Bernard Paelinck - Academia.edu (original) (raw)

Papers by Bernard Paelinck

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Echocardiography, 2020

A patent foramen ovale (PFO) is a persistent fetal inter-atrial communication at the site of the ... more A patent foramen ovale (PFO) is a persistent fetal inter-atrial communication at the site of the embryonic ostium secundum, resulting from incomplete fusion between the septum primum and secundum after birth. 1 The overall incidence in the general population varies between 20% and 34%. According to autopsy studies, the size of a PFO varies considerably, with a maximal potential diameter ranging from 1 to 19 mm, measured with calibrated probes. 2 Several anatomical variants have been described, with a tunnel or slit-like appearance of variable dimensions. 1 In most cases, a PFO is harmless and does not cause any symptoms. However, some PFOs have the ability to open under certain circumstances enabling thrombi or air to migrate from the venous to the arterial circulation. This so-called paradoxical embolization links a PFO to several conditions including cryptogenic stroke, decompression illness, orthodeoxia, and

Kardiologia polska, 2020

CONFLICT OF INTEREST None declared. OPEN ACCESS This is an Open Access article distributed under ... more CONFLICT OF INTEREST None declared. OPEN ACCESS This is an Open Access article distributed under the terms of the Creative Commons Attribution ‐NonCommercial ‐NoDerivatives 4.0 In‐ ternational License (CC BY ‐NC ‐ND 4.0), allowing third parties to download ar‐ ticles and share them with others, provided the original work is properly cited, not changed in any way, distributed under the same license, and used for non‐ commercial purposes only. For commercial use, please contact the journal of‐ fice at kardiologiapolska@ptkardio.pl. HOW TO CITE Paelinck BP, De Bock D, Laga S, et al. Thoracoscopic resection of a symptomatic pericardial cyst. Kardiol Pol. 2020; 78: 1057‐1058. doi:10.33963/ KP.15497

The American Journal of Cardiology, 2020

We evaluated the effect of baseline (indexed) LVESD on MR reduction, symptom control, HF hospital... more We evaluated the effect of baseline (indexed) LVESD on MR reduction, symptom control, HF hospitalization, and mortality in a contemporary real-world cohort of HF patients with secondary MR, treated with MitraClip.

European Heart Journal - Case Reports

BMJ Open Sport — Exercise Medicine, 2021

Introduction Low and moderate endurance exercise is associated with better control of cardiovascu... more Introduction Low and moderate endurance exercise is associated with better control of cardiovascular risk factors, a decreased risk of coronary artery disease and atrial fibrillation (AF). There is, however, a growing proportion of individuals regularly performing strenuous and prolonged endurance exercise in which the health benefits have been challenged. Higher doses of endurance exercise have been associated with a greater coronary atherosclerotic plaque burden, risk of AF and myocardial fibrosis (MF). Methods and analysis Master@Heart is a multicentre prospective cohort study aiming to assess the incidence of coronary atherosclerosis, AF and MF in lifelong endurance athletes compared to late-onset endurance athletes (initiation of regular endurance exercise after the age of 30 years) and healthy non-athletes. The primary endpoint is the incidence of mixed coronary plaques. Secondary endpoints include coronary calcium scores, coronary stenosis >50%, the prevalence of calcified...

Journal of Interventional Cardiology, 2020

Background. A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dy... more Background. A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dyspnea. Due to a right-to-left shunt, desaturated blood enters the systemic circulation in a subset of patients resulting in dyspnea and a subsequent reduction in quality of life (QoL). Percutaneous closure of PFO is the treatment of choice. Objectives. This retrospective multicentre study evaluates short- and long-term results of percutaneous closure of PFO in patients with dyspnea and/or reduced oxygen saturation. Methods. Patients with respiratory symptoms were selected from databases containing all patients percutaneously closed between January 2000 and September 2018. Improvement in dyspnea, oxygenation, and QoL was investigated using pre- and postprocedural lung function parameters and two postprocedural questionnaires (SF-36 and PFSDQ-M). Results. The average follow-up period was 36 [12–43] months, ranging from 0 months to 14 years. Percutaneous closure was successful in 15 of the ...

Interactive cardiovascular and thoracic surgery, 2015

With the expanding use of transcatheter aortic valve implantation (TAVI), we have encountered inc... more With the expanding use of transcatheter aortic valve implantation (TAVI), we have encountered increasing numbers of patients without ideal femoral access. Although many alternatives have been described, vascular access and access-related complications remain a point of concern. We report our series of 20 patients undergoing TAVI via brachiocephalic artery access. Between September 2011 and May 2014, we performed 107 consecutive CoreValve bioprosthesis implantations, of which 20 were by the brachiocephalic approach due to unfavourable iliac or femoral anatomy. No vascular or access-related complications were seen. Procedural feasibility, device success and early safety, as defined by the Valve Academic Research Consortium-2 criteria, were good, at 100, 95 and 95%, respectively. No stroke, transient ischaemic attack, acute kidney injury, major vascular or major bleeding complications were observed. At a mean follow-up of 497 days, the 1-year survival rate is 75.0%. Echocardiography at...

European Journal of Clinical Investigation, 2014

Aims The appropriate timing for surgery in severe asymptomatic primary mitral regurgitation (MR) ... more Aims The appropriate timing for surgery in severe asymptomatic primary mitral regurgitation (MR) remains controversial. It has been shown that late gadolinium enhancement on cardiovascular magnetic resonance (LGE CMR), which may identify myocardial fibrosis, is associated with a worse outcome in various cardiomyopathies. We sought to investigate the prevalence and significance of delayed enhancement in primary MR. Methods We prospectively included 41 patients with at least moderate primary MR and without overt signs of left ventricular (LV) dysfunction. Patients with evidence of coronary artery disease, arrhythmias or significant concomitant valvular disease were excluded. All patients were scheduled for transthoracic echocardiography and LGE CMR. Results A total of 39 patients had interpretable LGE CMR images. Among them, 12 (31%) had late contrast uptake of the LV wall. LGE CMR showed an infarct pattern in three patients, a pattern of mid-wall fibrosis in seven patients and two patients had a combined pattern. Patients with delayed enhancement on CMR had significant higher LV diameters (LV end-systolic diameter 39 AE 4 vs. 34 AE 5 mm, P = 0Á002; LV end-diastolic diameter 57 AE 5 vs. 50 AE 5 mm, P = 0Á001). There was a trend towards a higher indexed left atrial volume (55 AE 21 vs. 44 AE 13 mL/m², P = 0Á06). By contrast, there was no significant association between myocardial contrast uptake and age, LV ejection fraction and MR severity. Conclusion Left ventricular remodelling seems to be associated with the presence of delayed enhancement on CMR in primary MR. Further data are needed to determine whether LGE CMR can predict a less favourable outcome or could improve risk stratification in asymptomatic primary MR.

European heart journal cardiovascular Imaging, 2015

Although pericardial diseases are common in the daily clinical practice and can result in a signi... more Although pericardial diseases are common in the daily clinical practice and can result in a significant morbidity and mortality, imaging of patients with suspected or known pericardial disorders remain challenging. Multimodality imaging is part of the management of pericardial diseases. Echocardiography, cardiac computed tomography, and cardiovascular magnetic resonance are often used as complementary imaging modalities. The choice of one or multiple imaging modalities is driven by the clinical context or conditions of the patient. The scope of the present document is to highlight the respective role of each technique according to the clinical context in the diagnosis and management of pericardial diseases.

Journal of the American College of Cardiology, 2011

Background: Risk factors that determine the occurence of late atrial arrhythmia in patients with ... more Background: Risk factors that determine the occurence of late atrial arrhythmia in patients with atrial septal defect (ASD) type II drive clinical management. However, a quantitative event-free survival prediction tool has not yet been established. Methods: Data from 220 patients were analyzed to assess predictors of event-free survival. Independent risk factors were identified through consecutive uni-and multivariate analysis. Based on the multivariate analyses, a weighted risk score was derived. The discriminatory ability of the risk model was assessed with the c-index. To approximate an independent validation, for each 1000 bootstrap samples, the model was refit and reassessed on the original model to compute c-index and hazard ratios. Results: A total of 220 patients (23% men, mean age at repair 52±16) was included. Fifty-seven patients presented with late atrial arrhythmia. Multivariate analysis showed that mPAP ≥25mmHg (HR 2.94; 95%CI 1.60-5.41; P=0.001), gender (HR 1.94; 95%CI 1.08-3.46; P=0.027), atrial arrhythmia before (HR 3.62; 95%CI 1.93-6.79; P<0.0001) and ≤1 month after repair (HR 5.92; 95%CI 2.91-12.02; P<0.0001) were predictive of late atrial arrhythmia. A risk score (0 to 19 points) to predict event-free survival was derived and validated by bootstrapping technique. Conclusions: We identified predictors of arrhythmia-free survival and formulated a prognostic risk score. This may allow for individualization and optimization of therapeutic strategies after ASD closure.

International Journal of Cardiology, 2013

Objectives: To develop a quantitative event-free prediction model of late atrial arrhythmia after... more Objectives: To develop a quantitative event-free prediction model of late atrial arrhythmia after atrial septal defect (ASD) repair. Background: The clinical management of ASD is driven by risk factors that determine the occurrence of late atrial arrhythmia. Methods: Data from ASD type secundum patients, included in the Belgian Congenital Heart Disease Registry, were analyzed. Based on review of the literature, age at repair, gender, pulmonary hypertension, atrial arrhythmia before and within one month after repair were included in the model. Using Cox-regression analysis, a weighted risk score was derived, which was validated using the Brier score. Results: A total of 155 patients (117 women; median age at follow-up 53.9 years, range 18.0-78.8) having 349 follow-up years was included. Thirty-nine patients (25.2%) presented with late atrial arrhythmia. Multivariate analysis showed that a mPAP ≥ 25 mmHg (HR 4.39; 95%CI 2.17-9.09; P b 0.0001), the presence of atrial arrhythmia before (HR 3.52; 95%CI 1.75-7.14; P = 0.002) and ≤ 1 month after repair (HR 6.62; 95%CI 2.38-20.00; P b 0.0001) and gender (HR 2.18 95%CI 1.11-4.35) were associated with late atrial arrhythmia. A risk score (0 to 28 points) to predict atrial arrhythmia free survival was derived for follow-up times ranging from one to 5 years. Mean Brier score for the model was 0.10. Conclusions: We formulated a well validated risk model to predict arrhythmia-free survival in ASD patients undergoing ASD repair. Further research is needed whether this model can be used for individual clinical risk stratification and whether the model can be adapted for application in other congenital heart defects.

European Journal of Cardiovascular Prevention & Rehabilitation, 2005

European Journal of Cardiovascular Prevention & Rehabilitation, 2007

Both endurance training (ET) and cardiac resynchronization therapy (CRT) improve quality of life ... more Both endurance training (ET) and cardiac resynchronization therapy (CRT) improve quality of life (QOL) and exercise tolerance in patients with advanced chronic heart failure (CHF). A randomized intervention trial to study the effect on exercise capacity of ET in addition to CRT in patients with CHF and dyssynchrony. Seventeen patients (eight men, aged 59+/-9 years) with CHF and dyssynchrony were randomized to CRT with (n=8) or without (n=9) ET and compared with two matched control CHF groups (standard care with ET: n=9, standard care only: n=10). At baseline and after 5 months, exercise tolerance, left ventricular (LV) remodelling, QOL and NT-pro brain natriuretic peptide (NT-proBNP) levels were assessed. Peak oxygen consumption (VO2peak), maximal workload (Wattmax), circulatory power, LV ejection fraction, dyssynchrony and QOL improved in both CRT groups. However, the increase in VO2peak (+40% versus +16%, P=0.005), Wattmax (+43% versus +13%, P=0.0005), and circulatory power (+74% versus +32%, P=0.01), was significantly greater in the trained versus the untrained CRT patients. Comparison of the four patient groups confirmed the cumulative effects of CRT plus ET. ET in resynchronized CHF patients is feasible and further enhances exercise tolerance. Patients with severe CHF should be prescribed an exercise training programme after implantation in order to maximize the expected benefit.

European Heart Journal - Cardiovascular Imaging, 2018

The effect of MitraClip implantation on left ventricular (LV) remodelling has been shown to be hi... more The effect of MitraClip implantation on left ventricular (LV) remodelling has been shown to be highly variable. The present study wants to assess patterns of LV remodelling and its relationship with outcome.