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Biomedical subjects

A Chabanier

Publications and source records attributed to A Chabanier.

At least 19 recordsLinked to original sources
PubMed1990

Doppler ultrasound in aortic dissections: a study of cephalic and peripheral arteries.

We investigated the role of continuous-wave Doppler ultrasound in predicting the presence of an aortic dissection prospectively in 28 patients whose diagnosis was confirmed either by arteriography or surgery (26 cases) or at autopsy (two cases). We hypothesized that dissections, by creating two channels for flow, would produce velocity disturbances detectable in accessible arteries such as the carotid, brachial, and femoral arteries. Of the 28 patients, 20 had Type I, two Type II, and six Type III dissections. Two abnormalities of the Doppler signals were found: in 18 of Type I dissections, notching was found in the systolic upslope of the velocity tracing from those arteries that were either involved in or distal to the dissection sites. Notching was much less frequent for Type II and III dissections: only one patient with Type II and two patients with Type III dissections showed notching. In addition diastolic backflow with marked aortic valvular insufficiency was present. Notching in brachiocephalic artery continuous-wave Doppler signals appears to have a high positive predictive value for Type I dissections.

Adult↗
PubMed1988

Iatrogenic cardiac tamponade after central venous catheter.

Myocardial perforations with a central venous catheter are rare in adults (67 cases published since 1968). These accidents are fatal in more than two-thirds of the cases owing to confusion caused by misleading symptoms which suggest pulmonary embolism. The perforation is generally localized in the right atrium (29 cases), less frequently in the right ventricle (18 cases). The superior vena cava is rarely affected (3 cases). The site of the perforation was not found in the other published cases. Clinical symptoms are signs of tamponade with disorders of cardiac rhythm. An enlargement of the cardiac shadow and an abnormal position of the catheter, buckled or openly intrapericardial, make the diagnosis radiologically. Echocardiography provides some information, but this is often too late for practical application. The diagnosis is made with right catheterization when it shows an equalization of the diastolic pressures. This allows the patient to be watched closely following the pericardial tap, after which a surgical approach may be indicated and performed. Prevention of these iatrogenic accidents must be systematic and strictly controlled for.

Adolescent↗
PubMed1988

[Hemodynamic effects at rest and exertion of a new partial beta-agonist (cicloprolol) in moderated cardiac failure].

The haemodynamic effects of cicloprolol, a new partial beta 1-adrenoceptor agonist, were investigated at rest and during exercise in 10 patients with moderate heart failure. At rest, cicloprolol (0.10 mg/kg i.v.) increased heart rate by 8 p. 100 (80.6 +/- 5.7 vs 74.7 +/- 11.9 beats/min; p less than 0.05), cardiac index by 17 p. 100 (3.74 +/- 0.57 vs 3.20 +/- 0.41 l/min/m2; p less than 0.001) and stroke index by 6 p. 100 (46.3 +/- 8.3 vs 43.7 +/- 8.8 ml/beat/m2; p less than 0.05). Left ventricular end-diastolic pressure was reduced by 35 p. 100 (9.9 +/- 5.0 vs 15.2 +/- 7.4 mmHg; p less than 0.01). There were no significant changes in aortic pressure. Systemic vascular resistance decreased by 15 p. 100 (1,030.8 +/- 234.6 vs 1,209.6 +/- 319.7 dynes.s.cm-5; p less than 0.01). During moderate exercise (114 +/- 13 watts) in supine position, cicloprolol induced a 10 p. 100 reduction of tachycardia (99.7 +/- 10.2 vs 112.2 +/- 16.5 beats/min; p less than 0.01), a 6 p. 100 decrease of mean aortic pressure (112.4 +/- 19.7 vs 119.5 +/- 19.2 mmHg; p less than 0.01) and an 8 p. 100 decrease of cardiac index (5.42 +/- 0.63 vs 5.88 +/- 0.75 l/min/m2; p less than 0.001). There were no significant changes in left ventricular filling pressure and stroke index. When data obtained at rest and during exercise were pooled, an inverse linear relationship (p less than 0.01) was found between heart rate before treatment with cicloprolol and cicloprolol-induced variations in heart rate and cardiac index.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗
PubMed1987

[Automatic quantitative analysis of myocardial tomography thallium-201 scintigraphy].

An automatic and quantitative analysis method for tomographic scintigraphy was applied to 104 patients with myocardial infarction (anterior 37, inferior 67, lateral 20, involving 2 territories in some cases). All patients underwent exercise and redistribution scintigraphy and coronary arteriography which served as reference. Two types of tomographic sections were used: 2 short axis sections exploring the left ventricle at different levels, and 1 apical section at a right angle with the first ones. A circumferential analysis program studied the isotopic activity of each section and drew an activity profile curve which was compared with those obtained in normal subjects. Exercise curves proved superior to redistribution and wash-out curves and were therefore used exclusively. Two sectoring methods for territories with infarcts were defined: conventional sectoring, which gives a 90 degrees angle to the anterior region and a 180 degrees angle to the inferior lateral region, and real sectoring established from the scintigraphic abnormalities observed in patients whose infarction was not accompanied by significant lesions in other territories. Real sectoring divides the territory into two regions (anterior and infero-lateral) and determines the extension territory and the territories specific to each necrotic region. The sensitivity and specificity of these two methods for the diagnosis of necrosis and the detection of a significant abnormality (greater than 70% stenosis, or necrosis) in a territory other than the one with infarct were compared. In the diagnosis of infarction: conventional sectoring sensitivity 92%, specificity 46% for anterior infarcts, 94% and 25% for inferior and lateral infarcts; real sectoring 94% and 63% respectively for anterior infarcts, 92% and 68% for inferior infarcts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Bepridil and torsades de pointes. Apropos of 11 cases].

The authors report 11 cases of spikes occurring under bepridil treatment. It concerns an elderly population, predominantly female, receiving most of the time 300 mg of bepridil. The frequency of associated hypokalemic or arrhythmic medications is emphasized. The comparison of these results to those from other series in the literature, enables to propose precautions for the use of this molecule.

Aged↗
PubMed1986

[Short and intermediate-term hemodynamic study at rest and during exercise of cardiac insufficiency treated by captopril].

Administration of 25 mg of captopril to 10 patients with heart failure (NYHA II, III) produces at rest after 60 min bradycardia (-7 per cent, p less than 0.01), hypotension (-8 per cent) and improvement of the preload (-30 per cent, p less than 0.01). This effect is still apparent after two months of treatment where PAP is decreased by 20 per cent (p less than 0.05). A prolonged effect of captopril is present in these 10 patients. The capacity to perform a muscular exercise on an ergometric bicycle is prolonged by 10 per cent (p less than 0.01) on the first day and by 18 per cent (p less than 0.01) after two months of treatment. This improvement seems to be related to improvement of the hemodynamic parameters, especially of preload indices. In 5 patients, lactacidemia, the arterio-venous difference and the extraction coefficient of O2 were studied at rest and during exercise. No significant difference are noted after the treatment with the inhibitors of conversion enzymes.

Adult↗
PubMed1986

[Intermittent dysfunction of a Björk-Shiley tricuspid prosthesis caused by thrombosis suspected through pulmonary scintigraphy].

Thrombosis of a Björk-Shiley tricuspid valve prosthesis was observed 4 years after its implantation. The resulting dysfunction was intermittent blocking the disc in the closed position leading to recurrent near-syncopal malaises probably due to a temporary fall in cardiac output and cerebral blood flow and a right to left interatrial shunt which was detected at pulmonary scintigraphy performed to exclude pulmonary embolism. The Björk-Shiley prosthesis was replaced with a Carpentier-Edwards n. 29 prosthesis with a good result after a follow-up of one year.

Adult↗
PubMed1986

Effects of captopril on myocardial perfusion in patients with coronary insufficiency: evaluation by the exercise test and quantitative myocardial tomoscintigraphy using thallium-201.

Nine patients with coronary insufficiency were investigated using an exercise test coupled with quantitative myocardial tomoscintigraphy with thallium-201 before and after 48 hours' treatment with captopril. After captopril treatment, an improvement in ST segment depression was noted during exercise. The quantitative tomoscintigraphy showed a reduction in the ischaemic zone with captopril during exercise. However, in three patients, although there was an overall improvement in myocardial perfusion during exercise, aggravation of wash-out was observed in some regions, reminiscent of a coronary steal effect.

Adult↗
PubMed1985

[A case of electrically and mechanically stunned myocardium].

The authors report the case of a 72 year old patient with ECG changes of anterior myocardial infarction complicated by left ventricular failure and shock which has a favourable outcome with regression of the pathological Q waves on the 7th day. Radionuclide investigation and coronary angiography showed no myocardial sequellae and the coronary arteries appeared normal. This case, an example of stunned myocardium, confirms that severe myocardial ischaemia, even of short duration, may induce reversible but prolonged metabolic disturbances. The practical implications of this concept are discussed.

Aged↗
PubMed1985

[Outcome of patients with inoperable multivessel coronary disease].

The authors studied the clinical course of 100 patients with two or three vessel coronary artery disease who were unsuitable for surgery because of the poor quality of the distal vascular bed or excessively depressed left ventricular function. The 6 year actuarial survival was 58 per cent; 43 of the 100 patients did not present any serious cardiac events causing death or requiring further admission to hospital, over this follow-up period. The severity of the clinical course in women and the presence of heart failure prior to coronary angiography were considered to be among the most important clinical prognostic factors. On the basis of the haemodynamic survey, the probability of survival or the risk of a further coronary accident appears to depend more on the extent of the left ventricular kinetic abnormalities than on the ejection fraction or the severity of the coronary lesions.

Adult↗
PubMed1984

[Long-term fate of 103 patients with auricular fibrillation lasting for over 15 days treated with cardioversion and preventive therapy].

103 patients with atrial fibrillation lasting more than 15 days were treated by cardioversion, with a return to normal sinus rhythm in 92 per cent of cases. If the atrial fibrillation recurred during the first six months, a further electric shock was given and the treated was changed or better adapted to the patient. The sinus rhythm was maintained in 85.7 per cent of patients at one year, 84.4 per cent at 2 years, 80.1 per cent at 3 years and 76.1 per cent at 4 years. The factors which predict a good result are: sex, the presence of mitral valve disease, especially when it has been operated, good tolerance of the arrhythmia and good haemodynamic status prior to the shock. The treatment used were quinidine arabogalactane sulfate (QAGS) and amiodarone. QAGS was better tolerated, while amiodarone proved to be more effective.

Adult↗
PubMedDate not supplied

[Coronary angiography after the age of 70 years].

100 patients over the age of 70 years underwent coronary angiography. The indications for this examination at this age were different from those in younger patients. After the age of 70 years, 58 per cent of coronary angiographies are performed as part of the haemodynamic survey of valvular disease. The risk of the examination appears to be higher, as two deaths occurred in this small series, while the mortality is estimated to be 2 per thousand in younger patients. Coronary angiography is very useful at this age in patients with valvular disease to determine the need for an associated coronary graft and also to determine contraindications for operation because of the severity of the lesions. A surgical indication was confirmed in 50 patients, but surgery was only performed in 36 of them. The follow-up of these patients demonstrates that patients operated for valvular disease had a longer survival that those considered to be inoperable or who refused operation. On the other hand, there was no difference in survival between grafted and non-operated patients over the age of 70 years.

Aged↗