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Biomedical subjects

C Le Feuvre

Publications and source records attributed to C Le Feuvre.

80 records · Page 5Linked to original sources
PubMed1989

[Drug-induced cardiovascular complications].

Many drugs, including those prescribed in cardiology, can induce adverse cardiovascular side effects. Most of the anti-arrhythmia drugs have a negative inotropic action and proarrhythmic effects. Estroprogestative contraceptive drugs favor thromboembolitic events and increase the incidence of hypertension. Due to the risk of coronary insufficiency, substitutive hormonotherapy in hypothyroidism must be introduced gradually. Tricyclic anti-depressive drugs and neuroleptics can induce orthostatic hypotension. However, all these adverse effects can usually be avoided if every drug-specific contra-indication is respected, if doses are individually adjusted to the patient's age and physical condition and if the patient is closely monitored.

Anti-Arrhythmia Agents↗
PubMed1989

[10-year outcome of aortocoronary bypass. Apropos of a consecutive series of 114 patients].

The cases of 114 consecutive patients undergoing saphenous vein coronary bypass surgery over 10 years ago were reviewed. The perioperative mortality was 2.6% and the incidence of non-fatal myocardial infarction in the same period was 6.1%. The 10 year survival rate was 80%; the most important prognostic factor for survival was left ventricular function (89% vs 51%; p less than 0.001). Other significant prognostic factors were the degree of revascularization (p less than 0.05) and the severity of the coronary artery disease (p less than 0.05). The incidence of recurrent ischaemia during follow-up depended mainly on the quality of myocardial revascularisation (p = 0.003). Taking into account the high proportion of patients with single vessel disease in this series (38.6%), our results were comparable with other reported studies of the same subject and the same period (1970-1976).

Adult↗
PubMed1988

[Annulo-ectasing disease of the aorta: apropos of 10 cases].

Ten patients were investigated and operated for severe aortic regurgitation due to dystrophic aortic dilatation. This is the third commonest cause of pure aortic regurgitation (18 p. 100) operated at Necker Hospital during the same period. This condition, comprising aneurysm of the ascending aorta, dilatation of the aortic ring and dystrophic aortic valves, is often responsible for severe aortic regurgitation and is noteworthy because of the associated risk of aortic dissection. Cardiovascular surgery is indicated and usually includes replacement of the ascending thoracic aorta with aortic valve replacement.

Adult↗
PubMedDate not supplied

Late results with bioprosthetic valves in the elderly.

AIM: We report the long-term outcome of aortic and mitral bioprostheses in patients over 65 years of age at the time of implantation. The aim was to determine actuarial patient survival, causes of death, and the rate of documented primary structural deterioration. METHODS: One hundred ten patients > or = 65 years of age (mean, 73.4; range, 65-82) underwent successful bioprosthetic valve replacement (aortic, n = 71; mitral, n = 32; both, n = 7) from 1979 to 1985. The valve was pericardial in 39 cases and porcine in 78. The mean follow-up was 8.5 years (101.9 months-total; 934 patient-years; range, 2 months to 15 years). RESULTS: Actuarial patient survival was 79.6% (71-86) at 5 years and 62.4% (52-71) at 10 years. Forty-four patients died, 21 from valve-related causes and 23 from other causes. Thirteen patients (11.8%) had reoperation for valve-related complications: 10 structural deteriorations, 2 paravalvular leaks, and 1 case of endocarditis. One surgical death occurred (7.7%). Twenty-six percent of the patients were receiving anticoagulants because of atrial fibrillation, and 6.4% developed severe bleeding (2.9% patient-years). CONCLUSIONS: Long-term follow-up of these patients > 65 years of age, undergoing bioprosthetic value replacement surgery revealed a low rate of documented primary structural deterioration (0.95% per patient-year), a low mortality rate on reoperation (7.7%), and a high mortality rate due to non-value-related causes (52.3%).

Aged↗
PubMedDate not supplied

[Comparison of clinical and ambulatory measurements of blood pressure with benazepril alone or combined with hydrochlorothiazide in hypertension].

The aim of this study was to analyse the respective values of clinic and ambulatory blood pressure measurements in patients with treated hypertension. Twenty-eight patients with mild to moderate hypertension were studied (clinic blood pressure > or = 160/95 mmHg), treated with benazepril alone (n = 7) or combined with hydrochlorothiazide (n = 21). A 24 h ambulatory blood pressure measurement was performed before (d0) and after 8 weeks of treatment (d56). The treatment was effective on the ambulatory blood pressure in 19 patients (Staessen criteria) and effective on clinic measurements in 20 patients (WHO criteria). The results were concordant in 25 of the 28 patients. The decrease of the ambulatory blood pressure values during the day between d0 and d56 was not significantly related to the decrease of the clinic values. The comparison of the ambulatory blood pressure values at each hour between d0 and d56 showed that the treatment was effective during 24 h. The 'white coat' effect has been evaluated at d0 and d56 by the difference between mean daytime ambulatory blood pressure and clinic values. Clinic values were higher than mean daytime ambulatory values in benazepril (14 +/- 12 mmHg and 7 +/- 7 mmHg for the systolic and diastolic pressure) and benazepril-hydrochlorothiazide group (12 +/- 12 mmHg and 0.2 +/- 9 mmHg for the systolic and diastolic pressure). This 'white coat' effect was not modified during the treatment. Previous studies have emphasized a better assessment of the cardiovascular risk with ambulatory than with clinic measurements. The differences in the assessment of the efficiency of the treatment between clinic and ambulatory measurements shown in our study prompt us to use ambulatory measurements in patients with apparently uncontrolled hypertension.

Adult↗
PubMedDate not supplied

[Prospects of prevention of restenosis after coronary angioplasty].

The prevention of restenosis after coronary angioplasty has been marked over recent years by the failure of trials of drug treatment based on inhibition of arterial smooth muscle cell proliferation. This failure could be due to an insufficient concentration of the orally or intravenously administered drug in the lesion to be treated. Another reason for this failure of drug treatment could be the nonexclusive role of intimal hyperplasia in the pathophysiology of restenosis, which also appears to be related to a education of the overall calibre of the artery at the site of dilatation. The pathogenesis of this phenomenon, called "remodelling", remains obecure and is only partly prevented by insertion of stents, which is currently the only treatment able to decrease the number of new revascularization procedures for restenosis. This benefit is related to optimization of the initial result (stents avoiding early "recoil", secondary to the elastic recoil forces of the arterial wall), and possibly to prevention of late remodelling of the vessel at the site of dilatation, either tonic (vasomotor) or trophic. On the other hand, the benefit related to the absence of "remodelling" of the stended lesions is partly limited by intimal hyperplasia, exacerbated by the presence of the stent. The future therapeutic strategy could combine insertion of stents and prevention of smooth muscle cell proliferation by new treatment strategies acting at the molecular level. Encouraging preliminary results have already been obtained in animals with chimeric toxins, antisense strategies and especially gene therapy using defective adenoviral vectors for replication.

Angioplasty, Balloon, Coronary↗