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 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 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 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 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 detailSerum albumin level and long-term outcome in acute heart failure
ANCION, Arnaud ULiege; Allepaerts, Sophie ULiege; Robinet, Sébastien ULiege et al

in Acta Cardiologica (2018)

Objective: Hypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic ... [more ▼]

Objective: Hypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic significance of serum albumin level in the prediction of long-term mortality in patients admitted for acute HF. Methods and results: We examined the association between albumin and hospital mortality in a cohort of 509 patients admitted for acute HF. None of the patients had infectious disease, severe arrhythmias (atrial fibrillation, ventricular tachycardia, ventricular fibrillation), required invasive ventilation or presented with acute coronary syndrome or primary valvular disease. Sixty-nine patients (14%) died during the 1-year follow-up. With multivariable analysis, haemoglobin level (p =.003), systolic blood pressure (p =.004) and serum albumin level (p =.003) emerged as independent predictors of long-term mortality. Hypoalbuminemia (<35.7 g/L) had a hazard ratio of 2.01 (95% CI 1.24–3.25) and haemoglobin of 2.6 (95% CI 1.29–5.22) for predicting long-term mortality. Conclusions: Serum albumin level measured at admission, especially if combined with anaemia, can serve as a simple prognostic factor in acute HF for predicting long-term outcome. © 2019, © 2019 Belgian Society of Cardiology. [less ▲]

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See detailMaladie coronaire et pratique sportive
ANCION, Arnaud ULiege; KAUX, Jean-François ULiege; PIERARD, Luc ULiege et al

in Revue Médicale de Liège (2017), 72(6), 281-287

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See detailLe cas clinique du mois. Embolie pulmonaire compliquée d’un œdème laryngé angioneurotique.
LOPEZ IGLESIAS, Raphaelle ULiege; CUPPENS, Benoit ULiege; ROBINET, Sébastien ULiege et al

in Revue Médicale de Liège (2017), 72(6), 275-280

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See detailPlace du traitement médical bradycardisant dans l’insuffisance cardiaque
TRIDETTI, Julien ULiege; KRZESINSKI, François ULiege; D'ORIO, Virginie ULiege et al

in Revue Médicale de Liège (2017), 72

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See detailRevalidation cardiaque, etat des lieux en 2017.
Lancellotti, Patrizio ULiege; ANCION, Arnaud ULiege; Pierard, Luc ULiege

in Revue Médicale de Liège (2017), 72(11), 481-487

Cardiovascular disease remains the leading cause of death in western countries. Despite advances in acute management of patients, secondary prevention remains essential and should include cardiac ... [more ▼]

Cardiovascular disease remains the leading cause of death in western countries. Despite advances in acute management of patients, secondary prevention remains essential and should include cardiac rehabilitation. Recent data have confirmed the interest of this management in the various conventional indications : coronary disease, valvular heart disease, heart failure and heart transplantation. New indications emerge with some benefit that should be evaluated : ventricular assistance, pulmonary hypertension, trans-catheter aortic valve implantation. However, the different rehabilitation programs proposed are still too uneven in content and duration and the number of patients participating in these programs remains low. Home based cardiac rehabilitation technologies have already shown some effectiveness and could improve some of the weaknesses of rehabilitation programs. Again protocols and tools need to be improved and standardized. The budgetary impact will also have to be studied further. [less ▲]

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See detailLe cas clinique du mois. Embolie pulmonaire compliquee d'un oedeme larynge angioneurotique.
LOPEZ IGLESIAS, Raphaelle ULiege; CUPPENS, Benoit ULiege; ROBINET, Sébastien ULiege et al

in Revue Médicale de Liège (2017), 72(6), 275-280

Although angioneurotic oedema (AE) is a rare entity, it sometimes leads to devastating consequences. We report the case of an oro-pharyngeal angioneurotic attack following the initiation of a fibrinolysis ... [more ▼]

Although angioneurotic oedema (AE) is a rare entity, it sometimes leads to devastating consequences. We report the case of an oro-pharyngeal angioneurotic attack following the initiation of a fibrinolysis therapy by alteplase and relay by heparin in a patient with severe acute pulmonary embolism. In view of this original case, we propose to highlight the most recent elements concerning the physiopathology of this disease. [less ▲]

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See detailLes nouvelles recommandations 2016 dans l’insuffisance cardiaque & Présentation d'une étude de Télémédecine
Troisfontaines, Pierre ULiege; D'ORIO, Virginie ULiege; Melissopoulou, Maria et al

Conference (2016, October 06)

Epidémiologie, diagnostic et Approche médicamenteuse. Dr M. Melissopoulou (CHR de liège) • Approche non médicamenteuse & comorbidités. Dr Troisfontaines (CHR de Liège) • Insuffisance cardiaque aigue ... [more ▼]

Epidémiologie, diagnostic et Approche médicamenteuse. Dr M. Melissopoulou (CHR de liège) • Approche non médicamenteuse & comorbidités. Dr Troisfontaines (CHR de Liège) • Insuffisance cardiaque aigue & Insuffisance cardiaque terminale. Dr V. D’Orio (CHU de Liège) • Présentation de l’étude Télémédecine Dr A. Ancion (CHU de Liège) [less ▲]

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