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R Roudaut

Publications and source records attributed to R Roudaut.

At least 163 records · Page 9Linked to original sources
PubMed1985

[Evaluation of left ventricular mass by M-mode and bidimensional echocardiography].

The aim of this study was to validate an echocardiographic method of evaluating LV mass by assessing the reproducibility and comparing the results with those of angiography. 20 patients without abnormal regional wall motions or asymmetric septal hypertrophy underwent left ventriculography in the RAO plane and three successive M mode and 2D echocardiograms. Three 2D echo methods of measuring volumes and mass were used: the monoplane ellipsoid model obtained from apical views, the biplane ellipsoid model from an apical and a short axis parasternal view and the hemi-ellipsoid-cylinder model (HEC). The M mode evaluations showed good reproducibility with respect to volume (variation coefficient (VC): inter observer 9.8 p. 100 and intra patient 15.6 p. 100). The reproducibility of 2D echo measurements was much poorer (intra patient volume: VC = 34 to 45 p. 100; mass 29 to 46 p. 100). A close correlation was observed between the results of M mode echo and angiography; volume r = 0.85, SD = 60 g. With respect to the 2D method, the best results were obtained with the HEC model; volume r = 0.90, SD = 31 ml; mass r = 0.82, SD = 41 g. We suggest a method combining the M mode and 2D techniques, using a HEC model in which the long axis is obtained by 2D echocardiography and the short axis and wall thickness by M mode recordings. The following correlations with the angiographic method were obtained: volume r = 0.91, SD = 36 ml; mass r = 0.89, SD = 27 g.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Treatment of hypertension by a new transdermal form of clonidine.

We studied one or two adhesive systems per week of clonidine TTS (2.54 or 5.08 mg/week). The results showed a more marked antihypertensive action with these adhesive systems than with 0.15 or 0.30 mg/day of the oral form. The transdermal system was better tolerated systemically and local cutaneous reactions prevented its use in only one case in our series. Overall, the patients were satisfied with the treatment. In our opinion, the simplicity of administration of clonidine TTS should improve the long term patient compliance with antihypertensive treatment.

Adhesiveness↗
PubMed1985

[Value of echocardiography in cardiological emergencies in adults].

To-day, two dimensional echocardiography represents a fundamental technique for diagnosis in cardiovascular emergency in the adult. The appropriate place for that type of examination is in different pathologies such as acute myocardial infarction, cardiac tamponade, dissecting aortic aneurysm, pulmonary embolism, dysfunction of prosthetic cardiac valves.

Acute Disease↗
PubMed1985

[Thrombophlebitis and pulmonary embolism in congenital factor XII deficiency].

The case of a young man hospitalised for bilateral lower limb deep vein thrombosis is reported. None of the usual causes were found after systematic wide-ranging investigation. The only abnormality on admission was a spontaneous increase in the cephalin-kaolin time to 65 seconds compared to a control time of 40 seconds. Measurements of the clotting factors showed a moderate and isolated deficiency in factor XII (30 p. 100), also present in a brother (50 p. 100) and a sister (42.5 p. 100). Fibrinolytic therapy was administered : an initial course of Streptokinase was followed by extension of a left femoral vein thrombosis and pulmonary embolism. Two courses of Urokinase were given with an eight day interval without significantly improving the venous circulation. This case is an example of thrombogenic disease due to a deficiency of a clotting factor resulting in non-activation of physiological fibrinolysis.

Adult↗
PubMed1985

[Myxoma of the mitral leaflet. Apropos of a case].

This case of an intracardiac myxoma observed in a 15 year old girl had several points of interest: the mode of presentation: the clinical signs were exclusively systemic and articular; the mode of diagnosis: 2D echocardiography demonstrated an immobile, dense mass about the size of a walnut implanted on the ventricular surface of the posterior mitral leaflet along the whole of its base and seemingly adherent to the ventricular wall; the intraventricular location of the tumour (exceptionally rare) and its mitral valve origin. The site of the tumour imposed mitral valve replacement but we were able to discuss the surgical approach using the results of echocardiography before surgery and a bioprosthesis was inserted to protect the maternal future of the patient.

Adolescent↗
PubMed1984

The prolonged antihypertensive effect of once daily atenolol: a study of continuous non-invasive arterial blood pressure monitoring.

This study was carried out on 12 hospitalized hypertensive patients to assess the antihypertensive efficiency and the duration of action of a once daily dose of atenolol. 100 mg of atenolol was given at 8 am every day for 5 days. Before and during the therapeutic period. 24-h blood pressure recordings were obtained with a continuous, automatic, non-invasive method working on the principle of oscillometry (Dinamap 845.950). Atenolol induced a significant reduction in mean blood pressure from 119 +/- 3.6 to 102.3 +/- 4.7 (P less than 0.001). This effect was significant from the very first day of treatment and was maintained over the duration of the study in ten patients. The decrease in blood pressure induced by atenolol lasted 24 h. Clinical tolerance of atenolol was excellent. In particular no case of excessive bradycardia was noted.

Adult↗
PubMed1984

[M-mode and two-dimensional echocardiography of 7 cases of cardiac amyloidosis].

Although rare, cardiac amyloidosis is the commonest cause of infiltrative myocardiopathy. The diagnosis may be suspected clinically in patients with mainly right ventricular failure of sudden onset. The aim of this study was to assess the diagnostic value of M-Mode and 2D echocardiography in this condition. Seven cases of cardiac amyloidosis were studied. Biventricular hypertrophy, usually more severe on the left side with reduction in size of the left ventricular chamber, was observed in all cases. Parameters of systolic and diastolic function were abnormal. A significant pericardial effusion was demonstrated in 3 patients. 2D echocardiography also allows evaluation of the myocardial structure: in 3 cases the whole of the left ventricular myocardium seemed granular, sparkling and abnormally echogenic. In patients with cardiac failure these appearances are very suggestive of amyloidosis, especially when the ECG shows low voltage complexes and pathological Q waves. In 3 other patients, this abnormal echogenic myocardial appearance was observed only in the interventricular septum, which is much less suggestive of cardiac amyloidosis. In conclusion, in patients with cardiac failure with cardiomegaly and a low voltage ECG, echocardiographic findings of hypertrophic cardiomyopathy (only rarely with dilatation) and hypokinetic wall motion are suggestive of cardiac amyloidosis, especially when the myocardium has a granular, sparkling appearance.

Aged↗
PubMed1984

[Critical study of the prognostic value of echocardiography in chronic aortic insufficiency].

The aim of this study was to assess whether, as previously reported series have suggested, aortic valve replacement is too late when echocardiography shows a left ventricular end systolic diameter (LVS) greater than or equal to 55 mm, a left ventricular fractional shortening (FS) less than or equal to 25%, and a ratio of left ventricular radius to wall thickness (R/H) greater than or equal to 4. Sixty-seven patients with pure chronic aortic regurgitation were operated in the period between 1979 and June 1981. All had at least one good quality preoperative M mode recording. Using the above mentioned parameters, the patients were divided into two groups: Group I (n = 41) "good surgical candidates" with LVS less than or equal to 55 mm, FS greater than 25%, and/or R/H less than 4; and Group II (n = 26) "high risk candidates" with LVS greater than 55 mm, FS less than or equal to 25% and/or R/H greater than or equal to 4. The clinical improvement was spectacular in both groups after surgery (mean follow-up 28 +/- 8 months). There were no operative deaths but 5 patients out of each group died secondarily. An echocardiogram was recorded in the immediate post-operative period in 55 cases; there was a significant reduction in LV diameters in both groups but the values in Group II remained higher. A control echocardiogram was recorded 17,5 +/- 8,9 months later 46 cases. The LV diameters had returned to normal in Group I but remained at the upper limit of normal in Group II. We conclude that patients with echocardiographic indices of " high risk " usually have a favourable postoperative course. However, although the echocardiographic parameters to improve, they do not return completely to normal.

Adult↗
PubMed1984

[Echocardiography in the study of left ventricular function].

Ultrasound provides anatomical (wall thickness, diameter) and functional (thickening of the wall, ventricular ejection, ventricular filling) information about the left ventricle. The reliability and reproducibility of these measurements have been improved by the development of mono and bidimensional techniques, so that, today, ultrasound is the method of choice for the investigation and surveillance of left ventricular function, provided it is of good quality. Apart from the indirect information about left ventricular function drawn from mitral or aortic traces, the echocardiogram has proven to be a reproducible method for estimation of the thickness of the ventricular wall, the ventricular diameters and the left ventricular muscle mass. Whatever the geometry of the left ventricle, the ventricular volume is assessed most accurately by bidimensional ultrasound.

Cardiac Volume↗
PubMed1983

Prevalence and significance of asymmetric septal hypertrophy in hypertension: an echocardiographic and clinical study.

To assess the prevalence of asymmetric septal hypertrophy (ASH) in hypertensive patients, 613 echocardiographic examinations performed over a period of one year were reviewed. Asymmetric septal hypertrophy (defined by an echocardiographic interventricular septum to left ventricular free wall thickness ratio of greater than or equal to 1.3 and by the presence of suggestive two-dimensional echocardiographic abnormalities) was found in 28 patients (5%). Clinical characteristics of asymmetric septal hypertrophy were assessed in 101 patients who underwent a complete evaluation. Patients with asymmetric septal hypertrophy (n = 9) were compared with patients with echocardiographic symmetrical left ventricle hypertrophy (n = 38) and without left ventricular hypertrophy (n = 54). Our results indicate that neither the severity of hypertension, nor the renin-angiotensin system nor sympathetic nerve activity appear to be the primary determinants in the development of asymmetric septal hypertrophy.

Adult↗
PubMed1983

[Fibrinolytic treatment of valve thrombosis. Apropos of 16 cases].

Sixteen cases of prosthetic valve thrombosis (9 mitral, 5 aortic), occurring in 14 patients, were treated by fibrinolysis. All were disc prostheses. The clinical state of the patients was very poor in 11 of the 16 cases with pulmonary oedema, low output and arrhythmias, but less dramatic in the 5 others who presented with thromboembolism and left ventricular failure. The diagnosis was made by echocardiography (9 cases), radio-cinema of the valve (9 cases) and/or angiography (4 cases). The therapy comprised Urokinase (UK) 4,500 U/kg/hour (6 cases) of Streptokinase (SK) 2,000,000 U in 10 hours (7 cases) or SK and UK at equal doses (3 cases). The outcome was assessed clinically, echocardiographically and radiologically. There were 11 definite successes, 2 partial improvements requiring surgical revision, 2 apparent successes but with massive recurrence at the 7th and 10th days, and 1 failure. Although the biological activity of SK is greater than that of UK, the clinical results were comparable with both fibrinolytic agents. Four patients had regressive embolic episodes during lysis of the valvular thrombosis. As fibrinolytic therapy was effective in 70 p. 100 of patients in this series, it could provide an acceptable alternative to surgery, especially in patients who would be poor operative risks. The management of patients after successful fibrinolysis remains divided between intensive medical follow-up or prosthetic valve replacement.

Adult↗
PubMed1983

Diagnosis of dissecting aortic aneurysm by two dimensional echocardiography: experience with 58 patients.

UNLABELLED: Recent improvements in surgical technics have dramatically changed the outcome of patients with aortic dissection (AD). The aim of this work is to evaluate the reliability of two dimensional echocardiography (2DE) in the diagnosis of AD. The 2DE was recorded in all patients with a systematic approach in order to visualize the entire aorta (Ao). 58 cases were studied in a three years period. At the beginning of this study we validate 2DE by comparison with angiography (angio) in 14 of our first patients: the 2 angio criteria (dilatation, abnormal intraluminal image) have been found on 2DE in 12 pts (92%), with intraluminal image) have been found on 2DE in 12 pts (92%), with no significant difference between internal diameter of Ao on angio and 2DE. In our experience with 58 pts a positive diagnosis was possible in 90% of AD type I and only 18% of AD type III. IN CONCLUSION: 2DE is a practical and valuable method for the assessment of type I and II AD. Two 2DE criteria must be present at the same anatomical level (dilatation, abnormal intraluminal echo). In these conditions we have been able to avoid aortography in 26 of our last patients with type I and II.

Adult↗
PubMed1982

[Outcome of echocardiographic vegetations in bacterial endocarditis during and after anti-infective therapy].

Echocardiography is a practical and reliable method of detecting endocardial vegetations. The aim of this study was to assess the course of echocardiographic vegetations in bacterial endocarditis under anti infectious therapy and to assess the prognostic significance of the vegetations. Twenty four patients with echocardiographic signs of vegetations were included in a standardised protocol: M mode and 2D examination at the beginning and at the end of medical treatment and when possible after bacteriological cure (average period of follow-up 16 +/- 6 weeks). Special attention was paid to the volume (assessed I to III) and acoustic density of the vegetations. Fifteen patients underwent surgery (62.5%). The size of the vegetations did not differ significantly from that observed in the other patients. The size of the vegetations remained constant during medical therapy and after bacteriological cure in 2/3 of cases. The vegetations grew during medical therapy (even when the patients were apyrexic) in 29% of cases, and even after a 40 day course of anti infectious therapy in 2 cases. The size of the vegetations decreases in 3 cases during treatment (2 cases of embolisation) and in 2 cases after bacteriological cure (without embolisation). No correlations could be drawn between the acoustic density of the vegetations and the outcome. In conclusion, the presence of a large vegetation in bacterial endocarditis does not in itself mean a poor prognosis. However, these large vegetations are often associated with severe mutilating lesions (62.5% in our series). The size of the vegetations remained unchanged during and after medical treatment in two thirds of cases.

Adult↗
PubMed1981

Echocardiographic assessment of left ventricular filling characteristics after mitral valve replacement with the St Jude medical prosthesis.

The major cause of late mortality and morbidity after prosthetic valve replacement is thromboembolism. The nidus for initiation of thrombus formation has been blood metal interfaces, and a new valve--the St Jude prosthesis--has therefore been developed without any metal components. We have assessed echocardiographically in 27 patients the effects of this valve on left ventricular filling characteristics when inserted in the mitral position and compared the findings with those in patients having mitral valve replacement with Starr-Edwards or Björk-Shiley prostheses and with those in patients undergoing repair of the native mitral valve. Echocardiograms were recorded and digitised. Measurements were made of the peak rate of increase of dimension (dD/dt) and duration of rapid filling. Values for the St Jude valve were 13.2 +/- 3.4 cm/s and 160 +/- 40 ms, respectively. The peak rate of dD/dt increase was significantly greater than with either the Björk-Shiley valve or the Starr-Edwards valve and was comparable with findings in mitral valve repair. The duration of the rapid filling phase was not significantly different from control values but was less than that of the Starr-Edwards valve. This study indicates that the new St Jude medical valve is less obstructive than either the Björk-Shiley or Starr-Edwards prostheses. This together with its low thrombogenicity suggests that further trials of this new valve should be undertaken.

Adolescent↗