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Biomedical subjects

P Audouin

Publications and source records attributed to P Audouin.

13 recordsLinked to original sources
PubMed1996

[Return to work following myocardial infarction. Medical and socio-professional factors].

The aim of this study was to assess the influence of medical and socioprofessional factors on return to work after myocardial infarction. The authors studied a continuous series of 174 patients with an average age of 51.3 years, all of whom were active before their illness. The average follow-up period was 33 months. One hundred and thirty of the patients (75%) returned to work. The only clinical factors predictive of not returning to work were older age short exercise time and fall in blood pressure on exercise. On the other hand, nearly all socioprofessional factors, social class, type of occupation, size of company, length of employment in their company, physical stresses related to their occupation, were related to return to work. The average time before returning to work was 5.5 +/- 1 month. Though certain immediate criteria of severity of infarction such as previous myocardial infarction or anterior wall infarction were related to a more delayed return to work. The cardiac status evaluated by complementary investigations (left ventricular ejection fraction, exercise testing and Holter monitoring) was not related to the time before return to work. Of the socioprofessional factors, only difficulties related to the patients' work (modification or change of job) were associated with a more delayed return to work. Forty-four patients (33.8%) returned to work after a change in working hours (28 patients), the tasks involved (20 patients) or position (7 patients). Only the lower socioprofessional classes, independent workers and extremes of age could benefit from these measures.

Adult↗
PubMed1993

[Detection and prognostic value of silent myocardial ischemia].

Silent myocardial ischaemia (SMI) is a common manifestation of coronary artery disease. Continuous electrocardiographic recordings have shown that 75% of ischemic episodes are asymptomatic. In addition, SMI has the same consequences as symptomatic ischaemia on myocardial perfusion and ventricular function. There are many means of detecting SMI, continuous electrocardiographic monitoring, exercise stress testing with or without methods of analysis of myocardial perfusion or wall motion using radioactive tracers or echocardiography. The latter techniques seem to improve the sensitivity of exercise stress testing. More recently, pharmacological stress testing coupled with myocardial scintigraphy or echocardiography has been introduced. In coronary patients, the prevalence of SMI on Holter monitoring is about 50% in angina and 25% after myocardial infarction. The prognostic value of SMI has been the object of much research. In asymptomatic patients with documented coronary artery disease, SMI is associated with a relative risk of a cardiac event 2 to 3 times greater than that of subjects without ischaemia. In angina pectoris, the relative risk of future cardiac events is 5.3 times greater, and that of death is 2.3 times greater. These results reported with the Holter method have been confirmed by those of exercise stress testing with and without coupled imaging techniques. In unstable angina, the results are the same: the relative risk of cardiac events in patients with SMI on Holter monitoring is increased by a factor of 4.5, and that of death by a factor of 4. This increased risk is also observed after myocardial infarction whether SMI is recorded by Holter monitoring or exercise stress testing. However, these observations are not confirmed in all reports.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1988

Influence of training on blood lipids and coagulation.

Even if the effects of physical training on secondary prevention are controversial, it is known that exercise may influence several of the risk factors for coronary heart disease (CHD). One of the most important is cholesterol. Studies conducted to determine the influence of training on lipid profile have shown in normals, as well as in CHD patients, a favourable influence: a small decrease in total cholesterol and low-density lipoprotein cholesterol, and an increase in high-density lipoprotein cholesterol. These results are obtained after prolonged and intensive training. The influence of training on coagulation is more controversial and less well known. During short bouts of exercise the following changes are generally observed: an increase in platelet count and platelet aggregation (the effects on platelet adhesiveness and activation are controversial), potentiation of coagulation with an increase in factor VIII, and an increase in fibrinolytic activity due to an increase in plasminogen activator level. The effects of training have been less well studied. It is supposed that training could diminish the clotting potentiation observed during short exercise. Fibrinolysis is also increased in these conditions. If the influence of training on blood lipid profile may be considered as favourable in secondary prevention, no study has yet assessed the role of training on coagulation factors in secondary prevention.

Blood Coagulation↗
PubMed1988

Prognostic significance of angina pectoris recurring soon after myocardial infarction.

The prognostic significance of an early occurrence, or recurrence, of angina pectoris after myocardial infarction was studied in 254 patients (221 male, 33 female; mean age 58 +/- 11 years). During the in-hospital rehabilitation program, 41 patients (16%) had anginal pain. The mean follow-up was 21 months (range 12-33 months). Among the 254 patients, 21 died, five had recurrent myocardial infarction, 13 had unstable angina, and 22 underwent aortocoronary bypass surgery. An early recurrence of angina pectoris was predictive of combined (medical + surgical) events (21 patients, P less than 0.05), medical events (11 patients, P less than 0.05) and surgical events (10 patients, P less than 0.001), but failed to predict individual death (six patients), recurrent myocardial infarction (two patients) or unstable angina (three patients). Of the events that occurred in the 254 patients, 34% were predicted by the early recurrence of angina pectoris. Early post-infarction angina was observed more frequently in older patients and patients with previous history of angina pectoris. This represents an important prognostic factor after myocardial infarction, which defines a high-risk group of patients requiring further investigation and appropriate therapeutic approaches.

Aged↗
PubMed1987

Acute effects of trimetazidine evaluated by exercise testing.

A single dose of 60 mg trimetazidine (the normal daily dose) improved exercise capacity in angina pectoris, as reflected by an increase in the duration of exercise, total work performed, and improvement in ECG signs of ischaemia. All these effects occurred without any detectable chronotropic or vasomotor effect. The importance of this study is to demonstrate that these beneficial effects, already well-recognized after chronic administration of 20 mg three times a day, also occur after a single administration equivalent to the normal daily dose.

Angina Pectoris↗
PubMed1987

[Prognostic value of the exercise test after myocardial infarction].

A stress test performed in the early stage after myocardial infarction enables to evaluate directly or indirectly three of the main prognosis factors: alteration of ventricular function, presence of ventricular arrhythmias, residual ischemia. This test, performed around the 15th day, after previous anti-angina treatment have been discontinued, is only done in the absence of the classic contra-indications. It permits to detect abnormalities: electrical positivity (with or without pain), disorder of the ventricular rhythm, abnormality of the blood pressure profile, low stress level. The predictive value of these abnormalities has been the subject of many studies. Although all the results are not in agreement, each one of these abnormalities seems to carry an increased risk of cardiac occurrences after myocardial infarction. In addition, an early stress test enables to detect pluritroncular coronary lesions with, however, an average sensitivity. Thallium scintigraphy in conjunction with a stress test improves, however, the performances of this test. The advantage of an early stress test is the rapid screening of high risk patients who should benefit from additional exploratory measures and possibly of myocardial revascularization procedures.

Exercise Test↗
PubMed1986

[Ergometric effects of a single administration of trimetazidine].

The effects on exercise capacity of a single oral dose of 60 mg of trimetazidine were studied during a double-blind, placebo controlled cross-over study. Ten patients with stable angina and angiographically proven coronary artery lesions underwent ergometric bicycle exercise tests before and two hours after administration of the drug. A blood sample, for trimetazidine levels, was taken at the end of the recovery period. The homogeneity of the group and the lack of significance of the order of administration were established by cross-over analysis of the "control" tests and the "treated" tests. As compared with placebo, a statistically significant difference was noted after trimetazidine in the following parameters: total work (+31%, P less than 0.02), duration of exercise (+17%, P less than 0.02), percentage of the predicted maximal heart rate reached (+4%, P = 0.05), time to 1 mm ST segment depression (+17%, P less than 0.05) and degree of ST depression at maximum exercise level of the first control test (-31%, P less than 0.05); there was no significant difference in heart rate, blood pressure at rest and rate-pressure product during exercise between treatment and placebo. Two patients showed no response to trimetazidine. In the eight patients who did respond, there was a correlation factor of 0.73 between the plasma levels of trimetazidine and the increase in work performed. In conclusion, a single 60 mg dose of trimetazidine improves exercise tolerance and delays the ischaemic threshold during exercise without any detectable peripheral haemodynamic effects.

Administration, Oral↗
PubMed1982

Dark Stomatal Movement in Sunflowers in Response to Illumination under Nitrogen.

Experiments were performed on intact sunflowers (Helianthus annuus) placed in a specially designed experimental chamber which allows instantaneous modifications of the atmospheric composition without changing any other conditions. After one night in normal conditions, the plant was illuminated under pure nitrogen atmosphere; the opening stomatal movement, measured as a transpiration rate variation, was inhibited. After an anoxia time period not exceeding one hour, the light was turned off and normal air restored. The stomatal movement was no longer inhibited, and a transient increase in the transpiration rate, referred to here as the postillumination transpiration peak (PITP), was observed.The quantity of transpired water during the PITP can be related to the total incident light energy supplied during the light-nitrogen period. Furthermore, the addition of a dark-nitrogen period between the light-nitrogen and dark-air periods caused the PITP to decrease. The PITP is almost suppressed after a 20-minute dark-nitrogen period.It is shown that the PITP does not result from a hydropassive mechanism but is metabolically controlled. Moreover, it seems that the PITP is not due to a CO(2)-suppression effect during the light-nitrogen period.The results are interpreted in terms of stomatal mechanism. The metabolites leading to PITP originate from the reducing equivalents created during the light-nitrogen period. They could be synthesized at the beginning of the PITP period (darkness under normal air) or during the dark-nitrogen plus CO(2) period between the light-nitrogen and PITP periods. The results obtained are related to the first steps of classical photoactive stomatal opening.

Journal Article↗