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Biomedical subjects

C Cabrol

Publications and source records attributed to C Cabrol.

At least 181 records · Page 10Linked to original sources
PubMed1986

Prevention of atrial fibrillation or flutter by acebutolol after coronary bypass grafting.

Supraventricular tachyarrhythmias are common after coronary artery bypass graft surgery (CABG) and may have deleterious hemodynamic consequences. To determine if acebutolol, a cardioselective beta-blocking drug, prevents such tachyarrhythmias after CABG, 100 consecutive patients, aged 30 to 77 years (mean +/- standard deviation 53 +/- 9), were entered into a randomized, controlled study. Exclusion criteria were: contraindications to beta-blocking drugs, left ventricular aneurysm, major renal failure, history of cardiac arrhythmia and cardiac arrhythmia during the immediate postoperative period. From 36 hours after surgery until discharge (usually on the seventh day), 50 patients were given 200 mg of acebutolol (or 400 mg if weight was more than 80 kg) orally twice a day (dosage than modified to maintain a heart rate at rest between 60 and 90 beats/min). The 50 patients in the control group did not receive beta-blocking drugs after CABG. The 2 groups were comparable in angina functional class, ejection fraction, number of diseased vessels, antianginal therapy before CABG, number of bypassed vessels and duration of cardiopulmonary bypass All patients were clinically evaluated twice daily and had continuous electrocardiographic monitoring and daily electrocardiograms. A 24-hour continuous electrocardiogram was recorded in the last 20 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Acebutolol↗
PubMed1986

Vasopressin, aldosterone and renin responses to volume depletion in heart-transplant recipients.

Plasma arginine vasopressin (AVP), renin activity (PRA) and aldosterone (ALD) were measured immediately before and 60 min after intravenous administration of frusemide and passage from lying to standing in 10 untreated healthy subjects (group 1), eight asthmatic patients treated with prednisone (group 2) and 13 heart-transplant recipients treated with prednisone and cyclosporin (group 3). Three different tests for cardiac vagal innervation were performed in the study population. They confirmed that the patients of group 3 were denervated whereas those of groups 1 and 2 had an intact cardiac innervation. Plasma volume depletion after frusemide administration estimated from the rise in plasma proteins was 10-12%. Mean blood pressure was higher in the transplant recipients but did not change in the three groups. Heart rate was also greater in the transplant recipients as a result of vagal denervation. PRA and ALD increased in all the subjects: 2.8, 3.3 and 2.2 times basal value for PRA, 2.7, 4.6 and 2.1 times basal value for ALD in groups 1, 2 and 3 respectively. In contrast, plasma AVP increased only in the two control groups (x1.45 and x1.65 in groups 1 and 2 respectively) whereas it was unchanged in the group of heart-transplant recipients (x1.05). In order to better understand the etiology of the high basal AVP plasma levels observed in group 3, AVP response to a standard water load was studied in eight supplementary heart-transplant recipients: 81.5% of the water load was excreted over 3 h and plasma AVP fell significantly (x0.76).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries.

From November, 1976, to June, 1983, 100 patients, 84 male and 16 female patients ranging in age from 13 to 74 years, were operated on for aortic insufficiency associated with an aneurysm of the ascending aorta. Twenty patients were in New York Heart Association Class I, 22 in Class II, 51 in Class III, and seven in Class IV. The surgical treatment in all cases consisted of total replacement of the ascending aorta with a tube graft containing a prosthetic aortic valve and reimplantation of the coronary arteries by an intermediate tube graft according to the technique already reported. In 68 patients an uncomplicated annulo-aortic ectasia existed, and in 32, an aortic dissection; nine of the latter group were operated on during the acute phase. The operative mortality for the entire group was 4% (four deaths). One patient has been lost to follow-up during a period ranging from 18 months to 8 years (average 54 months). The late mortality has been 11/96. Among the 84 survivors, clinical improvement is readily apparent (89% are in Class I or II). Twenty-five patients have been restudied by angiography, which revealed a satisfactory coronary and aortic appearance in all cases with neither stenosis nor aneurysm. The actuarial survival rate is 75% at 8 years. In conclusion, the treatment of aortic insufficiency associated with an aneurysm of the ascending aorta by insertion of a composite graft and reimplantation of the coronary arteries through an intermediate Dacron tube is a reliable method with low mortality and excellent long-term results.

Actuarial Analysis↗
PubMed1986

[Use of specific photo-markers in experimental laser coronary angioplasty].

Research into improving the efficacy of laser in the vaporisation of atheromatous plaques has led to the study of their modes of emission and to attempts at changing the natural absorption properties of the target lesion. This was achieved in vitro by incubation with solutions of derived haematoporphyrin and in vivo by oral administration of therapeutic doses of tetracycline. The selective nature of the coloration produced having been proved, the use of appropriate lasers allowed reduction of 50 to 100 p. 100 of the emitted energy; the exploitation of the fluorescent properties of tetracycline, investigated by laser spectrofluoroscopy in this study, has led to the concept of in situ photodiagnosis of the plaque. These results may open up a new field of research into unknown photobiological characteristics radically different to the thermic energy used at present.

Coronary Artery Disease↗
PubMed1986

[Acute native endocarditis. The results of surgical treatment].

Between January 1978 and December 1984, 141 cases of acute native valve endocarditis were treated surgically in the Department of Thoracic and Cardiovascular Surgery of the Pitié Hospital. The diagnostic criteria of acute native valve endocarditis were the duration of treatment (antibiotic therapy for less than 40 days), the characteristic operative appearances of the lesions, and the results of anatomo-pathological examination of the excised valves. The infecting organism was not isolated in 35% of cases. The aortic valve was the commonest site of infection (65.2% with a high incidence of abscess of the aortic ring, irrespective of the causal organism. The operative mortality was 5.6%. This depended mainly on the preoperative haemodynamic status of the patient. The duration of antibiotic therapy prior to surgery did not seem to be relevant. The 3 years survival rate was 78%. The secondary reoperation rate was 7%. There was a higher incidence of secondary perivalvular regurgitation in patients who had previously had an abscess of the aortic ring.

Acute Disease↗
PubMed1986

[Detection of cardiac graft rejection using proton nuclear magnetic resonance].

Rejection of cardiac transplants can be detected by NMR imaging if it is associated with a change in myocardial T1 and/or T2 proton relaxation time. T1 and T2 were studied in 14 Lewis rats that underwent heterotopic cardiac transplantation. T1 and T2 were measured in vitro immediately after sacrifice 3, 4, 7 or 11 days after the graft using a Minispec BRUKER PC20. The myocardial water content was measured by dehydration in a vacuum for 24 hours. Histological analysis of sections classified the rejection process in 4 stages according to the degree of lymphocyte infiltration and percentage of myolysis. There was a significant difference between the ortho and heterotopic hearts: (Formula: see text). In particular, there was highly significant relationship between T2 and the stage of rejection (r = 0.90, p less than 0.005), and between T2 and % myolysis (r = 0.84, p less than 0.005). In addition, there was a close relationship between the T2 of the ortho and heterotopic hearts and their water content (r = 0.95, p less than 0.001). If these results are confirmed in man, is should be possible to detect rejection by NMR imaging using sequences of activation concentrating on changes of T2.

Animals↗
PubMed1986

[Essential and iatrogenic gingival hyperplasia. Its morphology and significance].

11 specimens were carried out in patients with idiopathic gingival hyperplasia (3 cases), gravidic hyperplasia (1 case), iatrogenic hyperplasia (5 cases after cyclosporin A administrated in patients with cardiac grafts, 2 cases after treatment by Adalat). By optic microscopy, the deep collagen base is thickened, associated sometimes to an inflammatory process. By histoenzymology, the fibroblasts have high activities of their oxidative enzymes and also of the enzymes of protein synthesis. The electron microscopy corroborates the numerous globular fibroblasts with well-developed rough endoplasmic reticulum. These results prove the main role of fibroblasts in these lesions and the etiopathogenesis of this hyperplasia is discussed.

Adolescent↗
PubMed1986

[Renal lesions induced by cyclosporin. Apropos of 4 renal biopsies and 22 necropsies of recipients of heart transplant].

The morphological study of kidney in patients without any preexistent renal disease and treated by cyclosporine corroborated the nephrotoxicity of this immunosuppressive drug. 4 biopsies (in 2 patients with Behçet's disease, in 1 recipient of allogenic medullary graft and 1 recipient of heart transplant) were performed for acute renal failure observed in a variable time after the beginning of treatment (7th day to 14 months). In two cases, they demonstrated obvious vascular lesions (arteriolar or glomerular thrombosis, fibrinoïd necrosis) and they detected constantly changes of proximal convoluted tubules (epithelial vacuolization or necrosis, calcifications). In addition, the ultrastructural study performed in all cases showed a striking increase of lysosomes and some giant mitochondria. The 8 autopsies of recipients with heart transplants treated by cyclosporine for more than 1 month corroborated also these renal changes which were always correlated with biological perturbations of the renal function (increase of level of serum creatinine). Besides the proximal convoluted tubular lesions (vacuolization, necrosis and calcifications), an obvious increase of the interstitial tissue proportional to the long time of treatment was always detected.

Adolescent↗
PubMed1986

[Heart transplantation 1985. Experience of the Pitié].

Heart transplant surgery has come of age over the last four years, after 17 years of clinical application: indications have been specified, techniques systematized and treatment and post-operative follow-ups have been clarified. The results are remarkable: survival at four years is more than 80 per cent, with normal socio-familial and often professional reintegration for almost all heart transplant patients. Increased application of heart transplant surgery in the months to come will transform prognosis in patients presenting irreversible cardiac lesions, but will raise the problem of the supply of donor organs.

Adult↗
PubMed1986

[Experimental coronary angioplasty using hematoporphyrin coloration simultaneously with a pulsed laser beam].

The setting up of a reliable method for angioplasty by laser irradiation is based. On the one hand, on the simultaneous control of the observed thermal, mechanical and photochemical effects within the atheromatous material and, on the other, on the demonstration of the absence of effects damaging to the arterial tunica. Theoretical modelling and experimental use have together proved the unique importance of pulsed emission, which strongly reduces thermal diffusion. Labelling of the atheromatous plaque by a hematoporphyrin derivative (HPD), as exemplified in the carcinological process, cancels the superficial reflectivity and strongly reduces the diffusion coefficient in the plaque. It confers on it a spectral absorption characteristic which is the basis of the exact physical coupling between the frequency of the exciting radiation and the absorption which generates vaporization in the pathological material. The preparation of chemically more homogeneous HPD and the spectrometric study of other colouring agents in vivo point to a further development of this technique of angioplasty.

Coronary Disease↗
PubMed1985

Systemic hypertension after cardiac transplantation: effect of cyclosporine on the renin-angiotensin-aldosterone system.

Fifteen patients who had undergone cardiac transplantation and who had hypertension (164 +/- 14/112 +/- 13 mm Hg), aged 16 to 57 years (mean 39), were treated with cyclosporine, 8 +/- 3 mg/kg/day, and prednisolone, 0.27 +/- 0.1 mg/kg/day, for 63 to 788 days (mean 288) after transplantation. They were not given antihypertensive drugs. Before treatment, the mean urinary sodium level was 104 +/- 48 mEq/day. Two discrete abnormalities accompanied their high blood pressure (BP): an increase in serum creatinine levels (p less than 0.05) to values exceeding those measured just before transplantation (2.1 +/- 1.0 vs 1.35 +/- 0.54 mg/dl) with low creatinine clearance (61 +/- 28 ml/min X 1.73 m2), and a 15% increase in plasma volume (+445 +/- 686 ml, p less than 0.02). Urinary excretion of vanilmandelic acid and total metanephrines was normal. Supine plasma renin activity was also normal (0.78 +/- 0.32 nmol/ml/hour). The stimulation of renin release after acute inhibition of converting enzyme by captopril was less marked than is usual in hypertensive subjects (0.86 +/- 0.54 nmol/liter/hour). Captopril induced a smaller drop in BP than nifedipine (-8 +/- 13/-6 +/- 10 mm Hg vs -14 +/- 11/-15 +/- 10 mm Hg). Levels of plasma aldosterone, angiotensinogen and converting enzyme activity were all normal, 308 +/- 147 pmol/liter, 712 +/- 164 nmol/ml and 30 +/- 6 mU/ml, respectively. It is concluded that hypertension is common in cardiac transplantation patients treated with cyclosporine, since 13 of our 15 subjects were normotensive before transplant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗