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Personne :
Bergeron, Sébastien

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Bergeron

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Sébastien

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Université Laval. Département de médecine

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ncf13729623

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Voici les éléments 1 - 10 sur 24
  • PublicationAccès libre
    Bioprosthetic mitral valve thrombosis : a multifaceted and challenging clinical and imaging spectrum
    (Elsevier Inc., 2021-11-17) Châteauneuf, Gabriel; De Larochellière, Hugo; Clavel, Marie-Annick; Kalavrouziotis, Dimitri; Charbonneau, Éric; Dagenais, François; Morin, Francis; Silva, Iria; Turgeon, Pierre-Yves; Paradis, Jean-Michel; Bernier, Mathieu; Beaudoin, Jonathan; Bergeron, Sébastien; Rodés-Cabau, Josep; Mohammadi, Siamak; Pibarot, Philippe; O'Connor, Kim; Salaun, Erwan
    Subclinical leaflet thrombosis of bioprosthetic aortic valves after transcatheter aortic valve replacement has been emphasized in recent published data, but few reports have focused on bioprosthetic mitral valve thrombosis. Bioprosthetic mitral valve thrombosis is a complex and multifaceted process that is associated with a wide spectrum of clinical and imaging features. The clinical presentation ranges from incidental discovery to systemic embolic events and acute heart failure. Comprehensive transthoracic echocardiographic assessment is key for early detection of subtle changes in bioprosthetic valve morphology and / or function, and indirect signs of reduced leaflet motion such as color paucity. Transesophageal echocardiography is essential to confirm the presence of valve thrombosis. Multimodality imaging is gaining increased acceptance for the evaluation of systemic embolism and for ruling out infective endocarditis using cardiac and extracardiac anatomical and metabolic imaging. This report illustrates both : 1) the spectrum of clinical and imaging characteristics associated with mitral bioprosthetic valve thrombosis ; and 2) the case-by-case management of this challenging condition by the heart team.
  • PublicationAccès libre
    La régulation du métabolisme du glucose par la protéine tyrosine phosphatase SHP-1
    (2007) Bergeron, Sébastien; Marette, André
    Lorsque l’insuline se lie à son récepteur, elle induit une cascade de réactions indispensables à l’utilisation du glucose. La résistance à l’insuline et le diabète de type 2 qui affectent une fraction croissante de la population résultent d’un défaut de signalisation de l’insuline. La voie de signalisation PI3K qu’emprunte l’insuline pour promouvoir l’utilisation du glucose est d’abord décrite en introduction de cette thèse. Aussi, il existe plusieurs mécanismes de désensibilisation qui sont essentiels pour limiter l’ampleur du signal à la réponse métabolique requise. Cependant, ces mécanismes sont altérables et de faibles dérèglements peuvent devenir responsables d’une propagation défaillante du signal insulinique. Les souris viable motheaten (mev), déficientes en activité SHP-1, nous ont permis au premier chapitre de démontrer que SHP-1 constitue un de ces mécanismes de désensibilisation. Ces souris montrent une plus grande tolérance au glucose et une meilleure sensibilité à l’insuline que les souris non-déficientes en SHP-1, ainsi qu’une meilleure signalisation de l’insuline dans le foie et le muscle squelettique. De plus, nous avons pu démontrer que SHP-1 contrôle aussi la clairance hépatique de l’insuline, importante pour réguler la concentration et la sensibilité systémique de l’insuline. Cette première étude a donc permis d’établir un nouveau rôle pour SHP-1 dans la régulation de l’action de l’insuline. Par la suite, il devenait primordial de décrire les mécanismes impliqués dans la sensibilisation à l’insuline par la déficience en SHP-1 dans le muscle et le foie. À l’aide d’adénovirus codant pour un mutant catalytiquement inerte de SHP-1 (DNSHP-1), nous rapportons au deuxième chapitre, par l’expression de DNSHP-1 dans les hépatocytes Fao, que la diminution de la production hépatique de glucose observée chez les souris mev résulte d’une augmentation de la glycogénèse plutôt que d’une diminution de la gluconéogenèse. Enfin, au dernier chapitre, DNSHP-1 exprimé dans les myocytes L6 favorise la signalisation via Akt, et accroît l’expression de GLUT4, le principal transporteur de glucose sensible à l’insuline. Ensemble, nos résultats suggèrent clairement que SHP-1 est un nouveau modulateur de l’action de l’insuline dans le foie et le muscle squelettique. SHP-1 pourrait donc représenter une nouvelle cible thérapeutique pour traiter le diabète de type 2.
  • PublicationRestreint
    Feasibility and initial results of percutaneous aortic valve implantation including selection of the transfemoral or transapical approach in patients with severe aortic stenosis
    (Elsevier, 2008-11-01) Bertrand, Olivier; Dumont, Éric; Villeneuve, Jacques; De Larochellière, Robert; Rodés-Cabau, Josep; Doyle, Daniel; Bergeron, Sébastien; Lemieux, Jerome; Pibarot, Philippe; Clavel, Marie-Annick; Raby, Kathlee
  • PublicationRestreint
    Severe valvular regurgitation and late prosthesis embolization after percutaneous aortic valve implantation
    (Elsevier Science, 2009-01-19) Villeneuve, Jacques; Dumont, Éric; Rodés-Cabau, Josep; Couture, Christian; Doyle, Daniel; Bergeron, Sébastien; De Larochellière, Robert; Pibarot, Philippe; Clavel, Marie-Annick
    We report the case of a 79-year-old man with low-flow, low-gradient aortic stenosis who underwent transapical aortic valve implantation. The deployment of a 26-mm Edwards SAPIEN valve (Edwards Lifesciences Inc, Irvine, CA) was complicated with the occurrence of severe central aortic regurgitation that was successfully treated with the implantation of a second valve (“valve-in-valve”). Postoperative progress was satisfactory but 2 days after the procedure he suddenly developed cardiogenic shock secondary to the migration of the aortic bioprothesis into the left ventricular outflow tract. Open-heart surgery was undertaken to remove the valves and perform standard aortic valve replacement, but the patient died perioperatively.
  • PublicationRestreint
    Validation and characterization of transcatheter aortic valve effective orifice area measured by Doppler echocardiography
    (American College of Cardiology, 2011-10-04) Larose, Éric; Rodés-Cabau, Josep; Dumont, Éric; Bergeron, Sébastien; Bagur, Rodrigo Hernan; Pibarot, Philippe; De Larochellière, Robert; Dumesnil, Jean G.; Doyle, Daniel; Clavel, Marie-Annick
    Objectives : The objectives were to compare different Doppler echocardiographic methods for the measurement of prosthetic valve effective orifice area (EOA) following transcatheter aortic valve implantation (TAVI) and to determine the factors influencing the EOA of transcatheter balloon expandable valves.
  • PublicationRestreint
    Stress echocardiography to assess stenosis severity and predict outcome in patients with paradoxical low-flow, low-gradient aortic stenosis and preserved LVEF
    (Elsevier, 2013-02-01) Vladimir Ennezat, Pierre; Bergeron, Sébastien; Maréchaux, Sylvestre; Capoulade, Romain; Pibarot, Philippe; Dumesnil, Jean G.; Hachicha, Zeineb; Clavel, Marie-Annick; Mathieu, Patrick; Bellouin, Annaïk; Arsenault, Marie; Meimoun, Patrick; Le Tourneau, Thierry; Couture, Christian; Pasquet, Agnès
    The objective of this study was to examine the value of stress-echocardiography in patients with paradoxical low-flow, low-gradient (PLFLG) aortic stenosis (AS). The projected aortic valve area (AVAProj) at a normal flow rate was calculated in 55 patients with PLFLG AS. In the subset of patients (n = 13) who underwent an aortic valve replacement within 3 months after stress echocardiography, AVAProj correlated better with the valve weight compared to traditional resting and stress echocardiographic parameters of AS severity (AVAProj: r = -0.78 vs. other parameters: r = 0.46 to 0.56). In the whole group (N = 55), 18 (33%) patients had an AVAProj >1.0 cm2, being consistent with the presence of pseudo severe AS. The AVAProj was also superior to traditional parameters of stenosis severity for predicting outcomes (hazard ratio: 1.32/0.1 cm2 decrease in AVAProj). In patients with PLFLG AS, the measurement of AVAproj derived from stress echocardiography is helpful to determine the actual severity of the stenosis and predict risk of adverse events.
  • PublicationRestreint
    Comparison of the hemodynamic performance of percutaneous and surgical bioprostheses for the treatment of severe aortic stenosis
    (Elsevier Biomedical, 2009-05-19) Bertrand, Olivier; Webb, John G. (John Graydon); Rodés-Cabau, Josep; Bergeron, Sébastien; Altwegg, Lukas; Pibarot, Philippe; Dumont, Éric; Clavel, Marie-Annick; Thompson, Chris; De Larochellière, Robert; Doyle, Daniel; Masson, Jean-Bernard
    Objectives : This study was undertaken to compare the hemodynamic performance of a percutaneous bioprosthesis to that of surgically implanted (stented and stentless) bioprostheses for the treatment of severe aortic stenosis. Methods : Fifty patients who underwent percutaneous aortic valve implantation (PAVI) with the Cribier-Edwards or Edwards SAPIEN bioprosthetic valve (Edwards Lifesciences, Inc., Irvine, California) were matched 1:1 for sex, aortic annulus diameter, left ventricular ejection fraction, body surface area, and body mass index, with 2 groups of 50 patients who underwent surgical aortic valve replacement (SAVR) with a stented valve (Edwards Perimount Magna [SAVR-ST group]), or a stentless valve (Medtronic Freestyle, Medtronic, Minneapolis, Minnesota [SAVR-SL group]). Doppler echocardiographic data were prospectively obtained before the intervention, at discharge, and at 6- to 12-month follow-up. Results : Mean transprosthetic gradient at discharge was lower (p < 0.001) in the PAVI group (10 ± 4 mm Hg) compared with the SAVR-ST (13 ± 5 mm Hg) and SAVR-SL (14 ± 6 mm Hg) groups. Aortic regurgitation (AR) occurred more frequently in the PAVI group (mild: 42%, moderate: 8%) compared with the SAVR-ST (mild: 10%, moderate: 0%) and SAVR-SL (mild: 12%, moderate: 0%) groups (p < 0.0001). At follow-up, the mean gradient in the PAVI group remained lower (p < 0.001) than that of the SAVR-ST group, but was similar to that of the SAVR-SL group. The incidence of severe prosthesis-patient mismatch was significantly lower (p = 0.007) in the PAVI group (6%) compared with the SAVR-ST (28%) and SAVR-SL (20%) groups. However, the incidence of AR remained higher (p < 0.0001) in the PAVI group compared with the 2 other groups. Conclusions : PAVI provided superior hemodynamic performance compared with the surgical bioprostheses in terms of transprosthetic gradient and prevention of severe prosthesis-patient mismatch, but was associated with a higher incidence of AR.
  • PublicationRestreint
    A simple Doppler echocardiography method to evaluate pulmonary capillary wedge pressure in patients with atrial fibrillation
    (Wiley-Blackwell Publishing, 2007-08-22) O'Connor, Kim; Deblois, Jonathan; Sénéchal, Mario; Magne, Julien; Bergeron, Sébastien; Poirier, Paul; Pibarot, Philippe; Dumesnil, Jean G.
    OBJECTIVE: The accuracy of E/E' ratio has not been validated in atrial fibrillation (AF). The objective of this study is to compare the accuracy of the E/E' ratio averaged over a sample of 10 cardiac cycles and E/E' ratio obtained in the cycle with the longest RR interval for the estimation of wedge pressure in patients with AF using a simultaneous pulmonary artery occlusive pressure measured with a Swan-Ganz catheter. DESIGN: Twenty-four consecutive patients with AF with a Swan-Ganz catheter were recruited in this study. The majority of patients (92%) were in the early postoperative phase of cardiac surgery. RESULTS: The best sensitivity and specificity was reached with E/E' ratio in the medial position using the one-beat method; E/E' ratio > or = 16 with one beat predicts a wedge pressure >15 mmHg with a sensitivity and specificity of 91% and 85%, respectively. CONCLUSIONS: Measuring E/E' ratio using the one-beat method is a simple and clinically accurate way to estimate wedge pressure in patients with AF.
  • PublicationRestreint
    Left atrial decompression using unidirectional left-to-right interatrial shunt : initial experience in treating symptomatic heart failure with preserved ejection fraction with the W-Wave device
    (American College of Cardiology, 2015-05-01) Campelo-Parada, Francisco; Abdul-Jawad Altisent, Omar; Rodés-Cabau, Josep; Bergeron, Sébastien; Amat Santos, Ignacio J.; Del Trigo, Maria; Bernier, Mathieu; Verheye, Stefan; Pibarot, Philippe; Keren, Gad; Puri, Rishi; Katzenellenbogen, Rotem; Rozenfeld, Erez; Abraham, William T.
  • PublicationRestreint
    Unidirectional left-to-right interatrial shunting for treatment of patients with heart failure with reduced ejection fraction : a safety and proof-of-principle cohort study
    (Elsevier, 2016-03-26) Campelo-Parada, Francisco; Abdul-Jawad Altisent, Omar; Rodés-Cabau, Josep; Bergeron, Sébastien; Amat Santos, Ignacio J.; Del Trigo, Maria; Bernier, Mathieu; Pibarot, Philippe; Eigler, Neal; Puri, Rishi; Rozenfeld, Erez; Regueiro, Ander; Abraham, William T.
    Background: In patients with heart failure, interventions to reduce elevated left atrial pressure improve symptoms and reduce the risk of hospital admission. We aimed to assess the safety and potential efficacy of therapeutic left-to-right interatrial shunting in patients with heart failure with reduced ejection fraction. Methods: We did this proof-of-principle cohort study at one centre in Canada. Patients (aged =18 years) with New York Heart Association (NYHA) class III chronic heart failure with reduced ejection fraction were enrolled under the Canadian special access programme. Shunt implants were done after transseptal catheterisation with transoesophageal echocardiographic guidance under general anaesthesia. Patients had clinical and echocardiography evaluations at baseline and months 1 and 3 after shunt implantation. Findings: Between Oct 10, 2013, and March 27, 2015, we enrolled ten patients. The device was successfully implanted in all patients; no device-related or procedural adverse events occurred during follow-up. Transoesophageal echocardiography at 1 month showed that all shunts were patent, with no thrombosis or migration. From baseline to 3 month follow-up, we recorded improvements in NYHA classification (from class III to class II in seven [78%] of nine patients, from class III to class I in one [11%] patient, and no change in one [11%] patient; p=0·0004); quality of life, as assessed by the Duke Activity Status Index (from a mean score of 13 [SD 6·2] to 24·8 [12·9]; p=0·016) and the Kansas City Cardiomyopathy Questionnaire (from a mean score of 44·3 [SD 9·8] to 79·1 [13·0]; p=0·0001); and 6 min walk test distance (from a mean of 244 m [SD 112] to 318 m [134]; p=0·016). Pulmonary capillary wedge pressure was reduced from a mean of 23 mm Hg (SD 5) at baseline to 17 mm Hg (8) at 3 months (p=0·035), with no changes in right atrial pressure, pulmonary arterial pressure, or pulmonary resistance. No patient was admitted to hospital for worsening heart failure. One (10%) patient was admitted to hospital with gastrointestinal bleeding at month 1; one (10%) patient died after incessant ventricular tachycardia storm, which led to terminal heart failure 2 months post-procedure. Interpretation: This first-in-man experience with an implanted left-to-right interatrial shunt demonstrates initial safety and early beneficial clinical and haemodynamic outcomes in patients with heart failure with reduced ejection fraction. Further large-scale randomised studies are warranted.