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6. The relation of body mass index and abdominal adiposity with dyslipidemia in 27 general populations of the WHO MONICA Project

Author

Hobbs, MST, Jamrozik, K., Thompson, PL, Armstrong, BK, de Backer, G, De Craene, I, Van Onsem, P, Van Parys, L., De Henauw, S, De Bacquer, D, Kornitzer, M, Berghmans, L., Bara, L, de Smet, P, Jeanjean, M, Brohet, C, Kulbertus, HE, Degre, S, Lavenne, F, Jansens, D, Lefebvre, F., Beck, D, Wunsch, G., Bertrand, F., van Houte, M., Rime, B., Rorive, G, Hannot, R., Adrienne, A, Luyckx, A, Wolf, HK, Gregor, RD, Bata, IR, Brownell, B., Webber, K, Skodova´, Z, Pisa, Z., Berka, L., Cicha, Z., Cerovska´, J, Emrova´, R, Hoke, M, Hronkova, M., Pikhartova´, J., Grafnetter, D., Poledne, R., Vojtisek, P., Vorlicek, J., Wiesner, E, Schroll, M, Kirchhoff, M, Sjøl, A., Quitsau Lund, S, Tuomilehto, J, Puska, P., Vartiainen, E., Korhonen, H., Jousilahti, M, Ducimetie`re, P, Richard, JL, Bingham, A., Lang, T, Amouyel, P, Cottel, D., Nuttens, MC, Marecaux, N., Dallongeville, J., Salomez, J. L., Montaye, M., Steclebout, C, Arveiler, D, Schaffer, P, Haas, V, Wagner, A, Lamamy, N., Savouret, M, Houset, M., Pierau, F., Goetz, V, Ferrie`res, J, Ruidavets, JB, Cambou, JP, Rodier, P., Saulet, C, Greiser, E., Herman, B., Stu¨demann, G, Nu¨ssel, E., Osto¨r Lamm, E., Scheidt, R., Morgenstern, W., Stadler, M, Ganova, M, Keil, U, Tietze, M., Banos, R., Do¨ring, A., Filipiak, B, Barth, W, Heinemann, L, Muche, J., Schmalfuss, S., Assmann, A., Bo¨thig, S., Voigt, G., Brasche, S., Quietzsch, D., Classen, E, Sigfu´sson, N, Gudmundsdo´ttir, II, Stefa´nsdo´ttir, I, Thorsteinsson, T., Sigvaldason H, Menotti, A, Giampaoli, S., Verdecchia, A, Righetti, G., De Pasquale, B., Di Raimo, P, Forte, E., Majetta, A, Vanuzzo, D, Feruglio, GA, Pilotto, L., Cignacco, G., Marini, R., Zilio, G, Cesana, GC, Ferrario, M, Sega, R., Mocarelli, P, BRAMBILLA, PAOLO, Bluzhas, J, Domarkiene, S., Tamosiunas, A., Reklaitiene, R, Beaglehole, R, Jackson, R, Bonita, R, Stewart, A., Mahon, V, Bingley, W, Pajak, A, Sznajd, J, Kawalec, E., Pazucha, T., Malczewska, M., Mo´rawska, I, Rywik, SL, Broda,V, Polakowska, M., Kurjata, P, Varlamova, A, Britov, A., Konstantinov, V, Timofeeva, V, Alexandri, V, Konstantinova, O, Nikitin, Y.u. P, Malyutina, S., Gafarov, V, Feigin, V, Sans, S., Balaguer Vintro´, V, Balana`, V, Gonzalez, V, Gomez, V, Borras, V, Rode´s, A, Wilhelmsen, L, Harmsen, P., Rosengren, A., Lappas, G, Asplund, K., Huhtasaari, F., Stegmayr, B., Lundberg V, Gutzwiller, F, Paccaud, F., Rickenbach, M., Wietlisbach, V., Barazzoni, F, Mainieri, F., Tullen, B, Evans, V, McCrum, EE, Falconer, T, Cashman, S., Patterson, C., Kerr, M., O’Reilly, D., Scott, A., McConville, M., McMillan, I., McMaster, D, Tunstall Pedoe, H., Smith, WCS, Tavendale, R., Crombie, V, Barrett, K., Brown, C., Shewry, M., Hannh, M. K, Morrisson, C, Planojevic, M, Jakovljevic, D., Svircevic, A., Mirilov, V., Strasser, V., Mendis, S., Martin8, I, Gyarfas8, V, Pı´_sa8, V, Dodu8, S. R. A., Bo¨thig8, S., Watson, M. J., Hill, M., Price, A, Kuulasmaa, K., Tuomilehto, J., Ruokokoski, E, Rajakangas, A. M., Ma¨kinen, M., Virman Ojanen, T, Palonen, L., Akkila, J, Cepaitis, Z., Molarius, A., Moltchanov, V., Tolonen, H, Grafnetter, D, Dobson, A., Fortmann, SP, Shatchkute, A, Zaitsev, V, Epstein, FH, Feinleib, M, Karvonen, MJ, Prineas, RJ, Williams, OD, Hobbs, M, Jamrozik, K, Thompson, P, Armstrong, B, de Backer, G, De Craene, I, Van Onsem, P, Van Parys, L, De Henauw, S, De Bacquer, D, Kornitzer, M, Berghmans, L, Bara, L, de Smet, P, Jeanjean, M, Brohet, C, Kulbertus, H, Degre, S, Lavenne, F, Jansens, D, Lefebvre, F, Beck, D, Wunsch, G, Bertrand, F, van Houte, M, Rime, B, Rorive, G, Hannot, R, Adrienne, A, Luyckx, A, Wolf, H, Gregor, R, Bata, I, Brownell, B, Webber, K, Skodova´, Z, Pisa, Z, Berka, L, Cicha, Z, Cerovska´, J, Emrova´, R, Hoke, M, Hronkova, M, Pikhartova´, J, Grafnetter, D, Poledne, R, Vojtisek, P, Vorlicek, J, Wiesner, E, Schroll, M, Kirchhoff, M, Sjøl, A, Quitsau Lund, S, Tuomilehto, J, Puska, P, Vartiainen, E, Korhonen, H, Jousilahti, M, Ducimetie`re, P, Richard, J, Bingham, A, Lang, T, Amouyel, P, Cottel, D, Nuttens, M, Marecaux, N, Dallongeville, J, Salomez, J, Montaye, M, Steclebout, C, Arveiler, D, Schaffer, P, Haas, V, Wagner, A, Lamamy, N, Savouret, M, Houset, M, Pierau, F, Goetz, V, Ferrie`res, J, Ruidavets, J, Cambou, J, Rodier, P, Saulet, C, Greiser, E, Herman, B, Stu¨demann, G, Nu¨ssel, E, Osto¨r Lamm, E, Scheidt, R, Morgenstern, W, Stadler, M, Ganova, M, Keil, U, Tietze, M, Banos, R, Do¨ring, A, Filipiak, B, Barth, W, Heinemann, L, Muche, J, Schmalfuss, S, Assmann, A, Bo¨thig, S, Voigt, G, Brasche, S, Quietzsch, D, Classen, E, Sigfu´sson, N, Gudmundsdo´ttir, I, Stefa´nsdo´ttir, I, Thorsteinsson, T, Sigvaldason, H, Menotti, A, Giampaoli, S, Verdecchia, A, Righetti, G, De Pasquale, B, Di Raimo, P, Forte, E, Majetta, A, Vanuzzo, D, Feruglio, G, Pilotto, L, Cignacco, G, Marini, R, Zilio, G, Cesana, G, Ferrario, M, Sega, R, Mocarelli, P, Brambilla, P, Bluzhas, J, Domarkiene, S, Tamosiunas, A, Reklaitiene, R, Beaglehole, R, Jackson, R, Bonita, R, Stewart, A, Mahon, V, Bingley, W, Pajak, A, Sznajd, J, Kawalec, E, Pazucha, T, Malczewska, M, Mo´rawska, I, Rywik, S, Broda, V, Polakowska, M, Kurjata, P, Varlamova, A, Britov, A, Konstantinov, V, Timofeeva, V, Alexandri, V, Konstantinova, O, Nikitin, Y, Malyutina, S, Gafarov, V, Feigin, V, Sans, S, Balaguer Vintro´, V, Balana`, V, Gonzalez, V, Gomez, V, Borras, V, Rode´s, A, Wilhelmsen, L, Harmsen, P, Rosengren, A, Lappas, G, Asplund, K, Huhtasaari, F, Stegmayr, B, Lundberg, V, Gutzwiller, F, Paccaud, F, Rickenbach, M, Wietlisbach, V, Barazzoni, F, Mainieri, F, Tullen, B, Evans, V, Mccrum, E, Falconer, T, Cashman, S, Patterson, C, Kerr, M, O’Reilly, D, Scott, A, Mcconville, M, Mcmillan, I, Mcmaster, D, Tunstall Pedoe, H, Smith, W, Tavendale, R, Crombie, V, Barrett, K, Brown, C, Shewry, M, Hannh, M, Morrisson, C, Planojevic, M, Jakovljevic, D, Svircevic, A, Mirilov, V, Strasser, V, Mendis, S, Martin8, I, Gyarfas8, V, Pı´_sa8, V, Dodu8, S, Bo¨thig8, S, Watson, M, Hill, M, Price, A, Kuulasmaa, K, Ruokokoski, E, Rajakangas, A, Ma¨kinen, M, Virman Ojanen, T, Palonen, L, Akkila, J, Cepaitis, Z, Molarius, A, Moltchanov, V, Tolonen, H, Dobson, A, Fortmann, S, Shatchkute, A, Zaitsev, V, Epstein, F, Feinleib, M, Karvonen, M, Prineas, R, and Williams, O

Subjects
Adult, Male, Canada, medicine.medical_specialty, BIO/12 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA, Waist, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Logistic regression, Body Mass Index, Risk Factors, Internal medicine, Prevalence, medicine, Humans, Triglycerides, Abdominal obesity, Adiposity, Dyslipidemias, Nutrition and Dietetics, business.industry, Cholesterol, HDL, Smoking, Australia, nutritional and metabolic diseases, Cholesterol, LDL, Middle Aged, medicine.disease, Health Surveys, Europe, Menopause, Cross-Sectional Studies, Logistic Models, Endocrinology, Dyslipidemia, Quartile, Obesity, Abdominal, Female, Waist Circumference, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Body mass index, New Zealand, Demography
Abstract

Background and aims: The association between adiposity measures and dyslipidemia has seldom been assessed in a multipopulational setting. Methods and results: 27 populations from Europe, Australia, New Zealand and Canada (WHO MONICA project) using health surveys conducted between 1990 and 1997 in adults aged 35-64 years (n = 40,480). Dyslipidemia was defined as the total/HDL cholesterol ratio >6 (men) and >5 (women).Overall prevalence of dyslipidemia was 25% in men and 23% in women. Logistic regression showed that dyslipidemia was strongly associated with body mass index (BMI) in men and with waist circumference (WC) in women, after adjusting for region, age and smoking. Among normal-weight men and women (BMI84.8 cm) in normal-weight men, menopause in women and regular smoking further defined subgroups at increased risk. Conclusion: standard categories of BMI and WC, or their combinations, do not lead to optimal risk stratification for dyslipidemia in middle-age adults. Sex-specific adaptations are necessary, in particular by taking into account abdominal obesity in normal-weight men, post-menopausal age in women and regular smoking in both sexes

Published
2013
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13. Downward trends in the prevalence of childhood overweight in two pilot towns taking part in the VIASANO community-based programme in Belgium: data from a national school health monitoring system

Author

Vinck, J, Brohet, C, Roillet, M, Dramaix, M, Borys, J-M, Beysens, J, Jacobs, N, Jebb, S, De Laet, C, and Nève, J

Subjects
Male, Science et gestion hospitalières, obesity, Pédiatrie, Informatique appliquée logiciel, Pilot Projects, Health Promotion, Santé publique, Childhood overweight, Body Mass Index, prevention, Belgium, Prevalence, Humans, Child, Health Education, Nutrition, Original Research, School Health Services, Sciences bio-médicales et agricoles, Overweight, community-based intervention, Cross-Sectional Studies, Child, Preschool, community‐based intervention, Female, EPODE, Diététique, Program Evaluation
Abstract

Background: Multilevel approaches involving environmental strategies are considered to be good practice to help reduce the prevalence of childhood overweight. Objectives: The objective of this study was to evaluate the effects of VIASANO, a community-based programme using the EPODE methodology, on the prevalence of overweight in two pilot towns in Belgium. Methods: We analysed data from a national school health monitoring system to compare changes in the prevalence of overweight and obesity over a 3-year period (2007-2010) in children aged 3-4 and 5-6 years in the pilot towns with those of children of the same ages from the whole French-speaking community of Belgium. Heights and weights of all participants were measured by trained school nurses using a standardized method. Results: The prevalence of overweight (-2.1%) and overweight + obesity (-2.4%) decreased in the pilot towns, but remained stable in the comparison population (+0.1% and +0.2%, respectively). After adjustment for lack of homogeneity between the study populations, there was a trend towards a decrease in overweight (P = 0.054) and overweight + obesity (P = 0.058) in the pilot towns compared with the general population. Conclusions: These results suggest that a community-based programme, such as VIASANO, may be a promising strategy for reducing the prevalence of childhood overweight even over a short period of time., SCOPUS: ar.j, FLWOA, info:eu-repo/semantics/published

Published
2016

14. Effect of Sibutramine on Cardiovascular Outcomes in Overweight and Obese Subjects

Author

James, Wp, Caterson, Id, Coutinho, W, Finer, N, VAN GAAL LF, Maggioni, Ap, TORP-PEDERSEN, C, Sharma, Am, Shepherd, Gm, Rode, Ra, Renz, Cl, Van Gaal LF, Torp-Pedersen, C, Pepine, C, Pocock, S, Drexler, H, Swedberg, K, Sleight, P, Armstrong, P, Kerr, D, Dagenais, G, Brophy, J, Avezum, A, Bogaty, P, Fabbri, G, Galli, M, Hildebrandt, P, Mann, J, Ostergren, J, Sherman, D, Zannad, F, Colquhoun, D, Hollanders, G, e Forti A, Costa, Cifkova, R, Toubro, S, Ziegler, O, Scherbaum, Wa, Jordan, J, Halmy, L, Ferrannini, E, Santini, F, Gonzalez, C, Narkiewicz, K, Hancu, N, Payer, J, Pascual, J, Wilding, J, Campbell, L, Carey, D, Gerstman, M, Karrasch, J, Lefkovits, J, Marks, J, Marks, S, Moses, R, Phillips, P, Proietto, J, Roberts, D, Roberts-Thomson, P, Shaw, J, Simpson, R, Singh, B, Singleton Jeffries, W, Stuckey, B, Boland, J, Brohet, C, Coucke, F, Dendale, P, Jouret, G, Kolanowski, J, Kutnowski, M, Martens, F, Muls, E, Peiffer, F, Penninckx, H, Scheen, A, Schoors, D, Vaerenberg, M, Van Cleemput, J, Van Crombrugge, P, Van Kuyk, M, Verhaegen, A, Wollaert, B, de Albuquerque DC, Appolinario, J, de Godoy Matos AF, Gross, Jl, Halpern, A, Kerr Saraiva JF, Milagres, R, Repetto, G, Suplicy, Hl, Zanella, Mt, Bednarova, J, Cepelak, V, Cerny, P, Hainer, V, Havranek, P, Homza, M, Jansa, P, Karlicek, M, Kolesar, J, Kotik, I, Kucera, D, Kuchar, J, Kunc, M, Kvapil, M, Linhart, A, Machova, V, Matuska, J, Oral, I, Pavlas, J, Pesatova, S, Povolny, J, Semrad, B, Smetana, K, Soucek, M, Svacina, S, Tesinsky, P, Urbanek, R, Wasserburger, B, Zachoval, R, Zahumensky, E, Zidkova, E, Astrup, A, Dominguez, H, Faber, J, Hilderbrant, P, Kober, L, Perrild, H, Richelsen, B, Sogaard, P, Svendsen, Ol, Urhammer, S, Archambeaud, F, Basdevant, A, Borys, Jm, Bringer, J, Brunetiere, C, Charpentier, G, Cocaul-André, M, Dabadie, H, Dubreuil, A, Estour, B, Gautier, Jf, Gibault, T, Halimi, S, Hespel, Jp, Issa Sayegh, M, Krempf, M, Laville, M, Lecerf, Jm, Louvet, Jp, Penfornis, A, Ritz, P, Schlienger, Jl, Schmitt, B, Valensi, P, Baar, M, Beermann, J, Bock, M, Boenner, G, Dammann, Hg, Diehm, C, Ditschuneit, H, Gadow, J, Gehlhar, S, Gessner, S, Guthersohn, A, Hamann, A, Hanefeld, M, Hasenfuss, G, Herzner, A, Heun, Kc, Heufelder, Ae, Hohensee, H, Jacob, S, Krings, P, Krätzig, B, Krosse, B, Lehmann, Rt, Mindt-Prüfert, S, Maisch, B, Pfeiffer, Af, Richard, F, Rose, B, Schmidt, E, Scholze, J, Schreckenberg, A, Stuebler, P, Walter, J, Wirth, A, Wunderlich, J, Abraham, G, Altorjay, A, Augusztin, G, Csaszar, A, Czuriga, I, Dinnyes, J, Gero, L, Gyimesi, A, Janosi, A, Kovacs, I, Liziczai, I, Majtenyi, A, Medvegy, M, Nadhazi, Z, Pados, G, Polak, G, Ronaszeki, A, Sido, Z, Simon, K, Anzà, C, Bevilacqua, M, Bosello, O, Chiariello, M, Cordera, R, Ferrari, E, Frittitta, L, Giorgino, R, Liuzzi, A, Malinverni, C, Di Mario, U, Melchionda, N, Occhi, G, Perticone, F, Pinchera, A, Pinelli, G, Rovera, G, Santeusanio, F, Urbinati, S, Alpizar-Salazar, M, Carrillo-Ortega, E, Fanghanel Salmon, G, Laviada-Molina, Ha, Madero, Ma, Rodriguez, G, Saldate, C, Sanchez-Castillo, Cp, Violante, Rm, Wacher, N, Zayas-Jaime, Fj, Zuniga-Guajardo, S, Adamiec, R, Banasiak, W, Chrusciel, P, Derlaga, B, Gebala, A, Gessek, J, Janik, K, Janion, M, Kalina, Z, Kozlowski, A, Kusnierz, B, Majcher, Z, Miekus, P, Niegowska, J, Okopien, B, Ostrowska, L, Pasowicz, M, Piepiorka, M, Pluta, W, Polaszewska-Muszynska, M, Ponikowski, P, Pupek-Musialik, D, Sawicki, A, Sobocik, H, Stankiewicz, A, Szpajer, M, Trojnar, R, Tykarski, A, Wrabec, K, Wyrzkowski, B, Zahorska-Markiewicz, B, Zalewski, M, Carrageta, M, Mendes Pedro MM, Parente Martins LM, dos Santos, L, Babes, A, Creteanu, G, Dan, Ga, Dragulescu, Si, Graur, M, Tirgoviste, Ci, Morosanu, M, Mota, M, Paveliu, Fs, Radoi, M, Ranetti, A, Totoian, I, Andre, I, Bugan, V, Cencarik, J, Csala, L, Farsky, S, Gonsorcik, J, Kamensky, G, Kmec, J, Krahulec, B, Kurian, R, Macek, V, Majercak, I, Micko, K, Mokan, M, Riecansky, I, Sojka, G, Uhliar, R, Urgeova, L, Vancik, J, Baro, Fm, Barrios Merino, A, Borras, Jl, Caixas, A, Cuatrecasas Cambra, G, Dominguez Escribano JR, Duran Garcia, S, Escobar-Jimenez, L, Esteva de Antonio, I, Formiguera Sala, X, Garcia-Luna, Pp, Garcia Robles, R, Gonzalez Albarran, O, Hernandez-Mijares, A, Martin Hidalgo, A, Masmiquel Comas, L, Morales Perez, F, Moreno Esteban, B, Pascual Izuel JM, Redon Mas, J, Ricart, W, Rubio, Ma, Ruilope, Lm, Salas-Salvado, J, Terroba Larumbe, M, Tinahones, F, de la Torre Casares ML, Vidal Cortada, J, Zuniga-Perez Lemaur, M, Abdulhakim, Ee, Adler, A, Barnett, Ah, Bodmer, C, Campbell, Iw, Chowdhury, T, Cleland, J, Cook, Rc, Dinneen, S, Donnachie, H, Haslam, Dw, Hillis, Gs, Horne, M, Howarth, Dj, Hughes, E, Jackson, S, Jones, Sc, Jones, Th, Kumar, S, Lean, M, Maroni, J, Mcinnes, G, Middleton, A, Morris, A, Newcombe, G, O'Kane, Kp, Pavel, Ic, Pawa, R, Perry, C, Pitts, C, Raja, A, Reckless, J, Robinson, J, Sarmiento, R, Soo, Sc, Taylor, S, Thomas, Ho, Thomson, Ma, and Wilkins, M.

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, Blood Pressure, Kaplan-Meier Estimate, Type 2 diabetes, Klinikai orvostudományok, Placebo, law.invention, Double-Blind Method, Randomized controlled trial, Weight loss, law, Internal medicine, Appetite Depressants, medicine, Humans, Obesity, Myocardial infarction, Stroke, Aged, business.industry, Hazard ratio, Orvostudományok, General Medicine, Middle Aged, Overweight, medicine.disease, Surgery, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Cardiology, Female, Human medicine, medicine.symptom, business, Cyclobutanes, Sibutramine, medicine.drug
Abstract

Background The long-term effects of sibutramine treatment on the rates of cardiovascular events and cardiovascular death among subjects at high cardiovascular risk have not been established. Methods We enrolled in our study 10,744 overweight or obese subjects, 55 years of age or older, with preexisting cardiovascular disease, type 2 diabetes mellitus, or both to assess the cardiovascular consequences of weight management with and without sibutramine in subjects at high risk for cardiovascular events. All the subjects received sibutramine in addition to participating in a weight-management program during a 6-week, single-blind, lead-in period, after which 9804 subjects underwent random assignment in a double-blind fashion to sibutramine (4906 subjects) or placebo (4898 subjects). The primary end point was the time from randomization to the first occurrence of a primary outcome event (nonfatal myocardial infarction, nonfatal stroke, resuscitation after cardiac arrest, or cardiovascular death). Results The mean duration of treatment was 3.4 years. The mean weight loss during the lead-in period was 2.6 kg; after randomization, the subjects in the sibutramine group achieved and maintained further weight reduction (mean, 1.7 kg). The mean blood pressure decreased in both groups, with greater reductions in the placebo group than in the sibutramine group (mean difference, 1.2/1.4 mm Hg). The risk of a primary outcome event was 11.4% in the sibutramine group as compared with 10.0% in the placebo group (hazard ratio, 1.16; 95% confidence interval [CI], 1.03 to 1.31; P=0.02). The rates of nonfatal myocardial infarction and nonfatal stroke were 4.1% and 2.6% in the sibutramine group and 3.2% and 1.9% in the placebo group, respectively (hazard ratio for nonfatal myocardial infarction, 1.28; 95% CI, 1.04 to 1.57; P=0.02; hazard ratio for nonfatal stroke, 1.36; 95% CI, 1.04 to 1.77; P=0.03). The rates of cardiovascular death and death from any cause were not increased. Conclusions Subjects with preexisting cardiovascular conditions who were receiving long-term sibutramine treatment had an increased risk of nonfatal myocardial infarction and nonfatal stroke but not of cardiovascular death or death from any cause. (Funded by Abbott; ClinicalTrials.gov number, NCT00234832.)

Published
2010
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22. The relation of body mass index and abdominal adiposity with dyslipidemia in 27 general populations of the WHO MONICA Project

Author

Hobbs, M, Jamrozik, K, Thompson, P, Armstrong, B, de Backer, G, De Craene, I, Van Onsem, P, Van Parys, L, De Henauw, S, De Bacquer, D, Kornitzer, M, Berghmans, L, Bara, L, de Smet, P, Jeanjean, M, Brohet, C, Kulbertus, H, Degre, S, Lavenne, F, Jansens, D, Lefebvre, F, Beck, D, Wunsch, G, Bertrand, F, van Houte, M, Rime, B, Rorive, G, Hannot, R, Adrienne, A, Luyckx, A, Wolf, H, Gregor, R, Bata, I, Brownell, B, Webber, K, Skodova ́, Z, Pisa, Z, Berka, L, Cicha, Z, Cerovska ́, J, Emrova ́, R, Hoke, M, Hronkova, M, Pikhartova ́, J, Grafnetter, D, Poledne, R, Vojtisek, P, Vorlicek, J, Wiesner, E, Schroll, M, Kirchhoff, M, Sjøl, A, Quitsau Lund, S, Tuomilehto, J, Puska, P, Vartiainen, E, Korhonen, H, Jousilahti, M, Ducimetie`re, P, Richard, J, Bingham, A, Lang, T, Amouyel, P, Cottel, D, Nuttens, M, Marecaux, N, Dallongeville, J, Salomez, J, Montaye, M, Steclebout, C, Arveiler, D, Schaffer, P, Haas, V, Wagner, A, Lamamy, N, Savouret, M, Houset, M, Pierau, F, Goetz, V, Ferrie`res, J, Ruidavets, J, Cambou, J, Rodier, P, Saulet, C, Greiser, E, Herman, B, Stu ̈demann, G, Nu ̈ssel, E, Osto ̈r Lamm, E, Scheidt, R, Morgenstern, W, Stadler, M, Ganova, M, Keil, U, Tietze, M, Banos, R, Do ̈ring, A, Filipiak, B, Barth, W, Heinemann, L, Muche, J, Schmalfuss, S, Assmann, A, Bo ̈thig, S, Voigt, G, Brasche, S, Quietzsch, D, Classen, E, Sigfu ́sson, N, Gudmundsdo ́ttir, I, Stefa ́nsdo ́ttir, I, Thorsteinsson, T, Sigvaldason, H, Menotti, A, Giampaoli, S, Verdecchia, A, Righetti, G, De Pasquale, B, Di Raimo, P, Forte, E, Majetta, A, Vanuzzo, D, Feruglio, G, Pilotto, L, Cignacco, G, Marini, R, Zilio, G, Cesana, G, Ferrario, M, Sega, R, Mocarelli, P, Brambilla, P, Bluzhas, J, Domarkiene, S, Tamosiunas, A, Reklaitiene, R, Beaglehole, R, Jackson, R, Bonita, R, Stewart, A, Mahon, V, Bingley, W, Pajak, A, Sznajd, J, Kawalec, E, Pazucha, T, Malczewska, M, Mo ́rawska, I, Rywik, S, Broda, V, Polakowska, M, Kurjata, P, Varlamova, A, Britov, A, Konstantinov, V, Timofeeva, V, Alexandri, V, Konstantinova, O, Nikitin, Y, Malyutina, S, Gafarov, V, Feigin, V, Sans, S, Balaguer Vintro ́, V, Balana`, V, Gonzalez, V, Gomez, V, Borras, V, Rode ́s, A, Wilhelmsen, L, Harmsen, P, Rosengren, A, Lappas, G, Asplund, K, Huhtasaari, F, Stegmayr, B, Lundberg, V, Gutzwiller, F, Paccaud, F, Rickenbach, M, Wietlisbach, V, Barazzoni, F, Mainieri, F, Tullen, B, Evans, V, Mccrum, E, Falconer, T, Cashman, S, Patterson, C, Kerr, M, O’Reilly, D, Scott, A, Mcconville, M, Mcmillan, I, Mcmaster, D, Tunstall Pedoe, H, Smith, W, Tavendale, R, Crombie, V, Barrett, K, Brown, C, Shewry, M, Hannh, M, Morrisson, C, Planojevic, M, Jakovljevic, D, Svircevic, A, Mirilov, V, Strasser, V, Mendis, S, Martin8, I, Gyarfas8, V, Pı ́_sa8, V, Dodu8, S, Bo ̈thig8, S, Watson, M, Hill, M, Price, A, Kuulasmaa, K, Ruokokoski, E, Rajakangas, A, Ma ̈kinen, M, Virman Ojanen, T, Palonen, L, Akkila, J, Cepaitis, Z, Molarius, A, Moltchanov, V, Tolonen, H, Dobson, A, Fortmann, S, Shatchkute, A, Zaitsev, V, Epstein, F, Feinleib, M, Karvonen, M, Prineas, R, Williams, O, Hobbs, MST, Jamrozik, K., Thompson, PL, Armstrong, BK, Van Parys, L., Berghmans, L., Kulbertus, HE, Lefebvre, F., Wunsch, G., Bertrand, F., van Houte, M., Rime, B., Hannot, R., Wolf, HK, Gregor, RD, Bata, IR, Brownell, B., Pisa, Z., Berka, L., Cicha, Z., Hronkova, M., Pikhartova ́, J., Grafnetter, D., Poledne, R., Vojtisek, P., Vorlicek, J., Sjøl, A., Puska, P., Vartiainen, E., Korhonen, H., Richard, JL, Bingham, A., Cottel, D., Nuttens, MC, Marecaux, N., Dallongeville, J., Salomez, J. L., Montaye, M., Lamamy, N., Houset, M., Pierau, F., Ruidavets, JB, Cambou, JP, Rodier, P., Greiser, E., Herman, B., Nu ̈ssel, E., Osto ̈r Lamm, E., Scheidt, R., Morgenstern, W., Tietze, M., Banos, R., Do ̈ring, A., Muche, J., Schmalfuss, S., Assmann, A., Bo ̈thig, S., Voigt, G., Brasche, S., Quietzsch, D., Gudmundsdo ́ttir, II, Thorsteinsson, T., Sigvaldason H, Giampaoli, S., Righetti, G., De Pasquale, B., Forte, E., Feruglio, GA, Pilotto, L., Cignacco, G., Marini, R., Cesana, GC, Sega, R., BRAMBILLA, PAOLO, Domarkiene, S., Tamosiunas, A., Stewart, A., Kawalec, E., Pazucha, T., Malczewska, M., Rywik, SL, Broda,V, Polakowska, M., Britov, A., Nikitin, Y.u. P, Malyutina, S., Sans, S., Harmsen, P., Rosengren, A., Asplund, K., Huhtasaari, F., Stegmayr, B., Lundberg V, Paccaud, F., Rickenbach, M., Wietlisbach, V., Mainieri, F., McCrum, EE, Cashman, S., Patterson, C., Kerr, M., O’Reilly, D., Scott, A., McConville, M., McMillan, I., McMaster, D, Tunstall Pedoe, H., Smith, WCS, Tavendale, R., Barrett, K., Brown, C., Shewry, M., Hannh, M. K, Jakovljevic, D., Svircevic, A., Mirilov, V., Strasser, V., Mendis, S., Dodu8, S. R. A., Bo ̈thig8, S., Watson, M. J., Hill, M., Kuulasmaa, K., Tuomilehto, J., Rajakangas, A. M., Ma ̈kinen, M., Palonen, L., Cepaitis, Z., Molarius, A., Moltchanov, V., Dobson, A., Fortmann, SP, Epstein, FH, Karvonen, MJ, Prineas, RJ, Williams, OD, Hobbs, M, Jamrozik, K, Thompson, P, Armstrong, B, de Backer, G, De Craene, I, Van Onsem, P, Van Parys, L, De Henauw, S, De Bacquer, D, Kornitzer, M, Berghmans, L, Bara, L, de Smet, P, Jeanjean, M, Brohet, C, Kulbertus, H, Degre, S, Lavenne, F, Jansens, D, Lefebvre, F, Beck, D, Wunsch, G, Bertrand, F, van Houte, M, Rime, B, Rorive, G, Hannot, R, Adrienne, A, Luyckx, A, Wolf, H, Gregor, R, Bata, I, Brownell, B, Webber, K, Skodova ́, Z, Pisa, Z, Berka, L, Cicha, Z, Cerovska ́, J, Emrova ́, R, Hoke, M, Hronkova, M, Pikhartova ́, J, Grafnetter, D, Poledne, R, Vojtisek, P, Vorlicek, J, Wiesner, E, Schroll, M, Kirchhoff, M, Sjøl, A, Quitsau Lund, S, Tuomilehto, J, Puska, P, Vartiainen, E, Korhonen, H, Jousilahti, M, Ducimetie`re, P, Richard, J, Bingham, A, Lang, T, Amouyel, P, Cottel, D, Nuttens, M, Marecaux, N, Dallongeville, J, Salomez, J, Montaye, M, Steclebout, C, Arveiler, D, Schaffer, P, Haas, V, Wagner, A, Lamamy, N, Savouret, M, Houset, M, Pierau, F, Goetz, V, Ferrie`res, J, Ruidavets, J, Cambou, J, Rodier, P, Saulet, C, Greiser, E, Herman, B, Stu ̈demann, G, Nu ̈ssel, E, Osto ̈r Lamm, E, Scheidt, R, Morgenstern, W, Stadler, M, Ganova, M, Keil, U, Tietze, M, Banos, R, Do ̈ring, A, Filipiak, B, Barth, W, Heinemann, L, Muche, J, Schmalfuss, S, Assmann, A, Bo ̈thig, S, Voigt, G, Brasche, S, Quietzsch, D, Classen, E, Sigfu ́sson, N, Gudmundsdo ́ttir, I, Stefa ́nsdo ́ttir, I, Thorsteinsson, T, Sigvaldason, H, Menotti, A, Giampaoli, S, Verdecchia, A, Righetti, G, De Pasquale, B, Di Raimo, P, Forte, E, Majetta, A, Vanuzzo, D, Feruglio, G, Pilotto, L, Cignacco, G, Marini, R, Zilio, G, Cesana, G, Ferrario, M, Sega, R, Mocarelli, P, Brambilla, P, Bluzhas, J, Domarkiene, S, Tamosiunas, A, Reklaitiene, R, Beaglehole, R, Jackson, R, Bonita, R, Stewart, A, Mahon, V, Bingley, W, Pajak, A, Sznajd, J, Kawalec, E, Pazucha, T, Malczewska, M, Mo ́rawska, I, Rywik, S, Broda, V, Polakowska, M, Kurjata, P, Varlamova, A, Britov, A, Konstantinov, V, Timofeeva, V, Alexandri, V, Konstantinova, O, Nikitin, Y, Malyutina, S, Gafarov, V, Feigin, V, Sans, S, Balaguer Vintro ́, V, Balana`, V, Gonzalez, V, Gomez, V, Borras, V, Rode ́s, A, Wilhelmsen, L, Harmsen, P, Rosengren, A, Lappas, G, Asplund, K, Huhtasaari, F, Stegmayr, B, Lundberg, V, Gutzwiller, F, Paccaud, F, Rickenbach, M, Wietlisbach, V, Barazzoni, F, Mainieri, F, Tullen, B, Evans, V, Mccrum, E, Falconer, T, Cashman, S, Patterson, C, Kerr, M, O’Reilly, D, Scott, A, Mcconville, M, Mcmillan, I, Mcmaster, D, Tunstall Pedoe, H, Smith, W, Tavendale, R, Crombie, V, Barrett, K, Brown, C, Shewry, M, Hannh, M, Morrisson, C, Planojevic, M, Jakovljevic, D, Svircevic, A, Mirilov, V, Strasser, V, Mendis, S, Martin8, I, Gyarfas8, V, Pı ́_sa8, V, Dodu8, S, Bo ̈thig8, S, Watson, M, Hill, M, Price, A, Kuulasmaa, K, Ruokokoski, E, Rajakangas, A, Ma ̈kinen, M, Virman Ojanen, T, Palonen, L, Akkila, J, Cepaitis, Z, Molarius, A, Moltchanov, V, Tolonen, H, Dobson, A, Fortmann, S, Shatchkute, A, Zaitsev, V, Epstein, F, Feinleib, M, Karvonen, M, Prineas, R, Williams, O, Hobbs, MST, Jamrozik, K., Thompson, PL, Armstrong, BK, Van Parys, L., Berghmans, L., Kulbertus, HE, Lefebvre, F., Wunsch, G., Bertrand, F., van Houte, M., Rime, B., Hannot, R., Wolf, HK, Gregor, RD, Bata, IR, Brownell, B., Pisa, Z., Berka, L., Cicha, Z., Hronkova, M., Pikhartova ́, J., Grafnetter, D., Poledne, R., Vojtisek, P., Vorlicek, J., Sjøl, A., Puska, P., Vartiainen, E., Korhonen, H., Richard, JL, Bingham, A., Cottel, D., Nuttens, MC, Marecaux, N., Dallongeville, J., Salomez, J. L., Montaye, M., Lamamy, N., Houset, M., Pierau, F., Ruidavets, JB, Cambou, JP, Rodier, P., Greiser, E., Herman, B., Nu ̈ssel, E., Osto ̈r Lamm, E., Scheidt, R., Morgenstern, W., Tietze, M., Banos, R., Do ̈ring, A., Muche, J., Schmalfuss, S., Assmann, A., Bo ̈thig, S., Voigt, G., Brasche, S., Quietzsch, D., Gudmundsdo ́ttir, II, Thorsteinsson, T., Sigvaldason H, Giampaoli, S., Righetti, G., De Pasquale, B., Forte, E., Feruglio, GA, Pilotto, L., Cignacco, G., Marini, R., Cesana, GC, Sega, R., BRAMBILLA, PAOLO, Domarkiene, S., Tamosiunas, A., Stewart, A., Kawalec, E., Pazucha, T., Malczewska, M., Rywik, SL, Broda,V, Polakowska, M., Britov, A., Nikitin, Y.u. P, Malyutina, S., Sans, S., Harmsen, P., Rosengren, A., Asplund, K., Huhtasaari, F., Stegmayr, B., Lundberg V, Paccaud, F., Rickenbach, M., Wietlisbach, V., Mainieri, F., McCrum, EE, Cashman, S., Patterson, C., Kerr, M., O’Reilly, D., Scott, A., McConville, M., McMillan, I., McMaster, D, Tunstall Pedoe, H., Smith, WCS, Tavendale, R., Barrett, K., Brown, C., Shewry, M., Hannh, M. K, Jakovljevic, D., Svircevic, A., Mirilov, V., Strasser, V., Mendis, S., Dodu8, S. R. A., Bo ̈thig8, S., Watson, M. J., Hill, M., Kuulasmaa, K., Tuomilehto, J., Rajakangas, A. M., Ma ̈kinen, M., Palonen, L., Cepaitis, Z., Molarius, A., Moltchanov, V., Dobson, A., Fortmann, SP, Epstein, FH, Karvonen, MJ, Prineas, RJ, and Williams, OD

Abstract

Background and aims: The association between adiposity measures and dyslipidemia has seldom been assessed in a multipopulational setting. Methods and results: 27 populations from Europe, Australia, New Zealand and Canada (WHO MONICA project) using health surveys conducted between 1990 and 1997 in adults aged 35-64 years (n = 40,480). Dyslipidemia was defined as the total/HDL cholesterol ratio >6 (men) and >5 (women).Overall prevalence of dyslipidemia was 25% in men and 23% in women. Logistic regression showed that dyslipidemia was strongly associated with body mass index (BMI) in men and with waist circumference (WC) in women, after adjusting for region, age and smoking. Among normal-weight men and women (BMI<25 kg/m2), an increase in the odds for being dyslipidemic was observed between lowest and highest WC quartiles (OR = 3.6, p < 0.001). Among obese men (BMI ≥ 30), the corresponding increase was smaller (OR = 1.2, p = 0.036). A similar weakening was observed among women. Classification tree analysis was performed to assign subjects into classes of risk for dyslipidemia. BMI thresholds (25.4 and 29.2 kg/m2) in men and WC thresholds (81.7 and 92.6 cm) in women came out at first stages. High WC (>84.8 cm) in normal-weight men, menopause in women and regular smoking further defined subgroups at increased risk. Conclusion: standard categories of BMI and WC, or their combinations, do not lead to optimal risk stratification for dyslipidemia in middle-age adults. Sex-specific adaptations are necessary, in particular by taking into account abdominal obesity in normal-weight men, post-menopausal age in women and regular smoking in both sexes

Published
2013

24. ARE ACE-INHIBITORS OR ARB’S STILL NEEDED FOR CARDIOVASCULAR PREVENTION IN HIGH RISK PATIENTS? INSIGHTS FROM PROFESS AND TRANSCEND

Author

Van Mieghem, W., primary, Billiouw, J.-M., additional, Brohet, C., additional, Dupont, A.G., additional, Gazagnes, M.-D., additional, Heller, F., additional, Krzesinski, J.-M., additional, Missault, L., additional, Persu, A., additional, Piérard, L., additional, Rottiers, R., additional, Vanhooren, G., additional, Vervaet, P., additional, and Herman, A.G., additional

Published
2010
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25. LESSONS FROM ONTARGET

Author

Berlaimont, V., primary, Billiouw, J.-M., additional, Brohet, C., additional, Dupont, A.G., additional, Gazagnes, M.-D., additional, Heller, F., additional, Krzesinski, J.-M., additional, Missault, L., additional, Persu, A., additional, Piérard, L., additional, Rottiers, R., additional, Vanhooren, G., additional, Van Mieghem, W., additional, Vervaet, P., additional, and Herman, A.G., additional

Published
2008
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26. THE DIAGNOSTIC PERFORMANCE OF COMPUTER-PROGRAMS FOR THE INTERPRETATION OF ELECTROCARDIOGRAMS

Author

WILLEMS, JL ABREULIMA, C ARNAUD, P VANBEMMEL, JH BROHET, C DEGANI, R DENIS, B GEHRING, J GRAHAM, I VANHERPEN, G MACHADO, H MACFARLANE, PW MICHAELIS, J MOULOPOULOS, SD and RUBEL, P ZYWIETZ, C

Subjects
cardiovascular diseases
Abstract

Background. Computer programs for the interpretation of electrocardiograms (ECGs) are now widely used. However, a systematic assessment of various computer programs for the interpretation of ECGs has not been performed. Methods. We undertook a large international study to compare the performance of nine electrocardiographic computer programs with that of eight cardiologists in interpreting ECGs in 1220 clinically validated cases of various cardiac disorders. ECGs from the following groups were included in the sample: control patients (n = 382); patients with left ventricular hypertrophy (n = 183), right ventricular hypertrophy (n = 55), or biventricular hypertrophy (n = 53); patients with anterior myocardial infarction (n = 170), inferior myocardial infarction (n = 273), or combined myocardial infarction (n = 73); and patients with combined infarction and hypertrophy (n = 31). The interpretations of the computer programs and the cardiologists were compared with the clinical diagnoses made independently of the ECGs, and the computer interpretations were compared with those of the cardiologists. Results. The percentage of ECGs correctly classified by the computer programs (median, 91.3 percent) was lower than that for the cardiologists (median, 96.0 percent; P < 0.01). The median sensitivity of the computer programs was also significantly lower than that of the cardiologists in diagnosing left ventricular hypertrophy (56.6 percent vs. 63.9 percent, P < 0.02), right ventricular hypertrophy (31.8 percent vs. 46.6 percent, P < 0.01), anterior myocardial infarction (77.1 percent vs. 84.9 percent, P < 0.001), and inferior myocardial infarction (58.8 percent vs. 71.7 percent, P < 0.0001). The median total accuracy level (the percentage of correct classifications) was 6.6 percent lower for the computer programs (69.7 percent) than for the cardiologists (76.3 percent; P < 0.001). However, the performance of the best programs nearly matched that of the most accurate cardiologists. Conclusions. Our study shows that some but not all computer programs for the interpretation of ECGs perform almost as well as cardiologists in identifying seven major cardiac disorders.

Published
1991

34. Book Reviews

Author

Brohet, C., primary, Van Ypersele, Ch., additional, Vancamp, B., additional, and Jadoul, M., additional

Published
1992
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43. Improving the reproducibility of QT dispersion measures.

Author

Lund, Kaspar, Perkiömäki, Juha S., Brohet, Christian, Zaïdi, Mohammed, Elming, Hanne, Pedersen, Christian Torp, Huikuri, Heikki V., Nygaard, Hans, Pedersen, Anders Kirstein, Lund, K, Perkiömäki, J S, Brohet, C, Zaïdi, M, Elming, H, Pedersen, C T, Huikuri, H V, Nygaard, H, and Pedersen, A K

Abstract

Background: The low reproducibility of the QT dispersion (QTD) method is a major reason why it is not used in clinics. The purpose of this study was to develop QT dispersion parameters with better reproducibility and identification of patients with a high risk of ventricular arrhythmia or death.Methods and Results: Three institutions using different methods for measuring QT intervals provided QT databases, which included more than 3500 twelve-lead surface ECGs. The data represented low and high risk subjects from the following groups: the normal population EpiSet (survivors vs dead from cardiovascular causes), acute myocardial infarction patients AmiSet (survivors vs dead) and remote myocardial infarction patients ArrSet (with vs without a history of ventricular arrhythmia). The EpiSet, AmiSet, and the ArrSet contributed with N = 122, 0, and 110 ECGs for reproducibility analysis, and 3244, 446, and 100 ECGs for the analysis of prognostic accuracy. The prognostic accuracy was measured as the area under the Receiver Operator Curve. The QT intervals were divided into six QT pairs; the longest pair consisted of the longest and the shortest QT intervals etc. The QT dispersion trend (QTDT) was defined as the slope of the linear regression of the N longest QT pairs after estimation of missing QT intervals by interpolation of measured QT intervals. The QTMAD and the QTSTD methods were defined as twice the mean absolute deviation and the standard deviation of the N longest QT pairs. The reproducibility was improved by 27% and 19% in the EpiSet and the ArrSet relative to the reproducibility of QTD. The accuracy improved for the EpiSet and the ArrSet and was maintained for the AmiSet.Conclusions: By using the three longest and the three shortest QT intervals in QTDT, QTMAD, or QTSTD, the reproducibility improved significantly while maintaining or improving the prognostic accuracy compared to QTD. [ABSTRACT FROM AUTHOR]

Published
2001
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45. Effect of combining elecrocardiographic interpretation results on diagnostic accuracy.

Author

WILLEMS, J.L., ABREU-LIMA, C., ARNAUD, p., VAN BEMMEL, J.H., BROHET, C., DEGNAI, R., DENIS, B., GRAHAM, I, VAN HERPEN, G., MACFARLANE, P.W., MICHAELIS, J., MOULOPOULOS, S., PÖPPL, S., and ZYWIETZ, C.

Abstract

In order to test the diagnostic performance of various ECG computer programs a references library of ECGs is being established and evaluation methods are being developed in an international co-operative project. A pilot study was undertaken in which 250 validated electrocardiograms(ECG) and vectorcardiograms (VCG) comprising seven diagnostic groups i.e, normal, left, right and bi-ventricular hypertrophy, anterior, inferior and combained infarction have been analysed independently by 11 different computer programs as well as by six cardiologists. A coding scheme was applied to assign individual diagnostic statements to a common set and to obtain combained program and cardioligist interpretion results. Preliminary results indicate that the accuracy of classification by different programs varies widely. Total accuracy varied between 57.2%and 75.8% (median 69.4%). The cardiologists had a higher accuracy (median 74.3%) than the majority of programs, at least when using the standard ECG. As it is considered premature to stress individual program results in view of the current sample size, the enhancement in diagnostic accuracy obtained by combining interpretation results is highlighted. Indeed combined cardiologist accuracy obtained by combining interpretation results is highlighted. Indeed combained cardiologist and program results demonstrated the highest accuracy i.e. respectively 78.7% and 76.1% higher than the result of any individual reader or program. The combined result of the five most accurate programs was 78.4% that of the six least accurate was 71.5% which is again higher than the respective individual components. These findings demonstrate that the combination of expert knowledge of computer programs can similar to panel review and group analysis in clinical practice, enhance diagnostic accuracy. [ABSTRACT FROM PUBLISHER]

Published
1988
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46. Non-invasive data provide independent prognostic information in patients with chest pain without previous myocardial infarction: findings in male patients who have had cardiac catheterization.

Author

LUWAERT, R. J., MELIN, J. A., BROHET, C. R., ROUSSEAU, M. F., PONLOT, R., D'HONDT, A. M., VANBUTSELE, R., ROBERT, A., and DETRY, J. M. R.

Abstract

From 1978 to 1985, 470 consecutive male patients with complaints of chest pain underwent a maximal exercise test with a thallium scan and coronary angiography (CA). Patients with a history of myocardial infarction (MI) were excluded. During the follow-up (from 12 to 96 months), 32 patients died and 30 had a non-fatal MI. Survival (SR) and event-free rates (EFR) were estimated by actuarial methods; the influence of non-invasive and invasive variables were examined in univariate and multivariate models using Cox analysis. The five-year SR was 89% and EFR was 81%. Among historical data, age ( < 0.001), type of complaints ( <0.01) and pretest likelihood of CAD ( <0.01) were univariate predictors of EFR; by multivariate analysis, age was the only significant predictor ( <0.001). Most of the maximal-exercise (MEX) test data were good univariate predictors; by multivariate analysis, workload ( <0.001) and the maximal-exercise test score ( < 0001) were the significant predictors. From history and maximal-exercise test data, multivariate analysis indicated that the prognostic information was given by age (<0.05) and maximal-exercise test score ( <0.001). Among the invasive data, the number of diseased vessels ( <0.001) and ejection fraction were the predictors. The combination of invasive and non-invasive data indicated that age, MEX score, number of diseased vessels and ejection fraction contributed significantly and independently to the estimation of prognosis. Among 242 patients with two or three diseased vessels, the prognosis was determined by the maximal workload ( < 0.01); ejection fraction ( < 0.07) was no longer significant. Thus, in symptomatic patients without previous MI, the best estimation of prognosis is given by a combination of non-invasive and invasive data. [ABSTRACT FROM PUBLISHER]

Published
1988
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47. Diagnostic value of computerized exercise testing in men without previous myocardial infarction. A multivariate, compartmental and probabilistic approach.

Author

DETRY, J.-M. R., ROBERT, A., LUWAERT, R. J., ROUSSEAU, M. F., BRASSEUR, L. A., MELIN, J. A., BROHET, C. R., DERWAEL-BARCHY, C., FESLER, R., and VANBUTSELE, R. J.

Abstract

The value of exercise testing for the diagnosis of coronary artery disease is disputed but very few studies have taken advantage of all recent improvements, namely computer averaging of the ECG signals, multivariate analysis of the data, a compartmental diagnostic approach and probabilistic interpretation of the results. These methods were tested in a group of 387 men who had a computer-assisted multistage maximal exercise test; none had a history of myocardial infarction. In 284 symptomatic patients, the diagnosis was made by arteriography; 103 ostensibly healthy men were also included. The computer-averaged ECG signals (X, Y, Z) recorded at maximal exercise, maximal heart rate, blood pressure and workload, and the onset of angina pectoris during exercise were submitted to a multivariate stepwise discriminant analysis. The pretest likelihood for CAD was calculated from age and history; the post-test likelihood was calculated from Bayes' theorem and the average information content of several diagnostic methods was assessed in categorical and compartmental models. By multivariate analysis, 5 variables collected at maximal exercise were selected, namely the heart-rate, the ST segment level, the onset of angina during the test, the workload and the slope of the ST segment in lead X. The average information content of the analysis using 5 variables was 44% in a categorical model versus 55% in a compartmental model (P<0.001). For comparison, the information content of the analysis using the ST segment level alone was only 16% in the categorical model and 27% in the compartmental model. The clinical value of these diagnostic methods (categorical versus compartmental, univariate versus multivariate) was assessed by a probabilistic classification of the patients. The classification provided by the analysis of the ST segment changes was barely better than that one provided by the simple history. The probabilistic use of a multivariate and compartmental analysis of the data led to a significantly better and more accurate classification of the patients (83% of correct classification). [ABSTRACT FROM PUBLISHER]

Published
1985
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48. Reassessment of the relation between QRS forces of the orthogonal electrocardiogram and left ventricular ejection fraction.

Author

LUWAERT, R. J., COSYNS, J., ROUSSEAU, M. F., BRASSEUR, L. A., DETRY, J. M., and BROHET, C. R.

Abstract

Previous studies have demonstrated the existence of a strong positive correlation between the amplitude of QRS forces of the orthogonal electrocardiogram and the angiographically determined left ventricular ejection fraction. In a large group of patients evaluated for chest pain, we examined the relationship between the arithmetic summation of R+R+Q (ΣR) the maximal and mean spatial QRS vectors and the ejection fraction (EF). In a total of 252 patients, there was a statistically significant correlation between ΣR and EF but a low correlation coefficient value (r: 0.22, P<0.001). This relationship was essentially due to the group of patients with coronary artery disease and myocardial infarction (r: 0.24, P<0.015) whereas there was no correlation in the group of normal subjects or in patients with coronary artery disease without myocardial infarction. In the group with myocardial infarction, a significant correlation between ΣR and EF existed only in patients with anterior myocardial infarction (r: 0.41, P<0.025). In conclusion, both ejection fraction and amplitude of QRS forces decrease in coronary artery disease especially when an anterior myocardial infarction is present. However, despite the positive association between these angiographic and electrocardiographic indices, the low value of the correlation coefficient indicates that it is not possible to predict ejection fraction from the value of ΣR in individual patients. [ABSTRACT FROM PUBLISHER]

Published
1983
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49. Spatial Frank vectorcardiogram in left posterior fascicular block. Criteria and correlation with clinical and electrocardiographic data.

Author

Brohet, C R and Arnaud, P

Abstract

Computer processing of spatial QRS parameters (Frank vectorcardiogram) was used to study left posterior fascicular block. The best set of vectorcardiographic criteria was sought in order to characterise the classic pattern of left posterior fascicular block. Using these criteria, 18 cases were selected from a group of 4600 patients and 340 healthy subjects; isolated left posterior fascicular block was seen in 10 cases, and was associated with right bundle-branch block in 8 cases. It is shown that some external factors can influence the aspect of the spatial QRS loop in left posterior fascicular block: cardiomegaly tends to produce a superior displacement of the main QRS forces: right bundle-branch block enhances the superior displacement of the initial forces and shifts the main QRS forces more anteriorly and to the right. The 'masquerading effect' of the left posterior fascicular block on a concomitant inferior myocardial infarct was also shown. The most important diagnostic feature was the opposite direction of the initial forces (left anterosuperior) and the maximal vector (right postero-inferior): the angle between these two vectors averaged 152 degrees. Other criteria, such as the direction of rotation or the axis of the frontal loop, the vertical direction of the spatial loop, the presence of a Q wave in leads II, III, and aVF of the electrocardiogram, are not mandatory for the diagnosis of left posterior fascicular block. [ABSTRACT FROM PUBLISHER]

Published
1977
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