Biomedical subjects

H Lardani

Publications and source records attributed to H Lardani.

13 recordsLinked to original sources

PubMed1993

Experience with moderate intensity anticoagulation and aspirin after mechanical valve replacement. A retrospective, non-randomized study.

A selected group of patients who underwent valve replacement were analyzed to evaluate the feasibility, effectiveness and safety of combined treatment with moderate intensity anticoagulation plus aspirin. One hundred ninety-six patients who received a total of 204 mechanical valve prostheses between 1985 and 1991 were selected according to rigid criteria. The prostheses included 124 valves of caged ball design, 62 St. Jude valves and 18 others. The follow up of the whole population was 581.8 patient years, with an average of 2.97 patient years, and was complete by the definition criteria. All patients received moderate intensity anticoagulation with acenocoumarol (target International Normalized Ratio 2.5 to 3.5) and daily aspirin (100 mg or 325 mg). The incidence of thromboembolic events for the whole group was 3.26% per patient year, but only 1.6% in patients "compliant" with treatment. Preoperative embolism and non-compliance with treatment had a strong correlation with postoperative thromboembolism. The INR values had a strong correlation with both thromboembolic and hemorrhagic events. The incidence of serious hemorrhagic events was 4.12% patient years although only two cases (0.34%/pty) were fatal (cerebral hemorrhages). There was no difference in hemorrhagic incidence between patients receiving either 325 mg or 100 mg daily. A low incidence of thromboembolic complications was attained with the use of combined antithrombotic and antiplatelet therapy, even in the first generation caged ball type prostheses. However, the combination of moderate intensity anticoagulation with either 325 mg or 100 mg aspirin was associated with a risk of bleeding similar to high intensity anticoagulation alone. The risk of bleeding appeared to be greater in the presence of gastric pathology, and the combination of anticoagulants and aspirin should be avoided in patients with these conditions.

Acenocoumarol↗

PubMed1982

Effects of angiographic contrast medium on isolated canine coronary arteries.

In isolated canine coronary arteries previously contracted by high potassium concentration, angiographic contrast medium decreased active tension by 61 +/- 2%. The relaxant effect was dose dependent and was not prevented by beta-blockade with d-l-propranolol (10(-5) M). This effect was similar to that obtained with nitroglycerin (10(-6) M), and further relaxation was evident when this vasodilator was administered after exposure to the contrast medium. When arteries were precontracted by alpha-receptor stimulation with norepinephrine (10(-5) M) at normal potassium concentration, a maximal relaxation of 83 +/- 6% was elicited after exposure to contrast medium. The relaxant effect could not be reproduced by a similar increase in osmolarity brought about by addition of sucrose. When arterial strips were processed by radioimmunoassay for dosage of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) after the relaxing action of the contrast medium occurred, a decrease in cAMP from 2.61 +/- 0.86 to 0.63 +/- 0.1 pmol/mg protein (p less than 0.05) was observed, whereas no significant changes in cGMP were detected. These nucleotides do not appear to be involved in the relaxant effect of the dye in the same way as they are when relaxation is elicited by some other coronary vasodilators.

Animals↗

PubMed1978

Hemodynamics and coronary angiography in idiopathic hypertrophic subaortic stenosis.

One hundred eighteen patients with idiopathic hypertrophic subaortic stenosis were studied with cardiac catheterization and coronary arteriography. In 112 a gradient across the left ventricular outflow tract was present in the resting state. Seventeen of the 61 patients who had right heart catheterization had a mild resting gradient across the right ventricular outflow tract, that was considered clinically and hemodynamically insignificant. Ninety-five patients (80 percent) had a left ventricular end-diastolic pressure greater than 10 mm Hg; 60 percent had mitral regurgitation that was of mild degree in most cases. Almost 20 percent had coexistent coronary atherosclerosis (25 percent incidence rate in subjects aged 40 years or older). Patients with associated severe coronary atherosclerosis had a lower intraventricular gradient at rest than other patients. Coronary atherosclerosis appears to be a coincidental condition. The need for objective evaluation of the coronary circulation is emphasized.

Adult↗

PubMed1976

Ectopic origin of the left anterior descending coronary artery from the right coronary sinus. Report of a case simulating anterior descending obstruction.

A patient with anomalous aortic origin of the left anterior descending coronary artery was studied. The clinical picture and the preliminary angiographic findings simulated obstruction of the left anterior descending coronary artery near its origin. Careful catheter exploration of the right coronary sinus led to the correct diagnosis, emphasizing the importance of complete visualization of all branches of the coronary tree, including distal radicles of a supposedly occluded vessel.

Adult↗

PubMed1974