G Habib

Institut de France, Lutetia Parisorum, Île-de-France, France

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Publications (150)421.36 Total impact

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    ABSTRACT: To assess the value of cardiac magnetic resonance (CMR) using phase-contrast velocity mapping for paravalvular aortic regurgitation (PAR) quantification. All patients undergoing transcatheter aortic valve implantation (TAVI) in our centre between November 2012 and August 2013, without CMR-contraindication were included. PAR severity was assessed 5 days after TAVI using: transthoracic echocardiography (TTE) and CMR [regurgitant volume (RV), regurgitant fraction (RF)]. Aortic regurgitation (AR) index was obtained during TAVI. Thirty of 51 patients who underwent TAVI were included (COREVALVE, n = 10; or EDWARDS SAPIEN XT, n = 20). At TTE, PAR was mild in 22, moderate in 3, and severe in 5 patients. Reliable phase-contrast images were acquired at the sino-tubular junction for SAPIEN and at the tubular portion of the ascending aorta for COREVALVE. The reproducibility of CMR was high (coefficient of correlation = 0.99 for intra- and inter-operator variability). At CMR, RV, and RF were significantly (P < 0.0005) correlated with AR severity at TTE, with mean RF values at 9.2 ± 7.6% in mild, 20.3 ± 4.2% in moderate, and 46.8 ± 10.8% in severe PAR. A cut-off value of RF < 14% at CMR accurately discriminated mild from moderate/severe (sensitivity: 100%, specificity: 82%). The mean AR index was 29.4 ± 6 for mild and 13.8 ± 5 for moderate/severe PAR. Three patients had a RF > 14% and a low AR index <25 despite a mild PAR at TTE, suggesting an underestimation at TTE. CMR is a reproducible, accurate, and reliable method to assess PAR severity. CMR may allow correcting an underestimation at TTE when AR index is doubtful. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.
    European Heart Journal Cardiovascular Imaging 07/2015; DOI:10.1093/ehjci/jev177 · 4.11 Impact Factor
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    ABSTRACT: The purpose of the present study was to evaluate the prognostic value of left atrial (LA) mechanics and stiffness in a prospective cohort of 82 asymptomatic patients (31 men, mean age 73±10 years) with severe aortic stenosis (AS) and normal left ventricular ejection fraction. Methods: By the use of 2-dimensional speckle tracking echocardiography, LA reservoir, strain rate and stiffness, LV strain, rotations, and twist were evaluated. The predefined end points were the occurrence of symptoms,aortic valve replacement and death. Results: At study entry, all patients had reduced LA reservoir (19.6±5%) and LV global longitudinal strain (LVGLS) (-15.3±3%), enhanced Zva (7.3 ±0.7 mm Hg/ml/m2) and LA stiffness (0.9±0.1). During follow-up (17.2±15.3 months) 53 patients (64.6%) reached the predefined end-points. No difference was found between symptomatic and asymptomatic patients as regards LV ejection fraction, LA volumes and AS severity. On the contrary, patients with events had lower indexed stroke volume p=0.001), LVGLS (p<0.001), LA reservoir (p<0.001) and higher LV mass (p=0.007), Zva (p<0.001) and LA stiffness (p<0.001), than those asymptomatic. Patients with lower LA reservoir (≤ 19.3%, median value) and higher LA stiffness (≥ 0.89, median value) had significantly worse event-free survival (figure 1). When the global population was split according to the median of LVGLS and Zva (GLS ≥ -15.2% and Zva ≤ 6.26 mmHg/ml/m2), amoung patients with minor impairment of LVGLS and Zva, the subgroup with events had significantly lower LA reservoir (p=0.01 and p=0.02, respectively) and higher LA stiffness (p=0.02 and p=0.02, respectively) if compared to the asymptomatic; Conclusion: LA mechanics may be a relevant contributor to the prognostic stratification of patients with asymptomatic severe AS.
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    ABSTRACT: Purpose: We have previously demonstrated that multi-line transmit (MLT) beam forming can provide high quality full field-of-view (90° sector) B-mode images at very high frame rates, i.e. up to 500 fps. The purpose of this study was to test the feasibility of this technique in imaging the mechanical intraventricular waves such as the one associated with activation of the left ventricle. Methods: A dedicated pulse sequence using MLT was implemented on the ULA-OP research scanner equipped with a 2.0 MHz phased array to obtain 90° sector images at a frame rate of 436 fps. The left ventricle of a healthy volunteer was imaged from the apical 4 chamber view and the RF data was acquired. Subsequently, the strain rate was extracted from the RF data using a normalized cross-correlation method. Results: As expected, during the early filling phase, myocardium lengthening (positive strain rate) was observed propagating from the base of the septum to the apex and back (Figure a). A similar wave was detected in the lateral wall, although a brief shortening (negative strain rate) was detected in the mid-wall which could be the result of reverberations (Figure b). During isovolumetric contraction, the septal wall shortened before the lateral wall (as expected) - moreover - there seemed to be an intra-wall base-apex shortening gradient (Figure c and d). Conclusions: Our preliminary results show that visualization of the cardiac mechanical activation could be feasible using MLT based high frame rate imaging. Further research is required to examine this in depth, which is the topic of on-going work.
    European Heart Journal – Cardiovascular Imaging 12/2014; 15(suppl 2):ii25-ii51. DOI:10.1093/ehjci/jeu248 · 4.11 Impact Factor
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    ABSTRACT: Purpose: Although delayed-enhancement magnetic resonance imaging (DEMRI) is essential for diagnosis of cardiac sarcoidosis (CS), the test was not available when pacemaker was implamted. Recently, MR-conditional pacemaker has become avilable and we hypothesized that this device would be useful for diagnosis and management of CS. The aim of this study was to assess the diagnostic ability of MR-conditional pacemaker about CS in patients with advanced A-V nodal block (AAVB). Methods: Twenty-seven AAVB patients (14 men, 13 women; mean age, 69 ± 11 years) who were implanted MR-conditional pacemaker were studied. DEMRI was performed 6 weeks after implantation of permanent pacemaker. In patients with positive for DE, additional examinations like echocardiography, radioisotope imaging, biopsy, and coronary computed-tomography were performed due to confirm the diagnosis of CS and exclude coronary artery disease. Results: DE was observed in 12 patients (44 %). Out of 12 patients, 2 patients were excluded for having prior myocardial infarction. Seven of 10 (70 %) patients were diagnosed of CS by the consensus criteria. Compared with non-CS group, CS group had significantly lower age (61 ± 12 years vs. 72 ± 9 years p = 0.017). There was no significant difference about sex, angiotensin-converting enzyme, brain natriuretic peptide, and left ventricular ejection fraction between 2 groups. Six patients had started corticosteroid therapy and 5 patients (83%) recovered A-V nodal conduction. Conclusion: MR-conditional pacemaker was useful for diagnosis and management of patients with AAVB caused by CS.
    European Heart Journal – Cardiovascular Imaging 12/2014; 15 Suppl 2(suppl 2):ii168-ii195. DOI:10.1093/ehjci/jeu256 · 4.11 Impact Factor
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    ABSTRACT: Background. The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration on Endocarditis–Prospective Cohort Study. Methods. Participants were enrolled between June 2000 and December 2006. Cox proportional hazards modeling that included surgery as a time-dependent covariate and propensity adjustment for likelihood to receive cardiac surgery was used to evaluate the impact of EVS and 1-year all-cause mortality on patients with definite left-sided S. aureus PVIE and no history of injection drug use. Results. EVS was performed in 74 of the 168 (44.3%) patients. One-year mortality was significantly higher among patients with S. aureus PVIE than in patients with non–S. aureus PVIE (48.2% vs 32.9%; P = .003). Staphylococcus aureus PVIE patients who underwent EVS had a significantly lower 1-year mortality rate (33.8% vs 59.1%; P = .001). In multivariate, propensity-adjusted models, EVS was not associated with 1-year mortality (risk ratio, 0.67 [95% confidence interval, .39–1.15]; P = .15). Conclusions. In this prospective, multinational cohort of patients with S. aureus PVIE, EVS was not associated with reduced 1-year mortality. The decision to pursue EVS should be individualized for each patient, based upon infection-specific characteristics rather than solely upon the microbiology of the infection causing PVIE.
    Clinical Infectious Diseases 11/2014; 60(5). DOI:10.1093/cid/ciu871 · 8.89 Impact Factor
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    N. E. Bruun · G. Habib · F. Thuny · P. Sogaard ·

    European Heart Journal 09/2014; 35(34):2334-2334. DOI:10.1093/eurheartj/ehu166 · 15.20 Impact Factor

  • La Revue de Médecine Interne 06/2014; 35:A84-A85. DOI:10.1016/j.revmed.2014.03.112 · 1.07 Impact Factor
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    M Million · F Thuny · E Angelakis · J-P Casalta · R Giorgi · G Habib · D Raoult ·
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    ABSTRACT: Background: Antibiotics, used for 60 years to promote weight gain in animals, have been linked to obesity in adults and in children when administered during early infancy. Lactobacillus reuteri has been linked to obesity and weight gain in children affected with Kwashiorkor using ready-to-use therapeutic food. In contrast, Escherichia coli has been linked with the absence of obesity. Both of these bacteria are resistant to vancomycin. Objectives and methods: We assessed vancomycin-associated weight and gut microbiota changes, and tested whether bacterial species previously linked with body mass index (BMI) predict weight gain at 1 year. All endocarditis patients treated with vancomycin or amoxicillin in our center were included from January 2008 to December 2010. Bacteroidetes, Firmicutes, Lactobacillus and Methanobrevibacter smithii were quantified using real-time PCR on samples obtained during the 4–6 weeks antibiotic regimen. L. reuteri, L. plantarum, L. rhamnosus, Bifidobacterium animalis and E. coli were quantified on stool samples obtained during the first week of antibiotics. Results: Of the193 patients included in the study, 102 were treated with vancomycin and 91 with amoxicillin. Vancomycin was associated with a 10% BMI increase (odds ratio (OR) 14.1; 95% confidence interval (CI; 1.03–194); P=0.047) and acquired obesity (4/41 versus 0/56, P=0.01). In patients treated with vancomycin, Firmicutes, Bacteroidetes and Lactobacillus increased, whereas M. smithii decreased (P<0.05). The absence of E. coli was an independent predictor of weight gain (OR=10.7; 95% CI (1.4–82.0); P=0.02). Strikingly, a patient with an 18% BMI increase showed a dramatic increase of L. reuteri but no increase of E. coli. Conclusion: The acquired obesity observed in patients treated with vancomycin may be related to a modulation of the gut microbiota rather than a direct antibiotic effect. L. reuteri, which is resistant to vancomycin and produces broad bacteriocins, may have an instrumental role in this effect.
    Nutrition & Diabetes 09/2013; 3(9):e87. DOI:10.1038/nutd.2013.28 · 2.65 Impact Factor

  • La Revue de Médecine Interne 06/2013; 34:A95. DOI:10.1016/j.revmed.2013.03.026 · 1.07 Impact Factor
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    Archives of Cardiovascular Diseases 04/2013; 106(4):260–261. DOI:10.1016/j.acvd.2013.03.043 · 1.84 Impact Factor

  • Revue d Épidémiologie et de Santé Publique 04/2011; 59. DOI:10.1016/j.respe.2011.02.013 · 0.59 Impact Factor
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    Archives of Cardiovascular Diseases 04/2011; 104(4):293-293. DOI:10.1016/j.acvd.2011.03.072 · 1.84 Impact Factor
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    ABSTRACT: La cardiomyopathie hypertrophique (CMH) est une affection d’origine génétique (transmission autosomique dominante) caractérisée par une hypertrophie localisée ou diffuse du ventricule gauche (VG). La prévalence de cette affection est de 0,2 % et elle représente la première cause de mort subite chez l’adulte jeune et le sportif. La place de l’IRM dans l’évaluation pronostique de ces patients est double à la fois sur le diagnostic positif de l’affection et plus directement sur l’évaluation du risque de mort subite lié à cette affection. Un dépistage précoce et de qualité de la CMH apparaît donc nécessaire afin de pouvoir au mieux prévenir le risque de mort subite. Le diagnostic de CMH débutante est parfois délicat, surtout lorsque l’affection est suspectée chez un sportif de bon niveau (⩾ 10 heures de sport par semaine). Le diagnostic différentiel entre l’hypertrophie physiologique du sportif et la cardiomyopathie hypertrophique requiert des explorations spécifiques qui doivent inclure la réalisation d’une IRM cardiaque. L’échocardiographie reste, évidemment, l’examen de référence et de première intention. Néanmoins, l’IRM a l’avantage par rapport à l’échocardiographie de : 1) explorer l’ensemble des segments du VG y compris sa paroi latérale et la zone apicale, 2) de permettre des mesures très précises de l’épaisseur télédiastolique, des volumes et de la masse ventriculaire gauche, 3) de permettre la visualisation des zones de fibrose dans le myocarde. Le but de cette mise au point est : 1) d’exposer le rôle de l’IRM dans le diagnostic positif des CMH, 2) de préciser le rôle de l’IRM et des séquences de rehaussement tardif dans l’évaluation du risque de mort subite.
    12/2010: pages 37-41;
  • G Habib · A Torbicki ·
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    ABSTRACT: Pulmonary hypertension (PH) is defined as an increased mean pulmonary artery pressure (P(pa)) >25 mmHg at rest as assessed by right heart catheterisation (RHC). However, this technique is invasive and noninvasive alternatives are desirable for early diagnosis of PH. Although estimation of systolic pulmonary arterial pressure is easily obtained using Doppler echocardiography, cases of under- and over-estimations are not rare and direct measurement of P(pa) is not possible using this method. Therefore, echocardiography should be considered as a tool for assessment of the likelihood rather than the definite presence or absence of PH. Transthoracic echocardiography may be useful for noninvasive screening of patients at risk of PH. On the basis of an echocardiographic assessment, patients showing signs suggestive of PH can be referred for a confirmatory RHC. A number of variables measured during echocardiography reflect the morphological and functional consequences of PH and have prognostic value. The presence of pericardial effusion, reduced tricuspid annular plane excursion and right atrial enlargement are associated with a poorer prognosis. Echocardiography is also an important procedure for monitoring the response of patients to therapy, and is recommended 3-4 months after initiation of, or a change in, therapy. Echocardiographic assessment as part of a goal-oriented approach to therapy is essential for the effective management of PH patients.
    European Respiratory Review 12/2010; 19(118):288-99. DOI:10.1183/09059180.00008110
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    ABSTRACT: To analyse characteristics and outcomes of infective endocarditis (IE) on bicuspid aortic valves (BAV) and to compare the risk of death according to the presence or absence of BAV. 5-year observational study. Population of 856 patients with definite IE according to the Duke criteria from two tertiary centres (Amiens and Marseille, France). 310 consecutive patients with definite native aortic valve IE enrolled between 1991 and 2007. Patients underwent transthoracic and transoesophageal echocardiography during hospitalisation. Surgery was performed on a case-by-case basis according to conventional guidelines. In-hospital mortality and 5-year overall mortality. Patients with BAV IE (n=50, 16%) were younger, had fewer comorbidities and a higher frequency of aortic perivalvular abscess (50%). Presence of BAV (OR 3.79 (1.97-7.28); p<0.001) was independently predictive of abscess formation. Early surgery was performed in 36 BAV patients (72%) with a peri-operative mortality of 8.3%, comparable to that of patients with tricuspid aortic valve IE (p=0.89). BAV was not independently predictive of in-hospital mortality (OR 0.89 (0.28-2.85); p=0.84) or 5-year survival (HR 0.71 (0.37-1.36); p=0.30). Age, comorbidities, heart failure, Staphylococcus aureus and uncontrolled infection were associated with increased 5-year mortality in BAV patients. BAV is frequent in adults with native aortic valve IE. Patients with BAV IE incur high risk of abscess formation and require early surgery in almost three-quarters of cases. IE is a severe complication in the setting of BAV and warrants prompt diagnosis and treatment.
    Heart (British Cardiac Society) 11/2010; 96(21):1723-9. DOI:10.1136/hrt.2009.189050 · 5.60 Impact Factor
  • G. Habib ·

    Archives des Maladies du Coeur et des Vaisseaux - Pratique 10/2010; 2010(191):7-10. DOI:10.1016/S1261-694X(10)70126-7
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    ABSTRACT: Pulmonary arterial hypertension (PAH) is a progressive, fatal disease. We studied 674 consecutive adult patients who were prospectively enrolled in the French PAH registry (121 incident and 553 prevalent cases). Two survival analyses were performed. First, the cohort of 674 patients was followed for 3 yrs after study entry and survival rates described. Then, we focused on the subset with incident idiopathic, familial and anorexigen-associated PAH (n = 56) combined with prevalent patients who were diagnosed <3 yrs prior to study entry (n = 134). In the cohort of 674 patients, 1-, 2-, and 3-yr survival rates were 87% (95% CI 84-90), 76% (95% CI 73-80), and 67% (95% CI 63-71), respectively. In prevalent idiopathic, familial and anorexigen-associated PAH, 1-, 2-, and 3-yr survival rates were higher than in incident patients (p = 0.037). In the combined cohort of patients with idiopathic, familial and anorexigen-associated PAH, multivariable analysis showed that survival could be estimated by means of a novel risk-prediction equation using patient sex, 6-min walk distance, and cardiac output at diagnosis. This study highlights survivor bias in prevalent cohorts of PAH patients. Survival of idiopathic, familial and anorexigen-associated PAH can be characterised by means of a novel risk-prediction equation using patients' characteristics at diagnosis.
    European Respiratory Journal 09/2010; 36(3):549-55. DOI:10.1183/09031936.00057010 · 7.64 Impact Factor
  • G. Habib · S. Renard · G. Simonneau ·

    Archives des Maladies du Coeur et des Vaisseaux - Pratique 03/2010; 2010(186):38–39. DOI:10.1016/S1261-694X(10)70022-5

Publication Stats

2k Citations
421.36 Total Impact Points


  • 2011
    • Institut de France
      Lutetia Parisorum, Île-de-France, France
  • 2009
    • MIT Portugal
      Porto Salvo, Lisbon, Portugal
    • Policlinico Federico II di Napoli
      Napoli, Campania, Italy
  • 2008
    • Aix-Marseille Université
      • Faculté de Médecine
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2003
    • Hôpital Européen Georges-Pompidou (Hôpitaux Universitaires Paris-Ouest)
      Lutetia Parisorum, Île-de-France, France
  • 2002
    • French National Centre for Scientific Research
      • Laboratoire Information Génomique et Structurale (IGS)
      Lutetia Parisorum, Île-de-France, France
    • Hospital Centre University of Fort de France
      Fort Royal, Martinique, Martinique
  • 1992-1998
    • Hôpital Européen, Marseille
      Marsiglia, Provence-Alpes-Côte d'Azur, France