Search PubMed⌕ Search

Biomedical subjects

C Thery

Publications and source records attributed to C Thery.

At least 37 records · Page 2Linked to original sources

[New inotropic drugs in chronic cardiac insufficiency: progress or wrong track].

The first results of the long-term treatment of chronic heart failure with inotrope positive medications are disappointing, especially in that survival is not prolonged and even a greater mortality is suggested. Is it because of the regular failure of specific medications, of a class of medications or because the overall concept of inotropism stimulation during chronic heart failure should be condemned? The mechanisms of inotropism of normal muscles or muscles in human chronic heart failure are reviewed as well as the various pharmacological means available to stimulate inotropism.

Cardiotonic Agents↗

Effectiveness of intravenous streptokinase on infarct size and left ventricular function in acute myocardial infarction. Prospective and randomized study.

Within 3 h after the onset of symptoms of myocardial infarction, 64 patients were randomly assigned to receive either a 1-h intravenous infusion of 1,500,000 IU of streptokinase (SK) or a conventional therapy. Infarct size was estimated in CK gram equivalent (CKg) by measurement of CK-MB every 3 hours during a 48-h period. Enzymatic study revealed that myocardial infarction of the SK group was significantly smaller (61.4 +/- 45 vs. 89.4 +/- 56 CKg, p less than .05). Angiograms were performed at early stage and five weeks after myocardial infarction. At first coronary angiogram, the infarct-related vessel was open in 82% in the SK group versus 12% in controls. The SK group had higher global ejection fraction at second angiogram (57 +/- 11% vs. 49 +/- 11%, p less than .02), but differences in regional wall motion were not significant. By analysis according to patency or occlusion of infarct-related vessel, global and regional ejection fractions were significantly better at first and at second angiograms in all patients and in anterior infarctions with a patent infarct-related coronary artery. There was no significant difference for inferior infarction. We conclude that intravenous streptokinase infusion early after the onset of myocardial infarction reduces infarct size and improves left ventricular function, chiefly in anterior infarction. This benefit appears to be closely correlated to patency of infarct-related vessels.

Acute Disease↗

[Coxsackie B virus infections in cardiology. Apropos of 66 cases].

Coxsackie B virus infections are common and frequently asymptomatic. However in young people, they can cause primary congestive cardiomyopathy and complicate previous cardiovascular illnesses. Virus diagnosis is difficult and based mainly on the detection of significant rising or stating high neutralizing antibody titers. A clinical and epidemiological five years study investigated 3,856 sera. 30.2% of the patients had evidence of a significant antibody titer (greater than or equal to 64) to one of the group B Coxsackie viruses; this percentage reaches 34.6% in cardiology and fluctuates from year to year; Coxsackie B2 is predominant (55.9%) in cardiology; coxsackie B1 and B2 antibody responses were detected more frequently than B3, B4 and B5. Coxsackie B6 appears to be uncommon. From these, 66 patients have evidence of coxsackie B virus infections with 60.2% for Coxsackie B2; they include pericarditis (30.3%), acute and chronic congestive cardiomyopathies (19.7%). Moreover it has been suggested that Coxsackie B virus might be responsible for electrocardiographic abnormalities (9.1%), ischemic heart disease and myocardial infarction. Enzyme linked immunosorbent assay (ELISA) and radioimmunoassay with purified antigens (VP1 and VP4) did not appear better than microneutralisation for evaluation of IgM and IgG antibodies. To elucidate the mechanisms of cardiac injury it is refer to viral replication, virus specific and auto-reactive T cells cytotoxic activities.

Coxsackievirus Infections↗

Persistent sinus nodal electrograms during abnormally prolonged postpacing atrial pauses in sick sinus syndrome in humans: sinoatrial block vs overdrive suppression.

A transvenous electrode catheter technique was used for direct recording of bipolar sinus node electrograms during postpacing atrial pauses. Multiple repetitive local sinus node electrograms during atrial quiescence validate sinus node electrograms. Such atrial pauses with sinus node electrograms are due to sinoatrial block; atrial pauses without sinus node electrograms are due to overdrive suppression or improper recording. Eight consecutive patients were prospectively selected on the basis of a corrected sinus node recovery time greater than 1500 msec during diagnostic electrophysiologic evaluation. Six patients had atrial pauses with sinus node electrograms; three patterns of sinus node electrograms during atrial pauses were observed. We conclude that (1) sinus node electrogram recording is of value in understanding the mechanism underlying postpacing atrial pauses; (2) atrial pauses are usually (6/8) caused by sinoatrial block; (3) three patterns of sinus node electrograms are observed, thus making indirect interpretation unreliable.

Adult↗

[Assessment of external cardiac massage efficiency or Kouwenhoven revisited (author's transl)].

The external cardiac massage mechanism is commonly related to the ventricles compression between the vertebral block and the sternum. This over-simple explanation must be reconsidered. Following recent data, the intra thoracic pressure changes take probably a major part in it efficiency. Six patients have been studied by hemodynamic intra aortic measurements and Doppler carotidian velocimetry. Intra thoracic pressure have been recorded by an oesophageal catheter. Results are in agreement with the prominent part of the intra thoracic pressure variations. Various external cardiac methods are investigated following this monitoring. Some aspects of the classical management of the cardiac arrest have to be discussed.

Heart Massage↗

Pathology of sinoatrial node. Correlations with electrocardiographic findings in 111 patients.

Histological study of the sinoatrial node (SAN) was performed in 111 patients in order to estabilsh correlations between the ECG findings and the anatomical lesions. This series includes both patients with sinus rhythm and patients with atrial arrhythmias. The results are as fololows: (a) the amount of nodal cells in the SAN was found to be inversely proportional to the age of the patients (p less than 0.001); (b) normal sinus rhythm was present in some cases with severe fibrosis of the SAN; (c) the present study does not support lesions of the SAN as responsible for atrial fibrillation; (d) chronic sinoatrial block was associated with extensive lesions of the approaches of the AV node or the AV node itself; (e) the auricular tachycardia-bradycardia syndrome was associated in most cases with both lesions of the main feature of the SAN lesion. The pathogenesis of these fibrotic lesions are discussed.

Adolescent↗