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B Lancelin

Publications and source records attributed to B Lancelin.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Retrograde dissection of the common trunk of the left coronary vessel during angioplasty of left anterior descending coronary artery. Apropos of 2 cases].

Acute dissection of the left main coronary artery during coronary angiography or angioplasty is a rare but well known complication; it is attributed to a mechanical trauma caused by the tip of the catheter guide wire. The authors present two cases of dissection at the site of coronary angioplasty with a retrograde extension to the left main stem requiring emergency coronary surgery.

Aged↗
PubMed1991

[Hemodynamic response to intracoronary injection of a vasodilator during coronary angiography. A randomized comparative study of trinitrin and linsidomin ].

Intracoronary injection of a vasodilator agent in an almost systematic practice during coronary angiography or angioplasty because of the dynamic information that it provides concerning the stenosis, the artery in the unstenosed segment and spastic phenomena. Nitroglycerin is the reference drug with, however, a significant dose-dependent hypotensive effect. The aim of this randomised open trial was to compare the effects of Linsidomine, the active metabolite of molsidomide with the reference product. Eighty patients aged 59.2 +/- 10.4 years received either 0.15 mg of nitroglycerin or 0.8 mg of linsidomine during coronary angiography. Aortic pressure and heart rate were monitored continuously over 3 minutes; at the 3rd minute and injection of contrast was performed under fluoroscopic control under the same conditions as the basal injection for an experienced coronary angiographist to judge semi-quantitatively the quality of vasodilation at the site of stenosis and in the whole artery. In the linsidomine group, the only significant change was a moderate fall in systolic pressure from the 1st to the 3rd minute. In the nitroglycerin group, all pressure parameters fell from the 30th second. The heart rate remained stable in both groups. The maximal pressure differences were significantly different in the two groups: -4 +/- 7.3 mmHg versus -11.3 +/- 9.2 mmHg (linsidomine versus nitroglycerin), p less than 0.001 for systolic pressure; -0.1 +/- 5 mmHg versus -3 +/- 5.4 mmHg respectively for diastolic pressure (p less than 0.05); and -1 +/- 6 mmHg versus -5.3 +/- 6.4 mmHg (p less than 0.01) for mean pressure. These pressure changes were not associated with any detectable untoward clinical effect in either group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1981

[Contribution of the exercise test to the diagnosis of sinus dysfunction. Correlation with endocavitary explorations].

Standardised exercise electrocardiography was performed in 50 patients undergoing endocavitary electrophysiological investigation of sinus node function. There was no previous history of cardiac failure or coronary insufficiency, and the patients, who were not trained athletes, were investigated after interruption of any medication which could affect sinus node function. The endocavitary investigations comprised overdrive suppression with rapid atrial pacing (Mandel) premature extrastimulus method (Strauss) and stimulation at a relative constant prematurity of 50% (Normal values: A2 A3 - 2d - return cycle - sinoatrial conduction time - = 0,77 A1 A1 - spontaneous cycle - +345). A significant difference in the maximal heart rate on stress testing between normal subjects and patients with sinus node dysfunction was observed only when values obtained with the relative constant prematurity method was taken into consideration (24 cases) the relative constant prematurity method became more significant (p less than 0,001). This held true to a lesser degree for Mandel's method (p less than 0,02), but no significant difference was obtained with Strauss' method. The ratio of maximal heart rate to theoretical maximal heart rate for age gave similar results. The correlation between stress testing and the relative constant prematurity method is probably related to intra sinusal shift of the dominant pacemaker. Both investigations would seem to test the functional properties and the reserve of the sinus node, taking extrinsic factors such as vago sympathetic stimulation into account. Patients with functional sinus node dysfunction increase their heart rates normally on exercise (average maximum of 170 bpm); a maximal heart rate of less than 120 bpm is very suggestive of organic sinus node dysfunction.

Adolescent↗
PubMed1981

[Clinical application of the alkalosis induction test for coronary artery spasm].

Alkalosis was used for stress testing for coronary artery spasm in 70 patients (average age: 56 years) with resting angina. A rapid intravenous infusion of an alkaline buffer (THAM) immediately followed by 5 minutes' maximal ventilation increased the arterial pH to 7.67 +/- 0.5. Anginal pain and ECG changes were observed in 24 Patients, with ST elevation in 10 cases and ST depression in 14 cases. The ischaemic changes occurred during hyperventilation in 16 cases and in the 3 minutes following the test in 8 cases. The heart rate increased from 66 +/- II to 71 +/- 14 bpm (p less than 0,01) but systolic blood pressure fell from 139 +/- 12 to 130 +/- 12 mm Hg during hyperventilation; there was no significant change in the rate-pressure product (1130 +/- 1750 to 8990 +/- 2690). In all cases, the angina and ischaemic changes regressed after intravenous Trinitrin. Coronary angiography was performed in 56 patients: in the 24 patients with positive responses (Group I) and in 30 of the 46 patients with negative responses (Group II). Significant coronary artery narrowing (greater than 70%) was observed in 21 patients of Group I: in the 3 patients without coronary lesions an intravenous injection of 0.4 mg methylergometrine provoked coronary spasm. In Group II, significant narrowing was demonstrated in 18 patients: in the 12 other patients, coronary spasm could not be induced by methylergometrine. Therefore, in the absence of organic coronary lesions, an excellent correlation has been shown between the alkalosis and methylergometrine tests. This stress test was repeated in 16 of the 24 patients in Group I one hour after administration of 20 mg of Nifedepine: the test was negative in all cases. We conclude that the alkalosis test could be useful in the coronary care unit as a stress test for coronary spasm to determine the antianginal treatment of choice and to evaluate its efficacity.

Coronary Angiography↗
PubMed1980

[Treatment of left ventricular failure with percutaneous nitroglycerin (author's transl)].

In 12 patients aged from 45 to 75 years (mean : 62.57 +/- 8.37 years) a 2% percutaneous prepartion of nitroglycerin (PCNG) was applied on a square thoracic area measuring 15 x 15 cm, and its efficacy and duration of action were assessed by recording pressures in the right cavities and in the brachial artery. Left ventricular failure was due to recent myocardial infarction in nine cases, ischemic cardiopathy in two and non-obstructive cardiomyopathy in one. The 15 mg initial dose of PCNG was progressively increased until optimal dosage was reached. The efficacy of the drug was reflected in a significant fall in pulmonary artery diastolic pressure (PADP), equivalent to the mean capillary pressure, from 21.8 +/- 7.9 to 12.75 +/- 8.6 mmHg (p < 0.001). The mean systemic arterial pressure was reduced from 92.2 +/- 17.4 to 83 +/- 16.7 mmHg (P < 0.01). The cardiac index rose from 2.7 +/- 1 to 2.8 +/- 0.51/mn/m2 (N.S.) and the systolie index from 30.1 +/- 12.7 to 31.7 +/- 9.1 ml/systole/m2 (N.S.). Changes in PADP were significant (p < 0.05) during six hours and maximal at two hours (p < 0.001). There was a good correlation (r = 0.68 ; p < 0.02) between the time required to return to the initial values and the optimal fall in PADP. This shows that PCNG is undoubtedly long-acting in left ventricular failure, provided the doses are sufficient to induce a marked decrease in PADP.

Aged↗
PubMed1980

[Role of the renin-angiotensin system in arterial hypertension with aortic coarctation in young adults].

The renin-angiotensin system (RAS) was evaluated in 7 hypertensives with pure isthmic coarctation of the aorta. RAS was studied under basal conditions, standing, after saralasine (a specific angiotensin II antagonist) and after acebutolol (a cardioselective beta-blocker and an inhibitor of renin secretion). Plasma volume was measured by radio isotopic methods and cardiac catheterisation was performed to assess the pressure gradient across the coarctation. On a normal salt diet on orthostatism, plasma renin activity (PRA) was increased in 5 patients and normal in the other 2. After moderate salt depletion, saralasine injection caused a significant fall in diastolic blood pressure (89,2 +/- 4,4 to 77,3 +/- 6,6 mmHg; p < 0,02) with an associated rise in PRA (5,7 +/- 4,4 to 17,1 +/- 9,1; p < 0,01). There was no correlation between these two parameters or their variations. The test was negative in two patients. The antihypertensive effect of acebutolol was moderate due partly to the absence of salt depletion. Inhibition of renin secretion by acebutolol was significant (4,7 to 1,95 +/- 1,10 ng AI/ml/h; p < 0,02) but did not correlate with variations of arterial blood pressure. There was no correlation between the antihypertensive effect of saralasine and acebutolol (R = 0,51). Plasma volume (n = 5) was almost always increased (47,15 +/- 5,4 ml/kg). No correlations were observed between the different levels of PRA, plasma volume, and the systolic and/or diastolic gradient. In conclusion, this study underlines the limitations of isolated peripheral assessment of PRA and the acebutolol test. On the other hand, the effectiveness of saralasine, a specific RAS antagonist, and the demonstration of the effective participation of this system associated with the usual increase in plasma volume, seems to liken coarctation of the aorta to the single kidney Goldblatt experimental model.

Adolescent↗