Papers by Augustin Coisne
Cardiopulmonary exercise testing is a better outcome predictor than exercise echocardiography in asymptomatic aortic stenosis
International Journal of Cardiology, 2017
Omentin-1, epicardial fat and coronary artery disease
Atherosclerosis, 2016
Post aortic dissection: Gap between activity recommendation and real life patients aerobic capacities
International Journal of Cardiology, 2016
Regular exercise at a safe level, i.e. 3-5 metabolic equivalents, is recommended to improve blood... more Regular exercise at a safe level, i.e. 3-5 metabolic equivalents, is recommended to improve blood pressure control and quality of life even after aortic dissection, although aerobic exercise capacities in these patients are unexplored yet. We prospectively collected data from 105 patients with a history of post aortic dissection referred for a cardiopulmonary exercise testing (CPX) aiming to guide exercise rehabilitation. The population was composed of 76% of male, with a mean age of 57.9±12.4years. There were an equal distribution between the two type of dissection (47% of type A and 53% of type B aortic dissection). No cardiac event occurred during or after CPX. One third of patients have normal aerobic exercise capacity defined as peak oxygen uptake upper than 85% of their predicted capacity. Mean oxygen uptake peak was quite low 19.2±5.2ml/kg/min (5.5±1.5 metabolic equivalents). Aerobic capacity was limited by cardiac chronotropic incompetence in 42% or peripheral deconditioning in 45%. Blood pressure remained in an acceptable range during the exercise. Systolic and diastolic blood pressures were respectively 151±20 and 77±13mmHg at first ventilatory threshold. CPX is a safe exploration in patients with post aortic dissection syndrome. Given the fact that most of these patients are faced with significant alteration of aerobic capacities, the recommended daily practice of moderate exercise at 3-5 METS should be adapted and personalized to each patient thanks to CPX.
Circulation, Jan 12, 2014
Obesity and diabetes mellitus are independently associated with the development of heart failure.... more Obesity and diabetes mellitus are independently associated with the development of heart failure. In this study, we determined the respective effects of obesity, insulin resistance, and diabetes mellitus on the intrinsic contraction and mitochondrial function of the human myocardium before the onset of cardiomyopathy. Right atrial myocardium was obtained from 141 consecutive patients presenting no sign of cardiomyopathy. We investigated ex vivo isometric contraction, mitochondrial respiration and calcium retention capacity, and respiratory chain complex activities and oxidative stress status. Diabetes mellitus was associated with a pronounced impairment of intrinsic contraction, mitochondrial dysfunction, and increased myocardial oxidative stress, regardless of weight status. In contrast, obesity was associated with less pronounced contractile dysfunction without any significant perturbation of mitochondrial function or oxidative stress status. Tested as continuous variables, glycat...
0091: Aortic stenosis: the interest of the cardiopulmonary exercise testing
Archives of Cardiovascular Diseases Supplements, 2014
International Journal of Cardiology, 2008
In this study, the left ventricular dimensions, systolic function, and left ventricular myocardia... more In this study, the left ventricular dimensions, systolic function, and left ventricular myocardial performance index in the firstdegree relatives of the children with dilated cardiomyopathy (n = 19), 30.0 ± 17.6 years to normal age-and sex-matched controls (n = 25), 27.4 ± 17.7 years. The percentage ratio of the measured left ventricular end-diastolic dimension to the predicted left ventricular enddiastolic dimension (109 ± 9.6 vs 105 ± 11.8), left ventricular shortening fraction (34.5 ± 6.6 vs 37.2 ± 7%), and left ventricular ejection fraction (63.2 ± 9.2 vs 66.5 ± 8.1%) were not significantly different in the first-degree relatives and controls, respectively. However, the left ventricular myocardial performance index was significantly greater in the first-degree relatives than in controls (0.40 ± 0.11 vs 0.31 ± 0.03, p = 0.01). In conclusion, the left ventricular myocardial performance index may be useful in early detect familial dilated cardiomyopathy in asymptomatic first-degree relatives of children with dilated cardiomyopathy.
Electrical atrial vulnerability and renal complications in type 2 diabetes
Diabetologia, 2015
Comment on Patel et al. ACE2 Deficiency Worsens Epicardial Adipose Tissue Inflammation and Cardiac Dysfunction in Response to Diet-Induced Obesity. Diabetes 2016;65:85-95
Diabetes, 2016
An unexpected cause of cardiomyopathy revealed by arrhythmias and conduction disorders in an athlete
International Journal of Cardiology, 2015
The slope of the stretch–strain relationship as a non-invasive contractility index: Insights from mitral regurgitation surgery
International Journal of Cardiology, 2015
Feasibility of Doppler hemodynamic evaluation of primary and secondary mitral regurgitation during exercise echocardiography
The international journal of cardiovascular imaging, 2015
Exercise transthoracic echocardiography (ExE) was recently proposed to evaluate tolerance and hel... more Exercise transthoracic echocardiography (ExE) was recently proposed to evaluate tolerance and help risk stratification of mitral regurgitation (MR). Few data are available on the feasibility of Doppler echocardiographic recordings at exercise in daily practice in both secondary and primary MR. Comprehensive resting and ExE were performed in 72 unselected patients (age 59 ± 15 years, 62 % men), with no or minimal symptoms, with at least moderate (mean effective regurgitant orifice area (ERO) = 36 ± 14 mm(2)) primary or secondary MR in two French university hospitals. At rest, quantification of ERO was more challenging in semi-supine position than in classic left lateral decubitus position (55/72; 76 % vs 66/72; 92 %; p = 0.012), particularly in mitral valve (MV) prolapse (35/47; 74 %). During exercise, ERO was only obtained in 30/55 (55 %) patients and was more difficult to assess in MV prolapse than in rheumatic or ischemic MR (respectively in 43, 67 and 88 %, p = 0.046). At peak ex...
Myocardial contractile dysfunction is associated with impaired mitochondrial function and dynamics in type 2 diabetic but not in obese patients
Circulation, Jan 12, 2014
Obesity and diabetes mellitus are independently associated with the development of heart failure.... more Obesity and diabetes mellitus are independently associated with the development of heart failure. In this study, we determined the respective effects of obesity, insulin resistance, and diabetes mellitus on the intrinsic contraction and mitochondrial function of the human myocardium before the onset of cardiomyopathy. Right atrial myocardium was obtained from 141 consecutive patients presenting no sign of cardiomyopathy. We investigated ex vivo isometric contraction, mitochondrial respiration and calcium retention capacity, and respiratory chain complex activities and oxidative stress status. Diabetes mellitus was associated with a pronounced impairment of intrinsic contraction, mitochondrial dysfunction, and increased myocardial oxidative stress, regardless of weight status. In contrast, obesity was associated with less pronounced contractile dysfunction without any significant perturbation of mitochondrial function or oxidative stress status. Tested as continuous variables, glycat...
0091: Aortic stenosis: the interest of the cardiopulmonary exercise testing
Archives of Cardiovascular Diseases Supplements, 2014
Mitochondrial Dysfunction as an Arrhythmogenic Substrate
Journal of the American College of Cardiology, 2013
This study sought to provide bedside evidence of the potential link between cardiac mitochondrial... more This study sought to provide bedside evidence of the potential link between cardiac mitochondrial dysfunction and arrhythmia as reported in bench studies. Atrial fibrillation (AF) is a frequent complication of cardiac surgery. Underlying mechanisms of post-operative atrial fibrillation (POAF) remain largely unknown. Because cardiac mitochondrial dysfunction has been reported in clinical conditions with a high risk of POAF, we investigated whether a causal link exists between POAF onset and pre-operative function of cardiac mitochondria. Pre-operative mitochondrial respiration and calcium retention capacity, respiratory complex activity, and myocardial oxidative stress were quantified in right atrial tissue from 104 consecutive patients with metabolic syndrome, in sinus rhythm, and undergoing coronary artery bypass graft surgery. In this high-risk population, POAF occurred in 44% of patients. Decreased pre-operative mitochondrial respiration and increased sensitivity to calcium-induced mitochondrial permeability transition pore opening were significantly associated with POAF. Adenosine diphosphate-stimulated mitochondrial respiration supported by palmitoyl-l-carnitine was significantly lower in POAF patients and remained independently associated with AF onset after adjustment for age, body mass index, heart rate, beta-blocker use, and statin medication (multivariate logistic regression coefficient per unit = -0.314 ± 0.144; p = 0.028). Gene expression profile analysis identified a general downregulation of the mitochondria/oxidative phosphorylation gene cluster in pre-operative atrial tissue of patients in whom AF developed. Our prospective study identifies an association between pre-operative mitochondrial dysfunction of the atrial myocardium and AF occurrence after cardiac surgery in patients with metabolic disease, providing novel insights into the link between mitochondria and arrhythmias in patients.
International Journal of Cardiology, 2008
In this study, the left ventricular dimensions, systolic function, and left ventricular myocardia... more In this study, the left ventricular dimensions, systolic function, and left ventricular myocardial performance index in the firstdegree relatives of the children with dilated cardiomyopathy (n = 19), 30.0 ± 17.6 years to normal age-and sex-matched controls (n = 25), 27.4 ± 17.7 years. The percentage ratio of the measured left ventricular end-diastolic dimension to the predicted left ventricular enddiastolic dimension (109 ± 9.6 vs 105 ± 11.8), left ventricular shortening fraction (34.5 ± 6.6 vs 37.2 ± 7%), and left ventricular ejection fraction (63.2 ± 9.2 vs 66.5 ± 8.1%) were not significantly different in the first-degree relatives and controls, respectively. However, the left ventricular myocardial performance index was significantly greater in the first-degree relatives than in controls (0.40 ± 0.11 vs 0.31 ± 0.03, p = 0.01). In conclusion, the left ventricular myocardial performance index may be useful in early detect familial dilated cardiomyopathy in asymptomatic first-degree relatives of children with dilated cardiomyopathy.
Contrasting effects of diabetes and metabolic syndrome on post-operative atrial fibrillation and in-hospital outcome after cardiac surgery
International Journal of Cardiology, 2013
International Journal of Cardiology, 2013
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Papers by Augustin Coisne