Publications of Arnaud ANCION
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See detailLe COVID-19 pourrait être dangereux pour le coeur des sportifs
ANCION, Arnaud ULiege; LE GOFF, Caroline ULiege; Kaux, Jean-François ULiege

Article for general public (2020)

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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 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 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 detailconstrictive pericarditis after heart transplantation : a case report
TCHANA-SATO, Vincent ULiege; ANCION, Arnaud ULiege; ansart, francois et al

in European Heart Journal: Case Reports (2020)

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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 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 detailFirst report of a successful pediatric heart transplantation from donation after circulatory death with distant procurement using normothermic regional perfusion and cold storage.
Tchana-Sato, Vincent ULiege; Ledoux, Didier ULiege; Vandendriessche, Katrien et al

in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (2019), 38(10), 1112-1115

Heart transplantation (HT) from donation after circulatory death (DCD) is a promising alternative to expand the heart donor pool. Cold storage can be used in a strategy to successfully retrieve and ... [more ▼]

Heart transplantation (HT) from donation after circulatory death (DCD) is a promising alternative to expand the heart donor pool. Cold storage can be used in a strategy to successfully retrieve and transplant DCD hearts after reconditioning using normothermic regional perfusion for distant procurement. Herein, we present the first report of a pediatric DCD heart reconditioned with normothermic regional perfusion, preserved using only cold storage while being transported to a neighboring center, and then successfully transplanted after nearly 2 hours of cold static storage. If supported by an appropriate trial, this finding could obviate the need to use expensive perfusion devices for short interhospital distances for DCD heart transportation and stimulate more centers across the world to embrace DCD HT. [less ▲]

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See detailSuccessful clinical transplantation of hearts donated after circulatory death using normothermic regional perfusion
TCHANA-SATO, Vincent ULiege; LEDOUX, Didier ULiege; DETRY, Olivier ULiege et al

in Journal of Heart and Lung Transplantation (2019), 38(6), 593-598

BACKGROUND: Heart transplantation (HT) from donation after circulatory death (DCD) has yet to achieve wide clinical application despite the encouraging resultsreported recently. In this study we describe ... [more ▼]

BACKGROUND: Heart transplantation (HT) from donation after circulatory death (DCD) has yet to achieve wide clinical application despite the encouraging resultsreported recently. In this study we describe 2 cases of successful adult DCD HT performed at our institution using an original protocol. METHODS: Our local abdominal DCD protocol was updated to allow DCD heart procurement, and was accepted by the institutional ethics committee. The main features of the protocol include: pre-mortem insertion of peripheral venoarterial extracorporeal membrane oxygenation cannulas; thoracoabdominal normothermic regional perfusion (NRP) by clamping the 3 aortic arch vessels to exclude cerebral circu- lation; and in-situ heart resuscitation. The retrieved hearts were directly transplanted into recipients located in an adjoining operating room. RESULTS: The procurement warm ischemic time was 25 minutes for the first donor, and 26 minutes for the second donor. The cold ischemic time was 16 minutes for the first recipient and 17 minutes for the second recipient. The suture time was 30 minutes for the first recipient, and 53 minutes for the second recipient. Both recipients were easily weaned off cardiopulmonary bypass in sinus rhythm and inotro- pic support. Post-operative evaluation of cardiac function was excellent and the patients were subse- quently discharged home. CONCLUSIONS: Transplantation of hearts from DCD donors is now a clinical reality.NRP is a useful tool for resuscitation, reperfusion, and preservation of transplanted hearts. It also offers the opportunity to assess the function and viability of organs before transplantation. However,due to ethical issues, some may object to ante-mortem intervention. [less ▲]

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See detailHeart donation after circulatory death
LEDOUX, Didier ULiege; MASSION, Paul ULiege; HANS, Grégory ULiege et al

Conference (2019, March 14)

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See detailA Review of the Role of Bradykinin and Nitric Oxide in the Cardioprotective Action of Angiotensin-Converting Enzyme Inhibitors: Focus on Perindopril.
ANCION, Arnaud ULiege; TRIDETTI, Julien ULiege; NGUYEN TRUNG, Mai-Linh ULiege et al

in Cardiology and Therapy (2019)

The functional integrity of the endothelium is essential for vascular health. In addition to maintaining a delicate balance between vasodilation and vasoconstriction, the endothelium has numerous other ... [more ▼]

The functional integrity of the endothelium is essential for vascular health. In addition to maintaining a delicate balance between vasodilation and vasoconstriction, the endothelium has numerous other complex roles involved in the maintenance of vascular homeostasis. Chronic exposure to cardiovascular risk factors and oxidative stress results in an imbalance in these functions, creating an environment that favors reduced vasodilation and a proinflammatory and prothrombic state. The involvement of endothelial dysfunction in all stages of the cardiovascular continuum makes it an important target for treatment. One of the major endothelial-derived factors involved in the maintenance of endothelial function is nitric oxide (NO). Angiotensin-converting enzyme (ACE) inhibitors increase NO production both directly and indirectly by preventing production of angiotensin II (which diminishes NO production) and inhibiting the degradation of bradykinin (which stimulates local release of NO). Among the ACE inhibitors, perindopril appears to have the greatest effects on bradykinin and has demonstrated efficacy in a number of markers of endothelial dysfunction including arterial stiffness and progression of atherosclerosis. There is also strong evidence supporting the use of perindopril-based therapy for the treatment of hypertension and for reducing the risk of cardiovascular morbidity and mortality in a wide range of patients across the cardiovascular continuum.Funding: The journal's Rapid Service Fee was funded by Servier. [less ▲]

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See detailSerial heart rate measurement and mortality after acute heart failure.
ANCION, Arnaud ULiege; TRIDETTI, Julien ULiege; NGUYEN TRUNG, Mai-Linh ULiege et al

in ESC Heart Failure (2019)

AIM: Heart failure (HF) poses a unique medical burden of high morbidity and mortality. Elevated resting heart rate (HR) is associated with worse outcomes in chronic HF, but little is known about the ... [more ▼]

AIM: Heart failure (HF) poses a unique medical burden of high morbidity and mortality. Elevated resting heart rate (HR) is associated with worse outcomes in chronic HF, but little is known about the prognostic impact of serial HR measurement during hospital stay after acute HF. We examined the association between HR obtained at admission at Day 4 and at discharge and long-term mortality in a cohort of 672 patients discharge from hospital after management of acute HF. METHODS AND RESULTS: All patients examined were in sinus rhythm. HR was derived from electrocardiogram and was defined as the first reported HR in the medical record. At 1 year follow up, 60 patients died. Median HR was 86 +/- 17 b.p.m. (first tertile: 75 b.p.m., third tertile: 97 b.p.m.) at admission, 76 +/- 14 b.p.m. (first tertile: 67 b.p.m., third tertile 85 b.p.m.) at Day 4, and 72 +/- 11 b.p.m. (first tertile: 64 b.p.m., third tertile 80 b.p.m.) at discharge. Patients who died were significantly older (75 +/- 11 vs. 71 +/- 12 years; P = 0.027), had more frequently a history of ischemic cardiomyopathy (n = 34/60, P = 0.012) and of chronic obstructive pulmonary disease (n = 26/60, P = 0.027), had higher admission N terminal pro brain natriuretic peptide (14 572 +/- 21 600 vs. 7647 +/- 7964 pg/ml; P = 0.027), had lower systolic and diastolic blood pressures (P < 0.05), haemoglobin level (10.6 +/- 2.2 vs. 12.2 +/- 2.2 g/L; P = 0.005), albumin level (35.2 +/- 4.3 vs 37.1 +/- 4.1 g/dl; P = 0.003) and estimated glomerular filtration rate (47 +/- 21 vs. 60 +/- 28 ml/min/1.73 m(2) ; P = 0.0017). There were no significant differences between survivors and nonsurvivors in left ventricular ejection, the use of beta-blocker and angiotensin-converting enzyme-inhibitor, and the rate of comorbidities (hypertension, diabetes) (P=NS, for all). HR at admission was not significantly associated with 1 year mortality (P = 0.20), whereas there was a significant increase in 1 year mortality for HRs>85 b.p.m. at Day 4 (P < 0.0001) and > 80 b.p.m. at discharge (P < 0.0001). In the multivariable model that included the third tertile at Day 4 and discharge HR and adjusted for all other significant covariates, haemoglobin (P = 0.019), and HR at Day 4 (P = 0.023) were independently associated with 1 year mortality. When only discharge HR was included haemoglobin (P = 0.0004) and HR at discharge (P = 0.00053) remained independently associated with 1 year mortality. CONCLUSIONS: In patients surviving the acute HF phase, a high HR at Day 4, and at a lesser degree at discharge, but not at admission, is a strong predictor of 1 year mortality. [less ▲]

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See detailEffets cardiovasculaires indesirables de l'alcool.
Trung Nguyen, M; ANCION, Arnaud ULiege; TRIDETTI, Julien ULiege et al

in Revue medicale de Liege (2019), 74(5-6), 321-325

Alcohol consumption is a serious problem in terms of public health because it remains a major cause of illness and premature death. The effects of alcohol on cardiovascular system are particularly complex ... [more ▼]

Alcohol consumption is a serious problem in terms of public health because it remains a major cause of illness and premature death. The effects of alcohol on cardiovascular system are particularly complex. Current data report both favourable and adverse effects depending on the level of consumption, the type of alcohol consumed and the pathology considered. The goal of this review is to describe the spectrum of cardiovascular events associated with alcohol consumption. [less ▲]

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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 ▲]

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See detailWhat is the risk of cancer transmission with heart transplantation
Stiennon, Laurie ULiege; TCHANA-SATO, Vincent ULiege; ANCION, Arnaud ULiege et al

Poster (2018, March 16)

The organ donor shortage is particularly severe for heart grafts. Donor history of malignancy is a contra-indication for organ donation, but as the heart is an organ at lower risk of metastasis compared ... [more ▼]

The organ donor shortage is particularly severe for heart grafts. Donor history of malignancy is a contra-indication for organ donation, but as the heart is an organ at lower risk of metastasis compared to the liver or the lungs, the authors aimed to better determine this risk with heart transplantation (HTx) through an extensive review of the literature. Results: 7 cases (melanoma, glioblastoma (2), renal carcinoma, choriocarcinoma, hypernephroma, prostate) of transmission of cancer with HTx were reported. All recipients died from transmitted cancer. Interestingly, in 9 other cases, HTx did not induce cancer transmission at long term, despite the evidence of active cancer in the donor proven by autopsy or by cancer transmission in recipients of other organs from the same donor. Reports of UNOS described 274 heart donors with history of various cancers, without transmission to the recipients. In another report, UNOS reported 212 HTx from donor with brain cancer without cancer transmission to the recipients. Conclusion: HTx is not protected from the risk of donor cancer transmission, but very few cases were reported so far. This fact might indicate that donors with past history of cancer might be considered for heart donation in selected cases, considering the actual organ donor shortage. [less ▲]

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See detailLa tamponnade cardiaque.
ANCION, Arnaud ULiege; ROBINET, Sébastien ULiege; Lancellotti, Patrizio ULiege

in Revue Médicale de Liège (2018), 73(5-6), 277-282

Cardiac tamponade is a vital emergency. It occurs when the accumulation of intra-pericardial fluid exceeds the pericardial adaptation capacity. Pericardial pressure is equalized with that of cardiac ... [more ▼]

Cardiac tamponade is a vital emergency. It occurs when the accumulation of intra-pericardial fluid exceeds the pericardial adaptation capacity. Pericardial pressure is equalized with that of cardiac cavities and severe heart failure occurs, most often rapidly. Several clinical presentations are possible. The diagnosis is based on the assessment of pericardial effusion and its impact on the heart by echocardiography. Supportive treatments have limited effectiveness. The only emergency treatment is drainage of the pericardium by direct puncture or by surgical approach. [less ▲]

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See detailL'insuffisance cardiaque severe et l'oedeme pulmonaire aigu.
D'ORIO, Virginie ULiege; ANCION, Arnaud ULiege; Lancellotti, Patrizio ULiege

in Revue Médicale de Liège (2018), 73(5-6), 251-256

Acute heart failure is a common cause of admission in emergency department. Management requires rapid support when haemodynamic or respiratory parameters are altered. Identifying enabling factors and ... [more ▼]

Acute heart failure is a common cause of admission in emergency department. Management requires rapid support when haemodynamic or respiratory parameters are altered. Identifying enabling factors and their specific treatment is an integral part of management. The most common clinical presentation is volume overload, whose treatment remains the combination of diuretics and vasodilators. In case of impaired perfusion, various inotropic supports may be considered, but also more and more circulatory assistance devices. [less ▲]

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See detailBradykinine et protection cardiovasculaire. Role du perindopril, un inhibiteur de l'enzyme de conversion de l'angiotensine.
Lancellotti, Patrizio ULiege; ANCION, Arnaud ULiege; D'ORIO, Vincenzo ULiege et al

in Revue Médicale de Liège (2018), 73(4), 197-205

The endothelium plays a vital role as part of the cardiovascular continuum. Risk factors such as hypertension and dyslipidemia unbalance angiotensin II - bradykinin homeostasis, leading to endothelial ... [more ▼]

The endothelium plays a vital role as part of the cardiovascular continuum. Risk factors such as hypertension and dyslipidemia unbalance angiotensin II - bradykinin homeostasis, leading to endothelial dysfunction and changes in vascular structure that promote atherosclerosis and thrombosis. When dealing with risk factors, treatment should focus on the prevention and restoration of endothelial function. Not all cardiovascular drugs are able to reverse vascular and structural endothelial dysfunction. Increasing levels of bradykinin is an effect of the use of angiotensin-converting enzyme inhibitors (ACE-Is), and also a fundamental part of their mode of action. The cardiovascular protection observed with ACE-I, and not with sartans, can be explained rationally by the specific effects of bradykinin on the endothelium. In the pharmacological class of ACE-Is, perindopril likely produces the strongest effects on bradykinin, which may explain, at least in part, the documented superiority of this drug in the prevention and treatment of cardiovascular disease. [less ▲]

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