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Biomedical subjects

G Rouvinez

Publications and source records attributed to G Rouvinez.

5 recordsLinked to original sources
PubMed1996

Regional wall motion changes with dobutamine as a pharmacological stress test during cardiac catheterization in patients with significant coronary artery disease.

BACKGROUND: Preliminary study to test the feasibility of pharmacological stress testing during cardiac catheterization, thus combining anatomical and functional information. PATIENTS AND METHODS: 21 consecutive patients with known or suspected coronary artery disease, referred for diagnostic catheterization. Biplane ventriculography was performed before and during dobutamine infusion. The patients were subdivided into 3 groups: Group I (n = 11, 52%) with at least one territory supplied by a significantly stenosed coronary artery and showing normal resting regional wall motion. Group II (n = 6, 29%) patients in whom the affected vessel(s) supplied exclusively a territory with regional wall motion abnormalities at rest. Group III (n = 4, 19%) had no significant coronary artery disease and served as control. RESULTS: In group I, 9/11 (82%) patients and in group II, 3/6 (50%) patients showed either ischemia or viability reactions or both after dobutamine stress. Overall, substantial functional information was gathered in 12/17 patients (71%). Control patients showed no worsening of regional wall motion under dobutamine. Neither global left ventricular ejection fraction nor left ventricular end diastolic pressure were as accurate in detecting ischemia as regional wall motion analysis. In patients who had only ischemia and no viability reaction as judged by regional wall motion analysis, ejection fraction fell significantly in 4/6 (67%) patients; end diastolic pressure on the other hand rose significantly in 3/6 (50%). CONCLUSIONS: Dobutamine stress testing performed during cardiac catheterization is convenient, feasible and safe and yields clinically useful information in a high percentage (71%) of patients with significant coronary artery disease. Further experience is needed to evaluate the sensitivity, specificity and predictive value of this new approach.

Cardiac Catheterization↗
PubMed1995

[Cardioprotection in chemo- and radiotherapy for malignant diseases--an echocardiographic pilot study].

AIM: Pilot study, examining the cardioprotective effect of an antioxidant regimen in patients with malignancies receiving high dose chemo- or radiotherapy. PATIENTS AND METHODS: 14 patients with chemotherapy and 10 patients with radiotherapy were randomized in a double-blind fashion (placebo versus vitamin E and C and N-acetylcysteine). Systolic and diastolic echocardiographic parameters were determined before and within three weeks of treatment completion. RESULTS: Left ventricular ejection fraction fell significantly in patients receiving placebo (radiotherapy: 67 +/- 6 to 56 +/- 2%, p = 0.008, chemotherapy: 67 +/- 7 to 60 +/- 8%, p = 0.05). Patients on antioxidants showed no significant fall in EF (radiotherapy: 63 +/- 8 to 61 +/- 7%, chemotherapy: 67 +/- 5 to 64 +/- 6%). CONCLUSION: The small number of patients in the study precludes a definitive statement. The preliminary results, however, suggest efficient cardioprotection by this cheap and safe antioxidant combination, so that larger studies are warranted for confirmation.

Acetylcysteine↗
PubMed1994

[Cardiac interventions in Switzerland 1992. PTCA and Fibrinolysis Work Group of the Swiss Cardiology Association].

In 1992, 14,348 coronary angiographies were performed in Switzerland (2110 per 1 million population). This represents a 10% (+1332) increase over the previous year. About 50% were performed at university hospitals. Over the past 5 years, interventions for myocardial revascularization (coronary angioplasty [PTCA] and coronary artery bypass grafting [CABG] have increased constantly and nearly linearly. The increase from 1991 to 1992 was 8% (510) (PTCA: +18% [+469]; CABG: +1% [+41]). The PTCA/CABG ratio amounted to 0.9/1 for all Swiss hospitals. At university hospitals, angioplasty was performed more frequently than bypass grafting (PTCA/CABG 1.3/1) in contrast to the private hospitals (PTCA/CABG 0.4/1). More than a third of all revascularizations were performed in private hospitals. The increase in angioplasty is a consequence of an increase in coronary angiography and not of an increase in the percentage of multivessel PTCAs. This indicates that coronary artery disease is being diagnosed and treated more actively without necessarily adopting more aggressive PTCA indications. There was an obvious difference in morbidity and mortality rates, both after PTCA and CABG, between some private and public hospitals. The fact that public hospitals are obliged to accept high risk emergency cases is to their disadvantage. So is their more complete data collection, which reveals the actual incidence of complications more accurately.

Angioplasty, Balloon, Coronary↗