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Biomedical subjects

D Babuty

Publications and source records attributed to D Babuty.

80 records · Page 5Linked to original sources
PubMed1991

[Study of the arrhythmogenicity of cardiomyopathies. Hypertrophic cardiomyopathies].

Forty-four cases of hypertrophic cardiomyopathy (23 men, 21 women; 55 +/- 15 years) referred for evaluation of chest pain (28 cases), dyspnoea (26 cases), palpitations (25 cases), dizziness (11 cases) and syncope (4 cases), were investigated prospectively between February 1983 and February 1989. The cardiomyopathy was concentric (N = 16), obstructive (N = 24) or apical (N = 4) and the diagnosis confirmed by angiography. Twenty-four hour Holter monitoring showed no ventricular extrasystoles in 43% of patients: the others had Grade I (25%), Grade III (2%), Grade 4A (14%) or 4B (16%) ventricular arrhythmias with diurnal predominance in half the cases. Patients with greater than or equal to Grade III ventricular extrasystoles had greater left axis deviation but did not differ from the others from the hemodynamic point of view. Exercise stress testing induced an isolated ventricular arrhythmia in 23% of patients and repetitive extrasystoles in 23%. The prevalence of surface late ventricular potentials was no greater in these patients than in normal subjects (4% vs 1%; NS). Programmed ventricular stimulation (N = 37) induced a repetitive response in only 25% of patients, with only two cases of sustained monomorphic ventricular tachycardia. There were no correlations between the results of programmed ventricular stimulation and those of Holter monitoring, exercise stress testing or late ventricular potential recording, but patients with inducible ventricular tachycardia or fibrillation had proportionally more syncopal episodes and greater than or equal to Grade III ventricular extrasystoles on Holter monitoring, but the difference was not statistically significant in this series.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Partial interruption of the inferior vena cava using a percutaneous endovenous filter].

Partial interruption of the inferior vena cava (IVCI) by a percutaneous endovenous filter (Günther filter n = 65, LEM filter n = 36) was undertaken in 100 patients with an average of 72 +/- 11 years for recent deep vein thrombosis. The indications were: contraindications to anticoagulant therapy (36.5%); recurrent pulmonary embolism (12%); threatening venous thrombosis with a previous embolic episode (12%); caval thrombosis (15.7%); prophylactic, with no previous pulmonary embolism (23.8%). The filters were evaluated at short and mid term. There were no technical problems. The mortality rate was 17.5%, one death being probably due to recurrent pulmonary embolism. No other recurrences of pulmonary embolism were observed, indicating an efficacy of 99 per cent. The early patency rate was 96.5%, there being no difference between the two filters used, independent of the initial site of venous thrombosis, of distal migration of the filter and associated medical treatment (anticoagulation). Distal migration was observed in 76% of IVCI by the Günther filter and 48.5% by the LEM filter (p less than 0.001); tilting was observed in 7.4% of Günther and 3% of LEM filters. Five LEM filters were incompletely opened. The IVC was transfixed by 3 Günther filters. One Günther filter had fractured spokes. There were 12 recurrences of lower limb deep vein thrombosis and 16 post-deep vein thrombosis complications were recorded. These percutaneous endovenous filters are similar to the Kimray Greenfield filter with respect to efficacy and permeability although the follow-up was relatively short. The advantages of these percutaneous filters are the facility, innocuity and rapidity of their insertion with, however, a higher incidence of distal migration.

Adult↗
PubMed1990

[Evaluation of the arrhythmogenic potential of myocardiopathy. Apropos of 113 cases].

The exploration of 113 cases of myocardiopathy (69 cases of dilated myocardiopathy (DMC) and 44 of hypertrophic myocardiopathy (HMC) by a 24-hour Holter recording, exercise tests, recording of surface-delayed ventricular potentials (DVPs) and forced right ventricular stimulation (PVS), revealed an arrhythmogenic potential in both forms of this disorder. In cases of DMC, ventricular arrhythmias were common (81% of cases), frequently recurrent and may constitute one sign of the disease, although they are fairly independent of hemodynamic changes. The presence of DVPs in cases of DMC (25% of cases) was significantly correlated with ventricular extra-systole greater than or equal to grade 3 on the lown scale revealed by the Holter with induction of tachycardia or ventricular fibrillation in response to PVS. Ventricular arrhythmia is less common in HMC (57%). DVPs were rare, and spontaneous or induced ventricular arrhythmia appeared to be more closely correlated with syncope than with any other hemodynamic factor. This study of the arrhythmogenic potential therefore appears to be necessary in myocardiopathy in order to obtain a better definition of the prognostic risk.

Arrhythmias, Cardiac↗
PubMed1989

[Significance of isotopes in the study of pre-excitation and ventricular tachycardia].

In normal patients, Mac Carthy has demonstrated that there was a very close correlation between the ventricular contractile activity, evaluated by Fourier's isotopic phase analysis, and electrical depolarization, evaluated by endocardial mapping. It has therefore been possible to study asynchronisms or asymmetries of the ventricular contraction-depolarization and particularly the syndromes of ventricular pre-excitation and ventricular tachycardias. In Wolff-Parkinson-White syndromes (WPW), the mapping obtained by heart cavity tomography in addition to dual-plane gamma-angiography, provides most useful informations, due to additional section planes permitting tridimensional location of the earliest site of ventricular activation. It is quite useful to locate the bundle of Kent always difficult on surface electrocardiogram, or when the endocardial exploration does not permit to precisely locate the site of the excentric atrial activation in case of multiple bundles of Kent or without retrograde conduction. When the left bundle of Kent is barely identified, the isotopic image may be improved by oesophageal stimulation. Additional parameters (use of several harmonics, factorial analysis) will permit to improve the localization of accessory pathways, to be destroyed by fulguration or surgery. In case of ventricular tachycardias with limited functional tolerance, only gamma-angiography, lasting only 3 to 5 minutes, may be used. Combined with endocardial tomography or even gamma-angiography performed in sinus rhythm, not only the site of origin of the ventricular ectopy may be localized, but it also can be correlated with ventricular kinetics abnormalities and the cardiopathy in question may be identified. Most authors consider that there is a close relationship between isotopic site, electrocardiographic appearance and the site found by endocardial mapping or "pace-mapping". In patients with ventricular tachycardias of different morphologies, isotopic mapping permits to differentiate those originating from a same lesion (which may be treated by surgery of fulguration) from those originating in remote areas. Therefore, this technique is a non aggressive and rapid method providing accurate informations on severe rhythm disorders currently treated by eradication of their anatomical substratum.

Electrocardiography↗
PubMed1988

[Control of the patency of coronary-internal mammary artery bypasses by non-selective angiography].

98 successive coronary bypasses using the internal mammary artery were controlled systematically, at an early stage, about the 17th postoperative day, by non selective brachial angiography using a retrograde injection. This control method, simple, quick, reliable and non-aggressive, enables to visualize the internal mammary artery and the bypassed coronary vessel, over its entire length. There were no failure in the control, nor any local or general complication during this examination. The overall patency of such bypasses, evaluated with this method, is 98 p. cent in our series, with however, 12 p. cent of angiographic aspects of a poorly functional bypass. These aspects are related to a slow flow in the by-pass (spindly internal mammary artery, anastomotic stenosis or thin distal bed of the bypassed coronary artery), or to a competitive flow (non significant coronary stenosis). The perfusion of the bypassed coronary, which is not so well studied in the literature, is important to analyze and difficult to evaluate with our technique because of the static views that are used. A similar non-selective angiographic method using a dynamic recording (radio-cinema with dual incidence) is currently being evaluated.

Adult↗
PubMedDate not supplied

Fourier phase analysis of SPECT equilibrium radionuclide angiography in symptomatic patients with mitral valve prolapse without significant mitral regurgitation: assessment of biventricular functional abnormalities suggesting a cardiomyopathy.

BACKGROUND: Ventricular premature beats are common in patients with mitral valve prolapse (MVP). The purpose of this study was to determine whether symptomatic patients with MVP had certain functional characteristics and if ventricular arrhythmia (VA) could be explained by functional extravalvular abnormalities. Single photon emission computed tomography equilibrium radionuclide angiography with Fourier phase analysis was preferred to the planar radionuclide method. Only patients without significant mitral regurgitation were studied. METHODS AND RESULTS: A total of 23 symptomatic patients with MVP (13 men, 10 women, mean age, 47+/-14 years) without mitral regurgitation underwent single photon emission computed tomography equilibrium radionuclide angiography. Symptoms were present in 20 patients, and VA was present in 14 patients. Ejection fraction, regional wall motion, and Fourier phase analysis were examined in both ventricles and compared with results for normal subjects. Ventricular abnormalities were observed in 20 (87%) patients: decreased left ventricular and right ventricular ejection fractions, increased standard deviations of the mean phase and focal wall motion, and/or delayed phase abnormalities. Abnormalities were less frequent but more marked in the right ventricular free wall, the infundibulum, or the septum compared with left ventricular delayed abnormalities, which were more frequent but limited. In 12 of 14 patients with VA, phase-delayed areas were observed in the ventricle where the origin of ventricular premature beats was suspected on the basis of their electrocardiographic morphologic features. A relation was found between late potentials and delayed-phase areas (right ventricle or septum) and left bundle branch block morphologic features of VA. CONCLUSIONS: Symptomatic patients with MVP frequently have ventricular dysfunction in 1 or both ventricles, sometimes limited but more marked in the presence of severe VA even without significant mitral regurgitation, suggesting structural modification. The use of a sensitive, accurate, and 3-dimensional method such as single photon emission computed tomography equilibrium radionuclide angiography may be of interest for a noninvasive investigation, especially in young symptomatic patients with MVP and VA.

Arrhythmias, Cardiac↗