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Pokeerbux MR, Mavingui P, Gérardin P, Agrinier N, Gokalsing E, Meilhac O, Cournot M. A Holistic Approach to Cardiometabolic and Infectious Health in the General Population of Reunion Island: The REUNION Study. J Epidemiol Glob Health 2024:10.1007/s44197-024-00221-9. [PMID: 38564109 DOI: 10.1007/s44197-024-00221-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Reunion Island is a French overseas department in the South West Indian Ocean with a unique multi-ethnic population. Cardiovascular diseases are the most common chronic conditions with higher prevalences of hypertension and diabetes compared to mainland France. Moreover, Reunion Island is particularly exposed to vector-borne diseases such as chikungunya and dengue. Our objective is to describe the prevalence of cardiometabolic and infectious diseases in Reunion Island and explore causal mechanisms linking these diseases. METHODS The REUNION study is an ongoing French prospective study. From January 2022, 2,000 consenting participants (18-68 years old) are being recruited from the general population according to polling lists and random generation of cellphone number. Baseline examination consists of (i) general health examination, assessment of cardiovascular risk factors, markers of subclinical atherosclerosis, bronchial obstruction, neuropathic and autonomic dysfunction, (ii) questionnaires to determine sociodemographic characteristics, diet, exposure to vector-borne diseases, mental health and cognitive functions, social inequalities in health and ethnic origins, (iii) biological sampling for determination of cardiovascular risk factors, seroprevalence of infectious diseases, innovative lipid biomarkers, advanced omics, composition of intestinal, periodontal and skin microbiota, and biobanking. CONCLUSIONS The REUNION study should provide new insights into the prevalence of cardiometabolic and infectious diseases, as well as their potential associations through the examination of various environmental pathways and a wide range of health aspects.
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Affiliation(s)
- Mohammad Ryadh Pokeerbux
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France.
| | - Patrick Mavingui
- Université de La Réunion, UMR Processus Infectieux en Milieu Insulaire et Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Sainte-Clotilde, La Réunion, 97490, France
| | - Patrick Gérardin
- Plateforme de Recherche Clinique et Translationnelle, INSERM CIC1410, CHU de La Réunion, Saint-Pierre, La Réunion, 97400, France
| | - Nelly Agrinier
- CHRU-Nancy, Université de Lorraine, CIC, Epidémiologie clinique, Inserm, Nancy, F-54000, France
- Université de Lorraine, Inserm, INSPIIRE, Nancy, F-54000, France
| | - Erick Gokalsing
- Etablissement Public de Santé Mentale de La Réunion, 42 chemin du Grand Pourpier, 97866, Saint-Paul Cedex, France
- Laboratoire IRISSE (IngéniéRIe de la Santé, du Sport et de l'Environnement), Université de La Réunion, UFR SHE, Saint Pierre, EA, 4075, France
| | - Olivier Meilhac
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France
- Plateforme de Recherche Clinique et Translationnelle, INSERM CIC1410, CHU de La Réunion, Saint-Pierre, La Réunion, 97400, France
| | - Maxime Cournot
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France
- Groupe de santé Clinifutur, Clinique Les Orchidées, Le Port, La Réunion, 97420, France
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Monié A, Cournot M, Dumez J, Miquel J, Bertolotti A, Sultan-Bichat N. Evaluation of a school-based sun safety education program in Reunion Island, 2016-2017. Ann Dermatol Venereol 2023; 150:195-198. [PMID: 37385911 DOI: 10.1016/j.annder.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/16/2023] [Accepted: 03/24/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Sun exposure, especially during childhood, is the main environmental risk factor for skin cancers. This study evaluated the impact of the school-based sun safety education program "Living with the Sun" on the knowledge and behavior of primary school children regarding sun safety in Reunion Island. METHODS This multicenter, comparative intervention study was conducted in selected primary schools of Reunion during the 2016-2017 school year. The intervention consisted of an in-class slide-show presentation on sun safety, a teaching guide, and school trips during which children were offered sunscreen and were requested to wear sunglasses, a T-shirt, and a cap. The children completed a questionnaire before and after the intervention. The percentage of children wearing a cap in school playgrounds at the end of the school year was compared between paired intervention and control schools. RESULTS Seven hundred children from 7 Reunionese schools completed the questionnaire before and after the intervention. There was a statistically significant improvement in children's knowledge of sun safety, with differences between schools, teachers, school levels, and questionnaire responses. The percentage of children wearing a cap at the end of the school year was significantly higher in intervention schools compared to control schools. CONCLUSIONS Children's knowledge and behavior regarding sun safety improved significantly as a result of the intervention.
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Affiliation(s)
- A Monié
- Mission Soleil Réunion, Saint Paul, La Réunion, France
| | - M Cournot
- CHOR, Service de Cardiologie, Saint Paul, La Réunion, France
| | - J Dumez
- UFR La Réunion, Département de Médecine Générale, La Réunion, France; CIC-INSERM 1410, CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France.
| | - J Miquel
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CHU Réunion, Unité de Dermatologie - pédiatrique, Saint Pierre, La Réunion, France
| | - A Bertolotti
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CIC-INSERM 1410, CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France; CHU Réunion, Service des Maladies Infectieuses - Dermatologie, Saint Pierre, La Réunion, France
| | - N Sultan-Bichat
- Mission Soleil Réunion, Saint Paul, La Réunion, France; CHOR, Service de Dermatologie, Saint Paul, La Réunion, France
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Nicot F, Charbonnel C, Jego C, Jourda F, Vinsonneau U, Garçon P, Turlotte G, Rivière JF, Maurin M, Lubret R, Meimoun P, Akret C, Cournot M, Sokic C, Michel L, Lescure M, Kenizou D, Melay M, Fayard M, Chauvat A, Fouché R, Cartigny G, Dijoux N, Martin AC, Tho-Agostini A, Mann H, Magnin D, Goralski M, Pico F, Georges JL, Belle L. Use of ADAM-C and CHA2DS2-VASc scores to predict complex aortic atheroma after brain ischemia: A prospective observational study. Echocardiography 2021; 38:612-622. [PMID: 33764608 DOI: 10.1111/echo.15034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/03/2021] [Accepted: 03/01/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS Complex aortic atheroma (CAA) is a common cause of acute brain ischemia (BI), including ischemic stroke (IS) and transient ischemic attack (TIA), and is associated with recurrence. The CHA2DS2-VASc score is a useful tool for predicting stroke in patients with atrial fibrillation (AF), and can also predict cardiovascular events in other populations, including non-AF populations. The ADAM-C score is a new risk score for predicting the diagnostic yield of transesophageal echocardiography (TEE) after BI. We aimed to evaluate the ability of CHA2DS2-VASc and ADAM-C scores to predict CAA after BI. METHODS This prospective, multicenter, observational study included 1479 patients aged over 18 years who were hospitalized for BI. CAA was defined as the presence of one or more of the following criteria: thrombus, ulcerated plaque, or plaque thickening ≥ 4 mm. RESULTS CAA was diagnosed in 216 patients (14.6%). CHA2DS2-VASc and ADAM-C scores were significantly higher in the CAA group versus the non-CAA group (P < .0001 for both). The CHA2DS2-VASc and ADAM-C scores appear to be good predictors of CAA (AUC 0.699 [0.635, 0.761] and 0.759 [0.702, 0.814], respectively). The sensitivity, specificity, predictive positive value (PPV), and negative predictive value (NPV) of the scores for detecting CAA were 94%, 22%, 17%, and 96%, respectively, for a CHA2DS2-VASc score < 2, and 90%, 46%, 22%, and 96%, respectively, for an ADAM-C score < 3 CONCLUSIONS: CHA2DS2-VASc and ADAM-C scores are able to predict CAA after BI. CHA2DS2-VASc < 2 and ADAM-C < 3 both have an interesting NPV of 96%.
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Affiliation(s)
- Florence Nicot
- Department of Cardiology, Versailles Hospital, Le Chesnay, France
| | | | - Christophe Jego
- Department of Cardiology, Toulon inter-armée Hospital, Toulon, France
| | | | - Ulric Vinsonneau
- Department of Cardiology, Brest inter-armée Hospital, Brest, France
| | - Philippe Garçon
- Department of Cardiology, Saint Joseph Hospital, Paris, France
| | - Guillaume Turlotte
- Department of Cardiology, La Roche sur Yon Hospital, La Roche sur Yon, France
| | | | - Marion Maurin
- Department of Cardiology, CHU Grenoble-Alpes, Grenoble, France
| | - Rémy Lubret
- Department of Cardiology, Boulogne sur mer Hospital, Boulogne sur mer, France
| | - Patrick Meimoun
- Department of Cardiology, Compiègne Hospital, Compiègne, France
| | - Chrystelle Akret
- Department of Cardiology, Annecy-Genevois Hospital, Annecy, France
| | - Maxime Cournot
- Department of Cardiology, Saint Paul Hospital, Saint Paul, France
| | - Charles Sokic
- Department of Cardiology, Haguenau Hospital, Haguenau, France
| | - Laurent Michel
- Department of Cardiology, Saint Lo Hospital, Saint Lo, France
| | | | - David Kenizou
- Department of Cardiology, Mulhouse Hospital, Mulhouse, France
| | - Marie Melay
- Department of Cardiology, Vichy Hospital, Vichy, France
| | - Maxime Fayard
- Department of Cardiology, Chalon sur Saone Hospital, Chalon sur Saone, France
| | - Anthony Chauvat
- Department of Cardiology, Argenteuil Hospital, Argenteuil, France
| | - Renaud Fouché
- Department of Cardiology, Montbéliard Hospital, Montbéliard, France
| | | | - Nicolas Dijoux
- Department of Cardiology, Saint Pierre Hospital, Saint Pierre, France
| | - Anne Céline Martin
- Department of Cardiology, European Georges Pompidou Hospital, Paris, France
| | | | - Hubert Mann
- Department of Cardiology, Voiron Hospital, Voiron, France
| | | | - Marc Goralski
- Department of Cardiology, Orléans Hospital, Orléans, France
| | - Fernando Pico
- Department of Cardiology, Versailles Hospital, Le Chesnay, France.,Department of Neurology, Université Versailles Saint-Quentin en Yvelines et Paris Saclay, Le Chesnay, France
| | | | - Loïc Belle
- Department of Cardiology, Annecy-Genevois Hospital, Annecy, France
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Tanaka S, Stern J, Bouzid D, Robert T, Dehoux M, Snauwaert A, Zappella N, Cournot M, Lortat-Jacob B, Augustin P, Atchade E, Tran-Dinh A, Meilhac O, Montravers P. Relationship between lipoprotein concentrations and short-term and 1-year mortality in intensive care unit septic patients: results from the HIGHSEPS study. Ann Intensive Care 2021; 11:11. [PMID: 33469739 PMCID: PMC7815878 DOI: 10.1186/s13613-021-00800-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background High-density lipoproteins (HDLs), particles characterized by their reverse cholesterol transport function, display pleiotropic properties, including anti-inflammatory and antioxidant functions. Moreover, all lipoproteins (HDLs but also low-density lipoproteins (LDLs)) neutralize lipopolysaccharides, leading to increased bacterial clearance. These two lipoproteins decrease during sepsis, and an association between low lipoprotein levels and poor outcome was reported. The goals of this study were to characterize the lipid profile of septic patients hospitalized in our intensive care unit (ICU) and to determine the relationship with the outcome. Methods A prospective observational study was conducted in a university hospital ICU. All consecutive patients admitted for septic shock or sepsis were included. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels were assessed at admission (day 1), at day 3, and at ICU discharge. When available, a prehospitalization lipid profile collected prior to the patient’s hospitalization was compiled. Short-term and 1-year prognostic outcomes were prospectively assessed. Results A total of 205 patients were included. We found a decrease in HDL-C concentration between previous values and those at admission, followed by an additional decrease at day 3. At ICU discharge, the concentration was higher than that at day 3 but did not reach the concentration measured prior to hospitalization (prior HDL-C = 1.22 (1.04–1.57) mmol/l; day 1 HDL-C = 0.44 (0.29–0.70) mmol/l; day 3 HDL-C = 0.30 (0.25–0.48) mmol/l; and HDL-C at discharge = 0.65 (0.42–0.82) mmol/l). A similar trend was found for LDL-C (prior LDL-C = 2.7 (1.91–3.33) mmol/l; day 1 LDL-C = 1.0 (0.58–1.50) mmol/l; day 3 LDL-C = 1.04 (0.64–1.54) mmol/l; and LDL-C at discharge = 1.69 (1.26–2.21) mmol/l). Mixed models for repeated measures of lipoprotein concentrations showed a significant difference in HDL-C and LDL-C concentrations over time between survivors and nonsurvivors at day 28. An HDL-C concentration at admission of less than 0.4 mmol/l was associated with increased mortality at day 28 (log-rank test, p = 0.034) but not at 1 year (log-rank test, p = 0.24). An LDL-C concentration at admission of less than 0.72 mmol/l was associated with increased mortality at day 28 and at 1 year (log-rank test, p < 0.001 and p = 0.007, respectively). No link was found between prior lipid profile and mortality. Conclusions We showed no relationship between the prehospitalization lipid profile and patient outcome, but low lipoprotein levels in the ICU were strongly associated with short-term mortality.
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Affiliation(s)
- Sébastien Tanaka
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France. .,Réunion Island University, French Institute of Health and Medical Research (INSERM), U1188 Diabetes Atherothrombosis Réunion Indian Ocean (DéTROI), CYROI Plateform, Saint-Denis de La Réunion, France.
| | - Jules Stern
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France
| | - Donia Bouzid
- Université de Paris, Paris, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Emergency Department, Bichat-Claude Bernard Hospital, Paris, France.,French Institute of Health and Medical Research (INSERM) U1137, Infection, Antimicrobials, Modelling, Evolution, Paris, France
| | - Tiphaine Robert
- Assistance Publique - Hôpitaux de Paris (AP-HP), Biochemistry Department, Bichat-Claude Bernard Hospital, Paris, France
| | - Monique Dehoux
- Assistance Publique - Hôpitaux de Paris (AP-HP), Biochemistry Department, Bichat-Claude Bernard Hospital, Paris, France
| | - Aurélie Snauwaert
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France
| | - Nathalie Zappella
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France
| | - Maxime Cournot
- Réunion Island University, French Institute of Health and Medical Research (INSERM), U1188 Diabetes Atherothrombosis Réunion Indian Ocean (DéTROI), CYROI Plateform, Saint-Denis de La Réunion, France
| | - Brice Lortat-Jacob
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France
| | - Pascal Augustin
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France
| | - Enora Atchade
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France
| | - Alexy Tran-Dinh
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France.,French Institute of Health and Medical Research (INSERM) U1148, Laboratory for Vascular Translational Science, Paris, France
| | - Olivier Meilhac
- Réunion Island University, French Institute of Health and Medical Research (INSERM), U1188 Diabetes Atherothrombosis Réunion Indian Ocean (DéTROI), CYROI Plateform, Saint-Denis de La Réunion, France.,Réunion Island University-Affiliated Hospital, Saint-Denis de la Réunion, France
| | - Philippe Montravers
- Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, DMU PARABOL, Bichat-Claude Bernard Hospital, Paris, France.,Université de Paris, Paris, France.,French Institute of Health and Medical Research (INSERM) U1152, Physiopathology and Epidemiology of Respiratory Diseases -ANR-10-LABX-17, Paris, France
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Billet S, Pugnet G, Chollet T, Charbonnier G, Fournier P, Prévot G, Tetu L, Cournot M, Derumeaux H, Carrié D, Galinier M, Lairez O. The Use of Transthoracic Echocardiogram to Quantify Pulmonary Vascular Resistance in Patients with Systemic Sclerosis. J Rheumatol 2019; 46:1495-1501. [PMID: 30824639 DOI: 10.3899/jrheum.180571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the accuracy of tricuspid regurgitation velocity (TRV) to right ventricular outflow tract time-velocity integral (TVIRVOT) ratio by Doppler to determine pulmonary vascular resistance (PVR) in patients with systemic sclerosis (SSc). METHODS Thirty-five consecutive adult patients with SSc, fulfilling the 2013 European League Against Rheumatism/American College of Rheumatology classification criteria, with sinus rhythm referred for right heart catheterization (RHC), were retrospectively included. All patients underwent a transthoracic echocardiogram (TTE) performed within 24 h of RHC. Patients with SSc were recruited regardless of disease activity, cardiac symptoms, and treatment regimen. Doppler measurements were compared to RHC measurements. A linear regression equation was generated to predict PVR by echocardiogram based on the TRV/TVIRVOT ratio. The accuracy of Doppler measurements for predicting PVR > 3 Wood units was assessed by computing the areas under the receiver-operating characteristic curves. RESULTS There were 20 (57%) females in the study. The mean age was 65 ± 12 years. Mean and systolic pulmonary arterial pressures were 31 ± 8 and 53 ± 15 mmHg, respectively. There was a good correlation between TRV/TVIRVOT ratio assessed by Doppler and PVR measured by RHC (R = 0.743, p < 0.001). The equation generated by this analysis was the following: PVR by Doppler = 11.3 × (TRV/TVIRVOT) + 1.7. A cutoff value of 0.21 for TRV/TVIRVOT ratio provided the best sensitivity (86%) and specificity (86%) to determine PVR > 3 Wood units. CONCLUSION Our study suggests that TTE using Doppler could be a useful and noninvasive tool for estimating PVR in patients with SSc.
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Affiliation(s)
- Sophie Billet
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Grégory Pugnet
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France. .,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital.
| | - Thomas Chollet
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Gaétan Charbonnier
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Pauline Fournier
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Grégoire Prévot
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Laurent Tetu
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Maxime Cournot
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Hélène Derumeaux
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Didier Carrié
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Michel Galinier
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
| | - Olivier Lairez
- From the Department of Cardiology, Rangueil University Hospital; Cardiac Imaging Centre, Toulouse University Hospital; UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III; Medical School of Rangueil, University Paul Sabatier; Department of Internal Medicine, University Hospital of Purpan; Department of Pneumology, Larrey University Hospital, Toulouse; Department of Cardiology, La Réunion University Hospital, Saint-Pierre; INSERM, UMR 1188, Sainte-Clothilde; Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; Medical School of Purpan, University Paul Sabatier; Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.,S. Billet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Pugnet, MD, PhD, UMR 1027, INSERM, Faculté de Médecine, Université de Toulouse III, and Medical School of Rangueil, University Paul Sabatier, and Department of Internal Medicine, University Hospital of Purpan; T. Chollet, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Charbonnier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; P. Fournier, MD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital; G. Prévot, MD, Department of Pneumology, Larrey University Hospital; L. Tetu, MD, Department of Pneumology, Larrey University Hospital; M. Cournot, MD, PhD, Department of Cardiology, La Réunion University Hospital, and INSERM, UMR 1188, Sainte-Clothilde; H. Derumeaux, MD, PhD, Département d'Information Médicale, Centre Hospitalier Universitaire de Toulouse; D. Carrié, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Purpan, University Paul Sabatier; M. Galinier, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier; O. Lairez, MD, PhD, Department of Cardiology, Rangueil University Hospital, and Cardiac Imaging Centre, Toulouse University Hospital, and Medical School of Rangueil, University Paul Sabatier, and Department of Nuclear Medicine, Toulouse University Hospital
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Cournot M, Bonfanti O, Mohsinaly H, Geoffroy O, Guittet A, Fels O, Nobécourt E. Risk factors, clinical features, management and in-hospital outcome of ST-elevation myocardial infarction in La Réunion. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Nativel M, Schneider F, Saulnier PJ, Gand E, Ragot S, Meilhac O, Rondeau P, Burillo E, Cournot M, Potier L, Velho G, Marre M, Roussel R, Rigalleau V, Mohammedi K, Hadjadj S. Prognostic Values of Inflammatory and Redox Status Biomarkers on the Risk of Major Lower-Extremity Artery Disease in Individuals With Type 2 Diabetes. Diabetes Care 2018; 41:2162-2169. [PMID: 30072406 DOI: 10.2337/dc18-0695] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/01/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Inflammation and oxidative stress play an important role in the pathogenesis of lower-extremity artery disease (LEAD). We assessed the prognostic values of inflammatory and redox status biomarkers on the risk of LEAD in individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Plasma concentrations of tumor necrosis factor-α receptor 1 (TNFR1), angiopoietin-like 2, ischemia-modified albumin (IMA), fluorescent advanced glycation end products, protein carbonyls, and total reductive capacity of plasma were measured at baseline in the SURDIAGENE (Survie, Diabete de type 2 et Genetique) cohort. Major LEAD was defined as the occurrence during follow-up of peripheral revascularization or lower-limb amputation. RESULTS Among 1,412 participants at baseline (men 58.2%, mean [SD] age 64.7 [10.6] years), 112 (7.9%) developed major LEAD during 5.6 years of follow-up. High plasma concentrations of TNFR1 (hazard ratio [95% CI] for second vs. first tertile 1.12 [0.62-2.03; P = 0.71] and third vs. first tertile 2.16 [1.19-3.92; P = 0.01]) and of IMA (2.42 [1.38-4.23; P = 0.002] and 2.04 [1.17-3.57; P = 0.01], respectively) were independently associated with an increased risk of major LEAD. Plasma concentrations of TNFR1 but not IMA yielded incremental information, over traditional risk factors, for the risk of major LEAD as follows: C-statistic change (0.036 [95% CI 0.013-0.059]; P = 0.002), integrated discrimination improvement (0.012 [0.005-0.022]; P < 0.001), continuous net reclassification improvement (NRI) (0.583 [0.294-0.847]; P < 0.001), and categorical NRI (0.171 [0.027-0.317]; P = 0.02). CONCLUSIONS Independent associations exist between high plasma TNFR1 or IMA concentrations and increased 5.6-year risk of major LEAD in people with type 2 diabetes. TNFR1 allows incremental prognostic information, suggesting its use as a biomarker for LEAD.
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Affiliation(s)
- Mathilde Nativel
- Département d'Endocrinologie, Diabétologie, Nutrition, Hôpital Haut-Lévêque, Pessac, Bordeaux, France
| | - Fabrice Schneider
- Département de Chirurgie Vasculaire, CHU de Poitiers, Poitiers, France.,UFR de Médecine et Pharmacie, Université de Poitiers, Poitiers, France
| | - Pierre-Jean Saulnier
- UFR de Médecine et Pharmacie, Université de Poitiers, Poitiers, France.,Centre d'Investigation Clinique, CHU de Poitiers, Poitiers, France.,CIC 1402, INSERM, Poitiers, France
| | - Elise Gand
- Pôle Dune, CHU de Poitiers, Poitiers, France
| | - Stéphanie Ragot
- UFR de Médecine et Pharmacie, Université de Poitiers, Poitiers, France.,Centre d'Investigation Clinique, CHU de Poitiers, Poitiers, France.,CIC 1402, INSERM, Poitiers, France
| | - Olivier Meilhac
- UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), INSERM, Université de La Réunion, Saint Denis de La Réunion, France.,CHU de La Réunion, Saint Denis de La Réunion, France
| | - Philippe Rondeau
- UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), INSERM, Université de La Réunion, Saint Denis de La Réunion, France
| | - Elena Burillo
- UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), INSERM, Université de La Réunion, Saint Denis de La Réunion, France
| | - Maxime Cournot
- UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI), INSERM, Université de La Réunion, Saint Denis de La Réunion, France.,Service de cardiologie, Centre Hospitalier Gabriel Martin, Saint-Paul, France
| | - Louis Potier
- DHU FIRE, Département d'Endocrinologie, Diabétologie, Nutrition, Assistance Publique Hôpitaux de Paris, Bichat Hospital, Paris, France.,UFR de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,UMRS 1138, Centre de Recherche des Cordeliers, INSERM, Paris, France
| | - Gilberto Velho
- UMRS 1138, Centre de Recherche des Cordeliers, INSERM, Paris, France
| | - Michel Marre
- DHU FIRE, Département d'Endocrinologie, Diabétologie, Nutrition, Assistance Publique Hôpitaux de Paris, Bichat Hospital, Paris, France.,UFR de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,UMRS 1138, Centre de Recherche des Cordeliers, INSERM, Paris, France
| | - Ronan Roussel
- DHU FIRE, Département d'Endocrinologie, Diabétologie, Nutrition, Assistance Publique Hôpitaux de Paris, Bichat Hospital, Paris, France.,UFR de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.,UMRS 1138, Centre de Recherche des Cordeliers, INSERM, Paris, France
| | - Vincent Rigalleau
- Département d'Endocrinologie, Diabétologie, Nutrition, Hôpital Haut-Lévêque, Pessac, Bordeaux, France.,Faculté de Médecine, Université de Bordeaux, Bordeaux, France.,Centre de Recherche INSERM-Université de Bordeaux U1219 "Bordeaux Population Health," Bordeaux, France
| | - Kamel Mohammedi
- Département d'Endocrinologie, Diabétologie, Nutrition, Hôpital Haut-Lévêque, Pessac, Bordeaux, France .,Faculté de Médecine, Université de Bordeaux, Bordeaux, France.,Centre de Recherche INSERM-Université de Bordeaux U1219 "Bordeaux Population Health," Bordeaux, France
| | - Samy Hadjadj
- UFR de Médecine et Pharmacie, Université de Poitiers, Poitiers, France.,CIC 1402, INSERM, Poitiers, France.,Département d'Endocrinologie, Diabétologie, Nutrition, CHU de Poitiers, Poitiers, France.,Research Unit 1082, INSERM, Poitiers, France
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8
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Zadro C, Roussel N, Cassol E, Pascal P, Petermann A, Meyrignac O, Jaffro M, Fournier P, Cournot M, Galinier M, Carrié D, Rousseau H, Berry I, Lairez O. Prognostic impact of myocardial perfusion single photon emission computed tomography in patients with major extracardiac findings by computed tomography for attenuation correction. J Nucl Cardiol 2018; 25:1574-1583. [PMID: 28281088 DOI: 10.1007/s12350-017-0842-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 02/21/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Attenuation correction computed tomography (CT) contributes to an improvement in the diagnostic accuracy of myocardial perfusion imaging (MPI) by single photon emission tomography (SPECT). The aim of this study was to explore the prognosis of patients with major findings by CT according to the results of MPI. METHODS AND RESULTS 1506 patients who underwent MPI by SPECT were retrospectively included. Attenuation correction CT images were systematically analyzed for major and minor abnormalities. 830 (55.1%) and 212 (14.1%) patients had minor and major extracardiac findings, respectively. Among patients with major extracardiac findings, the abnormality was previously unknown in 113 (53.3%) patients. 90 (41.9%) had abnormal MPI, 73 (34.4%) had a myocardial infarction scar, 55 (25.9%) had myocardial ischemia, and 38 (17.7%) patients had both myocardial infarction scar and myocardial ischemia. Among the 201 patients available for survival analysis, there were 67 (31.2%) deaths over a follow-up period of 3.2±1.3 years. There was no significant impact on survival arising from MPI, whatever the result. The results were the same among the 103 patients with previously unknown major extracardiac findings. CONCLUSION Extracardiac findings by CT during MPI are frequent. Patients with major extracardiac findings have a poor mid-term outcome, whatever the results of the myocardial perfusion imaging. Extracardiac findings should be systematically checked when attenuation correction CT is performed.
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Affiliation(s)
- Charline Zadro
- Department of Radiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
| | - Noé Roussel
- Department of Radiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
| | - Emmanuelle Cassol
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
- Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Pierre Pascal
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
- Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France
| | - Antoine Petermann
- Department of Radiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
| | - Olivier Meyrignac
- Department of Radiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
| | - Marion Jaffro
- Department of Radiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
| | - Pauline Fournier
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
| | - Maxime Cournot
- Department of Cardiology, Gabriel Martin Hospital, Saint-Paul, France
| | - Michel Galinier
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France
| | - Hervé Rousseau
- Department of Radiology, Toulouse University Hospital, Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Isabelle Berry
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France
- Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Olivier Lairez
- Cardiac Imaging Center, Toulouse University Hospital, 1, Avenue Jean Poulhès, TSA 50032, 31059, Toulouse Cedex 9, France.
- Department of Nuclear Medicine, Toulouse University Hospital, Toulouse, France.
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France.
- Department of Cardiology, University Hospital of Rangueil, Toulouse, France.
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9
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Abstract
Due to its short-term consequences on perinatal outcome, preeclampsia has been long regarded as an obstetrical disease, strictly confined to a management by OB/GYNs. It has been now widely accepted that preeclampsia is most a systemic inflammatory and systemic vascular disease during pregnancy and then a lifelong risk factor for subsequent cardiovascular event in women's life. The aim of this review is to propose an overview in the current state-of-art in definition, early identification and management of preeclampsia. We will also discuss the growing evidence that support that cardiologists must be fully involved in screening and prevention of preeclampsia during pregnancy and beyond in the subsequent medical follow-up of women who have experienced a preeclampsia.
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Affiliation(s)
- M Cournot
- Services de cardiologie et de gynécologie-obstétrique, centre hospitalier Gabriel Martin, Saint-Paul, France; Inserm, UMR 1188 Diabète athérothrombose thérapies Réunion Océan Indien (DéTROI), université de La Réunion, Saint-Denis de La Réunion, France.
| | - O Lairez
- Department of cardiology, Rangueil university hospital, Toulouse, France
| | - B Medzech
- Services de cardiologie et de gynécologie-obstétrique, centre hospitalier Gabriel Martin, Saint-Paul, France
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10
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Orloff E, Fournier P, Bouisset F, Moine T, Cournot M, Elbaz M, Carrié D, Galinier M, Lairez O, Cognet T. Myocardial multilayer strain does not provide additional value for detection of myocardial viability assessed by SPECT imaging over and beyond standard strain. Echocardiography 2018; 35:1300-1309. [PMID: 29756381 DOI: 10.1111/echo.14022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the value of multilayer strain analysis to the assessment of myocardial viability (MV) through the comparison of both speckle tracking echocardiography and single-photon emission computed tomography (SPECT) imaging. We also intended to determine which segmental longitudinal strain (LS) cutoff value would be optimal to discriminate viable myocardium. METHODS We included 47 patients (average age: 61 ± 11 years) referred to our cardiac imaging center for MV evaluation. All patients underwent transthoracic echocardiography with measures of LS, SPECT, and coronary angiography. RESULTS In all, 799 segments were analyzed. We correlated myocardial tracer uptake by SPECT with sub-endocardial, sub-epicardial, and mid-segmental LS values with r = .514 P < .0001, r = .501 P < .0001, and r = .520 P < .0001, respectively. The measurements of each layer strain (sub-endocardial, sub-epicardial, and mid) had the same performance to predict MV viability as defined by SPECT with areas under curve of 0.819 [0.778-0.861, P < .0001], 0.809 [0.764-0.854, P < .0001], and 0.817 [0.773-0.860, P < .0001], respectively. The receiver-operating characteristic analysis yielded a cutoff value of -6.5% for mid-segmental LS with a sensitivity of 76% and specificity of 76% to predict segmental MV as defined by SPECT. CONCLUSIONS Multilayer strain analysis does not evaluate MV with more accuracy than standard segmental LS analysis.
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Affiliation(s)
- Elisabeth Orloff
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France
| | - Frédéric Bouisset
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Thomas Moine
- Department of Cardiology, Rangueil University Hospital, Toulouse, France
| | - Maxime Cournot
- Department of Cardiology, La Réunion University hospital, Saint-Pierre, France.,Inserm, UMR 1188, Sainte-Clotilde, France
| | - Meyer Elbaz
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Didier Carrié
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Medical School of Purpan, University Paul Sabatier, Toulouse, France
| | - Michel Galinier
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Olivier Lairez
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Medical School of Rangueil, University Paul Sabatier, Toulouse, France.,Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
| | - Thomas Cognet
- Department of Cardiology, Rangueil University Hospital, Toulouse, France.,Cardiac Imaging Center, Toulouse University Hospital, Toulouse, France.,Department of Nuclear Medicine, Rangueil University Hospital, Toulouse, France
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11
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Charbonnel C, Jego C, Jourda F, Vinsonneau U, Garçon P, Turlotte G, Rivière JF, Maurin M, Lubret R, Meimoun P, Akret C, Cournot M, Sokic C, Michel L, Lescure M, Kenizou D, Melay M, Fayard M, Gallet B, Fouche R, Janin-Manificat L, Dijoux N, Martin AC, Tho-Agostini A, Mann H, Ricard C, Pico F, Georges JL, Belle L, Jourdain P. ADAM-C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia. Echocardiography 2018; 35:1171-1182. [PMID: 29756387 DOI: 10.1111/echo.14010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIM The clinical utility of transesophageal echocardiography (TEE) after brain ischemia (BI) remains a matter of debate. We aimed to evaluate the clinical impact of TEE and to build a score that could help physicians to identify which patients should better benefit from TEE. METHODS This prospective, multicenter, observational study included patients over 18 years old, hospitalized for BI. TEE findings were judged discriminant if the results showed important information leading to major changes in the management of patients. Most patients with patent foramen ovale were excluded. Variables independently associated with a discriminant TEE were used to build the prediction model. RESULTS Of the entire population (1479 patients), 255 patients (17%) were classified in the discriminant TEE group. Five parameters were selected as predictors of a discriminant TEE. Accordingly, the ADAM-C score could be calculated as follows: Score = 4 (if age ≥60) + 2 (if diabetes) + 2 (if aortic stenosis from any degrees) + 1 (if multi-territory stroke) + 2 (if history of coronary artery disease). At a threshold lower than 3, the sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of detecting discriminant TEE were 88% (95% CI 85-90), 44% (95% CI 41-47), 21% (95% CI 19-27), and 95% (95% CI 94-97), respectively. CONCLUSION A simple score based on clinical and transthoracic echocardiographic parameters can help physicians to identify patients who might not benefit from TEE. Indeed, a score lower than 3 has an interesting NPV of 95% (95% CI 94-97).
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Affiliation(s)
| | - Christophe Jego
- Department of Cardiology, Toulon Inter-army Hospital, Toulon, France
| | | | - Ulric Vinsonneau
- Department of Cardiology, Brest Inter-army Hospital, Brest, France
| | - Philippe Garçon
- Department of Cardiology, Saint Joseph Hospital, Paris, France
| | - Guillaume Turlotte
- Department of Cardiology, La Roche sur Yon Hospital, La Roche sur Yon, France
| | | | - Marion Maurin
- Department of Cardiology, Papeete Hospital, Papeete, France
| | - Rémy Lubret
- Department of Cardiology, Boulogne sur mer Hospital, Boulogne sur mer, France
| | - Patrick Meimoun
- Department of Cardiology, Compiègne Hospital, Compiègne, France
| | - Chrystelle Akret
- Department of Cardiology, Annecy-Genevois Hospital, Annecy, France
| | - Maxime Cournot
- Department of Cardiology, Saint Paul Hospital, Saint Paul, France
| | - Charles Sokic
- Department of Cardiology, Haguenau Hospital, Haguenau, France
| | - Laurent Michel
- Department of Cardiology, Saint Lo Hospital, Saint Lo, France
| | | | - David Kenizou
- Department of Cardiology, Mulhouse Hospital, Mulhouse, France
| | - Marie Melay
- Department of Cardiology, Vichy Hospital, Vichy, France
| | - Maxime Fayard
- Department of Cardiology, Chalon sur Saone Hospital, Chalon sur Saone, France
| | - Bruno Gallet
- Department of Cardiology, Argenteuil Hospital, Argenteuil, France
| | - Rémi Fouche
- Department of Cardiology, Montbéliard Hospital, Montbéliard, France
| | | | - Nicolas Dijoux
- Department of Cardiology, Saint Pierre Hospital, Saint Pierre, France
| | - Anne Céline Martin
- Department of Cardiology, Val de Grace Inter-army Hospital, Paris, France
| | | | - Hubert Mann
- Department of Cardiology, Voiron Hospital, Voiron, France
| | - Cécile Ricard
- Department of Cardiology, Annecy-Genevois Hospital, Annecy, France
| | - Fernando Pico
- Department of Neurology, Versailles Hospital, Le Chesnay, France.,University of Versailles, Saint-Quentin en Yvelines and Paris Saclay, Saint-Quentin en Yvelines, France
| | | | - Loïc Belle
- Department of Cardiology, Annecy-Genevois Hospital, Annecy, France
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12
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Cournot M, Burillo E, Saulnier PJ, Planesse C, Gand E, Rehman M, Ragot S, Rondeau P, Catan A, Gonthier MP, Feigerlova E, Meilhac O, Hadjadj S. Circulating Concentrations of Redox Biomarkers Do Not Improve the Prediction of Adverse Cardiovascular Events in Patients With Type 2 Diabetes Mellitus. J Am Heart Assoc 2018; 7:JAHA.117.007397. [PMID: 29478972 PMCID: PMC5866317 DOI: 10.1161/jaha.117.007397] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Despite pathophysiological relevance and promising experimental data, the usefulness of biomarkers of oxidative stress for cardiac risk prediction is unclear. The aim of our study was to investigate the prognostic value of 6 biomarkers exploring different pathways of oxidative stress for predicting adverse cardiovascular outcomes in patients with type 2 diabetes mellitus beyond established risk factors. Methods and Results The SURDIAGENE (Survie, Diabete de type 2 et Genetique) prospective cohort study consecutively recruited 1468 patients with type 2 diabetes mellitus. Assays were performed at baseline, and incident cases of major adverse cardiovascular events (MACE)—first occurrence of cardiovascular death, nonfatal myocardial infarction, or stroke—were recorded during a median of 64 months. Advanced oxidation protein products, oxidative hemolysis inhibition assay, ischemia‐modified albumin, and total reductive capacity of plasma were not associated with the risk of MACE in univariate analyses. Fluorescent advanced glycation end products and carbonyls were associated with MACE (hazard ratio=1.38 per SD, 95% confidence interval 1.24‐1.54, P<0.001 and hazard ratio=1.15 per SD, 95% confidence interval 1.04‐1.27, P=0.006, respectively) in univariate analysis, but when added to a multivariate predictive model including traditional risk factors for MACE, these markers did not significantly improve c‐statistics or integrated discrimination index of the model. Conclusions These plasma concentrations of 6 markers, which cover a broad spectrum of oxidative processes, were not significantly associated with MACE occurrence and were not able to improve MACE risk discrimination and classification beyond classical risk factors in type 2 diabetes mellitus patients.
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Affiliation(s)
- Maxime Cournot
- INSERM UMR 1188 DéTROI (Diabète Athérothrombose Thérapies Réunion Océan Indien) Université de La Réunion, Saint Denis de La Réunion, France .,Centre d'Investigation Clinique, CHU de La Réunion, Saint Denis de La Réunion, France.,Service de Cardiologie, Centre Hospitalier Gabriel Martin, Saint-Paul, France
| | - Elena Burillo
- INSERM UMR 1188 DéTROI (Diabète Athérothrombose Thérapies Réunion Océan Indien) Université de La Réunion, Saint Denis de La Réunion, France
| | - Pierre-Jean Saulnier
- Centre d'Investigation Clinique, CHU de Poitiers, France.,INSERM, CIC 1402, Poitiers, France.,UFR Médecine Pharmacie, Université de Poitiers, France
| | - Cynthia Planesse
- INSERM UMR 1188 DéTROI (Diabète Athérothrombose Thérapies Réunion Océan Indien) Université de La Réunion, Saint Denis de La Réunion, France
| | | | | | - Stéphanie Ragot
- Centre d'Investigation Clinique, CHU de Poitiers, France.,Pole Dune, CHU de Poitiers, France.,INSERM, CIC 1402, Poitiers, France
| | - Philippe Rondeau
- INSERM UMR 1188 DéTROI (Diabète Athérothrombose Thérapies Réunion Océan Indien) Université de La Réunion, Saint Denis de La Réunion, France
| | - Aurélie Catan
- INSERM UMR 1188 DéTROI (Diabète Athérothrombose Thérapies Réunion Océan Indien) Université de La Réunion, Saint Denis de La Réunion, France
| | - Marie-Paule Gonthier
- INSERM UMR 1188 DéTROI (Diabète Athérothrombose Thérapies Réunion Océan Indien) Université de La Réunion, Saint Denis de La Réunion, France
| | - Eva Feigerlova
- Centre d'Investigation Clinique, CHU de Poitiers, France.,Endocrinologie-Diabétologie, CHU de Poitiers, France.,INSERM, CIC 1402, Poitiers, France.,UFR Médecine Pharmacie, Université de Poitiers, France.,INSERM U1082, Poitiers, France
| | - Olivier Meilhac
- INSERM UMR 1188 DéTROI (Diabète Athérothrombose Thérapies Réunion Océan Indien) Université de La Réunion, Saint Denis de La Réunion, France.,Centre d'Investigation Clinique, CHU de La Réunion, Saint Denis de La Réunion, France
| | - Samy Hadjadj
- Centre d'Investigation Clinique, CHU de Poitiers, France.,Endocrinologie-Diabétologie, CHU de Poitiers, France.,INSERM, CIC 1402, Poitiers, France.,UFR Médecine Pharmacie, Université de Poitiers, France.,INSERM U1082, Poitiers, France
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13
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Couret D, Bourane S, Catan A, Nativel B, Planesse C, Dorsemans AC, Ait-Arsa I, Cournot M, Rondeau P, Patche J, Tran-Dinh A, Lambert G, Diotel N, Meilhac O. A hemorrhagic transformation model of mechanical stroke therapy with acute hyperglycemia in mice. J Comp Neurol 2018; 526:1006-1016. [PMID: 29277912 DOI: 10.1002/cne.24386] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 12/25/2022]
Abstract
Clinical benefit for mechanical thrombectomy (MT) in stroke was recently demonstrated in multiple large prospective studies. Acute hyperglycemia (HG) is an important risk factor of poor outcome in stroke patients, including those that underwent MT. The aim of this therapy is to achieve a complete reperfusion in a short time, given that reperfusion damage is dependent on the duration of ischemia. Here, we investigated the effects of acute HG in a mouse model of ischemic stroke induced by middle cerebral artery occlusion (MCAO). Hyperglycemic (intraperitoneal [ip] injection of glucose) and control (ip saline injection) 10-week male C57BL6 mice were subjected to MCAO (30, 90, and 180 min) followed by reperfusion obtained by withdrawal of the monofilament. Infarct volume, hemorrhagic transformation (HT), neutrophil infiltration, and neurological scores were assessed at 24 hr by performing vital staining, ELISA immunofluorescence, and behavioral test, respectively. Glucose injection led to transient HG (blood glucose = 250-390 mg/dL) that significantly increased infarct volume, HT, and worsened neurological outcome. In addition, we report that HG promoted blood-brain barrier disruption as shown by hemoglobin accumulation in the brain parenchyma and tended to increase neutrophil extravasation within the infarcted area. Acute HG increased neurovascular damage for all MCAO durations tested. HTs were observed as early as 90 min after ischemia under hyperglycemic conditions. This model mimics MT ischemia/reperfusion and allows the exploration of brain injury in hyperglycemic conditions.
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Affiliation(s)
- David Couret
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France.,CHU de La Réunion, Service de Neuroréanimation, Saint-Pierre de La Réunion, France
| | - Steeve Bourane
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Aurélie Catan
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Brice Nativel
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Cynthia Planesse
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Anne-Claire Dorsemans
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Imade Ait-Arsa
- Plateforme CYROI, Cyclotron Réunion Océan Indien, Sainte-Clotilde, France
| | - Maxime Cournot
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France.,Hôpital Gabriel Martin, Service de Cardiologie, Saint-Paul de La Réunion, France.,CHU de La Réunion, Saint-Denis de La Réunion, France
| | - Philippe Rondeau
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Jessica Patche
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | | | - Gilles Lambert
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Nicolas Diotel
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France
| | - Olivier Meilhac
- Université de La Réunion, INSERM, UMR 1188 Diabète Athérothrombose Réunion Océan Indien (DéTROI), Saint-Denis de La Réunion, France.,CHU de La Réunion, Service de Neuroréanimation, Saint-Pierre de La Réunion, France.,CHU de La Réunion, Saint-Denis de La Réunion, France
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14
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Billet S, Pugnet G, Chollet T, Charbonnier G, Fournier P, Prévot G, Tétu L, Cournot M, Derumeaux H, Carrié D, Galinier M, Lairez O. Transthoracic echocardiography to quantify pulmonary vascular resistances in patients with systemic sclerosis. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Couret D, Catan A, Nativel B, Planesse C, Dorsemans AC, Ait-Arsa I, Cournot M, Tran-Dinh A, Lambert G, Diotel N, Meilhac O. A hemorrhagic transformation model of mechanical stroke therapy with acute hyperglycemia in mice. Atherosclerosis 2017. [DOI: 10.1016/j.atherosclerosis.2017.06.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cournot M, Lenclume V, Le Moullec N, Debussche X, Doussiet E, Fagot-Campagna A, Favier F. Prevalence, treatment and control of hypertension in La Réunion: the RÉDIA population-based cohort study. Blood Press 2016; 26:39-47. [PMID: 27195533 DOI: 10.1080/08037051.2016.1182854] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A better knowledge of prevalence, management and determinants of hypertension is needed in regions in epidemiological transition to adapt the strategies of public health screening and prevention, and to reduce the burden of cardiovascular diseases. We conducted a prospective cohort study including 4610 participants aged between 18 and 69 years and representative of the general population of La Réunion, a French overseas island located in the western Indian Ocean. The median time between inclusion and follow-up was 7.4 years. Blood pressure data at baseline and follow-up of 3087 participants were analyzed. We found a high prevalence of hypertension, especially in women (36.7% [34.5-39.0]) and in men (40.3% [37.6-43.0]) and in the under 30s (17.1% [14.0-20.5]), with an increase of 10% at follow-up. Treatment rates were very low in men (19.5% versus 39.1% in women) as was awareness of their condition (25.7% versus 44.6%). Blood pressure control rates were similar (18% at baseline and 34% at follow-up for both sexes). Diagnosis of hypertension at follow-up among subjects normotensive at baseline was independently associated with obesity at baseline (relative risk (RR) = 1.40 [1.12-1.75] for BMI between 27 and 30 kg/m2 and 1.72 [1.33-2.25] for BMI ≥30 kg/m2 as compared with BMI <27 kg/m2) and HbA1C (RR =1.12 [1.05-1.19] per %), suggesting a prominent role of insulin resistance in our population. Our study provides original data that cannot be assimilated to any existing model and should guide the implementation of original community-based programs in such countries.
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Affiliation(s)
- Maxime Cournot
- a CHU de La Réunion, Centre d'Investigations Cliniques , Saint Denis , France.,b INSERM, CIC 1410 , Saint Pierre , France.,c INSERM, UMR 1188 Diabète athérothrombose Thérapies Réunion Océan Indien (DéTROI) , Sainte-Clotilde , France.,d Centre Hospitalier Gabriel Martin, Service de cardiologie , Saint-Paul , France
| | | | - Nathalie Le Moullec
- e CHU de La Réunion, Service d'endocrinologie, diabétologie et nutrition , Saint-Pierre , France
| | - Xavier Debussche
- f CHU de La Réunion, Service d'endocrinologie et diabétologie , Saint-Denis , France
| | | | - Anne Fagot-Campagna
- g Direction de la Stratégie, des Etudes et des Statistiques, Caisse Nationale d'Assurance Maladie des Travailleurs Salariés , Paris , France
| | - François Favier
- b INSERM, CIC 1410 , Saint Pierre , France.,e CHU de La Réunion, Service d'endocrinologie, diabétologie et nutrition , Saint-Pierre , France
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Charpentier S, Maupas-Schwalm F, Cournot M, Elbaz M, Botella JM, Lauque D. Combination of copeptin and troponin assays to rapidly rule out non-ST elevation myocardial infarction in the emergency department. Acad Emerg Med 2012; 19:517-24. [PMID: 22594355 DOI: 10.1111/j.1553-2712.2012.01350.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the diagnostic accuracy and the clinical usefulness of the combination of troponin I (cTnI) and copeptin measured at presentation with an automated assay to rapidly rule out non-ST elevation myocardial infarction (NSTEMI) in patients with suspected cardiac chest pain presenting to an emergency department (ED). METHODS This study was an ancillary analysis of a prospective observational study. Copeptin and cTnI levels were sampled at presentation in 641 consecutive patients admitted to the ED for chest pain with onset within the last 12 hours and without ST elevation on a 12-lead electrocardiogram (ECG). Copeptin was measured with an automated assay and troponin with conventional assay. The performance of a combination of cTnI and copeptin for NSTEMI diagnosis was studied, the clinical utility was assessed by multivariate analysis, and an area under the curve (AUC) calculation was used to determine accuracy. RESULTS NSTEMI was diagnosed in 95 patients (15%). The sensitivity and negative predictive value (NPV) of the combination of copeptin and cTnI measures were 90.4% (95% confidence interval [CI] = 88.2% to 92.7%) and 97.6% (95% CI = 96.4% to 98.7%) versus 55.3% (95% CI = 51.5% to 59.2%) and 92.8% (95% CI = 90.8% to 94.8%) with cTnI alone. The AUC of the combination of copeptin and cTnI was 0.89 (95% CI = 0.85% to 0.92%) and was significantly higher than the AUC of cTnI alone (0.77, 95% CI = 0.72% to 0.82%, p < 0.05). The patient classification was slightly improved when copeptin was added to the usual diagnostic tools used for NSTEMI management. CONCLUSIONS In this study, determination of copeptin, in addition to cTnI, improves early diagnostic accuracy of NSTEMI. However, the sensitivity of this combination even using a conventional troponin assay remains insufficient to safely rule out NSTEMI at the time of presentation.
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Charpentier S, Schwalm FM, Cournot M, Elbaz M, Ducassé JL, Lauque D. 373 Rapid non ST elevation myocardial infarction rule out with combination of copeptin and troponin in emergency department. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70769-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Charpentier S, Maupas-Schwalm F, Cournot M, Elbaz M, Ducassé JL, Bottela JM, Lauque D. Diagnostic accuracy of quantitative heart-fatty acid binding protein assays compared with Cardiodetect® in the early detection of acute coronary syndrome. Arch Cardiovasc Dis 2011; 104:524-9. [DOI: 10.1016/j.acvd.2011.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 07/15/2011] [Accepted: 07/29/2011] [Indexed: 10/16/2022]
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Cournot M, Bura A, Cambou JP, Taraszkiewicz D, Maloizel J, Galinier M, Broutin HH, Chamontin B, Carrié D, Ferrieres J. Arterial Ultrasound Screening as a Tool for Coronary Risk Assessment in Asymptomatic Men and Women. Angiology 2011; 63:282-8. [DOI: 10.1177/0003319711414865] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
One of the imaging tests most commonly used to assess cardiovascular diseases (CVDs) in daily practice is Doppler ultrasonography of the carotid and femoral arteries. We included 2709 participants with no history or symptoms of CVD; they had a risk factor assessment and a carotid and femoral ultrasonography at baseline. Incident cases of definite coronary events were recorded during a median follow-up of 6 years. Approximately, 63% of the sample presented abnormalities (carotid stenosis >50%, carotid plaque, femoral plaque, increased intima–media thickness [IMT]). A moderately increased IMT (>0.63 mm) or the presence of carotid or femoral artery plaque was related to prognosis. The associations persisted after adjustment for pretest risk, treatment with statins, and other Doppler ultrasonography abnormalities. The hazard ratio increased significantly with the number of abnormalities (varying from 2.35 [1.16-4.74] to 14.83 [6.47-33.9]).
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Affiliation(s)
- Maxime Cournot
- Department of cardiology, Centre Hospitalier du Val d’Ariège, Foix, France
| | - Alessandra Bura
- Department of Vascular Medicine, CHU Rangueil, Toulouse, France
- INSERM U858, Toulouse, France
| | | | | | - Julie Maloizel
- Department of Vascular Medicine, CHU Rangueil, Toulouse, France
| | | | | | - Bernard Chamontin
- Department of Internal Medicine and Hypertension, CHU Rangueil, Toulouse, France
| | - Didier Carrié
- Preventive Cardiology Unit, CHU Rangueil, Toulouse, France
| | - Jean Ferrieres
- Preventive Cardiology Unit, CHU Rangueil, Toulouse, France
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Charpentier S, Cournot M, Lauque D, Girardi C, Bounes V, Elbaz M, Ducasse JL. Usefulness of initial glucose level to improve acute coronary syndrome diagnosis in the emergency department. Emerg Med J 2010; 28:564-8. [DOI: 10.1136/emj.2010.094284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Agrinier N, Cournot M, Ruidavets JB, Ahluwalia N, Ferrières J. Causal mechanism for atherosclerosis or coronary heart disease in women: A constellation of components. Maturitas 2010; 65:404-5. [DOI: 10.1016/j.maturitas.2010.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Accepted: 01/27/2010] [Indexed: 11/16/2022]
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Agrinier N, Cournot M, Dallongeville J, Arveiler D, Ducimetière P, Ruidavets JB, Ferrières J. Menopause and modifiable coronary heart disease risk factors: A population based study. Maturitas 2010; 65:237-43. [DOI: 10.1016/j.maturitas.2009.11.023] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Revised: 10/28/2009] [Accepted: 11/25/2009] [Indexed: 11/26/2022]
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Charpentier S, Ducassé JL, Cournot M, Maupas-Schwalm F, Elbaz M, Baixas C, Juchet H, Lang T, Lauque D. Clinical assessment of ischemia-modified albumin and heart fatty acid-binding protein in the early diagnosis of non-ST-elevation acute coronary syndrome in the emergency department. Acad Emerg Med 2010; 17:27-35. [PMID: 20078436 DOI: 10.1111/j.1553-2712.2009.00614.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Heart fatty acid-binding protein (h-FABP) and ischemia-modified albumin (IMA) have recently been evaluated, but to the best of our knowledge, no study has reported an analysis of these two markers for the detection of early myocardial infarction and myocardial ischemia in a large cohort of consecutive patients presenting to an emergency department (ED). This study evaluates the diagnostic accuracy and the clinical utility of h-FABP and IMA for non-ST-segment elevation acute coronary syndrome (ACS) diagnosis in the first hour of management in an ED. METHODS In a prospective 11-month study, 677 patients admitted to the ED with chest pain and suspected non-ST-segment elevation ACS were enrolled. On presentation, blood samples were obtained for the measurement of the biomarkers h-FABP (immunodetection with CardioDetect) and IMA (albumin cobalt-binding test). Two physicians, blinded to the results of the markers, independently categorized patients as having or not having non-ST-segment elevation ACS. RESULTS Of the 677 patients who were prospectively recruited, non-ST-segment elevation ACS was diagnosed in 185 (27.3%). While IMA was not predictive of the ACS diagnosis (odds ratio [OR] = 1.23; 95% CI = 0.87 to 1.81), h-FABP was predictive of ACS diagnosis (OR = 4.65; 95% CI = 2.39 to 9.04) with specificity at 96.8% (95% CI = 95.4% to 98.1%) and sensitivity at 13.5% (95% CI = 10.9% to 16.1%). However, h-FABP did not add significant additional information to a predictive model that included the usual diagnostic tools for non-ST-elevation ACS management (p = 0.40). CONCLUSIONS In this study on a large cohort of patients admitted to an ED for chest pain, IMA and h-FABP did not provide valuable information for ACS diagnosis.
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Cournot M, Taraszkiewicz D, Cambou JP, Galinier M, Boccalon H, Hanaire-Broutin H, Chamontin B, Carrié D, Ferrières J. Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention. Am Heart J 2009; 158:845-51. [PMID: 19853707 DOI: 10.1016/j.ahj.2009.08.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 08/06/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND The choice of noninvasive tests used in primary prevention of cardiovascular diseases must be based on medical evidence. The aim of this study was to assess the additional prognostic value, over conventional risk factors, of physical examination, exercise testing, and arterial ultrasonography, in predicting a first coronary event. METHODS A prospective cohort study was conducted between 1996 and 2004 (n = 2,709), with follow-up in 2006 (response rate 96.6%). Participants had no history or symptoms of cardiovascular disease and had a standardized physical examination, a cardiac exercise testing, and carotid and femoral ultrasonography at baseline. Incident cases of definite coronary events were recorded during follow-up. RESULTS Over the Framingham risk score, femoral bruit, positive exercise test, intima-media thickness >0.63 mm, and a femoral plaque provided significant additional information to the prediction model. The addition of the exercise test to the traditional risk factors, then the intima-media thickness and lastly the presence of femoral plaques, produces incremental increases in the area under the receiver operating characteristic curve (0.73-0.78, P = .02) and about a 50% increase in the positive predictive value (15.8%-31.4%), with no effect on the negative predictive value (96.4%-96.9%). CONCLUSION Physical examination, exercise testing, and arterial ultrasonography provide incremental information on the risk of coronary event in asymptomatic adults. Exercise testing and femoral ultrasonography also improve the accuracy of the risk stratification.
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Agrinier N, Cournot M, Ferrières J. [Dyslipidemia in women after 50: age, menopause or both?]. Ann Cardiol Angeiol (Paris) 2009; 58:159-164. [PMID: 18980752 DOI: 10.1016/j.ancard.2008.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 09/07/2008] [Indexed: 05/27/2023]
Abstract
A high prevalence of cardiovascular risk factors is reported in postmenopausal women. The objective of this review was to determine whether the effect of the menopause on lipid profile remained after adjusting for age in middle age women. The results of 10 cross sectional studies and nine longitudinal studies added evidence of a worsening effect of the menopause on total cholesterol, LDL cholesterol and triglyceride plasmatic levels. This effect remained after adjustment for age. Menopausal estrogenic deficiency could be an explanation for those results, even if the hormonal replacement therapy effect on the lipid profile remains unclear.
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Affiliation(s)
- N Agrinier
- Epidémiologie et Evaluation Cliniques, CHU de Nancy, Nancy, France.
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Charpentier S, Sagnes-Raffy C, Cournot M, Cambou JP, Ducassé JL, Lauque D, Puel J. Determinants and prognostic impact of compliance with guidelines in reperfusion therapy for ST-segment elevation myocardial infarction: results from the ESTIM Midi-Pyrénées Area. Arch Cardiovasc Dis 2009; 102:387-96. [PMID: 19520324 DOI: 10.1016/j.acvd.2009.02.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 02/01/2009] [Accepted: 02/03/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Early reperfusion therapy has proven benefit in reducing mortality in patients with ST-segment elevation myocardial infarction (STEMI). Expert guideline committees have defined recommendations to improve the management of patients with STEMI and decrease their mortality rates. AIMS To identify predictors of compliance with American College of Cardiology/American Heart Association guidelines for reperfusion therapy in STEMI and to determine the prognostic impact of compliance. METHODS ESTIM Midi-Pyrénées was a multidisciplinary, prospective registry in patients with STEMI, conducted between June 2001 and June 2003 in French hospitals. Data were analysed from 1277 patients managed by emergency physicians in the prehospital system or emergency room and/or cardiologists in interventional or non-interventional cardiology departments. RESULTS A revascularization strategy was performed in 89.4% of patients; treatment complied with the guidelines in 61.1% of patients. After multivariable analysis, factors associated with compliance were age less or equal than 75years (odds ratio [OR] 1.56, 95% confidence interval [CI] 1.18-2.08), symptom onset during the day (OR 1.43, 95% CI 1.12-1.82), typical electrocardiographic symptoms of STEMI (OR 3.2, 95% CI 2.19-4.5), and initial medical contact. After adjustment for confounders, 1-month mortality was significantly lower in patients managed according to guideline recommendations (OR 0.60, 95% CI 0.40-0.92). CONCLUSION A number of factors can be used to identify STEMI patients who are less likely to be managed according to guidelines. Training focused on these factors should improve management and clinical outcomes of STEMI.
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Affiliation(s)
- Sandrine Charpentier
- Departmen of EMergency, Purpan University Hospital, place du Dr-Baylac, 31059 Toulouse, France.
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Roche JB, Malavaud B, Soulié M, Cournot M, Gamé X, Mazerolles C, Bachaud JM, Plante P, Rischmann P. Cancer de la prostate de stade pT3 après prostatectomie totale : étude rétrospective de 246 cas. Prog Urol 2008; 18:586-94. [DOI: 10.1016/j.purol.2008.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 04/06/2008] [Accepted: 05/20/2008] [Indexed: 01/29/2023]
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Odent T, Accadbled F, Koureas G, Cournot M, Moine A, Diene G, Molinas C, Pinto G, Tauber M, Gomes B, de Gauzy JS, Glorion C. Scoliosis in patients with Prader-Willi Syndrome. Pediatrics 2008; 122:e499-503. [PMID: 18606625 DOI: 10.1542/peds.2007-3487] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Our goals were to determine the prevalence and estimate the evolution of spinal deformities in patients suffering from Prader-Willi syndrome; find out which kind of spine deformity predominates regarding genotype and clinical patterns; and evaluate the affect of growth-hormone treatment on the onset and progression of spinal deformities. PATIENTS AND METHODS This was a retrospective longitudinal, clinical, and radiologic study. One hundred forty-five children followed between 1980 and 2006 were studied in 2 referral centers for Prader-Willi syndrome. Genetic testing confirmed the diagnosis in 133 patients. Ninety-three patients (64%) received growth-hormone therapy. For statistical analysis, age-adjusted comparison between groups was performed by using multivariate logistic regression. RESULTS Mean age of the patients was 10.2 +/- 6.2 years. Sixty-three (43.4%) patients were afflicted with scoliosis. Scoliosis frequency steadily rose with age, and a large majority of patients were affected at skeletal maturity (66.7%). Scoliosis prevalence was not affected by the genotype or by growth-hormone treatment. Patients with higher BMI values had an increased risk of developing a kyphotic deformity in association with scoliosis. We found a statistical association between kyphotic deformity and the need for surgical treatment. CONCLUSIONS Scoliosis is a major concern for patients with Prader-Willi syndrome, and a regular (annual) systematic back examination is mandated. The role of growth-hormone treatment on the natural history of scoliosis could not be determined, and careful monitoring during treatment is recommended.
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Affiliation(s)
- Thierry Odent
- Department of Orthopaedic Surgery, Hôpital des Enfants-Malades Assistance-Publique Hôpitaux de Paris, Faculté de Médicine Paris Descartes, Paris, France.
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Douat J, Ancele E, Cournot M, Pagot-Mathis V, Mathis A, Quintyn JC. [Treatment of central retinal vein occlusion by isovolemic hemodilution]. J Fr Ophtalmol 2008; 30:1007-12. [PMID: 18268441 DOI: 10.1016/s0181-5512(07)79278-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Evaluate the effects of hemodilution in the treatment of central retinal vein occlusion (CRVO). PATIENTS AND METHODS We carried out a retrospective, noncomparative study of 25 patients presenting unilateral CRVO, treated with one to three hemodilution sessions. The patients were re-examined in the 1st, 2nd, 3rd, 6th and 12th months following treatment with measurement of visual acuity, fluorescein angiography, and optical coherence tomography. RESULTS Our study included 17 men and eight women, averaging 63 years of age (range, 35-87 years), and monitored for an average of 7 months (range, 3-12 months). After the 6th month following treatment, average visual acuity improved compared to initial visual acuity. Initial visual acuity of less than 1/10, with the existence of poorly irrigated areas in the angiography, presented negative prognosis factors. The number of hemodilutions did not produce a significant difference in final visual acuity. No serious complications due to hemodilution were observed. DISCUSSION Treatment of CRVO is subject to debate. Some practitioners recommend against treatment, while others advocate intervention and offer laser-induced chorioretinal venous anastomosis. Surgical vitrectomy and radial optical neurotomy, with or without injection of triamcinolone, await evaluation. Hemodilution may offer a therapeutic approach to this pathology, in which the etiopathogenesis is not yet recognized, but in which blood viscosity plays a key role. This treatment is well tolerated. CONCLUSION Hemodilutions appear to have beneficial effects in treating CRVO, whatever the number of hemodilutions used. This study should be confirmed by a prospective study using an untreated control group.
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Affiliation(s)
- J Douat
- Service d'Ophtalmologie, CHU Rangueil, Toulouse
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Cournot M, Boccalon H, Cambou JP, Guilloux J, Taraszkiewicz D, Hanaire-Broutin H, Chamontin B, Galinier M, Ferrières J. Accuracy of the screening physical examination to identify subclinical atherosclerosis and peripheral arterial disease in asymptomatic subjects. J Vasc Surg 2007; 46:1215-21. [DOI: 10.1016/j.jvs.2007.08.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 08/14/2007] [Accepted: 08/14/2007] [Indexed: 10/22/2022]
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Gallay A, De Valk H, Cournot M, Ladeuil B, Hemery C, Castor C, Bon F, Mégraud F, Le Cann P, Desenclos JC. A large multi-pathogen waterborne community outbreak linked to faecal contamination of a groundwater system, France, 2000. Clin Microbiol Infect 2007; 12:561-70. [PMID: 16700706 DOI: 10.1111/j.1469-0691.2006.01441.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A large waterborne outbreak of infection that occurred during August 2000 in a local community in France was investigated initially via a rapid survey of visits to local physicians. A retrospective cohort study was then conducted on a random cluster sample of residents. Of 709 residents interviewed, 202 (28.5%) were definite cases (at least three liquid stools/day or vomiting) and 62 (8.7%) were probable cases (less than three liquid stools/day or abdominal pain). Those who had drunk tap water had a three-fold increased risk for illness (95% CI 2.4-4.0). The risk increased with the amount of water consumed (chi-square trend: p < 0.0001). Bacteriological analyses of stools were performed for 35 patients and virological analyses for 24 patients. Campylobacter coli, group A rotavirus and norovirus were detected in 31.5%, 71.0% and 21% of samples, respectively. An extensive environmental investigation concluded that a groundwater source to this community had probably been contaminated by agricultural run-off, and a failure in the chlorination system was identified. This is the first documented waterborne outbreak of infection involving human C. coli infections. A better understanding of the factors influencing campylobacter transmission between hosts is required.
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Affiliation(s)
- A Gallay
- Institut de Veille Sanitaire, Saint Maurice, France
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Maiza JC, Vezzosi D, Matta M, Donadille F, Loubes-Lacroix F, Cournot M, Bennet A, Caron P. Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa. Clin Endocrinol (Oxf) 2007; 67:282-9. [PMID: 17524029 PMCID: PMC1974833 DOI: 10.1111/j.1365-2265.2007.02878.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT The role of somatostatin analogues (SSTa) in the treatment of acromegaly. OBJECTIVE To evaluate the antihormonal and antitumour efficacy of long-term (up to 18 years) primary treatment with SSTa in patients with GH-secreting pituitary adenoma responsive to SSTa. DESIGN An open, prospective, single-centre, clinical study. PATIENTS Thirty-six acromegalic patients, aged 17-75 years (postoral glucose tolerance test GH > 1 microg/l, increased IGF-1 for age and sex), were monitored in a single centre and treated with SSTa as first-line therapy. The mean pretreatment GH level was 13.5 +/- 3.1 microg/l, and IGF-1 (as a percentage of the value over the normal range) was 302 +/- 26%. The patients had macroadenoma (n = 25), microadenoma (n = 8) or empty sella turcica (n = 3). The mean duration of treatment was 8 years (range 3-18 years). Hormonal and morphological monitoring was undertaken after 6 months, and then the patients were followed annually. RESULTS After 1 year, the mean GH and IGF-1 levels had reduced considerably (GH: 2.4 +/- 0.3 microg/l; IGF-1; 174 +/- 14%, P < 0.01), and they continued to decrease over 10 years, with a mean GH level of 1.6 +/- 0.1 microg/l and IGF-1 of 123 +/- 18% (P = 0.02). GH < 2 microg/l, normal IGF-1, or both were observed in 25 (70%), 24 (67%) and 21 (58%) patients, respectively. The mean reduction in tumour volume was 43% (range 13-97%) and shrinkage > 20% was obtained in 21 patients (72%). SSTa treatment was well tolerated with few digestive or metabolic side-effects. CONCLUSION Long-term (up to 18 years) treatment with SSTa used as first-line therapy is effective from both an antihormonal and antitumour perspective, and is well tolerated in acromegalic patients.
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Rumeau P, Acar P, Paranon S, Bassil R, Cournot M, Dulac Y, Guitton J, Latcu G. [Evaluation of left ventricular diastolic function in children by doppler tissue imaging]. Arch Mal Coeur Vaiss 2007; 100:405-10. [PMID: 17646765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Left ventricular diastolic function may change at an early stage in cardiac disease. It is often difficult to assess in daily practice. The use of Doppler tissue imaging at the annulus has been validated in adults. This method is little used in paediatrics and the physiological norms have not been established in children. Forty three children aged 7 days to 241 months were referred for a cardiological opinion with normal echocardiogrammes were included. Myocardial velocities were measured by Doppler tissue imaging of the left and right ventricular walls at different moments of the cardiac cycle in the apical 4-chamber view. A complete study was possible in 39 cases (91%). Doppler tissue imaging was not performed in one case and was incomplete on the right ventricle in 3 children. The median of the lateral mitral tissue E wave (Ea) was 16.3 cm/s and that of the right ventricle was 15.8 cm/s with a tissue Ea/Aa ratio of 2.6 and 1.6 respectively. The median of the tissue S waves was 8.8 cm/s for the left ventricular lateral wall and 13.3 cm/s for the right ventricular lateral wall. The E/Ea ratio of the left ventricular lateral wall was 5.9. Although the velocities of the left ventricular lateral wall were not related to the children's' age or size, the correlations between the E/Ea ratio and age and size were statistically significant. The myocardial velocities of the neonate were characteristic and different to those of the older paediatric population (slower Ea and S waves, faster Aa with a higher E/Ea ratio). The authors conclude that Doppler tissue imaging is feasible in clinical paediatric cardiology. Comparative studies with populations with cardiac disease are necessary to determine pathological values.
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Affiliation(s)
- P Rumeau
- Service de cardiologie pédiatrique, Hôpital des Enfants, CHU Toulouse
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Escudié L, Francoz C, Vinel JP, Moucari R, Cournot M, Paradis V, Sauvanet A, Belghiti J, Valla D, Bernuau J, Durand F. Amanita phalloides poisoning: reassessment of prognostic factors and indications for emergency liver transplantation. J Hepatol 2007; 46:466-73. [PMID: 17188393 DOI: 10.1016/j.jhep.2006.10.013] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2006] [Revised: 09/23/2006] [Accepted: 10/04/2006] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS Amanita phalloides poisoning is an uncommon cause of acute liver failure with an especially rapid course. The aim of this study was to re-assess transplantation criteria in patients with mushroom poisoning. METHODS Twenty-seven patients admitted for Amanita phalloides poisoning were studied. Previously reported transplantation criteria, including the recent Ganzert's criteria, were tested retrospectively. RESULTS The rate of fatal intoxication (death and/or transplantation) was 8/27 (30%). An interval between ingestion and diarrhea <8h was a very early predictor of a fatal outcome (accuracy of 78%). Later on, non-paracetamol and paracetamol King's College criteria were superior to Clichy's and Ganzert's criteria (accuracy of 100% compared to 85% and 85%, respectively). Encephalopathy and renal insufficiency were not constant in the fatal intoxication group. Prothrombin index below 10% 4 days or more after ingestion had a 100% accuracy for predicting a fatal outcome. CONCLUSIONS Liver transplantation should be strongly considered in patients with an interval between ingestion and diarrhea <8h. Encephalopathy should not be an absolute prerequisite for deciding transplantation. From day 4 after ingestion, prothrombin index lower than 10% ( approximately INR of 6) alone is a reliable tool for deciding emergency transplantation.
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Affiliation(s)
- Luc Escudié
- Hepatology Unit and INSERM U773, Hospital Beaujon, Clichy, France
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Thomas D, Collet JP, Cottin Y, Cournot M, Ducimetière P, Ferrières J, Paillard F, Valensi P, Zeller M, Cambou JP. [The best of epidemiology and cardiovascular prevention in 2006]. Arch Mal Coeur Vaiss 2007; 100 Spec No 1:57-64. [PMID: 17405566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The recent analysis of the French MONICA registries report a reduction in the incidence of fatal MI related to improvement of care whereas the overall incidence of coronary events remain stable, suggesting the need for a better primary prevention. The extensive review of the death certificates and the analysis of the death classification from the same registries indicate an under estimation of MI-related death in the national death registry. It is also confirmed that instead of 50%, approximately 80% of coronary death are explained by the four major risk factors including smoking, hypercholesterolemia, hypertension and diabetes. The international REACH registry has enrolled more than 67 000 individuals including patients with symptomatic atherothrombotic disease and patients with multiple risk factors. The analysis of baseline characteristics and of the one year FU shows a high residual risk and a lack of efficacy of secondary prevention. The existence of a symptomatic disease and the number of symptomatic localization of atherothrombosis are critical factors to predict recurrence of major vascular events Secondary analysis of the INTERHEART study provide the essence of what should any physician know about the relationship between coronary heart disease and smoking, either active or passive. Prevention with respect to this risk factor remains very insufficient. Varenicline, a new nicotinic receptor partial agonist, should help patients involved in smoking cessation program. The established detrimental effects of perioperative smoking represent a unique opportunity to promote smoking cessation in individuals scheduled for surgery. The major cardiovascular impact of second hand smoking has been recently demonstrated by the short-term effects of banning smoking in public places on the incidence of acute coronary events. The SPARCL study has demonstrated the benefit of high dose of atorvastatine to prevent recurrent acute ischemic cerebrovascular event in patients with a prior history of stroke or TIA. In the open ASTEROID study, high doses of rosuvastatine confirm the possibility of reducing the volume of coronary atheroma analyzed by IVUS. The expected benefit of glitazones to reduce the incidence of death, MI and stroke in diabetes patients with a prior history of vascular event has been confirmed in the PROactive study. Pioglitazone provided a clear reduction of recurrent vascular events in diabetes patient with a prior MI at a cost of a significant increase of the risk of heart failure. In the DREAM study, neither ramipril nor rosiglitazone have reduced the incidence of cardiovascular events significantly. The moderate benefit of the fenofibrate to prevent cardiovascular events in the FIELD study, which was carried out in diabetics mostly in primary prevention, needs to be considered after adjustment on statin use in a higher proportion of patients of the placebo group. Postprandial hyperglycaemia, analyzed by the peak of glycaemia after a load in glucose, has been confirmed as a more powerful independent predictive factor of the risk of cardiovascular event than fasting glycaemia. The systematic screening postprandial hyperglycaemia represents an interesting strategy for primary prevention which warrants further investigation. If obesity is a risk factor whose impact on morbi-mortality is well established, a French study shows that body mass index has an unfavourable influence on the cognitive functions in middle-aged men and women.
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Affiliation(s)
- D Thomas
- Groupe épidémiologie et prévention de la Société française de cardiologie. institut de cardiologie, groupe hospitalier Pitié-Salpêtriere, 47, boulevard de l'Hôpital. 75651 Paris Cedex 13.
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Cournot M, Leprince P, Destrac S, Ferrières J. Usefulness of Inhospital Change in B-Type Natriuretic Peptide Levels in Predicting Long-Term Outcome in Elderly Patients Admitted for Decompensated Heart Failure. ACTA ACUST UNITED AC 2007; 16:8-14. [PMID: 17215637 DOI: 10.1111/j.1076-7460.2007.05297.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The usefulness of repeated measures of B-type natriuretic peptide (BNP) in elderly subjects with decompensated heart failure to improve risk stratification remains poorly known. This prospective cohort study included 61 consecutive patients older than 70 years (mean age, 82.7 years) hospitalized for decompensated heart failure. Clinical, radiologic, biologic, and echographic data were collected at admission and at discharge. The median BNP level at admission was 1136 pg/mL and the mean change during the hospitalization was -32%. Cardiac death or readmission were best predicted by the change in BNP levels, with the poorest prognosis in patients who did not achieve a decrease of at least 40% (hazard ratio, 4.03; 95% confidence interval, 1.50-10.84 in multivariate analysis). Admission of an elderly patient for decompensated heart failure is a daily situation in clinical practice, in which 2 BNP measurements seem to provide reliable information on long-term prognosis.
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Affiliation(s)
- Maxime Cournot
- Cardiovascular Epidemiology Unit, INSERM U558, Toulouse, France.
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Cournot M, Marquié JC, Ansiau D, Martinaud C, Fonds H, Ferrières J, Ruidavets JB. Relation between body mass index and cognitive function in healthy middle-aged men and women. Neurology 2006; 67:1208-14. [PMID: 17030754 DOI: 10.1212/01.wnl.0000238082.13860.50] [Citation(s) in RCA: 319] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess whether body mass index (BMI) is associated with cognitive function and cognitive decline in healthy men and women. METHODS In this prospective cohort study, we analyzed data from 2,223 healthy workers aged 32 to 62 years at baseline. Medical, psychosocial, and environmental data were collected in 1996 and in 2001. We tested cognitive functions at baseline and at follow-up with word-list learning (four recalls), a Digit-Symbol Substitution Test, and a selective attention test. RESULTS Cross-sectionally, a higher BMI was associated with lower cognitive scores after adjustment for age, sex, educational level, blood pressure, diabetes, and other psychosocial covariables. A higher BMI at baseline was also associated with a higher cognitive decline at follow-up, after adjustment for the above-cited confounding factors. This association was significant for word-list learning. For the changes in scores at word-list learning (delayed recall), regression coefficients were -0.008 +/- 0.13, -0.09 +/- 0.13, -0.17 +/- 0.14, and -0.35 +/- 0.14 (p for trend < 0.001) for the second, third, fourth, and fifth quintiles of BMI at baseline when compared with the first quintile. No significant association was found between changes in BMI and cognitive function. CONCLUSIONS Body mass index was independently associated both with cognitive function (word-list learning and Digit-Symbol Substitution Test) and changes in word-list learning in healthy, nondemented, middle-aged men and women.
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Affiliation(s)
- M Cournot
- INSERM U558, Toulouse University School of Medicine, Toulouse, France.
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Cournot M, Ferrières J. [Exercise stress testing and primary prevention]. Arch Mal Coeur Vaiss 2006; 99:900-8. [PMID: 17100141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The detection of coronary artery disease is a major objective in public health. Over the last twenty years, much effort has been put into the development of investigations to detect coronary artery disease at an infra-clinical stage of which exercise stress testing is the most documented. However, it has never been possible to formally confirm the benefits of this test, or of any of the others, in the detection of silent coronary artery disease. The aim of this article is to summarise the current state of our scientific knowledge about the diagnostic and prognostic performances in primary prevention and to analyse how this investigation may be useful in asymptomatic patients. The authors particularly address the three following questions: 1) Does exercise stress testing improve the quality of primary prevention and the prognosis? 2) Does exercise stress testing detect a silent coronary lesion? And 3) does exercise stress testing improve risk evaluation in the asymptomatic patient?
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Affiliation(s)
- M Cournot
- INSERM U558, département d'epidémiologie, faculté de médecine, 37, all6ées Jules Guesdes, 31073 Toulouse
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Cournot M, Taraszkiewicz D, Galinier M, Chamontin B, Boccalon H, Hanaire-Broutin H, Puel J, Ferrières J. Is exercise testing useful to improve the prediction of coronary events in asymptomatic subjects? ACTA ACUST UNITED AC 2006; 13:37-44. [PMID: 16449862 DOI: 10.1097/01.hjr.0000198447.26613.3d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The value of exercise testing (ET) in asymptomatic subjects remains controversial and is unknown in countries with a low coronary heart disease (CHD) incidence. The aim of this study was to investigate the ability of ET to improve the prediction of a first coronary event in such a population. METHODS Using a prospective cohort study, 1051 consecutive healthy asymptomatic adults were enrolled in a cardiovascular screening program including ET. The pre-test risk of CHD was evaluated by the 10-year Framingham risk function. Positive ET was defined as a horizontal or downsloping ST-segment depression >/=1.0 mm. The primary outcome was total coronary events (CE) occurrence, including cardiac deaths, acute myocardial infarction and stable or unstable angina. The mean follow-up period was 6 years. RESULTS Subjects were aged 18-79 years and 36% were women. A total of 89 subjects (8.5%) had a positive ET. Positive exercise testing was associated with CE occurrence in a univariate analysis only in subjects with higher pre-test risk, defined by a 10-year Framingham risk >10.4% [hazards ratio (HR)=2.61; 95% confidence interval (CI) (1.07-6.40)]. In this risk category, ET was able to provide incremental information over the major risk factors in both men and women [risk factor-adjusted HR for positive ET=2.86; 95% CI (1.14-7.20)]. This risk excess in subjects with positive ET persisted even when a coronary revascularization was performed. Subjects with intermediate pre-test probability (10-15%) and positive ET had a post-test probability of CE largely equivalent to the probability in subjects with known CHD. CONCLUSION Additional information provided by ET in subjects with a pre-test risk at 10-years >10% should lead to a more efficient use of risk-reducing therapies than it would be the case in this risk category with the analysis of traditional risk factors only.
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Affiliation(s)
- Maxime Cournot
- Département d'Epidémiologie, INSERM U558, CHU Toulouse, France
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Cournot M, Ruidavets JB, Marquié JC, Esquirol Y, Baracat B, Ferrières J. Environmental factors associated with body mass index in a population of Southern France. ACTA ACUST UNITED AC 2006; 11:291-7. [PMID: 15292762 DOI: 10.1097/01.hjr.0000129738.22970.62] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE Environmental-factor changes may largely be accountable for the dramatic increase of obesity prevalence in industrialized countries. This study investigated the relationships between body mass index (BMI) and various socio-economic, clinical, behavioural and reproductive factors in a population from Southern France. METHODS Using a cross-sectional study, a sample of 3127 current and former salaried workers (1658 men and 1469 women) completed a questionnaire on personal and medical histories, and had a clinical examination including height and weight measurements. Age-adjusted and multiple linear regression analyses were performed. RESULTS The overall prevalence of obesity (BMI> or =30 kg/m) was 9.8% and was higher in men than in women (11.1 versus 8.3%). Multivariate analyses showed that in both sexes, low educational level, television watching, low physical activity and ex-smoking habits, were independently associated with a higher BMI. Furthermore, in women, we found independent and positive associations between BMI and the number of naps per week, short sleep duration, daily alcohol consumption, the number of pregnancies, early age at menarche or the non-use of oral contraceptives. CONCLUSIONS Our results reveal the complexity that exists between BMI and environmental factors and stress the need to analyse and to handle these factors simultaneously.
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Cournot M, Cambou JP, Quentzel S, Danchin N. [Reasons for the under-use of secondary prevention therapies in coronary patients over the age of 70 years]. Ann Cardiol Angeiol (Paris) 2005; 54 Suppl 1:S17-23. [PMID: 16411647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
INTRODUCTION Although platelet antiaggregants, beta-blockers and statins have proved their efficacy as secondary prevention in all types of patients with arterial and thrombotic disease, these therapeutic categories remain under-used in the elderly. The reasons for this under-prescription are poorly understood. The aim of this study was to determine the reasons for not prescribing the principal secondary prevention therapies in elderly coronary patients. METHODS Two transversal pharmaco-epidemiological surveys were carried out in a representative sample of French cardiologists. They included 1489 coronary patients aged 35 to 69 years and 1148 patients aged over 70 years, respectively. Risk factors, medical history, current treatments and reasons for non-prescription of the principal therapies were collected. RESULTS In subjects aged 70 years or over, antiaggregants were not prescribed in 24% of patients, versus 7.5% of younger patients. Statins were not prescribed in 37% of those over 70 years, versus 14% of younger patients. Beta-blockers were not prescribed in 42% of elderly patients versus 23% of younger patients. ACE inhibitors were not prescribed in 57.6% of elderly subjects and 48.2% of younger subjects. Combinations of three or four secondary prevention treatments were half as frequently prescribed in patients over the age of 70. According to the physicians, the main reason for non-prescription in elderly patients was a lack of indication, which concerned 8% of the entire sample with respect to antiaggregants, 9% for beta-blockers and 14% for statins. These very high percentages were not found in younger subjects (1%, 3% and 2.5%, respectively). CONCLUSION Our results confirm under-use of the principal secondary prevention therapies in elderly subjects, mainly because of a lack of indication, according to the physicians. In these patients, indications for secondary prevention appear to be tributary to numerous factors, such as age, the type of medical history, the availability of lipid parameters or compliance. In response to questions by practitioners, specific recommendations would be useful concerning secondary prevention in elderly coronary patients.
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Affiliation(s)
- Maxime Cournot
- Département d'epidémiologie, INSERM U558, Toulouse, France.
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Ruidavets JB, Cassadou S, Cournot M, Bataille V, Meybeck M, Ferrières J. Increased resting heart rate with pollutants in a population based study. J Epidemiol Community Health 2005; 59:685-93. [PMID: 16020647 PMCID: PMC1733118 DOI: 10.1136/jech.2004.026252] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Air pollution is associated with cardiovascular mortality. Changes in the autonomic nervous system may contribute to cardiac arrhythmias and cardiovascular mortality. This study investigated the relations between air pollutant concentrations of sulphur dioxide (SO(2)), ozone (O(3)), nitric dioxide (NO(2)), and resting heart rate (RHR) in a population based study. METHODS A sample of 863 middle aged men and women, living in Toulouse (MONICA centre) area, was randomly recruited. A cross sectional survey on cardiovascular risk factors was carried. RHR was measured twice in a sitting position after a five minute rest. Multivariate analyses with quintiles of RHR were performed using polytomous logistic regression. Models were adjusted for temperature, season, relative humidity, sex, physical activity, blood pressure, C reactive protein, and cardiovascular drugs. RESULTS For NO(2), the OR (odds ratio) (95% CI) associated with an increase of 5 microg/m(3) in the current day of medical examination was 1.14 (1.03 to 1.25) in quintile Q5 of RHR compared with Q1, p for trend = 0.003. For SO(2), OR was 1.16 (0.94 to 1.44) in Q5 compared with Q1, p for trend = 0.05, and for O(3), OR was 0.96 (0.91 to 1.01) in Q5 compared with Q1, p for trend = 0.11. No significant association was seen when the daily mean concentration of NO(2), SO(2), and O(3) was considered during the previous day as well as when day lag 2 or 3 was considered. The cumulative concentration (three consecutive days) of O(3) is negatively associated with RHR (p for trend = 0.02). CONCLUSION Changes in pulse rate could reflect cardiac rhythm changes and may be part of the pathophysiological link between pollution and cardiovascular mortality.
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Cournot M, Cambou JP, Quentzel S, Danchin N. Key factors associated with the under-prescription of statins in elderly coronary heart disease patients: Results from the ELIAGE and ELICOEUR surveys. Int J Cardiol 2005; 111:12-8. [PMID: 16046011 DOI: 10.1016/j.ijcard.2005.06.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Revised: 06/07/2005] [Accepted: 06/11/2005] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The reasons why statins are under-utilized in elderly patients remain poorly understood. The aim of this study was to identify the reasons given by cardiologist for the non-prescription of statins in elderly CHD patients. METHODS Two cross-sectional pharmaco-epidemiological surveys were carried out among French cardiologists. The sample consisted of 1148 coronary patients aged 35 to 69 years and 1489 patients aged > or =70 years. Patients' risk factors, medical history, treatments, lipid values and the physicians' various motives for the non-prescription of statins were recorded. RESULTS Patients not treated with statins reached 37% in the age-group > or =70 years and 14% in the age-group 35-69 years. The main reason given for statin non-prescription was the lack of a medical indication (2.5% of the age-group 35-69 years and 14% of the age-group > or =70 years). Among patients > or =70 years, the lack of indication was more often cited in the following conditions: 1) in very old patients (36% of lack of indication in the age-group >85 years vs. 10% in 70-75 years), 2) when lipid values were not available (20% when data were not available vs. 9%) and 3) when the patient had no prior history of myocardial infarction (MI) (20% when no history of MI vs. 7%). These factors were not associated with lack of indication among patients <70 years. History of intolerance or side effect was given for 1.3% and 14% of patients for each of the groups (35-69 and > or =70) and poor overall patient adherence was cited in 1% and 2%, respectively. CONCLUSION The primary reason for the under-prescription of statins in elderly coronary patients is the perceived lack of indication, which stresses the need of extensive guidelines for prescription in elderly patients. Several factors associated with this perception seem to be specific to the elderly.
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Affiliation(s)
- Maxime Cournot
- Département d'épidémiologie, INSERM U558, 37, allées Jules Guesdes, 31073 Toulouse cedex, France.
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Abstract
BACKGROUND Despite the diversity of the studied health outcomes, types and levels of pollution, and various environmental settings, there is substantial evidence for a positive link between urban air pollution and cardiovascular diseases. The objective of this study was to test the associations between air pollutants and the occurrence of acute myocardial infarction (AMI). METHODS AND RESULTS Pollutant concentrations (SO2, NO2, and O3) were measured hourly as part of the automated air quality network. Since 1985, an AMI registry (the Toulouse MONICA Project) has been collecting data in the southwest of France. All cases of AMI and sudden and probable cardiac deaths are recorded for subjects 35 to 64 years of age. We studied the short-term exposure effect of pollution on the risk of AMI (from January 1, 1997, to June 30, 1999) using a case-crossover design method. We performed a conditional logistic regression analysis to calculate relative risks (RRs) and their 95% CIs. After adjustment for temperature, relative humidity, and influenza epidemics, the RRs (for an increase of 5 microg/m3 of O3 concentration) for AMI occurrence were significant for the current-day and 1-day-lag measurements (RR, 1.05; 95% CI, 1.01 to 1.08; P=0.009; and RR, 1.05; 95% CI, 1.01 to 1.09; P=0.007, respectively). Subjects 55 to 64 years of age with no personal history of ischemic heart disease were the most susceptible to develop an AMI (RR, 1.14; 95% CI, 1.06 to 1.23). NO2 and SO2 exposures were not significantly associated with the occurrence of AMI. CONCLUSIONS Observational data confirm that short-term O3 exposure within a period of 1 to 2 days is related to acute coronary events in middle-aged adults without heart disease, whereas NO2 and SO2 are not.
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Cournot M, Cambou JP, Ferrières J, Grenier O, Herrmann MA, Cantet C, Leizorovicz A. [Management of the cardiology patient with polyvascular disease: PRISMA study]. Arch Mal Coeur Vaiss 2004; 97:841-8. [PMID: 15521475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION Myocardial infarction (MI), peripheral vascular disease and ischaemic cerebral vascular accident (CVA) are three manifestations of the same disease, atherothrombosis, and they share the same pathophysiology and prognosis. OBJECTIVE The aim of this work was to describe the clinical characteristics and the medical management of polyvascular patients in cardiology. METHOD Cardiologists from all over the country participated in a consultation register for 3 weeks. The clinical characteristics and medical management for the first 3 patients on the register for each cardiologist were studied in a national multicentre study and then compared according to whether the atherothrombotic disease was isolated or polyvascular. RESULTS In total, 100,429 patients were examined during the period of the register and 2,780 were included in the study. Polyvascular patients represented 7% of the register and 22% of the vascular patients. These patients with multiple manifestations were frequently diabetics. A lipid profile was available less often in the cardiac patients when they had another disorder (72.4%) than in the case of an isolated disorder (78.9%). Whatever the initial disorder, dyslipidaemia was less often controlled in the case of polyvascular disease (63% of LDL-C > or = 1.3g/l in polyvascular cardiac patients vs 52% in cardiac patients with isolated disease). In cardiac patients, the presence of peripheral vascular disease was associated with less prescription of beta blockers (OR=0.4 [0.3-0.6]), the presence of CVA was associated with less prescription of statins (OR=0.7 [0.5-0.9]). Eight out of 10 polyvascular patients received anti-platelet aggregation treatment. The presence of multiple atherothrombotic manifestations was associated with greater prescription of ACEI, except in cardiac patients. CONCLUSION These results improve our understanding of the specific management of polyvascular patients, for whom secondary prevention is paramount due to the higher risk of recurrence. They should prompt the reinforcement of measures which have been shown to be effective, such as managing major risk factors, and in particular the dislipidaemias.
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Affiliation(s)
- M Cournot
- INSERM U5558, Département d'épidémiologie, Faculté de médecine, Toulouse
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Cournot M, Glibert A, Castel F, Druart F, Imani K, Lauwers-Cances V, Morin T. Management of hepatitis C in active drugs users: experience of an addiction care hepatology unit. ACTA ACUST UNITED AC 2004; 28:533-9. [PMID: 15243385 DOI: 10.1016/s0399-8320(04)95008-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Recent guidelines on the management of patients chronic hepatitis C virus (HCV) infection recommend the same anti-HCV therapy for active intravenous drug users and other patients, however some physicians are reluctant to treat active drug users. The aim of this study was to compare hepatitis C management practices and clinical outcome after treatment between active intravenous drug users and other patients. METHODS Four hundred and thirty-five naive HCV seropositive patients were recruited from 1990 to 2000 and followed up for a mean period of 2.5 years (SD 1 Year). At the beginning of the study, 116 of the patients were active intravenous drug users. Social, clinical, biological and histological data were collected. The different steps of HCV management and responses to treatment were compared between active intravenous drug users and other patients. RESULTS There was no statistically significant difference in HCV management practices and compliance between active intravenous drug users and other patients: search for viral RNA (85% versus 67%), liver biopsy performed when indicated (82% versus 87%), initiation of anti-HCV treatment (33.6% versus 43.2%), loss to follow up during treatment (24% vs 16%). The rate of sustained viral response was not significantly different between active intravenous drug users and other patients (28% versus 21%). At multivariate analysis, factors independently associated with sustained viral response were female gender (OR=5.6 [1.02-41.2]), genotype 3 (OR=29.7 [1.4-61.7]), low viral load (OR=33.3 [2.25-100]), low fibrosis score (OR=1.4 [1.0-2.0]), elevated transaminase level (OR=12.7 [0.9-97.2]), and bitherapy protocol (OR=10 [1.18-85.3]). CONCLUSION This study illustrates that active intravenous drug use does not affect either patient compliance with proposed management or viral response to treatment, but pluridisciplinary care should focus both on drug addiction and HCV infection.
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Affiliation(s)
- Maxime Cournot
- Service Hépato-Gastroentérologie, Centre Hospitalier 65013 Tarbes Cedex
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Cournot M, Ferriéres J, Bousquet V, Bénazet P, Sassi JL, Destrac S. [Management of myocardial infarction in patients over 75 years of age from 1983 to 1999]. Arch Mal Coeur Vaiss 2004; 97:201-6. [PMID: 15106743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Elderly patients are often excluded from therapeutic methods which have been shown to improve the prognosis of myocardial infarction (MI). The aim of this study was to describe the changes in management of MI in the elderly and to analyse the factors associated with hospital mortality due to MI during this period. All cases of acute MI in patients over 75 years of age from 1983 to 1999 and admitted to the Centre Hospitalier du Val d'Ariège were reviewed. The clinical features, the modalities of initial management and their treatment on discharge were compared by periods: 1983-88, 1989-93 and 1994-99. The changes in hospital mortality and the factors associated with this mortality were studied. Five hundred and forty-four cases of patients with an average age of 81 years were reviewed. The proportion of patients who were treated medically alone decreased over the 3 periods whereas treatment by angioplasty and thrombolysis increased (1.2% in 1983-88 versus 18.2% in 1994-99). Betablockers, ACE inhibitors and aspirin were much more prescribed on discharge from hospital. In parallel, the hospital mortality from MI decreased by half (50.8% in 1983-88 versus 24.9% in 1994-99). The independent factors associated with hospital mortality were age, anterior infarction (OR = 2.08 [1.39-3.13]), revascularisation of the culprit artery by thrombolysis or angioplasty (OR = 0.24 [0.09-0.61]) and the period of hospital stay (OR = 0.22 [0.12-0.38] in 1994-99 compared with 1983-88). The authors' experience reflects an improved prognosis of MI in the elderly partially due to the benefits of treatment by angioplasty and thrombolysis. Improvement of pre-hospital treatment, better diagnostic methods and more aggressive management of the elderly with MI also contribute to these results.
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Affiliation(s)
- M Cournot
- INSERM U558, départment d'épidémiologie, faculté de médecine, Toulouse
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Rolland Y, Lauwers-Cances V, Cournot M, Nourhashémi F, Reynish W, Rivière D, Vellas B, Grandjean H. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. J Am Geriatr Soc 2003; 51:1120-4. [PMID: 12890076 DOI: 10.1046/j.1532-5415.2003.51362.x] [Citation(s) in RCA: 301] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To determine whether calf circumference (CC), related to appendicular skeletal muscle mass, can be used as a measure of sarcopenia and is related to physical function. DESIGN Retrospective analysis of data from 1992 to 1994 of the European Patient Information and Documentation Systems Study. SETTING Community setting in France. PARTICIPANTS One thousand four hundred fifty-eight French women aged 70 and older without previous history of hip fracture were recruited from the electoral lists. MEASUREMENTS Muscular mass was assessed using dual-energy x-ray absorptiometry (DEXA). CC was measured using a tape measure. Anthropometric measurements (height; weight; and waist, hip, and calf circumference), strength markers (grip strength), and self-reported physical function were also determined. Sarcopenia was defined (using DEXA) as appendicular skeletal muscle mass (weight (kg)/height (m2)) less than two standard deviations below the mean of a young female reference group. RESULTS The prevalence of sarcopenia was 9.5%. CC was correlated with appendicular skeletal muscle mass (r = 0.63). CC under 31 cm was the best clinical indicator of sarcopenia (sensitivity = 44.3%, specificity = 91.4%). CC under 31 cm was associated with disability and self-reported physical function but not sarcopenia (defined using DEXA), independent of age, comorbidity, obesity, income, health behavior, and visual impairment. CONCLUSION CC cannot be used to predict sarcopenia defined using DEXA but provides valuable information on muscle-related disability and physical function.
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Affiliation(s)
- Yves Rolland
- Internal Medicine Service and Gerontology Clinic, Hôpital La Grave-Casselardit, Toulouse, France.
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Cournot M. On the Ideas of Species and Race Applied to Man and Human Society: On Anthropology and Ethnology. Anthropological Review 1864. [DOI: 10.2307/3024975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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