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Biomedical subjects

D Marcadet

Publications and source records attributed to D Marcadet.

6 recordsLinked to original sources
PubMed1985

[Detection of anterior interventricular involvement after primary posterior wall infarct].

Forty-five patients (average age 53.3 +/- 9.4 years) underwent exercise stress testing coupled with exercise myocardial scintigraphy and right heart catheterisation on exercise during the 3rd week after primary posterior wall infarction. Coronary angiography and ventriculography were carried out 24 to 48 hours later. Significant (greater than or equal to 75%) left anterior descending disease was present in 9 patients (Group I) and absent in 36 patients (Group II). Tolerance of maximal exercise stress testing was good in all patients. The results were uninterpretable in on third of the cases because the theoretical maximal heart rate was not attained. No significant difference was noted between groups I and II with respect to: mean age, percentage of theoretical maximal heart rate attained, mean pulmonary capillary pressures at rest and during exercise, basal and exercise cardiac index, end diastolic index and angiographic left ventricular ejection fraction. The sensitivity and specificity for the detection of LAD disease were 80% and 84% for the exercise stress testing (n = 30), 44% and 75% for exercise right heart catheterisation (n = 30), 60% and 92% for exercise myocardial scintigraphy (n = 30), 100% and 75% for combined exercise stress testing and myocardial scintigraphy (n = 30) and 78% and 64% for combined exercise stress testing and myocardial scintigraphy and exercise right heart catheterisation (n = 45). These results show that in patients capable of performing maximal exercise stress tests, the best method of early detection of significant LAD disease after primary posterior infarction was combined exercise stress testing and exercise myocardial scintigraphy. These investigations are useful for the selection of candidates for coronary angiography.

Adult↗
PubMed1985

[Exercise test coupled with thallium-201 myocardial scintigraphy after a primary posterior wall infarct. Apropos of 123 patients subjected to coronarography].

The following investigations were performed in 123 patients (118 men and 5 women) with an average age of 51 +/- 6 years, between the 3rd and 6 week after primary posterior infarction, a standard exercise stress test on a bicycle ergometer coupled with Thallium 201 myocardial scintigraphy, followed by coronary angiography in the following 15 days. The object of these investigations was to detect severe stenosis (greater than 70%) of the left anterior descending artery and 50% stenosis of the left main stem. Thirteen investigations could not be interpreted because of a submaximal exercise stress test which did not attain 85% of the theoretical maximal heart rate. The sensitivity of exercise stress testing was 73% and that of myocardial scintigraphy 71%. On the other hand, the specificity of scintigraphy was 94% compared to 68% for exercise stress testing. The predictive value of a positive scintigraphy was 88% compared to 47% for stress testing. However, the predictive value of a negative test was similar with both techniques (87% for exercise stress testing, 90% for scintigraphy). When all the positive results were considered, the sensitivity was 93% but the specificity only 66%. The simplest and most rational way of exploiting the information provided by these investigations is to combine the results: when they are concordant they indicate the true diagnosis in 90% of cases. Discordant results pose a more difficult problem with myocardial scintigraphy being the more reliable: its positive predictive value was 71% when exercise stress testing was negative; its negative predictive value was 87% when exercise stress testing was positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Exercise myocardial scintigraphy for the positive and topographic diagnosis of coronary disease. Study in 115 patients without antecedents of myocardial infarction].

In a group of 53 subjects (prevalence of the disease = 91%), the sensitivity of stress myocardial scintigraphy is lower (66%); the predictive value of a negative SMS is only 28 per cent: these results can be explained by the clinical profile of the subjects included in this group (men with an average age of 50 with typical effort angina), but also by the high incidence of one vessel stenoses of the right coronary artery or the circumflex artery (19/35) which are less accessible to SMS. For the series as a whole, the combination of the two tests provided optimal results: double positivity (SMS+/stress ECG+) has a predictive value of 97 per cent; double negativity (SMS-/SE-) corresponds to 83 per cent true negatives. Furthermore, the combination of SMS+/SE+ is suggestive of more severe coronary disease (defined by the presence of a tight stenosis of the IVA or multi-vessel disease). Such severe disease is encountered in less than 7 per cent of cases when the two tests are negative.

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