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Biomedical subjects

A Davignon

Publications and source records attributed to A Davignon.

At least 55 records · Page 3Linked to original sources
PubMed1986

Wall thickness, cavity dimensions, and myocardial contractility of the left ventricle in patients with simple transposition of the great arteries. A multicenter study of patients from 10 to 20 years of age.

Fifty-one patients with uncomplicated transposition of the great arteries (TGA) and normal pulmonary pressure who were 10 to 20 years old and 69 normal subjects matched for age were studied by M mode echocardiography. Left ventricular internal dimensions and posterior wall thickness showed positive correlation with the body surface area in the TGA as well as in the control groups. Values for these parameters in the TGA group were generally smaller than those in the normal population. Septal thickness of patients with TGA (5.9 +/- 1 mm) was also smaller than that in the control group (6.6 +/- 1 mm) (p less than .01). Septal motion was normal in 11 patients with TGA and paradoxical in 19 patients in this group. In the other 21 patients the septum was flat. The following systolic time intervals of the left ventricle were found for patients with TGA: preejection period (PEP) 64 +/- 11 msec, ejection time (ET) 310 +/- 37 msec, and PEP/ET 0.21 +/- 0.04. These values were significantly different from those of the right ventricle for the normal population: PEP 77 +/- 12 (p less than .01), ET 327 +/- 25 (p less than .05), and PEP/ET 0.24 +/- 0.03 (p less than .01). Shortening fraction and mean velocity of circumferential fiber shortening (49 +/- 7% and 1.6 +/- 0.3 circ/sec, respectively) were also significantly higher (p less than .01) in patients with TGA than in the control group (33 +/- 4% and 1.1 +/- 0.2 circ/sec). These data should help achieve reliable quantitative and qualitative interpretations of echocardiograms of patients with TGA.

Adolescent↗
PubMed1985

[Respiratory variations in the right ventricular diameter: an echocardiographic element in the diagnosis of partial isolated pulmonary venous return anomaly].

Isolated partial anomalous pulmonary venous drainage (PAPVD), in contrast to atrial septal defect (ASD), does not cancel out the effects of respiration on blood flow in the right ventricle. The aim of this study was to see whether this difference could contribute to the diagnosis of PAPVD without ASD on M mode echocardiography. The diastolic dimensions of the right ventricle on expiration and inspiration were compared in 4 groups of patients aged 2 to 17 years. Group 1 comprised 6 children with PAPVD without ASD; Group 2: 10 children with PAPVD and ASD; Group 3: 11 children with isolated non-restrictive ASD, and Group 4: 10 normal children. Groups 1 and 4 were comparable with a respiratory variation of RV dimension of 10 to 29%. On the other hand, in Groups 2 and 3 the percentage variation was less than 6%. The finding of isolated RV dilatation with normal respiratory variation of its internal dimension should therefore alert the operator to the possible diagnosis of PAPVD without ASD.

Adolescent↗
PubMed1985

[Kawasaki's disease. Epidemiological aspects and cardiovascular manifestations. Apropos of 106 cases].

One hundred and six patients fulfilling accepted diagnostic criteria for Kawasaki disease (90 p. 100 of French-Canadian origin) were evaluated with serial electrocardiograms and echocardiograms (M mode and two-dimensional). Half of the patients (53) had cardiovascular manifestations at one time during their illness. Thirty-one had abnormal electrocardiograms: non specific ST and T wave changes inferiorly (27), prolonged QT intervals (6), first degree AV block (3). M mode echo was abnormal in 31 cases showing: slight pericardial effusion (17), flat septal movement (11), left ventricular dilatation (4), decrease of shortening fraction (2). Seven patients (6.4 p. 100) presented fusiform coronary aneurysm detected in 6 by two-dimensional echography (with angiographic confirmation) and at autopsy in another. M mode echo and electrocardiogram abnormalities were transient in the great majority of patients disappearing during an average follow-up period of 10 months. Coronary aneurysm had disappeared at the end of follow-up in two patients, regressed in three and remained identical in another. There were no relations between severity of clinical symptoms, electrocardiographic or echocardiographic (M mode) abnormalities and the development of coronary aneurysm. Serial studies with two-dimensional echo should be done in every patient with this disease for early detection and follow-up of coronary aneurysm.

Adolescent↗
PubMed1985

Echocardiographic assessment of left ventricular function in patients with hypokalemia.

Based on clinical and experimental data, a cardiomyopathic syndrome has been attributed to chronic hypokalemia. Analysis of the published data indicates the presence of numerous other complicating factors which might have compromised cardiac function. Echocardiographic studies on 5 children with lifelong (Bartter's syndrome, 3 cases; congenital renal alkalosis, 1 case) or prolonged (primary hyperaldosteronism, 1 case) hypokalemia did not reveal any abnormalities of myocardial performance, thus questioning the premise that hypokalemia causes cardiomyopathy.

Bartter Syndrome↗
PubMed1985

[Plain films in supero-inferior ventricles].

Chest radiographs of 11 patients with supero-inferior ventricles proven by echocardiography and angiocardiography are presented. The main feature is the modified configuration of the left heart contour. Even if not specific, this sign is encountered frequently (72%) and may suggest the diagnosis.

Abnormalities, Multiple↗
PubMed1985

Use of the internal mammary artery for preservation of circulation to the left arm after subclavian flap aortoplasty in correction of coarctation in children.

In 14 children aged 4 to 12 years in whom the anatomy of the coarctation did not allow for an end-to-end anastomosis, we have performed a subclavian flap angioplasty. To correct the inconvenience of ligating the subclavian artery and to avoid the use of synthetic material, we used the internal mammary artery to reestablish circulation from the aorta to the subclavian artery. All patients are well. At postoperative catheterization (18 to 42 months, average 24) in the first eight, the mammary artery was patent and the flow to the subclavian was good.

Aortic Coarctation↗
PubMed1984

Value of systolic time intervals in the diagnosis of large patent ductus arteriosus in fluid-restricted and mechanically ventilated preterm infants.

M-mode echocardiographic features suggesting a patent ductus arteriosus are based on two groups of indirect criteria: dilation of the left cardiac cavities and changes of systolic time intervals. The reliability of the first group of criteria has been questioned in fluid-limited, mechanically ventilated preterm infants. The sensitivity of the systolic time intervals in the same circumstances is investigated. Twenty-three patients with a large patent ductus arteriosus were selected. Review of their echocardiograms shows that the sensitivity of the various criteria (expressed as percentage of positivity) was as follows: inversion of the ratio of left ventricular preejection period to right ventricular preejection period, 91.3%; left ventricular preejection period to left ventricular ejection time over right ventricular preejection period to right ventricular ejection time less than 1,83%; left atrium dilation, 74%; shortening of left ventricular preejection period, 70%; dilation of left ventricular internal dimensions in diastole, 65%; increase in left atrium/aorta, 52%; and decrease of left ventricular preejection period to left ventricular ejection time, 48%. Three criteria involving time intervals (left ventricular preejection period to right ventricular preejection period, left ventricular preejection period, and left ventricular preejection period to left ventricular ejection time) had 100% specificity. The lowest specificity was found with criteria involving the left atrium (left atrial to aortic root ratio 75% and left atrium 63%). It is concluded that study of systolic time intervals is a reliable means of detecting preterm infants with hemodynamically significant left-to-right shunt through a patent ductus arteriosus even if the infants are mechanically ventilated and fluid restricted.

Ductus Arteriosus, Patent↗
PubMed1983

Subxiphoid two-dimensional echocardiographic diagnosis of double-chambered right ventricle.

The echocardiographic features of 14 patients with double-chambered right ventricle are presented. Diagnosis was confirmed in 13 patients at cardiac catheterization and in one at necropsy. The ultrasonic diagnosis was based on the visualization in subxiphoid short-axis view of an anomalous muscle bundle at the lower margin of the right ventricular infundibulum; this structure was present in diastole and systole and the distal portion of infundibulum was wide and free of obstruction. Associated lesions were very frequent (especially ventricular septal defects, present in 13 patients). Subxiphoid two-dimensional echocardiography is an easy, reliable, noninvasive means of assessing this disease in infants and children.

Cardiac Catheterization↗
PubMed1983

Influence of age on wall thickness, cavity dimensions and myocardial contractility of the left ventricle in simple transposition of the great arteries.

This study was carried out to establish a reference table of echocardiographic values for the left ventricle of simple d-transposition of the great arteries (d-TGA) and to determine at what age left ventricular dimensions in these patients become different from those of a normal population. Fifty-three patients with d-TGA and normal pulmonary pressure and 395 normal children ages 1 day to 10 years were studied by M-mode echocardiography. Results show that in d-TGA, left ventricular systolic and diastolic internal diameters are normal at birth. After 1 month, however, both diameters were below normal and despite a progressive increase with age, the mean values were always below normal. The mean posterior wall thickness of patients with d-TGA was also normal at birth but did not increase with age (2.3 mm in diastole and 4.3 mm in systole) and became significantly thinner than normal at 10 months of age in diastole and 7 months in systole. Septal thickness of patients with d-TGA did not differ from that of the control group. The shortening fraction and mean velocity of circumferential fiber shortening were significantly greater in d-TGA at all ages. Left ventricular measurements related to age are presented and should be of help in interpreting M-mode echocardiograms of patients with d-TGA.

Age Factors↗
PubMed1983

Echocardiographic assessment of cardiac function in children with chronic renal failure.

Echocardiographic assessment of cardiac function was made on 24 children with chronic renal failure of varying etiology and severity. In 20 patients without evidence of cardiac failure, parameters of left ventricular performance as represented by PEP/LVET and mean velocity of circumferential fiber shortening were within normal limits in the majority of patients. In addition, ejection fraction and shortening fraction were, in most children, within the 95% confidence limits for their age. In 4 patients who presented with congestive heart failure, marked left ventricular dilatation was noted in association with decreased shortening and ejection fractions and depressed mean velocity of circumferential fiber shortening. Also the PEP/LVET in these patients suggested the presence of a uremic cardiomyopathic condition. These studies, in addition to our own studies on children who have undergone fistula construction, hemodialysis, and transplantation, suggest that cardiac performance, in the majority of pediatric patients with end-stage renal disease, is well maintained and that the major factor involved in reducing exercise tolerance is the presence of uremic anemia. Only a minority of patients may develop severe uremic heart disease.

Adolescent↗
PubMed1982

Hang-out time of pulmonary valve in d-transposition of great arteries.

Recently it has been shown that in patients with transposition of the great arteries the isometric relaxation time of the left ventricle could be negative in the presence of normal pulmonary artery pressure. In order to find an explanation for this apparently paradoxical situation, it was decided to evaluate the importance of the delay of closure of the pulmonary valve in 15 patients with transposition of the great arteries. This delay is called the hang-out time. The hang-out time was found to correlate inversely with the isometric relaxation time as well as with the pulmonary artery systolic (r = -0 . 70) and mean pressures. A weaker correlation was found between the isometric relaxation time and the time of mitral valve opening. These results show that in transposition of the great arteries with normal pulmonary artery pressure, the pulmonary valve has a prolonged hang-out time, to the extent that it frequently closes after the opening of the mitral valve, explaining the negative isometric relaxation time found in these cases. This finding may help in the non-invasive assessment of the pulmonary vascular resistance of patients with transposition of the great arteries.

Child, Preschool↗
PubMed1982

Cardiac dimensions and myocardial function of infants with congenital hypothyroidism. An echocardiographic study.

This study was undertaken to evaluate the cardiac dimensions and various indices of myocardial function, determined by echocardiography, in a group of 12 infants with congenital hypothyroidism. Left ventricular systolic and diastolic dimensions, posterior wall thickness, enddiastolic and systolic volumes were all significantly lower in the hypothyroid infants compared with 25 normal infants of the same age. No pericardial effusion was found. Hypothyroid infant had a lower heart rate with a reduced cardiac output. The mean velocity of circumferential fibre shortening and the shortening fraction of the left ventricle were normal. The pre-ejection period of the left ventricle (PEP), however, was abnormally prolonged as well as the ratio PEP over left ventricular ejection time (PEP/ET). This ratio correlated inversely with the end-diastolic volume, suggesting that the increased PEP/ET could be partly the result of decreased preload.

Cardiac Volume↗
PubMed1982

[Neonatal electrocardiographic manifestations of congenital hypothyroidism. Correlation with echocardiographic data].

Twelve infants, average age 5, 4 weeks (range 3 to 8 weeks) with congenital hypothyroidism were studied. In addition to routine evaluation including plasma T3, T4 and TSH estimation and the establishment of a clinical index of hypothyroidism on electrocardiogram and an echocardiogram were performed. The following variables were analysed: heart rate, QRS axis in the frontal plane, PR interval in Lead II, corrected QT interval in V5, amplitude of the P waves in Lead II, R waves in V3R, V1, V5 and V6; S waves in V1, V2 and V4 and T wave in V6. The ventricular activation time in V5 and QRS duration in V3R, V1 and V6 were also measured. The presence of pericardial effusion, left ventricular posterior wall and septal thickness, and left ventricular internal diastolic and systolic dimensions were determined by echocardiography. The following conclusions were drawn: 1. The ECG of hypothyroidism in the neonatal period is characterised by the low amplitude of the left ventricular potentials while increased conduction times were much less evident; 2. Only the sum of R + S in V2, the amplitude of the T wave in V6 and increase in QRS duration in V3R were influenced by severity of hypothyroidism; 3. Left ventricular microvoltage is not due to pericardial effusion which was absent in all our cases.

Congenital Hypothyroidism↗
PubMed1982

Renal transplantation and cardiac function in pediatric patients.

Nine pediatric patients underwent echocardiographic evaluation prior to and after renal transplantation. Prior to transplantation parameters of cardiac contractility such as mean velocity of circumferential fiber shortening, ejection time, ejection fraction and shortening fraction were within the normal ranges for the age group. Post transplantation there was a significant decrease in heart rate and cardiac index. In addition a dramatic increase in hemoglobin levels was observed. The improvement in circulating hemoglobin levels rather than the removal of uremia appears to be the dominant beneficial result in improving cardiovasuclar hemodynamics.

Adolescent↗
PubMed1981

Palliative surgery in tetralogy of Fallot.

Because much controversy surrounds the palliative surgical treatment of young children with tetralogy of Fallot the authors review their experience over 13 years with two procedures--the Blalock-Taussig operation and the Waterston shunt. Blalock shunts were performed 195 times in 172 patients; 147 had a single Blalock anastomosis which carried them through the critical period and allowed for later correction of the tetralogy. Thrombosis of the Blalock anastomosis occurred in two patients in the early postoperative period. In 23 patients a second shunt was necessary after the first Blalock shunt became inadequate in spite of being patent. The age of the children ranged from 2 weeks to 9 years, 74% being operated upon under the age of 2 years. There were four early deaths (2%) and five late deaths (2.5%) in this group. Of the last 91 consecutive patients operated upon between Sept. 1, 1972 and June 30, 1980 none have died. Between September 1968 and June 1980, 14 patients with tetralogy of Fallot underwent a Waterston shunt. Their ages ranged from 2 days to 4 years. Six patients were younger than 35 days at the time of operation. There were two operative deaths in this group. The Waterston shunt carries a high risk and is reserved for the occasional patient who needs palliation during the first weeks of life and in whom the anatomy of the subclavian artery does not favour a good Blalock-Taussig shunt. The Blalock-Taussig operation is preferred because it is safe and gives good sustained clinical results. The mortality was much lower than previously reported. The growth of the pulmonary arteries was good in most patients. The Blalock shunt did not increase the pulmonary resistance and it did not influence the operative mortality.

Child↗
PubMed1980

Relation between isovolumic relaxation period of left ventricle and pulmonary artery pressure in d-transposition of the great arteries.

The study aimed to identify the best echocardiographic time interval (systolic or diastolic) for assessing pulmonary artery pressure in children with d-transposition of the great arteries. Echocardiograms were performed in 21 children with d-transposition of the great arteries within 48 hours of cardiac catheterisation. None of the children had had a Mustard procedure. Twenty-four recordings were obtained, three patients having been catheterised twice. Highest correlations were found for the ratio of the isovolumic relaxation time over the ejection time of the left ventricle (IRT/LVET) to the systolic pressure in the pulmonary artery and also between IRT/LVET and the difference between mean pulmonary artery pressure and mean left atrial pressure. All patients with a negative IRT/LVET ratio had a pulmonary systolic pressure lower than 35 mmHg and a mean pulmonary pressure lower than 25 mmHg. In patients with d-transposition, a negative IRT/LVET ratio appears to be a reliable indication of normal pressure in the pulmonary circulation. Serial echocardiographic studies for the follow-up of patients with d-transposition should include measurement of the time of relaxation of the left ventricle.

Blood Pressure↗