Karine Marquis

Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Québec, Quebec, Canada

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Publications (18)64.06 Total impact

  • Canadian respiratory journal: journal of the Canadian Thoracic Society 05/2014; · 1.66 Impact Factor
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    ABSTRACT: Reduced heart rate variability (HRV) is a predictor of poor outcome in several pathologies and in general population. Whether HRV is altered during normal daily activities or influenced by anticholinergic and β-adrenergic medications in chronic obstructive pulmonary disease (COPD) remains unknown. Forty-one clinically stable COPD patients and 19 healthy controls matched for age, sex and smoking history underwent a 24-hour ambulatory ECG recording during normal daily activities. HRV was assessed by standardized temporal and spectral analysis. COPD patients showed a reduced HRV (LF/HF ratio) compared with healthy controls (median [interquartile range]) during daytime (2.6 [1.5-3.8] vs. 3.5 [2.9-5.6]), nighttime (1.8 [1.1-4.3] vs. 4.2 [2.7-6.9]) as well as during the entire 24-hour (1.9 [1.5-3.4] vs. 3.9 [3.2-5.6]) recordings (all P < 0.005). There was no significant difference between the two groups in the time domain and in the low frequency or high frequency domain for the 24-hour period analysis. In COPD patients, the 24-hour LF/HF ratio positively correlated with forced expiratory volume in 1 second (FEV(1)) (r = 0.342, P = 0.028) and negatively correlated with age (r = -0.317, P = 0.044). In multiple regression analysis, LF/HF ratio was associated with FEV(1) (P = 0.05) but not with age (P = 0.08). There was no difference of HRV between patients using or not anticholinergic or β-agonist medications. These results demonstrate that COPD patients have a reduced sympatho-vagal balance compared with healthy subjects. HRV correlates with disease severity and does not seem to be influenced by anticholinergic or adrenergic medications.
    COPD Journal of Chronic Obstructive Pulmonary Disease 12/2010; 7(6):391-7. DOI:10.3109/15412555.2010.528083 · 2.62 Impact Factor
  • M Bedard · K Marquis · S Provencher · P Poirier
    American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California; 04/2009
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    ABSTRACT: The present pilot study was undertaken to evaluate the efficacy of an aerobic exercise training (AET) program alone or combined with an antihypertensive agent (irbesartan) to reduce blood pressure (BP) and enhance heart rate variability (HRV) in chronic obstructive pulmonary disease patients. Twenty-one patients were randomly assigned to a double-blind treatment with exercise and placebo (n=11) or exercise and irbesartan (n=10). Subjects underwent 24 h BP monitoring and 24 h electrocardiographic recording before and after the 12-week AET. HRV was investigated using three indexes from the power spectral analysis and three indexes calculated from the time domain. The AET program consisted of exercising on a calibrated ergocycle for 30 min three times per week. Five patients in the placebo group were excluded during follow-up because they were not compliant. There was no change in 24 h systolic and diastolic BP before (130+/-14 mmHg and 70+/-3 mmHg, respectively) and after (128+/-8 mmHg and 70+/-8 mmHg, respectively) exercise training in the placebo group, whereas in the irbesartan group systolic and diastolic BP decreased from 135+/-9 mmHg and 76+/-9 mmHg to 126+/-12 mmHg and 72+/-8 mmHg, respectively (P<0.02). There were no changes in HRV parameters in either group. The present study suggests that a 12-week AET program is not associated with a significant reduction in BP or enhancement in HRV, whereas an AET program combined with irbesartan is associated with a reduction in 24 h BP.
    Canadian respiratory journal: journal of the Canadian Thoracic Society 10/2008; 15(7):355-60. · 1.66 Impact Factor
  • K Marquis · F Maltais · P Poirier
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    ABSTRACT: INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is characterized mainly by airway obstruction due to chronic bronchitis and/or emphysema. In addition, COPD is frequently associated with other health problems with serious systemic manifestations. In particular, COPD patients are at increased risk of cardiovascular disease. BACKGROUND: Current knowledge about cardiovascular disease in patients with COPD mainly concerns the high prevalence of cardiac arrhythmias in this population. Systemic hypertension, cardiovascular disease, heart failure and cerebro-vascular disease are also frequently encountered. This review discusses the cardiovascular manifestations associated with COPD, excluding right heart failure due to pulmonary hypertension. VIEWPOINTS AND CONCLUSION: Non pulmonary health problems in patients with COPD, such as cardiovascular disease, are arousing increasing interest in the medical community. More studies are needed to increase our knowledge of cardiovascular disease in COPD and allow better medical management of patients.
    Revue des Maladies Respiratoires 07/2008; 25(6):663-73. · 0.49 Impact Factor
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    K Marquis · F Maltais · P Poirier
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    ABSTRACT: Résumé Introduction La bronchopneumopathie obstructive chronique (BPCO) affecte principalement la fonction respiratoire. Or, cette maladie est fréquemment associée à d'autres problèmes de santé appelés manifestations systémiques. Notamment, les patients atteints d'une BPCO présentent un risque élevé de maladies cardiovasculaires.
    Revue des Maladies Respiratoires 06/2008; 25(6). DOI:10.1016/S0761-8425(08)73805-1 · 0.49 Impact Factor
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    ABSTRACT: Several chronic diseases are known to negatively affect the ability of an individual to perform exercise. However, the altered exercise capacity observed in these patients is not solely associated with the heart and lungs dysfunction. Exercise has also been shown to play an important role in the management of several pathologies encountered in the fields of cardiology and pneumology. Studies conducted in our institution regarding the influence of diabetes, chronic heart failure, congenital heart disease and chronic pulmonary obstructive disease on the acute and chronic exercise responses, along with the beneficial effects of exercise training in these populations, are reviewed.
    The Canadian journal of cardiology 10/2007; 23 Suppl B:89B-96B. DOI:10.1016/S0828-282X(07)71018-8 · 3.94 Impact Factor
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    ABSTRACT: Little is known about the comparative impact of chronic obstructive pulmonary disease (COPD) between women and men and about women's response to pulmonary rehabilitation. To compare lung function, disability, mortality and response to pulmonary rehabilitation between women and men with COPD. In the present retrospective study, 68 women (mean age 62.5+/-8.9 years) and 168 men (mean age 66.3+/-8.4 years) were evaluated by means of pulmonary function testing and an incremental symptom-limited cycle exercise test. Forty women and 84 men also participated in a 12-week pulmonary rehabilitation program. A 6 min walking test and the chronic respiratory questionnaire were used to assess the effects of pulmonary rehabilitation. Survival status was also evaluated. Compared with men, women had a smaller tobacco exposure (31+/-24 versus 48+/-27 pack-years, P<0.05), displayed better forced expiratory volume in 1 s (44+/-13 versus 39+/-14 % predicted, P<0.05), a higher functional residual capacity (161+/-37 versus 149+/-36 % predicted, P<0.05) and total lung capacity (125+/-20 versus 115+/-19 % predicted, P<0.001). Peak oxygen consumption was not different between women and men when expressed in predicted values but lower in women when expressed in absolute values. Pulmonary rehabilitation resulted in significant improvements in 6 min walking test and quality of life in both sexes, but women had a greater improvement in chronic respiratory questionnaire dyspnea. Survival status was similar between sexes, but predictors of mortality were different between sexes. Women may be more susceptible to COPD than men. The clinical expression of COPD may differ between sexes with greater degree of hyperinflation in women, who also benefit from pulmonary rehabilitation.
    Canadian respiratory journal: journal of the Canadian Thoracic Society 04/2007; 14(2):93-8. · 1.66 Impact Factor
  • Sleep Medicine 09/2006; 7. DOI:10.1016/j.sleep.2006.07.288 · 3.10 Impact Factor
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    ABSTRACT: Abnormal heart rate recovery (HRR) after exercise, a marker of cardiac autonomic dysfunction, is associated with poor prognosis in various populations. As chronic obstructive pulmonary disease (COPD) is associated with cardiac autonomic dysfunction, we tested the hypothesis that patients with COPD have a lower HRR than healthy people, and evaluated whether a delay in HRR is associated with an increased risk of mortality in COPD. The records of 147 COPD patients were reviewed (65.1+/-9.1 years, mean+/-sd, 42 women/105 men, forced expiratory volume in 1s (FEV1): 42+/-15% predicted) and compared to 25 healthy subjects (61.6+/-4.5 years, 5 women/20 men, FEV1: 100+/-14% predicted) during recovery after an exercise test. Heart rate was measured at peak exercise and at 1-min recovery, the difference between the two being defined as HRR (11+/-9 beats in COPD patients vs. 20+/-9 beats in healthy subjects, P < 0.0001). During a mean follow-up of 43.1+/-22.0 months, 32 patients died. Abnormal HRR (14 beats) was a strong predictor of mortality in COPD patients (adjusted hazard ratio: 5.12, 95% CI [1.54-17.00]). In conclusion, COPD patients have a lower HRR than healthy subjects, and have a worse prognosis when presenting abnormal HRR.
    Respiratory Medicine 08/2005; 99(7):877-86. DOI:10.1016/j.rmed.2004.11.012 · 2.92 Impact Factor
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    ABSTRACT: This study was undertaken to evaluate the presence of the metabolic syndrome in COPD patients who participated in a cardiopulmonary rehabilitation program. The metabolic syndrome is characterized by the presence of abdominal obesity, atherogenic dyslipidemia, raised blood pressure, presence of insulin resistance, and prothrombotic and inflammatory states that predispose to cardiovascular diseases. Thirty-eight COPD patients (age: 66 +/- 7 years, [mean +/- SD], FEV1: 43 +/- 16% predicted) and 34 control participants matched for age and gender are included in this study. The criteria for the identification of the metabolic syndrome include 3 or more of the following features: abdominal obesity (waist circumference: > 102 cm in men, > 88 cm in women), triglycerides levels (>or= 1.69 mmol/L), high-density lipoprotein cholesterol levels (< 1.0 mmol/L in men, < 1.3 mmol/L in women), blood pressure (>or= 130/ >or= 85 mm Hg), and fasting glucose levels (>or= 6.1 mmol/L). Forty-seven percent of COPD patients and 21% of control participants presented 3 or more determinants of the metabolic syndrome. The presence of metabolic syndrome is frequent in patients with COPD who participated in a cardiopulmonary program. Hence, this population should be considered for screening for the metabolic syndrome.
    Journal of Cardiopulmonary Rehabilitation 07/2005; 25(4):226-32; discussion 233-4. DOI:10.1097/00008483-200507000-00010
  • Karine Marquis · Anne-Marie Bezeau · Jean Jobin · Paul Poirier
    Medicine &amp Science in Sports &amp Exercise 05/2004; 36(Supplement). DOI:10.1097/00005768-200405001-01000 · 4.46 Impact Factor
  • Medicine &amp Science in Sports &amp Exercise 05/2004; 36(Supplement):S209. DOI:10.1249/00005768-200405001-01000 · 4.46 Impact Factor
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    ABSTRACT: The mechanisms leading to muscle wasting in patients with COPD are still uncertain. This study was undertaken to evaluate the relationships among circulating levels of catabolic factors (ie, interleukin [IL]-6 and cortisol), anabolic factors (ie, bioavailable testosterone [Tbio], dehydroepiandrosterone sulfate [DHEAS], and insulin-like growth factor [IGF]-I), and mid-thigh muscle cross-sectional area (MTCSA) in patients with COPD. Serum levels of the above factors were measured in 45 men with COPD (mean [+/- SEM] FEV(1), 43 +/- 3% predicted; mean age, 67 +/- 1 years) and 16 sedentary healthy men of similar age. MTCSA was quantified using CT scanning. Patients with COPD were subdivided into two groups according to the MTCSA (< 70 or >or= 70 cm(2)). There was a greater prevalence of hypogonadism (ie, Tbio, < 2 nmol/L) in patients with COPD compared to control subjects (22% vs 0%, respectively). Patients with an MTCSA of < 70 cm(2) had significantly reduced levels of DHEAS compared to those in healthy subjects (p < 0.01). IL-6 levels were significantly higher in both subgroups of COPD patients compared to those in control subjects (p < 0.005). The cortisol/DHEAS, IL-6/DHEAS, IL-6/Tbio, and IL-6/IGF-I ratios were significantly greater in COPD patients with an MTCSA of < 70 cm(2) compared to those in control subjects (p < 0.05). The cortisol/DHEAS and IL-6/DHEAS ratios were also significantly greater in COPD patients with an MTCSA of < 70 cm(2) than in COPD patients with an MTCSA of >or= 70 cm(2) (p < 0.05). In a stepwise multiple regression analysis, the IL-6/DHEAS ratio explained 20% of the variance in MTCSA (p < 0.005). Catabolic/anabolic disturbances were found in COPD patients leading to a shift toward catabolism and possibly to the development of peripheral muscle wasting.
    Chest 08/2003; 124(1):83-9. DOI:10.1378/chest.124.1.83 · 7.13 Impact Factor
  • K Marquis · F Maltais · J Jobin · P LeBlanc · P Poirier
    Medicine &amp Science in Sports &amp Exercise 05/2003; 35(Supplement 1). DOI:10.1097/00005768-200305001-00977 · 4.46 Impact Factor
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    ABSTRACT: This study was undertaken to test the hypothesis that a reduction in midthigh muscle cross-sectional area obtained by CT scan (MTCSACT) is a better predictor of mortality in chronic obstructive pulmonary disease (COPD) than low body mass index (BMI). We also wished to evaluate whether anthropometric measurements could be used to estimate MTCSACT. One hundred forty-two patients with COPD (age = 65 ± 9 years, mean ± SD, 26 F, BMI = 26 ± 6 kg/m2, FEV1 = 42 ± 16% predicted) were recruited from September 1995 to April 2000 with a mean follow-up of 41 ± 18 months. The primary end-point was all-cause mortality during the study period. A Cox proportional hazards regression model was used to predict mortality using the following independent variables: age, sex, daily use of corticosteroid, FEV1, DLCO, BMI, thigh circumference, MTCSACT, peak exercise workrate, PaO2, and PaCO2. Only MTCSACT and FEV1 were found to be significant predictors of mortality (p = 0.0008 and p = 0.01, respectively). A second analysis was also performed with FEV1 and MTCSACT dichotomized. Patients were divided into four subgroups based on FEV1 (< or ≥ 50% predicted) and MTCSACT (< or ≥ 70 cm2). Compared with patients with an FEV1 ≥ 50% predicted and a MTCSACT ≥ 70 cm2, those with an FEV1 < 50% predicted and a MTCSACT ≥ 70 cm2 had a mortality odds ratio of 3.37 (95% confidence interval, 0.41-28.00), whereas patients with an FEV1 < 50% predicted and a MTCSACT < 70 cm2 had a mortality odds ratio of 13.16 (95% confidence interval, 1.74-99.20). MTCSACT could not be estimated with sufficient accuracy from anthropometric measurements. In summary, we found in this cohort of patients with COPD that (1) MTCSACT was a better predictor of mortality than BMI, and (2) MTCSA had a strong impact on mortality in patients with an FEV1< 50% predicted. These findings suggest that the assessment of body composition may be useful in the clinical evaluation of these patients.
    American Journal of Respiratory and Critical Care Medicine 09/2002; 166(6):809-13. DOI:10.1164/rccm.2107031 · 11.99 Impact Factor
  • K Marquis · P Poirier · G Turcotte · P LeBlanc · J Jobin · F Maltais
    Medicine &amp Science in Sports &amp Exercise 05/2002; 34(5). DOI:10.1097/00005768-200205001-00284 · 4.46 Impact Factor
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    ABSTRACT: Enzymatic and histochemical abnormalities of the peripheral muscle may play a role in exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). A study was undertaken to measure the mitochondrial enzyme activity of the vastus lateralis muscle in patients with COPD and to evaluate the relationship between enzyme activities and functional status. Fifty seven patients with COPD of mean (SD) age 66 (7) years with forced expiratory volume in one second (FEV(1)) 39 (15)% predicted and peak oxygen uptake (VO(2)) of 14 (4) ml/min/kg and 15 normal subjects of similar age were included in the study. Each subject performed a stepwise exercise test up to maximal capacity during which five-breath averages of VO(2) were measured. Muscle specimens were obtained by percutaneous needle biopsy of the vastus lateralis muscle and the activity of two mitochondrial enzymes (citrate synthase (CS) and 3-hydroxyacyl CoA dehydrogenase (HADH)) was measured. The functional status of the patients was classified according to peak VO(2). CS and HADH activities were markedly reduced in patients with COPD compared with normal subjects (22.3 (2.7) versus 29.5 (7.3) micromol/min/g muscle (p<0.0001) and 5. 1 (2.0) versus 6.7 (1.9) micromol/min/g muscle (p<0.005), respectively). The activity of CS decreased progressively with the deterioration in the functional status while that of HADH was not related to functional status. Using a stepwise regression analysis, percentage predicted functional residual capacity (FRC), the activity of CS, oxygen desaturation during exercise, age, and inspiratory capacity (% pred) were found to be significant determinants of peak VO(2). The regression model explained 59% of the variance in peak VO(2) (p<0.0001). The oxidative capacity of the vastus lateralis muscle is reduced in patients with moderate to severe COPD compared with normal subjects of similar age. In these individuals the activity of CS correlated significantly with peak exercise capacity and independently of lung function impairment.
    Thorax 10/2000; 55(10):848-53. · 8.56 Impact Factor

Publication Stats

808 Citations
64.06 Total Impact Points

Institutions

  • 2005–2008
    • Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval)
      Québec, Quebec, Canada
    • Institut universitaire de cardiologie et de pneumologie de Québec
      Quebec City, Quebec, Canada
  • 2004
    • Laval University
      Quebec City, Quebec, Canada