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Coronary Artery Disease: HELP
Articles by Robert H. Fagard
Based on 7 articles published since 2008

Between 2008 and 2019, R. Fagard wrote the following 7 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 Guideline 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. 2013

Anonymous3190768 / Montalescot, Gilles / Sechtem, Udo / Achenbach, Stephan / Andreotti, Felicita / Arden, Chris / Budaj, Andrzej / Bugiardini, Raffaele / Crea, Filippo / Cuisset, Thomas / Di Mario, Carlo / Ferreira, J Rafael / Gersh, Bernard J / Gitt, Anselm K / Hulot, Jean-Sebastien / Marx, Nikolaus / Opie, Lionel H / Pfisterer, Matthias / Prescott, Eva / Ruschitzka, Frank / Sabaté, Manel / Senior, Roxy / Taggart, David Paul / van der Wall, Ernst E / Vrints, Christiaan J M / Anonymous3200768 / Zamorano, Jose Luis / Achenbach, Stephan / Baumgartner, Helmut / Bax, Jeroen J / Bueno, Héctor / Dean, Veronica / Deaton, Christi / Erol, Cetin / Fagard, Robert / Ferrari, Roberto / Hasdai, David / Hoes, Arno W / Kirchhof, Paulus / Knuuti, Juhani / Kolh, Philippe / Lancellotti, Patrizio / Linhart, Ales / Nihoyannopoulos, Petros / Piepoli, Massimo F / Ponikowski, Piotr / Sirnes, Per Anton / Tamargo, Juan Luis / Tendera, Michal / Torbicki, Adam / Wijns, William / Windecker, Stephan / Anonymous3210768 / Knuuti, Juhani / Valgimigli, Marco / Bueno, Héctor / Claeys, Marc J / Donner-Banzhoff, Norbert / Erol, Cetin / Frank, Herbert / Funck-Brentano, Christian / Gaemperli, Oliver / Gonzalez-Juanatey, José R / Hamilos, Michalis / Hasdai, David / Husted, Steen / James, Stefan K / Kervinen, Kari / Kolh, Philippe / Kristensen, Steen Dalby / Lancellotti, Patrizio / Maggioni, Aldo Pietro / Piepoli, Massimo F / Pries, Axel R / Romeo, Francesco / Rydén, Lars / Simoons, Maarten L / Sirnes, Per Anton / Steg, Ph Gabriel / Timmis, Adam / Wijns, William / Windecker, Stephan / Yildirir, Aylin / Zamorano, Jose Luis. ·The disclosure forms of the authors and reviewers are available on the ESC website www.escardio.org/guidelines. ·Eur Heart J · Pubmed #23996286.

ABSTRACT: -- No abstract --

2 Review Prognostic impact of sex-ambulatory blood pressure interactions in 10 cohorts of 17 312 patients diagnosed with hypertension: systematic review and meta-analysis. 2015

Roush, George C / Fagard, Robert H / Salles, Gil F / Pierdomenico, Sante D / Reboldi, Gianpaolo / Verdecchia, Paolo / Eguchi, Kazuo / Kario, Kazuomi / Hoshide, Satoshi / Polonia, Jorge / de la Sierra, Alejandro / Hermida, Ramon C / Dolan, Eamon / Fapohunda, Jadesola / Anonymous3090814. ·aABC-H, UCONN School of Medicine, St. Vincent's Medical Center, Bridgeport, Connecticut, USA bHypertension Unit, U.Z., University of Leuven, Leuven, Belgium cUniversity Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil dDipartimento di Medicina e Scienze dell'Invecchiamento, Universita Gabriele d'Annunzio, Chieti eDepartment of Internal Medicine, University of Perugia, Perugia fStruttura Complessa di Medicina, Ospedale di Assisi, Assisi, Italy gJichi University School of Medicine, Shimotsuke, Tochigi, Japan hFaculdade de Medicine do Porto, Porto, Portugal iDepartment of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Terrassa jBioengineering and Chronobiology Laboratories, University of Vigo, Vigo, Spain kCambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK lUCONN School of Medicine, St. Vincent's Medical Center, Bridgeport, Connecticut, USA. ·J Hypertens · Pubmed #25479023.

ABSTRACT: BACKGROUND: Whether ambulatory blood pressure (BP) among hypertensive patients better predicts cardiovascular events (CVEs) in women relative to men is unclear. METHODS: We searched PUBMED and OVID databases. Cohorts were required to have hypertension, 1+ years of follow-up, with stroke and coronary artery disease as outcomes. Lead investigators for these cohorts provided ad hoc analyses. Random-effect meta-analyses gave hazard ratios for CVEs from a 1 standard deviation (SD) mmHg increase and a 10 mmHg increase in SBP. Subgroup and meta-regression analyses quantified the relative increase in risk in women versus men. RESULTS: Patients were from Europe, Brazil, and Japan (10 cohorts, n = 17 312, CVEs = 1892). One cohort lacked sex-specific hazard ratios from 24 h and clinic SBP. Compared with men, women tended to have greater SDs and coefficients of variation of SBP. Subgroup analyses showed higher hazard ratios in women than in men from increases in ambulatory but not clinic SBPs. For women relative to men, a 1 SD increase in night-time, daytime, 24 h, and clinic SBP gave hazard ratios (95% confidence limits) of 1.17 (1.06-1.30), 1.24 (1.10-1.39), 1.21 (1.08-1.36), and 0.94 (0.84-1.05), respectively, whereas a 10 mmHg increase in SBP, gave hazard ratios of 1.06 (0.99-1.14), 1.13 (1.03-1.23), 1.10 (1.01-1.21), and 0.96 (0.89-1.03), respectively. CONCLUSION: In patients with hypertension, increases in ambulatory, but not clinic, SBP predict higher risks for CVEs in women than in men. Although women tended to have greater variability in SBP, this did not entirely explain the sex-ambulatory BP interactions.

3 Article Exercise-based cardiac rehabilitation improves endothelial function assessed by flow-mediated dilation but not by pulse amplitude tonometry. 2014

Cornelissen, Véronique A / Onkelinx, Steven / Goetschalckx, Kaatje / Thomaes, Tom / Janssens, Stefan / Fagard, Robert / Verhamme, Peter / Vanhees, Luc. ·Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium. ·Eur J Prev Cardiol · Pubmed #22962311.

ABSTRACT: We aimed to investigate the effect of exercise on endothelium-dependent vasodilator function assessed simultaneously in the brachial artery and in the distal arterial bed by flow-mediated dilation and the pulse amplitude tonometry method, respectively, in coronary artery disease patients. The study included 146 patients with stable coronary artery disease (123 men, mean age 62 ± 9 years) who participated in the Cardiac Rehabilitation and Genetics of Exercise performance study. All patients completed a 12-week supervised cardiac rehabilitation programme (three sessions per week at an intensity of 80% of the heart rate reserve). At baseline and upon completion of the training, we measured brachial artery diameters by means of ultrasound scanning (linear array transducer of 12 MHz) and simultaneously assessed pulse amplitudes in the fingertip using a pulse amplitude tonometry device both at rest and after reactive hyperaemia induced by a 5-min forearm cuff occlusion. Peak oxygen uptake significantly increased (+22%; p < 0.0001) and flow-mediated dilation improved from 10.0% to 13.1% (+37%; p < 0.0001), whereas the reactive hyperaemia index of the pulse amplitude tonometry method remained unchanged (p = 0.47) following exercise-based cardiac rehabilitation. However, the basal digital pulse amplitude (+58%; p < 0.001) increased as a result of training, as did the digital pulse amplitude after reactive hyperaemia (+22%; p < 0.05). Exercise-based cardiac rehabilitation is associated with an improvement in endothelial function, as can be measured by flow-mediated dilation but not by the reactive hyperaemia index of the pulse amplitude tonometry method.

4 Article Genetic predisposition scores associate with muscular strength, size, and trainability. 2013

Thomaes, Tom / Thomis, Martine / Onkelinx, Steven / Goetschalckx, Kaatje / Fagard, Robert / Lambrechts, Diether / Vanhees, Luc. ·Research Group for Cardiovascular and Respiratory Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium. ·Med Sci Sports Exerc · Pubmed #23439425.

ABSTRACT: INTRODUCTION: The number of studies trying to identify genetic sequence variation related to muscular phenotypes has increased enormously. The aim of this study was to identify the role of a genetic predisposition score (GPS) based on earlier identified gene variants for different muscular endophenotypes to explain the individual differences in muscular fitness characteristics and the response to training in patients with coronary artery disease. METHODS: Two hundred and sixty coronary artery disease patients followed a standard ambulatory, 3-month supervised training program for cardiac patients. Maximal knee extension strength (KES) and rectus femoris diameter were measured at baseline and after rehabilitation. Sixty-five single nucleotide polymorphisms (SNP) in 30 genes were selected based on genotype-phenotype association literature. Backward regression analysis revealed subsets of SNP associated with the different phenotypes. GPS were constructed for all sets of SNP by adding up the strength-increasing alleles. General linear models and multiple stepwise regression analysis were used to test the explained variance of the GPS in baseline and strength responses. Receiver operating characteristic curve analyses were performed to discriminate between high- and low-responder status. RESULTS: GPS were significantly associated with the rectus femoris diameter (P < 0.01) and its response (P < 0.0001), the isometric KES (P < 0.05) and its response (P < 0.01), the isokinetic KES at 60° · s (P < 0.05) and 180° · s (P < 0.001) and their responses to training (P < 0.0001), and the isokinetic KES endurance (P < 0.001) and its change after training (P < 0.0001). The GPS was shown as an independent determinant in baseline and response phenotypes with partial explained variance up to 23%. Receiver operating characteristic analysis showed a significant discriminating accuracy of the models, including the GPS for responses to training, with areas under the curve ranging from 0.62 to 0.85. CONCLUSION: GPS for muscular phenotypes showed to be associated with baseline KES, muscle diameter, and the response to training in cardiac rehabilitation patients.

5 Article Muscular strength and diameter as determinants of aerobic power and aerobic power response to exercise training in CAD patients. 2012

Thomaes, Tom / Thomis, Martine / Onkelinx, Steven / Goetschalckx, Kaatje / Fagard, Robert / Cornelissen, Véronique / Vanhees, Luc. ·Research Group for Cardiovascular and Respiratory Rehabilitation, Department of Rehabilitation Sciences, KULeuven, Leuven, Belgium. ·Acta Cardiol · Pubmed #22997993.

ABSTRACT: OBJECTIVE: Low exercise capacity and skeletal muscle strength are important predictors of all-cause mortality in healthy as well as diseased individuals. Compared to sedentary subjects, CAD patients have a decreased oxygen uptake (peakVO2) and show accompanying increased muscle fatiguability. Despite the known importance of oxygen extraction by peripheral muscles on improving peakVO2 and of the relationship between muscle strength and aerobic capacity, only few studies in CAD patients include measurements of muscle strength before and after cardiac rehabilitation. This study therefore aimed to evaluate how much of the variance in baseline peakVO2 and its response to exercise training can be explained by muscular parameters. METHODS: 260 CAD patients performed maximal incremental cycle ergometer testing and maximal knee muscle strength measurements. The rectus femoris diameter was measured using ultrasound. Zero order correlations were calculated and determinants of baseline and response in peakVO2 were analysed by multiple regression analysis. RESULTS: PeakVO2 and muscle strength and diameter increased significantly after three months of cardiac rehabilitation (P < 0.0001). Zero order correlations showed significant correlations between muscular parameters and baseline peakVO2 (P < 0.0001). 63% of the total variance in baseline peakVO2 could be explained by seven parameters with knee extensor muscular endurance as the strongest predictor (P < 0.0001). 32% of the variation in relative increase in peakVO2 could be explained by 5 determinants of which the increase in muscular endurance was the strongest determinant (P < 0.0001). CONCLUSIONS: Knee extensor muscular endurance and its response after training are the strongest muscular predictors in explaining peakVO2 and its response in CAD patients.

6 Article The CAREGENE study: genetic variants of the endothelium and aerobic power in patients with coronary artery disease. 2011

Onkelinx, Steven / Cornelissen, Veronique / Defoor, Johan / Matthijs, Gert / Thomaes, Tom / Coeckelberghs, Ellen / Buys, Roselien / Schepers, Dirk / Fagard, Robert / Vanhees, Luc. ·Cardiovascular Rehabilitation Unit, Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Belgium. ·Acta Cardiol · Pubmed #21894794.

ABSTRACT: OBJECTIVES: Aerobic phenotypes show a wide variability to similar aerobic training stimuli, which can be partly attributed to heritability. Endothelial function affects aerobic power. Various physiological pathways may influence the endothelial function. Therefore, we aimed to examine whether polymorphisms of the eNos gene, the CAT gene, the VEGF gene, the GPX1 gene, the subunit P22 phox of the NAD(P)H-odixase gene, the PPAR-alpha gene, and the PGC-alpha gene are associated with aerobic power or with its response to physical training in patients with coronary artery disease (CAD). METHODS: 935 biologically unrelated Caucasian patients with CAD who had exercised until exhaustion during graded bicycle testing at baseline and after completion of 3 months of training were included in the CAREGENE study (Cardiac Rehabilitation and GENetics of exercise performance). Polymorphisms were detected using the invader assay and MassARRAY technology. Haplotype analysis was performed on the polymorphisms of the eNos gene, the VEGF gene and the NAD(P)H-oxidase gene. RESULTS: Physical training significantly increased aerobic power by 24.2 +/- 0.6% (P < 0.001). Associations of P < 0.05 were found between aerobic power and the eNOS 273C>T variant and the catalase -262C>T variant and aerobic power response. Haplotypes of the eNOS polymorhisms were predictive of aerobic power and its response to training (P < 0.05). After Bonferroni correction of multiple testing no significant differences remained. CONCLUSION: We believe that genetic factors are very important in the explanation of the great variability of aerobic power and its response. However, after Bonferroni-correction, differences in these polymorphisms remained no longer statistically significant.

7 Article Effect of creatine supplementation as a potential adjuvant therapy to exercise training in cardiac patients: a randomized controlled trial. 2010

Cornelissen, V A / Defoor, J G M / Stevens, A / Schepers, D / Hespel, P / Decramer, M / Mortelmans, L / Dobbels, F / Vanhaecke, J / Fagard, R H / Vanhees, L. ·Cardiovascular Rehabilitation Unit, Department of Rehabilitation Sciences, K.U.Leuven, Leuven, Belgium. ·Clin Rehabil · Pubmed #20576665.

ABSTRACT: OBJECTIVE: To investigate the effect of oral creatine supplementation in conjunction with an exercise programme on physical fitness in patients with coronary artery disease or chronic heart failure. DESIGN: Single centre double-blind randomized placebo controlled trial. SETTING: Cardiac rehabilitation centre. SUBJECTS AND INTERVENTION: 70 (4 women) cardiac patients (age 57.5 (8.4) years) were randomized to a placebo (n = 37) or creatine (n = 33) treatment for three months. Combined aerobic endurance and resistance training (three sessions/ week) was performed during supplementation. MAIN MEASURES: Aerobic power was determined during graded bicycle testing, knee extensor peak isometric and isokinetic strength, endurance and recovery were assessed by an isokinetic dynamometer, and health related quality of life was evaluated with the SF-36 and MacNew Heart Disease questionnaires. In addition, blood samples were taken after an overnight fast and 24 hour urinary collection was performed. RESULTS: At baseline there were no significant differences between both groups. We observed main time effects for aerobic power, muscle performance, health related quality of life, high density lipoprotein cholesterol and triglycerides (pre vs post; P<0.05 for all). However, changes after training were similar between placebo group and creatine group (P>0.05). Further, no detrimental effect on renal or liver function was observed nor were there any reports of side effects. CONCLUSION: Oral creatine supplementation in combination with exercise training does not exert any additional effect on the improvement in physical performance, health related quality of life, lipid profile in patients with coronary artery disease or chronic heart failure than exercise training alone.