Pierre Abraham

Pierre Abraham
Universite d Angers, Centre Hospitalier Universitaire d'Angers

MD PhD

About

403
Publications
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Introduction

Publications

Publications (403)
Article
Background: To evaluate the quality of life of surgically treated patients for TOS. Methods: A prospective observational study including patients treated surgically for TOS, on 2018. Two standardized questionnaires: Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and the Short-Form 12 (SF-12) were used. The SF-12 consists of a phy...
Article
The use of Artificial Intelligence in medical decision support systems has been widely studied. Since a medical decision is frequently the result of a multi-objective optimization problem, a popular challenge combining Artificial Intelligence and Medicine is Multi-Objective Feature Selection (MOFS). This article proposes a novel approach for MOFS a...
Article
Objective It was hypothesised that there is a linear relationship between the severity of exercise induced calf ischaemia and the prevalence of calf claudication on a treadmill until a plateau is reached. It was expected that no pain would be present in the absence of ischaemia and all severely ischaemic calves would be symptomatic. Methods This w...
Article
Full-text available
Objective Thoracic outlet syndrome (TOS) should be considered of arterial origin only if patients have clinical symptoms that are the result of documented symptomatic ischemia. Simultaneous recording of inflow impairment and forearm ischemia in patients with suspected TOS has never been reported to date. We hypothesized that ischemia would occur in...
Article
Clinical differentiation of buttock claudication from pseudo-claudication (neuromuscular etiology) is often challenging and cannot be diagnosed non-invasively using standard ankle-brachial index (ABI) with exercise. The aim of this study was to evaluate the reliability of exercise transcutaneous oximetry (ExTcPO2) to accurately detect significant i...
Article
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Determination of the self-reported walking capacity by interview or standardized questionnaire is important. However, the existing questionnaires require the patient to be able to read and write in a specific language. We recently proposed the WELSH (Walking Estimated Limitation Stated by History) tool to be administrable to illiterate people. The...
Article
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Background Cardiac surgery is known to induce acute endothelial dysfunction, which may be central to the pathophysiology of postoperative complications. Preoperative endothelial dysfunction could also be implicated in the pathophysiology of postoperative complications after cardiac surgery. However, the relationship between preoperative endothelial...
Article
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Objective: Fingertip photoplethysmography (PPG) resulting from high-pass filtered raw PPG signal is often used to record arterial pulse changes in patients with suspected thoracic outlet syndrome (TOS). Results from venous (low-pass filtered raw signal) forearm PPG (V-PPG) during the Candlestick-Prayer (Ca + Pra) maneuver were recently classified i...
Article
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Aim: A better knowledge of the biological consequences in the blood of these exercise-induced ischemic events in lower extremity artery disease (LEAD) may improve the prospects of disease management. We explored the preminus postexercise metabolomic difference in 39 patients with LEAD referred for a treadmill oximetry test [transcutaneous oximetry...
Article
Purpose: This study investigated the correlations of hemodynamic parameters measured to quantify stenosis between the gold-standard duplex ultrasonography and the dual-gate Doppler mode. Methods: Patients examined due to suspicion of carotid artery stenosis or for surveillance of known stenosis were invited to participate in this prospective sin...
Article
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PurposeMany tasks, sports or leisure activities require maximal knee flexion. We hypothesized that this position could result in reduced calf perfusion, in young European subjects.Methods We quantified calf ischemia resulting from the knee flexion with transcutaneous oxygen pressure (TcpO2) sensors by assessing the decrease from rest of TcpO2 (DROP...
Article
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The level of pulse amplitude (PA) change in arterial digital pulse plethysmography (A-PPG) that should be used to diagnose thoracic outlet syndrome (TOS) is debated. We hypothesized that a modification of the Roos test (by moving the arms forward, mimicking a prayer position (“Pra”)) releasing an eventual compression that occurs in the surrender/ca...
Article
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Neurogenic thoracic outlet syndrome (NTOS) is a chronic painful and disabling condition. Patients complain about upper-limb paresthesia or weakness. Weakness has been considered one of the diagnostic criteria of NTOS, but objective comparisons to healthy controls are lacking. We compared the grip and the key pinch strengths between NTOS patients an...
Article
Full-text available
Objective: Hemodynamic investigations in thoracic outlet syndrome (TOS) remain difficult, even in trained hands. Results are generally reported as either presence or absence of venous compression. In fact, in patients with suspected TOS but without chronic venous occlusion, the forearm volume changes may result from various combinations of forearm...
Article
Full-text available
The ways in which locations of ischemia and ischemic pain affect spatiotemporal gait parameters and leg electromyographic activity during walking have never been investigated in patients with peripheral arterial disease presenting intermittent claudication. Two groups were classified according to unilateral location of ischemia (distal, n = 10, or...
Article
Background We seek to evaluate whether ischemia extent (unilateral or bilateral) impacts spatiotemporal and neuromuscular gait parameters differently in patients with peripheral arterial disease and presenting intermittent claudication (PAD‐IC). Methods Two groups of PAD‐IC patients: unilateral (Unilat‐IC; n=15), bilateral (Bilat‐IC; n=15) and a g...
Article
Background and aims Transcutaneous oxygen pressure (TcpO2) is used in patients with suspected critical limb ischemia (CLI). Sinusoidal changes (SC~) in TcpO2 are found in patients with Cheyne-Stokes respiration (CSR). We aimed to determine the characteristics of TcpO2 changes at rest in patients with suspected CLI, define the objective criteria for...
Article
Background Previous studies in patients with arterial claudication have focused on calf hemodynamic recovery. We hypothesized that the duration of hemodynamic recovery with TcpO2 at calf and non-calf levels would be shorter than 10 min. We analyzed the factors that influence the recovery time. Methods We monitored limb changes minus chest changes...
Article
Full-text available
Neurogenic thoracic outlet syndrome (NTOS) is the most frequent form of TOS. It may affect both sides, but specific complementary exams are lacking. We aimed to evaluate duplex scanning results in a group of patients with unilateral or bilateral NTOS and no clinical vascular signs, referred for rehabilitation. We performed a retrospective observati...
Conference Paper
Aging is a complex phenomenon that can be studied by analyzing age-related alterations in the execution of various tasks. This work deals with the processing of navigation data acquired from a bike simulator in two populations: young healthy subjects and older adults with loss of autonomy. Our goal is to analyze the influence of age in the ability...
Article
The evidence‐based medicine allows the physician to evaluate the risk‐benefit ratio of a treatment through setting and data. Risk‐based choices can be done by the doctor using different information. With the emergence of new technologies, a large amount of data is recorded offering interesting perspectives with machine learning for predictive data...
Article
Background and aims Calf pain is the most frequent symptom of arterial claudication. We hypothesized that patients with self-reported isolated calf claudication have frequent exertional non-calf symptoms during objective laboratory testing, and that many would show not only distal, but also proximal ischemia. Methods We retrospectively analyzed th...
Article
Background In patients with peripheral arterial disease and presenting intermittent claudication (PAD-IC), the pain due to ischemia impacts gait parameters, particularly in cases of unilateral disease. Deterioration of gait parameters in a pathological context is frequently associated with increased coactivation (simultaneous activation of agonist...
Article
Background Galvanic current-induced vasodilation (CIV) is impaired in patients under low-dose aspirin (ASA; ≤ 500 mg/day), but potential covariates and the impact of the time since the last ASA intake are unknown. Objectives We used tissue viability imaging (TiVi) in patients at risk of cardiovascular disease and examined its association with self...
Article
Studying the impact of age is important to understand the phenomenon of aging and the disorders that are associated with it. In this work, we analyze age-related alterations on the capacities to navigate on a bike. For this purpose, we use CycléoONE, a bike simulator, and entropy measures. We thus record navigation data (handlebar angle and speed)...
Article
Intermittent Claudication due to Peripheral Arterial Disease (PAD-IC) induces ischemic pain in exercising muscles, and therefore impaired gait. In a pathological context, the analysis of the Vertical component of Ground Reaction Force (VGRF) is frequently used to describe gait pattern. This paper aims to define gait profiles according to the relati...
Article
Background: Epidemiological, imaging, and anatomical studies suggest an association between proximal arterial atherosclerosis and development of low back pain (LBP). Objectives: We aimed to define (1) the frequency and (2) factors associated with exercise-induced proximal ischemia (EIPI) in individuals with LBP and (3) develop a clinical screeni...
Article
Transcutaneous oxygen pressure (TcpO2) measurement has been used for years at rest in patients with lower extremity artery disease. It was proposed for exercise testing (Ex-TcpO2) in the 80ies to evaluate regional blood flow impairment (RBFI) at the proximal and distal levels simultaneously and on both sides, in case of claudication. It was suggest...
Article
Aim: To compare the transcutaneous oxygen pressure results observed in patients with severe walking limitation during standard procedures (3.2 km/h, 10% slope) versus during a test performed at a low speed (2 km/h, 10% slope). Methods: In 31 patients the decrease from rest of oxygen pressure (DROP) index was measured on both buttocks, both thigh...
Article
Full-text available
To study the concordance of exercise-oximetry and of ankle-brachial pressure index (ABI) and ankle pressure (AP) at rest, and after exercise, in patients complaining of vascular-type claudication to diagnose lower extremity artery disease (LEAD). Treadmill test in 433 patients with exercise-oximetry included constant load (3.2 km/h, 10% slope) phas...
Article
Objectives: Ambient temperature (that impacts differently venous flow in superficial and deep veins) could have a different effect on the risk of superficial and deep venous thrombosis. We searched for a trimestral variation of the risk of superficial venous thrombosis among all lower-limb thrombotic events (lower-limb thrombotic events = superfic...
Article
Background: Non-invasive tests are still required to improve the holistic diagnostic approach of thoracic outlet syndrome (TOS). Objectives: We aimed to analyze the diagnostic accuracy of the decrease from rest oxygen pressure (DROP) index of transcutaneous oximetry (TcpO2) in TOS. Methods: Seventy-six patients and 40 asymptomatic volunteers (...
Article
BACKGROUND: Measurement of ankle and brachial blood pressure after maximal exercise is largely used to diagnose exercise-induced arterial endofibrosis (EIAE). AIMS AND OBJECTIVES: We aimed to compare the different available methods and combination of these and propose a method based on graphical interpretation, for the diagnosis of EIAE. MATERIAL...
Article
Background: The prevalence of cardiovascular diseases is increasing in low-income countries. Various questionnaires to estimate walking capacity in patients are available in multiple languages but they are not suitable for illiterate patients. Objective: The walking estimated limitation stated by history (WELSH) tool aims at rating individual wa...
Article
Objective: To determine if using a telephone can induce forearm pain and ischemia. Design: Prospective case-control trial. Setting: Vascular laboratory in the university hospital in Angers between September 2018 and March 2019. Participants: Fifteen apparently healthy subjects (controls) and 32 patients with suspected thoracic outlet syndrom...
Article
Objective: Learning basic vascular examination is a complex process. Very few studies have focused on the ability to measure the arterial systolic blood pressure at the ankle (ASBPa). The aim of this study was to objectively assess the effects of a 1-h practical educational intervention on the ability to measure ASBPa among medical students. Meth...
Poster
We present herein a new approach – the so-called time-shift multiscale cross-distribution entropy (TSMCDE) – to quantify the complexity between two sequences. By analyzing biomedical data, we reveal that TSMCDE overperforms other cross-entropy measures. Thus, TSMCDE, multiscale cross-sample entropy (MCSE), multiscale cross-distribution entropy (MCD...
Conference Paper
We present herein a new approach -- the so-called time-shift multiscale cross-distribution entropy (TSMCDE) -- to quantify the complexity between two sequences. By analyzing biomedical data, we reveal that TSMCDE overperforms other cross-entropy measures. Thus, TSMCDE, multiscale cross-sample entropy (MCSE), multiscale cross-distribution entropy (M...
Poster
Full-text available
Les perturbations motrices en condition de double tâche, visant à explorer le contrôle moteur cérébral, sont majoritairement examinées au moyen de tapis d’analyse spatio-temporelle de la marche. Pourtant, les patients âgés qui viennent pratiquer ces examens sont en partie sujets à un risque accru de chute du fait de troubles moteurs et/ou cognitifs...
Article
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Tyrosine kinase inhibitors are considered as highly effective and relatively safe drugs for the treatment of chronic myeloid leukemia. If several side effects on short and long term are well known and described, their involvement in the development of carotid stenosis remains unclear. Here, we describe a case of carotid stenosis in a patient receiv...
Article
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Background Patients with lower extremity peripheral artery disease (PAD) frequently experience claudication, a clinical symptom indicative of reduced walking capacity. Recommended care consists of exercise rehabilitation combined with optimal medical treatment and surgery. The effects of a single oral dose of sildenafil, a phosphodiesterase type-5...
Article
Purpose: To determine any difference between bare metal stents (BMS) and balloon-expandable covered stents in the treatment of innominate artery atheromatous lesions. Materials and methods: A multicenter retrospective study involving 13 university hospitals in France collected 93 patients (mean age 63.2±11.1 years; 57 men) treated over a 10-year...
Article
Objective: Determining the maximum walking time (MWT) using the treadmill test is the gold standard method for evaluating walking capacity and treatment effect in patients with peripheral arterial disease (PAD). However, self reported functional disability is important when assessing quality of life. Changes in the Walking Estimated Limitation Cal...
Article
Introduction Le Nilotinib est un inhibiteur de tyrosine kinase (ITK) de seconde génération et constitue un des traitements majeurs de la leucémie myéloïde chronique (LMC). Ses effets indésirables à court terme ont été bien étudiés mais de nombreuses interrogations persistent sur le long terme. Suite à différentes études montrant le rôle de ce trait...
Article
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Background: Exercise oximetry allows operator-independent recordings of microvascular blood flow impairments during exercise and can be used during upper arm provocative maneuvers. Objective: To study the test-retest reliability of upper-limb oximetry during the Roos test in patients with suspected thoracic outlet syndrome (TOS). Materials and Meth...
Article
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Background The prevalence of exercise-induced ischemia in the asymptomatic limb of patients with unilateral claudication based on history and treadmill evaluation, and with unilateral ipsilateral peripheral artery disease (i.e ankle-to-brachial systolic pressure index <0.90) is unknown. Methods We detected exercise-induced ischemia in the asymptom...
Article
Chronic critical lower limb ischemia (CLI) has been defined as ischemia that endangers the leg. An attempt was made to give a precise definition of CLI, based on clinical and hemodynamic data (Second European Consensus). CLI may be easily defined from a clinical point of view as rest pain of the distal foot or gangrene or ulceration. It is probably...
Article
Objectives: Mechanisms of walking limitation in arterial claudication are incompletely elucidated. We aimed to identify new variables associated to walking limitation in patients with claudication. Methods: We retrospectively analyzed data of 1120 patients referred for transcutaneous exercise oxygen pressure recordings (TcpO2). The outcome measu...
Article
Background: Forearm cutaneous blood flux (CBF) measurement with post-occlusive reactive hyperemia (PORH) is uncomfortable and may not be devoid of risks. We aimed to investigate post-compression reactive hyperemia (PCRH) with a custom-made indenter that was designed to be easily used routinely by inexperienced observers. Methods: Medical students e...
Article
To the Editor Dr McDermott and colleagues¹ investigated the effect of a home-based exercise intervention combining wearable technology and telephone coaching compared with usual care on walking performance in patients with peripheral artery disease (PAD). Although the authors acknowledged limitations regarding the participants’ use of the wearable...
Article
Exertional lower limb pain is a frequent diagnostic issue in elderly patients. Arterial claudication results from the mismatch between the oxygen requirement of, and oxygen delivery to the exercising muscles. Non-invasive vascular investigations (ultrasound imaging, plethysmography or segmental pressure) are used in routine at rest or following exe...
Article
The goal of this study was to assess the relationship between the severity of obstructive sleep apnoea (OSA) and liver stiffness measurement (LSM), one of the most accurate noninvasive screening tools for liver fibrosis in nonalcoholic fatty liver disease. The study included 147 patients with at least one criterion for the metabolic syndrome, asses...
Article
Introduction The American Heart Association (AHA) recommendations for diagnosing peripheral artery disease (PAD) after exercise are a decrease > 20% of ankle brachial index (ABI) or > 30 mmHg of ankle systolic blood pressure (ASBP) from resting values. We evaluated ABI and ASBP values during incremental maximal exercise in physically active and asy...
Article
Full-text available
Objective: This study aims to compare the structural and mitochondrial alterations between muscle segments affected by exercise-induced ischemia and segments of the same muscle without ischemia, in the same subject. Methods: In a prospective analysis, 34 patients presenting either peripheral arterial disease or chronic coronary syndrome without...
Article
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A recent report in the journal evaluated microvascular response at the facial and peripheral level during various types and levels of emotional stresses with laser speckle contrast imaging. Our short letter aims at underlying the importance of artifact removal in this situation and suggest directions for improving the results of this kind of experi...