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Biomedical subjects

G Drobinski

Publications and source records attributed to G Drobinski.

160 records · Page 9Linked to original sources
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[Hemodynamic effects of quinacainol administered via an intravenous route. Study in patients with normal left ventricular function].

The haemodynamic effects of a new antiarrhythmic drug quinacainol (RP 54272) were evaluated in 12 untreated patients with normal left ventricular function referred for diagnostic cardiac catheterisation. The haemodynamic data were obtained before, 5 and 25 minutes after the injection of the drug (0.21 mg/kg/min during 6 minutes). A slight decrease of cardiac contractility indexes was constantly observed: dp/dtmax decreased (-15%) in all patients (p less than 0.05), with no concomitant change of left ventricular pressure or left ventricular end diastolic volume with respect to control values. Cardiac output and left ventricular ejection fraction did not change significantly. Heart rate increased in all patients from 74.3 +/- 9.8 to 79.9 +/- 8.6 beats per minute after 5 minutes (paired t test p less than 0.05), and was 79.8 +/- 9.0 beats per minute after 25 minutes. Systemic arterial resistance increased in 7 patients due to a reflex adrenergic discharge. The interpretation of the haemodynamic data was difficult in 3 cases due to systemic vasodilatation, which was poorly tolerated in one patient. The contribution of vagolytic reaction and adrenergic reaction to the negative inotropic effects of the drug must be evaluated before giving in to patients with impaired left ventricular function.

Adult↗
PubMedDate not supplied

[Absence of an anti-ischemic effect of the peripheral benzodiazepine receptor antagonist PK 11195. Study by atrial stimulation in man].

We investigated the anti-ischemic effects of PK 11195 (RP 52028), a selective ligand for peripheral type benzodiazepine binding sites in man. In a first series of patients, we did not find any hemodynamic effect of 10 mg (8 patients) or 20 mg (8 patients) of the intravenously administered drug. The anti-ischemic effect was evaluated on 16 patients with coronary heart disease and a positive stress test in a double blind study of 20 mg of intra-venous PK 11195 (8 patients) versus placebo (8 patients). Ischemia was induced by pacing, and assessed by ST segment depression and lactates extraction before and 15 minutes after administration of the drug. No statistical differences could be found on these ischemia indices between the placebo and PK 11195 treated groups. Although experimental studies have shown interaction of the drug with the calcium channels, our study did not demonstrate any anti-ischemic effect with the dosage used.

Adult↗
PubMedDate not supplied

[Early postoperative thrombosis of an aortic Saint-Jude prosthesis. Success of fibrinolytic treatment].

We are reporting the case of a 63 year-old woman presenting an early thrombosis of a mechanical aortic Saint-Jude prosthesis, on the 21st post-operative day, following an insufficient anti-coagulant treatment and discovered by the presence of a well tolerated murmur of aortic insufficiency. The treatment consisted in fibrinolysis using urokinase, administered intravenously at a dose of 4,400 IU/kg/hour, for 12 hours. The clinical, ultrasound and radiocinematographic control performed on the 75th day, were normal; the patient, at that time being treated with anti-vitamin K and platelets anti-aggregates. No complication was observed. This case demonstrates the advantages of fibrinolytic treatments in early thrombosis following insertion of a valvular prosthesis.

Aortic Valve↗
PubMedDate not supplied

[Criteria of selection of mitral valve prolapse truly pathological].

Considering the high frequency of mitral valve prolapse in the general population and the frequent errors concerning its diagnosis, we have attempted to select a few criteria in order to differentiate the forms which are really pathological. This selection, in light of the data from the literature, is based on the clinical context and ultrasound results.

Echocardiography↗
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[Acute myocarditis disclosing leptospirosis].

A 44 year old patient presents with acute myocarditis and cardiogenic shock. The evolution is progressively favorable at the price of a residual involvement of the left ventricular function, evolving to a dilated cardiopathy, within three years. The responsibility of an advanced ictero-hemorrhagic leptospirosis is established. The severity of this myocarditis and the revealing characteristics of the leptospirosis are peculiar to this observation which is discussed in terms of data from the literature.

Acute Disease↗
PubMedDate not supplied

[Right coronary ostial stenosis in homozygotic hypercholesterolemia. Coronarographic and echocardiographic diagnosis].

Ostial stenosis of the right coronary artery was discovered in 2 patients with homozygous familial hypercholesterolaemia. The lesion was confirmed in one case at post-mortem examination and in the other case by cross-sectional echocardiography. In both patients the stenosis could not be visualized at coronary arteriography when the right coronary vessel was selectively injected, but the lack of reflux of the contrast medium into the aortic sinus proved very useful for the diagnosis. To recognize this sign is important since the other criteria of ostial stenosis are not always present, notably in essential hypercholesterolaemia where post-stenosis dilatation is absent due to diffuse parietal lesions of the arteries. In addition, ostial stenoses are associated with a characteristic stenosis localized to the proximal aorta above the coronary ostia. Owing to the dangers of overlooking ostial stenoses, echocardiography and aortography should be performed before coronary arteriography, and the lack of reflux of the contrast medium should be acknowledged as a diagnostic sign.

Adolescent↗
PubMedDate not supplied

[Echographic evaluation of the severity of aortic stenosis in cases with associated mitral stenosis].

The echocardiographic findings of six patients with pure mitral stenosis associated with pure aortic stenosis were compared with the findings from a series of ten cases of pure aortic stenosis without mitral disease. Each patient also underwent haemodynamic studies in order to quantitate the severity of the stenoses. The aortic stenosis was of the same degree of severity in both series (0.71 +/- 0.24 cm2 and 0.73 +/- 0.16 cm2). The systolic separation of the aortic valve was greater than 1 cm in 4 of the 6 cases on echocardiography, corresponding to a false negative of tight aortic stenosis. This appearance corresponded to a doming of the aortic valve on 2D echocardiography. The wall thickness was significantly less in the AS + MS series than in pure SA series (1.13 +/- 0.13 cm compared with 1.52 +/- 0.21 cm; p less than 0.01). The wall was found to be thicker, the tighter the MS. Overall, the diagnostic criteria of the severity of AS on echocardiography (restricted opening of the valve and the severity of ventricular wall hypertrophy) were absent in the association of AS + MS. The absence of myocardial hypertrophy can not be fully explained. It could be related to a decreased filling on the left ventricle and therefore a smaller systolic ejection volume because of the mitral obstruction.

Aortic Valve Stenosis↗