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Biomedical subjects

F Cherrier

Publications and source records attributed to F Cherrier.

At least 145 records · Page 8Linked to original sources
PubMed1984

[Socio-professional rehabilitation after transluminal coronary angioplasty].

Between April 1980 and October 1982, 109 patients underwent attempted transluminal coronary angioplasty (TCA) with a primary success rate of 71,6% (78 patients). Two patients died of complications of TCA and another one died suddenly 3 months after TCA. The socio-professional rehabilitation of the 106 survivors was studied by questionnaire to which 98 subjects (81 men, 17 women; average age 50,2 +/- 9,2 years) replied. Seventy seven patients were working before their coronary disease and 73 (62 men, 11 women; average age 46,4 +/- 9,1 years) replied to the questionnaire (95%). This constituted the study group, the socio-professional outcome or which was compared to that of 37 active patients who underwent single aorto-coronary bypass surgery during the same period. After TCA, 53 patients (73% returned to work, 48 as full time workers, after an average convalescent period of 4 months. Professional rehabilitation depended mainly on the initial result of TCA: 85% after primary success; 40% after failure (p less than 0,001); in the latter case, the rate of return to work improved if the patients had surgery (58%) rather than medical therapy (125%). Similarly, the average age of re-employed patients was lower (46,1 +/- 7,9 years, compared to 49,3 +/- 6,8 years, p less than 0,05). Finally, the patients returning to work usually claimed to be in good or very good health (72% compared to 30% p less than 001). After single aorto-coronary bypass, only 14 patients (38%) returned to work, 8 full-time, after an average 7 months' convalescence. The duration off work before surgery was related to the incidence of re-employment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Cost of a coronary transluminal angioplasty compared with a single coronary bypass. Economic effects].

The authors discuss the financial incidence of transluminal coronary angioplasty (TCA) compared to isolated coronary bypass surgery (CBS). The study was limited to 1982 (76 cases of TCA) and compares two groups: successful TCA (17 consecutive cases: group I); isolated CBS (18 cases: group II). The following parameters were studied in each group: average length of hospital study, credits received from the Department of Social Security, hospital expenditure. Hospital expenditure was classified under 6 headings: personnel, material, investigations, drugs, hospital costs and administration costs. The results expressed as the mean per patient were: in group I: hospital stay, 10 days; Social Security reimbursement, 10 813 FF; hospital expenditure, 10 586 FF. In group II: hospital stay, 18 days (including 4 days in the ICU); Social Security reimbursement 46 656 FF; hospital expenditure, 28 955 FF. The hospital costs of personnel were relatively small (especially for TCA). The economies realised by reutilising catheters designed for single usage were significant: the use of guide wires, catheters and balloon catheters falls from 1.64, 1.9 and 0.1 per patient to 0.47, 0.53 and 0.05 respectively, a saving of 5 068 FF per TCA and 385 168 FF per year. Compared to costs in the United States (4 773 and 14 952 dollars) TCA and CBS is much cheaper in France.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon↗
PubMed1984

[Results of the systematic application of ventricular stimulation methods].

This study was undertaken to test the validity of methods of evaluating ventricular tachycardia and in therapeutic surveillance. One hundred and thirty nine patients aged 16 to 84 years, with and without severe ventricular arrhythmias (ventricular tachycardia, VT, and fibrillation, VF) were divided into two groups after clinical, echocardiographic and 24 hour Holter investigations: Group I comprised 26 patients with a least one documented attack of VT or VF; Group II comprised 113 patients without these arrhythmias, who complained of dizziness, syncope, and/or their ECG showed a conduction defect, and so electrophysiological investigation was undertaken. A protocol of ventricular stimulation was undertaken in addition to the usual measurements of conduction times, comprising incremental ventricular stimulation from 100 to 200/min, single and paired extrastimulus in sinus rhythm and during ventricular pacing at rates of 100 and 150/min, the first extrastimulus being programmed 10 ms after the end of the ventricular effective refractory period. Excluding bundle to bundle reentry, the following results were obtained: In Group I: VT was triggered 16 times (61,5 p. 100), and in 4 of these cases VF occurred and required defibrillation. Ten patients had previous myocardial infarction; 5 patients had left ventricular dilatation. In 2 cases runs of 3 or 4 VES were recorded. No arrhythmia could be induced in 8 cases (30,8 p. 100); 5 of these patients had apparently normal hearts. In Group II: VT (greater than 5 VES) was triggered in 22 cases (19,5 p. 100) and in 4 cases this degenerated to VF requiring defibrillation. 11 patients had apparently normal hearts; 6 patients had left ventricular dilatation and 4 patients had previous myocardial infarction. 1 to 4 repetitive VES were observed in 67 cases (59,3 p. 100): the heart was judged to be normal in all patients except those with previous infarction. No correlation was established between the ability to induce VT and age, syncope, or ECG changes (especially bundle branch block). However, a correlation was found between the induction of VT and underlying cardiac disease and the method of induction of VT; in Group II, all episodes of VT were triggered by delivering paired ventricular extrastimuli on a background paced rhythm. These results show that repetitive ventricular responses can easily be triggered and that this has no pathological significance.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1984

[Retrospective study of the role of systematic coronarography in patients with heart valve diseases].

The aim of this study was to assess retrospectively the valve of routine coronary angiography in the investigation of patients with valvular heart disease. Between 1978 and 1981, 598 patients over 40 years old underwent left heart catheterisation with routine coronary angiography. In the group with a medical history of angina or infarction (N = 149), there were 49 cases (33%) of severe coronary artery disease (greater than or equal to 70%) and 17 cases of moderate coronary artery disease (11%); of the 49 patients with severe lesions, 2 died after catheterisation, 8 were considered to have too high an operative risk because of their coronary disease and 19 were operated. Valve replacement was associated with a procedure for myocardial revascularisation in 15 cases. In the group without angina (N = 449), severe coronary lesions were much less common (3.6%) and only 5.1% had moderate coronary disease. Severe coronary lesions were found more frequently in certain sub-groups: Stage IV dyspnoea (9%), patients over 65 years of age (11.5%), and coronary calcification (24%). Of the 39 patients without angina and over 50% narrowing on coronary angiography, 17 underwent isolated valve surgery, and 9 underwent combined valvular and coronary surgery (2% of catheterised patients without angina; 3.5% of patients operated without angina. These results show that routine coronary angiography is fully justified in patients with valvular heart disease and a history of angina as vital information is obtained in a high proportion of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Return to work after myocardial infarction].

The working status of 41 men under the age of 60, who developed myocardial infarction while in vocational activity was investigated by means of a questionnaire, 3 years on average after the infarction: 63% had resumed work some time after the disease and 59% were working when the enquiry was made. The ability to resume work cannot be predicted from the patient's medical condition at the time of infarction (location of the infarct, complications during the acute stage, left ventricular ejection fraction). The only unfavourable factors are age and the presence of residual angina or marked post-infarction dyspnoea, although most patients who had not resumed work were fit for employment. Clinicians should be fully aware of the occupational future of patients with coronary artery disease--a future that is particularly at stake in this period of economic crisis in industrial countries.

Disability Evaluation↗
PubMed1983

[Tachycardia and ensuing electrosystole].

The benign or severe nature of a ventricular extrasystole depends on a number of parameters which involve the pathophysiological mechanism of the extrasystole: re-entry, exaggerated normal or abnormal automatism and therefore the presence or absence of an underlying cardiac disease. The prognosis depends directly on the morphology, the number and the characteristics of the arrhythmia. Various investigations are often necessary to evaluate this prognosis, including 24 hour Holter monitoring, stress test and electrophysiological investigations.

Cardiac Complexes, Premature↗
PubMed1983

[Natural development of old heart valve disease].

The authors report the natural history of 36 patients with end-stage valvular disease defined by the presence of a functional stage IV and/or a 0.60 and/or dilatation of the LA 90 mm and/or dilatation of the LV 70 mm and/or increase in the systolic PAP 80 mmHg and/or a decrease in the EF of 0.45. 11 patients are alive with a mean survival of 36.8 months (30.5%) and 25 have died after a mean interval of 7.8 months. The prognosis is very poor for aortic valvular disease (14 deaths out of 16 cases), but there were only 3 deaths out of 10 patients with isolated mitral valve disease.

Adult↗
PubMed1982

[Early detection of myocardial alterations in mitral insufficiency with the angiotensin test].

Left ventricular function was assessed at rest and after increasing systemic arterial resistance by angiotensin in 40 patients with isolated mitral insufficiency. Angiotensin was administered intravenously at a dose of 0,4 micrograms/mn until the systolic blood pressure rose by at least 30 mm Hg. Left ventricular and aortic pressures, cardiac index and left ventriculography in the 30 degree right anterior oblique projection (50 frames per second) were recorded before and during angiotensin infusion. The mean rise in systolic left ventricular pressure was 40 +/- 2,8 mm Hg; the heart rate increased slightly but significantly; left ventricular and diastolic pressure rose from 12,0 +/- 1,0 to 24,0 +/- 1,2 mmHg. The systolic index (Fick's method) was significantly decreased (37 +/- 1,6 ml/m2 to 26 +/- 1,6 ml/m2) though the angiographic systolic index remained unchanged. This is explained by an increase in the regurgitant fraction (51 +/- 2,5% ao 65 +/- 3%). The end diastolic volume index was unchanged; the ejection fraction was significantly decreased. The resting hemodynamic status was only slightly disturbed in 29 patients (mean capillary pressure less than 15 mm Hg, 8,8 +/- 0,52 mmHg). The left ventricular function curves with angiotensin distinguished two groups of patients: Group A (20 patients) with left ventricular dysfunction induced by angiotensin, Group B (9 patients) who maintained the systolic index despite the increase in left ventricular end diastolic pressure. These results suggest that the angiotensin test may be useful for detecting early left ventricular dysfunction in patients with isolated mitral insufficiency and virtually normal resting hemodynamic parameters.

Angiotensin II↗
PubMed1982

[Spasm of the coronary arteries].

Spontaneous spasm and methylergometrine maleate-provoked spasm are defined, the latter being observed in nearly all cases of so-called Prinzmetal angina, in approximately one out of three cases of angina at rest, and a certain number of cases of unstable angina: it has even been demonstrated during effort tests with coronarography. Several studies have demonstrated its possible implication in myocardial infarction. Continuous electrocardiogram recordings and isotopic studies have also shown the frequency of silent spasms, or those associated with other ECG modifications than an increased STT latency period. It is now well-established that this type of angina is provoked by reduction in myocardial oxygen supply. To explain the triggering mechanism of the spasm, various factors have been successively evoked: alpha- and beta-receptor disequilibrium, a vagal effect, the very important role played by thromboxane A2 of platelet origin. Emphasis is also placed on circadian variations observed during the spasm, but the course of spastic angina is often unpredictable, leading to necrosis or sudden death in a fairly large number of cases. Medical treatment is essentially by long-acting nitrate derivatives and calcium inhibitors (beta-blockers are considered, according to different teams, as being useless or even dangerous). Surgical treatment may be by aortocoronary shunt or transluminal angioplasty in cases that are stable with trinitrate compounds; associated plexectomy has given good results according to teams in Lille; while heart transplantation has been performed in rare cases. Choice of therapy is difficult in cases with apparently non-surgical moderate stenosis and recurrent spastic angina.

Angina Pectoris, Variant↗
PubMed1982

[Arterial spasm of the lower limbs caused by pheochromocytoma].

The authors report the case of a 66-year-old man hospitalised with a clinical picture of stage III arterial disease of the lower limbs. Aortography revealed complete spasm of both popliteal arteries and a right adrenal tumour. Excision of the phaeochromocytoma led to the disappearance of symptoms of obliterative arterial disease and normalisation of Doppler results. The role of catecholamines in spasm is discussed.

Adrenal Gland Neoplasms↗