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Biomedical subjects

J Bensaïd

Publications and source records attributed to J Bensaïd.

At least 19 recordsLinked to original sources
PubMed1996

[Efficacy and tolerability of trandolapril in overweight hypertensive patients].

An open multicentre study, performed in 340 overweight (body mass index: BMI > or = 25), hypertensive (95 mmHg < or = DBP < 115 mmHg) patients, evaluated the clinical and metabolic safety of trandolapril and confirmed its antihypertensive activity. After a two-week washout period, the patients received trandolapril 2 mg as a single morning dose for 12 weeks. Doubling of the dosage was authorized after the first four weeks when the DBP remained higher than 90 mmHg with a fall in DBP < 10 mmHg. Of the 287 patients who completed the study, 15.1% had to receive a double dose of trndolapril during the second treatment period. After four weeks of treatment, SBP was decreased by 18.6 mmHg, DBP was decreased by 13.4 mmHg and 63.1% of patients were controlled. After three months of treatment, SBP was decreased by 23.3 mmHg, DBP was decreased by 16.8 mmHg and 84.7% of patients were controlled. Subgroup analysis, according to the BMI (BMI > or = or < 30), showed that the fall in blood pressure was identical regardless of the BMI; the proportion of patients treated with a double dose of trandolapril was also independent of the BMI. A second subgroup analysis, according to the waist/hips ratio, did not reveal any difference according to the android or gynoid profile of excess weight. Twelve patients (3.9%) dropped out of the trial because of adverse events, 10 of which were attributable to treatment; 6.5% of patients reported an adverse effect attributable to treatment. Laboratory assays performed before and after three months of treatment demonstrated the very good metabolic safety profile of trandolapril, in view of the slight but significant reduction of total cholesterol, triglycerides and blood glucose. However, an average weight loss of one kilogram was reported. The global safety was considered to be good or excellent by the investigators in 94.8% of cases.

Adult↗
PubMed1992

[Exercise echocardiography in coronary disease].

Exercise echocardiography is a new method used in the investigation of coronary disease. It evaluates the repercussions on regional contractile function of the increase in oxygen consumption induced by physical exercise. It makes it possible to analyse in real time not only the amplitude of endocardial displacement, but also that of parietal thickening and thereby seems to be more precise than conventional ergonomic tests in the diagnosis of myocardial ischaemia. Its recent development owes much to the advent of digital technologies which make it easier and more accurate to interpret the changes observed in left ventricular regional kinetics by comparing the data at rest with those recorded at peak physical effort. When associated with an equally non-invasive ergometric test it is well accepted by the patients. Another of its advantages is its moderate cost. Echocardiographists must devote as much time as necessary to training. Training is indispensable to rapidly capture the images, particularly during efforts, and to reliably interpret the variations observed in left ventricular wall contraction. Exercise echocardiography is still under evaluation. Experience is lacking for the cardiologist to choose, only on its results, the most appropriate treatment for each individual patient, but its help will be appreciated in some difficult therapeutic decisions. Behind this phase of training for, and evaluating this technique several of its main clinical indications can already be outlined.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1991

[Dissecting aneurysms of the aorta: from causes to therapeutic indications].

In its acute phase, aortic dissection (a term that is now preferred to dissecting aneurysm of the aorta) is a medico-surgical emergency. The diagnosis is suspected on clinical data: intensive thoracic pain with recently appeared diastolic murmur and abolition of a peripheral pulse, contrasting with an electrocardiogram that is either normal or not suggestive of acute coronary thrombosis. It is confirmed by imaging methods, notably echocardiography and/or angiography. These methods, rapidly performed in all circumstances, provide the surgeon with useful information on the size and extent of the dissection and on its complications. Surgery still is the only effective treatment of dissections involving the ascending aorta. In dissections of the descending aorta it may or may not be envisaged, depending on the results of medical treatment. In chronic aortic dissections, which may have a long course, surgery is not mandatory, byt it is necessary in case of mediastinal compression or severe aortic insufficiency.

Acute Disease↗
PubMed1991

[Echocardiography: a quantitative evaluation method of ventricular remodeling].

Left ventricular remodeling consists of changes in size and geometry of the left ventricular cavity associated with changes in wall thickness. These changes occur in different conditions such as during growth, pressure or volume overload or after myocardial infarction. Echocardiography in M or two dimensional modes provides a means of evaluating global and regional left ventricular function and of measuring variations of wall thickness during the cardiac cycle. Using mathematical models in the parasternal (surface-length method) or apical views (Simpson's method) of the left ventricle, the end diastolic and end systolic volumes and ejection fraction can be calculated with reasonable accuracy, so enabling detection of spontaneous or therapeutically-induced variations of clinical significance. The extent of the akinetic or dyskinetic myocardium can be compared with the diastolic perimeter and expressed as a percentage value. This parameter is one of the quantitative values for expressing "expansion" of the necrosed segment and the changes occurring in the non-infarcted areas. M-mode echocardiography more than the two dimensional mode enables measurement of wall thickness and calculation of myocardial mass, providing the clinician with an assessment of myocardial hypertrophy and its relation to left ventricular chamber size (wall thickness/LV radius ratio). Of the different available methods of cardiac imaging, echocardiography is the most widely used because it is non-invasive and can be used repetitively to document the progressive changes in size and wall thickness of the left ventricle, known as "remodeling".

Cardiomegaly↗
PubMed1991

[Mitral valve prolapse: a benign abnormality?].

Mitral valve prolapse should be considered a benign condition as there are few complications. The natural history is not significantly different to that of a matched control population. There are potentially severe forms of the condition which are mainly observed in specialised centres and this introduces a bias in patient selection when compared with the general population. These forms are relatively rare in clinical practice and can be easily identified by simple echocardiographic criteria of valvular thickness. In any case, patients with mitral valve prolapse should be reassured in order not to create or unduly increase anxiety which in itself may cause incapacity.

Arrhythmias, Cardiac↗
PubMed1990

[Doppler echocardiography in myocardial infarction and its complications].

Echocardiography has established an important role in the surveillance of patients with myocardial infarction. Segmental wall motion abnormalities are easily identified and their extension reflects the size of the infarct. Global left ventricular function may be assessed and left ventricular dilatation documented. This information is useful in evaluating the long-term prognosis. In addition, Doppler echocardiography is valuable for detecting complications persisting or occurring after the acute phase such as pericardial effusion, mural thrombus, aneurysm or mitral regurgitation. The indications of Doppler echocardiography should be guided by the symptomatology and the results of clinical examination.

Coronary Disease↗
PubMed1989

[Clinical application of echocardiography using a transesophageal approach].

Transesophageal echocardiography is a new method of cardiac imaging with well-defined indications. In view of the absence of hindering anatomical obstacle between the probe and cardiac structures, the images obtained are of high definition, especially as regards the atria and atrial appendages, the mitral, aortic and tricuspid valves and the thoracic aorta. Being easy to perform and little traumatic, this method can be used in ambulatory patients. It is also valuable in intensive care patients and in the peri-operative period. Transesophageal echocardiography is primarily indicated to explore cardiac valve prostheses, notably those of the mitral valve, to identify vegetations and abscesses in infective endocarditis, to detect intra-atrial tumours and thrombi, to evaluate dissections of the aorta, to study the mechanism of mitral regurgitation, to investigate some congenital cardiopathies in adults, such as interatrial septal defects, and to monitor left ventricular function before and after surgery. Owing to its major contribution to the diagnosis of these potentially dangerous diseases, it should soon become a very useful and even indispensable complement of transthoracic exploration in certain cases.

Aortic Diseases↗
PubMed1988

[Left ventricular ejection impediment during mitral valve replacement. Apropos of a case after insertion of a Carpentier-Edwards bioprosthesis].

Left ventricular ejection impediment is one of the complications of mitral valve replacement, especially in case of isolated mitral stenosis with small left ventricle. The use of a "low profile" valve does not prevent this complication. The diagnosis is based on catheterization but the advent of the ultrasound-Doppler may make it easier.

Bioprosthesis↗
PubMed1988

[Obstacle to left ventricle ejection after mitral valvular replacement with a Carpentier-Edwards bioprosthesis. Apropos of 2 cases].

Impairment of the left ventricular ejection induced by a mitral prosthesis remains an infrequent complication, perhaps because it often is unrecognized. This complication would mainly be seen with ball prostheses or standard bioprosthesis used in mitral valve replacements with a small ventricle. Two cases have been recently reported during mitral valve replacement. The two patients were successfully re-operated upon, one after five weeks and the second immediately after the first procedure. A review of the literature enable to specify the etiology and diagnostic criteria with the assistance of Doppler-sonocardiography. Early re-operation may prevent death, often due to a post-operative myocardial dysfunction.

Bioprosthesis↗
PubMed1987

[Automatic quantitative analysis of myocardial tomography thallium-201 scintigraphy].

An automatic and quantitative analysis method for tomographic scintigraphy was applied to 104 patients with myocardial infarction (anterior 37, inferior 67, lateral 20, involving 2 territories in some cases). All patients underwent exercise and redistribution scintigraphy and coronary arteriography which served as reference. Two types of tomographic sections were used: 2 short axis sections exploring the left ventricle at different levels, and 1 apical section at a right angle with the first ones. A circumferential analysis program studied the isotopic activity of each section and drew an activity profile curve which was compared with those obtained in normal subjects. Exercise curves proved superior to redistribution and wash-out curves and were therefore used exclusively. Two sectoring methods for territories with infarcts were defined: conventional sectoring, which gives a 90 degrees angle to the anterior region and a 180 degrees angle to the inferior lateral region, and real sectoring established from the scintigraphic abnormalities observed in patients whose infarction was not accompanied by significant lesions in other territories. Real sectoring divides the territory into two regions (anterior and infero-lateral) and determines the extension territory and the territories specific to each necrotic region. The sensitivity and specificity of these two methods for the diagnosis of necrosis and the detection of a significant abnormality (greater than 70% stenosis, or necrosis) in a territory other than the one with infarct were compared. In the diagnosis of infarction: conventional sectoring sensitivity 92%, specificity 46% for anterior infarcts, 94% and 25% for inferior and lateral infarcts; real sectoring 94% and 63% respectively for anterior infarcts, 92% and 68% for inferior infarcts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

[Short and intermediate-term hemodynamic study at rest and during exercise of cardiac insufficiency treated by captopril].

Administration of 25 mg of captopril to 10 patients with heart failure (NYHA II, III) produces at rest after 60 min bradycardia (-7 per cent, p less than 0.01), hypotension (-8 per cent) and improvement of the preload (-30 per cent, p less than 0.01). This effect is still apparent after two months of treatment where PAP is decreased by 20 per cent (p less than 0.05). A prolonged effect of captopril is present in these 10 patients. The capacity to perform a muscular exercise on an ergometric bicycle is prolonged by 10 per cent (p less than 0.01) on the first day and by 18 per cent (p less than 0.01) after two months of treatment. This improvement seems to be related to improvement of the hemodynamic parameters, especially of preload indices. In 5 patients, lactacidemia, the arterio-venous difference and the extraction coefficient of O2 were studied at rest and during exercise. No significant difference are noted after the treatment with the inhibitors of conversion enzymes.

Adult↗