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Badaoui A, De Wergifosse M, Rondelet B, Deprez PH, Stanciu-Pop C, Bairy L, Eucher P, Delos M, Ocak S, Gillain C, Duplaquet F, Pirard L. Improved Accuracy and Sensitivity in Diagnosis and Staging of Lung Cancer with Systematic and Combined Endobronchial and Endoscopic Ultrasound (EBUS-EUS): Experience from a Tertiary Center. Cancers (Basel) 2024; 16:728. [PMID: 38398119 PMCID: PMC10886864 DOI: 10.3390/cancers16040728] [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: 01/16/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Combined endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided tissue acquisition (EUS-TA) are accurate procedures for the diagnosis and staging of mediastinal lymph nodes (MLNs) in lung cancer. However, the respective contribution of separate and combined procedures in diagnosis and staging has not been fully studied. The aim of this study was to assess their respective performances. METHODS Patients with suspected malignant MLNs in lung cancer or recurrence identified by PET-CT who underwent combined EBUS-TBNA and EUS-TA were retrospectively reviewed. RESULTS A total of 141 patients underwent both procedures. Correct diagnosis was obtained in 82% with EBUS-TBNA, 91% with EUS-TA, and 94% with the combined procedure. The overall sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of EBUS-TBNA, EUS-TA, and the combined procedure for diagnosing malignancy were [75%, 100%, 100%, 58%], [87%, 100%, 100%, 75%], and [93%, 100%, 100%, 80%], respectively, with a significantly better sensitivity of the combined procedure (p < 0.0001). Staging (82/141 patients) was correctly assessed in 74% with EBUS-TBNA, 68% with EUS-TA, and 85% with the combined procedure. The overall sensitivity, specificity, PPV, and NPV of EBUS-TBNA, EUS-TA, and the combined procedure for lung cancer staging were [62%, 100%, 100%, 55%], [54%, 100%, 100%, 50%], and [79%, 100%, 100%, 68%], respectively, significantly better in terms of sensitivity for the combined procedure (p < 0.001). CONCLUSION The combined EBUS-EUS approach in lung cancer patients showed better accuracy and sensitivity in diagnosis and staging when compared with EBUS-TBNA and EUS-TA alone.
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Affiliation(s)
- Abdenor Badaoui
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (A.B.); (C.G.)
| | - Marion De Wergifosse
- Department of Pneumology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (M.D.W.); (S.O.); (F.D.)
| | - Benoit Rondelet
- Department of Vascular and Thoracic Surgery, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (B.R.); (P.E.)
| | - Pierre H. Deprez
- Department of Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 1200 Bruxelles, Belgium;
| | - Claudia Stanciu-Pop
- Department of Pathological Anatomy, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (C.S.-P.); (M.D.)
| | - Laurent Bairy
- Department of Anesthesiology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium;
| | - Philippe Eucher
- Department of Vascular and Thoracic Surgery, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (B.R.); (P.E.)
| | - Monique Delos
- Department of Pathological Anatomy, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (C.S.-P.); (M.D.)
| | - Sebahat Ocak
- Department of Pneumology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (M.D.W.); (S.O.); (F.D.)
- Pole of Pneumology, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, 1200 Bruxelles, Belgium
| | - Cédric Gillain
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (A.B.); (C.G.)
| | - Fabrice Duplaquet
- Department of Pneumology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (M.D.W.); (S.O.); (F.D.)
| | - Lionel Pirard
- Department of Pneumology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium; (M.D.W.); (S.O.); (F.D.)
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Maruyama H, Sakai S, Dewachter L, Dewachter C, Rondelet B, Naeije R, Ieda M. Prostacyclin receptor agonists induce DUSP1 to inhibit pulmonary artery smooth muscle cell proliferation. Life Sci 2023; 315:121372. [PMID: 36608870 DOI: 10.1016/j.lfs.2023.121372] [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: 10/09/2022] [Revised: 12/08/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
AIMS Upregulated p38MAPK signaling is implicated in the accelerated proliferation of pulmonary artery smooth muscle cells (PA-SMCs) and the pathogenesis of pulmonary artery remodeling observed in pulmonary arterial hypertension (PAH). Previously, we reported that after endothelin-1 (ET-1) pretreatment, bone morphogenetic protein 2 (BMP2) activates p38MAPK signaling and accelerates PA-SMC proliferation. The activity of p38MAPK signaling is tightly regulated by the inactivation of dual-specificity phosphatase 1 (DUSP1). Activated p38MAPK induces DUSP1 expression, forming a negative feedback loop. Prostacyclin IP receptor agonists (prostacyclin and selexipag) are used to treat PAH. In this study, we aimed to verify whether IP receptor agonists affect DUSP1 expression and accelerate the proliferation of PA-SMCs. MAIN METHODS PA-SMCs were treated with BMP2, ET-1, prostacyclin, and MRE-269, an active metabolite of selexipag, either alone or in combination. We quantified mRNA expressions using real-time quantitative polymerase chain reaction. Pulmonary artery specimens and PA-SMCs were obtained during lung transplantation in patients with PAH. KEY FINDINGS Both prostacyclin and MRE-269 increased DUSP1 expression. Combined treatment with BMP2 and ET-1 induced cyclin D1 and DUSP1 expression and increased PA-SMC proliferation. MRE-269 attenuated BMP2/ET-1-induced cell proliferation. ET-1 increased DUSP1 expression in PA-SMCs from control patients but not in PA-SMCs from patients with PAH. SIGNIFICANCE This study showed that the p38MAPK/DUSP1 negative feedback loop is impaired in PAH, contributing to unregulated p38MAPK activation and PA-SMC hyperplasia. IP receptor agonist MRE-269 increases DUSP1 expression and inhibit p38MAPK-mediated PA-SMC proliferation. Future elucidation of the detailed mechanism underlying reduced DUSP1 expression would be informative for PAH treatment.
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Affiliation(s)
- Hidekazu Maruyama
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, 300-8585 Tsuchiura, Japan; Division of Cardiovascular Medicine, Faculty of Medicine, University of Tsukuba, 305-8577 Tsukuba, Japan; Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium.
| | - Satoshi Sakai
- Faculty of Health Science, Tsukuba University of Technology, 305-8520 Tsukuba, Japan
| | - Laurence Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Céline Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium; Department of Cardiology, Erasme Academic Hospital, 1070 Brussels, Belgium
| | - Benoit Rondelet
- Department of Cardiac, Vascular and Thoracic Surgery, CHU UCL Namur, 5530 Yvoir, Belgium
| | - Robert Naeije
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Masaki Ieda
- Division of Cardiovascular Medicine, Faculty of Medicine, University of Tsukuba, 305-8577 Tsukuba, Japan
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3
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Belhaj A, Dewachter L, Remmelink M, Rondelet B. Tacrolimus for Prevention of Right and Left Ventriculo-Arterial Coupling Changes in Experimental Brain Death. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.351] [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: 11/25/2022] Open
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4
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Belhaj A, Dewachter L, Remmelink M, Rondelet B. Effects of Tacrolimus on Mechanical and Humoral Determinants of Brain Death-Induced Lung Injury. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.761] [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: 11/24/2022] Open
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5
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Vos R, Smits J, Strelniece A, Buhl R, Deuse T, Dzubur F, Evrard P, Harlander M, Hoek R, Hoefer D, Hoetzenecker K, Knoop C, Kwakkel-van Erp H, Lang G, Langer F, Luijk B, Madurka I, Rondelet B, Schramm R, Seghers L, van Kessel D, Verleden G, Verschuuren E, Witt C, Green D, Gottlieb J. Requests for Exceptional LAS in Eurotransplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.482] [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: 11/24/2022] Open
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Maruyama H, Sakai S, Dewachter L, Dewachter C, Rondelet B, Naeije R, Ieda M. Endothelin-1 induces lysyl oxidase expression in pulmonary artery smooth muscle cells. Can J Physiol Pharmacol 2020; 98:629-636. [PMID: 32615041 DOI: 10.1139/cjpp-2019-0658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/20/2022]
Abstract
The increase in thickening of the arterial wall of pulmonary arterial hypertension (PAH) includes cellular proliferation as well as matrix deposition and interrupted internal elastic lamina (IEL) consisting of a thick homogeneous sheet of elastin. Little is, although, known about the detail of IEL formation in PAH. Endothelin-1 is overexpressed in pulmonary arterioles of PAH. We aimed to examine the expression of genes contributing to IEL formation in pulmonary artery smooth muscle cells (PASMCs) especially focused on lysyl oxidase (LOx), an exreacellular matrix enzyme that catalyzes the cross-linking of collagens or elastin. We quantified mRNA expressions of genes contributing to IEL formation including LOx in PASMCs using real-time quantitative polymerase chain reaction. We stimulated human PASMCs with endothelin-1 with prostacyclin or trapidil. Endothelin-1 significantly increased LOx expression. Prostacyclin and trapidil restored endothelin-1-induced LOx expression to the basal level. Endothelin-1 increased LOx expression strongly in PASMCs from PAH patients compared to those from controls. Trapidil reduced LOx expression only in PASMCs from PAH patients. Overexpressed endothelin-1 in PAH patients can increase expression of LOx and agitate cross-linking of elastin and collagen, resulting in ectopic deposition of these in the vascular media.
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Affiliation(s)
- Hidekazu Maruyama
- Department of Cardiology, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan.,Faculty of Health Science, Tsukuba University of Technology, Tsukuba, Japan.,Division of Cardiovascular Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Satoshi Sakai
- Faculty of Health Science, Tsukuba University of Technology, Tsukuba, Japan.,Division of Cardiovascular Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Laurence Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Céline Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Department of Cardiology, Erasme Academic Hospital, Brussels, Belgium
| | - Benoit Rondelet
- Department of Cardiac, Vascular and Thoracic Surgery, CHU UCL Namur, Yvoir, Belgium
| | - Robert Naeije
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Masaki Ieda
- Division of Cardiovascular Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Vos R, Smits J, Hoek R, Green D, Evrard P, Knoop C, Verleden G, Rondelet B, Kwakkel-vanErp J, Seghers L, van Kessel D, Luijk B, Verschuuren E, Lang G, Hoetzenecker K, Laufer G, Hoefer D, Langer F, Schramm R, Deuse T, Buhl R, Witt C, Gottlieb J. Exceptional LAS Requests in Eurotransplant: Analysis of an 8-year Effort to Improve Lung Allocation for Precarious Patients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.475] [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: 10/24/2022] Open
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Di Santo M, Belhaj A, Rondelet B, Gustin T. Intraspinal Iliac Venous Stent Migration with Lumbar Nerve Root Compression. World Neurosurg 2020; 137:372-375. [PMID: 32058121 DOI: 10.1016/j.wneu.2020.02.028] [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: 11/10/2019] [Revised: 02/03/2020] [Accepted: 02/04/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Venous stenting is a common treatment for chronic peripheral venous disease. The most frequent complications caused by this technique are stent misplacement and intracardiac or intravascular stent migration. In this publication, we will describe the first case of an intraspinal stent misplacement leading to lumbar nerve root compression. CASE DESCRIPTION Our patient was a 20-year-old woman with a bilateral pulmonary embolism caused by a right common iliac vein thrombosis and a severe compression of the left common iliac vein by the right common iliac artery (May-Thurner or Cockett syndrome). She underwent an endovascular stenting of the left iliac vein. A few days later, she reported some pain in the right L5 radicular and showed signs of hypoesthesia of the left leg and of paresis of the left extensor hallucis longus muscle. A lumbar computed tomography scan showed a stent misplacement into the spinal canal through the left L5 foramen with nerve root compression. She underwent a surgical removal of the stent through a unilateral L5-S1 laminarthrectomy. The postoperative follow-up showed a complete clinical recovery and a control lumbar computed tomography scan confirmed the L5 nerve root decompression. CONCLUSIONS The intraspinal misplacement of a venous stent is a rare complication that may cause nerve root injury. It requires a prompt treatment. Surgically removing the stent by a posterior approach seems to be a simple and safe therapeutic option.
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Affiliation(s)
- Mélissa Di Santo
- Department of Neurosurgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium.
| | - Asmae Belhaj
- Department of Vascular Surgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium
| | - Benoit Rondelet
- Department of Vascular Surgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium
| | - Thierry Gustin
- Department of Neurosurgery, CHU University Hospital Center, Université Catholique de Louvain (UCL), Yvoir, Namur, Belgium
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9
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Smits JM, Gottlieb J, Verschuuren E, Evrard P, Hoek R, Knoop C, Lang G, Kwakkel-van Erp JM, Vos R, Verleden G, Rondelet B, Hoefer D, Langer F, Schramm R, Hoetzenecker K, van Kessel D, Luijk B, Seghers L, Deuse T, Buhl R, Witt C, Strelniece A, Green D, de Vries E, Laufer G, Van Raemdonck D. Impact of donor lung quality on post-transplant recipient outcome in the Lung Allocation Score era in Eurotransplant - a historical prospective study. Transpl Int 2020; 33:544-554. [PMID: 31984577 PMCID: PMC7216955 DOI: 10.1111/tri.13582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/02/2019] [Accepted: 01/20/2020] [Indexed: 12/21/2022]
Abstract
The aim of this study was to investigate whether there is an impact of donation rates on the quality of lungs used for transplantation and whether donor lung quality affects post-transplant outcome in the current Lung Allocation Score era. All consecutive adult LTx performed in Eurotransplant (ET) between January 2012 and December 2016 were included (N = 3053). Donors used for LTx in countries with high donation rate were younger (42% vs. 33% ≤45 years, P < 0.0001), were less often smokers (35% vs. 46%, P < 0.0001), had more often clear chest X-rays (82% vs. 72%, P < 0.0001), had better donor oxygenation ratios (20% vs. 26% with PaO2 /FiO2 ≤ 300 mmHg, P < 0.0001), and had better lung donor score values (LDS; 28% vs. 17% with LDS = 6, P < 0.0001) compared with donors used for LTx in countries with low donation rate. Survival rates for the groups LDS = 6 and ≥7 at 5 years were 69.7% and 60.9% (P = 0.007). Lung donor quality significantly impacts on long-term patient survival. Countries with a low donation rate are more oriented to using donor lungs with a lesser quality compared to countries with a high donation rate. Instead of further stretching donor eligibility criteria, the full potential of the donor pool should be realized.
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Affiliation(s)
| | - Jens Gottlieb
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.,Biomedical Research in End-stage and Obstructive Disease (Breath), German Centre for Lung Research (DZL), Hannover, Germany
| | - Erik Verschuuren
- Department of Pulmonary Medicine and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Patrick Evrard
- Department of Intensive Care, Centre Hospitalier Universitaire Université Catholique de Louvain, Namur Godinne, Belgium
| | - Rogier Hoek
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Christiane Knoop
- Department of Respiratory Medicine, Hôpital Erasme, Brussels, Belgium
| | - György Lang
- Department of Thoracic Surgery, University Hospital, Vienna, Austria
| | - Johanna M Kwakkel-van Erp
- Department of Respiratory Medicine, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - Robin Vos
- Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven, Belgium
| | - Geert Verleden
- Department of Respiratory Medicine, University Hospital Gasthuisberg, Leuven, Belgium
| | - Benoit Rondelet
- Department of Thoracic Surgery, Centre Hospitalier Universitaire Université Catholique de Louvain, Namur Godinne, Belgium
| | - Daniel Hoefer
- Department of Thoracic and Cardiovascular Surgery, University Hospital Innsbruck, Innsbruck, Austria
| | - Frank Langer
- Department of Thoracic and Cardiovascular Surgery, University Hospital Saarland, Homburg, Germany
| | - Rene Schramm
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr-University Bochum, Bad Oeyenhausen, Germany
| | | | - Diana van Kessel
- Department of Respiratory Medicine, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Bart Luijk
- Division of Heart and Lungs, Department of Respiratory Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Leonard Seghers
- Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tobias Deuse
- Department of Thoracic and Cardiovascular Surgery, University Hospital Eppendorf, Hamburg, Germany
| | - Roland Buhl
- Department of Respiratory Medicine, University Hospital Mainz, Mainz, Germany
| | - Christian Witt
- Department of Respiratory Medicine, University Hospital Charité, Berlin, Germany
| | - Agita Strelniece
- Eurotransplant International Foundation, Leiden, The Netherlands
| | - Dave Green
- Eurotransplant International Foundation, Leiden, The Netherlands
| | - Erwin de Vries
- Eurotransplant International Foundation, Leiden, The Netherlands
| | - Guenter Laufer
- Department of Cardiac Surgery, University Hospital Vienna, Vienna, Austria
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospital Gasthuisberg, Leuven, Belgium
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Belhaj A, Dewachter L, Mc Entee K, Naeije R, Rondelet B. Effects of tacrolimus on mechanical and humoral determinants of brain death-induced lung injury. Transplantation 2019. [DOI: 10.1183/13993003.congress-2019.pa3353] [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: 11/05/2022]
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Michaux I, Bulpa P, Dincq AS, Dumonceaux M, Rondelet B, Seldrum S, Patrick E. One-year survival impact of early right ventricular diastolic dysfunction after lung transplantation. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.047] [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: 11/11/2022]
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12
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Michaux I, Bulpa P, Dincq AS, Dumonceaux M, Rondelet B, Seldrum S, Evrard P. Right ventricular systolic dysfunction early after lung transplantation: prevalence and impact on 1-year survival. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.048] [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: 11/11/2022]
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13
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van Erp J, Smits J, Verplancke V, Evrard P, Lang G, Schramm R, Vos R, Verleden G, Rondelet B, Hoefer D, Verschuuren E, van der Bij W, Hoek R, Laufer G, Hoetzenecker K, Knoop C, Buhl R, Witt C, Gotlieb J, van de Graaf E. Outcomes of Donor-Recipient Gender Mismatched Lung Transplantation in the Eurotransplant Area. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1062] [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] Open
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14
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Noël A, Vastrade C, Dupont S, de Barsy M, Huang TD, Van Maerken T, Leroux-Roels I, Delaere B, Melly L, Rondelet B, Dransart C, Dincq AS, Michaux I, Bogaerts P, Glupczynski Y. Nosocomial outbreak of extended-spectrum β-lactamase-producing Enterobacter cloacae among cardiothoracic surgical patients: causes and consequences. J Hosp Infect 2019; 102:54-60. [PMID: 30630000 DOI: 10.1016/j.jhin.2019.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 10/14/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Enterobacteriaceae are recognized as leading pathogens of healthcare-associated infections. AIM To report the investigation of a nosocomial outbreak of extended-spectrum β-lactamase-producing Enterobacter cloacae affecting cardiothoracic surgery patients in a Belgian academic hospital. METHODS Cases were defined based on epidemiological and microbiological investigations, including molecular typing using repetitive element-based polymerase chain reaction and multi-locus sequence typing. Case-control studies followed by field evaluations allowed the identification of a possible reservoir, and the retrospective assessment of human and financial consequences. FINDINGS Over a three-month period, 42 patients were infected or colonized by CTX-M-15-producing E. cloacae strains that belonged to the same clonal lineage. Acquisition mainly occurred in the intensive care unit (N = 23) and in the cardiothoracic surgery ward (N = 16). All but one patient had, prior to acquisition, undergone a cardiothoracic surgical procedure, monitored by the same transoesophageal echocardiography (TOE) probe in the operating room. Despite negative microbiological culture results, the exclusion of the suspected probe resulted in rapid termination of the outbreak. Overall, the outbreak was associated with a high mortality rate among infected patients (40%) as well as significant costs (€266,550). CONCLUSION The outbreak was indirectly shown to be associated with the contamination of a manually disinfected TOE probe used per-operatively during cardiothoracic surgery procedures, because withdrawal of the putative device led to rapid termination of the outbreak.
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Affiliation(s)
- A Noël
- Infection Control Unit, CHU UCL Namur, Yvoir, Belgium.
| | - C Vastrade
- Infection Control Unit, CHU UCL Namur, Yvoir, Belgium
| | - S Dupont
- Infection Control Unit, CHU UCL Namur, Yvoir, Belgium
| | - M de Barsy
- National Reference Centre for Monitoring Antimicrobial Resistance in Gram-Negative Bacteria, CHU UCL Namur, Yvoir, Belgium
| | - T D Huang
- National Reference Centre for Monitoring Antimicrobial Resistance in Gram-Negative Bacteria, CHU UCL Namur, Yvoir, Belgium
| | - T Van Maerken
- Infection Control Unit, Ghent University Hospital, Ghent, Belgium
| | - I Leroux-Roels
- Infection Control Unit, Ghent University Hospital, Ghent, Belgium
| | - B Delaere
- Infectious Diseases Unit, Internal Medicine Department, CHU UCL Namur, Yvoir, Belgium
| | - L Melly
- Cardiovascular, Thoracic Surgery and Lung Transplantation Department, CHU UCL Namur, Yvoir, Belgium
| | - B Rondelet
- Cardiovascular, Thoracic Surgery and Lung Transplantation Department, CHU UCL Namur, Yvoir, Belgium
| | - C Dransart
- Anesthesiology Department, CHU UCL Namur, Yvoir, Belgium
| | - A S Dincq
- Anesthesiology Department, CHU UCL Namur, Yvoir, Belgium
| | - I Michaux
- Intensive Care Unit Department, CHU UCL Namur, Yvoir, Belgium
| | - P Bogaerts
- National Reference Centre for Monitoring Antimicrobial Resistance in Gram-Negative Bacteria, CHU UCL Namur, Yvoir, Belgium
| | - Y Glupczynski
- Infection Control Unit, CHU UCL Namur, Yvoir, Belgium; National Reference Centre for Monitoring Antimicrobial Resistance in Gram-Negative Bacteria, CHU UCL Namur, Yvoir, Belgium
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Smits JM, Nossent G, Evrard P, Lang G, Knoop C, Kwakkel-van Erp JM, Langer F, Schramm R, van de Graaf E, Vos R, Verleden G, Rondelet B, Hoefer D, Hoek R, Hoetzenecker K, Deuse T, Strelniece A, Green D, de Vries E, Samuel U, Laufer G, Buhl R, Witt C, Gottlieb J. Lung allocation score: the Eurotransplant model versus the revised US model - a cross-sectional study. Transpl Int 2018; 31:930-937. [DOI: 10.1111/tri.13262] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/19/2018] [Accepted: 03/30/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - George Nossent
- Department of Respiratory Medicine; University Medical Center Groningen; Groningen The Netherlands
| | - Patrick Evrard
- Department of Intensive Care; Centre Hospitalier Universitaire Université Catholique de Louvain; Namur Godinne Belgium
| | - György Lang
- Department of Thoracic Surgery; University Hospital; Vienna Austria
| | - Christiane Knoop
- Department of Respiratory Medicine; Hôpital Erasme; Brussels Belgium
| | | | - Frank Langer
- Department of Thoracic and Cardiovascular Surgery; University Hospital Saarland; Homburg Germany
| | - Rene Schramm
- Department of Thoracic and Cardiovascular Surgery; University Hospital Munich; Munich Germany
| | - Ed van de Graaf
- Department of Respiratory Medicine; University Medical Center Utrecht; Utrecht The Netherlands
| | - Robin Vos
- Department of Respiratory Medicine; UZ Leuven; Leuven Belgium
| | - Geert Verleden
- Department of Respiratory Medicine; UZ Leuven; Leuven Belgium
| | - Benoit Rondelet
- Department of Thoracic Surgery; Centre Hospitalier Universitaire Université Catholique de Louvain; Namur Godinne Belgium
| | - Daniel Hoefer
- Department of Thoracic and Cardiovascular Surgery; University Hospital Innsbruck; Innsbruck Austria
| | - Rogier Hoek
- Department of Pulmonary Medicine; Erasmus University Medical Center; Rotterdam The Netherlands
| | | | - Tobias Deuse
- Department of Thoracic and Cardiovascular Surgery; University Hospital Eppendorf; Hamburg Germany
| | | | - Dave Green
- Eurotransplant International Foundation; Leiden The Netherlands
| | - Erwin de Vries
- Eurotransplant International Foundation; Leiden The Netherlands
| | - Undine Samuel
- Eurotransplant International Foundation; Leiden The Netherlands
| | - Guenther Laufer
- Department of Cardiac Surgery; University Hospital; Vienna Austria
| | - Roland Buhl
- Department of Respiratory Medicine; University Hospital Mainz; Mainz Germany
| | - Christian Witt
- Department of Respiratory Medicine; University Hospital Charité; Berlin Germany
| | - Jens Gottlieb
- Department of Respiratory Medicine; Hannover Medical School; Hannover Germany
- Biomedical Research in End-stage and Obstructive Disease (Breath); German Centre for Lung Research (DZL); Hannover Germany
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16
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Belhaj A, Chimanuka D, Rondelet B. Giant true aneurysm of superficial femoral artery in patient with multiple atherosclerotic aneurysms: A case report. Int J Surg Case Rep 2017; 35:94-97. [PMID: 28463742 PMCID: PMC5413207 DOI: 10.1016/j.ijscr.2017.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 01/17/2017] [Revised: 04/05/2017] [Accepted: 04/12/2017] [Indexed: 11/26/2022] Open
Abstract
True atherosclerotic aneurysms of superficial femoral artery (SFA) are rare and often associated with other peripheral or aortic aneurysms. We report the case of a 84-year-old patient presenting a giant degenerative ruptured aneurysm of the superficial femoral artery. The patient underwent successful aneurysm resection and bypass grafting, with a satisfying long-term follow-up and patency of the graft. The patient was also operated one year before, for a ruptured aneurysm of the abdominal aorta. This case report is rare, because we described a case of patient with multiple atherosclerotic aneurysms, who present, for the second time, a life threating ruptured aneurysm. In this report, we see extreme and rapid evolution of SFA Aneurysm before being symptomatic. Degenerative aneurysms of the lower extremity most commonly involve the popliteal artery, while they are rarely detected in the femoral region (Leon et al., 2008). In this region, aneurysms most frequently involve the common femoral artery (CFA), whereas true aneurysms of the superficial femoral artery (SFA) represent only 15% to 25% of femoral arterial aneurysms [1-5]. Degenerative aneurysms of the SFA display peculiar characteristics (in terms of clinical onset, diagnostic timing, and clinical behavior) so that they differ from other peripheral aneurysms. Because the relative rarity of this location, our case report can be useful to participate to increase the number of reported cases, and define the therapeutic approach for this rare location.
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Affiliation(s)
- Asmae Belhaj
- Department of Cardio-Vascular, Thoracic Surgery and Lung Transplantation, CHU UcL Namur, Université Catholique de Louvain, Belgium.
| | - Dominique Chimanuka
- Provincial Referral General Hospital of Bukavu, Catholic University of Bukavu, Democratic Republic of the Congo
| | - Benoit Rondelet
- Department of Cardio-Vascular, Thoracic Surgery and Lung Transplantation, CHU UcL Namur, Université Catholique de Louvain, Belgium
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17
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Maruyama H, Dewachter C, Sakai S, Belhaj A, Rondelet B, Remmelink M, Vachiéry JL, Naeije R, Dewachter L. Bosentan reverses the hypoxia-induced downregulation of the bone morphogenetic protein signaling in pulmonary artery smooth muscle cells. Life Sci 2016; 159:111-115. [PMID: 27188586 DOI: 10.1016/j.lfs.2016.05.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 11/01/2015] [Revised: 05/12/2016] [Accepted: 05/12/2016] [Indexed: 12/15/2022]
Abstract
AIMS Pulmonary hypertension (PH) is a common complication of chronic hypoxic lung diseases. Bone morphogenetic protein (BMP) and endothelin-1 signaling pathways have been shown to be altered in hypoxic PH and to play crucial roles in the associated pulmonary artery remodeling. We, therefore, aimed to study the potential link between hypoxia and the alteration of BMP and endothelin-1 signaling observed in pulmonary artery smooth muscle cells (PA-SMCs) in hypoxic PH. MATERIALS AND METHODS Human PA-SMCs were treated with hypoxia-mimetic agent cobalt chloride (CoCl2; 100μM), with or without pretreatment with a dual endothelin receptor antagonist bosentan (10μM). Expressions of preproendothelin-1 (PPET1), BMP type 2 receptor (BMPR-2), and one BMP signaling target gene, the inhibitor of DNA binding 1 (ID1) were evaluated by real time quantitative polymerase chain reaction. BMP2-treated PA-SMCs were assessed for Smad1/5/8 signaling activation by Western Blotting. KEY FINDINGS Treatment of PA-SMCs with CoCl2 increased PPET1 gene expression, while it did not alter expressions of endothelin converting enzyme, endothelin receptor type A or type B. Hypoxia-mimetic agent CoCl2 decreased the expressions of BMPR-2 and ID1 maximally after 3- and 6-hour treatment respectively, while CoCl2 treatment progressively increased noggin expression. Bosentan pretreatment restored expressions of BMPR-2 and ID1, as well as the activation (by phosphorylation) of Smad1/5/8 signaling induced by BMP2. SIGNIFICANCE Hypoxia induces the downregulation of the BMP signaling in PA-SMCs, at least, partly through the endothelin system. In hypoxic PH, increased endothelin-1 production might therefore contribute to the altered BMP signaling and subsequent PA-SMC hyperplasia.
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Affiliation(s)
- Hidekazu Maruyama
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium,.
| | - Céline Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Satoshi Sakai
- Division of Cardiovascular Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Asmae Belhaj
- Department of Thoracic Surgery, Erasmus University Hospital, Brussels, Belgium
| | - Benoit Rondelet
- Department of Thoracic Surgery, Erasmus University Hospital, Brussels, Belgium
| | - Myriam Remmelink
- Department of Anatomopathology, Erasmus University Hospital, Brussels, Belgium
| | - Jean-Luc Vachiéry
- Department of Cardiology, Erasmus University Hospital, Brussels, Belgium
| | - Robert Naeije
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Laurence Dewachter
- Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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18
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Verleden S, Vos R, Ruttens D, Vandermeulen E, Bellon H, Mcdonough J, Verbeken E, Verschakelen J, Van Raemdonck D, Rondelet B, Knoop C, Hogg J, Verleden G, Vanaudenaerde B. Differential Airway Involvement in Restrictive Phenotypes of Chronic Lung Allograft Dysfunction. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.071] [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: 10/23/2022] Open
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19
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Belhaj A, Dewachter L, Dewachter C, Mc Entee K, Naeije R, Rondelet B. Right Ventricular Dysfunction in Brain Death: Effect of Corticosteroids. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.186] [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: 11/25/2022] Open
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20
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Donadello K, Antonucci E, Cristallini S, Roberts JA, Beumier M, Scolletta S, Jacobs F, Rondelet B, de Backer D, Vincent JL, Taccone FS. β-Lactam pharmacokinetics during extracorporeal membrane oxygenation therapy: A case-control study. Int J Antimicrob Agents 2014; 45:278-82. [PMID: 25542059 DOI: 10.1016/j.ijantimicag.2014.11.005] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [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: 06/23/2014] [Accepted: 11/03/2014] [Indexed: 11/19/2022]
Abstract
Most adult patients receiving extracorporeal membrane oxygenation (ECMO) require antibiotic therapy, however the pharmacokinetics of β-lactams have not been well studied in these conditions. In this study, data from all patients receiving ECMO support and meropenem (MEM) or piperacillin/tazobactam (TZP) were reviewed. Drug concentrations were measured 2h after the start of a 30-min infusion and just before the subsequent dose. Therapeutic drug monitoring (TDM) results in ECMO patients were matched with those in non-ECMO patients for (i) drug regimen, (ii) renal function, (iii) total body weight, (iv) severity of organ dysfunction and (v) age. Drug concentrations were considered adequate if they remained 4-8× the clinical MIC breakpoint for Pseudomonas aeruginosa for 50% (TZP) or 40% (MEM) of the dosing interval. A total of 41 TDM results (27 MEM; 14 TZP) were obtained in 26 ECMO patients, with 41 matched controls. There were no significant differences in serum concentrations or pharmacokinetic parameters between ECMO and non-ECMO patients, including Vd [0.38 (0.27-0.68) vs. 0.46 (0.33-0.79)L/kg; P=0.37], half-life [2.6 (1.8-4.4) vs. 2.9 (1.7-3.7)h; P=0.96] and clearance [132 (66-200) vs. 141 (93-197)mL/min; P=0.52]. The proportion of insufficient (13/41 vs. 12/41), adequate (15/41 vs. 19/41) and excessive (13/41 vs. 10/41) drug concentrations was similar in ECMO and non-ECMO patients. Achievement of target concentrations of these β-lactams was poor in ECMO and non-ECMO patients. The influence of ECMO on MEM and TZP pharmacokinetics does not appear to be significant.
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Affiliation(s)
- Katia Donadello
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Elio Antonucci
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Stefano Cristallini
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Jason A Roberts
- Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, QLD, Australia; Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Marjorie Beumier
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Sabino Scolletta
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Frédérique Jacobs
- Department of Infectious Diseases, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Benoit Rondelet
- Department of Thoracic Surgery, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Daniel de Backer
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Jean-Louis Vincent
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium
| | - Fabio Silvio Taccone
- Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Brussels, Belgium.
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21
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Verleden S, Vasilescu D, Willems S, Ruttens D, Vos R, Vandermeulen E, Mcdonough J, Verbeken E, Verschakelen J, Van Raemdonck D, Rondelet B, Knoop C, Decramer M, Cooper J, Hogg J, Hostens J, Verleden G, Vanaudenaerde B. Airway Alterations in Chronic Lung Allograft Dysfunction. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.316] [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: 10/25/2022] Open
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22
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Makanga M, Dewachter C, Maruyama H, Vuckovic A, Rondelet B, Naeije R, Dewachter L. Downregulated bone morphogenetic protein signaling in nitrofen-induced congenital diaphragmatic hernia. Pediatr Surg Int 2013; 29:823-34. [PMID: 23832098 DOI: 10.1007/s00383-013-3340-6] [Citation(s) in RCA: 14] [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] [Accepted: 06/24/2013] [Indexed: 12/14/2022]
Abstract
PURPOSE Bone morphogenetic proteins (BMP) have been shown to play crucial roles in not only lung and heart development, but also in the pathogenesis of pulmonary vascular remodeling in pulmonary hypertension (PH). We therefore hypothesized that BMP signaling could be altered in nitrofen-induced congenital diaphragmatic hernia (CDH) and associated PH. METHODS Pregnant rats were exposed to either 100 mg nitrofen or vehicle on embryonic day (E) 9.5. On E17 and E21, fetuses were delivered by cesarean section, killed and checked for left-sided CDH. The tissue was then harvested for pathobiological evaluation. RESULTS In nitrofen-induced CDH, pulmonary expressions of BMP4, BMP receptor (BMPR) type 2 and Id1 decreased on E17 and E21. On E17, pulmonary gremlin-1 expression increased, while BMP7 decreased. In the lungs, Id1 expression was correlated to BMP4 and BMPR2 and inversely correlated to gremlin-1 expression. Myocardial expressions of BMPR2, BMPR1A, BMP7 and SERCA-2A decreased, while gremlin-1 and noggin expressions increased on E17. On E21, myocardial expressions of Id1 and SERCA-2A decreased, while gremlin-1 expression increased. Moreover, BMPR2 and BMPR1A expressions were correlated to SERCA-2A expression and inversely correlated to pro-apoptotic Bax/Bcl2 ratio within the myocardium. CONCLUSION Downregulation of BMP signaling seems to contribute to pulmonary and myocardial anomalies observed in nitrofen-induced CDH.
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Affiliation(s)
- Martine Makanga
- Laboratory of Physiology and Physiopathology, Faculty of Medicine, Université Libre de Bruxelles, 808, Lennik Road, 1070, Brussels, Belgium
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23
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Verleden S, Vasilescu D, Willems S, Ruttens D, Vandermeulen E, Vaneylen A, Van Raemdonck D, Vos R, Mcdonough J, Verbeken E, Verschaekelen J, Rondelet B, Knoop C, Cooper J, Decraemer M, Hogg J, Verleden G, Vanaudenaerde B. New Insights in Bronchiolitis Obliterans Syndrome after Lung Transplantation Using (micro-)CT. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.1025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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24
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Taccone FS, Fagnoul D, Rondelet B, Vincent JL, de Backer D. Cerebral oximetry during extracorporeal cardiopulmonary resuscitation. Crit Care 2013; 17:409. [PMID: 23356515 PMCID: PMC4056022 DOI: 10.1186/cc11929] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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25
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Belhaj A, Knoop C, Dumonceaux M, Estenne M, Rondelet B. 300 Lung transplantation in cystic fibrosis with donation from non-heart-beating donors: early transplant outcomes in a single centre. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60468-8] [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: 10/28/2022]
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26
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Hombrouck A, Lemy A, Dumonceaux M, Estenne M, Belhaj A, Rondelet B, Thomas I, Knoop C. 273 Seroconversion and Safety of H1N1 Vaccination in Lung Transplant Recipients: Data from the Brussels Lung Transplant Group. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.280] [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: 10/28/2022] Open
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27
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Rondelet B, Dewachter C, Kerbaul F, Kang X, Fesler P, Brimioulle S, Naeije R, Dewachter L. Prolonged overcirculation-induced pulmonary arterial hypertension as a cause of right ventricular failure. Eur Heart J 2011; 33:1017-26. [PMID: 21606077 DOI: 10.1093/eurheartj/ehr111] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [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: 02/01/2023] Open
Abstract
AIMS Three-month chronic systemic-to-pulmonary shunting in growing piglets has been reported as an early pulmonary arterial hypertension (PAH) model with preserved right ventricular (RV) function. We sought to determine whether prolonged shunting might be associated with more severe PAH and RV failure. METHODS AND RESULTS Fourteen growing piglets were randomized to a sham operation or the anastomosis of the left innominate artery to the pulmonary arterial trunk. Six months later, the shunt was closed and the animals underwent haemodynamic evaluation followed by tissue sampling for pathobiological assessment. Prolonged shunting had resulted in increased mean pulmonary artery pressure (22 ± 2 versus 17 ± 1 mmHg) and pulmonary arteriolar medial thickness, while cardiac output was decreased. However, RV-arterial coupling was markedly deteriorated, with a ~50% decrease in the ratio of end-systolic to pulmonary arterial elastances (Ees/Ea). Lung tissue expressions of endothelin-1, angiopoietin-1, and bone morphogenetic protein receptor-2 were similarly altered compared with previously observed after 3-month shunting. At the RV tissue level, pro-apoptotic ratio of Bax-to-Bcl-2 expressions and caspase-3 activation were increased, along with an increase in cardiomyocyte size, while expressions in voltage-gated potassium channels (Kv1.5 and Kv2.1) and angiogenic factors (angiopoietin-2 and vascular endothelial growth factor) were decreased. Right ventricular expressions of pro-inflammatory cytokines [interleukin (IL)-1α, IL-1β, tumour necrosis factor-α (TNF-α)] and natriuretic peptide precursors (NPPA and NPPB) were increased. There was an inverse correlation between RV Ees/Ea and pro-apoptotic Bax/Bcl-2 ratios. CONCLUSIONS Prolonged left-to-right shunting in piglets does not further aggravate pulmonary vasculopathy, but is a cause of RV failure, which appears related to an activation of apoptosis and inflammation.
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Affiliation(s)
- Benoit Rondelet
- Physiology Laboratory, Faculty of Medicine, Université Libre de Bruxelles, 808 Lennik Road, 1070 Brussels, Belgium
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28
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Ouazzani A, Sokolow Y, Hanebaly M, Rondelet B, Patino MR, Remmelink M, Jacobovitz D, Cappello M, Cogan E. [Pulmonary granulomatous necrotizing vasculitis: an extra-intestinal manifestation of ulcerative colitis or Wegener's granulomatosis?]. Rev Med Brux 2011; 32:93-97. [PMID: 21688593] [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: 05/30/2023]
Abstract
Respiratory symptoms are rare manifestations of ulcerative colitis as well as intestinal manifestations in Wegener granulomatosis. We report the case of a 17-year old man previously diagnosed as having ulcerative colitis who presented with diffuse thoracic pain. Hypermetabolic pulmonary nodules were discovered at the positron emission tomographic scan. Necrotizing granulomatous vasculitis was demonstrated at lung biopsy. In this paper, we describe the association between pulmonary nodules and ulcerative colitis and we discuss the possibility of an overlap syndrome between ulcerative colitis and Wegener granulomatosis.
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Affiliation(s)
- A Ouazzani
- Services de Chirurgie Thoracique, Hôpital Erasme, Bruxelles.
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29
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Rondelet B, Dewachter L, Kerbaul F, Dewachter C, Hubloue I, Fesler P, Franck S, Remmelink M, Brimioulle S, Naeije R. Sildenafil added to sitaxsentan in overcirculation-induced pulmonary arterial hypertension. Am J Physiol Heart Circ Physiol 2010; 299:H1118-23. [DOI: 10.1152/ajpheart.00418.2010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [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: 11/22/2022]
Abstract
Experimental left-to-right shunt-induced pulmonary arterial hypertension (PAH) can be partially prevented by the endothelin-A receptor blocker sitaxsentan or by the phosphodiesterase-5 inhibitor sildenafil. We hypothesized that the combined administration of these drugs would completely prevent shunt-induced PAH, arguing in favor of a major role of endothelial dysfunction in the initiation of the disease. Twenty-four 3-wk-old piglets were randomized to a sham operation or to placebo, sitaxsentan therapy, or sitaxsentan combined with sildenafil after the anastomosis of the left subclavian artery to the pulmonary arterial trunk. Three months later, the animals underwent a hemodynamic evaluation, followed by pulmonary tissue sampling for morphometry and quantitative real-time PCR for endothelin-1, angiopoietin-1, and bone morphogenetic protein receptor (BMPR) signaling molecules. Three months of left-to-right shunting induced an increase in pulmonary vascular resistance (PVR) and medial thickness, an overexpression of endothelin-1, and angiopoietin-1 and decreased expressions of BMPR-2 and BMPR-1A. Sitaxsentan partially prevented a shunt-induced increase in PVR, medial thickness, and associated biological disturbances. Sildenafil combined with sitaxsentan normalized PVR, medial thickness, and the expression of endothelin-1. However, the expression of angiopoietin-1 remained increased, and the expressions of BMPR-1A and BMPR-2 were incompletely returned to normal. The coupling of right ventricular end-systolic to arterial elastances was maintained in all circumstances. Sitaxsentan combined with sildenafil prevents shunt-induced PAH more effectively than sitaxsentan alone, suggesting a major role for the targeted signaling pathways in the initiation of the disease. Sitaxsentan alone or combined with sildenafil did not affect right ventricular function.
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Affiliation(s)
- Benoit Rondelet
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
- Heart and Lung Transplantation Unit, Departments of Cardiac and Thoracic Surgery, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Laurence Dewachter
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
| | - François Kerbaul
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
- Department of Anesthesiology and Critical Care, Hôpital La Timone, Marseille, France
| | - Céline Dewachter
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
| | - Ives Hubloue
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
- Department of Emergency, Academisch Ziekenhuis, Vrije Universiteit Brussels, Brussels, Belgium
| | - Pierre Fesler
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
- Department of Internal Medicine, Hôpital Lapeyronie, Montpellier, France
| | - Stephane Franck
- Department of Critical Care, Hôpital Tivoli, Université Libre de Bruxelles, La Louvière, Belgium
| | - Myriam Remmelink
- Department of Pathology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Serge Brimioulle
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
- Department of Critical Care, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Robert Naeije
- Laboratory of Physiology, Faculté de Médecine, Université Libre de Bruxelles, Brussels, Belgium
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30
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Knoop C, Dumonceaux M, Rondelet B, Estenne M. Complications de la transplantation pulmonaire : complications médicales. Rev Mal Respir 2010; 27:365-82. [DOI: 10.1016/j.rmr.2010.02.009] [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] [Subscribe] [Scholar Register] [Received: 11/29/2009] [Accepted: 12/16/2009] [Indexed: 02/06/2023]
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31
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Knoop C, Rondelet B, Dumonceaux M, Estenne M. [Medical complications of lung transplantation]. Rev Pneumol Clin 2010; 67:28-49. [PMID: 21353971 DOI: 10.1016/j.pneumo.2010.08.002] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Accepted: 08/15/2010] [Indexed: 05/30/2023]
Abstract
In 2010, lung transplantation is a valuable therapeutic option for a number of patients suffering from of end-stage non-neoplastic pulmonary diseases. The patients frequently regain a very good quality of life, however, long-term survival is often hampered by the development of complications such as the bronchiolitis obliterans syndrome, metabolic and infectious complications. As the bronchiolitis obliterans syndrome is the first cause of death in the medium and long term, an intense immunosuppressive treatment is maintained for life in order to prevent or stabilize this complication. The immunosuppression on the other hand induces a number of potentially severe complications including metabolic complications, infections and malignancies. The most frequent metabolic complications are arterial hypertension, chronic renal insufficiency, diabetes, hyperlipidemia and osteoporosis. Bacterial, viral and fungal infections are the second cause of mortality. They are to be considered as medical emergencies and require urgent assessment and targeted therapy after microbiologic specimens have been obtained. They should not, under any circumstances, be treated empirically and it has also to be kept in mind that the lung transplant recipient may present several concomitant infections. The most frequent malignancies are skin cancers, the post-transplant lymphoproliferative disorders, Kaposi's sarcoma and some types of bronchogenic carcinomas, head/neck and digestive cancers. Lung transplantation is no longer an exceptional procedure; thus, the pulmonologist will be confronted with such patients and should be able to recognize the symptoms and signs of the principal non-surgical complications. The goal of this review is to give a general overview of the most frequently encountered complications. Their assessment and treatment, though, will most often require the input of other specialists and a multidisciplinary and transversal approach.
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Affiliation(s)
- C Knoop
- Unité de transplantation cardiaque et pulmonaire (UTCP), service de pneumologie, hôpital universitaire Érasme, Bruxelles, Belgique.
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Dewachter C, Dewachter L, Rondelet B, Fesler P, Brimioulle S, Kerbaul F, Naeije R. Activation of apoptotic pathways in experimental acute afterload-induced right ventricular failure. Crit Care 2010. [PMCID: PMC2934498 DOI: 10.1186/cc8365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Dumonceaux M, Knoop C, Rondelet B, Estenne M. Complications de la transplantation pulmonaire : complications péri-opératoires, rejet aigu et chronique. Rev Mal Respir 2009. [DOI: 10.1016/s0761-8425(09)74717-5] [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: 10/20/2022]
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Dumonceaux M, Knoop C, Rondelet B, Estenne M. Complications de la transplantation pulmonaire : complications péri-opératoires, rejet aigu et chronique. Rev Mal Respir 2009; 26:639-53. [DOI: 10.1016/s0761-8425(09)74694-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dumonceaux M, Knoop C, Rondelet B, Estenne M. Complications de la transplantation pulmonaire : complications péri-opératoires, rejet aigu et chronique. Rev Mal Respir 2009. [DOI: 10.1016/s0761-8425(09)74709-6] [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: 10/20/2022]
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Cabaton J, Rondelet B, Gergele L, Besnard C, Piriou V. [Tako-Tsubo syndrome after anaphylaxis caused by succinylcholine during general anaesthesia]. ACTA ACUST UNITED AC 2008; 27:854-7. [PMID: 18829243 DOI: 10.1016/j.annfar.2008.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Accepted: 08/05/2008] [Indexed: 11/15/2022]
Abstract
The Tako-Tsubo syndrome (or transient left ventricular apical balloning) is a new clinical entity, very similar to acute myocardial infarction, but different by its excellent short-term prognosis. It has been reported after a physical or an emotional stress, and it is diagnosed by a coronary angiogram and a left ventriculography. We report here a case of Tako-Tsubo syndrome related to an anaphylactic shock caused by succinylcholine during general anaesthesia of a female patient, wearing an unadjustable gastric band.
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Affiliation(s)
- J Cabaton
- Service d'anesthésie-réanimation, centre hospitalier Lyon-Sud, chemin du Petit-Revoyer, 69495 Pierre-Bénite cedex, France
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Estenne M, Kienzl D, Knoop C, Rondelet B, Dumonceaux M, Jaksch P, Klepetko W, Bankier A. 51: Effects of Native Lung Physiology (Obstructive vs. Restrictive) on Graft Volume after Single-Lung Transplantation (SLT). J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.056] [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: 10/22/2022] Open
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Rondelet B, Kerbaul F, Vivian GF, Hubloue I, Huez S, Fesler P, Remmelink M, Brimiouille S, Salmon I, Naeije R. Sitaxsentan for the prevention of experimental shunt-induced pulmonary hypertension. Pediatr Res 2007; 61:284-8. [PMID: 17314684 DOI: 10.1203/pdr.0b013e318030d169] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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] [Indexed: 11/06/2022]
Abstract
We previously reported on the partial prevention of experimental shunt-induced pulmonary arterial hypertension (PAH) by the nonselective endothelin (ET) ET-A/ET-B receptor antagonist bosentan. As the respective roles of the ET-A and ET-B receptor signaling in the pathobiology of the disease remain undefined, we investigated the effects of selective ET-A receptor blockade by sitaxsentan in the same early stage PAH model. Twenty-one 3-wk-old piglets were randomized to placebo or sitaxsentan therapy (1.5 mg/kg/d), after anastomosis of the left subclavian artery to the pulmonary arterial trunk or after a sham operation. Three months later, the animals underwent a hemodynamic evaluation, followed by pulmonary tissue sampling for morphometry and real-time-quantitative-PCR for ET-1, angiopoietin-1, and bone morphogenetic receptor (BMPR) signaling molecules. Three months of left to right shunting induced an increase in pulmonary vascular resistance (PVR) and medial thickness, an overexpression of ET-1, ET-B receptor, and angiopoietin-1, and a decreased expression of BMPR-2 and BMPR-1A. Pretreatment with sitaxsentan prevented shunt-induced increase in PVR and decreased medial thickness by 64%. Sitaxsentan therapy completely prevented the decreased expression of BMPR-2 and limited the overexpression of ET-1, ET-B and angiopoietin-1, and the decreased expression of BMPR-1A. In conclusion, selective ET-A receptor blockade partially prevents shunt-induced PAH.
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Affiliation(s)
- Benoit Rondelet
- Laboratory of Physiology, Department of Cardiac Surgery, Hôpital Erasme, Université Libre de B-1070 Bruxelles, Belgium.
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Abstract
Sildenafil has been shown to be an effective treatment of pulmonary arterial hypertension and is believed to present with pulmonary selectivity. This study was designed to determine the site of action of sildenafil compared with inhaled nitric oxide (NO) and intravenous sodium nitroprusside (SNP), known as selective and nonselective pulmonary vasodilators, respectively. Inhaled NO (40 ppm), and maximum tolerated doses of intravenous SNP and sildenafil, (5 microg x kg(-1) x min(-1) and 0.1 mg x kg(-1) x h(-1)), respectively, were administered to eight dogs ventilated in hypoxia. Pulmonary vascular resistance (PVR) was evaluated by pulmonary arterial pressure (Ppa) minus left atrial pressure (Pla) vs. flow curves, and partitioned into arterial and venous segments by the occlusion method. Right ventricular hydraulic load was defined by pulmonary arterial characteristic impedance (Zc) and elastance (Ea) calculations. Right ventricular arterial coupling was estimated by the ratio of end-systolic elastance (Ees) to Ea. Decreasing the inspired oxygen fraction from 0.4 to 0.1 increased Ppa - Pla at a standardized flow of 3 l x min(-1) x m(-2) from 6 +/- 1 to 18 +/- 1 mmHg (mean +/- SE). Ppa - Pla was decreased to 9 +/- 1 by inhaled NO, 14 +/- 1 by SNP, and 14 +/- 1 mmHg by sildenafil. The partition of PVR, Zc, Ea, and Ees/Ea was not affected by the three interventions. Inhaled NO did not affect systemic arterial pressure, which was similarly decreased by sildenafil and SNP, from 115 +/- 4 to 101 +/- 4 and 98 +/- 5 mmHg, respectively. We conclude that inhaled NO inhibits hypoxic pulmonary vasoconstriction more effectively than sildenafil or SNP, and sildenafil shows no more selectivity for the pulmonary circulation than SNP.
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Affiliation(s)
- Pierre Fesler
- Department of Internal Medicine, Hôpital Lapeyronie, Montpellier, France
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Haccuria A, Knoop C, Magro C, Knight D, Waldman J, Pope-Harman A, Dumonceaux M, Remmelink M, Rondelet B, Vachiéry J, Estenne M. 412. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kerbaul F, Rondelet B, Collart F, Naeije R, Gouin F. Hypertension artérielle pulmonaire en anesthésie–réanimation. ACTA ACUST UNITED AC 2005; 24:528-40. [PMID: 15904732 DOI: 10.1016/j.annfar.2005.02.022] [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: 06/09/2004] [Accepted: 02/22/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To review the perioperative anaesthetic management of pulmonary arterial hypertension. DATA SOURCES Extraction from Pubmed database of French and English articles on the perioperative anaesthetic management of pulmonary hypertension for 9 years. DATA SELECTION The collected articles were reviewed and selected according their quality and originality. The more recent data were selected. DATA SYNTHESIS Pulmonary arterial hypertension is classically divided in primary and secondary. Primary pulmonary hypertension (familial and sporadic) is relatively severe and rare. Muscularization of the terminal portion of the pulmonary vascular arterial tree, caused by smooth muscle cell hyperplasia is the first change. Pulmonary arterial hypertension linked with disorders of the respiratory system and hypoxemia or pulmonary venous hypertension including mitral valve disease and chronic left ventricular dysfunction are often associated with high morbidity and mortality. The main consequence of pulmonary hypertension development is the occurrence of right-sided circulatory failure. A better understanding of disease pathophysiology will contribute to the development of new therapies increasing then the prognosis of these patients. The management of primary pulmonary hypertension or secondary pulmonary arterial hypertension is a challenge for the anaesthesiologist because the risk of right ventricular failure is markedly increased.
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MESH Headings
- Anesthesia/methods
- Anesthetics/pharmacology
- Case Management
- Critical Care/methods
- Echocardiography, Doppler
- Heart Failure/etiology
- Humans
- Hypertension, Pulmonary/epidemiology
- Hypertension, Pulmonary/etiology
- Hypertension, Pulmonary/physiopathology
- Hypertension, Pulmonary/therapy
- Intraoperative Complications/prevention & control
- Intraoperative Complications/therapy
- Middle Aged
- Mitral Valve Insufficiency/complications
- Mitral Valve Insufficiency/physiopathology
- Nitric Oxide/physiology
- Oxygen/administration & dosage
- Oxygen/therapeutic use
- Preanesthetic Medication
- Pulmonary Circulation/drug effects
- Pulmonary Disease, Chronic Obstructive/complications
- Respiration, Artificial/methods
- Vascular Resistance
- Vasodilator Agents/pharmacology
- Vasodilator Agents/therapeutic use
- Ventricular Dysfunction, Left/complications
- Ventricular Dysfunction, Left/physiopathology
- Ventricular Dysfunction, Right/etiology
- Ventricular Function, Left/drug effects
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Affiliation(s)
- F Kerbaul
- Département d'anesthésie-réanimation adultes, CHU de La Timone, 126 rue saint-Pierre, 13385 Marseille cedex 5, France.
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Rondelet B, Kerbaul F, Van Beneden R, Motte S, Fesler P, Hubloue I, Remmelink M, Brimioulle S, Salmon I, Ketelslegers JM, Naeije R. Signaling Molecules in Overcirculation-Induced Pulmonary Hypertension in Piglets. Circulation 2004; 110:2220-5. [PMID: 15466636 DOI: 10.1161/01.cir.0000143836.40431.f5] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [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] [Indexed: 11/16/2022]
Abstract
Background—
The phosphodiesterase type-5 (PDE-5) inhibitor sildenafil has been reported to improve pulmonary arterial hypertension (PAH), but the mechanisms that account for this effect are incompletely understood. Severe pulmonary hypertension has been characterized by defects in a signaling pathway involving angiopoietin-1 and the bone morphogenetic receptor-2 (BMPR-2). We investigated the effects of sildenafil on hemodynamics and signaling molecules in a piglet overcirculation-induced model of early PAH.
Methods and Results—
Thirty 3-week-old piglets were randomized to placebo or sildenafil therapy 0.75 mg/kg TID after anastomosis of the left subclavian artery to the pulmonary arterial trunk or after a sham operation. Three months later, the animals underwent a hemodynamic evaluation followed by pulmonary tissue sampling for morphometry, immunohistochemistry or radioimmunoassay, and real-time quantitative-polymerase chain reaction. Chronic systemic-to-pulmonary shunting increased pulmonary mRNA for angiopoietin-1, endothelin-1 (ET-1), angiotensin II, inducible nitric oxide synthase, vascular endothelial growth factor, and PDE-5. Pulmonary messenger RNA for BMPR-1A and BMPR-2 decreased. Pulmonary angiotensin II, ET-1, and vascular endothelial growth factor proteins increased. Pulmonary artery pressure increased from 20±2 to 33±1 mm Hg, and arteriolar medial thickness increased by 91%. The expressions of angiopoietin-1, ET-1, and angiotensin II were tightly correlated to pulmonary hypertension. Sildenafil prevented the increase in pulmonary artery pressure, limited the increase in medial thickness to 41%, and corrected associated biological perturbations except for the angiopoietin-1/BMPR-2 pathway, PDE-5, and angiotensin II.
Conclusions—
Sildenafil partially prevents overcirculation-induced PAH and associated changes in signaling molecules. Angiotensin II, PDE-5, and angiopoietin-1/BMPR-2 signaling may play a dominant role in the early stages of the disease.
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MESH Headings
- 3',5'-Cyclic-GMP Phosphodiesterases
- Anastomosis, Surgical/adverse effects
- Angiopoietin-1/biosynthesis
- Angiopoietin-1/genetics
- Angiopoietin-1/physiology
- Angiotensin II/biosynthesis
- Angiotensin II/genetics
- Animals
- Arterioles/ultrastructure
- Bone Morphogenetic Protein Receptors, Type I
- Bone Morphogenetic Protein Receptors, Type II
- Cyclic Nucleotide Phosphodiesterases, Type 5
- Drug Evaluation, Preclinical
- Endothelin-1/biosynthesis
- Endothelin-1/genetics
- Gene Expression Regulation/drug effects
- Hyperplasia
- Hypertension, Pulmonary/etiology
- Hypertension, Pulmonary/metabolism
- Hypertension, Pulmonary/prevention & control
- Models, Animal
- Nitric Oxide Synthase/biosynthesis
- Nitric Oxide Synthase/genetics
- Nitric Oxide Synthase Type II
- Phosphodiesterase Inhibitors/pharmacology
- Phosphodiesterase Inhibitors/therapeutic use
- Phosphoric Diester Hydrolases/biosynthesis
- Phosphoric Diester Hydrolases/drug effects
- Phosphoric Diester Hydrolases/genetics
- Piperazines/pharmacology
- Piperazines/therapeutic use
- Protein Serine-Threonine Kinases/biosynthesis
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/physiology
- Pulmonary Artery/surgery
- Purines
- RNA, Messenger/biosynthesis
- Random Allocation
- Receptors, Growth Factor/biosynthesis
- Receptors, Growth Factor/genetics
- Signal Transduction/drug effects
- Sildenafil Citrate
- Subclavian Artery/surgery
- Sulfones
- Sus scrofa
- Vascular Endothelial Growth Factor A/biosynthesis
- Vascular Endothelial Growth Factor A/genetics
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Affiliation(s)
- Benoit Rondelet
- Laboratory of Physiology, Faculty of Medicine, Free University Brussels, Belgium
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Rondelet B, Van Beneden R, Kerbaul F, Motte S, Fesler P, McEntee K, Brimioulle S, Ketelslegers JM, Naeije R. Expression of the serotonin 1b receptor in experimental pulmonary hypertension. Eur Respir J 2004; 22:408-12. [PMID: 14516127 DOI: 10.1183/09031936.03.00036203] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [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: 11/05/2022]
Abstract
The pathogenesis of pulmonary arterial hypertension (PAH) remains uncertain. Both the serotonin and endothelin (ET) systems are believed to be involved. Recent studies pointed to the importance of the serotonin 2B receptor as a limiting step. The current authors investigated the lung tissue expression of serotonin receptors and of the serotonin transporter (5-HTT) by real-time-quantitative polymerase chain reaction in chronic overcirculation-induced PAH in growing piglets, with and without treatment with the dual ET receptor blocker bosentan. Pulmonary haemodynamic changes were described by pulmonary arterial impedance spectra. Three months after the surgical anastomosis of the left subclavian artery to the pulmonary arterial trunk, there was a shift of the impedance spectra to higher ratios of pressure and flow moduli, with increases in both 0 Hz impedance and characteristic impedance, and these changes were completely prevented by bosentan therapy. There was an increase in the expression of the serotonin 1B receptor. There was no change in the expression of the 5-HTT, and of the serotonin 2B, 1D, and 4 receptors. The overexpression of the serotonin 1B receptor was partially prevented by bosentan therapy. The present authors conclude that this early pulmonary arterial hypertension model is characterised by an endothelin receptor-dependent increased expression of the serotonin 1B receptor.
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Affiliation(s)
- B Rondelet
- Laboratory of Physiology, Free University of Brussels, Brussels, Belgium
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Motte S, van Beneden R, Mottet J, Rondelet B, Mathieu M, Havaux X, Lause P, Clercx C, Ketelslegers JM, Naeije R, McEntee K. Early activation of cardiac and renal endothelin systems in experimental heart failure. Am J Physiol Heart Circ Physiol 2003; 285:H2482-91. [PMID: 14613913 DOI: 10.1152/ajpheart.00419.2003] [Citation(s) in RCA: 25] [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] [Indexed: 11/22/2022]
Abstract
We investigated the time course of the expression of cardiac and renal endothelin systems in tachycardia-induced heart failure in dogs. Eleven beagles underwent rapid pacing at a progressively increased rate over a period of 5 wk, with a weekly clinical examination, echocardiography, measurement of circulating and urinary endothelin-1 (ET-1), and myocardial and renal tissue biopsies. Real-time quantitative PCR was used for determinations of tissue prepro-ET-1 (ppET-1), ET-1-converting enzyme (ECE-1), and ETA and ETB receptor mRNA. Cardiac and renal tissue ET-1 contents were evaluated by immunostaining and measured by radioimmunoassay at autopsy. Rapid pacing caused a progressive increase in end-systolic and end-diastolic ventricular volumes (P < 0.05) from week 2 together with a decrease in ejection fraction and in mean velocity of circumferential shortening (P < 0.05) from week 1. These changes were tightly correlated to myocardial ppET-1 and renal ETA receptor mRNA and less so to myocardial ECE-1 mRNA, and they occurred before any increase in plasma and urinary ET-1 (P < 0.05 from week 4) and clinical signs of heart failure. Renal ppET-1 did not change. Both cardiac and renal ET-1 peptide contents were increased at autopsy. We conclude that tachycardia-induced heart failure in dogs is characterized by an early activation of the cardiac and renal tissue endothelin systems, which occurs before any changes in circulating and urinary ET-1 and is closely related to altered ventricular function.
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Affiliation(s)
- Sophie Motte
- Laboratory of Physiology, Faculty of Medicine, Free University of Brussels, Brussels B-1070, Belgium
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De Smet JM, Rondelet B, Jansens JL, De Canniere D, Antoine M, Le Clerc JL. Conversion from ministernotomy to full sternotomy in aortic valve replacement. Heart Surg Forum 2003; 5 Suppl 4:S296-300. [PMID: 12759204] [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] [Accepted: 06/27/2001] [Indexed: 03/02/2023]
Abstract
Conversion (C) from ministernotomy (M.S.) to full sternotomy was necessary in 5% of the cases in a series of 100 patients consecutively operated for Aortic Valve Replacement (A.V.R.) Analysis of the demographics and surgical techniques indicate older age, aortic fragility, diffuse coronary disease, chronic renal failure and left vent insertion as contributing factors. Despite increased operative blood losses, extra-corporeal circulation (E.C.C.) times, intensive care unit (I.C.U.) stay and hospital stay, no mortality was observed in the conversion group, as compared to 4.2% mortality in the total ministernotomy (MS) population. Preoperative patients selection, avoidance of technical pitfalls, and knowledge of alternative surgical measures are suggested to further decrease the incidence of conversions.
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Affiliation(s)
- J M De Smet
- Service of Cardiac Surgery, C.U.B. Hospital Erasme, University of Brussels Belgium
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Abstract
Cervical spine motion was investigated by three-dimensional electrogoniometry in 257 asymptomatic volunteers and in 32 patients with cervical disc hernia or whiplash syndrome. Maximal ranges of main and coupled motions were considered. Motion curves were analysed qualitatively and using fitting of sixth degree polynomials. Motion ranges obtained were in agreement with previous observations. Significant differences between patients and volunteers concerned several primary and coupled components but not all. Qualitatively, patients displayed less harmonic curves, with irregularities and plateau-like appearances. Root mean square differences between data and fit were significantly modified in patients. Although cervical spine motion ranges may remain within normal limits in patients, motion patterns were altered qualitatively and quantitatively. Motion pattern analysis might prove a useful discrimination parameter in patients in whom anatomical lesions are not clearly identifiable.
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Affiliation(s)
- V. Feipel
- />Laboratory for Functional Anatomy, University of Brussels, CP 619; 808, Route de Lennik, B-1070 Brussels, Belgium Tel: +32-2-555-6329; Fax: +32-2-555-6378; e-mail: , , , , BE
| | - B. Rondelet
- />Laboratory for Functional Anatomy, University of Brussels, CP 619; 808, Route de Lennik, B-1070 Brussels, Belgium Tel: +32-2-555-6329; Fax: +32-2-555-6378; e-mail: , , , , BE
| | - J. P. LePallec
- />Laboratory for Functional Anatomy, University of Brussels, CP 619; 808, Route de Lennik, B-1070 Brussels, Belgium Tel: +32-2-555-6329; Fax: +32-2-555-6378; e-mail: , , , , BE
| | - O. DeWitte
- />Department of Neurosurgery, Erasme University Hospital, University of Brussels, Brussels, Belgium, , , , BE
| | - M. Rooze
- />Laboratory for Functional Anatomy, University of Brussels, CP 619; 808, Route de Lennik, B-1070 Brussels, Belgium Tel: +32-2-555-6329; Fax: +32-2-555-6378; e-mail: , , , , BE
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Abstract
OBJECTIVE Establishment of a normal database and clinical reference of active global cervical spine motion ranges and patterns using a commercial electrogoniometer. DESIGN Three-dimensional cervical motion ranges and patterns were analyzed in 250 asymptomatic volunteers. BACKGROUND In vivo out-of-plane motion patterns of the cervical spine have not yet been reported in large populations, but could be of clinical interest. METHODS In 250 subjects (aged 14-70 yr), motion range and patterns between the first thoracic vertebra and the head were analyzed for flexion-extension, lateral bending, rotation in neutral sagittal plane position and in full flexion using the CA 6000 Spine Motion Analyzer. RESULTS AND CONCLUSIONS Average motion range in the sagittal plane was 122 degrees (SD: 18 degrees ). Flexion was slightly more important than extension. Out-of-plane components were negligible. Global bending range averaged 88 degrees (SD: 16 degrees ), left and right bending being comparable. Homolateral rotation was associated to lateral bending. Its extent was approximately 40% of the bending range. Global rotation range in neutral sagittal plane position was 144 degrees (SD: 20 degrees ), without significant difference between right and left rotations. Associated motion components were small. During rotation in flexed head position, global range (134 degrees, SD: 24 degrees ) was comparable to the one in neutral flexion. But heterolateral bending, averaging 60% of the primary motion, was associated to flexed rotation. Significant reduction of all primary (but not conjunct) motions with age were obtained. Sex had no influence on cervical motion range. RELEVANCE Our results agreed with previous observations, validating the methodology used. They thus constitute reference data of cervical out-of-plane motion for clinical applications.
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Affiliation(s)
- V Feipel
- Laboratory for Functional Anatomy, University of Brussels, 808 route de Lennik (CP619), B-1070, Brussels, Belgium.
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49
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Feipel V, Rondelet B, Le Pallec J, Vogt F, Rooze M. Analysing motion patterns in the cervical and lumbar spine. A new discrimination parameter of pathology. J Biomech 1998. [DOI: 10.1016/s0021-9290(98)80240-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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