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C Guerot

Publications and source records attributed to C Guerot.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Significance of exercise-induced arrhythmias].

Four personal cases of exercise-induced conduction defects occurring during stress testing are reported. The significance of these changes is discussed in the light of the authors' observations and of the cases published in the literature. The development of atrioventricular block is usually related to pre-existing disease of the conduction system, whilst left anterior or posterior hemiblock is usually due to transient ischaemia related to significant stenosis of the coronary artery responsible for the vascularisation of the relevant bundle branch (usually a proximal stenosis of the left anterior descending artery). Complete left bundle branch block may be due to a number of conditions (including chronic ischaemic heart disease).

Aged↗
PubMed1988

[Influence of the distribution of collateral circulation on left ventricular segmental kinetics].

Correlations between left ventricular segmental kinetics and collateral circulation patterns were studied in 292 patients with coronary disease (182 women, 274 men: mean age 54 years). Left ventricular segmental kinetics were analyzed qualitatively by angiography (10 segments were individualized on RAO and LAO projections) and rated as normal, hypokinetic, akinetic or aneurysmal. The type of collateral circulation observed (contralateral, homocoronary and homolateral) and the number of collateral vessels were recorded. Collateral circulation was present in 49 p. 100 of the patients and in 29 p. 100 of the 587 pathological arteries (i.e. more than 50 p. 100 stenosis) identified. 89 p. 100 of the occluded arteries were revascularized by collateral circulation, the latter being effected by 213 collateral vessels (mean: 1.41 +/- 0.36 vessel per occluded artery). Collateral circulation through 1, 2 or 3 collateral vessels was noted in 62 p. 100, 35 p. 100 and 3 p. 100 respectively of the cases. Collateral circulation was contralateral in 51 p. 100, homocoronary in 33 p. 100 and homolateral in 16 p. 100 of the cases. Normal or hypokinetic segments in the territory of an occluded artery were more frequent in the presence (43 p. 100) than in the absence (31 p. 100) of collateral circulation, but the difference was not significant. They were also more frequent in three-vessel patients (59 p. 100) than in one-vessel (21 p. 100; p less than 0.01) or two-vessel (37 p. 100; p less than 0.05) patients in the presence of collateral circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Collateral Circulation↗
PubMed1988

[Prognostic factors in dilated cardiomyopathies].

One hundred and sixteen patients (mean age 46 years) with dilated cardiomyopathy documented by haemodynamic investigations and angiography with normal coronary arteriography were followed up for a mean period of 29 +/- 19 months. During that period, 36% of the patients died after a follow-up of 30 +/- 20 months. The actuarial death rates were 15% at 2 years, 45% at 6 years and 60% at 10 years. The main factors predictive of survival at 10 years were the clinical and haemodynamic markers of left heart failure. The death rate was multiplied by 1.6 in patients in stages III or IV of the NYHA classification (83% vs 51%, p less than 0.01), by 2.6 in patients with left ventricular end-diastolic pressure above 15 mmHg (73% vs 29%, p less than 0.01), by 2.2 when the indexed end-diastolic volume rose above 200 ml/m2 (75% vs 35%, p less than 0.01), by 2.2 when the left ventricular ejection fraction was below 40% (75% vs 35%, p less than 0.05) and by 2.6 when angiographic mitral valve regurgitation was present (75% vs 34%, p less than 0.01). The death rate at 9 years was 2.3 times higher in patients with left bundle branch block (72% vs 36%, p less than 0.05). A cardiothoracic index over 0.60 proved to be of poor prognosis at one year (death rate: 19%). While alcoholism played no part in the prognosis, the death rate in smokers was consistently higher than in non smokers (56% vs 32% at 6 years, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1986

Investigation of drug interactions with pinaverium bromide.

A series of studies was carried out at 6 centres to investigate possible drug interaction between the spasmolytic, pinaverium bromide, and cardiac glycosides, anticoagulants and hypoglycaemic agents given to patients as part of the long-term treatment of their condition. The results of clinical and laboratory investigations did not show any evidence of pinaverium bromide interfering with the action or activity of any of the drugs studied.

Acenocoumarol↗
PubMed1985

Total and unbound cortisol-, progesterone-, oestrone- and transcortin-binding activities in sera from patients with myocardial infarction: evidence for differential responses of good and bad prognostic cases.

Day-of-admission sera from myocardial infarction patients (MI) and patients with cardiopathies other than MI (non-MI) were analysed for total and unbound cortisol (F), progesterone (P4), oestrone (E1), and corticosteroid binding activities (CBG). The MI who survived (n = 28) showed high increases of F, P4 and E1 compared to healthy controls. By contrast, the MI who died within 10 days of admission (n = 6) had unchanged F and less increased P4 and E1 than survivors. The non-MI (n = 6) had higher F and E1 than controls but normal P4. The unbound steroids were increased in all patients: however, the MI who died showed much smaller rises than survivors (P less than 0.001 for unbound F and E1 increases in survivors vs. deceased). The CBG activity was in all MI lower than in normals (P less than 0.001) but unchanged in non-MI. These results are discussed in terms of the potential significance of unbound plasma steroids as predictors of MI severity.

Adult↗
PubMed1983

Intra-coronary thrombolysis with streptokinase or lys-plasminogen/urokinase in acute myocardial infarction: effects on recanalization and blood fibrinolysis.

Forty-two patients with total occlusion of a coronary vessel were treated with intracoronary fibrinolytic agents. Four therapeutic protocols were compared: group I received streptokinase (SK) as a continuous infusion; group II and III received SK as a bolus at different doses and group IV received lysplasminogen (Pg) plus urokinase (UK); maximal doses were 350,000 IU of SK and 250,000 IU of UK plus 75 microK of Pg. Thrombolysis was assessed by coronary angiography. Coagulation studies were performed prior to, 15 min and 6 hr after the end of the thrombolytic treatment. Recanalization was achieved in 27 of the 31 SK-treated patients (87%) and in 7 of the 11 Pg-UK-treated patients (63.6%). The recanalization frequency was the same in the three SK-treated groups, even though when SK was administered as a bolus, the dose was significantly less than when administered on a continuous infusion. Although systemic fibrinolysis occurred in all 4 groups of patients, this effect was less pronounced in the UK-treated patients than in the three SK-treated groups. This study also shows that recanalization can be achieved with a dose of SK lower than the anti-SK antibody level. Haemorrhagic side effects were minimal in all patients studied. Severe defibrination is usually considered a risk of haemorrhage. These preliminary results suggest that bolus injection of SK or the use of UK plus lys-Pg can reduce the level of defibrination and thus the haemorrhagic risk.

Adult↗
PubMed1982

[Intracoronary thrombolytic treatment in the acute phase of myocardial infarction (author's transl)].

Thrombolysis by intracoronary injection of streptokinase was attempted in 18 patients with recent myocardial infarction. Streptokinase was administered by continuous i.v. infusion or by repeated injections to a maximal total dose of 250 000 units. Complete recanalization was obtained in 13 out of 16 patients with total occlusion of one vessel confirmed by angiography of the coronary arteries. Pain was relieved in 12 of these 13 patients and there was immediate and significant reduction of the lesion current in 9. The treatment was well tolerated. Arrhythmias in an usually minor form (ventricular ectopy) may occur during thrombolysis. No haemorrhage has been reported. There is no systemic fibrolysis in most cases.

Acute Disease↗
PubMed1982

[Cardiac toxicity of ajmaline. Comparison of acute voluntary poisoning with complications of the ajmaline test].

A comparative and retrospective study of 59 cases of acute voluntary self-poisoning observed at the Toxicology Department of Fernand Widal Hospital, and 15 cases of complications of the Ajmaline test observed in the Cardiology Department of Bichat Hospital showed a similarity in the cardiac effects of high dosage regardless of the mode of administration of the antiarrhythmic. Acute suicidal poisoning in adults or accidental poisoning in children caused toxic effects at doses over more than Ig: they are characterised by their sudden onset after a latent period of 1 to 2 hours and their short duration (no effects after the 12th hour). The ECG changes included:--First degree atrioventricular block (15 p. 100).--Intraventricular conduction defects were observed in almost all cases. They were proportional to the dose taken and were of prognostic interes (no cardiac arrests when the QRS remained less then 0,2 sec).--ST-T wave changes were observed in all patients. They lasted longer and were of no prognostic importance.--Extrasystoles and ventricular tachycardia are nearly always associated with poor hemodynamic tolerance (70 p. 100 of cardiac arrests, compared to only 16 p. 100 in this absence). This intoxication is serious with a mortality of 24 p. 100 of the reported cases and of 9 p. 100 of cases admitted to an Intensive Care Unit.--The complications of the Ajmaline test were similar, the time of apparition being a few minutes instead of a few hours. There were no deaths or serious hemodynamic complications in this series. This is without doubt related to the observation of the contraindications and the fractional administration of the Ajmaline. We conclude that oral Ajmaline, though well tolerated at therapeutic does may cause severe toxic overdose effects. Although its use remains justified in the treatment of arrhythmias, it should not be used for the symptomatic treatment of palpitations and neurovegetative imbalance.

Acute Disease↗
PubMed1981

[Predictive value of the ajmaline test for the diagnosis of distal paroxysmal atrioventricular block (author's transl)].

An ajmaline test was conducted in 120 patients with a history of disorders of consciousness : Adams-Stokes syndrome (n = 49), loss of consciousness (n = 42), or lipothymia (n = 29). Four types of response were observed after ajmaline : VH less than 80 ms (n = 63); VH between 80 and 100 ms (n = 19); VH greater than 100 ms (n = 17); distal block (n = 21). One hundred and fifteen of these patients were followed-up for from three to six years (mean 56 months). Pacemakers had been fitted in 46 of them. Atrioventricular block was eventually detected in 37 patients but was excluded in the other 78 cases, either because the syncope attacks did not recur or because another cause was demonstrated. The predictive value of the ajmaline test was confirmed by the subsequent course of the disorders. Based on only clinical findings, diagnosis was confirmed in 42 p. cent, excluded in 12 p. cent, and impossible to define in 46 p.cent of cases. After the ajmaline test, diagnosis was confirmed in 79 p.cent, excluded in 6 p.cent, and impossible to define in 15 p.cent. The risk of atrioventricular block can be evaluated as 1-6 p.cent when the increase in VH is less than 80 ms, 35.3 p.cent when the increase is between 80 and 100 ms, 62.5 p.cent when it is greater than 100 ms, and 100 p.cent when there is a distal block. The indications for fitting a pacemaker depend upon the results of this test. If contra-indications are respected (recent history of an infarct, cardiac failure, marked enlargement of the heart), complications are rare, being observed in less than 3 p.cent of cases.

Aged↗