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Biomedical subjects

F Cherrier

Publications and source records attributed to F Cherrier.

At least 181 records · Page 10Linked to original sources

[An attempt to estimate the value of myocardial contractility in left ventricular aneurysms].

Using monoplanar angiography at 30 degrees, the authors have attempted to quantify the effectiveness of the non-aneurysmal myocardium in 50 patients (17 of them having undergone surgery) with an aneurysm of the left ventricle. Having fixed the position of two points during systole and diastole, they first delimit the aneurysmal zone and/or neighbouring dyskinetic zones in relation to the zones which are still 'healthy'. By a method of integration based on the formula of the three levels, they first measure the global volume of the left ventricle and its ejection fraction, and gain an idea of the size of the aneurysm. They then evaluate the ejection fraction and the volumes of each of the other zones. They have shown that the prognosis depends upon the ejection fraction and the end-diastolic volume of the ventricle which is presumed to be healthy, these measurements being corrected according to the size, expressed as an ejection volume, of the adjacent dyskinetic zone, which can be assessed by an index (volume of the dyskinetic zone as a proportion of the total 'healthy' and dyskinetic zones, in turn expressed as a ratio of the ejection fraction). The application of this work is to be found in seeking a limit of operability for extensive left ventricular aneurysms with cardiac failure.

Heart Aneurysm↗

[Comparative study of different methods of evaluation of left ventricular volume by monoplane angiocardiography].

The authors compare 5 methods of evaluating left ventricular volume and the ejection fraction by monoplanar angiocardiography in the 30 degrees right oblique incidence: the method of Green (1 and 2), Snow and Dodge, and by trapezoidal integration which was used as a reference. The have calculated the regression ordinates and the correlation coefficients for various systolic and diastolic volumes as well as for various ejection fractions. For these latter, Dodge's quadratic equation can also be used. Provided there is no gross distorsion of ventricular contolr, there is fairly good correlation, but there is a marked discrepancy for large volumes or small ejection fractions (less than 0.40). When more elaborate methods are not available, it seems reasonable to use a single method to calculate these parameters, but it is essential to have recourse to other techniques when there are gross changes in the left ventricle.

Angiocardiography↗

[Exercise test after myocardial infarct. Correlations with data of coronary angiography and ventriculography].

The authors have studied the exercise test carried out at least three months (3-6 months: 52 cases; greater than 6 months: 48 cases) after myocardial infarction in the anterior position (50 cases), in the "inferior" position (42 cases), and of a diffuse type (8 cases), in patients who were taking no treatment which might interfere with interpretation of the test. For the anterior infarctions there was a good correlation between ST elevation (J max greater than or equal to 1 mm, or better than the sun of the J greater than or equal to 2 mm) and the presence of severe involvement of the left ventricle. A depressed ST segment beyond the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 36 p. 100 of cases. In inferior infarctions, the correlation between ST elevation and left ventricular involvement is also specific but less sensitive. ST depression outside the area of necrosis corresponds to a stenosis greater than or equal to 75 p. 100 in 66 p. 100 of cases; it is then lateral, but may extend as far as V2. They also indicate a mirror image, especially when the depressed area slopes upwards, and is localised in V2-V3. The other changes which were found have no practical application.

Adult↗

[Variations of distribution of the coronary arteries (apropos of 3,000 coronarographies)].

The various types of anomalous origin and unusual course and/or predominance of the coronary arteries encountered in a review of 3 000 selective coronary arteriograms were studied. 1. Abnormal ostia: Ectopic ostia with anterior, posterior or lateral displacement (11 cases). Variations in the number of ostia:--accessory ostium for the conus branch (68 cases);--distinct ostia for LAD and circumflex artery (21 cases);--single coronary artery (6 cases). 2. Abnormal course of coronary arteries: Anomalous circumflex origin from the right coronary artery (8 cases). Unusual predominance of the left coronary artery:--right predominance 74,5 %;--left predominance 14 %;--balanced 11,5 %. In aortic stenosis, the frequency of these different malformations is very different. Different patterns of vascularizattion of the centers of automatism and of the left ventricular free wall were also studied.

Coronary Angiography↗

[Infarction with late disappearance of the Q wave. Apropos of 30 cases].

A selective coronary arteriography was performed in 30 subjects with myocardial infarction, after disappearance of the necrosis wave. The angiographic characteristics of this group when compared with a series of infarctions, unselected by the clinical course, wers: a decreased severity index; a better development of the compensatory circulation; and a lesser frequency of severe disturbances of ventricular dynamics. Disappearance of the Q wave might be explained by a very distal occlusion in 2 cases, by a recanalization in 4 cases and by a very intense development of the collateral circulation in 8 cases. One subject had a normal coronary arteriography.

Angiography↗

[Atrial systole. Study of its role in the normal subject and in left ventricular insufficiency].

In order to study the importance of atrial systole, the authors used different stimulus modalities at the same rate; they stimulated the right ventricle, the right atrium, and the two. The haemodynamic parameters were monitored by microcatheterisation of both right and left sides. A comparative study using controls and patients with left ventricular failure showed the improvement in the haemodynamic picture which was obtained in the latter group when the atrio-ventricular sequence was correct.

Blood Pressure↗

[Hemocynamic role of atrial contraction in the acute phase of myocardial infarct].

The authors have studied the haemodynamic role of atrial systole in patients in the acute stage of a myocardial infarction, usually with left ventricular failure. Their main comparison is between the results obtained with stimulation of the right ventricle at a fixed rate and those obtained with bifocal stimulation, thus restoring the atrio-ventricular sequence. The authors discuss their results, and especially their findings of improvement in cardiac output and systemic arterial blood pressure. They raise the question of synchronous stimulation in cases of infarction with heartblock complicated by left ventricular failure, and also of re-establishing sinus rhythm in cases of arrhythmia of supraventricular origin.

Acute Disease↗

[Pre-infarction syndrome involving the anterior interventricular artery. Therapeutic and diagnostic considerations].

Based on the study of 25 cases, the authors define menace syndrome in the anterior descending artery (ADA) according to three criteria: angina of recent onset and rapid development, a major disorder of repolarisation in the anterior part of the heart, and a tight proximal stenosis of the ADA. Of seven patients who could not undergo surgery, three sustained anterior infarctions, and three died after 30 days. 18 patients underwent surgery to revascularise the myocardium by anastomosis of the internal mammary artery to the ADA; 13 of these were carried out as urgent procedures (an average of 26 hours after coronary arteriography). The functional results were excellent, and all of the internal mammary anastomoses studied at 6 months (9 cases) were patent. This study has shown that menace syndrome of the ADA is a surgical emergency, and that a procedure to anastomose the coronary arteries should be carried out immediately after coronary anteriography.

Adult↗