C. Mounier-Vehier

Centre Hospitalier Régional Universitaire de Lille, Lille, Nord-Pas-de-Calais, France

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Publications (216)367.31 Total impact

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    J Coquart · G Boitel · B Borel · A Duhamel · R Matran · P Delsart · C Mounier-Vehier · M Garcin
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    ABSTRACT: Purpose: This study investigated the effects of an exercise program at the intensity corresponding to the crossover point of substrate utilization (COP) on anthropometric measures, health-related quality of life (HRQoL) and cardiorespiratory fitness (i.e., peak oxygen uptake: VO2peak and peak power output: Ppeak) in women with metabolic syndrome (MetS). Methods: Nineteen obese and post-menopausal women with MetS (age: 54.8 ± 8.1 y, body mass: 89.0 ± 12.2 kg, body mass index: 34.5 ± 4.0 kg.m-2) followed a 12-week program consisting of three 45-min sessions per week of cycle ergometer exercise. The imposed exercise intensity corresponded to COP. Before and after the program, HRQoL, VO2peak and Ppeak were measured and then compared. Results: Body mass (89.0 ± 12.2 vs 86.2 ± 11.0 kg), body mass index (34.5 ± 4.0 vs 33.4 ± 3.6 kg.m-2), waist (106 ± 10 vs 100 ± 9 cm) and hip (117 ± 11 vs 114 ± 11 cm) circumferences, waist-to-hip ratio (0.91 ± 0.07 vs 0.88 ± 0.07), fat mass (43.3 ± 4.6 vs 41.9 ± 4.6%), fat-free mass (56.7 ± 4.6 vs 58.2 ± 4.6%), VO2peak (16.6 ± 3.4 vs 18.1 ± 4.1 mL.min-1.kg-1) and Ppeak (102 ± 22 vs 125 ± 27 W) were significantly improved after the exercise program (P < 0.05), but HRQoL showed no significant improvement on any subscale (i.e., physical functioning: performance limitation for physical activities including bathing and dressing, role physical: problems with work or other daily activities, bodily pain, general health, vitality, social functioning, role emotional and mental health; P > 0.05). Conclusion: Although a 12-week exercise program at COP improved anthropometric measures and cardiorespiratory fitness in women with MetS, self-perceived HRQoL did not significantly improve. This finding may be linked to a significant but nevertheless insufficient reduction in body mass, probably because COP is too weak exercise intensity to induce important energy expenditure.
    Full-text · Article · Sep 2015 · The Journal of sports medicine and physical fitness
  • C. Douillard · C. Do Cao · C. Mounier-Vehier · A.S. Parent · E. Leteurtre · F. Pattou · J.L. Wemeau

    No preview · Article · Sep 2015
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    ABSTRACT: To evaluate the prognostic value of the renal resistive index (Ri) after renal artery revascularization in the context of flash pulmonary edema. Between 2000 and 2008, 43 patients (mean age 72.1±10.9 years; 23 women) underwent renal artery angioplasty/stenting in the context of flash pulmonary edema. Intrarenal Ri was assessed using duplex ultrasound. The majority (97.7%) of patients had hypertension, and nearly half (46.5%) had diabetes mellitus. For this retrospective analysis, the patients were divided into 2 groups according to the median Ri (<0.8 and ≥0.8) of the population. A Cox proportional hazards model was used to identify predictors of all-cause mortality (primary endpoint) and rehospitalization for heart failure; the results are presented as the hazard ratio (HR) and 95% confidence interval (CI). The mean follow-up was 49.8±30.6 months. There was no difference between the groups regarding clinical characteristics. A high Ri was associated with the risk of all-cause death (HR 2.54, 95% CI 1.15 to 5.60, p=0.021). This relationship was still statistically significant after adjustment for age, gender, diabetes, glomerular filtration rate, and treatment with a renin-angiotensin system inhibitor (HR 1.74, 95%CI 1.08 to 2.81, p=0.032). A high Ri was also associated with cardiovascular death in unadjusted and adjusted analyses. In contrast, a high Ri was not associated with the risk of rehospitalization for heart failure. After renal artery revascularization for flash pulmonary edema, a high intrarenal Ri is independently associated with all-cause mortality. Determination of the intrarenal Ri after this procedure may be useful for identifying at-risk patients. © The Author(s) 2015.
    No preview · Article · Aug 2015 · Journal of Endovascular Therapy
  • Article: PP.20.17
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    ABSTRACT: Objective: The association between a structural anomaly of the aortic wall and uncontrolled hypertension are the main causing factors of aortic dissection. Follow-up management is based on an optimal blood pressure control. The data on blood pressure control and on medical therapy prescription at discharge after an acute surgery in this population are scares. Design and method: We retrospectively analyzed the data of 74 patients hospitalized from 2005 to 2010 for an emergency surgical type A aortic dissection. All patients benefited of a 24-hour blood pressure monitoring at discharge, medical prescription before admission and at discharge were collected. Statistical analyses were made with non parametric tests. Results: 67% of the population was male, median age of 53 years, 9.5 % with a prior history of ascending aorta aneurysm, 6.7 % with an elastic aortic wall disease. 50% take an antihypertensive therapy before admission, 8% of patients received 3 or more drugs, 4 % of diabetes mellitus, 31 % of former smoker and median Body Mass Index was of 26.4 Kg/m2. We note 23 % of left ventricular hypertrophy on electrocardiogram. The median systolic and diastolic blood pressure on the 24 h monitoring were respectively 125/71 mmHg. The results on medical therapy prescription are summarized in the Table. Copyright
    No preview · Article · Jun 2015 · Journal of Hypertension
  • Claire Mounier-Vehier · Fanny Boudghène · Gonzague Claisse · Pascal Delsart
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    ABSTRACT: Various toxic or drug agents can induce arterial hypertension, aggravate or limit the efficiency of anti-hypertensive drugs. Iatrogenic and drug-induced hypertension should be well known by the clinicians and the pharmacists, given the impact for driving the management of patients. In the food, an excessive alcohol consumption (more than 30 g per day) and more rarely glycerizine (active ingredient of the licorice) should be systematically looked for in front of a recent hypertension or do not respond to usual treatment. In the list of offending medicines, we must remember ethinyl estradiol contained in the contraception (oral, vaginal ring or transcutaneous patch), non steroidal anti-inflammatory drugs, immunosuppressants (cyclosporine, tacrolimus), vascular endothelial growth factor and its receptor R2 (avastin, inhibitors of receptor tyrosine kinases), recombinant human erythropoietin, sympathomimetics (nasal decongestants), anabolic steroids, bromocriptine (inhibitor of lactation), psychotropes (tricyclics antidepressants, monoamine oxydase inhibitors). The diagnosis of iatrogenic hypertensions should be systematically suspected in front of a suggestive clinical context with a meticulous food questioning because these hypertensions are partially or fully reversible after exposure stops.
    No preview · Article · Jun 2015 · La Revue du praticien
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    ABSTRACT: Obstructive sleep apnea (OSA) is the most common factor involved in uncontrolled blood pressure (BP). Management of OSA is part of cardiologist work. We have few data on BP control in a population of OSA followed by cardiologists. We evaluated the prevalence of effective BP control using ambulatory measurement in a population of patients followed in cardiology. Data from 69 OSA patients treated for more than 6 months by continuous positive airway pressure (CPAP) were collected prospectively from March 2012 until December 2012. These patients were divided into 2 groups according to the results of 24-h ambulatory BP monitoring (ABPM). Controlled BP was defined as a 24 h BP <130/80 mmHg. All patients were hypertensive. 44 patients (63 %) had uncontrolled hypertension (HTN). The onset of OSA (p = 0.01) and persistent daytime sleepiness appeared as predictors of uncontrolled BP. Systolic BP (SBP) during consultation and all the ABPM variables were higher in uncontrolled BP patients. Uncontrolled BP was associated with greater left ventricular mass (p = 0.02) and greater diameter of the ascending aorta (p = 0.04). Control of HTN should be evaluated in all OSA patients, using ABPM. The onset of OSA and high SBP during consultation are both factors associated with uncontrolled BP in this population. Repeating ABPM should be of interest for the follow up of these patients.
    No preview · Article · Apr 2015 · High Blood Pressure & Cardiovascular Prevention
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    ABSTRACT: Resistant hypertension is common, mainly idiopathic, but sometimes related to primary aldosteronism. Thus, most hypertension specialists recommend screening for primary aldosteronism. To optimize the selection of patients whose aldosterone-to-renin ratio (ARR) is elevated from simple clinical and biological characteristics. Data from consecutive patients referred between 1 June 2008 and 30 May 2009 were collected retrospectively from five French 'European excellence hypertension centres' institutional registers. Patients were included if they had at least one of: onset of hypertension before age 40 years, resistant hypertension, history of hypokalaemia, efficient treatment by spironolactone, and potassium supplementation. An ARR>32ng/L and aldosterone>160ng/L in patients treated without agents altering the renin-angiotensin system was considered as elevated. Bayesian network and stepwise logistic regression were used to predict an elevated ARR. Of 334 patients, 89 were excluded (31 for incomplete data, 32 for taking agents that alter the renin-angiotensin system and 26 for other reasons). Among 245 included patients, 110 had an elevated ARR. Sensitivity reached 100% or 63.3% using Bayesian network or logistic regression, respectively, and specificity reached 89.6% or 67.2%, respectively. The area under the receiver-operating-characteristic curve obtained with the Bayesian network was significantly higher than that obtained by stepwise regression (0.93±0.02 vs. 0.70±0.03; P<0.001). In hypertension centres, Bayesian network efficiently detected patients with an elevated ARR. An external validation study is required before use in primary clinical settings. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    No preview · Article · Apr 2015 · Archives of cardiovascular diseases
  • C. Mounier-Vehier · F. Bougdhène-Stambouli · G. Claisse · P. Delsart

    No preview · Article · Mar 2015 · Journal des Maladies Vasculaires
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    ABSTRACT: Based on theoretical evidence, intensity at the crossover point (COP) of substrate utilization could be considered as potential exercise intensity for metabolic syndrome (MetS). This study aimed to examine the effects of a training program at COP on exercise capacity parameters in women with MetS and to compare two metabolic indices (COP and the maximal fat oxidation rate point LIPOXmax®) with ventilatory threshold (VT). Nineteen women with MetS volunteered to perform a 12-week training program on cycle ergometer, with an intensity corresponding to COP. Pre- and post-training values of anthropometric and exercise capacity parameters were compared in order to determine the effects of exercise training. The pre-post training change of COP, LIPOXmax® and VT were also investigated. After training, anthropometric parameters were significantly modified, with a reduction of body mass (3.0 ± 3.0%, p<0.001), fat mass (3.3 ± 3.4%, p<0.001) and body mass index (3.2 ± 3.4%, p<0.001). Exercise capacity was improved after the training program, with significant increase of maximal power output (25.0 ± 18.4%, p<0.001) and maximal oxygen uptake (VO2max = 9.0 ± 11.2%, p<0.01). Lastly, when expressed in terms of power output, COP, LIPOXmax® and VT occurred at a similar exercise intensity but the occurrence of these three indices is different when expressed in terms of oxygen uptake, heart rate or rating of perceived exertion. This study highlights the effectiveness of 12-week training program at COP to improve physical fitness in women with MetS. The relationships between metabolic indices and VT in terms of power output highlight the determination of VT from a shorter maximal exercise as a useful method for the determination of metabolic indices in MetS.
    No preview · Article · Mar 2015 · Medicine and science in sports and exercise
  • J. Lecocq · F. Boudghene-Stambouli · G. Claisse · P. Delsart · C. Mounier-Vehier

    No preview · Article · Mar 2015 · Journal des Maladies Vasculaires
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    ABSTRACT: L’hypertension artérielle masquée (HTAm), définie par une pression artérielle (PA) normale en consultation mais élevée en ambulatoire, est caractérisée par une prévalence élevée dans la population générale et un mauvais pronostic cardiovasculaire. Cette étude a cherché à évaluer l’intérêt d’un dépistage systématique de l’HTAm par monitoring de PA des 24 h chez les patients ayant une artériopathie oblitérante des membres inférieurs (AOMI).
    No preview · Article · Jan 2015 · Journal des Maladies Vasculaires
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    ABSTRACT: Conflicting blood pressure-lowering effects of catheter-based renal artery denervation have been reported in patients with resistant hypertension. We compared the ambulatory blood pressure-lowering efficacy and safety of radiofrequency-based renal denervation added to a standardised stepped-care antihypertensive treatment (SSAHT) with the same SSAHT alone in patients with resistant hypertension. The Renal Denervation for Hypertension (DENERHTN) trial was a prospective, open-label randomised controlled trial with blinded endpoint evaluation in patients with resistant hypertension, done in 15 French tertiary care centres specialised in hypertension management. Eligible patients aged 18-75 years received indapamide 1·5 mg, ramipril 10 mg (or irbesartan 300 mg), and amlodipine 10 mg daily for 4 weeks to confirm treatment resistance by ambulatory blood pressure monitoring before randomisation. Patients were then randomly assigned (1:1) to receive either renal denervation plus an SSAHT regimen (renal denervation group) or the same SSAHT alone (control group). The randomisation sequence was generated by computer, and stratified by centres. For SSAHT, after randomisation, spironolactone 25 mg per day, bisoprolol 10 mg per day, prazosin 5 mg per day, and rilmenidine 1 mg per day were sequentially added from months two to five in both groups if home blood pressure was more than or equal to 135/85 mm Hg. The primary endpoint was the mean change in daytime systolic blood pressure from baseline to 6 months as assessed by ambulatory blood pressure monitoring. The primary endpoint was analysed blindly. The safety outcomes were the incidence of acute adverse events of the renal denervation procedure and the change in estimated glomerular filtration rate from baseline to 6 months. This trial is registered with ClinicalTrials.gov, number NCT01570777. Between May 22, 2012, and Oct 14, 2013, 1416 patients were screened for eligibility, 106 of those were randomly assigned to treatment (53 patients in each group, intention-to-treat population) and 101 analysed because of patients with missing endpoints (48 in the renal denervation group, 53 in the control group, modified intention-to-treat population). The mean change in daytime ambulatory systolic blood pressure at 6 months was -15·8 mm Hg (95% CI -19·7 to -11·9) in the renal denervation group and -9·9 mm Hg (-13·6 to -6·2) in the group receiving SSAHT alone, a baseline-adjusted difference of -5·9 mm Hg (-11·3 to -0·5; p=0·0329). The number of antihypertensive drugs and drug-adherence at 6 months were similar between the two groups. Three minor renal denervation-related adverse events were noted (lumbar pain in two patients and mild groin haematoma in one patient). A mild and similar decrease in estimated glomerular filtration rate from baseline to 6 months was observed in both groups. In patients with well defined resistant hypertension, renal denervation plus an SSAHT decreases ambulatory blood pressure more than the same SSAHT alone at 6 months. This additional blood pressure lowering effect may contribute to a reduction in cardiovascular morbidity if maintained in the long term after renal denervation. French Ministry of Health. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jan 2015 · The Lancet
  • Source
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    ABSTRACT: The present study examined the effects of a training program at a special exercise intensity—the crossover point of substrate utilization (COP)—on the metabolic abnormalities and cardiovascular risk factors in obese women with metabolic syndrome (MetS). Eighteen postmenopausal obese women with MetS (age, 54.8 ± 8.4 years; height, 160 ± 6 cm) followed a 12-week training program consisting of three 45-minute sessions/wk on a cycle ergometer. The intensity imposed during the training sessions corresponded to COP. Before and after the training program, anthropometric, biological, and blood pressure data were collected and compared. After the training program, body mass (88.4 ± 12.3 kg vs. 85.7 ± 11.1 kg), fat mass (43.2 ± 4.8% vs. 41.8 ± 4.8% body mass), body mass index (34.3 ± 3.9 kg/m2 vs. 33.2 ± 3.6 kg/m2), and waist circumference (105 ± 10 cm vs. 100 ± 9 cm) were significantly lower (p < 0.01). Moreover, fasting plasma glucose was significantly lower after the training program (114 ± 20 mg/dL vs. 107 ± 15 mg/dL; p = 0.02) and the quantitative insulin-sensitivity check index was significantly higher (0.58 ± 0.08 vs. 0.61 ± 0.05; p = 0.05). A significant reduction in systolic blood pressure was also observed (141 ± 15 mmHg vs. 129 ± 11 mmHg; p = 0.02). After the program, the number of patients with fasting plasma hyperglycemia and arterial hypertension was significantly decreased by 54.4% and 44.4%, respectively, and the number of patients with MetS was nonsignificantly reduced by 22.2% (p = 0.10). The present study shows that a training program at COP is an efficient means to treat MetS.
    Full-text · Article · Nov 2014 · Journal of exercise science and fitness (JESF)
  • N. Kpogbemabou · G. Claisse · P. Devos · P. Delsart · P. Fontaine · C. Mounier-Vehier

    No preview · Article · Oct 2014 · Journal des Maladies Vasculaires
  • C Mounier-Vehier · F Boudghene · P Delsart · G Claisse · N Kpogbemadou · V Debarge · B Letombe
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    ABSTRACT: Cardiovascular (CV) diseases are the primary cause of death of women. Since they kill 10 times more than breast cancer, preventive measures should be implemented. According to U.S. recommendations, a woman is either at "CV risk" or at "optimal health status" if she has no risk factors and a perfectly healthy lifestyle. Some risk factors are more deleterious to women (smoking, diabetes, stress, depression, atrial fibrillation); or specific to women (preeclampsia, gestational diabetes, contraception, menopause, headaches). The lifestyle plays a key role for them. The blood pressure measurement is the most frequent opportunity to detect women at risk. CV tests should be performed to all symptomatic women and for those over the age of 45 who want to start practicing sport. The cardiologist can play a key role to improve women's CV health by integrating their hormonal risks. Women can also be a powerful medium of prevention by adopting a healthy lifestyle. From those recommendations concerning women's CV health, there is a great opportunity to initiate a health path for women at high cardiovascular risk. The objectives of the specific path "heart, arteries and women" of University hospital of Lille will be to improve professional practice, awareness of women, educate public authorities and within a few years reduce the epidemic of CVD of French women.
    No preview · Article · Jun 2014 · Annales de cardiologie et d'angeiologie
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cardiovascular (CV) diseases are the primary cause of death of women. Since they kill 10 times more than breast cancer, preventive measures should be implemented. According to U.S. recommendations, a woman is either at “CV risk” or at “optimal health status” if she has no risk factors and a perfectly healthy lifestyle. Some risk factors are more deleterious to women (smoking, diabetes, stress, depression, atrial fibrillation); or specific to women (preeclampsia, gestational diabetes, contraception, menopause, headaches). The lifestyle plays a key role for them. The blood pressure measurement is the most frequent opportunity to detect women at risk. CV tests should be performed to all symptomatic women and for those over the age of 45 swho want to start practicing sport. The cardiologist can play a key role to improve women's CV health by integrating their hormonal risks. Women can also be a powerful medium of prevention by adopting a healthy lifestyle. From those recommendations concerning women's CV health, there is a great opportunity to initiate a health path for women at high cardiovascular risk. The objectives of the specific path “heart, arteries and women” of University hospital of Lille will be to improve professional practice, awareness of women, educate public authorities and within a few years reduce the epidemic of CVD of French women.
    No preview · Article · Jan 2014 · Annales de cardiologie et d'angeiologie

  • No preview · Article · Nov 2013 · Archives des Maladies du Coeur et des Vaisseaux - Pratique
  • T Pretorean · G Claisse · P Delsart · T Caudrelier · P Devos · C Mounier-Vehier
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    ABSTRACT: Therapeutic inertia (TI) is a recent concept still unknown by many physicians. In chronic diseases such as hypertension, it is defined as the tendency of physicians not to increase or change antihypertensive medications when the target blood pressure is not reached. Acting on TI could improve blood pressure control in France. This was a single-center prospective pilot study conducted by hypertension specialist physicians at the University Cardio-Vascular Center in Lille (France). It was conducted between March and June 2011. Data was collected from 161 hypertensive patients (mean age: 61.64±11.18 years; 98 (60.9%) male; 75 secondary prevention patients). Each physician completed a questionnaire on therapeutic inertia. TI was defined as a consultation in which treatment change was indicated (systolic blood pressure [BP]≥140 and/or diastolic BP≥90mmHg in all patients), but did not occur, with absence of an adapted justification of this choice. We considered as an adapted justification: a white coat effect demonstrated by ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring; scheduled reassessment of the BP by ABPM; recent change in antihypertensive treatment (less than 4 weeks); hospitalization needed for complete evaluation of secondary causes of hypertension and a more detailed assessment of potential target organ damage in patients with grade 1 or 2 hypertension. Our study aimed to evaluate rates of TI, to identify factors associated with TI, and to test the TI questionnaire. Therapeutic inertia as defined in this study occurred in 11 consultations (8.3%) of the 133 hypertensive patients having uncontrolled BP above or equal to 140 and/or 90mmHg. Significant factors associated with TI were older age (Z=2.35, P<0.05) and sleep apnea syndrome (χ(2)=8.33, P<0.05). The absence of ambulatory blood pressure monitoring before the consultation (χ(2)=4.28, 0.1>P>0.05) and the number of consultations (Z=1.92, 0.1>P>0.05) exhibited a significant trend to be associated with TI. Although the rate of TI was low in our study conducted in a specialized center, a well-accepted definition of therapeutic inertia would be useful for further study. The feasibility of using the questionnaire tested with this study shows that this measurement tool could help physicians become more aware of TI, both in the hospital and primary care setting. Further multicenter studies are needed for validation.
    No preview · Article · Oct 2013 · Journal des Maladies Vasculaires
  • C. Mounier-Vehier

    No preview · Article · Oct 2013 · Archives des Maladies du Coeur et des Vaisseaux - Pratique
  • C. Mounier-Vehier · J. Sobosinski · R. Azzaoui · I. Sediri · S. Haulon

    No preview · Article · Oct 2013 · Archives des Maladies du Coeur et des Vaisseaux - Pratique

Publication Stats

1k Citations
367.31 Total Impact Points

Institutions

  • 1998-2015
    • Centre Hospitalier Régional Universitaire de Lille
      • Department of Cardio Vascular Surgery
      Lille, Nord-Pas-de-Calais, France
  • 1993-2014
    • CHRU de Strasbourg
      • Pôle Gynécologie-obstétrique
      Strasburg, Alsace, France
    • Hôpital Universitaire Necker
      Lutetia Parisorum, Île-de-France, France
  • 2009-2012
    • Université du Droit et de la Santé Lille 2
      Lille, Nord-Pas-de-Calais, France
  • 1998-2012
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France
  • 2005
    • Claude Bernard University Lyon 1
      Villeurbanne, Rhône-Alpes, France
  • 2000
    • Centre Hospitalier Intercommunal Fréjus Saint-Raphael
      Saint-Raphaël, Provence-Alpes-Côte d'Azur, France