Xavier Pillois

Electrophysiology and Heart Modeling Institute

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Michel Haı̈ssaguerre

Electrophysiology and Heart Modeling Institute

Alan T. Nurden

Hôpital Xavier Arnozan

Pierre Jaı̈s

Hôpital Cardiologique du Haut-Lévêque

Nicolas Derval

Hôpital Cardiologique du Haut-Lévêque

Frédéric Sacher

Université de Bordeaux

Mélèze Hocini

Hôpital Cardiologique du Haut-Lévêque

Mathieu Fiore

Université de Bordeaux

Arnaud Denis

Centre Hospitalier Universitaire de Bordeaux

Paquita Nurden

Hôpital Xavier Arnozan

Hubert Cochet

Electrophysiology and Heart Modeling Institute

Cooperative Institutions

Inserm

237

Université de Bordeaux

199

Centre Hospitalier Universitaire de Bordeaux

187

Hôpital Cardiologique du Haut-Lévêque

169

Electrophysiology and Heart Modeling Institute

114

Centre de Recherche Cardio-Thoracique de Bordeaux

Bordeaux Population Health

Centre National de la Recherche Scientifique

Lille’s Cardiology Hospital

Assistance Publique – Hôpitaux de Paris

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A diagnostic approach that may help to discriminate inherited thrombocytopenia from chronic immune thrombocytopenia in adult patients

Platelets (2016)

Mathieu Fiore Xavier Pillois Simon Lorrain Marie‐Agnès Bernard Nicholas Moore

Inherited thrombocytopenia (IT) is a heterogeneous group of rare diseases that are often confused with immune thrombocytopenia (ITP). The objective of this study was to supply clinicobiological elements that allow a distinction to be drawn between IT and chronic ITP. We then compared 23 adult patients with IT and 9 patients with chronic ITP. Our study revealed six discriminating criteria: (i) an age of discovery <34 years: positive predictive value (PPV) = 88.2% [63.6; 98.5], (ii) a family history of thrombocytopenia: PPV = 100.0% [82.4; 100.0], (iii) a personal history of bleeding: PPV = 100% [76.8; 100.0], (iv) a mean platelet volume >11 fL: PPV = 93.3% [68.1; 99.8], (v) an excess of giant platelets on blood smear: 100.0% [76.8; 100.0], and (vi) a percentage >44% of platelets with a surface area >4 µm2 in electron microscopy: PPV = 83.3% [58.6; 96.4]. If at least three of these criteria were combined, it was possible to distinguish IT from chronic ITP with 91.3% [72.0; 98.9] sensitivity and PPV = 100.0% [66.4; 100.0] specificity. The secondary objective of this study was to assess the prevalence of potential IT diagnosis in patients with chronic thrombocytopenia of uncertain origin. Applying our diagnostic approach to a series of 20 cases allowed us to estimate that 40% of them could be suffering from IT. Finally, our diagnostic approach may help to correctly distinguish IT from chronic ITP, particularly in the context of macrothrombocytopenia.

10.3109/09537104.2016.1143920

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Citations (19)

A single F153Sβ3 mutation causes constitutive integrin αIIbβ3 activation in a variant form of Glanzmann thrombasthenia

Blood Advances (2023)

Sevasti B. Koukouritaki Aye Myat Myat Thinn Katrina Ashworth Juan Fang Haley S. Slater

This report identifies a novel variant form of the inherited bleeding disorder Glanzmann thrombasthenia, exhibiting only mild bleeding in a physically active individual. The platelets cannot aggregate ex vivo with physiologic agonists of activation, although microfluidic analysis with whole blood displays moderate ex vivo platelet adhesion and aggregation consistent with mild bleeding. Immunocytometry shows reduced expression of αIIbβ3 on quiescent platelets that spontaneously bind/store fibrinogen, and activation-dependent antibodies (ligand-induced binding site-319.4 and PAC-1) report β3 extension suggesting an intrinsic activation phenotype. Genetic analysis reveals a single F153Sβ3 substitution within the βI-domain from a heterozygous T556C nucleotide substitution of ITGB3 exon 4 in conjunction with a previously reported IVS5(+1)G>A splice site mutation with undetectable platelet messenger RNA accounting for hemizygous expression of S153β3. F153 is completely conserved among β3 of several species and all human β-integrin subunits suggesting that it may play a vital role in integrin structure/function. Mutagenesis of αIIb-F153Sβ3 also displays reduced levels of a constitutively activated αIIb-S153β3 on HEK293T cells. The overall structural analysis suggests that a bulky aromatic, nonpolar amino acid (F,W)153β3 is critical for maintaining the resting conformation of α2- and α1-helices of the βI-domain because small amino acid substitutions (S,A) facilitate an unhindered inward movement of the α2- and α1-helices of the βI-domain toward the constitutively active αIIbβ3 conformation, while a bulky aromatic, polar amino acid (Y) hinders such movements and restrains αIIbβ3 activation. The data collectively demonstrate that disruption of F153β3 can significantly alter normal integrin/platelet function, although reduced expression of αIIb-S153β3 may be compensated by a hyperactive conformation that promotes viable hemostasis.

Clot retraction

10.1182/bloodadvances.2022009495

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Citations (2)

Founder effect and estimation of the age of the French Gypsy mutation associated with Glanzmann thrombasthenia in Manouche families

European Journal of Human Genetics (2011)

Mathieu Fiore Xavier Pillois Paquita Nurden Alan T. Nurden Frédéric Austerlitz

Founder effect

Glanzmann's thrombasthenia

Splice site mutation

10.1038/ejhg.2011.61

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Citations (33)

Management of prosthetic heart valve obstruction: Fibrinolysis versus surgery. Early results and long-term follow-up in a single-centre study of 263 cases

Archives of cardiovascular diseases (2009)

R Roudaut Stéphane Lafitte Marie-Françoise Roudaut Patricia Réant Xavier Pillois

Univariate analysis

10.1016/j.acvd.2009.01.007

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Citations (93)

A Randomized Comparison of Circular versus Single Point-By-Point Pulmonary Vein Isolation

American Journal of Cardiovascular and Thoracic Surgery (2018)

Nora Al- Jefairi Ruairidh Martin Antonio Frontera Arnaud Denis Nicolas Derval

Introduction: Point-by-point standard ablation using single-tip (conventional) catheter is the main current technique for pulmonary vein isolation (PVI) but it can be challenging.A circular, multielectrode, mapping and ablation catheter (nMARQ) may provide faster PVI. Methods:We designed a randomized comparison between circular versus conventional PVI with the primary end point of reconnection: acutely, in the index procedure, and at 3 months, at the time of a systematic repeat procedure.Results: Eighty-one patients randomized to circular (nMARQ n = 38) versus conventional (Thermocool Navistar n = 43) underwent PVI for paroxysmal atrial fibrillation.Both groups had similar characteristics: nMARQ age 61 ± 11 years (84% male) and TC age 60 ± 9 years (68% male).NMARQ procedures were shorter (RF and procedure duration), with fewer RIPV reconnections, both acutely and at 3 months (index: 1 (3%) versus 7 (16%), p = 0.044, redo: 21(18%) versus 36 (28%), p = 0.05).Patients ablated with the circular catheter also had shorter repeat procedures suggesting more discrete PV reconnections (nMRAQ: 142 ± 56 versus TC: 186 ± 76 minutes, p = 0.001).At 12 months follow up, 77% of patients in nMARQ group and 79% in TC group were in SR (p = 0.852).No major procedural complications were observed. Conclusion:This randomized study shows that nMARQ catheter is 3 times faster in isolating the PVs, with shorter RF and procedure time.It is also associated with fewer PV reconnections at 3 months.NMARQ appeared to be safe with no major procedural complications.

Isolation

10.15226/2573-864x/3/1/00132

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Genetic Testing in the Diagnostic Evaluation of Inherited Platelet Disorders

Seminars in Thrombosis and Hemostasis (2009)

Alan T. Nurden Mathieu Fiore Xavier Pillois Paquita Nurden

Inherited disorders of platelets give rise to rare bleeding syndromes through defects of platelet function and/or platelet production. Platelet function testing by biological and immunologic assays can identify the loss or abnormal functioning of specific receptor systems, signaling pathways, storage organelles, or enzymatic activities essential for adhesion, activation, and aggregation. In vitro culture of megakaryocytes can help identify the origin of familial thrombocytopenias, and electron microscopy can point to ultrastructural defects and giant platelet syndromes. But a full diagnosis can only be complete when the genetic defect has been defined for each patient. Glanzmann thrombasthenia (GT) and the Bernard-Soulier syndrome are the most studied of the membrane disorders and a wide range of mutations identified. We will use GT as an example to show how genetic studies can help understand the cell biology, pathophysiology, and management of a group of rare diseases where many of the genetic causes remain to be elucidated. Knowledge of the mutation in GT and whether it affects either of the ITGA2B or ITGB3 genes will be essential as we enter the period where accurate prenatal diagnosis and gene therapy may become viable options.

Platelet disorder

Blood Platelet Disorders

Bernard–Soulier syndrome

Molecular Genetics

Human genetics

10.1055/s-0029-1220328

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Citations (24)

2.W10.2 Potential roles of extracellular nucleotides in atherogenesis

Atherosclerosis (1997)

Claude Des̀granges C.S. Seye Xavier Pillois A.P. Gadeau

10.1016/s0021-9150(97)88597-8

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Citations (0)

Right Ventricular Electrical Activation in Patients With Repaired Tetralogy of Fallots

Circulation Arrhythmia and Electrophysiology (2019)

Zakaria Jalal Frédéric Sacher E Fournier Hubert Cochet Nicolas Derval

10.1161/circep.119.007141

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Citations (17)

Anti-α_IIbβ₃immunization in Glanzmann thrombasthenia: review of literature and treatment recommendations

British Journal of Haematology (2018)

Mathieu Fiore Roseline d’Oiron Xavier Pillois Marie‐Christine Alessi

Summary Glanzmann thrombasthenia ( GT ) is caused by inherited defects of the α II b β 3 platelet glycoprotein. This bleeding disorder can be treated with platelet transfusion therapy, but some patients will be immunized and begin to form anti‐human leucocyte antigen ( HLA ) and/or anti‐α II b β 3 antibodies. These antibodies can bind and interfere with the function of the transfused platelets, rendering treatment ineffective. However, platelet transfusion refractoriness attributable to HLA antibodies may be managed by the selection of compatible donors, although they are not always readily available, particularly in an emergency. Thus, anti‐α II b β 3 antibodies represent one of the most severe complications in GT . Both genetic and environmental factors may contribute to the risk of anti‐α II b β 3 development, but the underlying pathogenic mechanisms are still unknown. This review will summarize the current knowledge of the risk factors for development of anti‐α II b β 3 antibodies in patients with GT and discuss how these findings may influence the clinical management of patients.

Glanzmann's thrombasthenia

Platelet Transfusion

Platelet disorder

10.1111/bjh.15087

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Citations (22)

Acute and mid-term outcome of ethanol infusion of vein of Marshall for the treatment of perimitral flutter

EP Europace (2020)

Masateru Takigawa Konstantinos Vlachos Claire Martin Félix Bourier Arnaud Denis

We hypothesized that an epicardial approach using ethanol infusion in the vein of Marshall (EIVOM) may improve the result of ablation for perimitral flutter (PMF).We studied 103 consecutive patients with PMF undergoing high-resolution mapping. The first 71 were treated with radiofrequency (RF) ablation alone (RF-group), and the next 32 underwent EIVOM followed by RF on the endocardial and epicardial mitral isthmus (EIVOM/RF-group). Contact force was not measured during ablation. Acute and 1-year outcomes were compared. Flutter termination rates were similar between the RF-group (63/71, 88.7%) and EIVOM/RF-group (31/32, 96.8%, P = 0.27). Atrial tachycardia (AT) terminated with EIVOM alone in 22/32 (68.6%) in the EIVOM/RF-group. Bidirectional block of mitral isthmus was always achieved in the EIVOM/RF-group, but significantly less frequently achieved in the RF-group (62/71, 87.3%; P = 0.05). Median RF duration for AT termination/conversion was shorter [0 (0-6) s in the EIVOM/RF-group than 312 (55-610) s in the RF-group, P < 0.0001], as well as for mitral isthmus block in the EIVOM/RF-group [246 (0-663) s] than in the RF-group [900 (525-1310) s, P < 0.0001]. Pericardial effusion was observed in 1/32 (3.2%) in EIVOM/RF-group and 5/71 (7.0%) in RF-group (P = 0.66); two in RF-group required drainage and one of them developed subsequent ischaemic stroke. One-year follow-up demonstrated fewer recurrences in the EIVOM/RF-group [6/32 (18.8%)] than in the RF-group [29/71 (40.8%), P = 0.04]. By multivariate analysis, only EIVOM was significantly associated with less AT recurrence (hazard ratio = 0.35, P = 0.018).Ethanol infusion in the vein of Marshall may reduce RF duration required for PMF termination as well as for mitral isthmus block without severe complications, and the mid-term outcome may be improved by this approach.

Flutter

10.1093/europace/euaa137

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Citations (44)