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Biomedical subjects

B Marchandise

Publications and source records attributed to B Marchandise.

At least 55 records · Page 3Linked to original sources
PubMed1987

Noninvasive prediction of pulmonary hypertension in chronic obstructive pulmonary disease by Doppler echocardiography.

Thirty-six patients with chronic obstructive pulmonary disease (COPD) were studied by pulsed Doppler echocardiography. In 32 of the 36 patients, adequate Doppler signals were obtained in the pulmonary arterial trunk and correlated with right cardiac hemodynamics. The studied group included 26 patients with mean pulmonary arterial pressure (MPAP) greater than 20 mm Hg at rest (group A, with pulmonary hypertension) and six patients with MPAP of 20 mm Hg or less (group B, without pulmonary hypertension). A control group (group C) consisted of 12 subjects with normal hemodynamic data and pulmonary function. Analysis of Doppler data included flow velocity curve pattern, presence of a negative presystolic velocity, right ventricular pre-ejection period (RVPEP) and ejection period (RVEP), time between onset and peak of pulmonary velocity (time to peak velocity, TPV) and derived ratios of TPV/RVPEP and TPV/RVEP. In patients with pulmonary hypertension, the Doppler flow velocity curve in the pulmonary trunk showed a rapid acceleration and an early deceleration. The mean value for TPV was 78 +/- 12 msec in group A, 115 +/- 11 msec in group B, and 127 +/- 10 msec in group C. In patients with COPD, significant correlations were observed between TPV and log10 MPAP (r = -0.77; SEE = 0.07) and between TPV and log10 total pulmonary resistances (r = -0.84; SEE = 0.05). Accordingly, pulsed Doppler echocardiography may be a useful tool to predict pulmonary hypertension due to chronic pulmonary disease.

Echocardiography↗
PubMed1986

Experience with the selective use of the Carpentier-Edwards bioprosthesis.

Between April, 1977, and November 1984, 136 porcine bioprosthetic valves were implanted in 122 patients principally selected on the basis of age and contraindication to anticoagulants. The following procedures were carried out: aortic valve replacement (AVR) 88, pulmonary valve replacement (PVR) 1, mitral valve replacement (MVR) 38, and tricuspid valve replacement (TVR) 9. The ages ranged from 25 to 84 years (mean 64.6 years). The 30-day mortality was 11.5% overall. Survivors were followed up to 7 years (mean 29.2 months). Actuarial survival rates at 5 years, including operative deaths, were as follows: AVR 76.2 +/- 9.3%, MVR 59.7 +/- 12.6% and combined valve replacement (CVR) 47.1 +/- 19.4%. The 5-year probability of freedom from valve-related complications was 76.8 +/- 6.9% for all patients. The rate of thromboembolic events was 3.80% per patient-year after AVR and 2.72% per patient-year after MVR and CVR. The embolic rate did not differ between patients treated with anticoagulants and those treated with platelet antiaggregators. Primary tissue valve failure occurred in 2 patients for a linear incidence of 0.77% per patient-year. Postoperative echocardiography was performed in 83% of the survivors. Patients are now prospectively followed up by bidimensional echography and pulsed Doppler in order to detect early valvular dysfunction. The performance of the Carpentier-Edwards porcine bioprosthesis is, thus, satisfactory in this group of elderly patients.

Aged↗
PubMed1985

Paradoxical ventricular septal motion after cardiac surgery. Analysis of M-mode echocardiograms and follow-up in 324 patients.

Ventricular septal wall motion, assessed by M-mode echocardiography, was analyzed, retrospectively, in 324 patients after open heart surgery (214 patients with valvular replacement, 110 patients with aorto-coronary bypass surgery); the mean follow-up was 14 months (1 month to 5 years). In the early (less than 1 month) postoperative period, an anterior systolic (paradoxical) motion of septum (PVSM) was observed in 66% of the patients with valvular surgery, and in 76% of those with coronary surgery. PVSM disappears progressively: one year after surgery, it occurs in only 21% of patients with valvular surgery and in 16% of patients with coronary surgery. There is no significant difference in frequency and evolution of PVSM between the different types of surgical interventions (valvular versus coronary surgery; aortic versus mitral surgery; single bypass graft versus multiple bypass grafts). The similar frequency and evolution of PVSM after aorto-coronary venous graft surgery and valvular replacement surgery support the hypothesis that PVSM would be the expression of a greater anterior systolic motion of the whole heart, related to the loss of pericardial restraint. PVSM disappears slowly after surgery, probably following the development of cardiothoracic adherences.

Adolescent↗
PubMed1983

Left atrial myxoma causing fluttering of the anterior mitral leaflet.

This report describes the M-mode echocardiographic features of a left atrial myxoma, before and after excision of the tumor. Preoperative M-mode echocardiogram demonstrated fine diastolic fluttering of the anterior leaflet of the mitral valve which disappeared after surgery. Preoperative aortography and minutious examination of the aortic valve during operation excluded any associated lesion of the aortic valve. The fluttering of the anterior mitral valve is probably related to turbulent blood flow around the tumor prolapsing between mitral leaflets during diastole.

Aortic Valve Insufficiency↗
PubMed1979

Shear stress-induced changes in platelet reactivity.

We have investigated the effects on platelet function of a physiologic shear stress. The aggregation to thrombin and collagen, the release reaction [(14C) serotonin] and the procoagulant activity of washed platelet suspensions were assayed on samples undergoing laminar oscillatory flow for 20 minutes at 37 degree C in polyethylene tubes, and on paired samples kept at rest. The pulse rate was established at 72 cycles per minute and the shear stress at the wall estimated at 26.2 dynes/cm2. The platelet suspensions were prepared at 37 degree C from blood samples of 15 healthy volunteers and 15 patients with the diagnosis of coronary artery disease proven by angiography. Our results show enhancement of platelet aggregation in samples undergoing oscillatory flow. Furthermore, platelets from coronary patients gained additional procoagulant activity. However, no change was encountered in the rate and speed of the release reaction. It is concluded that exposure to a high shear stress within an oscillatory flow system enhances platelet reactivity; this reaction may take part in the production of platelet and coagulation changes seen in the atherosclerotic patient and after strenuous physical exercise.

Adult↗
PubMed1979

Influence of moxaprindine treatment on ventricular arrhythmias occurring during maximal exercise stress testing.

Moxaprindine, a new anti-arrhythmic drug, with characteristics similar to aprindine, has been demonstrated to be highly effective in suppressing ventricular arrhythmias occurring before, during and after maximal exercise stress testing. This effect was obtained both in subjects with clinically normal hearts and in a limited number of patients with ischemic heart disease. These findings demonstrate the efficacy and safety of anti-arrhythmic treatment by drugs prolonging ventricular depolarization for ventricular arrhythmias occurring during exercise.

Adult↗
PubMed1978

Angiographic evaluation of the natural history of normal coronary arteries and mild coronary atherosclerosis.

Between September 1966 and September 1976, a group of 48 patients with normal coronary arteries or nonsignificant coronary atherosclerosis documented in a first coronary arteriogram underwent a second angiogram because of persistent or recurrent chest pain. The interval between studies was 13 to 108 months (mean 42 months). The indication for the first angiogram was typical or atypical anginal pain. The patients were separated into two groups according to the results of the first angiogram. Group I included 22 patients, 9 men and 13 women, with normal coronary arteries (mean age 49 years, range 28 to 62). Group II included 26 patients, 18 men and 8 women, with coronary stenosis of less than 50% of intraluminal diameter (mean age 49 years, range 38 to 63). The second angiogram revealed normal coronary arteries in all 22 patients in Group I but showed progression of diseases in 7 (27%) of the 26 patients in group II. The coronary arterial narrowings were greater than 50% in four patients and greater than 70% in only two patients. The clinical course, coronary risk factors and interval between angiograms were not useful predictors of progression of disease. The data suggest that coronary artery disease is unlikely to developed in adults with normal coronary arteries and that roughly 75% of adults with nonsignificant atherosclerosis will not show progression of disease over a 3 to 4 year period.

Adult↗
PubMed1977

[Study of coronary flow in man].

Especially for the last decade, measurement of total and regional coronary blood flow has raised a considerable interest. Various techniques resorting to indicators introduced into the systemic or the coronary circulation are used. Measurement of the coronary blood flow is derived from the pattern of myocardial indicator uptake or washout curves. The currently available techniques for quantitating coronary flow include inert diffusible gases, radioisotopes and continuous thermodilution; each of these has some methodological limitations. Moreover, regulation of coronary circulation depends upon several factors, and quantitative assessment of coronary perfusion in patients with ischemic heart disease has raised appreciable difficulties. Recently, however, measurement of myocardial blood flow during stress in subjects with coronary artery disease has yielded promising results. The importance of these techniques, in assessing the functional consequences of coronary stenoses, is multifold and their clinical applications will grow quickly.

Coronary Circulation↗
PubMed1975

[Conduction disorders in aortic valve diseases].

Among 304 cases of aortic valvulopathies studied for surgical selection, the authors have found a high incidence of conduction disturbances (16% in aortic stenosis and 18,4% in aortic regurgitation). The conduction defects are mostly intraventricular among stenosis isolated or associated to regurgitation and mostly atrio-ventricular among pure aortic insufficiencies. The highest incidence (30%) being found in patients with bacterial endocarditis acute or healed. The incidence of conduction disturbances increases with age, with the presence of valvular calcifications, of left ventricular strain or failure, of coronary insufficiency and angina... practically with the duration and the severity of the valvular disease. Surgical risk is heavier and natural prognosis poorer in valvulopathies with conduction disturbances. But these disturbances never contraindicates surgery : it is sometimes necessary to insert a pacemaker with or without valvular replacement mostly in aortic stenosis with infrahisian conduction defects. During hemodynamic investigation of such cases one must be ready to stimulate the heart, particularly during right heart catheterization of patients with complete left bundle branch block.

Adult↗