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Personne :
Bastien, Marjorie

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Bastien

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Marjorie

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Université Laval. Faculté de pharmacie

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ncf11861212

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2011 - 201922020 - 20211
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  • PublicationAccès libre
    The physiological burden of the 6-minute walk test compared with cardiopulmonary exercise stress test in patients with severe aortic atenosis
    (Elsevier, 2021-02-06) Rodés-Cabau, Josep; Auclair, Audrey; Bagur, Rodrigo Hernan; Nadreau, Éric; Poirier, Paul; Pibarot, Philippe; Clavel, Marie-Annick; Bastien, Marjorie; Forman, Daniel E.
    Background Management of aortic stenosis (AS) relies on symptoms. Exercise testing is recommended for asymptomatic patients with significant AS but is often experienced as forbidding and/or technically unrealistic for patients who are often frail, deconditioned, and intimidated by the exercise test. We compared the physiological burden assessed with gas exchange assessments to gauge and respiratory exchange ratio (RER) of a 6-minute walk test (6MWT) to a cardiopulmonary exercise stress test (CPET) in patients with severe AS. peak oxygen utilization Methods Adults with equivocal symptoms and severe AS (1-aortic valve area [AVA] ≤ 1.0 cm2 or AVA index ≤ 0.6 cm2/m2, 2-peak aortic jet velocity ≥ 4.0 m/sec, 3-mean transvalvular pressure gradient ≥ 40 mm Hg by rest or dobutamine stress echocardiography, or 4-aortic valve calcification ≥ 1200 in women or ≥ 2000 AU in men) were studied. All participants completed both a 6MWT and symptom-limited progressive bicycle exercise testing. Breath-by-breath gas analysis and 12-lead electrocardiography were completed during 6MWT and CPET. Results: Eleven patients were studied. Patients walked on average 330 ± 75 m during the 6MWT and achieved a maximal workload of 48 ± 14 watts during the CPET. During the 6MWT, peak maximal oxygen uptake (O2peak) was 12.8 ± 2.5 vs 10.8 ± 4.2 mL/kg/min during the CPET. Respiratory exchange ratio exceeded 1.1 in both the 6MWT and CPET indicating similarly high exertion. Compared with the CPET, a larger proportion of the 6MWT was performed at a high intensity level (78% ± 28% vs 33% ± 24% at > 85% V̇O2peak; P = 0.004). Conclusions The 6MWT with breath-by-breath gas analysis was well tolerated and able to achieve a physiological intense RER and O2peak that are similar to symptom-limited CPET in patients with severe AS.
  • PublicationRestreint
    Impact of bariatric surgery on N-terminal fragment of the prohormone brain natriuretic peptide and left ventricular diastolic function
    (Elsevier, 2013-08-01) Bertrand, Fernand; Biertho, Laurent; Bergeron, Sébastien; Lescelleur, Odette; Poirier, Paul; Martin, Julie; Pibarot, Philippe; Simard, Serge; Bastien, Marjorie
    Background : Obesity is often associated with left ventricular (LV) diastolic dysfunction (DD). Elevated N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) is considered a biomarker of LV dysfunction. Weight loss induced by bariatric surgery may improve LV DD, but conflicting results regarding NT-proBNP levels have been reported. Our objective was to determine the impact of bariatric surgery–induced weight loss on NT-proBNP levels and LV DD. Methods : Seventy (70) patients were evaluated before and 6 and 12 months following a biliopancreatic diversion with duodenal switch (BPD-DS), and 33 subjects were followed as controls at baseline and 6 and 12 months later. Blood was collected for NT-proBNP measurement, and LV diastolic function was assessed with echocardiography. Results : Among the 103 severely obese patients, 82% presented some degree of LV DD. Systolic function was preserved in all subjects. Along with significant weight loss, LV DD significantly improved (P < 0.001) in the BPD-DS group, whereas there was no change in the control group. NT-proBNP levels decreased over time in the control group (P = 0.016) and increased in subjects following BPD-DS (baseline vs 6-month vs 12-month follow-up: 51.8 ± 62.8 vs 132.0 ± 112.9 vs 143.3 ± 120.4 pg/mL; P < 0.001). The most significant associations with changes in NT-proBNP levels were improvements in the metabolic profile. Conclusions : In severely obese patients, NT-proBNP levels decrease with sustained obesity for 1 year. Despite significant improvements in LV DD following bariatric surgery, NT-proBNP levels increase. These results suggest that monitoring NT-proBNP levels following bariatric surgery may be misleading regarding LV DD and symptoms of dyspnea.
  • PublicationAccès libre
    Étude des facteurs de risque de la maladie cardiovasculaire chez les patients avec maladie de l'aorte thoracique
    (2011) Bastien, Marjorie; Poirier, Paul
    À ce jour, on estime que 10,9 personnes par 100 000 par année sont atteintes d'un anévrisme de l'aorte thoracique. Bien que cette prévalence soit faible, la maladie est très mortelle et un suivi adéquat avec une prise en charge précoce de la condition aortique est hautement important. Ainsi, selon le récent guide de pratique de YAmehcan Heart Association, la prise en charge des facteurs de risque cardiovasculaire devrait faire partie intégrante du suivi de la maladie aortique. D'après nos observations, les individus atteints d'une maladie de l'aorte thoracique ne sont pas pris en charge de façon optimale quant à leur tension artérielle, leur dyslipidémie et leur obésité abdominale lorsque comparé à un groupe contrôle en prévention secondaire. À long terme, une prise en charge plus agressive de ces facteurs de risque aurait peut-être le potentiel de freiner la progression de la maladie.