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D Chollet

Publications and source records attributed to D Chollet.

62 records · Page 4Linked to original sources

[Differential diagnosis between constrictive pericarditis and cardiac amyloidosis by computerized M-mode echocardiography].

A diastole is a non specific haemodynamic syndrome which may result from constrictive pericarditis or from a restrictive cardiomyopathy. The aim of this study was to differentiate these two types of condition by analysis of computerised M mode recordings of the left ventricle. Three groups of patients were studied: 5 cases of confirmed cardiac amyloidosis (Am); 5 cases of constrictive pericarditis confirmed surgically (CP) and 10 normal subjects (NL). The study was based on analysis of parameters of ventricular filling and of diastolic thinning of the LV free wall. A significant difference was observed between AM and CP but not between PC and NL. Amyloidosis was characterised by a reduction in the maximum velocity of endocavitary diameter lengthening (AM 0,84 +/- 0,56 cir/sec; PC 3,95 +/- 0,77, p less than 0,01), prolongation of the rapid filling phase (AM 0,42 +/- 0,17 sec; PC 0,16 +/- 0,06 sec, p less than 0,02) and a decrease in maximum velocity of free wall thinning (AM 0,45 +/- 0,23 th/syst/sec; PC 4,79 +/- 2,1, p less than 0,01). The diastolic thickness of the free wall was greater in the amyloidosis group (AM 1,73 +/- 0,61 cm; PC 1,05 +/- 0,21, p less than 0,05) and correlated with the reduction of maximum velocity of free wall thinning. Parameters of global diastolic filling did not distinguish the two conditions. The M mode recordings were therefore digitalised to provide graphs of chamber filling and wall thinning and their derivatives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Diagnosis and evaluation of isthmic coarctations of the aorta by bidimensional echocardiography].

Two cases of thoracic aortic coarctation seen on the suprasternal incidence of bidimensional echocardiography are reported. In one case, the observed echocardiographic image is an obstruction of the vascular lumen. In the other there is only reduction of the vascular calibre. In both cases, a complete examination of the aortic arch and its major branches, substrictural aortic region, and cardiac valves was obtained. The echographic results were concordant with those of the angiography, except for an underestimation of the severity of the thoracic stenosis in the second case, with the echography. An echographic post-operative control in the first case showed normalization of the vascular calibre in the isthmus region. Echocardiography allows visualization of thoracic aortic coarctations and examination of associated vascular and cardiac lesions. However, problems remain in the quantification of stenosis, which are inherent to the technique.

Adolescent↗

[Mitral systolic anterior motion and left ventricular function in obstructive cardiomyopathy].

The term hypertrophic cardiomyopathy with obstruction encompasses a wide range of clinico-pathological conditions. The mildest forms have localised septal hypertrophy and obstruction only during pharmacodynamic stimulation. The more severe forms have major wall hypertrophy and are obstructive under basal conditions. Mitral systolic anterior motion (SAM) recorded at echocardiography is generally attributed to obstruction. However, the construction of this image by subvalvular structures and the relationship between the obstruction and anatomical deformation led us to study left ventricular haemodynamics with respect to the presence or absence of SAM under basal conditions. Thirty one cases of hypertrophic obstructive cardiomyopathy were divided into 2 groups: -- Group 1 without basal SAM (11 cases); -- Group 2 with SAM under basal conditions (20 cases). Under basal conditions there was no significant difference in LVEDP or ventricular volume between the two groups. An intraventricular pressure gradient was commoner in Group 2 (65% compared to 27%) as was mitral incompetence (53% compared to 27% in the 30 patients undergoing selective left ventriculography). Left ventriculography in the right anterior oblique plane distinguished two types of LV deformation: systolic biloculation of the chamber and systolic apical obliteration. The second form was mainly observed in Group 2. The effect of isoproterenol on LVEDP was studied in 9 cases in Group 1 and 13 cases in Group 2: LVEDP decreased from 14 +/- 6 mmHg to 8 +/- 6 mmHg in Group 1, and increased from 14.5 +/- 6 to 23.5 +/- 6.5 mmHg in Group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Uncompensated care and hospital conversions in Florida.

Hospital conversions to for-profit ownership have prompted concern about continuing access to care for the poor or uninsured. This DataWatch presents an analysis of the rate of uncompensated care provided by Florida hospitals before and after converting to for-profit ownership. Uncompensated care declined greatly in the converting public hospitals, which had a significant commitment to uncompensated care before conversion. Among converting nonprofit hospitals, uncompensated care levels were low before conversion and did not change following conversion. The study suggests that policymakers should assess the risk entailed in a conversion by considering the hospital's historic mission and its current role in the community.

Florida↗