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Biomedical subjects

G Drobinski

Publications and source records attributed to G Drobinski.

At least 127 records · Page 7Linked to original sources
PubMed1983

[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↗
PubMed1983

[Long-term treatment of chronic heart failure by an inhibitor of angiotensin converting enzyme].

We studied the hemodynamic, echocardiographic, phonomechanographic and hormonal changes during acute (25 mg) and chronic (6 months--75 to 225 mg/day) treatment of 10 patients with congestive cardiac failure due to cardiomyopathy with dilatation with SQ 14 225 (Captopril). The following changes were observed after the single dose: an increase in cardiac output (p less than 0,001), in stroke volume (p less than 0,01), a reduction in heart rate (p less than 0,01), in peripheral resistance (p less than 0,001) and pulmonary capillary pressure (p less than 0,001). There were no significant changes in end systolic or end diastolic left ventricular internal diameter. Plasma renin activity increased (p less than 0,001); there was a concurrent fall in serum aldosterone (NS): the plasma concentration of converting enzyme decreased (p less than 0,001). There was a correlation between the increase in peripheral resistance under basal conditions and the basal plasma renin activity (R = 0,72, p less than 0,02). The decrease in peripheral resistance after captopril also correlated with basal plasma renin activity (R = 0,89, p less than 0,01). After six months continuous therapy, the hemodynamic effect was sustained and was accompanied by a significant symptomatic improvement. Left ventricular internal end systolic and end diastolic diameters decreased (p less than 0,01 and p less than 0,01 respectively). The pre-ejectional period decreased (p less than 0,05). Serum aldosterone fell significantly (p less than 0,001) as did plasma renin activity (p less than 0,01); the serum level of converting enzyme remained low with respect to its initial value. These results show that captopril may be useful in severe cardiac failure without tolerance during long-term administration. No renal or hematological toxicity was observed in this group of patients.

Adult↗
PubMed1983

[Calculation of the peak systolic wall stress at the equator of the left ventricle by coupled M mode echo and pressure recordings].

The peak systolic wall stress at the equator of the left ventricle (sigma max) is the maximum load that the myocardial fibres bear during contraction. It is an index of the adaptation of the left ventricle to cardiac disease, and, when elevated, it indicates cardiac decompensation. sigma max was calculated by coupled M mode echo-LV pressure recordings in 51 cases: 11 patients without LV disease, 14 patients with aortic stenosis (AS), 14 patients with aortic incompetence (AI), 7 patients with severe mitral incompetence (MI) and 5 patients with cardiomyopathy with dilatation (CMP). sigma max was calculated from Mirsky's formula, the length of the long axis being deduced from the short axis and the diastolic:systolic ratio of these two axes from ventriculography. The normal value of sigma max by this method is 220 dynes 10(3)/cm2 +/- 30 with an upper limit of normal of 280 dynes 10(3)/cm2. sigma max was normal in patients with AS and AI, and increased in the cases of MI and CMP, in positive correlation with LV volume (r = 0,47) and the shape of the LV (long:short axis ratio). No correlations were found between sigma max and maximum LV pressure. The relatively low values of sigma max compared to the results obtained from coupled echo-angio recordings are partly due to the thick walled LV model and, to a large extent, to the lower values of short axis when measured by echo compared to angiography.(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗
PubMed1983

[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↗
PubMed1982

Long-term treatment of congestive heart failure with captopril.

1 The efficacy of the converting-enzyme inhibitor captopril in the management of severe congestive heart failure was assessed in 14 patients over 360-885 days by clinical evaluation, M-mode echocardiography, systolic time intervals, plasma renin activity, and plasma aldosterone. 2 As compared with baseline values, a significant reduction was observed in heart rate, mean arterial pressure, left ventricular end-diastolic and end-systolic diameters, left ventricular pre-ejection period, tension time index, body weight, and plasma aldosterone. Significant increases in left ventricular ejection time and fractional circumferential shortening (p less than 0.01) were also observed. 3 The functional and haemodynamic benefit provided by captopril was therefore sustained during long-term therapy without severe untoward effects or attenuation.

Adult↗
PubMed1981

[Angiographic morphological study of the left ventricle in obstructive cardiomyopathy. Comparison with haemodynamic data (author's transl)].

The right anterior oblique ventriculographs of 20 patients with obstructive cardiomyopathy were reviewed, and the images obtained during systole were divided into three groups: (1) bilocular left ventricular cavity with midventricular stenosis; (2) obliteration of the ventricle reduced to its infra-sigmoidal portion, with atrophy or even amputation of the apical portion; and (3) subnormal image. Haemodynamically, the most common abnormality (5/8 patients) in group 1 was the presence of a gradient in the basal state. In group 2, this gradient was only found in 2/8 patients, but the left ventricular telediastolic pressure was much higher in the basal state or after stimulation than in group 1. Haemodynamic changes were moderate in group 3. The abnormalities in left ventricular telediastolic pressure in this type of cardiomyopathy are interpreted as reflecting disorders in compliance which would then be maximal in group 2. This study is part of an attempt to classify the various characteristics of the left ventricle with the view of identifying some forms amenable to surgical treatment.

Adult↗
PubMed1980

[Echocardiographic study of the effects of a nitroglycerin microcapsule preparation (author's transl)].

An echocardiographic study performed on 15 patients after administration of sublingual nitroglycerin showed a significant decrease in internal diameters of the left ventricle, associated with a moderate fall in blood pressure. A significant, but smaller decrease in diameters was also found 3 to 4 hours after oral administration of a nitroglycerin microcapsule preparation. The parameters measuring cardiac performance and the quality of myocardial contraction remained unchanged. The decrease in left ventricle internal diameters may be attributed to a reduction in pre-load and intraparietal ventricular tension. In addition, these results obtained by a non-invasive technique have confirmed the prolonged activity of nitroglycerin microcapsule preparations, previously demonstrated by hemodynamic and pharmacological experiments.

Adult↗