P Asseman

Publications (71)275.98 Total impact

• Source

  Available from: narod.ru

  Article: Elevated left atrial pressure estimated by Doppler echocardiography is a key determinant of mitral valve tenting in functional mitral regurgitation.

  S Maréchaux, C Pinçon, M Poueymidanette, M Verhaeghe, A Bellouin, P Asseman, T Le Tourneau, T H Lejemtel, P Pibarot, P V Ennezat
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  ABSTRACT: Functional mitral regurgitation (FMR) may occur in patients with reduced or preserved left ventricular ejection fraction (LVEF) and has been associated with excess valvular tenting only in patients with reduced LVEF. This study aimed at identifying the predictors of FMR and to determine whether or not they are different in patients with reduced versus preserved LVEF. 190 consecutive patients free of congenital or primary valvular disease had a comprehensive echocardiographic assessment of LV remodelling and function, diastolic function and FMR severity. 112 patients had depressed LVEF (<50%) and 78 had preserved LVEF. FMR was present in 30 patients with preserved LVEF and in 65 with reduced LVEF. Higher E/Ea, E/A and larger mitral tenting were independent predictors of FMR regardless of LVEF. The mitral tenting area was an independent predictor of FMR severity in patients with reduced or preserved LVEF (p = 0.04 and p = 0.0045) in addition to E/A (p = 0.0007), E/Ea (p = 0.004) in patients with reduced and preserved LVEF, respectively. Higher E/Ea was independently associated with larger mitral tenting in patients with reduced and preserved LVEF. Mitral tenting area was linearly related to E/Ea (r = 0.30, p<0.0001) and E/A (r = 0.43, p<0.0001) and LA enlargement (r = 0.54, p<0.0001) after having paired 96 patients with and without FMR on indices of LV remodelling. In both patients with preserved and reduced LVEF, mitral tenting that leads to FMR is mainly determined by both mitral tethering forces-that is, displacement of papillary muscles and by pushing forces-that is, increased left atrial pressure. This study underscores that LV preload is a key determinant of FMR.
  Heart (British Cardiac Society) 02/2010; 96(4):289-97. · 4.22 Impact Factor
• Article: Aortic dissection may be suspected from the pulse oximetry plethysmographic curve.

  J L Auffray, P Asseman, P V Ennezat
  Emergency Medicine Journal 10/2009; 26(9):634. · 1.44 Impact Factor
• Article: Forgotten needles.

  D Montaigne, P-V Ennezat, P Asseman
  Case Reports 01/2009; 2009:bcr2007046045.
• Article: An unexpected finding in sudden cardiac death.

  S Pouwels, P-V Ennezat, P Asseman
  Emergency Medicine Journal 08/2008; 25(8):491. · 1.44 Impact Factor
• Article: Forgotten needles.

  D Montaigne, P-V Ennezat, P Asseman
  Emergency Medicine Journal 02/2008; 25(1):61. · 1.44 Impact Factor
• Article: [Heparin-induced thrombocytopenia: a case of persistent thrombocytopenia].

  M Jourdain, P-V Ennezat, J Darchis, J-M Aubert, J-J Bauchart, J-L Auffray, P Asseman
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  ABSTRACT: Heparin-induced thrombocytopenia is rare. It should be considered if there is a reduction of at least 40% in the number of platelets and/or a level<100,000/mm3 in any patients who have received heparin in the previous 100 days. On stopping heparin, the rise in platelets is classically rapid, and normal levels are usually obtained in under 7 days. We report a case of heparin-induced thrombocytopenia, which was marked by a severe thrombocytopenia that only returned to normal 19 days after stopping heparin, in a patient treated initially with non-fractionated heparin for a pulmonary embolism secondary to an extensive deep venous thrombosis of the right lower limb.
  Archives des maladies du coeur et des vaisseaux 12/2007; 100(11):959-62. · 0.40 Impact Factor
• Article: Delayed recovery of left ventricular systolic dysfunction: ''give time to medical therapy''.

  P V Ennezat, X Gonin, J Darchis, P De Groote, N Lamblin, C Bauters, T Lejemtel, P Asseman
  Minerva cardioangiologica 07/2007; 55(3):426-7.
• Article: [Pulmonary embolism and right diaphragmatic paralysis: "one train can hide another"].

  C Charbonnel, P V Ennezat, J Darchis, J L Auffray, J J Bauchart, J M Aubert, F Godart, P Goldstein, P Asseman
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  ABSTRACT: The authors report the case of an 84 year old woman admitted for a mild pulmonary embolism associated with severe hypoxaemia. The association of a right diaphragmatic paralysis with renewed patency of a foramenovale and creation of a right-to-left shunt is probably an underestimated cause of refractory hypoxaemia.
  Archives des maladies du coeur et des vaisseaux 02/2007; 100(1):61-3. · 0.40 Impact Factor
• Article: [Myocardial infarction with normal coronary arteries: role of transesophageal echocardiography].

  C Vannesson, P V Ennezat, J M Aubert, J Darchis, J L Auffray, J J Bauchart, M Lesenne, A Sudre, P Goldstein, P Asseman
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  ABSTRACT: We report the case of 74 years-old female patient hospitalized for a ST+ acute coronary syndrome with normal coronary angiography. The association of a patent foramen ovale, a deep venous thrombosis and a pulmonary embolism led us to conclude the diagnosis of paradoxical coronary embolism. This case allows us to remind different etiologies to be considered in case of myocardial infarction with normal coronary arteries, and the interest of transesophageal echocardiography for the diagnosis of its etiology.
  Archives des maladies du coeur et des vaisseaux 02/2007; 100(1):68-71. · 0.40 Impact Factor
• Article: Functional mitral regurgitation and chronic heart failure.

  P V Ennezat, S Marechaux, P Asseman, T H Lejemtel, E Van Belle, C Bauters, P De Groote
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  ABSTRACT: Functional mitral regurgitation (MR) frequently develops during the progression of chronic heart failure and predicts poor outcome. Impaired left ventricular (LV) function, LV remodeling associated with papillary muscle apical displacement and annular enlargement result in decreased mitral closing forces and tenting of the mitral valve at closure. Reduced closing forces and tenting both promote MR. Active myocardial ischemia, myocardial asynchronism and excessive loading conditions worsen MR at rest and during exercise. The therapeutic target in functional MR is the left ventricle and not the valve.
  Minerva cardioangiologica 01/2007; 54(6):725-33.
• Article: Cardiac resynchronisation therapy reduces functional mitral regurgitation during dynamic exercise in patients with chronic heart failure: an acute echocardiographic study.

  P-V Ennezat, B Gal, C Kouakam, C Marquie, T LeTourneau, D Klug, D Lacroix, D Logeart, A Cohen-Solal, S Dennetière, E Van Belle, G Deklunder, P Asseman, P de Groote, S Kacet, T H LeJemtel
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  ABSTRACT: To assess non-invasively the acute effects of cardiac resynchronisation therapy (CRT) on functional mitral regurgitation (MR) at rest and during dynamic exercise. 21 patients with left ventricular (LV) systolic dysfunction and functional MR at rest, treated with CRT, were studied. Each patient performed a symptom-limited maximal exercise with continuous two dimensional Doppler echocardiography twice. The first exercise was performed with CRT; the second exercise was performed without CRT. Mitral regurgitant flow volume (RV), effective regurgitant orifice area (ERO) and LV dP/dt were measured at rest and at peak exercise. CRT mildly reduced resting mitral ERO (mean 8 (SEM 2) v 11 (2) mm(2) without CRT, p = 0.02) and RV (13 (3) v 18 (3) ml without CRT, p = 0.03). CRT attenuated the spontaneous increase in mitral ERO and RV during exercise (1 (1) v 9 (2) mm(2), p = 0.004 and 1 (1) v 8 (2) ml, p = 0.004, respectively). CRT also significantly increased exercise-induced changes in LV dP/dt (140 (46) v 479 (112) mm Hg/s, p < 0.001). Attenuation of functional MR, induced by an increase in LV contractility during dynamic exercise, may contribute to the beneficial clinical outcome of CRT in patients with chronic heart failure and LV asynchrony.
  Heart (British Cardiac Society) 08/2006; 92(8):1091-5. · 4.22 Impact Factor
• Article: [Tako-tsubo syndrome and left ventricular obstruction: report of one case].

  P Marboeuf, P V Ennezat, X Gonin, J M Aubert, J L Auffray, J J Bauchart, J P Beregi, P Asseman
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  ABSTRACT: We report here the case of an 80 year old female suffering from Tako-tsubo syndrome diagnosed following type B aortic dissection, treated surgically with an aortic endoprosthesis. The recovery was marked by the secondary development of left intraventricular obstruction. Regression of the electrical and ultrasound anomalies was slow, taking 4 months of treatment with a beta-blocker. The intraventricular obstruction seemed to occupy a central role in this case, and we discuss the significance of this mechanical phenomenon in the pathophysiology of this syndrome.
  Archives des maladies du coeur et des vaisseaux 02/2006; 99(1):69-72. · 0.40 Impact Factor
• Article: Images in cardiology: an unusual cause of syncope.

  P V Ennezat, J M Aubert, A Vincentelli, P Asseman
  Heart (British Cardiac Society) 01/2006; 91(12):1511. · 4.22 Impact Factor
• Article: [Thrombolytics. Principles and rules of use].

  P Asseman, J J Bauchart, J L Auffray
  La Revue du praticien 03/2001; 51(4):459-61.
• Article: [Pheochromocytoma simulating myocardial infarct. Apropos of a case].

  C Moulin, M Delomez, J J Bauchart, M Lesenne, P Asseman, C Théry
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  ABSTRACT: The authors report the case of a pheochromocytoma in a 67 year old man in whom the initial clinical presentation suggested myocardial infarction. Pheochromocytoma is usually an adrenal tumour with a very variable clinical symptomatology. It is very rare for cardiac disease to be a presenting symptom. The diagnosis was suggested by major blood pressure abnormalities occurring after starting medical treatment for infarction. Pheochromocytomas may cause serious cardiovascular disorders. The diagnosis must be suspected in the presence of atypical signs, an essential requirement to reduce the mortality of the disease.
  Archives des maladies du coeur et des vaisseaux 01/2000; 92(12):1789-94. · 0.40 Impact Factor
• Article: Free-floating thrombi in the right heart: diagnosis, management, and prognostic indexes in 38 consecutive patients.

  L Chartier, J Béra, M Delomez, P Asseman, J P Beregi, J J Bauchart, H Warembourg, C Théry
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  ABSTRACT: Floating right heart thrombi (FRHTS) are a rare phenomenon, encountered almost exclusively in patients with suspected or proven pulmonary embolism and diagnosed by transthoracic echocardiography. Their management remains controversial. We report on a series of 38 consecutive patients encountered over the past 12 years. Thirty-two patients were in NYHA class IV, 20 in cardiogenic shock. Echocardiography usually demonstrated signs of cor pulmonale: right ventricular overload (91.7% of the population), paradoxical interventricular septal motion (75%), and pulmonary hypertension (86. 1%). The thrombus was typically wormlike (36 of 38 patients). It extended from the left atrium through a patent foramen ovale in 4 patients. Pulmonary embolism was confirmed in all but 1. Mortality was high (17 of 38 patients) irrespective of the therapeutic option chosen: surgery (8 of 17), thrombolytics (2 of 9), heparin (5 of 8), or interventional percutaneous techniques (2 of 4). The in-hospital mortality rate was significantly linked with the occurrence of cardiac arrest. Conversely, the outcome after discharge was usually good, because 18 of 21 patients were still alive 47.2 months later (range, 1 to 70 months). Severe pulmonary embolism was the rule in our series of FRHTS (mortality rate, 44.7%). The choice of therapy had no effect on mortality. Emergency surgery is usually advocated. However, thrombolysis is a faster, readily available treatment and seems promising either as the only treatment or as a bridge to surgery. In patients with contraindications to surgery or lytic therapy, interventional techniques may be proposed.
  Circulation 07/1999; 99(21):2779-83. · 14.74 Impact Factor
• Article: [Primary biliary cirrhosis associated with pericardial effusion].

  B Agraou, T Le Tourneau, H Agraou, F Leroy, P Asseman, J J Dujardin
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  ABSTRACT: The authors report a case of primary biliary cirrhosis, associated with moderate pericardial effusion, in a patient with antiphospholipid antibodies. The pericardial effusion resolved, and did not recur, in response to treatment with Colchicine and ursodesoxycholic acid.
  Annales de Cardiologie et d Angéiologie 11/1998; 47(8):576-8. · 0.28 Impact Factor
• Article: Enhanced monocyte tissue factor response after experimental balloon angioplasty in hypercholesterolemic rabbit: inhibition with dietary L-arginine.

  D Corseaux, T Le Tourneau, I Six, M D Ezekowitz, E P Mc Fadden, T Meurice, P Asseman, C Bauters, B Jude
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  ABSTRACT: There is evidence that tissue factor (TF) is a major contributor to the thrombogenicity of a ruptured atherosclerotic plaque. Nitric oxide (NO) has antiatherogenic and antithrombotic properties. We investigated whether L-arginine (L-arg), the endogenous precursor of NO, might affect the ability of monocytes to produce TF. We studied TF expression in 18 rabbits with atherosclerosis induced by bilateral iliac damage and 10 weeks of a 2% cholesterol diet. Six weeks after the initiation of the diet, an angioplasty was performed. After angioplasty, the surviving rabbits (n=15) were randomized to receive L-arg (2.25%) supplementation in drinking water (L-arg group, n=8) or no treatment (untreated group, n=7). TF expression was evaluated in mononuclear cells from arterial blood in the presence and absence of endotoxin stimulation. Monocyte TF expression, as assessed with an amidolytic assay, did not differ significantly before or after the induction of atherosclerotic lesions (87+/-15 versus 70+/-12 mU of TF/1000 monocytes, P=NS). Endotoxin-stimulated TF activity increased significantly 4 weeks after angioplasty (138+/-22 versus 70+/-12 mU of TF/1000 monocytes, P=0.02). This increase was blunted by L-arg (43+/-16 mU of TF/1000 monocytes, P=0.01). This study demonstrates that angioplasty-induced plaque rupture is associated with a marked increase in monocyte TF response that is blunted by the oral administration of L-arg. This suggests that the documented antithrombotic properties of NO may be related in part to an inhibitory effect on monocyte TF response.
  Circulation 11/1998; 98(17):1776-82. · 14.74 Impact Factor
• Article: [Mobile thrombi of the right heart in pulmonary embolism].

  L Chartier, P Michon, C Loubeyre, P Asseman, P Bérégi, J J Bauchart, H Warembourg, C Théry
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  ABSTRACT: Systematic transthoracic echocardiography in all cases of pulmonary embolism may demonstrate right heart thrombi. The results of this monocentric series of 28 consecutive cases observed between 1987 and 1996 were analysed. Twenty-four patients were in NYHA Class IV: thirteen were in cardiogenic shock. Echocardiographic signs of acute cor pulmonale were usually observed: 96.3% of patients had right ventricular dilatation, 85.2% paradoxical interventricular septal motion, 88.9% pulmonary hypertension. The thrombus was typical serpentine (27/28 cases) arising from the lower limb veins. Passage into the left heart chambers through a patent foramen ovale was observed in 3 cases. Pulmonary embolism was confirmed in all cases. This is an extreme therapeutic emergency and 13 patients (46.4%) died despite treatment: surgery (7/16), thrombolysis (2/5), heparin (3/4) or interventional radiology (1/3). After the acute phase, the prognosis was generally good, as demonstrated by the 100% survival rate at 28.6 +/- 25 months. This study confirms the gravity of mobile right heart thrombi in pulmonary embolism. The diagnosis is echocardiographic. No significant difference in mortality was observed between the different therapeutic approaches used in this series. The echocardiographic finding of these thrombi is a traditional indication for emergency surgical embolectomy. Thrombolysis is rapid and readily available and seems to provide promising results alone or before surgery. In patients with contraindications to thrombolysis, interventional radiology or simple heparin therapy may be proposed.
  Archives des maladies du coeur et des vaisseaux 11/1997; 90(11):1471-6. · 0.40 Impact Factor
• Article: [Acute myocarditis caused by toxoplasmosis simulating infarction. Apropos of a case].

  M Lesenne, P Asseman, B Fortier, P de Groote, J J Bauchart, A Millaire, Y Haftel, C Thery
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  ABSTRACT: Acute myocarditis due to toxoplasmosis infection has been previously reported, usually in patients suffering from immuno-depression. Cardiac involvement by toxoplasmosis is rare in subjects with a normal immunological status. The authors report the case of a 16-year-old patient without immuno-depression with acute myocarditis caused by toxoplasmosis simulating myocardial infarction.
  Archives des maladies du coeur et des vaisseaux 08/1996; 89(7):923-5. · 0.40 Impact Factor