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Biomedical subjects

L Chevalier

Publications and source records attributed to L Chevalier.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Segmental rehabilitation in cardiac failure: short and long-term results].

Many patients with chronic cardiac failure may benefit from exercise rehabilitation. However, the usual protocols, which may lead to haemodynamic disturbances or induce arrhythmias, are rarely applicable in the most severe cases. Therefore, the authors developed a protocol of segmental rehabilitation where the same muscle groups as in global readaptation are involved, but successively and not simultaneously. This study included 25 patients in the NYHA class III. Many parameters were analysed before and after forty sessions. Although the resting isotopic ejection fraction (0.26 +/- 0.1 vs 0.27 +/- 0.11; p = NS), oxygen consumption at the ventilatory threshold (14.3 +/- 3.5 vs 18.3 +/- 5.2 ml/kg/min; p = NS) or at peak effort (17.4 +/- 4.7 versus 18.3 +/- 5.2 ml/kg/min, p = NS) were unchanged, three other parameters were significantly improved: the duration of exercise (9.2 +/- 2.4 vs 10.4 +/- 3.4 min; p < 0.02) maximum work load (3 046 +/- 1 510 vs 3 992 +/- 2 482; p < 0.01) and muscular force (151 +/- 35 versus 220 +/- 41 kg; p < 0.0001). In addition, after a follow-up period of 43 +/- 18 months, a close inverse relationship was observed between the gains obtained in terms of duration of exercise and maximum work load and the number of hospital readmissions. Similarly, the 10 patients having undergone rehabilitation with this protocol had 11.7 times fewer hospital readmissions than the other 15. Segmental rehabilitation would therefore seem to be a safe technique for patients with severe cardiac for significantly increasing exercise capacity and lowering the number of readmissions to hospital.

Aged↗
PubMed1996

[Fortuitous discovery of Brugada syndrome in an asymptomatic 70-year-old sportsman].

The authors report the case of an elderly sportsman presenting with the electrical signs of the syndrome described by Brugada. The absence of any serious clinical events in this patient questions the pejorative prognosis usually reported and the specific identity of this syndrome in relation to right ventricular arrhythmogenic dysplasia.

Aged↗
PubMed1995

[Secondary prevention of atherosclerosis: effects on coronary plaques and on myocardial ischemia].

The coronary atherosclerotic plaque progresses in successive stages, determined by phenomena such as spasm, thrombosis and inflammation. Studies of regression are hindered by methodological problems involving the variability of angiographic results over intervals of several years. Longitudinal clinical studies are probably more useful. For long-term clinical outcome, it appears that stabilisation of young plaques is more important than regression of older plaques. To this end, cessation of smoking seems the most effective means; progressive plaques are most often seen early in the disease, in patients under 60 years of age, of whom more than 70% are smokers. The inevitable lack of studies as rigorous as those dealing with hyperlipidaemia reduction should not be used as a pretext for scruples leading to ignoring the results of clinical practice. Prevention by diet is no doubt essential, but prospective studies are still rare and biases are numerous. The same is true for physical exercise.

Coronary Artery Disease↗
PubMed1995

[Prognosis and predictive factors of mortality in patients with inoperable coronary disease].

In the period between September 1979 and December 1986, 105 out of 2,178 consecutive patients with coronary artery disease (men 93, women 12; age : 58.1 +/- 10 years; previous myocardial infarction : 67%) were considered inoperable because of poor distal coronary circulation (84.8%), left ventricular dysfunction (3.8%) or both (11.4%). Fifty-four clinical, ergometric and angiographic parameters were examined at inclusion. The mean follow-up was 69 +/- 40.2 months (1 to 146 months). The Kaplan Meier 10 year survival rate was 43%. Only 25% of the population remained free of major cardiac events. Multivariate analysis showed that only the coronary angiographic score had a significant predictive value. The authors conclude that the long-term prognosis of these patients is poor. Some did undergo coronary bypass surgery secondarily, and their prognosis was good, suggesting that revascularisation, even if only partial and at high risk, should be considered.

Adult↗