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Biomedical subjects

C Masquet

Publications and source records attributed to C Masquet.

At least 37 records · Page 2Linked to original sources
PubMed1985

Relationships between single-vessel coronary artery obstructions and wall motion dysfunction analyzed by four computer-based methods.

We analyzed regional wall motion in 238 patients by using cineangiograms recorded in the 30 degrees right anterior oblique projection. The sample was divided into three groups: a normal group (n = 71), a group with isolated obstruction of the left anterior descending coronary artery and previous anterior myocardial infarction (n = 85), and a group with isolated obstruction of the right coronary artery and previous inferior myocardial infarction (n = 82). Both anterior and inferior groups also had motion abnormality within the corresponding anterior or inferior wall as judged by the qualitative analysis of cineangiograms. Four quantitative methods were compared: a long axis method and a center of mass method using internal reference systems, a method derived from the Stanford model and an area-based method using external reference systems. Normal regional values were determined from the normal group to evaluate the specificity and sensitivity of the methods. The area-based method was the most sensitive in the anterior infarction group, whereas the center of mass method was the most sensitive in the inferior infarction group. We conclude that there is no evidence that any method, among those tested, is superior to others for every expected location of wall motion abnormality.

Adult↗
PubMed1985

Changes in left ventricular performance during chronic pressure or volume overload: importance of physical properties of the arterial system.

The present study was aimed at evaluation of changes in systolic and diastolic left ventricular function during chronic pressure of volume overload, in comparison with normal subjects. Sixty-two patients were included: group 1 was composed of 25 normal subjects, group 2 was composed of 20 subjects with essential hypertension, and group 3 was composed of 17 subjects with aortic regurgitation without congestive heart failure. Cardiac output, aortic and left ventricular pressures (micromanometers), ventricular volume and ascending aortic radius (cineangiography), ejection fraction (EF), mean velocity of fiber shortening (VCF), ventricular mass (m), and the ratio m/EDV (EDV, end diastolic volume) were determined. Also measured were maxima for end systolic pressure (ESP), end systolic stress (ESS), and end systolic volume (ESV) and radius (ESR), as well as the modulus of left ventricular chamber and muscle stiffness (method of Gaash et al.) (1) and characteristic impedance of the ascending aorta (Zc). In hypertensive patients, m and m/EDV were increased, as was the ESP/ESV ratio, whereas EF and VCF were not modified and the ESS/ESR was normal or sometimes decreased. The systolic "pump" function thus appeared to be increased, whereas the muscle function appeared normal or decreased. The moduli of left ventricular chamber stiffness and muscle stiffness were increased. Zc was increased because of a greater pulse wave velocity, although aortic radius was larger. A close relationship was found between Zc and the ratio m/EDV. In patients with aortic regurgitation, the increased left ventricular mass was closely related to the regurgitant fraction (RF). The m/EDV ratio was normal. EF was unmodified and VCF and the ESP/ESV ratio were decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Coronary angiography and coronary bypass in patients over 70 (valvular disease excluded). Indications and results].

Between 1982 and 1984, 30 patients aged 70 or over underwent coronary angiography for isolated coronary artery disease, complicated in 8 cases by an infarct and uncontrolled by major medical treatment, including triple therapy on 28 mmHg (range 5-30 mmHg). Coronary angiography was performed under intravenous trinitrin in 9 cases, under intra-aortic balloon pumping in 1 case, without any serious complications. The majority of patients had triple vessel disease (18 cases) and stenosis of anterior interventricular (27 cases). The left main stem was diseased in 5 patients. Twenty-four patients, with an EF of over 0.40, underwent a coronary bypass with an average of 27 grafts/patients; 4 myocardial infarcts and 5 postoperative deaths were observed. Nineteen patients survived at medium term follow-up and had an excellent clinical result. Of the non operated patients, there was one early death and 3 patients remained severely incapacitated. In the absence of a major contra-indication to surgery, coronary angiography can be offered to patients over 70 years old in cases of severe coronary insufficiency, resistant to major medical treatment. Coronary bypass is justified by the spectacular functional improvement which it alone can bring about.

Age Factors↗
PubMed1984

Reduction of myocardial infarct size by a fluorocarbon-oxygenated reperfusate.

This investigation assesses whether the size of an acutely revascularized myocardial infarct (MI) could be reduced by altering the composition of the initial reperfusate. Nineteen open-chest dogs underwent 4-hour occlusion of the left anterior descending coronary artery and were then assigned to a treatment group: 12 dogs to selective intracoronary infusion of the modified reperfusate over 30 minutes before resumption of blood flow for 60 minutes and 7 to a control group (90 minutes of unmodified blood reperfusion). The modified reperfusate consisted of 500 ml of a fluorocarbon-oxygenated crystalloid solution (PO2 650 mm Hg; total O2 content 5.5 vol%) whose composition was adjusted by decreasing Ca++ (0.25 mM), increasing pH (7.60) and adding glucose (1.8 g/liter). Four hours after occlusion, technetium-99m-labeled microspheres were injected into the left atrium. After 90 minutes of reperfusion, the heart was removed and sliced transversely. Areas not perfused by microspheres (areas at risk) were traced, planimetered and compared with the areas of necrosis after incubation in triphenyltetrazolium chloride. Areas were then converted into weights. In control dogs, the weight of necrotic myocardium was not significantly different from the weight at risk (5.0 +/- 0.7 vs 7.0 +/- 0.8 g, respectively [mean +/- standard error of the mean]), whereas it was markedly reduced in treated dogs (5.9 +/- 0.5 vs 9.4 +/- 0.7 g, respectively, p less than 0.001). The weight of salvaged myocardium was 3.4 +/- 0.5 g in treated dogs vs 1.9 +/- 0.4 g in the control group (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Ventricular function and arterial compliance in patients with congestive cardiomyopathy.

In order to study the interrelationship between left ventricular afterload, estimated from the mean left ventricular wall stress, and the mechanical properties of the aorta, we have simultaneously measured systemic arterial compliance and left ventricular wall stress in 19 patients with congestive cardiomyopathy. The strong linear relationship between the ejection fraction of the left ventricle and systemic arterial compliance, and between left ventricular wall stress and systemic arterial compliance, suggests that systemic arterial compliance is an important determinant of left ventricular afterload and thus of left ventricular function.

Adult↗
PubMed1984

Comparison of geometrical models for evaluating left ventricular wall motion from cineangiograms.

Regional wall motion of the left ventricle (LV) has been analyzed from contrast ventriculograms by using 4 methods based on different geometrical frameworks. Two of them utilize moving internal reference systems, the center of mass (CMM) and the long axis (LAM) methods; the two other ones use fixed external reference systems, the area-based (ABM) and the Palo Alto (PAM) methods. The techniques were applied on a set of 81 patients: 42 were normal and composed the group I; 22 had a single vessel obstruction greater than 75% of the left anterior descending coronary artery (group II) with old necrosis or active ischemia of the LV anterior wall; 17 had a single vessel obstruction greater than 75% of the right coronary artery (group III) with old necrosis or active ischemia of the LV inferior wall. ABM and PAM showed the highest specificities and sensitivities on the studied sample. Therefore, we believe these two methods, of the techniques tested, are the best to quantitate wall motion from cineangiograms.

Cineangiography↗
PubMed1984

[Acute myocarditis simulating an anterior infarction rupture. Apropos of 2 cases].

The first case report concerns a 31 year old woman presenting clinically and electrocardiographically as an anteroseptal myocardial infarction complicated by cardiogenic shock with equalization of right heart diastolic pressures. Coronary angiography performed under circulatory assistance was normal. The patient recovered, and clinical examination 4 years after the acute episode is absolutely normal. The second case was a 37 year old man admitted in cardiogenic shock thought to be due to a large anterior myocardial infarct. Catheterisation showed equalization of right heart diastolic pressures. Pericardial aspiration was negative and the most likely diagnosis appeared to be a localised rupture of the heart. The patient underwent emergency cardiac surgery but no infarct scar was observed and opening the pericardium did not improve the haemodynamics. Coronary angiography was carried out at the 24th hour under circulatory assistance and was found to be normal. The diagnosis was corrected to that of acute myocarditis and 5 months after the acute episode clinical cure was confirmed by normal echocardiography and angiography. The only positive aetiological finding in this case was the serology to chlamydia trachomatis which as strongly positive at increasing titres. Chlamydia was isolated from the patient's urethra and a chlamydia trachomatis exocervicitis was also found in the partner. This appears to be the first reported case of chlamydia trachomatis acute myocarditis in the adult.

Acute Disease↗
PubMed1984

[Cardiac manifestations of the hypereosinophilic syndrome. The value of 2-dimensional echography (12 cases)].

The prognosis of the hypereosinophilic syndrome (HS) depends mainly on the development of endomyocardial fibrosis (EMF). This complication may be overlooked at an early stage, although its presence is an indication for steroid or antimitotic therapy of the HS. Even at an advanced EMF and associated intracardiac thrombi may not be visualised by angiography. This study was undertaken to assess the diagnostic value of 2D echocardiography in 12 patients. The patients were all men (12 of them) aged 22 to 64 years with unexplained eosinophilia 1 500/mm3 for over 6 months, and visceral lesions. The patients were divided into 3 clinical groups. Group A comprised 4 "allergic" patients with chronic asthma and a significant elevation of IgE; Group B comprised 5 "myeloproliferative" patients with splenomegaly and/or hepatomegaly and a significant elevation of serum B12 levels. The 3 remaining patients who could not be allocated to either Group A or B formed the third group (Group C). 2D echocardiography was carried out on average 30 months after diagnosis of the HS and six planes of examination were used systematically (two parasternal, two apical, one extreme apical and one subcostal). Right and left ventriculography was performed in 6 patients (less than one month before or after 2D-echo). Anatomical studies were obtained in 4 cases (2 operations, 3 autopsies). Echocardiographic signs of EMF were observed in 8 cases. Four patients had a restrictive cardiopathy associated to a large LV thrombus in 2 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Coronary insufficiency in hypercholesterolemic xanthomatosis. Angiographic aspects].

Coronary arteriography for severe coronary artery disease was carried out in 21 patients with hypercholesterolaemic xanthomatosis (group I) and in 42 patients with serum lipids (group II). Both groups were matched with regard to age, sex and cardiovascular risk factors (hypertension, smoking habits, diabetes). The films were examined by an observer unaware of the patients' clinical features; the severity of the lesions observed was assessed by means of a coronary score system. Group I patients had significantly more severe coronary artery lesions and a significantly higher incidence (52% versus 7%; p less than 0.001) of left main coronary artery stenosis carrying a high risk of sudden death. The percentages of affected vessels amenable to surgery and abnormalities in left ventricular function were similar in both groups. It therefore seems reasonable to envisage early coronary angiography followed, if necessary, by aorto-coronary bypass in patients with hypercholesterolaemic xanthomatosis who experience anginal attacks, show ECG abnormalities on exercise and have persistent pain after myocardial infarction.

Adult↗
PubMed1983

Systemic arterial compliance in patients with non obstructive cardiomyopathy (NOCM), and coronary artery disease (CAD).

Arterial compliance had been estimated in three groups of patients: control, NOCM, and CAD, from analysis of the arterial pressure curve. In the three groups, a simple first order Winkessel model had been validated during normal and post extrasystolic beats. The measured arterial compliance depends mainly on i the diastolic pressure, ii, the mechanical properties of the aorta and major arteries. For the same range of age and diastolic pressure, the arterial compliance was not significantly different in the three groups of patients. Because of the significant variations of the arterial compliance during slight modifications of the diastolic pressure, the lack of difference in the compliance of control, NOCM, and CAD patients may be attributed to similar arterial mechanical properties.

Adult↗
PubMed1983

[The value of temporary electrosystolic pacing for treating low output in posterior necrosis with adiastole].

Early catheterisation was performed in 27 patients with an acute inferior myocardial infarction less than 3 days old complicated by signs of low output with right ventricular dysfunction. All patients had hemodynamic criteria of adiastole (PCP = 14.9 +/- 31 mmHg and LVEDP = 14.1 +/- 4.7 mmHg) with low cardiac output (CI = 1.41 +/- 0.32 l/min/m2). An atropine resistant bradycardia was characteristic (HR = 65 +/- 17.2/min) due to advanced or complete AV block (11 cases), sinoatrial block (3 cases, one with right atrial standstill) or sinus/parasinus rhythm (13 cases) inappropriate to the severity of their hemodynamic state. Although the prognosis based on the discriminating linear function FI = -0.427 + 0.00121 LVW - 0.00125 TPR was initially poor and predicted the death of 21 out of the 27 patients at one month, the outcome was usually favourable and only 8 patients died during the first month. Fifteen patients were treated by temporary endocavitary RV pacing. As the heart rate was increased from 53.8 +/- 11.2 to 92.4 +/- 4.9/min, the CI rose from 1.35 +/- 0.26 to 1.85 +/- 0.46 l/min/m2 (p less than 0.001) with a fall in SI from 26.7 +/- 8.3 to 20.1 +/- 5.6 ml/beat/m2 (p less than 0.005). The results were even further improved in 3 cases by sequential A-V pacing. The observed hemodynamic improvement continued during the period of pacing providing volumic expansion maintained LVEDP above 10 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗
PubMed1983

Coronary angiography in diabetic and non-diabetic patients with severe ischaemic heart disease.

In this retrospective study, the coronary angiograms of 36 diabetic and 36 non-diabetic patients, with severe ischaemic heart disease, were compared. Patient groups were closely matched for age, sex, cardiovascular risk factors, duration and functional disability of angina. Coronary angiograms were assessed by an independent observer without knowledge of the clinical status of the patients, and graded using a coronary score system. Left ventricular function was analyzed using computerized angiographic data. The same percentage of diabetic and non-diabetic patients had three-vessel disease. The mean coronary score per patient was similar in the two groups. Diabetic and non-diabetic patients had a statistically similar percentage of diseased vessels considered suitable for coronary bypass surgery. Left ventricular function was similar in the two groups. Thus diabetic patients with symptomatic coronary artery disease should be considered for angiographic evaluation using the same criteria as non-diabetics.

Coronary Angiography↗
PubMed1982

Effects of acebutolol on myocardial infarct extension: a randomized electrocardiographic, enzymatic and angiographic study.

The effect of acebutolol (1 mg/kg i.v. during the first 2 days followed by a daily oral dose of 600 mg for 3 weeks) was studied in a randomized trial involving 26 patients seen within 24 hours after the onset of uncomplicated anterior transmural myocardial infarction (TMI). Myocardial ischemia and necrosis were evaluated by precordial maps recorded daily for 9 days. Left ventricular pump function and dyssynergy were quantitatively measured on 30 degrees right anterior oblique cineangiograms. Angiography was performed, using the postextrasystolic potentiation technique, within the first 24 hours after TMI and was repeated 1 month later. The basal and postextrasystolic beats from the initial angiography were computerized and compared with those from the final angiogram. MB-CK serum level was measured from blood samples drawn every 3 hours for the first 72 hours. Fourteen patients selected at random received acebutolol within the first 24 hours; 12 subjects were untreated and served as controls. During the 1-month study, no other drugs were administered. Treated patients showed a significant reduction in capillary wedge pressure, extent of hypokinesis and ST-segment elevation; no significant differences were observed in the control group. However, the predictability based on the angiographic data was the same in both groups, and beta blockade did not alter this predictability significantly. Furthermore, no significant difference was found during the final evaluation for treated compared with control patients for any single variable or set of variables. The incidence of infarct extension was not decreased, but only significantly delayed in treated patients. The high variability of the measurements, probably related to the high variability of the pathophysiologic factors, may account for the failure to demonstrate the efficacy of acebutolol.

Acebutolol↗
PubMed1982

[Changes in the physical properties of the arterial system and left ventricular performance with age and in permanent arterial hypertension: their interrelation].

The purpose of this work was to study interactions between physical properties of the arterial system and left ventricular performance during aging in normal and in hypertensive patients. 50 patients were studied; 28 normal patients (age range 22 to 68 years) and 22 patients with essential hypertension (age range 23 to 63 years). In hypertensive patients, the end systolic pressure-volume ratio (ESP/ESV), modulus of chamber stiffness (kp), left ventricular wall thickness (h), mass (m), m/LVEDV ratio (LVEDV: left ventricular end diastolic volume), systemic arterial resistance (SAR), pulse wave velocity (C) and characteristic impedance of the ascending aorta (Zc) were increased compared to normal subjects of similar age. The ejection fraction (EF), the mean velocity of fiber shortening (VCF) and dp/dt max were unchanged. In normal patients: the ESP/ESV ratio, kp, h, m, m/LVEDV ratio, SAR, C and Zc increased with age; there were no age related changes in EF, VCF or dp/dt max. In both groups, there was a close relationship between the m/LVEDV ratio and Zc, the characteristic impedance of the ascending aorta. These results suggest that: 1. aging and arterial hypertension lead to similar changes in the physical properties of the arterial system and in left ventricular performance; 2. in both cases, the development of concentric cardiac hypertrophy is closely related to the physical properties of the arterial system.

Adult↗
PubMed1981

Detection of residual myocardial function in acute transmural infarction using postextrasystolic potentiation. A computerized angiographic study.

Twelve subjects without clinical or hemodynamic heart failure, admitted for a first untreated anterior transmural myocardial infarction, were evaluated within the first 24 hours after the onset of symptoms. Pulmonary angiography was performed while a right ventricular extrastimulus was delivered every fourth beat at 50% of the RR interval to systematically analyze the basal and the postextrasystolic left ventricular frames. Left ventriculograms were quantitatively processed to determine the ejection fraction (EF) and the percentage of the end-diastolic circumference showing hypokinetic (%HK) or akinetic (%AK) areas. Left ventricular angiography was performed 1 month later in all cases at the same paced atrial heart rate to compare this final angiogram to the basal and the electrically induced postextrasystolic initial beats. During the 1-month period of the study none of these subjects had complications such as recurrent chest pain, heart failure or rhythm disturbances, and no drug administration was necessary. Comparing the basal cycle of the initial angiogram and the final cycle, a poor correlation was found between the corresponding values of EF (r = 0.34), %HK (r = 0.38) and %AK (r = 0.48). The correlations were much better when a comparison was made between the postextrasystolic cycle of the initial angiogram and the final cycle (EF, r = 0.84; %HK, r = 0.96; %AK, r = 0.95). These results indicate that, from the first day after a TMI, the analysis of the postextrasystolic frame allows accurate estimation of the final left ventricular function and regional wall motion abnormalities. Postextrasystolic potentiation may be useful in the acute state of transmural infarction to discriminate potentially reversible ischemic from definitely jeopardized areas.

Acute Disease↗