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Ambrosi P, Riberi A, Attarian S, Nguyen K, Guieu R, Habib G. Association of Plasma Creatinine Phosphokinase Elevation and a History of Idiopathic Cardiomyopathy in Recipients of Heart Transplant. Am J Cardiol 2024; 213:50-54. [PMID: 38110026 DOI: 10.1016/j.amjcard.2023.11.070] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 12/20/2023]
Abstract
Plasma creatinine phosphokinase (CPK) elevation is frequent after heart transplantation. In the present study, we tested the hypothesis that this CPK elevation is related to idiopathic cardiomyopathy as primary cardiac disease. We included 203 patients who survived >1 year after heart transplantation. Plasma CPK was measured every 4 months during a 15.1 ± 7.7-year follow-up. In univariate analysis, CPK elevation was significantly associated with age at transplantation, length of follow-up, treatment with everolimus, and idiopathic cardiomyopathy as primary cardiac disease. In multivariate analysis, idiopathic cardiomyopathy and length of follow-up were the only significant predictors of CPK elevation (p = 0.002 and p = 0.0001, respectively). A subgroup of 19 patients had frequent CPK elevation (>20% of the dosages). All these patients but 1 had an idiopathic cardiomyopathy as primary disease. In 5 of these 19 patients, we identified a syndrome known to affect both cardiac and skeletal muscles. In conclusion, underlying idiopathic cardiomyopathy is a major determinant of plasma CPK elevation after heart transplantation. Our results show that besides well-described syndromes associating skeletal and cardiac muscle disease, idiopathic cardiomyopathy may be associated with subclinical skeletal muscle myopathy.
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Affiliation(s)
- Pierre Ambrosi
- Cardiac Transplant Unit, Timone University Hospital, Aix-Marseille University, Marseille, France; Department of Cardiology, Timone University Hospital, Aix-Marseille University, Marseille, France.
| | - Alberto Riberi
- Department of Cardiac surgery, Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Shahram Attarian
- Reference Center for Neuromuscular Disorders and ALS, Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Karine Nguyen
- Department of Medical Genetics, Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Régis Guieu
- Department of Biochemistry, Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Gilbert Habib
- Department of Cardiology, Timone University Hospital, Aix-Marseille University, Marseille, France
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Ambrosi P, Habib G. Unanswered questions from the IRONMAN trial. Lancet 2023; 401:1494-1495. [PMID: 37149299 DOI: 10.1016/s0140-6736(23)00447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/27/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Pierre Ambrosi
- Department of Cardiology, La Timone Hospital, Aix-Marseille University, Marseille 13385, France.
| | - Gilbert Habib
- Department of Cardiology, La Timone Hospital, Aix-Marseille University, Marseille 13385, France
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Ambrosi P, Basire A, Habib G. High rate of seroconversion after COVID-19 vaccination during the long term follow-up of heart transplant recipients. Transpl Infect Dis 2022; 24:e13945. [PMID: 36039842 PMCID: PMC9539005 DOI: 10.1111/tid.13945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 07/30/2022] [Accepted: 08/04/2022] [Indexed: 01/14/2023]
Affiliation(s)
- Pierre Ambrosi
- Cardiac Transplant UnitLa Timone Hospital, Aix‐Marseille UniversityMarseilleFrance
| | - Agnès Basire
- France Immunogenetic LaboratoryEtablissement Francais du Sang Provence‐Alpes‐Côte d'Azur‐CorseMarseilleFrance
| | - Gilbert Habib
- Cardiac Transplant UnitLa Timone Hospital, Aix‐Marseille UniversityMarseilleFrance
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Oliver L, Leauthier M, Jamme M, Arregle F, Martel H, Philip M, Gouriet F, Casalta JP, Torras O, Casalta AC, Camoin-Jau L, Lavagna F, Renard S, Ambrosi P, Lepidi H, Collart F, Hubert S, Drancourt M, Raoult D, Riberi A, Habib G. Mitral valve repair is better than mitral valve replacement in native mitral valve endocarditis: Results from a prospective matched cohort. Arch Cardiovasc Dis 2022; 115:160-168. [DOI: 10.1016/j.acvd.2022.02.002] [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] [Received: 08/17/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/25/2022]
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Arregle F, Martel H, Philip M, Gouriet F, Casalta JP, Riberi A, Torras O, Casalta AC, Camoin-Jau L, Lavagna F, Renard S, Ambrosi P, Lepidi H, Collart F, Hubert S, Drancourt M, Raoult D, Habib G. Infective endocarditis with neurological complications: Delaying cardiac surgery is associated with worse outcome. Arch Cardiovasc Dis 2021; 114:527-536. [PMID: 33935000 DOI: 10.1016/j.acvd.2021.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/23/2021] [Accepted: 01/28/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Infective endocarditis (IE) is associated with a high mortality rate, related in part to neurological complications. Studies suggest that valvular surgery should be performed early when indicated, but is often delayed by the presence of neurological complications. AIM To assess the effect of delaying surgery in patients with IE and neurological complications and to identify factors predictive of death. METHODS In a prospective, single-centre study in a referral centre for IE, all patients with IE underwent systematic screening for neurological complications. The primary outcome was 6-month death. In patients presenting with neurological complications, the prognosis according to surgical status was analysed and a Cox regression model used to identify variables predictive of death. RESULTS Between April 2014 and January 2018, 351 patients with a definite diagnosis of left-sided IE were included. Ninety-four patients (26.8%) presented with at least one neurological complication. Fifty-nine patients (17.7%) died during 6-month follow-up. Six-month mortality rates did not differ significantly between patients with and without neurological complications (P=0.60). Forty patients had a temporary surgical contraindication because of neurological complications. During the period of surgical contraindication, seven of these patients (17.5%) died, six (15.0%) presented a new embolic event, and 12 (30.0%) presented cardiac or septic deterioration. In multivariable analysis, predictive factors of death in patients presenting with neurological complications were temporary surgical contraindication (hazard ratio 7.36, 95% confidence interval 1.61-33.67; P=0.010) and presence of a mechanical prosthetic valve (hazard ratio 16.40, 95% confidence interval 2.22-121.17; P=0.006). CONCLUSIONS Patients with a temporary surgical contraindication due to neurological complications had a higher risk of death and frequent major complications while waiting for surgery. When indicated, the decision to postpone surgery in the early phase should be weighed against the risk of infectious or cardiac deterioration.
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Affiliation(s)
- Florent Arregle
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | - Helene Martel
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | - Mary Philip
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | - Frederique Gouriet
- Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France
| | - Jean Paul Casalta
- Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France
| | - Alberto Riberi
- Department of Cardiac Surgery, La Timone Hospital, 13005 Marseille, France
| | - Olivier Torras
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | | | - Laurence Camoin-Jau
- Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France; Department of Hematology, La Timone Hospital, 13005 Marseille, France
| | - Flora Lavagna
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | - Sebastien Renard
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | - Pierre Ambrosi
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | - Hubert Lepidi
- Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France
| | - Frederic Collart
- Department of Cardiac Surgery, La Timone Hospital, 13005 Marseille, France
| | - Sandrine Hubert
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France
| | - Michel Drancourt
- Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France
| | - Didier Raoult
- Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France
| | - Gilbert Habib
- AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France; Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France.
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Martínez-Sellés M, Tattevin P, Valerio-Minero M, de Alarcón A, Fariñas MC, Mirabet-Pérez S, Lavie-Badie Y, Ambrosi P, Chabanne C, Duval X, Lecomte R, López-Vilella R, Uribarri A, Vinuesa D, Muñoz P. Infective endocarditis in patients with heart transplantation. Int J Cardiol 2020; 328:158-162. [PMID: 33309761 DOI: 10.1016/j.ijcard.2020.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/19/2020] [Accepted: 12/03/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND The incidence of nosocomial and health care-related infective endocarditis (IE) is increasing. Heart transplantation (HT) implies immunosuppression and frequent health care contact. Our aim was to describe the current profile and prognosis of IE in HT recipients. METHODS Multicenter retrospective registry-based study in Spain and France that included cases between 2008 and 2019. RESULTS During the study period, 8305 HT were performed in Spain and France. We identified 18 IE cases (rate 0.2%). Median age was 57 years; 12 were men (67%). Valve involvement did not have a predominant location and three patients (16.7%) had atrial or ventricular vegetations without valve involvement. The median age-adjusted Charlson index was 4 (interquartile range 3-5). Eleven IE cases (61%) were nosocomial/health care-related. Median time (range) between HT and development of IE was 43 months (interquartile range 6-104). The major pathogens were Staphylococcus sp. (n = 8, 44%), Enterococcus sp. (n = 4, 22%), and Aspergillus sp. (n = 3, 17%). Although eight patients (44%) had a surgical indication, it was only performed in three cases (17%). Three patients (17%) died during the first IE hospital admission. CONCLUSIONS IE in HT recipients has specific characteristics. Valve involvement does not have a predominant location and non-valvular involvement is common. Three fifths have a nosocomial/health care-related origin. The major pathogens were staphylococci (44%), enterococci (22%), and Aspergillus (17%). In-hospital mortality was 17%.
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Affiliation(s)
- Manuel Martínez-Sellés
- Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Facultad de Ciencias Biomédicas, Universidad Europea, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou Univ. Hosp., Rennes, France
| | - Maricela Valerio-Minero
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Arístides de Alarcón
- Clinical Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS),University of Seville/CSIC/University Hospital Virgen del Rocío, Seville, Spain
| | - M Carmen Fariñas
- Infectious Diseases Unit, Hospital Universitario Marqués de Valdecilla, University of Cantabria, Santander, Spain
| | - Sònia Mirabet-Pérez
- Unidad de Insuficiencia Cardíaca y Programa de Trasplante Cardiaco, Servicio de Cardiología, Hospital de Sant Pau, Barcelona, Spain
| | - Yoan Lavie-Badie
- Heart Valve Center, Toulouse University Hospital 1, Toulouse, Cedex 9, France
| | - Pierre Ambrosi
- Aix-Marseille Université and Department of Cardiology, Hôpital de la Timone, Marseille, France
| | | | - Xavier Duval
- Inserm CIC 1425. AP-H, University Hospital of Bichat, Inserm UMR-1137 IAME, University Paris Diderot, Paris 7, UFR de Médecine-Bichat, Paris, France
| | - Raphaël Lecomte
- Department of Infectious Diseases, CHU Hôtel-Dieu, Centre d'Investigation Clinique, Unité d'Investigation Clinique 1413 INSERM, CHU Nantes, Nantes, France
| | - Raquel López-Vilella
- Unidad de Insuficiencia Cardíaca y Trasplante, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Aitor Uribarri
- Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, CIBER-CV, Spain
| | - David Vinuesa
- Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Clínico San Cecilio, Granada, Spain
| | - Patricia Muñoz
- Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
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Essayagh B, Resseguier N, Michel N, Casalta AC, Renard S, Donghi V, Carbone A, Piazzai C, Ambrosi P, Levy F, Martel H, Gérard H, Avierinos JF, N'Guyen K, Habib G. Left atrial dysfunction as marker of poor outcome in patients with hypertrophic cardiomyopathy. Arch Cardiovasc Dis 2020; 114:96-104. [PMID: 33039326 DOI: 10.1016/j.acvd.2020.06.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/18/2020] [Accepted: 06/27/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND The incremental prognostic value of left atrial (LA) dysfunction, emerging in various clinical contexts, remains poorly explored in hypertrophic cardiomyopathy (HCM). OBJECTIVE To assess LA strain correlation with outcome in HCM. METHODS A cohort of all 307 consecutive patients presenting with HCM between 2007 and 2017 (54±17 years; 34% women), with comprehensive echocardiography at diagnosis and LA peak longitudinal strain (PALS) and LA peak contraction strain (PACS) measurement, was enrolled and occurrence of HCM related cardiac events analysed. RESULTS Clinically, atrial fibrillation (AF) was present in 13%, New York Heart Association functional class II-III in 54%, and B-type natriuretic peptide (BNP) concentration was 199±278pg/mL. By echocardiography, left ventricular (LV) ejection fraction (EF) was 67±10%, LV thickness 21±5mm and European Society of Cardiology HCM risk score 3±3%, with 109 patients (36%) presenting obstructive HCM (LV outflow gradient 21±32mmHg). LA diameter was 41±8mm [with 109 (36%) presenting LA diameter ≥40mm], LA volume index 50±26mL/m2, PALS 24±13%, PACS 11±7% and LA peak systolic strain rate (LASRs) 1.7±0.6 s-1. In addition to AF, age, BNP, LVEF and LV thickness were all independent determinants of lower PALS, with odd ratios almost unchanged after adjustment (all P ≤0.0004). At a mean follow-up of 21 (range 18-23) months, patients with adverse cardiac events (n=65) presented with more impaired LA function (all P ≤0.0005), with a significant association between impaired PALS and worse outcome, hazard ratio 0.94 [95% confidence interval (CI) 0.92-0.97, P<0.0001]. After comprehensive adjustment, PALS remained strongly associated with worse outcome, adjusted hazard ratio 0.86 (95% CI 0.79-0.94; P=0.0008). CONCLUSIONS The present study, by gathering a unique HCM cohort, suggests a strong link between LA dysfunction and poor outcome, to be further investigated.
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Affiliation(s)
- Benjamin Essayagh
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France; Cardiology Department, Simone Veil Hospital, 06400 Cannes, France
| | | | - Nicolas Michel
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | | | - Sébastien Renard
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | - Valeria Donghi
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | - Andreina Carbone
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | - Chiara Piazzai
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | - Pierre Ambrosi
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | - Franck Levy
- Cardiothoracic centre of Monaco, 98000 Monaco, Monaco
| | - Hélène Martel
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | - Hilla Gérard
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France
| | | | - Karine N'Guyen
- Département de génétique médicale, hôpital d'enfants de la Timone, AP-HM, 13005 Marseille, France; Faculté de médecine, Marseille Medical Genetics, Aix-Marseille University, INSERM, 13005 Marseille, France
| | - Gilbert Habib
- Cardiology Department, La Timone Hospital, AP-HM, 13005 Marseille, France; IHU-Méditerranée Infection, Aix-Marseille University, IRD, AP-HM, MEPHI, 13005 Marseille, France.
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Ambrosi P. Comment on "Epidemiological and clinical characteristics of heart transplant recipients during the 2019 coronavirus outbreak in Wuhan, China" by Ren et al. J Heart Lung Transplant 2020; 39:729. [PMID: 32299650 PMCID: PMC7151477 DOI: 10.1016/j.healun.2020.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Pierre Ambrosi
- Cardiac Transplant Unit, La Timone Hospital, Marseille, France; Laboratory of Therapeutics, Aix-Marseille University, Marseille, France.
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Ambrosi P, Daumas A, Villani P, Giorgi R. Glycosylated Hemoglobin as a Surrogate for the Prevention of Cardiovascular Events in Cardiovascular Outcome Trials Comparing New Antidiabetic Drugs to Placebo. Cardiology 2020; 145:370-374. [PMID: 32088710 DOI: 10.1159/000506004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/20/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND OBJECTIVES The value of glycosylated hemoglobin (HbA1c) as a surrogate marker for the prevention of cardiovascular outcomes on antidiabetic drugs is debated. The 2008 FDA guidance led to multiple large clinical trials to evaluate the effect of new antidiabetic drugs versus placebo on major adverse cardiac events (MACE). The aim of this study was to evaluate the relation between MACE and HbA1c decrease between antidiabetic drug and placebo across the spectrum of cardiovascular outcome trials (CVOT). METHODS In this systematic review, we included randomized controlled trials that compared an antidiabetic drug to placebo in addition to current standard of care with the primary intention of demonstrating cardiovascular safety. We investigated the relationship between MACE decrease on antidiabetic drug and HbA1c reduction on antidiabetic drug using the coefficient correlation. We also studied the effects of potential confounders on MACE decrease. RESULTS Fourteen eligible trials including 128,149 patients were included, 12,114 of whom experienced MACE. Mean achieved HbA1c absolute reductions on antidiabetic treatment versus placebo varied from 0.29 to 1%. The decrease of MACE on antidiabetic drug was significantly correlated with mean HbA1c reduction (r = 0.88, 95% CI: 0.67-0.96, p < 0.001) and weight loss (r = 0.81, 95% CI: 0.46-0.94, p < 0.001). In a bivariate model including weight loss, only HbA1c reduction remained significantly correlated with the decrease of MACE on antidiabetic drug (p = 0.019). CONCLUSION Across CVOT, the decrease in MACE incidence on various antidiabetic drugs is significantly correlated with HbA1c reduction. This meta-analysis supports HbA1c as an appropriate surrogate endpoint for cardiovascular events. Our analysis supports that changes in HbA1c should be taken into account while interpreting effects of new antidiabetic drugs on cardiovascular outcomes.
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Affiliation(s)
- Pierre Ambrosi
- Department of Therapeutics, Marseille, France, .,Department of Cardiology, Hôpital de la Timone, Marseille, France,
| | | | | | - Roch Giorgi
- Aix Marseille Univ, APHM, INSERM, IRD, SESSTIM, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Hop Timone, BioSTIC, Biostatistique et Technologies de l'Information et de la Communication, Marseille, France
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Ambrosi P, Daumas A, Villani P, Giorgi R. Authors’ Reply to the Letter by Shoar et al. on “Glycosylated Hemoglobin as a Surrogate for the Prevention of Cardiovascular Events in Cardiovascular Outcome Trials Comparing New Antidiabetic Drugs to Placebo”. Cardiology 2020; 145:387. [DOI: 10.1159/000507361] [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] [Received: 03/14/2020] [Accepted: 03/15/2020] [Indexed: 11/19/2022]
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Wahbi K, Ben Yaou R, Gandjbakhch E, Anselme F, Gossios T, Lakdawala NK, Stalens C, Sacher F, Babuty D, Trochu JN, Moubarak G, Savvatis K, Porcher R, Laforêt P, Fayssoil A, Marijon E, Stojkovic T, Béhin A, Leonard-Louis S, Sole G, Labombarda F, Richard P, Metay C, Quijano-Roy S, Dabaj I, Klug D, Vantyghem MC, Chevalier P, Ambrosi P, Salort E, Sadoul N, Waintraub X, Chikhaoui K, Mabo P, Combes N, Maury P, Sellal JM, Tedrow UB, Kalman JM, Vohra J, Androulakis AFA, Zeppenfeld K, Thompson T, Barnerias C, Bécane HM, Bieth E, Boccara F, Bonnet D, Bouhour F, Boulé S, Brehin AC, Chapon F, Cintas P, Cuisset JM, Davy JM, De Sandre-Giovannoli A, Demurger F, Desguerre I, Dieterich K, Durigneux J, Echaniz-Laguna A, Eschalier R, Ferreiro A, Ferrer X, Francannet C, Fradin M, Gaborit B, Gay A, Hagège A, Isapof A, Jeru I, Juntas Morales R, Lagrue E, Lamblin N, Lascols O, Laugel V, Lazarus A, Leturcq F, Levy N, Magot A, Manel V, Martins R, Mayer M, Mercier S, Meune C, Michaud M, Minot-Myhié MC, Muchir A, Nadaj-Pakleza A, Péréon Y, Petiot P, Petit F, Praline J, Rollin A, Sabouraud P, Sarret C, Schaeffer S, Taithe F, Tard C, Tiffreau V, Toutain A, Vatier C, Walther-Louvier U, Eymard B, Charron P, Vigouroux C, Bonne G, Kumar S, Elliott P, Duboc D. Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies. Circulation 2019; 140:293-302. [PMID: 31155932 DOI: 10.1161/circulationaha.118.039410] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND An accurate estimation of the risk of life-threatening (LT) ventricular tachyarrhythmia (VTA) in patients with LMNA mutations is crucial to select candidates for implantable cardioverter-defibrillator implantation. METHODS We included 839 adult patients with LMNA mutations, including 660 from a French nationwide registry in the development sample, and 179 from other countries, referred to 5 tertiary centers for cardiomyopathies, in the validation sample. LTVTA was defined as (1) sudden cardiac death or (2) implantable cardioverter defibrillator-treated or hemodynamically unstable VTA. The prognostic model was derived using the Fine-Gray regression model. The net reclassification was compared with current clinical practice guidelines. The results are presented as means (SD) or medians [interquartile range]. RESULTS We included 444 patients, 40.6 (14.1) years of age, in the derivation sample and 145 patients, 38.2 (15.0) years, in the validation sample, of whom 86 (19.3%) and 34 (23.4%) experienced LTVTA over 3.6 [1.0-7.2] and 5.1 [2.0-9.3] years of follow-up, respectively. Predictors of LTVTA in the derivation sample were: male sex, nonmissense LMNA mutation, first degree and higher atrioventricular block, nonsustained ventricular tachycardia, and left ventricular ejection fraction (https://lmna-risk-vta.fr). In the derivation sample, C-index (95% CI) of the model was 0.776 (0.711-0.842), and the calibration slope 0.827. In the external validation sample, the C-index was 0.800 (0.642-0.959), and the calibration slope was 1.082 (95% CI, 0.643-1.522). A 5-year estimated risk threshold ≥7% predicted 96.2% of LTVTA and net reclassified 28.8% of patients with LTVTA in comparison with the guidelines-based approach. CONCLUSIONS In comparison with the current standard of care, this risk prediction model for LTVTA in laminopathies significantly facilitated the choice of candidates for implantable cardioverter defibrillators. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT03058185.
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Affiliation(s)
- Karim Wahbi
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Centre de Référence de Pathologie Neuromusculaire Nord/Est/Ile de France, Paris-Descartes, Sorbonne Paris Cité University (K.W., D.D.).,INSERM Unit 970, Paris Cardiovascular Research Centre (PARCC), France (K.W., C. Stalens, E.J.)
| | - Rabah Ben Yaou
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.).,Sorbonne Universités, INSERM UMRS 974, CNRS, UMR-7215, Center for Research in Myology, Myology Institute,(R.B.Y., G.B.)
| | - Estelle Gandjbakhch
- APHP, Institute of Cardiology (E.G., X.W., P.C.).,Sorbonne Universités, UPMC Univ Paris 06, INSERM 1166, Institute of Cardiometabolism and Nutrition (ICAN), France (E.G., P.C.).,Centre de Référence des Maladies Cardiaques Héréditaires, Paris, France† (E.G., P.C.)
| | - Frédéric Anselme
- Cardiology Department, University Hospital of Rouen, France (F.A.)
| | - Thomas Gossios
- Inherited Cardiovascular Diseases Unit, University College London & St. Bartholomew's Hospital, United Kingdom† (T.G., K.S., P.E.)
| | - Neal K Lakdawala
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA (N.K.L., U.B.T.).,Aix Marseille University, INSERM, GMGF; Department of Medical Genetics, Childrens' Hospital La Timone, France (A.D.S.-G., N.L.)
| | - Caroline Stalens
- INSERM Unit 970, Paris Cardiovascular Research Centre (PARCC), France (K.W., C. Stalens, E.J.).,Medical Affairs Department, AFM-Telethon, Evry, France (C. Stalens)
| | - Frédéric Sacher
- Centre de reference des maladies rythmiques héréditaires, Bordeaux University Hospital (CHU), IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Univ. Bordeaux, INSERM U1045, France (F.S.)
| | - Dominique Babuty
- Université François Rabelais, Cardiology Department, CHU Tours, France (D. Babuty)
| | - Jean-Noel Trochu
- INSERM, UMR1087, Université de Nantes, L'Institut du Thorax, CHU de Nantes, CIC, Centre de référence pour la prise en charge des maladies rythmiques héréditaires de Nantes, France† (J.-N.T.)
| | - Ghassan Moubarak
- Department of Electrophysiology and Pacing, InParys Clinical Research Group, Clinique Ambroise Paré, Neuilly-sur-Seine, France (G.M.)
| | - Kostantinos Savvatis
- Inherited Cardiovascular Diseases Unit, University College London & St. Bartholomew's Hospital, United Kingdom† (T.G., K.S., P.E.).,William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.)
| | - Raphaël Porcher
- APHP, Hôtel-Dieu Hospital, Centre d'Epidémiologie Clinique, INSERM U1153, Université Paris Descartes - Sorbonne Paris Cité, France (R.P.)
| | - Pascal Laforêt
- APHP, Hôpital Raymond Poincaré, Centre de Référence des maladies neuromusculaires Nord-Est-Île de France, Garches (P.L., A.F.)
| | - Abdallah Fayssoil
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.).,APHP, Hôpital Raymond Poincaré, Centre de Référence des maladies neuromusculaires Nord-Est-Île de France, Garches (P.L., A.F.)
| | - Eloi Marijon
- Hôpital Européen Georges Pompidou, Département de Cardiologie, Unité de Rythmologie, Paris, France (E.M.)
| | - Tanya Stojkovic
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Anthony Béhin
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Sarah Leonard-Louis
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Guilhem Sole
- Centre de référence des maladies neuromusculaires AOC, Hôpital Pellegrin, CHU Bordeaux, France (G.S., X.F.)
| | | | - Pascale Richard
- APHP, UF Cardiogénétique et Myogénétique, Centre de Génétique, GH Pitié Salpêtrière, Paris, France (P.R., C.M.)
| | - Corinne Metay
- APHP, UF Cardiogénétique et Myogénétique, Centre de Génétique, GH Pitié Salpêtrière, Paris, France (P.R., C.M.)
| | - Susana Quijano-Roy
- APHP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Service de Neurologie, Réanimation et Réeducation Pediatriques, Hôpital Raymond Poincaré, Garches, France; UMR 1179 INSERM, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux (S.Q.-R., I. Dabaj)
| | - Ivana Dabaj
- APHP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Service de Neurologie, Réanimation et Réeducation Pediatriques, Hôpital Raymond Poincaré, Garches, France; UMR 1179 INSERM, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux (S.Q.-R., I. Dabaj)
| | - Didier Klug
- Cardiologie A, University Hospital, Lille, France (D.K.)
| | - Marie-Christine Vantyghem
- CHU Lille, Endocrinology, Diabetology and Metabolism, Univ Lille, Inserm, UMR 1190 -Translational research in diabetes; EGID European Genomic Institute for Diabetes, France (M.-C.V.)
| | - Philippe Chevalier
- Sorbonne Universités, UPMC Univ Paris 06, INSERM 1166, Institute of Cardiometabolism and Nutrition (ICAN), France (E.G., P.C.).,Centre de Référence des Maladies Cardiaques Héréditaires, Paris, France† (E.G., P.C.).,Service de Cardiologie, Hôpital Est, Lyon, France† (P.C.)
| | - Pierre Ambrosi
- Department of Cardiology, La Timone Hospital, Aix-Marseille Université, France (P.A.)
| | - Emmanuelle Salort
- APHM, Centre de référence des maladies neuromusculaires PACA-Réunion-Rhône Alpes, Hôpital Timone; Aix Marseille Université, Inserm UMR_S 910, GMGF, France (E.S.)
| | - Nicolas Sadoul
- Department of Cardiology, Institut Lorrain du Coeur et des Vaisseaux, CHU Nancy-Brabois, Vandoeuvre les Nancy Cedex, France (N.S.)
| | | | - Khadija Chikhaoui
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Philippe Mabo
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, France (P. Mabo, R.M.)
| | - Nicolas Combes
- Département de Rythmologie, Clinique Pasteur, Toulouse, France (N.C.)
| | - Philippe Maury
- University Hospital Rangueil, Cardiology department; Unité Inserm U1048, Toulouse, France (P. Maury)
| | - Jean-Marc Sellal
- Département de Cardiologie, Centre Hospitalier Universitaire de Nancy; INSERM-IADI U1254, Vandœuvre lès-Nancy, France (J.-M.S.)
| | - Usha B Tedrow
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA (N.K.L., U.B.T.)
| | - Jonathan M Kalman
- Department of Cardiology, Division of Medicine (J.M.K., J.V.), The Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
| | - Jitendra Vohra
- Department of Cardiology, Division of Medicine (J.M.K., J.V.), The Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
| | | | - Katja Zeppenfeld
- Department of Cardiology, Leiden University Medical Centre, the Netherlands (A.G.A.A., K.Z.)
| | - Tina Thompson
- Department of Genetic Medicine (T.T.), The Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
| | - Christine Barnerias
- AP-HP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, service de neurologie pédiatrique, Hôpital Necker, GH Necker-Enfants malades, Paris, France (C.B., I. Desguerre).,Centre de référence des maladies neuromusculaires AOC, Département de Neurologie, Hôpital Purpan, CHU Toulouse, France (B.C.)
| | - Henri-Marc Bécane
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Eric Bieth
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, France (E.B.)
| | - Franck Boccara
- AP-HP, Hôpitaux de l'Est Parisien, Cardiology Unit, Hôpital Saint-Antoine; Sorbonne Universités, INSERM, UMR_S 938, Paris, France (F.B.).,Hospices Civils de Lyon, Centre de référence des maladies neuromusculaires PACA-Réunion-Rhône Alpes, Service d'ENMG, Hôpital Neurologique Pierre Wertheimer, Lyon-Bron, France (F.B., P.P.)
| | - Damien Bonnet
- AP-HP, Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence des Malformations Cardiaques Congénitales Complexes-M3C, Hôpital Necker Enfants Malades, Université Paris Descartes, Sorbonne Paris-Cité, France (D. Bonnet)
| | - Françoise Bouhour
- AP-HP, Hôpitaux de l'Est Parisien, Cardiology Unit, Hôpital Saint-Antoine; Sorbonne Universités, INSERM, UMR_S 938, Paris, France (F.B.)
| | - Stéphane Boulé
- Hôpital privé Le Bois, Service de Cardiologie, Lille, France (S.B.)
| | | | - Françoise Chapon
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neurologie, CHU Caen; INSERM U1075, Université de Normandie, Caen, France (F.C., S.S.)
| | | | - Jean-Marie Cuisset
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de Neuropédiatrie, Hôpital Roger Salengro, CHRU Lille (J.-M.C.)
| | - Jean-Marc Davy
- Service de Cardiologie, CHU Montpellier, France (J.-M.D.)
| | - Annachiara De Sandre-Giovannoli
- Aix Marseille University, INSERM, GMGF; Department of Medical Genetics, Childrens' Hospital La Timone, France (A.D.S.-G., N.L.)
| | - Florence Demurger
- Centre de Référence Maladies Rares CLAD-Ouest, Service de Génétique Clinique, CHU Rennes, Hôpital Sud, France (F.D., M.F.)
| | - Isabelle Desguerre
- AP-HP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, service de neurologie pédiatrique, Hôpital Necker, GH Necker-Enfants malades, Paris, France (C.B., I. Desguerre)
| | - Klaus Dieterich
- Unité de Génétique Clinique, Hôpital Couple Enfant, CHU Grenoble, INSERM U1216, Grenoble Institut des Neurosciences Cellular Myology and Pathologies, France (K.D.)
| | - Julien Durigneux
- Centre de référence des maladies neuromusculaires AOC, Service de Neuropédiatrie, CHU Angers, France (J.D.)
| | | | - Romain Eschalier
- Service de cardiologie, CHU Clermont-Ferrand; CNRS équipe thérapies guidées par l'image, Institut-Pascal, France (R.E.)
| | - Ana Ferreiro
- Basic and Translational Myology Laboratory, UMR8251, Université Paris Diderot/CNRS, France (A.F.)
| | - Xavier Ferrer
- Centre de référence des maladies neuromusculaires AOC, Hôpital Pellegrin, CHU Bordeaux, France (G.S., X.F.)
| | | | - Mélanie Fradin
- Unité de Génétique Clinique, Hôpital Couple Enfant, CHU Grenoble, INSERM U1216, Grenoble Institut des Neurosciences Cellular Myology and Pathologies, France (K.D.)
| | - Bénédicte Gaborit
- APHM, pole ENDO, Hôpital la conception; INSERM, INRA, C2VN, Aix Marseille University, France (B.G.)
| | - Arnaud Gay
- Cardio-Thoracic Surgery Unit and Pathology Department, Rouen University Hospital, France (A.G.)
| | - Albert Hagège
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris and INSERM U970, Hôpital Européen Georges Pompidou, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, France (A.H.)
| | - Arnaud Isapof
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neuropédiatrie, Hôpital Trousseau, Paris, France (A.I., M. Mayer)
| | - Isabelle Jeru
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | - Raul Juntas Morales
- Centre de référence des maladies neuromusculaires AOC, Department of Neurology, CHU Montpellier, France (R.J.M.)
| | - Emmanuelle Lagrue
- CHRU de Tours, Université François Rabelais de Tours, UMR INSERM U1253, Tours, FILNEMUS, French neuromuscular reference centers, France (E.L.)
| | - Nicolas Lamblin
- Univ. Lille, Inserm U1167, Institut Pasteur; CHRU de Lille, Department of Cardiology, France (N.L.)
| | - Olivier Lascols
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | - Vincent Laugel
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neuropédiatrie, CHU Strasbourg, Hôpital Hautepierre, Hôpitaux Universitaires de Strasbourg, France (V.L.)
| | - Arnaud Lazarus
- InParys Clinical Research Group, Clinique Ambroise Paré, Neuilly sur Seine, France (A.L.)
| | - France Leturcq
- Cardiology Department, University Hospital of Caen, France (F.L.).,Service de Génétique, Hopital Cochin, AP-HP, Paris (F.L.)
| | - Nicolas Levy
- Aix Marseille University, INSERM, GMGF; Department of Medical Genetics, Childrens' Hospital La Timone, France (A.D.S.-G., N.L.)
| | - Armelle Magot
- Centre de Référence des Maladies Neuromusculaires AOC, Laboratoire des Explorations Fonctionnelles, CHU de Nantes, France (A. Magot, Y.P.)
| | | | - Raphaël Martins
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, France (P. Mabo, R.M.)
| | - Michèle Mayer
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neuropédiatrie, Hôpital Trousseau, Paris, France (A.I., M. Mayer)
| | | | - Christophe Meune
- APHP, UF Cardiogénétique et Myogénétique, Centre de Génétique, GH Pitié Salpêtrière, Paris, France (P.R., C.M.)
| | | | | | | | | | - Yann Péréon
- Centre de Référence des Maladies Neuromusculaires AOC, Laboratoire des Explorations Fonctionnelles, CHU de Nantes, France (A. Magot, Y.P.)
| | - Philippe Petiot
- Hospices Civils de Lyon, Centre de référence des maladies neuromusculaires PACA-Réunion-Rhône Alpes, Service d'ENMG, Hôpital Neurologique Pierre Wertheimer, Lyon-Bron, France (F.B., P.P.)
| | | | | | | | | | | | - Stéphane Schaeffer
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neurologie, CHU Caen; INSERM U1075, Université de Normandie, Caen, France (F.C., S.S.)
| | | | | | | | | | - Camille Vatier
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | | | - Bruno Eymard
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | | | - Corinne Vigouroux
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | - Gisèle Bonne
- Sorbonne Universités, INSERM UMRS 974, CNRS, UMR-7215, Center for Research in Myology, Myology Institute,(R.B.Y., G.B.)
| | | | - Perry Elliott
- Inherited Cardiovascular Diseases Unit, University College London & St. Bartholomew's Hospital, United Kingdom† (T.G., K.S., P.E.)
| | - Denis Duboc
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Centre de Référence de Pathologie Neuromusculaire Nord/Est/Ile de France, Paris-Descartes, Sorbonne Paris Cité University (K.W., D.D.)
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12
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George F, Brisson C, Poncelet P, Laurent JC, Massot O, Arnoux D, Ambrosi P, Klein-Soyer C, Cazenave JP, Sampol J. Rapid Isolation of Human Endothelial Cells from Whole Blood Using S-Endo1 Monoclonal Antibody Coupled to Immuno-Magnetic Beads: Demonstration of Endothelial Injury after Angioplasty. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648397] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThe presence in whole blood of circulating endothelial cells (EC) has been a subject of debate for many years. It could represent a good marker of vessel injury. We demonstrate here that human endothelial cells can be directly isolated and identified in circulating blood by means of an endothelial cell specific monoclonal antibody, S-Endol, coupled to micromagnetic beads. The specificity and efficacy of the assay were established using normal blood samples with cultured EC added. Specific rosettes formed between EC and beads could subsequently be isolated with a magnet. The rosetted cells were recovered with a yield >80%. Their endothelial origin was confirmed by the positive labelling of von Willebrand factor and thrombomodulin, as well as the presence of Weibel-Palade bodies. We applied this method to demonstrate significantly increased levels of EC in venous and arterial human blood samples in patients undergoing heart catheterization. This new whole blood immuno-separation method may be useful in determining endothelial cell injury in vascular disorders.
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Affiliation(s)
- F George
- Laboratoire d’Hématologie, Faculté de Pharmacie, Marseille, France
| | - C Brisson
- INSERM U.311, Biologie et Pharmacologie des Interactions du Sang avec les Vaisseaux et les Biomatériaux, Centre Régional de Transfusion Sanguine, Strasbourg, France
| | - P Poncelet
- Laboratoire d’Hématologie, Faculté de Pharmacie, Marseille, France
| | - J C Laurent
- Centre Régional de Transfusion Sanguine, Marseille, France
| | - O Massot
- Centre Régional de Transfusion Sanguine, Marseille, France
| | - D Arnoux
- Laboratoire d’Hématologie, Faculté de Pharmacie, Marseille, France
| | - P Ambrosi
- Centre Régional de Transfusion Sanguine, Marseille, France
| | - C Klein-Soyer
- INSERM U.311, Biologie et Pharmacologie des Interactions du Sang avec les Vaisseaux et les Biomatériaux, Centre Régional de Transfusion Sanguine, Strasbourg, France
| | - J P Cazenave
- INSERM U.311, Biologie et Pharmacologie des Interactions du Sang avec les Vaisseaux et les Biomatériaux, Centre Régional de Transfusion Sanguine, Strasbourg, France
| | - J Sampol
- Laboratoire d’Hématologie, Faculté de Pharmacie, Marseille, France
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13
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Combes V, Joly P, Ambrosi P, Sabatier F, Camoin L, Pili J, Sampol J, Dignat-George F. Platelet Vesiculation in Angina Patients Treated with Coronary Angioplasty. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613853] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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14
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Aillaud MF, Habib G, Kreitmann B, Métras D, Luccioni R, Bouvenot G, Juhan-Vague I, Ambrosi P. Fluvastatin Decreases Soluble Thrombomodulin in Cardiac Transplant Recipients. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613755] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryWe conducted a randomized, placebo controlled, double-blind, cross-over study, to assess the effects of a 4-week fluvastatin therapy on plasma markers of endothelial activation or injury in 20 transplanted heart recipients. The levels of thrombomodulin and von Willebrand factor antigen were higher at baseline in cardiac transplant recipients than in age and sex-matched healthy controls. Plasma total cholesterol showed a 21% reduction on fluvastatin therapy (p = 0.0001). Fluvastatin treatment had no significant effect on creatininemia, plasma cyclosporine, PAI-1 antigen, PAI-1 activity, tPA antigen, and Von Willebrand factor. However, fluvastatin produced a significant decrease of plasma thrombomodulin (66.7 ng/ml on placebo versus 58.8 ng/ml on fluvastatin, p <0.001), suggesting a rapid improvement of endothelial injury in these patients.
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15
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Ambrosi P, Daumas A, Villani P, Giorgi R. Meta-analysis of major bleeding events on aspirin versus vitamin K antagonists in randomized trials. Int J Cardiol 2017; 230:572-576. [DOI: 10.1016/j.ijcard.2016.12.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 12/14/2016] [Accepted: 12/16/2016] [Indexed: 11/15/2022]
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16
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Voytchev M, Behrens R, Ambrosi P, Radev R, Chiaro P. EVOLUTION OF THE IEC AND EN STANDARDS FOR INDIVIDUAL MONITORING OF IONISING RADIATION. Radiat Prot Dosimetry 2016; 170:13-16. [PMID: 26443545 DOI: 10.1093/rpd/ncv423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article presents the evolution of the International Electrotechnical Commission (IEC) and the European standards for individual monitoring of ionising radiation issued, respectively, from the committees IEC/Sub Committee 45B and European Committee for Electro-technical Standardization/Technical Committee 45B 'Radiation protection instrumentation'. Standards for passive individual photon and beta dosimetry systems as well as those for active individual monitors are discussed. A neutron ambient dose equivalent (rate) meter standard and a technical report concerning the determination of uncertainty in measurement are also covered.
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Affiliation(s)
- M Voytchev
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSN-RES, SCA, LPMA, Saclay, Gif-sur-Yvette 91192, France
| | - R Behrens
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, Braunschweig D-38116, Germany
| | - P Ambrosi
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, Braunschweig D-38116, Germany
| | - R Radev
- Lawrence Livermore National Laboratory, PO Box 808, L-186, Livermore, CA 94550, USA
| | - P Chiaro
- Department of Homeland Security, Domestic Nuclear Detection Office (DNDO), 245 Murray Lane, Bldg 410, Washington, DC 20528, USA
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17
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Ambrosi P, Macé L, Habib G. Predictive value of E/A and E/E′ Doppler indexes for cardiac events in heart transplant recipients. Clin Transplant 2016; 30:959-63. [DOI: 10.1111/ctr.12772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Pierre Ambrosi
- Department of Cardiology; La Timone Hospital; Aix-Marseille University; Marseille France
| | - Loic Macé
- Department of Cardiac Surgery; La Timone Hospital; Aix-Marseille University; Marseille France
| | - Gilbert Habib
- Department of Cardiology; La Timone Hospital; Aix-Marseille University; Marseille France
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18
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Ambrosi P, Kreitmann B, Lepidi H, Habib G, Levy N, Philip N, De Sandre-Giovannoli A. A novel overlapping phenotype characterized by lipodystrophy, mandibular dysplasia, and dilated cardiomyopathy associated with a new mutation in the LMNA gene. Int J Cardiol 2016; 209:317-8. [PMID: 26922292 DOI: 10.1016/j.ijcard.2016.02.113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 02/14/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Pierre Ambrosi
- Department of Cardiology, La Timone Hospital, Aix-Marseille Université, Marseille, France.
| | - Bernard Kreitmann
- Department of Cardiac Surgery, La Timone Hospital, Aix-Marseille Université, Marseille, France
| | - Hubert Lepidi
- Department of Pathology, La Timone Hospital, Aix-Marseille Université, Marseille, France
| | - Gilbert Habib
- Department of Cardiology, La Timone Hospital, Aix-Marseille Université, Marseille, France
| | - Nicolas Levy
- Department of Medical Genetics, La Timone Hospital, Aix Marseille Université, INSERM, GMGF UMR S 910, 13385 Marseille, France
| | - Nicole Philip
- Department of Medical Genetics, La Timone Hospital, Aix Marseille Université, INSERM, GMGF UMR S 910, 13385 Marseille, France
| | - Annachiara De Sandre-Giovannoli
- Department of Medical Genetics, La Timone Hospital, Aix Marseille Université, INSERM, GMGF UMR S 910, 13385 Marseille, France
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19
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Behnke B, Hupe O, Ambrosi P. Implications of X-ray tube parameter deviations in X-ray reference fields. Radiat Prot Dosimetry 2016; 168:175-183. [PMID: 25889609 PMCID: PMC4884881 DOI: 10.1093/rpd/ncv184] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
For the purpose of radiation protection, ICRU Report 57/ICRP Publication 74 provides a list of monoenergetic conversion coefficients to be used with, among others, photon reference fields generated with X-ray tubes. A comprehensive definition of these photon reference fields can be found in international standard ISO 4037; however, it lacks thorough indication of the allowed deviations of essential parameters that influence these X-ray reference fields. These parameters are the high-voltage tube potential, the thickness of the beryllium window and the purity and thickness of the filter materials used to create different radiation qualities. Small variations of these parameters can lead to significant changes in the created X-ray spectra and, hence, the spectra-dependent conversion coefficients for phantom-related radiation-protection quantities. This can lead to situations in which the conversion coefficients listed in ISO 4037 cannot be used, resulting in time-consuming spectrometry measurements. In this work, the impact on the resulting conversion coefficients is investigated using a simplified mathematical approximation model. The findings are validated with an independent X-ray spectra calculation programme. As a result, well-founded upper limit values on the allowed deviations of the essential X-ray tube parameters are proposed to be used in a future revision of ISO 4037.
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Affiliation(s)
- B Behnke
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, Braunschweig D-38116, Germany
| | - O Hupe
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, Braunschweig D-38116, Germany
| | - P Ambrosi
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, Braunschweig D-38116, Germany
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20
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Jolly D, Ambrosi P, Chaffanjon P, Dreyfuss D, Le Jeunne C, Lorette G, Obert L, Palombi O, Romanet JP. Résultats des épreuves classantes nationales (ECN) 2015. Presse Med 2016; 45:133-42. [PMID: 26655258 DOI: 10.1016/j.lpm.2015.09.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/17/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Damien Jolly
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; CHU de Reims, hôpital Robert-Debré, pôle recherche, 51092 Reims cedex, France.
| | - Pierre Ambrosi
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; Assistance publique-Hôpitaux de Marseille, hôpital la Timone, service de cardiologie B, 13385 Marseille, France
| | - Philippe Chaffanjon
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; CHU Nord, hôpital A.-Michallon, service de chirurgie vasculaire et thoracique, 38700 Grenoble, France
| | - Didier Dreyfuss
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital Louis-Mourier, service de réanimation médicale, 92701 Colombes, France
| | - Claire Le Jeunne
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital Cochin, service de médecine interne, université Paris-Descartes, 75014 Paris, France
| | - Gérard Lorette
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; CHRU Trousseau, service de dermatologie, 37044 Tours cedex 9, France
| | - Laurent Obert
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; CHU de Besançon, hôpital Jean-Minjoz, service de chirurgie orthopédique, traumatologique et plastique, 25030 Besançon, France
| | - Olivier Palombi
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; CHU Nord, hôpital A.-Michallon, service de neurochirurgie, 38700 Grenoble, France
| | - Jean-Paul Romanet
- Centre national des concours d'internat (CNCI), conseil médecine, 1, rue Descartes, 75005 Paris, France; Conférence des doyens des facultés de médecine, faculté de médecine Paris Descartes, 15, rue de l'École-de-Médecine, 75006 Paris, France; CHU de Grenoble, hôpital A.-Michallon, service d'ophtalmologie, boulevard de la Chantourne, 38700 La Tronche, France
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21
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Ambrosi P, Kreitmann B, Fromonot J, Habib G, Guieu R. Plasma Ultrasensitive Cardiac Troponin During Long-Term Follow-up of Heart Transplant Recipients. J Card Fail 2015; 21:103-7. [DOI: 10.1016/j.cardfail.2014.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 08/18/2014] [Accepted: 10/27/2014] [Indexed: 12/30/2022]
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22
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Jolly D, Ambrosi P, Chaffanjon P, Dreyfuss D, Le Jeunne C, Lorette G, Obert L, Palombi O, Romanet JP. Résultats des épreuves classantes nationales (ECN) 2013. Presse Med 2014; 43:865-7. [PMID: 24703743 DOI: 10.1016/j.lpm.2013.10.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 10/16/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- Damien Jolly
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; CHU de Reims, hôpital Robert-Debré, pôle recherche, université de Reims Champagne-Ardenne, UFR médecine, 51092 Reims cedex, France.
| | - Pierre Ambrosi
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; Hôpital la Timone, service de cardiologie B, 13385 Marseille, France
| | - Philippe Chaffanjon
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; CHU de Grenoble, clinique de chirurgie thoracique vasculaire et endocrinienne, 38043 Grenoble cedex 9, France
| | - Didier Dreyfuss
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; Assistance publique-Hôpitaux de Paris, université Paris Diderot, hôpital Louis-Mourier, service réanimation médicale, 92701 Colombes, France
| | - Claire Le Jeunne
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; Assistance publique-Hôpitaux de Paris, université Paris Descartes, hôpital Cochin, service de médecine interne, 75014 Paris, France
| | - Gérard Lorette
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; CHRU Trousseau, service de dermatologie, 37044 Tours cedex 9, France
| | - Laurent Obert
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; CHU de Besançon, hôpital Jean-Minjoz, service de chirurgie orthopédique, traumatologique et plastique, 25030 Besançon, France
| | - Olivier Palombi
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; CHU de Grenoble, UFR médecine, service de neurochirurgie, BP 217, 38043 Grenoble, France
| | - Jean-Paul Romanet
- Centre national des concours d'internat (CNCI), conseil médecine, 75377 Paris cedex 15, France; CHU de Grenoble, UFR médecine, hôpital A.-Michallon, service d'ophtalmologie, conférence des doyens de facultés de médecine, 38700 Grenoble, France
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23
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Ambrosi P, Habib G. [Adult's heart failure]. Rev Prat 2014; 64:399-406. [PMID: 24851378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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24
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Daumas A, Ammar C, Darmon A, Leveque P, Tessonnier L, Ambrosi P, Valleix S, Villani P, Granel B. [Letter on the article: "senile systemic amyloidosis: definition, diagnosis, why thinking about?"]. Presse Med 2013; 42:1667-8. [PMID: 24216054 DOI: 10.1016/j.lpm.2013.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 08/18/2013] [Indexed: 11/18/2022] Open
Affiliation(s)
- Aurélie Daumas
- AP-HM, hôpital de la Timone, service de médecine interne et thérapeutique, 13385 Marseille cedex 05, France.
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25
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van Dijk J, Alves J, Ambrosi P, Bartlett D, Currivan L, Fantuzzi E, Kamenopoulou V. A Review of the New European Technical Recommendations for Monitoring Individuals Occupationally Exposed to External Radiation. RADIAT MEAS 2013. [DOI: 10.1016/j.radmeas.2013.01.005] [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: 11/17/2022]
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26
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Jolly D, Lorette G, Ambrosi P, Dreyfuss D, Chaffanjon P, Le Jeunne C, Obert L, Rogez JM. Résultats des épreuves classantes nationales (ECN) 2012. Presse Med 2013; 42:1138-40. [DOI: 10.1016/j.lpm.2012.11.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Accepted: 11/26/2012] [Indexed: 11/16/2022] Open
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27
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Ambrosi P. Effets cliniques à court terme des statines initiées avant une intervention. Presse Med 2013; 42:261-8. [DOI: 10.1016/j.lpm.2012.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 04/21/2012] [Accepted: 05/10/2012] [Indexed: 11/24/2022] Open
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28
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Zutz H, Hupe O, Ambrosi P, Klammer J. Determination of relevant parameters for the use of electronic dosemeters in pulsed fields of ionising radiation. Radiat Prot Dosimetry 2012; 151:403-410. [PMID: 22434926 DOI: 10.1093/rpd/ncs027] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Active electronic dosemeters using counting techniques are used for radioprotection purposes in pulsed radiation fields in X-ray diagnostics or therapy. The disadvantage of the limited maximum measurable dose rate becomes significant in these radiation fields and leads to some negative effects. In this study, a set of relevant parameters for a dosemeter is described, which can be used to decide whether it is applicable in a given radiation field or not. The determination of these relevant parameters-maximum measurable dose rate in the radiation pulse, dead time of the dosemeter, indication per counting event and measurement cycle time-is specified. The results of the first measurements on the determination of these parameters for an electronic personal dosemeter of the type Thermo Fisher Scientific EPD Mk2 are shown.
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Affiliation(s)
- H Zutz
- Physikalisch-Technische Bundesanstalt (PTB), Bundesallee 100, D-38116 Braunschweig, Germany.
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29
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Daumas A, Gayet S, Leveque P, Pellerey M, Ambrosi P, Villani P. Hémorragie bilatérale des surrénales révélant une maladie de Vaquez. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.165] [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: 11/26/2022]
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30
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31
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Ambrosi P, Bertucci F, Kreitmann B. High incidence of asymptomatic renal cancer in late survivors after heart transplantation. J Heart Lung Transplant 2011; 30:1202-3. [PMID: 21624838 DOI: 10.1016/j.healun.2011.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 04/26/2011] [Accepted: 05/01/2011] [Indexed: 01/20/2023] Open
Affiliation(s)
- Pierre Ambrosi
- Department of Cardiology, Hôpital de la Timone, Institut Paoli-Calmettes, Marseille, France
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32
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Arques S, Ambrosi P. Human Serum Albumin in the Clinical Syndrome of Heart Failure. J Card Fail 2011; 17:451-8. [DOI: 10.1016/j.cardfail.2011.02.010] [Citation(s) in RCA: 137] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 02/15/2011] [Accepted: 02/24/2011] [Indexed: 11/15/2022]
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33
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Abstract
This paper presents IEC/SC 45B 'Radiation protection instrumentation' and its standards for individual monitoring of ionising radiation: IEC 61526 Ed. 3 for active personal dosemeters and IEC 62387-1 for passive integrating dosimetry systems. The transposition of these standards as CENELEC (European) standards is also discussed together with the collaboration between IEC/SC 45B and ISO/TC 85/SC 2.
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Affiliation(s)
- M Voytchev
- IRSN/DSU/SERAC/BIREN, BP 68, Gif-sur-Yvette Cedex 91192, France.
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34
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Alves JG, Ambrosi P, Bartlett DT, Currivan L, van Dijk JWE, Fantuzzi E, Kamenopoulou V. The new EC technical recommendations for monitoring individuals occupationally exposed to external radiation. Radiat Prot Dosimetry 2011; 144:17-25. [PMID: 20959338 DOI: 10.1093/rpd/ncq295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The purpose of the European Commission technical recommendations (TR) for monitoring individuals occupationally exposed to external radiation is to provide guidance on those aspects of the implementation of the European Union Parliament and Council Directives directly related to individual monitoring of external radiation, and to encourage harmonisation thereof. They are mainly aimed at the management and staff of IM services but also at manufacturers, laboratories supplying type-testing services, national authorities trying to harmonise approval procedures, and government bodies to harmonise regulations and guidance. The TR main topics are: objectives and aims of IM for external radiation; dosimetry concepts; accuracy requirements; calibration, type testing and performance testing; approval procedures; quality assurance and quality control; and dose record keeping. Attention is paid to particular aspects, such as wide energy ranges for the use of personal dosemeters, pulsed fields and non-charged particle equilibrium; and use of active personal dosemeters. The TR give proposals towards achieving harmonisation in IM and the eventual mutual recognition of services and of dose results.
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Affiliation(s)
- J G Alves
- ITN, Estrada Nacional 10, 2686-953 Sacavém, Lisbon, Portugal
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35
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Ambrosi P, Kreitmann B, Habib G. Does heart rate predict allograft vasculopathy in heart transplant recipients? Int J Cardiol 2010; 145:256-257. [DOI: 10.1016/j.ijcard.2009.08.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 08/19/2009] [Indexed: 11/16/2022]
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36
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Bouvenot G, Villani P, Bouvenot J, Ambrosi P. [Pharmacologic and non-pharmacologic treatments. Legal rules]. Rev Prat 2010; 60:1165-1172. [PMID: 21197760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Gilles Bouvenot
- Laboratoire de Thérapeutique, Faculté de médecine de Marseille 13385, Marseille Cedex 5, France.
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37
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Bouvenot G, Villani P, Bouvenot J, Ambrosi P. [Therapeutic evaluation and the level of proof]. Rev Prat 2010; 60:1017-1022. [PMID: 21033506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Gilles Bouvenot
- Laboratoire de thérapeutique, faculté de médecine de Marseille 13385, Marseille Cedex 5, France.
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38
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Ankerhold U, Ambrosi P. Influence of the uniformity of the slab phantom illumination on the calibration of personal dosemeters. Radiat Prot Dosimetry 2010; 140:9-15. [PMID: 20176730 DOI: 10.1093/rpd/ncq036] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
For the calibration of personal dosemeters in terms of H(p)(10), the ISO water slab phantom shall be used. The irradiation geometry must be chosen such that the field diameter at the phantom front surface is large enough to irradiate the phantom completely and, in addition, homogeneously. However, in practice it is not always possible to achieve this, especially if high dose rates are required and hence the irradiation must be performed at short distances. The subject of this investigation is to determine the influence of the beam diameter on the calibration result or, more correctly, on the quantity value of H(p)(10). Measurements were performed with a PTB-developed secondary standard chamber for H(p)(10) at several radiation qualities of the ISO narrow-spectrum series. The results show that a reduced beam diameter of only 250 mm decreases the quantity value of H(p)(10) by a maximum of 5 %. This can be considered by adding an additional standard uncertainty of a maximum of 5 % for the quantity value of H(p)(10).
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Affiliation(s)
- U Ankerhold
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, D-38116 Braunschweig, Germany.
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39
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Lorette G, Jolly D, Ambrosi P, Dreyfuss D, Magne JL, Kohler C, Duhaut P, Gérard JL. Influence de la lecture critique d’articles sur les classements des étudiants aux épreuves classantes nationales 2009. Presse Med 2010; 39:e118-25. [DOI: 10.1016/j.lpm.2010.03.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 03/30/2010] [Accepted: 03/30/2010] [Indexed: 11/30/2022] Open
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40
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Ambrosi P. Correspondance à propos de l’article «Quel bilan lipidique et comment l’interpréter chez le patient ayant une maladie coronaire». Presse Med 2010; 39:286-7. [DOI: 10.1016/j.lpm.2009.11.004] [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] [Received: 08/27/2009] [Accepted: 11/26/2009] [Indexed: 10/20/2022] Open
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41
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Ambrosi P, Habib G, Kreitmann B. 048 Does heart rate predict coronary allograft vasculopathy and coronary events in heart transplant recipients? Archives of Cardiovascular Diseases Supplements 2010. [DOI: 10.1016/s1878-6480(10)70050-1] [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: 10/19/2022]
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42
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Ambrosi P. Aspirin in the primary prevention of vascular disease. Lancet 2009; 374:877; author reply 879. [PMID: 19748391 DOI: 10.1016/s0140-6736(09)61620-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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43
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Ambrosi P, Oddoze C, Habib G. Plasma adiponectin: risk factor or risk marker for arterial stiffness? Am J Cardiol 2009; 104:742. [PMID: 19699362 DOI: 10.1016/j.amjcard.2009.05.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 05/26/2009] [Indexed: 12/01/2022]
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44
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Ankerhold U, Hupe O, Ambrosi P. Deficiencies of active electronic radiation protection dosimeters in pulsed fields. Radiat Prot Dosimetry 2009; 135:149-153. [PMID: 19487426 DOI: 10.1093/rpd/ncp099] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Nowadays nearly all radiation fields used for X-ray diagnostics are pulsed. These fields are characterised by a high dose rate during the pulse and a short pulse duration in the range of a few milliseconds. The use of active electronic dosimeters has increased in the past few years, but these types of dosimeters might possibly not measure reliably in pulsed radiation fields. Not only personal dosimeters but also area dosimeters that are used mainly for dose rate measurements are concerned. These cannot be substituted by using passive dosimeter types. The characteristics of active electronic dosimeters determined in a continuous radiation field cannot be transferred to those in pulsed fields. Some provisional measurements with typical electronic dosimeters in pulsed radiation fields are presented to reveal this basic problem.
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Affiliation(s)
- U Ankerhold
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany.
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45
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Ambrosi P, Oddoze C, Nicolay A, Penet-Lorec AM, Riberi A, Métras D, Portugal H, Habib G. Plasma adiponectin in heart transplant recipients. Clin Transplant 2009; 23:83-8. [DOI: 10.1111/j.1399-0012.2008.00905.x] [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: 12/21/2022]
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Ambrosi P, Singeorzan S, Oddoze C, Arques S, Heim M. Correlation of NT-proBNP with diastolic left ventricular function in elderly patients with ischemic stroke. Int J Cardiol 2008; 140:126-8. [PMID: 19101051 DOI: 10.1016/j.ijcard.2008.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 11/01/2008] [Indexed: 11/19/2022]
Abstract
We tested the hypothesis that, in elderly survivors of ischemic stroke, high NT-proBNP levels are related with frequent diastolic dysfunction. We prospectively measured NT-proBNP, left ventricular ejection fraction (LVEF) and echographic parameters of diastolic function in 55 elderly consecutive patients, 6.8+/-2.6 days after acute ischemic stroke. We found that all the patients had systolic or diastolic dysfunction (14 had LVEF<50%, 26 mild diastolic dysfunction+LVEF > or = 50%, and 15 moderate or severe diastolic dysfunction+LVEF > or = 50%). The most powerful predictors of NT-proBNP were LVEF (R=0.38, p=0.004) and ratio of mitral E to the early diastolic velocity of the mitral annulus:E/E'(R=0.34, p=0.01).
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Arques S, Roux E, Sbragia P, Pieri B, Gelisse R, Luccioni R, Ambrosi P. Comparison of B-type natriuretic peptide with left atrial enlargement by echocardiography for the diagnosis of new-onset congestive heart failure with a preserved left ventricular systolic function in the setting of longstanding hypertension. Int J Cardiol 2008; 128:123-5. [PMID: 17659793 DOI: 10.1016/j.ijcard.2007.05.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2007] [Accepted: 05/26/2007] [Indexed: 11/26/2022]
Abstract
The present study attempted to determine the accuracy of B-type natriuretic peptide (BNP) compared with left atrial enlargement at echocardiography in the emergency diagnosis of new-onset heart failure with preserved systolic function (HFPSF) related to longstanding hypertension. The study comprised 57 patients in sinus rhythm hospitalized for acute dyspnea, 30 with hypertensive HFPSF and 27 with noncardiac cause. By stepwise logistic regression analysis, BNP provided independent and incremental diagnostic information over the score of Boston criteria. There was a trend toward superiority of this biomarker compared to the left atrial area index for the diagnosis of HFPSF. A BNP concentration >142 pg/ml was 93% sensitive and 85% specific for the diagnosis of HFPSF in this clinical setting (area under the ROC curve of 0.91 [0.8-0.97], p<0.001).
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Arques S, Ambrosi P, Roux E, Sbragia P, Gelisse R, Pieri B, Luccioni R. Tissue Doppler echocardiography for the diagnosis of new-onset heart failure with normal ejection fraction: Influence of serum protein concentration on clinical interpretation in elderly patients. Arch Cardiovasc Dis 2008; 101:343-50. [DOI: 10.1016/j.acvd.2008.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2007] [Accepted: 04/16/2008] [Indexed: 01/27/2023]
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Ambrosi P, Behrens R. New concept of IEC standards for radiation protection dosemeters. Radiat Prot Dosimetry 2008; 131:236-239. [PMID: 18420572 DOI: 10.1093/rpd/ncn134] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The International Electrotechnical Commission (IEC) develops new standards for radiation protection dosemeters which follow a new concept. They are much more flexible in detail, but still ensure the same measurement quality. They are, for example, no longer specific for the detector type, but rather specific for the measurement task, e.g. for individual monitoring with active direct-reading instruments. Another example is that they are flexible with respect to the ranges of influence quantities. The conceptual changes are described in this paper, together with the advantages this new concept provides for manufacturers, users and legislators.
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Affiliation(s)
- P Ambrosi
- Physikalisch-Technische Bundesanstalt, Bundesallee 100, 38116 Braunschweig, Germany.
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