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Biomedical subjects

A Azancot

Publications and source records attributed to A Azancot.

27 records · Page 2Linked to original sources
PubMed1985

Echocardiographic ventricular shape analysis in congenital heart disease with right ventricular volume or pressure overload.

In this 2-dimensional (2-D) echocardiographic study, a computerized Fourier analysis technique refined from one that allows quantification of changes in septal shapes in normal fetuses, newborns and infants allowed analysis of left ventricular (LV) shapes in 14 patients with right ventricular (RV) volume overload (atrial septal defects), 5 with volume and pressure overload (total anomalous pulmonary venous connection), and 10 with pressure overload (complete transposition of the great arteries [TGA] with intact ventricular septum). Diastolic shape factors in the 3 groups were significantly different from those of normal subjects (p less than 0.01). Highest diastolic values were found in patients with TGA (mean 4.59 +/- 1.28). Systolic shape factors were similar in patients with atrial septal defect and normal subjects. Significant differences existed between normal subjects and patients with total anomalous pulmonary venous connection, with the greatest differences in systolic shape factor being 5.61 for TGA vs 1.87 (p less than 0.005) for normal subjects. Shape factor correlated well with hemodynamic data for RV/LV systolic pressure ratios (r = 0.93, p less than 0.001) for normalized interventricular pressure differences (r = -0.95, p less than 0.001). The lower the normalized systolic pressure difference or the higher the RV/LV ratio, the more the septum encroached into the LV cavity. Significant but weaker correlations were noted for values during diastole. Quantitative application of Fourier shape factor analysis to LV shapes allows numerical expression of visually interpreted distortions over a wide range of geometric alterations.

Cardiac Volume↗
PubMed1983

Analysis of ventricular shape by echocardiography in normal fetuses, newborns, and infants.

Qualitative and quantitative changes in left ventricular shapes were analyzed in 14 normal fetuses, 29 normal newborns, and 12 normal infants. Qualitative observations demonstrated that most fetuses and newborns with dominant right ventricles had flattened or even indented interventricular septae, which changed left ventricular shape into an ellipse. In contrast, left ventricular shapes in infants were round, similar to shapes described in older children and adults. When changes in shape or septal distortions were gross, interobserver agreement was 100%; when changes were less altered from a circular shape, interobserver agreement was 78%. To avoid subjective misinterpretations, quantitative analyses were performed, including M mode echocardiographic comparisons of right ventricular/left ventricular dimensions and left ventricular cavity anterior-posterior/lateral diameters, as well as Fourier analysis of digitized tracings of the entire left ventricular shape. The right ventricular/left ventricular ratio, determined by M mode echocardiography, showed significant differences between fetuses (1.07 +/- 0.07) and newborns (0.62 +/- 0.12) (p less than .001). Infants had a significantly lower right ventricular/left ventricular ratio (0.45 +/- 0.01) when compared with newborns (p less than .01). Ratios of left ventricular anterior-posterior/lateral diastolic diameters were significantly lower (p less than .001) in newborns (0.66 +/- 0.08) when compared with those of infants (0.82 +/- 0.10). All diameters tended to increase (toward roundness) with systole and with aging. Fourier analysis allowed evaluation of the entire left ventricle, including that portion of the septum that qualitatively appeared most indented and could not be analyzed by either of the above techniques. Shape factor derived from idealized shapes ranging from a circle to an indented ellipse allowed comparison with digitized left ventricular tracings. This technique allowed accurate quantitation of the observed changes in shape. Fetuses had the highest diastolic shape factor (7.47 +/- 0.92), whereas infants' shape factors were lowest (2.12 +/- 0.41). A tendency toward roundness and loss of distortion occurred with aging. Systolic shape factor was lower with aging in each group studied. The Fourier technique used in this study allows evaluation of an arbitrarily large number of components of a shape, and thus a complete description of that shape is permitted. Comparisons of right ventricular/left ventricular diastolic dimensions and left ventricular anterior-posterior/lateral comparisons are subsets of this technique, which allow evaluation of only two points (circular component-first harmonic) or four points (elliptical component-second harmonic) of an overall shape.(ABSTRACT TRUNCATED AT 400 WORDS)

Echocardiography↗
PubMed1980

[Hemodynamic and echocardiographic investigations in children with severe meningococcosis (author's transl)].

In eight children presenting with severe meningococcosis, hemodynamic investigations were performed at various stages of the disease (thermodilution technique and echocardiography). Surveillance of hypovolemia and myocardial incompetence associated with sceptic shock allows a better adaptation of symptomatic treatment and a better prognosis in these severe cases. It seems that invasive hemodynamic methods (thermodilution) cannot be replaced presently by echocardiography alone.

Child↗
PubMed1977

[Severe viral pneumonia. A radiological classification with prognostic value].

In one year eighteen children were admitted to an intensive care unit with severe viral pneumonia. Four groups were identified by the appearance of the chest X-ray. Bronchiolitis was seen in eight patients, alveolitis in four, interstitial pneumonia in two and combined bronchiolitis and alveolitis in four. Three of the four children with alveolitis died and six of the twelve with bronchiolitis, alone or with alveolitis, had residual bronchial obstruction.

Adenoviridae Infections↗
PubMed1976

[The ventricular pressure-volume ratio, an index of left ventricular performance in man].

The left ventricular systolic pressure-volume diagram has been established before and after infusion of Nitro-prusside, Angiotensin and over post-extrasystolic potentiation on 33 patients, by the simultaneous measure of the aortic pressure and the left ventricular volume. In every case left ventricular dp/dt max. and (dp/dt/Pt) max. have been measured before and during post-extrasystolic potentiation, and in 16 cases after vasomotor therapy. The end-systolic left ventricular pressure-volume ratio appears to be independent of loading modifications--more than dp/dt max. and (dp/dt/Pt) max.--and on the opposite to be a good index of inotropic state alterations.

Angiotensin II↗
PubMedDate not supplied

[Total abnormal pulmonary venous return. Preoperative stabilization by extracorporeal veno-venous circulation].

BACKGROUND: Total anomalous pulmonary venous return (TAPVR) is a rare congenital cardiac disease. When this includes pulmonary artery hypertension, the infant is severely ill. Survival beyond infancy is rare without surgical correction. CASE REPORT: A girl in whom hydramnios and a short femur were discovered by ultrasonography at the 25th week of gestation was admitted to the intensive care unit a few hours after birth because of respiratory distress. Blood PaO2 was 37 mmHg, PaCO2, 36 mmHg, and pH 7.25. She had tachycardia (190/min) and circulatory insufficiency. Echocardiography showed right ventricular overload, a right-to-left shunt through a patent ductus arteriosus and foramen ovale and tricuspid insufficiency. This refractory hypoxemia was not corrected by conventional respiratory support, high-frequency oscillation plus dobutamine and dopamine followed by noradrenaline infusion. Because of further deterioration, the baby was given extracorporeal lung support; this rapidly improved the respiratory and hemodynamic conditions. Persistent pulmonary artery hypertension led to a second investigation that showed TAPVR She underwent emergency surgery. CONCLUSION: Extracorporeal lung support can stabilize a precarious state in a case of severe congenital cardiac disease, so allowing surgical treatment under satisfactory conditions.

Emergencies↗