectively). The best correlate of E/E' at peak stress was peak exertion capacity (r = - 0.50, P <  0.001). OB was also increased in OSA patients (P = 0.001) but, unlike OSA severity, was not associated with LV diastolic dysfunction. CONCLUSIONS: Evaluation of diastolic function and myocardial deformation during exercise is feasible through stress echocardiography. OSA patients with preserved LVEF show subclinical LV systolic dysfunction, impaired LV systolic and diastolic reserve, reduced exercise tolerance, and increased peripheral levels of OB. Therapy aimed at increasing LV diastolic function reserve might improve the quality of life and exercise tolerability in OSA patients. [less ▲]

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See detailTranscatheter Mitral Valve Replacement Guided by Echocardiographic-CT Scan Fusion: Early Human Clinical Experience.
Coisne, Augustin; Pontana, François; Modine, Thomas et al

in JACC. Cardiovascular Interventions (2020)

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