Publications of Laurent DAVIN
Bookmark and Share    
Full Text
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 (2019), 74(4), 277-281

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 ▲]

Detailed reference viewed: 416 (15 ULiège)
Full Text
See detailImagerie non invasive et cardiologie interventionnelle.
DAVIN, Laurent ULiege; DULGHERU, Raluca Elena ULiege; MARCHETTA, Stella ULiege et al

in Revue medicale de Liege (2019), 74(S1), 10-16

In the last decades, interventional cardiology has received fast and wide implementation as an effective alternative treatment to surgery for several congenital and acquired diseases. Imaging provides ... [more ▼]

In the last decades, interventional cardiology has received fast and wide implementation as an effective alternative treatment to surgery for several congenital and acquired diseases. Imaging provides solutions for most clinical needs, from diagnosis to prognosis and risk stratification, as well as anatomical and functional assessment. In this article, we present recent innovations in medical imaging for structural heart disease and coronary artery disease, emphasizing the progress achieved in the field of multimodality imaging. Intra-procedural guidance can be facilitated by established multimodality cardiac imaging such as transesophageal 2D and 3D echocardiography and by novel techniques as echo-fluoroscopy overlay and 3D imaging fusion. Computed tomography and magnetic resonance imaging are particularly helpful for preprocedural morphology assessment and device sizing. Successful planning, guidance, and monitoring of interventions depend heavily on accurate imaging for both structural heart disease and complex coronary artery disease. [less ▲]

Detailed reference viewed: 41 (3 ULiège)
Full Text
See detailFermeture percutanee de l'auricule gauche pour la prevention des complications thrombo-emboliques en cas de fibrillation auriculaire.
LEMPEREUR, Mathieu ULiege; DAVIN, Laurent ULiege; DULGHERU, Raluca Elena ULiege et al

in Revue medicale de Liege (2019), 74(S1), 97-103

Atrial fibrillation (AF) is the most common clinical arrythmia and can be associated with severe thromboembolic complications. For different reasons, a large number of AF patients who would benefit from ... [more ▼]

Atrial fibrillation (AF) is the most common clinical arrythmia and can be associated with severe thromboembolic complications. For different reasons, a large number of AF patients who would benefit from oral anticoagulation (OAC) are not treated. In case of contra-indications to long-term OAC, left atrial appendage (LAA) closure allows the exclusion of the LAA from the systemic circulation and significantly reduces the thromboembolism risk. Results from large randomized trials show that this technique is non-inferior in terms of efficacy compared to OAC and that it can significantly reduce the rate of haemorrhagic complications. Large-scale registries show promising results in patients with contra-indications to long-term OAC. Clinical trials are under way to define the role and spectrum of LAA occlusion and to optimize post-procedural treatment. [less ▲]

Detailed reference viewed: 77 (3 ULiège)
Full Text
See detailModalites d'imagerie endocoronaire en cardiologie interventionnelle.
GACH, Olivier ULiege; DAVIN, Laurent ULiege; Lancellotti, Patrizio ULiege

in Revue medicale de Liege (2019), 74(S1), 29-33

According to technical and pharmacological innovations and to a better comprehension in pathophysiology, interventional cardiology has continuously progressed to push forward the frontiers of its ... [more ▼]

According to technical and pharmacological innovations and to a better comprehension in pathophysiology, interventional cardiology has continuously progressed to push forward the frontiers of its indications. Despite these evolutions, it still uses an imaging modality based on X-ray, which presents numerous limitations in interpreting three-dimensional structures. The present chapter describes two available additive technologies used to optimize the resolution and the information obtained by intravascular imaging, adding key complementary information to angiography imaging : intravascular ultrasound (IVUS) and intravascular optical coherence tomography. [less ▲]

Detailed reference viewed: 33 (1 ULiège)
Full Text
See detailLe traitement percutané des occlusions coronaires chroniques.
MARECHAL, Patrick ULiege; DAVIN, Laurent ULiege; Lhoest, N. et al

in Revue medicale de Liege (2019), 74(S1), 44-50

Although frequent, chronic total occlusion (CTO) has long been neglected by interventional cardiologists, considering that the risk of complications was too high compared to the expected benefits. The ... [more ▼]

Although frequent, chronic total occlusion (CTO) has long been neglected by interventional cardiologists, considering that the risk of complications was too high compared to the expected benefits. The presence of a CTO has therefore been an essential decision-making factor for referral of patients with multivessel disease to surgical coronary revascularization, or for the choice of the optimization of medical treatment in patients with an isolated CTO. The recent years technical progress of and the development of specific tools for percutaneous treatment of CTO have allowed to gradually change the vision within the cardiology community as the benefits in terms of quality of life and of complete revascularization have been clearly demonstrated. In contrast, the benefit on survival and improvement of left ventricular systolic function, although highlighted in meta-analyses and in some registries, has yet to be demonstrated by prospective randomized studies. The different reasons for considering percutaneous revascularization of CTO are discussed in this article. We will also review how to select patients based on clinical and angiographic data. [less ▲]

Detailed reference viewed: 68 (5 ULiège)
Full Text
See detailComplication rare du syndrome coronarien aigu Survenue d'un pseudo-anevrysme ventriculaire gauche.
BENOIT, Arnaud ULiege; DAVIN, Laurent ULiege; BRUYERE, Pierre-Julien ULiege et al

in Revue medicale de Liege (2019), 74(7-8), 375-376

We report a case of left ventricular pseudo-aneurysm and we take the opportunity to briefly review the literature concerning etiologies, diagnosis and management of this pathology, emphasizing some ... [more ▼]

We report a case of left ventricular pseudo-aneurysm and we take the opportunity to briefly review the literature concerning etiologies, diagnosis and management of this pathology, emphasizing some differences with the true aneurysm. [less ▲]

Detailed reference viewed: 118 (21 ULiège)
Full Text
See detailAlcoolisation septale dans la cardiomyopathie hypertrophique obstructive.
Lancellotti, Patrizio ULiege; GACH, Olivier ULiege; DAVIN, Laurent ULiege et al

in Revue medicale de Liege (2019), 74(S1), 51-56

Alcohol septal ablation has become an attractive alternative to surgical myomectomy in symptomatic patients with obstructive hypertrophic cardiomyopathy. Its purpose is to achieve a therapeutic infarction ... [more ▼]

Alcohol septal ablation has become an attractive alternative to surgical myomectomy in symptomatic patients with obstructive hypertrophic cardiomyopathy. Its purpose is to achieve a therapeutic infarction in the sub-aortic territory responsible of the obstruction. It is indicated in symptomatic patients resistant to optimal medical treatment and having a left intraventricular gradient equal or higher than 50 mmHg, spontaneous or with exercise. The selection of candidates must be rigorous and the procedure must be performed in an experienced center, associating interventionalists and echocardiographists. Alcohol septal ablation is preferred in cases of favourable coronary anatomy, sub-aortic obstruction and absence of associated mitral valve defect. The septal alcohol technique is fast, effective and safe. The per-procedural contrast echocardiography helps identifying whether the myocardial segment is vascularized by the septal branch to be occluded. The benefits of alcohol septal ablation are comparable to those seen with surgical myectomy in terms of functional class, exercise capacity, and gradient regression. The morbidity and mortality observed in the short and mid terms are globally equivalent to that of the surgical intervention. The major complication is dominated by the occurrence of complete atrioventricular block requiring the implantation of a definitive pacemaker, a complication in sharp decline since the contrast ultrasound-guided technique has become widespread. [less ▲]

Detailed reference viewed: 43 (3 ULiège)
Full Text
See detailInterventions mitrales percutanees.
LEMPEREUR, Mathieu ULiege; DULGHERU, Raluca Elena ULiege; MARCHETTA, Stella ULiege et al

in Revue medicale de Liege (2019), 74(S1), 73-81

After aortic valve diseases, mitral valve diseases represent the most numerous indications of surgical or percutaneous valvular intervention. Surgical management is favoured in severe symptomatic mitral ... [more ▼]

After aortic valve diseases, mitral valve diseases represent the most numerous indications of surgical or percutaneous valvular intervention. Surgical management is favoured in severe symptomatic mitral regurgitation. In case of high or prohibitive surgical risk, new techniques are developed to allow percutaneous, less invasive management. In these circumstances, MitraClip(R) allows the treatment of mitral regurgitation in case of adequate valve morphology. Percutaneous balloon valvuloplasty is currently the first-line treatment of mitral stenosis related to rheumatic disease when anatomical features are favourable. Alongside the Inoue technique, which remains the classical procedure, other approaches are available with encouraging results. [less ▲]

Detailed reference viewed: 54 (2 ULiège)
Full Text
See detailCoronarographie diagnostique.
GACH, Olivier ULiege; DAVIN, Laurent ULiege; LEMPEREUR, Mathieu ULiege et al

in Revue medicale de Liege (2019), 74(S1), 17-21

Coronarography consists in selective angiography of the coronary arteries obtained invasively. It represents the gold standard for the anatomical exploration of the coronary arteries and establishes the ... [more ▼]

Coronarography consists in selective angiography of the coronary arteries obtained invasively. It represents the gold standard for the anatomical exploration of the coronary arteries and establishes the first step for the indication of possible percutaneous or surgical revascularisation. According to substantial progress, it represents an essential diagnostic tool frequently used with, despite its invasive characteristic, a very low complication's rate. The present article describes the patient's preparation for this procedure, technical modalities, major indications, contraindications and possible complications. [less ▲]

Detailed reference viewed: 134 (4 ULiège)
Full Text
See detailAngioplastie coronaire transluminale percutanée : de la révolution à l'évolution.
GACH, Olivier ULiege; DAVIN, Laurent ULiege; LEMPEREUR, Mathieu ULiege et al

in Revue medicale de Liege (2019), 74(S1), 34-38

In interventional cardiology, percutaneous transluminal coronary angioplasty (PTCA) definitely represents a revolution in the history of medicine, illustrating the medical community intention to replace ... [more ▼]

In interventional cardiology, percutaneous transluminal coronary angioplasty (PTCA) definitely represents a revolution in the history of medicine, illustrating the medical community intention to replace aggressive revascularization intervention by less invasive procedure. Rapidly adopted by physicians and patients, its utilization has grown exponentially and in parallel, numerous technical progresses have pushed forward the frontiers of its indications. This article summarizes the principal evolution of this revascularization technique from its beginning until its last innovations, describing some technical characteristics and emphasizing on some changes and extension of its indications. [less ▲]

Detailed reference viewed: 77 (4 ULiège)
Full Text
See detailLe "Heart Team" : definition et organisation. Point de Vue du Cardiologue.
Lancellotti, Patrizio ULiege; ANCION, Arnaud ULiege; DAVIN, Laurent ULiege et al

in Revue medicale de Liege (2019), 74(S1), 5-9

The management of complex cardiovascular disease has changed considerably with the development of new care strategies. In cardiology, the <<Heart Team>> or literally <<Equipe du coeur>> occupies a ... [more ▼]

The management of complex cardiovascular disease has changed considerably with the development of new care strategies. In cardiology, the <<Heart Team>> or literally <<Equipe du coeur>> occupies a prominent place in the latest European and American recommendations, particularly in the management of complex coronary or valvular diseases and in heart failure patients. The concept of <<Heart Team>> is based on the need for a multidisciplinary holistic approach based on evidence (respect of the recommendations of the scientific societies), the patient as a whole (comorbidities, preferences), risks and long-term benefits of the treatment selected and performed, as well as on the level of local expertise. It aims to determine the best management strategy for the patient, and perhaps to guarantee a better result (prognosis). [less ▲]

Detailed reference viewed: 80 (9 ULiège)
Full Text
See detailL'hypertension artérielle pulmonaire
GUIOT, Julien ULiege; Parzibut, Gilles ULiege; Weber, T. et al

in Revue Médicale de Liège (2019), 74(3), 139-145

Pulmonary arterial hypertension (PAH) is a rare vascular lung disease with a complex etiopathogeny characterized by an increased pulmonary arterial pressure of 25 mmHg or above assessed by right heart ... [more ▼]

Pulmonary arterial hypertension (PAH) is a rare vascular lung disease with a complex etiopathogeny characterized by an increased pulmonary arterial pressure of 25 mmHg or above assessed by right heart catheterization. The diagnosis is difficult due to the atypical presentation with shortness of breath requiring a sequential approach bringing at the end the clinician to perform a right heart catheterization. Nowadays, several therapies have proven to be efficient for treating PAH. Recently, international recommendations have moved to an initial combination therapy reducing the overall morbi-mortality of the patients. Therefore, early therapy appears to be a priority in PAH underlying the need for increasing the global knowledge around PAH. © 2019 Revue Medicale de Liege. All Rights Reserved. [less ▲]

Detailed reference viewed: 56 (7 ULiège)
Full Text
See detailStatin therapy modulates thickness and inflammatory profile of human epicardial adipose tissue
Parisi, V.; Petraglia, L.; D'Esposito, V. et al

in International Journal of Cardiology (2019)

Background: Epicardial adipose tissue (EAT) thickness and pro-inflammatory status has been shown to be associated with several cardiac diseases, including aortic stenosis (AS). Thus, cardiac visceral fat ... [more ▼]

Background: Epicardial adipose tissue (EAT) thickness and pro-inflammatory status has been shown to be associated with several cardiac diseases, including aortic stenosis (AS). Thus, cardiac visceral fat could represent a potential new target for drugs. In the present study we evaluate the effect of statin therapy on EAT accumulation and inflammation. Methods: Echocardiographic EAT thickness was assessed in 193 AS patients taking (n.87) and not taking (n.106) statins, undergoing cardiac surgery. To explore the association between statin therapy and EAT inflammation, EAT biopsies were obtained for cytokines immunoassay determination in EAT secretomes. An in vitro study was also conducted and the modulation of EAT and subcutaneous adipose tissue (SCAT) secretomes by atorvastatin was assessed in paired biopsies. Results: Statin therapy was significantly associated with lower EAT thickness (p < 0.0001) and with lower levels of EAT-secreted inflammatory mediators (p < 0.0001). Of note, there was a significant correlation between EAT thickness and its pro-inflammatory status. In vitro, atorvastatin showed a direct anti-inflammatory effect on EAT which was significantly higher compared to the SCAT response to statin incubation (p < 0.0001). Conclusions: The present study indicates a robust association between statin therapy and reduced EAT accumulation in patients with AS. The present data also suggest a direct relationship between EAT thickness and its inflammatory status, both modulated by statin therapy. The in vitro results support the hypothesis of a direct action of statins on EAT secretory profile. Overall our data suggest EAT as a potential new therapeutic target for statin therapy. © 2018 Elsevier B.V. [less ▲]

Detailed reference viewed: 143 (4 ULiège)
Full Text
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 ▲]

Detailed reference viewed: 156 (9 ULiège)
Full Text
See detailL'image du mois: Anévrysme de l'apex du ventricule gauche chez un patient avec cardiomyopathie hypertrophique apicale
Weerts, Victor ULiege; BRUYERE, Pierre-Julien ULiege; Acasandrei, C. et al

in Revue Médicale de Liège (2018), 73(4), 165-166

Detailed reference viewed: 139 (10 ULiège)
Full Text
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 ▲]

Detailed reference viewed: 54 (7 ULiège)
Full Text
See detailL’IMAGE DU MOIS.Une tumeur cardiaque indéterminée
RADERMECKER, Régis ULiege; RENSON, Virginie ULiege; Delvenne, Philippe ULiege et al

in Revue Médicale de Liège (2017), 72(1), 4-5

Detailed reference viewed: 86 (11 ULiège)
Full Text
See detailPourquoi traiter une occlusion coronaire totale chronique ?
MARECHAL, Patrick ULiege; GACH, Olivier ULiege; DAVIN, Laurent ULiege et al

in Revue Médicale Suisse (2017), 13(571), 1406-1409

Despite an incidence of about 15% of the patients undergoing coronary angiography, total chronic occlusions (CTO) are rarely revascularized by percutaneous angioplasty (PCI). Nevertheless, current ... [more ▼]

Despite an incidence of about 15% of the patients undergoing coronary angiography, total chronic occlusions (CTO) are rarely revascularized by percutaneous angioplasty (PCI). Nevertheless, current evidence suggest that successful CTO-PCI improve symptoms, quality of live and long-term survival. During the last years, improvement of specific techniques for these complexes procedures and increasing experience of operators allow actually to obtain success and complications rates almost equivalent to non-CTO lesions angioplasty. This review focus on the clinical benefits of CTO revascularization and on appropriate patient selection. [less ▲]

Detailed reference viewed: 174 (5 ULiège)
Full Text
See detailLe cas clinique du mois : Infarctus du myocarde sur dissection coronaire spontanée secondaire à une dysplasie fibromusculaire
JACKERS, L; DAVIN, Laurent ULiege; FALQUE, Bertrand ULiege et al

in Revue Médicale de Liège (2016), 71(10), 424-427

Detailed reference viewed: 23 (1 ULiège)