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Hsing J.M.,Beth Israel Deaconess Medical Center | Selzman K.A.,University of Utah | Leclercq C.,Center Hospitalier University Pontchaillou | Pires L.A.,St John Hospital And Medical Center | And 4 more authors.
Circulation: Arrhythmia and Electrophysiology | Year: 2011

Background-For patients with symptomatic New York Heart Association class III or IV, ejection fraction ≤35%, and QRS ≥130 ms, cardiac resynchronization therapy (CRT) has become an established treatment option. However, use of these implant criteria fails to result in clinical or echocardiographic improvement in 30% to 45% of CRT patients. Methods and Results-The Predictors of Response to CRT (PROSPECT)-ECG is a substudy of the prospective observational PROSPECT trial. ECGs collected before, during, and after CRT implantation were analyzed. Primary outcomes were improvement in clinical composite score (CCS) and reduction of left ventricular end systolic volume (LVESV) of >15% after 6 months. Age, sex, cause of cardiomyopathy, myocardial infarction location, right ventricular function, mitral regurgitation, preimplantation QRS width, preimplantation PR interval, preimplantation right ventricular-paced QRS width, preimplantation axis categories, LV-paced QRS width, postimplantation axis categories, difference between biventricular (Bi-V) pacing and preimplantation QRS width, and QRS bundle branch morphological features were analyzed univariably in logistic regression models to predict outcomes. All significant predictors (α=0.1), age, and sex were used for multivariable analyses. Cardiomyopathy cause interaction and subanalyses were also performed. In multivariable analyses, only QRS left bundle branch morphological features predicted both CCS (odds ratio [OR]=2.46, P=0.02) and LVESV (OR=2.89, P=0.048) response. The difference between Bi-V and preimplantation QRS width predicted CCS improvement (OR=0.89, P=0.04). LV-paced QRS width predicted LVESV reduction (OR=0.86, P=0.01). Specifically, an LV-paced QRS width of ≤200 ms was predictive of nonischemic LVESV reduction (OR=5.12, P=0.01). Conclusions-Baseline left bundle branch QRS morphological features, LV-paced QRS width, and the difference between Bi-V and preimplantation QRS width can predict positive outcomes after CRT and may represent a novel intraprocedural method to optimize coronary sinus lead placement. © 2011 American Heart Association, Inc. Source


Mahe G.,French Institute of Health and Medical Research | Ronziere T.,Center Hospitalier University Pontchaillou | Laviolle B.,Rennes University Hospital Center | Golfier V.,Center Hospitalier Of Saint Brieuc | And 3 more authors.
Journal of Vascular Surgery | Year: 2010

Objective: Ischemic strokes represent more than 80% of total strokes in Western countries. The influence of dietary factors on ischemic stroke risk is debated mainly because available data are limited. Our objective was to compare the dietary pattern of symptomatic ischemic stroke patients under 65 years old with control subjects using a validated 14-item food frequency questionnaire (FFQ). We also compared symptomatic ischemic stroke patients with carotid atherosclerosis with those without according to the presence or the absence of carotid plaque defined by duplex scanning. Methods: This was a case-control multi-center study that took place in one University hospital and two general hospitals in France. One hundred twenty-four symptomatic ischemic stroke patients (confirmation by a neurologist and imaging; 66% smokers) and 50 controls (34% smokers) without any known cardiovascular disease or previous nutritional advice were included. The main outcome measure(s) were intake scores for saturated (SFA), monounsaturated (MUFA), Ω-3 polyunsaturated (Ω-3 PUFA), and Ω-6 polyunsaturated fatty acids (Ω-6PUFA). Fruit and vegetables and an overall cardiovascular dietary score were evaluated with the FFQ. The overall cardiovascular score is calculated as (MUFA + Ω-3 PUFA + fruits and vegetables) - (SFA) scores. Results: Compared with controls, ischemic stroke patients had a higher SFA score (6.6 ± 3.0 vs 4.9 ± 2.7; P < .001), lower scores of MUFA (0.8 ± 0.9 vs 1.5 ± 1.2; P < .001), Ω-3 PUFA (1.7 ± 1.6 vs 2.2 ± 1.5; P = .013), Ω-6PUFA (2.6 ± 2.5 vs 3.9 ± 2.7; P = .002), fruit and vegetables (2.9 ± 1.7 vs 3.8 ± 1.6; P = .005), and a lower overall dietary score (-1.2 ± 5.0 vs 2.5 ± 4.4; P < .001). These results remained statistically significant after adjustment for age, gender, and smoking status. Ischemic stroke patients with carotid atherosclerosis (n = 54) had a worse overall cardiovascular dietary score than those without (n = 68): -2.2 ± 4.4 vs -0.2 ± 5.2; P = .024. Conclusion: Compared with controls, ischemic stroke patients, especially those with carotid atherosclerosis, have an unfavorable dietary pattern (high SFA, low fruit and vegetables, and Ω-3 PUFA consumptions) that may have been a facilitating condition of the ischemic stroke. Dietary recommendations of a healthy diet should be useful in ischemic stroke prevention, especially in patients with cardiovascular risk factors. © 2010 Society for Vascular Surgery. Source


The SEP-Bretagne network draws on the skills of the health professionals involved with patients with Multiple sclerosis. It brings together medical and paramedical professionals, to support actions aimed at improving the care pathway and the quality of life of patients. © 2015 Elsevier Masson SAS. All rights reserved. Source


Patent
French National Center for Scientific Research, Center Hospitalier University Pontchaillou and University of Rennes 1 | Date: 2011-03-04

The invention relates to a mixture comprising protolichesterinic acid or a salt thereof or a diastereoisomer thereof or a derivative thereof, and lichesterinic acid or a salt thereof or an enantiomer thereof or a derivative thereof, for use for stimulating pigmentation of the skin and/or of its appendages. The invention also relates to derivatives of lichesterinic acid of formula (A).


Patent
Center Hospitalier University Pontchaillou | Date: 2011-12-13

The present invention relates to gene promoters whose methylation status correlates with the clinical survival outcome of glioblastoma patients treated according to the Stupp protocol. More specifically, the invention provides methods and kits for the prognosis of survival outcome and/or treatment response in glioblastoma patients.

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