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Pulmonary hypertension (PH) is highly heterogeneous and despite treatment advances it remains a life-shortening condition. There have been significant advances in imaging technologies, but despite evidence of their potential clinical utility, practice remains variable, dependent in part on imaging availability and expertise. This statement summarizes current and emerging imaging modalities and their potential role in the diagnosis and assessment of suspected PH. It also includes a review of commonly encountered clinical and radiological scenarios, and imaging and modeling-based biomarkers. An expert panel was formed including clinicians, radiologists, imaging scientists, and computational modelers. Section editors generated a series of summary statements based on a review of the literature and professional experience and, following consensus review, a diagnostic algorithm and 55 statements were agreed. The diagnostic algorithm and summary statements emphasize the key role and added value of imaging in the diagnosis and assessment of PH and highlight areas requiring further research.

Pulmonary hypertension is highly heterogeneous and despite treatment advances it remains a life shortening condition. There have been significant advances in imaging technologies, but despite evidence of their potential clinical utility practice remains variable, dependent in part on imaging availability and expertise. This statement summarises current and emerging imaging modalities and their potential role in the diagnosis and assessment of suspected pulmonary hypertension. It also includes a review of commonly encountered clinical and radiological scenarios, and imaging and modeling-based biomarkers. An expert panel was formed including clinicians, radiologists, imaging scientists and computational modelers. Section editors generated a series of summary statements 1based on a review of the literature and professional experience and following consensus review, a diagnostic algorithm and fifty five statements were agreed. The diagnostic algorithm and summary statements, emphasise the key role and added value of imaging in the diagnosis and assessment of pulmonary hypertension and highlight areas requiring further research.

National audience

Les recherches sur l'élevage bovin à la Réunion remontent à 1962, mais ce n'est qu'à partir de 1987 que, à la demande des organisations professionnelles et de la Région, une équipe pluridisciplinaire et pluri-institutionnelle de recherch-développement s'est mise en place : le Cirad-Elevage. Cette équipe avait pour objectif de répondre aux préoccupations des acteurs de la filière : comment améliorer la reproduction des troupeaux ? comment résoudre le problème du déficit fourrager hivernal ? Au fur et à mesure de l'avancement des recherches, ces questions se sont enrichies et précisées : comment mieux gérer les prairies en fonction des systèmes de production et dans des contextes écologiques variés ? comment utiliser la diversité des ressources fourragères pour répondre aux besoins des animaux ? comment améliorer les performances zootechniques et sanitaires des troupeaux ?. L'élevage bovin à la Réunion offre une synthèse de ces quinze dernières années de recherche. A partir d'une analyse de la diversité et de la dynamique des systèmes d'élevage, dans leur contexte passé et actuel, il pose la problématique du développement de l'élevage bovin réunionnais. Puis il aborde la question centrale des ressources fourragères - comportement des espèces, installation, fertilisation et gestion agroécologique des prairies - et de l'alimentation des animaux - systèmes d'élevage, ensilage, ressources alimentaires extérieures à l'exploitation, rations. Il traite, enfin, des performances zootechniques et sanitaires des troupeaux. Ces recherches ont débouché sur de nombreuses applications concrètes comme l'instauration d'un suivi de reproduction pour les troupeaux laitiers et allaitants, la mise au point de la technique d'ensilage en balles enrubannées, l'élaboration de techniques et d'outils de diagnostic pour l'aide à la gestion raisonnée des prairies et l'organisation d'un suivi écopathologique de l'infertilité. Mais au-delà de leur intérêt strictement local, ces recherches sont riches d'enseignements pour l'ensemble des régions tropicales, et particulièrement pour les zones de montagne.

On account of the large areas involved, sugar cane is an abundant source of biomass for feeding animals. CIRAD has undertaken research on three aspects: (1) harvest and baling/storage of sugar cane residues, (2) improvement of feed value by ammonia treatment, and (3) feeding of store animals with this fodder. During straw drying, the trend of dry matter (DM) content is an increasing logarithmic function of the cumulative saturation deficit of the air (r2=0 .91). Bales harvested are mainly composed of leaves; unlike the leaves, which dry very well, the stem pieces and cane tops do not. Several tests were performed on different methods of treatment. For treatment in the baler (4.8% urea in relation to straw DM), the resulting product is uniform, giving a 16% increase in digestibility. For application in stacks, the result is less homogeneous (the lower part of the bales being less well treated). The increase in digestibility is 12% for an addition of water of 70 l per bale and a urea/DM ratio of 6% and 26% with a water addition of 100 l per bale with a urea/DM ratio of 8.4%. Two feeding trials have been conducted on growing Holstein dairy heifers. In trial 1, 11 heifers were given urea treated sugarcane straw plus 1 kg molasses (treatment U1), and 11 heifers were given untreated sugarcane straw plus 1 kg molasses urea mixture (treat. C1). In addition, both groups received 3 kg concentrate plus a mineral and vitamin mixture daily. The voluntary dry matter intake (DMI) of the roughage was greater for U1 than for C1: 1.8 and 1.4 kg per 1OO kg live weight (LW) respectively. The daily weight gain (DWG), 896g/d and 741g/d for U1 and C1 respectively, was significantly different (P< 0.05). In the second trial, 20 heifers were given urea treated sugarcane straw plus 0.5 kg molasses (treat. U2) and 20 heifers were given untreated sugarcane straw plus 0.5 kg molasses urea mixture (treat. C2). In addition, both groups received 4 kg concentrate plus a mineral/vitamin mixture daily. The DMI was the same as in trial 1 for both U2 and C2 group. The DWG was not significantly different (P>0.05), with 700g/d and 679g/d for the U2 and C2 groups respectively. More investigations are needed in order to determine the ideal supplementation for such a roughage.

6 Millions de litres de lait produits à la Réunion en 1989, 9 millions aujourd'hui et sans doute 20 millions en l'an 2000... Pour atteindre ce résultat et répondre à la demande future, les exploitants se spécialisent et font preuve d'une technicité croissante, dans le domaine laitier. Parallélement, la production de viande bovine s'est aussi fortement accrue bien qu'elle ne couvre que 20% du marché local. Les 600 hectares de prairies créées chaque année, les 12 000 hectares de surface fourragère consacrés à l'élevage qui se développe, témoignent de la bonne santé de la filière. L'action du CIRAD pour accompagner ce développement et le favoriser, s'inscrit dans plusieurs domaines : zootechnique, lutte contre les pathologies, maîtrise des pâturages, gestions des stocks de fourrage...

National audience; Several experiments were conducted for evaluating the effects of once daily milking (ODM) in Lacaune dairy ewes throughout the milking period. Milk production and composition, udder health, daily feed intake and energy metabolism were individually monitored. The effects of adopting ODM at the farm and the production region levels were also modelled. Individual milk yield was 14% lower either in adult or primiparous ewes. Milk fat and protein contents were lower and higher, respectively, when ewes were fed ad libitum; however, these parameters were almost not modified when diets were adjusted to the actual milk yield. Dry matter intake was not affected by ODM, which led to a marked positive energy balance in ODM ewes. The last was well illustrated by the metabolic profile of the ewes, showing lower body reserves mobilization in ODM ewes. The udder morphology and functioning was only disturbed during the first week of ODM, but it was rapidly recovered without associated further health constraints. At the farm level, adopting the ODM regime showed a decrease in the global farm incomes, possibly to be recovered by starting ODM in the mid-lactation or prolonging the milking period length. Further researches will be required for characterizing in a deeper way the related effects of applying ODM under different feeding and management situations at the flock, farm and regional production scales.; Une série d’expérimentations a été conduite pour mesurer l’impact de la monotraite à l’échelle de la lactation de brebis laitières de race Lacaune. La production de lait et sa composition, la physiologie et la morphologie de la mamelle, l’ingestion et le métabolisme énergétique ont été mesurés tout au long de la période de traite, du sevrage au tarissement. L’impact de la monotraite a été modélisé à l’échelle de l’exploitation et du bassin de production. La perte de lait a été de 14% chez les multipares comme les primipares. Selon la ration offerte, le taux butyreux a diminué ou a eu tendance à augmenter, alors que le taux protéique n’a pas été modifié ou a augmenté en lien avec une augmentation des protéines solubles. Les quantités ingérées n’étaient pas différentes entre brebis en traite biquotidienne et monotraite, ce qui a entraîné un bilan énergétique positif supérieur pour ces dernières. Cela s’est traduit par des taux d’acides gras non estérifiés rapidement plus bas et de leptine supérieurs. La mamelle a été perturbée dans les premiers jours de monotraite, mais a rapidement retrouvé son intégrité du fait d’une bonne plasticité sans aucune conséquence sur sa santé. Au niveau de l’exploitation, la monotraite entraîne une perte de revenu qui peut être compensée en tout ou partie par un passage en monotraite à un stade plus tardif ou un allongement de la période de traite. Des travaux complémentaires conduits à l’échelle de l’exploitation permettraient de mieux préciser les répercussions de cette pratique à ce niveau et à celui du bassin de production.

PURPOSE: Right ventricular (RV) capacity to adapt to increased afterload is the main determinant of outcome in pulmonary hypertension (PH), a common morbidity seen in systemic sclerosis (SSc). We hypothesized that supine bicycle echocardiography (SBE), coupled with RV longitudinal systolic strain (RVLSS), improves detection of limitations in RV reserve in SSc. METHODS: 56 SSc patients were prospectively studied during SBE with RV functional parameters compared at rest and peak stress. We further dichotomized patients based on resting RV systolic pressure (RVSP) to determine the effects of load on contractile response. RESULTS: Our pooled cohort analysis revealed reduced global RVLSS at rest (−16.2 ± 3.9%) with normal basal contractility (−25.6 ± 7.7%) and relative hypokinesis of the midventricular (−14.1 ± 6.0%) and apical (−8.9 ± 5.1%) segments. With exercise, global RVLSS increased significantly (p=0.0005), however despite normal basal contractility at rest, there was no further augmentation with exercise. Mid and apical RVLSS increased with exercise suggestive of RV contractile reserve. In patients with resting RVSP < 35 mmHg, global and segmental RVLSS increased with exercise. In patients with resting RVSP ≥35 mmHg, global and segmental RVLSS did not increase with exercise and there was evidence of exertional RV dilation. CONCLUSION: Exercise provocation in conjunction with RVLSS identified differential regional contractile response to exercise in SSc patients. We further demonstrate the effect of increased loading conditions on RV contractile response exercise. These findings suggest subclinical impairments in RV reserve in SSc that may be missed by resting noninvasive 2DE-based assessments alone.

Speckle tracking echo is a useful clinical tool to distinguish differential RV contractility between PAH subtypeshttp://ow.ly/6Wyr30fVTeu