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Biomedical subjects

M Delay

Publications and source records attributed to M Delay.

At least 37 records · Page 2Linked to original sources
PubMed1994

[A year follow-up of 328 patients with myocardial infarction].

Three hundred and twenty eight patients (238 men, 90 women) with an average age of 63.5 +/- 18 years admitted consecutively for acute myocardial infarction over a 24 month period (March 1989-March 1991) were followed up at one year by out-patient appointment, questionnaire or telephonic enquiry. The average delay before hospital admission was 6.7 +/- 44 hours (1 h-48 h). The infarct was transmural in 82% of cases, anterior in 45.3%, inferior in 46.3% and lateral in 8.4% of cases. Forty eight per cent had one or several complications during the hospital period with a 10.4% hospital mortality rate. Thirty eight per cent of patients underwent primary thrombolysis and 9% had primary angioplasty. Seventy four per cent of patients had coronary angiography; 41% underwent deferred angioplasty and 6% surgical revascularisation. The global 1 year survival rate was 81.4%. At follow-up, 52.6% of patients were asymptomatic, 31% had signs of cardiac failure and 18% had residual angina. Sixty five per cent were treated with 2 or 3 drugs; 6% underwent secondary angioplasty and 2.8% secondary coronary bypass surgery. Of the 34% of active subjects, 61.4% declared having returned to full-time professional activity. Therefore, in 1992, a continuous reduction of infarct-related mortality and morbidity was observed.

Actuarial Analysis↗
PubMed1994

[Production of oxygen free radicals in myocardial infarction treated by thrombolysis. Analysis of glutathione peroxidase, superoxide dismutase and malondialdehyde].

Many enzyme systems such as glutathione peroxidase (GPx) or superoxide dismutase (SOD) neutralise the oxygen derived free radicals produced during myocardial reperfusion by thrombolysis. Erythrocytic SOD, plasma and erythrocytic GPx and their cofactor selenium, substances reacting with thiobarbituric acid (TBARS) were analysed by repeated sampling between T0 and 48 hours in 24 patients treated by thrombolysis for acute myocardial infarction. Angiographic control was undertaken systematically between 60 and 180 minutes after initiating thrombolytic therapy: 18 patients had a patent vessel and 6 patients had an occluded vessel recanalised in 5 cases by angioplasty. Biological analysis was performed in the 23 patients successfully revascularised by thrombolysis, eventually completed by angioplasty. The plasma GPx decreased non-significantly between T0 and 2 hours from 246.8 +/- 53.3 to 233 +/- 39 U/ml with a significant increase between 2 and 48 hours from 233 +/- 39.2 to 294 +/- 76 U/ml, whereas the erythrocytic GPx rose significantly and constantly between T0 and 48 hours from 34.8 +/- 7.1 to 37.6 +/- 7.5 U/gHb with significant consumption of selenium between T0 and 4 hours from 81.2 +/- 14 to 68.5 +/- 12.6 micrograms/l. The erythrocytic SOD increased significantly between T0 and 48 hours from 318.9 +/- 40.8 to 337 +/- 59 U/gHb. Finally, the analysis of plasma TBARS showed a non-significant rise between T0 and 30 minutes from 1.59 +/- 0.30 to 1.71 +/- 1.43 mm/l with a return to the basic line values after about 2 hours. These results show a significant increase in the activity of enzymes protecting against the liberation of oxygen free radicals, such as erythrocyte or plasma GPx and erythrocyte SOD between T0 and 48 hours with consumption of selenium, cofactor of GPx, and an increase in circulating lipid peroxydes in acute myocardial infarction treated by thrombolysis. They also illustrate the oxidative stress which occurs in this situation.

Adult↗
PubMed1994

[Isoforms of creatine kinase and myoglobin in myocardial infarct treated by thrombolysis].

The isoforms of creatinine kinase (CK) and myoglobin were analysed by serial samplings in 45 patients admitted consecutively for myocardial infarction treated by thrombolysis according to the usual indications. Angiographic controls were carried out systematically in the first 24 hours, including 20 cases at the end of thrombolysis. The patients were divided into two groups according to the patency of the infarct related artery: Group I (n = 35) with a patent vessel and Group II (n = 10) with an occluded vessel; 4 patients in Group II were successfully revascularised by angioplasty. The total CK had a higher peak value in Group II (2,393 +/- 1,991 UI/l at 547 +/- 247 min versus 2,888 +/- 2,189 IU/l at 584 +/- 395 min) but the difference was not statistically significant. The analysis of CK isoforms showed the MM3/MM1 ratio to be higher at the 2nd hour in Group I (3.74 +/- 2.37 versus 3.09 +/- 1.43) with a faster increase, without attaining statistical significance. A fourth CK MM fraction was observed at the 2nd hour in 71% of patients in Group I compared with only 20% of patients in Group II. Analysis of myoglobin showed a significantly earlier peak value in Group I (1,218 +/- 1,117 micrograms/l at 133 +/- 62 min versus 1,309 +/- 1,549 micrograms/l at 210 +/- 84 min). The sensitivity and specificity of these different markers were respectively 40%, 86%, 77%, and 60%, 70% and 67% for the CK (peak before 8 hours), the MM3/MM1 ratio (increase of over 35% in the first hour) and myoglobin (peak before 2 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

Angiocardiography↗
PubMed1994

[Infarction in patients aged over 70. Apropos of 194 patients].

Among 498 patients hospitalised for myocardial infarction during a three year period, 194 (39%) were aged over 70 (mean age: 78.6 +/- 6), including 99 women and 95 men. Comparison of this group of patients with those aged under 70 showed a significantly higher hospital mortality (17.5% v. 6.5%) (p < 0.01) and a higher acute complication rate (60.8% v. 23.7% (p < 0.01), in particular after the age of 75. Twenty-eight patients were treated by thrombolysis (14.4% v. 50.6%) (p < 0.05), with a 79.2% patency rate in follow-up angiography at 48 h, and only one non-fatal hemorrhagic complication. Eighty-six patients were investigated by coronary arteriography (44.9% v. 87.2% (p < 0.05) without any complication. Mean ejection fraction was 57.3 +/- 13.5%. Fifty patients were treated by angioplasty (24.6% v. 57%) (p < 0.01) including 15 during the acute phase, with primary success in 40 of them (80%). Ten patients underwent coronary bypass following their infarction (5.1% v. 6.25%) (NS) with two per- or postoperative deaths (20%). Follow-up study revealed high secondary mortality with an overall survival rate at one year of 59.6% v. 81% in patients aged under 70 (p < 0.01). In total, infarction in the elderly is characterised by high mortality and morbidity as compared with infarctions in patients aged under 70, and requires active management during the acute phase, assessed according to the physiological status and age of the patient.

Aged↗
PubMed1993

[Value of continuous measurement of mixed venous oxygen saturation (SVO2) during coronary angioplasty].

Mixed venous oxygen saturation (SVO2) is an haemodynamic parameter of cardiovascular function. The object of this study was to measure SVO2 during percutaneous transluminal coronary angioplasty (PTCA) with prolonged balloon inflation in order to evaluate haemodynamic tolerance more precisely in two groups of patients. Twenty-six patients undergoing PTCA were divided into two groups: Group I, N = 15, with single vessel disease and good left ventricular function (EF: 61.63 +/- 10.1%); Group II, N = 11, with triple vessel disease and poor left ventricular function (EF: 48.05 +/- 14%; p < 0.05). Continuous monitoring of SVO2 with an oximetrix fiber optic catheter was performed in all patients during PTCA. Irrespective of the duration of balloon inflation, a significant correlation was observed between the changes in cardiac output and VSO2. Given that arterial oxygen pressure, global oxygen consumption and haemoglobin concentrations remained constant during balloon inflation, SVO2 was an indicator of cardiac output.

Adult↗
PubMed1993

[Simultaneous thrombosis of the left anterior interventricular and right coronary arteries in a 27 year-old patient with protein S deficiency].

The authors report a case of myocardial infarction in a 27 year old patient by simultaneous thrombosis of the left anterior descending and right coronary arteries in an angiographically normal coronary circulation. The young age of the patient, the absence of the usual risk factors and a normal angiographic network after arterial recanalisation by angioplasty led to the search for a risk factor of thrombosis. This showed a qualitative deficiency of protein S and the absence of any other abnormality of coagulation or fibrinolysis. This case raises the question of a causal relationship between a hereditary protein S deficiency and thrombotic arterial occlusion.

Adult↗
PubMed1993

[Acute severe coxsackie virus B myocarditis of pseudonecrotic form. Apropos of 2 cases].

This study reports two cases of acute severe Coxsackie virus B4 myocarditis in which the immediate clinical signs suggested the acute phase of myocardial infarction, apparently antero-lateral in the first case in a context of cardiogenic shock and infero-lateral in the second case, in the context of acute pulmonary edema. Both cases were characterized by the severity of the initial signs. Numerous other cases of acute Coxsackie virus B myocarditis, simulating myocardial infarction, have been reported in the literature and these contexts deserve to be recognized earlier as they call for specific treatment. The immediate outcome was favorable in both cases but required massive cardiological intensive care in the first patient. Long term follow-up was excellent.

Acute Disease↗
PubMed1993

[Systematic cardiovascular evaluation and hypercholesterolemia. Results in 200 asymptomatic patients].

This study reports the results of routine evaluation to detect coronary and carotid atherosclerosis in 200 asymptomatic and hypercholesterolemic patients (48 +/- 10 years: 72.5% men). All patients underwent physical examination, blood lipid profile, an exercise test and cervical echo-doppler. If the exercise electrocardiogram was abnormal, a thallium isotope scan and/or coronary arteriography were performed. Hypercholesterolemia was severe (3.03 +/- 0.52 g/l). 77.5% of patients had pure hypercholesterolemia. Carotid atherosclerosis in the form of plaque (27.5%) or stenosis (3.5%) was found in 31% of patients. This carotid atheroma was commoner in older patients (51.9 +/- 9 years as against 47 +/- 10 years, p < 0.01). Twenty patients (10%) had electrical signs of ischemia provoked by exercise. Six of them had a normal thallium isotope scan and did not undergo coronary arteriography. Coronary arteriography was abnormal in 10 patients (5%): 7 had stenotic lesions and 3 showed evidence of spasm during the methylergometrine test. In total, the hypercholesterolemic patients investigated here were characterised by subclinical atherosclerosis which was frequent but certainly underestimated by non-invasive studies. The existence of an atherosclerotic lesion is an additional argument in favour of starting cholesterol-lowering treatment.

Adult↗
PubMed1992

[Cardiocirculatory arrest after administration of combined mifepristone (Mifegyne) and sulprostone (Nalador) for induced abortion. Possible role of coronary vasospasm].

Reversible ventricular fibrillation occurred in a 35 year old multiparous woman after the administration of the association mifepristone (Mifegyne) and sulprostone (Nalador) for therapeutic abortion. A coronary spasm induced by the analogue of the prostaglandin PGE 2x was though to be the causative mechanism and was reproduced by the Ergonovine test. The evolution of the ECG and myocardial scintigraphy suggested a slowly regressive stunned myocardium.

Abortifacient Agents, Nonsteroidal↗
PubMed1990

The effects of lyotropic anions on charge movement, calcium currents and calcium signals in frog skeletal muscle fibres.

1. Intramembrane charge movement and Ca2+ currents were monitored in voltage-clamped segments of frog skeletal muscle fibres using the triple-Vaseline-gap technique. Calcium signals were measured in current-clamped fibres using either of the indicators Arsenazo III or Antipyrylazo III. 2. Non-linear capacitative currents (charge 1) were obtained using a subtraction procedure which employed either a -20 mV control pulse from a holding potential of -100 mV or alternatively a control pulse to +80 mV in depolarized fibres. The amount of charge mobilized depended on voltage according to a two-state Boltzmann function. The total charge (Qmax) was increased by ca 100% and the steepness parameter (k) by ca 70% when a +80 mV control pulse was used. 3. Thiocyanate (SCN-) and other lyotropic anions reversibly shifted the voltage dependence of mobilized charge towards negative potentials. Qmax was not significantly affected. 'Off' charge tails were greatly prolonged by lyotropic anions. 4. Extracellularly applied lyotropic anions affected the dihydropyridine-sensitive Ca2+ current by shifting the I-V relation toward more negative voltages and delaying deactivation of the tail currents. 5. The effects of lyotropic anions did not depend on whether the anion was introduced intracellularly or extracellularly. 6. Extracellular SCN- reversibly increased the peak amplitude and rate of rise of Ca signals, and decreased the latent period between stimulation and onset of the Ca signal. 7. It is concluded that lyotropic anions have similar effects on Ca2+ currents and on charge movement.

Animals↗
PubMed1990

[Cardiotoxicity of continuous intravenous infusion of 5-fluorouracil: clinical study, prevention and physiopathology. Apropos of 13 cases].

5-Fluorouracil (5FU) cardiotoxicity is thought to be an infrequent toxic effect, usually related to coronary vasospasm. Among 198 patients (pts) receiving 5FU as a continuous infusion (CI) over 96 or 120 h, at a daily dose of 1,000 mg/m2, 13 new cases of 5FU--cardiotoxicity are reported. In all cases but 1, cardiovascular symptoms occurred at the first 5FU-CI course, with mean time of onset of 3 d. Chest pain was the prominent inaugural symptom with angor pectoris (6 pts) and pericarditis (3 pts). Five pts developed cardiogenic shock, which was irreversible in 3 cases. The severity of such an evolution requires prompt 5FU discontinuation, if symptoms occur, and careful hemodynamic supervision during 5FU therapy. One patient experienced typical myocardial infarction, another one epicardo myocardiopathic process with adiastolia. Disorders of repolarisation on electrocardiographic tracing were the prominent abnormalities, associated with a significant increase of QT segment in 3 cases. Re-introduction of 5FU-CI resulted in chest pain recurrence in 2 out of 4 pts, despite calcium antagonist "prevention". In our retrospective study, the incidence of 5FU-CI cardiotoxicity is 6.5%, which is consistent with recent reports (10%). Whether 5FU-induced cardiotoxicity mechanism is related to vasospastic or direct effect remains unclear. However, our series suggests a 5FU-induced post ischaemic myocardial dysfunction as described in the "stunned myocardium" syndrome.

Adult↗
PubMed1989

[Improvement of left ventricular function after fibrinolysis using intravenous streptokinase].

Over a period of 13 months, 33 male patients, under the age of 72 years, admitted in the cardiology department following a myocardial infarction within 5 hours after painful onset, and treated with intravenous fibrinolytic agents, were included in this study. A coronary angiography with right anterior oblique ventriculography at 30 degrees was performed. Within the first 72 hours. The informations provided by this examination resulted in a coronary angioplasty performed in patients, a by-pass in 4 patients and medical treatment in 13 patients. After a mean delay of 8 months, a new control was performed using iodine ventriculography study of radial and segmental shortening fractions, Leighton's rotation). The results expressed, concern the sub-group of non-surgical patients: regardless of the site of the infarction, the percentage of akinesis (% AK) goes from 15.0 +/- 12.0 p. cent to 8.3 +/- 10.3 p. cent (p less than 0.01). The stroke volume (SV) is not significantly improved. In the group of inferior necroses, the global SV goes from 58.4 +/- 10.1 p. cent to 62.9 +/- 10.8 p. cent; p less than 0.05 and the % AK goes from 13.9 +/- 11.5 p. cent to 5.0 +/- 5.6 p. cent; p less than 0.001). Segmental kinetics in the inferior and infero-basal territories is significantly improved at eight months. In the anterior necrosis group, the study of the same parameters does not demonstrate any significant difference (too limited population). The imputability of the improvement of the parameters of the left ventricular function by arterial revascularization is clearly suggested by these results.

Adult↗
PubMed1989

Calcitonin gene-related peptide regulates calcium current in heart muscle.

The influx of Ca2+ due to the transmembrane calcium current, ICa, has a fundamental role in cardiac pacemaker activity, in the action potential plateau and in excitation-contraction coupling. Both sympathetic and parasympathetic neurotransmitters can modulate ICa. Recent studies indicate that in both the cardiovascular and the central nervous systems, nerve varicosities exist that contain a novel non-adrenergic, non-cholinergic peptide--calcitonin gene-related peptide (CGRP). Although CGRP is known to exert strong positive inotropic and chronotropic effects, as well as to cause vasodilation, very little is known about the ionic mechanisms of these effects. Here we report that CGRP dramatically increases ICa in single heart cells. Although this CGRP-induced increase in ICa resembles the effect of beta-adrenergic agonists, our results demonstrate some significant differences between the effects of CGRP and these agonists: (1) the increase due to CGRP cannot be blocked by beta-adrenergic antagonists; (2) the CGRP-induced effect is transient; and, (3) CGRP can inhibit isoproterenol-stimulated ICa. Our results provide the first electrophysiological evidence that CGRP can significantly modulate ICa in the heart, and suggest a new additional mechanism for the neurogenic control of cardiac function.

Action Potentials↗
PubMed1989

[Clinical, angiographic aspects and 18-month follow-up of 134 cases of left coronary trunk stenosis].

A series of 134 patients with left main coronary stenosis was followed up for an average of 18 months. The majority of patients presented with unstable angina and per-critical ECG changes. Coronary angiography showed that left main coronary stenosis is rarely an isolated entity but generally associated with diffuse coronary atherosclerosis. Left ventricular function is usually normal. Treatment is surgical whenever the coronary lesions, left ventricular function and general condition of the patient allow it. The medium-term surgical results are excellent on clinical symptoms and quality of life at the price of low perioperative mortality and morbidity.

Adult↗
PubMed1987

A chemical link in excitation-contraction coupling in skeletal muscle.

The process of EC coupling at the T-SR junction in skeletal muscle shows the characteristic features observed in other chemical junctions; namely, there is a considerable temperature-dependent latency between prejunctional and postjunctional events. This evidence gives further support to the possible involvement of inositol phosphates, InsP3 in particular, in the aforementioned process. Although the kinetics of Ca release in response to InsP3 microinjections have not been appropriately studied yet, our preliminary evidence does not rule out the proposed role of InsP3 as the chemical transmitter. The biochemical analysis of inositol phosphates and phosphoinositides in control and stimulated muscles demonstrates significant changes in the concentration of the key moieties proposed to be relevant in several other preparations. Apparently, the enzymatic machinery for the relevant biochemical reactions of the inositol phosphate/phosphoinositide cycle is present at high levels in muscle. It remains to be investigated whether some aspects of this cycle may have been selectively adapted for the fast process of Ca release in muscle.

Animals↗
PubMed1986

A transmission delay and the effect of temperature at the triadic junction of skeletal muscle.

The coupling process at the triadic junctions in skeletal muscle fibres is characterized by a significant latency between the depolarization of the transverse tubular membrane and the release of Ca from the sarcoplasmic reticulum. This time interval, the triadic delay, is sufficiently long to allow for the participation of a chemical process. The strong temperature dependence of the triadic delay (Q10 near 2.7) suggests that a sequence of chemical steps may link the electrical signal in the T-tubules to the opening of Ca channels in the terminal cisternae of the sarcoplasmic reticulum.

Animals↗