Anne‐Laure Castel

Université Catholique de Lille

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François Delelis

Université Catholique de Lille

Christophe Tribouilloy

Centre Hospitalier Universitaire Amiens-Picardie

Sylvestre Maréchaux

Université Catholique de Lille

P Graux

Université Catholique de Lille

Franck Lévy

Scientific Centre of Monaco

Aymeric Menet

Hôpital Saint-Philibert

Caroline Le Goffic

Université Catholique de Lille

Raphaëlle‐Ashley Guerbaai

Monash University

Pierre‐Vladimir Ennezat

Lille’s Cardiology Hospital

Camille Binda

Université Catholique de Lille

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Inserm

Institute of Cardiology

Assistance Publique – Hôpitaux de Paris

University of Leeds

European Society of Cardiology

Université Catholique de Lille

Centre Hospitalier Universitaire Amiens-Picardie

University of Belgrade

Université Paris Cité

Institut de Recherche pour le Développement

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Quantitative assessment of aortic regurgitation by Doppler echocardiography: Usefulness of the comparison of aortic and pulmonary flows

Echocardiography (2017)

Katell Gallais Sylvestre Maréchaux Daniel Czitrom Carole Saunier Raphaëlle‐Ashley Guerbaai

Aims Patients with significant (3+/4+) aortic regurgitation ( AR ) require careful monitoring or valve surgery. We sought to evaluate the diagnostic performance of aortic and pulmonary flow comparison in identifying patients with significant AR , by echocardiography. Method Two hundred forty‐six patients with more than trivial AR were prospectively enrolled from three centers. Aortic regurgitation ( AR ) severity was assessed by an expert using the currently recommended integrative approach. Aortic and pulmonary flows were independently assessed by another investigator to calculate the regurgitant fraction ( RF ), the aortic to pulmonary flow ratio (Qao/Qp) and the aortic to pulmonary velocity‐time integral ( VTI ao/ VTI p) ratio. The control group consisted of 195 patients without AR . Results A significant correlation was observed between AR grading and RF ( r = .82, P < .0001) and Qao/Qp ( r = .81, P < .0001), but the correlation was modest for VTI ao/ VTI p ratio ( r = .63; P < .0001). The accuracy of RF and Qao/Qp ratio to identify patients with significant AR was excellent (0.96 and 0.95, respectively), but was significantly lower for VTI ao/ VTI p ratio at 0.82. A RF > 40% indicated grade 3 or 4 AR with a sensitivity of 83% and a specificity of 93%. A Qao/Qp ratio > 1.6 indicated grade 3 or 4 AR with a sensitivity of 88% and a specificity of 89%. The VTI ao/ VTI p ratio was not helpful in identifying patients with significant AR , as a wide overlap was found between 1+/2+ and 3+/4+ patients. Conclusion Regurgitant fraction ( RF ) and Qao/Qp are helpful in identifying significant AR . The assessment of Doppler aortic/pulmonary flow should be incorporated in the comprehensive evaluation of AR .

Regurgitant fraction

10.1111/echo.13717

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Time course of secondary mitral regurgitation in patients with heart failure receiving cardiac resynchronization therapy: Impact on long-term outcome beyond left ventricular reverse remodelling

Archives of cardiovascular diseases (2017)

Camille Binda Aymeric Menet Ludovic Appert Pierre‐Vladimir Ennezat François Delelis

Clinical endpoint

10.1016/j.acvd.2017.05.009

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Clinical Significance of Ejection Dynamics Parameters in Patients with Aortic Stenosis: An Outcome Study

Journal of the American Society of Echocardiography (2018)

Anne Ringle Griguer Christophe Tribouilloy Ariane Truffier Anne‐Laure Castel François Delelis

Interquartile range

10.1016/j.echo.2017.11.015

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Citations (29)

Quantitative Evaluation of Mitral Regurgitation Secondary to Mitral Valve Prolapse by Magnetic Resonance Imaging and Echocardiography

The American Journal of Cardiology (2015)

Caroline Le Goffic Manuel Toledano Pierre‐Vladimir Ennezat Camille Binda Anne‐Laure Castel

Regurgitant fraction

Mitral valve prolapse

Ventricular outflow tract

10.1016/j.amjcard.2015.07.064

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Citations (20)

P908Prognostic value of energy loss index in patients with low gradient severe aortic stenosis and preserved ejection fraction

European Heart Journal (2019)

Alexandre Altes Anne Ringle Griguer Yohann Bohbot Olivier Bouchot François Delelis

Abstract Background Assessment of pressure recovery adjusted indexed aortic valve area (AVAi) – energy loss index (ELI) – has been shown of prognostic interest for patients with asymptomatic and/or mild aortic stenosis (AS), but limited data are available in the setting of low gradient aortic stenosis (LG-AS). Purpose We hypothesized that among these patients with LG-AS, reclassification of AS severity as moderate by ELI may help to identify a subgroup of patients with moderate AS. Methods 379 patients with low gradient severe AS (defined by AVAi ≤0.6 cm2/m2 and mean aortic pressure gradient (MPG) <40 mmHg) and preserved left ventricular ejection fraction (LVEF ≥50%) were prospectively included. Reclassification as moderate AS by ELI was defined as AVAi ≤0.6 cm2 /m2 but an ELI >0.6 cm2/m2. Clinical and echocardiographic features of patients reclassified by ELI were studied. Clinical outcomes were all-cause and cardiac mortality. Results 148 patients (39%) were reclassified as moderate AS by ELI. By multivariable logistic regression analysis, patients being reclassified as moderate AS by ELI were associated with increased stroke volume index (SVi), absence of documented coronary artery disease and decreased body surface area, left indexed ventricular mass (all p<0.05). During a median follow-up of 34 months (30–38 months), 119 patients died, 52 of them from cardiac causes. Three-year survival free from all-cause or cardiac death were 76±4%, 96±2% for patients with moderate AS by ELI and 71±3%, 84±3% for patients with severe AS by ELI (p=0.178 and p=0.013, respectively). After adjustment for variables of prognostic interest including aortic valve replacement as a time-dependent covariable, there was a significant reduction of risk of cardiac mortality in patients with moderate AS by ELI (adjusted HR 0.44 [95% CI, 0.23–0.85]; p=0.014) but not for all-cause mortality (adjusted HR 0.85 [95% CI, 0.58–1.25]; p=0.403) Conclusion In patients with low gradient “severe” AS and preserved ejection fraction, calculation of ELI permits to reclassify almost 40% of patients as having moderate AS. Patients reclassified as moderate AS by ELI had a reduction of risk of cardiac mortality during follow-up but not for all-cause mortality. Calculation of ELI may be useful for decision making in AS patients with discordant grading and preserved ejection fraction. Acknowledgement/Funding Local funding

Body surface area

10.1093/eurheartj/ehz747.0504

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Table of Contents

Canadian Journal of Cardiology (2018)

Amer M. Johri Paul Poirier Paul Dorian Anne Fournier Jack M. Goodman

Table (database)

10.1016/s0828-282x(18)31335-7

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Can left ventricular longitudinal function study using 2D speckle tracking predict postoperative atrial fibrillation after aortic valve replacement for aortic stenosis?

Archives of cardiovascular diseases (2011)

Franck Lévy Anne Laure Labescat Dorothée Malaquin P. Meimoun Antoine Jeu

Speckle tracking echocardiography

Ventricular Function

10.1016/j.acvd.2011.03.038

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Low-Gradient, Low-Flow Severe Aortic Stenosis With Preserved Left Ventricular Ejection Fraction

Journal of the American College of Cardiology (2015)

Christophe Tribouilloy Dan Ruşinaru Sylvestre Maréchaux Anne‐Laure Castel Nicolas Debry

10.1016/j.jacc.2014.09.080

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Citations (186)

Auzat : un paysage qui révèle l'interaction entre l'homme et son milieu

Anne‐Laure Castel

Auzat, village de la vallee du Vicdessos dans les Pyrenees ariegeoises, a ete marque tout au long de son histoire par plusieurs changements economiques. Dans un premier temps, le paysage marque par l’activite agropastorale s’est transforme au gre des evolutions economiques. Au debut du XXe siecle, l’activite industrielle metallurgique est passee du fer a l'aluminium avec l'emergence de nouvelles techniques et de l'hydroelectricite. Ces nouvelles activites ont entraine de nombreux bouleversements sociaux, economiques, urbains et paysagers. Aujourd’hui, avec la fin de l’ere industrielle, la vallee se tourne vers l’activite touristique. Le paysage montagnard devient une plus-value pour la principale ressource economique de la vallee.

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Continuing Medical Education Activity in Echocardiography

Echocardiography (2012)

Anne‐Laure Castel Sylvestre Maréchaux Jamal Laaouaj Dan Ruşinaru Franck Lévy

10.1111/echo.12060

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