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Biomedical subjects

G Roul

Publications and source records attributed to G Roul.

59 records · Page 4Linked to original sources
PubMed1985

[Course and prognosis of apparently primary congestive cardiomyopathies in chronic alcoholic patients].

The authors analyse a series of 36 chronic alcoholic patients with primary congestive cardiomyopathy. The clinical course of these cases was analysed in order to define the prognostic factors. All of the patients were male with a mean age of 47 years. 55 per cent of cases presented a functional deterioration. The 5 year mortality was 50 per cent. The high incidence of sudden death (38 per cent of deaths) was probably related to ventricular arrhythmias. The other deaths were due to end-stage heart failure. The survival did not differ significantly from that of primary congestive cardiomyopathy in non-alcoholic patients. It depends, above all, on the left ventricular function and is influenced by the initial value for the ejection fraction. Alcoholic withdrawal was found to be a beneficial prognostic factor when it was early, but it became ineffective in cases with major alteration in the left ventricular function. Ultrasound and radioisotope studies demonstrated the development of segmental kinetic disorders and intracavitary thrombi in the left ventricle. These lesions have a pejorative prognostic significance. The initial systolic diameter of the left auricle seems to have a prognostic value as it reflects the degree of activity of the disease.

Adult↗
PubMedDate not supplied

Detection and quantification of recent myocardial infarction: diagnostic value of multiecho multislice spin echo imaging.

Thirty-four patients with documented transmural MI were studied with gated three echo, multislice MR imaging. In 12 patients MRI MI size was compared with CK release measurement, Tl-201 SPECT defect, and with Tc-99m LVEF. Infarct was visualised in 29/34 patients on 3rd echo images (18/34 on 2nd and 6/34 on 1st echo images). Mean MR infarct size (planimetered from 3rd echo images): 33.1 +/- 9% overestimated the SPECT defect (mean value of 23.8 +/- 15%). However, the overall correlation between MRI and Tl-201 sizing was significant: r = 0.82; p less than 0.001; SEE = 5.5%. The correlation with LVEF also appeared significant: r = -0.61; p less than 0.038.

Adult↗
PubMedDate not supplied

[Acute dissection of the ascending aorta. Can the risk of reoperation be reduced?].

From January 1974 to October 1993, we operated 113 Stanford type A acute dissections of the ascending aorta. There were 19 cases of immediate death but overall mortality was low (17%). During the last 10 years, mortality was reduced to 12%. There were 94 survivors who were followed for 2 months to 19.2 years. Mean follow-up was 6.6 +/- 4.77 years. Total follow-up time was 583 patients/years. There were 21 secondary deaths occurring within 2 months of surgery and the 10th post-operative year. Actuarial survival rate, including operative mortality, was 80 +/- 3.7% at 1 year, 70 +/- 4.6% at 5 years and 53 +/- 6% at 10 years. There were 17 vascular complications during the follow-up including 12 requiring reoperation. There were no vascular complications in 90% of the patients at 3 years, 78% at 6 years and 60% at 10 years. Three cases of aortic insufficiency developed subsequently and required reoperation with prosthetic valve replacement. Operative techniques changed between the first and second decade of this series. During the second decade, cardioplegic protection of the myocardium, open distal anastomosis, systematic exploration of the aortic arch and finally extension of the resection to the isthmus when required were introduced successively. In the absence of sufficient follow-up in the patients operated during the second decade, it is not possible to establish whether these modifications have actually reduced the number of post-operative vascular complications commonly reported.

Acute Disease↗