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Biomedical subjects

J Beaune

Publications and source records attributed to J Beaune.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Prognosis of asymptomatic or slightly symptomatic chronic aortic insufficiency. Apropos of 54 patients followed for an average of 36 months].

A series of 54 patients with chronic aortic insufficiency with little (38) or no symptoms (16) were studied. All had severe regurgitation leading to discussion of aortic valve replacement. All patients (44 male and 10 female) underwent clinical, radiological, electrocardiographic, hemodynamic and angiographic investigation with assessment of left ventricular volume by monoplane 30 degrees cineangiography on entry to the study. They were then followed-up for an average of 36 months and the data assessed in a prospective study. At the end of the 36 months period, 4 patients had been lost to follow-up but were still alive, 31 patients were unchanged (Group A) and 19 patients had deteriorated (Group B). The parameters characterising Group B (P less than 0.001) were: corrected cardiac surface area of 1,72 +/- 0,13, a Sokolow index of 60,1 +/- 18,8 mm an ejection fraction of 56.2 +/- 14 % and a left ventricular end diastolic value of 225,3 ml/m2. Therefore, in chronic asymptomatic aortic incompetence, the parameters of cardiac dilatation, cardiac surface area greater than 1,70 and left ventricular end diastolic volume greater than 170 ml/m2, would appear to be good indications for aortic valve replacement. However, the values are nor formal criteria because a discrepancy between symptoms and the volumetric measurements may be observed in some cases, and also large variations in these measurements may be observed in patients in the same functional class.

Adult↗
PubMed1982

[Analysis of interobserver variations in the estimation of myocardial volume, thickness and mass in right anterior oblique monoplanar angiocardiography].

The parameter derived from right anterior oblique angiocardiography (end diastolic and end systolic volumes, stroke volume, ejection fraction, wall thickness and myocardial mass) are used to decide the most appropriate management of cardiac disease. It is important to assess their reliability especially as other clinical data may be underestimated and the objective results may play a prominent role in the decision. Therefore, good quality cinefilms of 31 patients were reinterpreted by three observers (A, B and C); the contours were traced on a Vanguard console with an electromagnetic pet and the data treated automatically by the SNIASS SYSCOMORAN program (Simpson's method, assimilating the left ventricle to an ellipsoid divided into n identical cylinders). The interobserver variability (A and B; A and C; B and C) was good in the assessment of end diastolic volume (R = 0,96; 0,98; 0,99), end systolic volume (R = 0,96; 0,96; 0,98). On the other hand, it was poor in the measurement of wall thickness (R = 0,63; 0,73; 0,69) and myocardial mass (R = 0,85; 0,83; 0,89). In addition, the ejection fraction and end systolic volume were perfectly reproducible from one observer to another whether or not the left ventricle was dilated. End diastolic volumes seemed to be more reproducible in dilated cavities (EDV greater than 104 ml/m2). These results confirm that monoplane RAO cineangiography remains a good method of assessing left ventricular performance.

Angiocardiography↗
PubMed1980

[Assessment of ejection fraction and left ventricular and diastolic volume by non-invasive methods: echocardiography and isotopic technics. Comparison with angiography in 30 patients].

Three methods of measuring the ejection and the left ventricular end-diastolic volume were compared in 30 consecutive patients (all adults, 3 normal, 3 congestive cardiomyopathy, 6 mixed aortic valve disease, 9 pure aortic stenosis and 9 pure aortic incompetence). The haemodynamic and angiographical data was compared to the results of M-mode echocardiography and gammaangiocardiography. The global results of the ejection fractions were compared: angiography gave the lowest values (0,58 +/- 18). The non-invasive methods gave very similar results (0,67 +/- 15 for the echo and gammaangio). A better correlation was obtained in the group with pure aortic incompetence; the results in pure aortic stenosis were not reliable. The global results of end-diastolic volume showed constant underestimation by the non-invasive methods compared to angiography. The choice of method in each technique may influence the results obtained; each laboratory should determine its normal values; results should not be accepted without a critical assessment. Standardisation of techniques would be desirable.

Adult↗
PubMed1980

[Prognosis of primary non-obstructive cardiomyopathies].

The prognosis of congestive cardiomyopathy was studied in 132 consecutive patients (110 male, 22 female, average age 45 +/- 11 years) in whom a thorough clinical evaluation had excluded a secondary cause. The patients presented with left ventricular failure, a history of systemic embolism, syncope or radiological cardiomegaly. Right (100 p. 100) and left (81 p. 100) heart catheterisation was performed and left ventricular endiastolic volumes (202 +/- 77 ml/m2) and ejection fractions (31 +/- 12 p. 100) calculated from angiography in the 30 degrees right anterior oblique projection. Regional abnormalities of contraction were observed in 32 patients. The average follow up period was 40,4 +/- 23,8 months. At the end of the study 48 patients (37 p. 100) had died and 2 had been lost to follow up. Survival rates were calculated by actuarial methods. Age, sex, the period they had been symptomatic, alcoholic intoxication and the degree of cardiac dilatation were not significant prognostic factors. Patients in Class IV NYHA had the worst prognosis: 63 p. 100 2 year mortality. Atrioventricular conduction defects were observed in 56 patients and were associated with a significantly increased mortality rate (43 p. 100 compared with 23 p. 100, p < 0.001). Atrial fibrillation (32 patients) was a better prognostic factor than the persistence of sinus rhythm; 2 year mortality 11,1 p. 100 compared to 37,6 p. 100 (p < 0.001). Increased left ventricular end diastolic pressures greater than 20 mmHg were related with a mortality of 51,5 p. 100. Also, the patients with a ejection fraction of 30 p. 100 and a 2 year mortality rate of 44 p. 100 compared to 17,5 p. 100 when the ejection fraction was greater than 30 p. 100 (p < 0,001). In conclusion : 1. Regional abnormalities of left ventricular contraction are not rare in primary cardiomyopathy. 2. The prognosis is directly related to the degree of cardiac failure and the extent of left ventricular dysfunction.

Adolescent↗
PubMed1978

[Auricular and left ventricular compliance in acute and chronic mitral insufficiency].

Left atrial and ventricular compliance has been studied in 25 cases of chronic mitral incompetence (CMI) and 9 cases of acute mitrale incompetence (AMI). Left atrial compliance was evaluated by the ratio between maximal variation in volume and corresponding maximal variation in pressure; it was found to be higher in cases of CMI than in cases of AMI. Left ventricular compliance was evaluated by various indices (Diamond, Mirsky, Gaasch, Laird), and was found to be increased equally in the chronic and acute types. It is possible that an explanation of this increase incompliance is to be found in the rearrangement of myocardial fibres which follows the dilatation. It constitutes a fundamental means of chronic adaptation, and shows that the diastolic elastic properties of the cavities of the atrium and ventricle are as important in the evaluation of mitral incompetence as the properties of systolic contraction.

Acute Disease↗
PubMed1978

Quantitative assessment of myocardial infarction prognosis to 1 and 6 mth--from clinical data.

Survival of 312 patients with acute myocardial infarction was studied from data collected during the first 48 h in the coronary care unit. Only patients with recent onset of symptoms (48 h), with a 48-h survival, and with evidence of myocardial infarction, were selected. Mortality rate at 1 mth was 15.3% and 24.6% at 6. The following factors were significant for poor survival: increasing age, female sex, diabetes, previous angina, low blood pressure on admission and at the 48th h low average value and the lowest observed value of blood pressure, clinical and radiological left ventricular failure, high level of LDH, increased urea and leukocytosis. Among ECG data, the presence of signs related to extent of infarction, anterior as compared to inferior location, antero-lateral as compared to anterior, QRS frontal axis deviation, absence of sinus rhythm, sinus tachycardia, tachyarrhythmias with wide QRS complex, right bundle branch block, 3rd-degree AV block with wide QRS complex, was associated with significantly worse survival than the absence of these signs. A multivariate analysis of the 42 most significant data, assuming linear regression, was used to establish a discriminant prognostic index. Using this index, survival was predicted correctly in 90.2% of patients at 1 mth and 85.7% at 6 mth. Thus prognosis can be established in nonclear-cut groups of patients with myocardial infarction (severe and benign forms being excluded by criteria) from simple clinical data.

Adult↗
PubMed1977

[Cause of death in recent myocardial infarct. Correlation between extent of necrosis and clinical, electrocardiographic and anatomical findings].

A retrospective study of 100 case notes of patients who died from a recent myocardial infarction (less than one month before death) has established the causes of death: cardiac failure (52), rupture of the heart (40), major pulmonary emboli (3), primary irreversible ventricular fibrillation (2), unexplained death (3). Study of the extent of the necrosis by the technique of segmentation of the ventricular mass has allowed us to clarify the correlation between the "index of extent" ("i"), an the clinico-pathological findings. It has been noted in particular that those infarctions complicated by cardiogenic shock and/or by bilateral bundle branch block were those with the highest value of index of extent (i = 8.91, i = 9.40); also that cardiac failure and ventricular tachycardia were found in the extensive infarctions (i = 7,33, i = 9.52); also that rupture of the outer wall and pulmonary thromboses complicated infarctions of very small extent (i = 4,80, i = 5,67). It would not seem possible to reduce the hospital mortality of infarctions significantly, since it is essentially linked with circulatory failure caused by extensive necrosis, and with ruptures of the heart which are unpredictable and untreatable.

Arrhythmias, Cardiac↗
PubMed1976

Cardiovascular effects of an antiarrhythmic aminosteroid ORG 6001 in the anesthetized pig.

The hemodynamic effects of 3alpha-amino-5alpha-androstan-2beta-ol-17-one-hydrochloride (ORG 6001), an aminosteroid possessing antiarrhythmic properties, were studied in 14 anesthetized pigs. ORG 6001 was administered i.v. cumulatively until a toxic level was reached. Doses less than 20mg/kg had, in spite of the negative inotropic properties of ORG 6001, no effect on the pump function of the heart, as the afterload was reduced and the filling pressure was not significantly altered. After administration of 40 mg/kg A-V conduction was depressed and second degree A-V block appeared. This was associated with deterioration of the pump function and for 6 of the 14 animals this was fatal. In the survivors, the alterations were reversible after cessation of drug administration. Since ORG 6001 has been shown to be effective against arrhythmias at doses less than 20 mg/kg, though in a different species (dog), it seems likely that it can be used safely for antiarrythmic treatment.

17-Ketosteroids↗
PubMed1975

[Tricuspid incompetence after surgical correction of mitral and mitrio-aortic value diseases. Reasons for its persistence or its recurrence].

53 patients with mitral or aortic valve disease, observed consecutively, had before operation a marked tricuspid incompetence. 24 had, in the course of corrective mitral or mitral-aortic correction, a surgical attempt at treatment of tricuspid regurgitation; in theremaining 29, tricuspid incompetence was not corrected surgically. The course of the latter group was studied (average follow-up period after operation = 18 months): the operative mortality was 10.3%, and secondary one 20.7%. The functional result was considered good in 55% of the patients, bad (classified III and IV of the NYHA) in 14% of the patients. The postoperative clinical and haemodynamic assessment showed that, in the patients in stages III and IV with persistent ou recurring tricuspid incompetence, the tricuspid lea was, in all cases, secondary to an anomalous function of the left heart (bad function of the prosthesis, persistence of aortic lesions either misvalued or uncorrected). Tricuspid repair in a second stage is unjestified in such cases.

Adult↗