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Biomedical subjects

P Larroque

Publications and source records attributed to P Larroque.

At least 19 recordsLinked to original sources
PubMed2002

[Importance of transesophageal echocardiography and computed tomography in the differential diagnosis of a case of papillary fibroelastoma revealed by a neurologic accident].

In the light of a new case revealed by a stroke, the authors confirm the importance of transesophagal echocardiography (TEE), and show that multislide computered tomography can be used as a new efficient tool for the diagnosis of cardiac papillary fibroelastoma (CPF). These benign tumours of endocardium are rare and case reports have been published sporadically. Stroke is an usual clinical complication and the most frequent symptom associated with CPF. Transesophageal echocardiography is the reference for diagnosis of CPF when transthoracic echocardiography is normal. When TEE is contraindicated or technically impossible, multislide computered tomography appears as an interesting alternate solution for diagnosis because of its fast acquisition and high spatial resolution. Symptomatology may be connected to either tumoral embolisation or cruoric emboli. Surgery is required for any symptomatic tumour.

Aged↗
PubMed2000

[Leiomyosarcoma of the right ventricle].

A 58-year-old woman has dyspnea and palpitations which reveal a leiomyosarcoma of the right ventricle. The medical imaging shows a lobulated sessile tumor attached to the ventricular septum and the tricuspid valve extending into the pulmonary artery trunk. The resection is performed with a tricuspid valvoplasty. In spite of chemotherapy (epirubicin-cyclophosphamide), relapse is observed with pulmonary metastases 17 months after the surgery. The death becomes on 18 months in congestive heart failure. From this case, the authors make a review of the literature about this exceptional tumour, and talk over the low possibilities of treatment, despite the capacities of the new ways of diagnosis.

Dyspnea↗
PubMed1999

[Importance of the blood pressure exercise graph in the diabetic].

The evaluation of the real blood pressure in the diabetic population has a major interest. Arterial blood pressure measure during standardised exercise test could be a supplementary aid in this field of research. This retrospective work is based on 134 diabetic patients compared with age, sex and body mass index matched controls. All of them were tested with a standardised protocol of bicycle ergometer. In the diabetic group, 62 patients present a microalbuminuria over 30 mg/day. The heart rate and arterial pressure do not differ between diabetics and controls before, during, and after the exercise. The registered parameters at the top of the effort are exactly the same for the pulse the systolic and the diastolic blood pressure. Systolic blood pressure gradient during effort is not different between the two groups. The presence of microalbuminuria into the diabetic group do not provoke any modification of cardiac frequency or pressure during the effort. Nevertheless a decrease in systolic blood pressure gradient is noted into the microalbuminuria group despite their older age is in favour of an increase in this parameter. Exercise test has a main place to track down coronary disease and the field of interest is the same that non diabetic patients to find white coat hypertension, to value arterial pressure reactivity during effort of hypertensive athletes or border line hypertensives. The signification and interest of the modification of systolic blood pressure gradient should to be evaluated by other works.

Blood Pressure↗
PubMed1998

[Comparison of magnetic resonance angiography with injection of gadolinium and conventional arteriography of the ilio-femoral arteries].

Twenty-three patients underwent conventional arteriography and 3D contrast enhanced magnetic resonance angiography explorations. The study was limited to the iliofemoral arteries (13 segments for each patient). Each segment was classified as having 0-49%, 50-99% or 100% stenosis. Overall results were excellent with K = 0.822, sensitivity 92% and specificity 93%. Segment by segment analysis corroborated the overall results except for the internal iliac arteries and the deep femoral arteries, demonstrating the limitations of this technique in this series.

Aged↗
PubMed1997

Relationship between diabetic autonomic dysfunction and heart rate variability assessed by recurrence plot.

Beat-to-beat heart rate (HR) and blood pressure were measured by the Finapres system in 44 healthy and 64 diabetic subjects in the at-rest condition. Autonomic control in diabetic subjects was assessed by the Ewing test. HR variability was explored by both linear and nonlinear methods. Linear methods used HR standard deviation and power spectrum. The percentage of the spectrum in the low frequencies was used to assess the sympathetic tone of the autonomic control. The nonlinear method used the "recurrence plot." This method explored long parallel subsequences in the HR time series. These sequences characterize the dependence of the HR dynamics on initial values. The HR standard deviation was reduced in the diabetic subjects compared with the healthy subjects (2.80 +/- 1.17 vs. 3.64 +/- 1.45 beats/min; P < 0.001). In the diabetic subjects, the HR standard deviation and the percentage of the spectrum in the low frequencies showed no correlations with the Ewing score (P > 0.10). In contrast, the longest length index was very strongly correlated to the Ewing score (r = -0.60; P < 0.0001). The results suggest that nonlinear methods might be powerful to explore the autonomic dysfunction in diabetic subjects.

Adult↗
PubMed1997

[Analysis of frequency-dependence of ventricular repolarisation by the Holter method in young adults. Influence of the autonomic nervous system on the rate-dependence of QT].

UNLABELLED: Adaptation of ventricular repolarization duration to heart rate provides additional information to the static duration of QT interval. METHODS: QT/RR relation and his slope were determined using 24-hour ECG recordings from 17 young male normal volunteers (mean age: 22 +/- 3 years). In order to determine the influence of the autonomic nervous system on the rate-dependence of QT, the authors compared the slopes obtained from recordings during the day and the night. Then, the respective rate-dependences of the entire QT interval (QTe) and its initial subdivision (QTa) and their correlations with parameters of heart rate variability were studied. RESULTS: the QTa/RR and QTe/RR relations were constantly linear, with very significant regression coefficients. The daytime QTa/RR and QTe/RR slopes were significantly steeper than the nighttime ones (0.138 +/- 0.035 vs 0.108 +/- 0.040, p < 0.05 for QTe/RR, 0.160 +/- 0.069 vs 0. 108 +/- 0.055, p < 0.01 for QTa/RR). The early part of QT showed a stronger rate-dependence than the global QT, but only at daytime (0.160 +/- 0.069 vs 0.138 +/- 0.035, p < 0.05). No correlation was found between rate dependences and heart rate variability parameters. CONCLUSION: the authors demonstrate, from ambulatory ECG recordings, the influence of the autonomic nervous system on the rate-dependence of ventricular repolarization in normal young adults, and a difference in rate-dependence between the entire QT interval and its initial part QTa, due to differences in autonomic nervous system tone. This heterogeneity should be taken to account in the study of pathological changes or drugs effects on ventricular repolarization.

Adolescent↗
PubMed1996

[Evaluation of the degree of diabetic dysautonomy with the analysis of heart rate measured at rest with the FINAPRES system].

In this work, we developped the ERK (Eckmann, Ruelle and Khamporst) method of recurrent plots to analyse Heart Rate Variability (HRV), measured by the FINAPRES system in diabetic subjects. Our aim was to search some indices that might characterize the degree of dysautonomy detected in diabetic subjects, using the Ewing tests. The idea was to analyze the recurrences of the HR to previously observed values. When a value of HR, xi measured at the j-th beat come back to an already observed value, we compare the distances between the following measures (xi + 1 to xj + 1), (xj + 2 to xj + 2)... If the distances are under a given criteria during k beats, xi is deterministic of order k. Let n1 be the number of recurrent points and nk the number of k-order deterministic points, with k = 2, 3, 4... We defined the index of determinism nk + 1/nk and the Shannon entropy of the Nk = nk-nk + 1. These indices will be correlated to the total score of the 5 Ewing tests, which represent the standard measure to evaluate the diabetic dysautonomy. Blood pressure (BP) and HR were measured during about 30 minutes using the FINAPRES system in 44 healthy subjects and 60 non-hypertensive diabetic subjects. In the diabetic subjects, the age, the body weight and systolic and diastolic BP were 56 +/- 13 years (mean +/- standard-deviation), 79 +/- 14 kg, 80 +/- 10 mmHg and 137 +/- 20 mmHg. HR was weakly correlated to age (r = 0.29; p = 0.02) and the Ewing score (r = 0.31; p = 0.01). Its standard-deviation is also weakly correlated to age (r = 0.32; p = 0.01) and to the Ewing score (r = 0.34; p = 0.01). Using the ERK method, we obtained indices which are much more correlated to the Ewing score. In particular, the ratio n2/n1 and Shannon entropy were correlated to the Ewing score with r = 0.51 and r = 0.53, respectively (p < 0.0001 in both cases). These indices are also correlated to age (r = 0.40; p = 0.003) in both cases. The ERK method give some indices which are easy to obtain (measurement of HR during a rest period) and easy to interpret. These indices are strongly linked to the dysautonomy score which required a good cooperation of the patient and a great vigilance during its execution. This method could be applied to BP to explore BP regulation in hypertensive subjects.

Adult↗
PubMed1995

[Chronic compartment syndrome].

Among causes of leg pains, a usual disability in athletes, chronic exertional compartment syndrome is far from being uncommon. To the opposite, descriptions concerning the others compartments such as the forearm or thigh are still scarce and poorly documented. A variety of techniques have been described for the measurement of intramuscular pressure. Intramuscular pressure measurement is a valuable and essential tool for diagnosing a compartment syndrome, but it is somewhat controversial when the deep posterior compartment is concerned. Conservative treatment is unsuccessful, whereas surgical decompression yield favorable results; two procedures are performed subcutaneous fasciotomy or open fasciotomy.

Chronic Disease↗
PubMed1994

Use of runs test to assess cardiovascular autonomic function in diabetic subjects.

OBJECTIVE: We suggest a simple, noninvasive method to assess the autonomic function in diabetic subjects. The method requires only a monitoring of heart rate (HR) with subjects in the sitting position. RESEARCH DESIGN AND METHODS: Sixty diabetic subjects, 44 men and 16 women, between 20-80 years of age, were recruited, chronologically, for this study. Subjects treated for high blood pressure were not included. Their autonomic function was assessed by the total score of five classical cardiovascular function tests. In the same subjects and in 44 healthy subjects, blood pressure and HR were determined from beat to beat by the Finapres system with subjects in the sitting position. We examined the randomness of the HR changes by calculating the zeta statistic of the runs test on 1,000 successive HR readings (the zeta value is low if the HR changes are random). When the HR changes are random, we consider that the autonomic control of HR is impaired. RESULTS: The zeta values of HR changes were significantly lower in diabetic subjects compared with normal subjects (2.98 +/- 0.97 vs. 3.54 +/- 0.97, P < 0.004). In diabetic subjects, the zeta value was closely correlated to the total score of disautonomy (r = -0.66, P < 0.0001, after correction for age effect) and to the office systolic blood pressure (r = -0.43, P < 0.001). CONCLUSIONS: The zeta value of HR changes might be a marker of the autonomic function in diabetic subjects.

Adult↗
PubMed1994

Ambulatory blood pressure in diabetic subjects.

Ambulatory blood pressure (ABP) was measured every 15 min for 24 h in 82 diabetic subjects aged 35 to 79 years and in 66 healthy controls having the same age and office blood pressure. The autonomic control in diabetic subjects was evaluated by the total score of five cardiovascular function tests (a high score means an autonomic neuropathy). The diurnal cycle of BP was assessed by the difference of BP between daytime and nighttime (delta BP = BP in the day - BP in the night). The variability of BP was evaluated by the standard deviations of the readings. Compared with control subjects, diabetic subjects had the same 24-h mean level of BP, a smaller delta BP, and an increased variability during the daytime; however, the differences were in the limit of statistical significance. Clearcut results were obtained in diabetic subjects with autonomic neuropathy. In the latter, the score of autonomic neuropathy was (1) negatively correlated to delta SBP (systolic) and delta DBP (diastolic) (r = 0.44, P = .0004 and r = 0.46, P = .0004, respectively) and (2) positively correlated to the variability of SBP and DBP during the daytime (r = 0.46, P .0004 and r = 0.29, P = .03, respectively). In diabetic subjects, mean level and variability of ABP were positively correlated to urinary microalbumin. The relationships were the most significant when one relates microalbuminuria to the level of SBP in the night (r = 0.42, P < .0003) and to the variability of SBP in the day (r = 0.32, P = .008).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Active ambulatory blood pressures and urinary electrolytes in young male subjects with normal blood pressure or borderline hypertension.

OBJECTIVES: To examine the relationship between ambulatory blood pressure (ABP) and 24-h urinary electrolytes in young subjects with normal blood pressure or borderline hypertension. DESIGN: ABP shows a circadian profile. We question whether high- and low-level pressure spans might have a relationship with urinary salt output. METHODS: ABP was monitored by the SpaceLabs 5200 system in 182 young male subjects (aged 17-25 years) with normal or borderline office blood pressure. In all subjects, 24-h urinary sodium, potassium and chloride were measured. The mean values and SD of ABP during 24 h, or during the daytime (0900-2100 h) and night-time (2115-0845 h), were estimated. In addition, using a 'cumulative sum' method, 'active' (high-level) and 'passive' (low-level) spans of APB were identified in each subject. RESULTS: No relationship was found between 24-h urinary sodium, potassium or chloride and office systolic blood pressure. Also, no relationship was found between the electrolytes and mean value or SD of ABP during 24 h, daytime or night-time. In contrast, significant positive correlations were found between 24-h urinary sodium and active systolic and diastolic blood pressure. The present study suggests that the active blood pressure span is associated with salt intake in normal and borderline blood pressure groups.

Adult↗
PubMed1993

Fractal dimension of heart rate and blood pressure in healthy subjects and in diabetic subjects.

Beat-to-beat heart rate (HR) and blood pressure (BP) were measured by the Finapres system in 28 healthy subjects and 64 diabetic subjects. Autonomic controls in diabetic subjects were assessed by scoring 5 cardiovascular function tests (high score = abnormal control). The fractal dimension (FD) of HR (or SBP) was estimated as follows: Measuring the curve of 500 successive HRs with a rule of length L, one obtains N times L. The FD is the slope of the regression line of Log(N) versus Log(1/L) for different L. We found a lower FD of HR in diabetic subjects than in healthy subjects (1.35 +/- 0.10/1.44 +/- 0.09, p = 0.0002) and a similar FD of SBP in the 2 groups. In diabetic subjects, the FD of HR was negatively correlated with age (r = -0.27, p = 0.03), duration of diabetes (r = -0.33, p = 0.0078) and score of disautonomy (r = -0.43, p = 0.0007). So, heartbeat is more fractal in healthy status: a low fractal fluctuation is a sign of pathology.

Adult↗