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J Lanfranchi

Publications and source records attributed to J Lanfranchi.

At least 19 recordsLinked to original sources
PubMed1998

Method for simultaneous measurements of traces of heptadeuterated cholesterol and cholesterol by gas chromatography-mass spectrometry: application in humans.

An assay was developed to quantify deuterated cholesterol (used as a tracer) and cholesterol using gas chromatography-mass spectrometry. Ergosterol and epicoprostanol were used as internal standards. Deuterated cholesterol was quantified by comparing its peak area to that of epicoprostanol and cholesterol to ergosterol. The mean absolute recovery in spiked serum was 99.96%; the precision was in the range 0.16-10.9% and accuracy 90.4-100%; the limit of detection in plasma was 3x10(-5) mmol l(-1). Using two internal standards, the method described herein seems particularly suitable for application in humans i.e., measuring traces of deuterated cholesterol (range: 0-6.26 x 10(-4) mmol l(-1)) along with natural cholesterol (range: 0.065-4.42 mmol l(-1)) in human plasma and lipid fractions postprandially.

Cholesterol↗
PubMed1998

[Plasma noradrenaline and the prognosis of chronic cardiac failure: a multicenter study].

Plasma noradrenaline is little used in evaluating the prognosis of cardiac failure because of the theoretical necessity of interrupting treatment for a few days before blood sampling. The present study reevaluated the prognostic value of this parameter with blood sampling performed during treatment and then 48 hours after withdrawal of treatment in 192 patients with chronic stable cardiac failure at an advanced stage (64% of patients in Classes III or IV with an average ejection fraction of 28.5 +/- 13.5%). During follow-up (average 43 months) there were 51 deaths and 17 transplants. None of the patients were lost to follow-up. Univariate analysis of 52 variable observers during the initial phase of evaluation found in decreasing order of predictive value for death plasma noradrenaline levels before and after withdrawal of treatment for 48 hours. Serum sodium, age, systolic mean and diastolic pulmonary artery pressures. In multivariate analysis: noradrenaline with or without withdrawal of treatment, hyponatraemia and systolic pulmonary artery pressure. Actuarial survival curves distinguished the following parameters: noradrenaline levels became predictive at concentrations of over 210 pg/mL and there was a significant difference in survival with respect to 4 levels of serum noradrenaline (with or without treatment) > 300 pg/mL, 300 to 600 pg/mL and > 900 pg/mL. This serum noradrenaline measured without withdrawal of treatment (especially angiotensin converting enzyme inhibitors) is a powerful predictor of mortality, carrying a progressively poorer prognosis as the concentration increases.

Adult↗
PubMed1995

[Calcium antagonists and treatment of chronic heart failure].

The history of the treatment of heart failure may be divided into three stages, the consequences of different conceptions of the physiopathology of the disease, with diuretics to counteract salt and water retention, vasodilators to improve conditions of cardiac load, angiotensin converting enzyme inhibitors to limit the effect of neurotumoral and sympathetic activation. There are two main reasons for using calcium antagonist in heart failure, the first being arterial vasodilatation leading to improve systolic function and the second being the beneficial effect on ventricular relaxation. However, their use has been controversial because of the results obtained with the first generation of these drugs. New molecules derived from dihydropyridine have been developed. Clinical trials with these second generation calcium antagonists are analysed.

Animals↗
PubMed1993

[Cardiomyopathies during acquired immunodeficiency syndrome].

Myocardial involvement in the acquired immunodeficiency syndrome is well established on clinical data, echocardiographic studies, macropathological findings and histological studies on autopsy or endomyocardial biopsy specimens. The condition may present with asymptomatic left ventricular dysfunction with a low ejection fraction, acute or subacute myocarditis or cardiac failure and dilated cardiomyopathy. A few cases of hypertrophic cardiomyopathy with HIV infection have also been reported.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Influence of the risk factors of atherosclerosis on the onset of early peri-operative complications in peripheral arterial surgery].

The influence of classical atherosclerosis risk factors (male sex, smoking, hypercholesterolemia, diabetes, overweight and hypertension on peri-hospital mortality and morbidity were studied in 83 patients (68 men and 15 women) aged 63 +/- 13 years and undergoing peripheral arterial surgery. None of these factors was statistically correlated with peri-operative complications with the exception of hypertension but the correlation was slight (0.5 less than p less than 0.10). In contrast, there was a powerful statistical (p less than 0.0003) link between age and morbidity and mortality associated with this type of surgery.

Aged↗
PubMed1990

Myocarditis in adult Still's disease.

An original case study of a myocardial involvement in a patient with adult Still's disease is presented. The fibrinoid necrosis appearance of a myocardial vessel is an unusual finding at histology.

Arthritis, Juvenile↗
PubMed1990

Factors predicting mortality in idiopathic dilated cardiomyopathy.

A study of factors predicting mortality was performed in 201 patients with dilated cardiomyopathy (163 men, 38 women, mean age: 48 +/- 11 years) by multivariate analysis (Cox Model) of 51 clinical, electrocardiographic, echocardiographic and haemodynamic parameters, 56 patients died during follow-up (mean follow-up: 57.1 +/- 29.9 months). 5 year survival was 77 +/- 3%. The following parameters were independent predictors of mortality: first symptom: pulmonary oedema, peripheral oedema, syncope; duration of symptoms at the time of inclusion; end systolic left ventricular volume; end diastolic left ventricular diameter; pulmonary artery systolic pressure; and their combination had the most accurate predictive value for death. A quantitative score (s) was calculated and used to define three subgroups: A:s less than or equal to 4.5; B: 4.5 less than s less than 6; C:s greater than or equal to 6. Five-year survival was 90 +/- 5% in group A; 84 +/- 4% in B and only 53 +/- 7% in C. In conclusion, overall survival was good in this population of all stage dilated cardiomyopathy; factors related to clinical severity, left ventricular dilation, systolic pulmonary artery pressure and duration of symptoms defined a subgroup of patients with poor prognosis.

Cardiomyopathy, Dilated↗
PubMed1990

[Analysis of predictive factors of mortality in dilated cardiomyopathy. A cooperative study by the Cardiomyopathy Working Group].

UNLABELLED: An analysis of factors predictive of mortality was undertaken in a group of 201 patients with dilated cardiomyopathy (163 men, 38 women; average age 46 +/- 11 years) using a multivariate analysis (Cox's model) of 51 clinical electrocardiographic, echocardiographic and haemodynamic parameters. The average follow-up period was 57.1 +/- 29.9 months. Fifty-six patients died and the probability of 5-year survival was 77 +/- 3 per cent. The best predictive factor of survival was determined by the combination of the following parameters: presenting symptom: pulmonary oedema, peripheral oedema, syncope; duration of symptoms before inclusion into the study; left ventricular end diastolic volume; left ventricular end diastolic dimension; systolic pulmonary artery pressure. A quantitative score "S" was calculated which enabled identification of 3 subgroups: A (S less than 4.5); B (4.5 less than S less than 6); C (S greater than 6). The probability of 5-year survival was 90 +/- 5 per cent in Group A, 84 +/- 4 per cent in Group B and 53 +/- 7 per cent in Group C. IN CONCLUSION: global survival was relatively long in this patient population with dilated cardiomyopathy at different stages of evolution; the combination of factors related to clinical severity, left ventricular dilatation, systolic pulmonary artery pressure and duration of symptoms allows identification of a subgroup of patients with a poor prognosis.

Adult↗
PubMed1989

[Histologic and microscopic study of striated skeletal muscles in primary dilated and hypertrophic cardiomyopathies].

Striated skeletal muscle from 20 patients with primary cardiomyopathies were examined histologically by light microscopy. The average age of the patients was 51 years (range 34-71 yr). Seventeen of them (16 men, 1 woman) had dilated cardiomyopathy, 9 of which were associated with chronic alcoholism, and 3 men had hypertrophic cardiomyopathy. All underwent routine peripheral muscle biopsies, without clinical or biological signs of neuromuscular involvement. Minor anomalies were observed in the dilated cardiomyopathy patients: 4 in chronic alcoholics and 1 in a diabetic patient. All 3 biopsies were normal in the hypertrophic cardiomyopathy group. Comparison of these results and those reported in the literature showed that our limited findings were not only due to the study protocol and that the histological lesions were not specific to cardiomyopathy.

Adult↗
PubMed1989

[Study of dilated cardiomyopathies using gallium 67 myocardial scintigraphy].

Twenty-seven patients were diagnosed as having dilated cardiomyopathies, based on increases in the cardiothoracic index greater than 0.50, in the diastolic and systolic diameters of the left ventricle, and in the telediastolic volume of the left ventricle, which was indexed by body surface determined by contrast ventriculography. They underwent gallium 67 scintigraphic examination of the myocardium, in order to non-invasively detect the presence of an inflammatory infiltrate. Fifteen of them also had endomyocardial biopsies and all had virology check-up. The results were disappointing. Only in one case was the scintigraphic image undeniably positive; in 20 other patients the findings were dubious or negative. This technique did not demonstrate the presence of an inflammatory infiltrate and thus we could not establish an association between myocarditis and dilated cardiomyopathy.

Adult↗
PubMed1989

[Prognostic factors in dilated cardiomyopathy].

Thirty-eight patients, 27 men and 11 women, mean age 49 +/- 12 yr, suffering from dilated cardiomyopathy were included in this prospective study of prognostic factors. Twenty-two subjects admitted heavy alcohol consumption (greater than 80 g/d, for at least 10 yr). The survival rates for 2, 5 and 7 yr were 87, 35 and less than 20%, respectively. Prognostic factors were evaluated in 34 (22 alcoholic and 12 non-alcoholic) patients: 10 improved or were cured, as determined clinically, radiologically and echocardiographically (group 1); 24 deteriorated, 13 of whom died (group 2). Statistically significant values for group 1 versus group 2 were: echocardiographic left ventricular (LV) end diastolic diameter (3.50 +/- 0.80 vs 4.02 +/- 0.5 cm/m2, p less than 0.026) and LV end systolic diameter (2.97 +/- 0.65 vs 3.43 +/- 0.53 cm/m2, p less than 0.02); hemodynamic LV systolic pressure (113.9 +/- 15 vs 101.82 +/- 17.36 mm Hg, p = 0.045); angiographic LV end diastolic volume (137.8 +/- 57.44 vs 177.85 +/- 55.45 ml/m2, p = 0.057), LV end systolic volume 93 +/- 53.5 s 139.28 +/- 48.99 ml/m2, p less than or equal to 0.036), ejection fraction 0.36 +/- 0.16 vs 0.22 +/- 0.7%, p less than or equal to 0.006) and velocity of fiber shortening (0.79 +/- 0.53 vs 0.36 +/- 0.3 circ/s, p = 0.036). Other electrical, radiological and hemodynamic parameters were not significant and alcohol consumption did not influence the prognosis. The severity of LV functional impairment appears to be the major determinant of a poor prognosis and reduced survival in idiopathic and alcoholic cardiomyopathies.

Adult↗
PubMed1988

[Identification of prognostic criteria of dilated cardiomyopathies associated with chronic alcoholism. 22 cases].

Between November, 1978 and August, 1983, 22 patients aged from 28 to 65 years with idiopathic dilated cardiomyopathy diagnosed on the basis of clinical and haemodynamic criteria were investigated. All these patients, who consumed alcohol in excessive amounts, were followed up for 1 to 58 months. The overall mortality rate was 10 p. 100 at 4 months and 25 p. 100 at 58 months. Six patients were clinically improved with reduction of heart size (group A); 10 patients showed deterioration with 3 deaths (group C) and 6 patients followed an intermediate course (group B). When the characteristics of the groups were evaluated, it was found that compared to group C patients those in groups A and B had a lower cardiothoracic ratio: 0.56 +/- 0.04 (B) vs 0.64 +/- 0.06 (C) (P less than 0.02), a lower indexed end-diastolic diameter and systolic diameter on TM echo: 3.20 +/- 0.50 cm/m2 (A) vs 4.13 +/- 0.39 cm/m2 (C) (P less than 0.02), and 2.72 +/- 0.37 cm/m2 (A) vs 3.57 +/- 0.47 cm/m2 (C) (P less than 0.02) respectively, and a lower indexed end-diastolic volume as evaluated by angiography: 121 +/- 61 ml/m2 (A) vs 202 +/- 65 ml/m2 (C) (P less than 0.06). Dilated cardiomyopathy associated with excessive alcohol consumption has a better prognosis when the patients stop drinking and when their heart dilatation is mild to moderate.

Adult↗
PubMed1988

Asymptomatic diabetic cardiomyopathy: a noninvasive study.

Forty-nine diabetic patients (26 type I and 23 type II), free of cardiovascular disease symptoms, were compared with 32 controls in a noninvasive study of left ventricular (LV) function. Absence of ischemic cardiopathy was confirmed by routine investigations and an exercise electrocardiogram using 12 leads with a thallium-201 myocardial scintigraphy. Diabetic patients had (1) a significantly prolonged mean isovolumetric relaxation time (IVRT) assessed by M-mode echocardiography and phonomechanography; (2) a significantly reduced E-F slope; (3) an increased mean Weissler index (pre-ejection period/LV ejection time). The IVRT and E-F slope abnormalities reflect increased myocardial stiffness and impaired LV compliance. The increased Weissler index reflects impaired myocardial contractility. These abnormalities were not related to sex, age, duration of diabetes or to the presence or extent of complications. No significant difference was found between diabetic patients and controls for mean diastolic and systolic LV diameters, thickness of the posterior wall or of the interventricular septum, assessed by echocardiography, or for the ejection fraction, determined by radionuclide angiocardiography. Finally, more than half of the patients with a frankly abnormal IVRT, Weissler index and E-F slope had had diabetes for less than 5 years, some even less than 2 years, without complications. These data show: (1) evidence of LV dysfunction specific to diabetes and unrelated to ischemic cardiopathy and hypertension; (2) the possible involvement of a metabolic factor in this early asymptomatic LV abnormality rather than microangiopathy.

Adult↗
PubMed1988

Chronic constrictive pericarditis associated with asbestosis.

Observation of chronic constrictive pericarditis associated with pulmonary asbestosis is reported here. Heart catheterization revealed typical patterns of cardiac constriction. The diagnosis of asbestosis was based on pathologic features associated with a long history of asbestos dust exposure without evidence for tuberculosis. The etiology of this constrictive pericarditis was related to an asbestosis pericarditis involvement.

Aged↗