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Biomedical subjects

J Bensaid

Publications and source records attributed to J Bensaid.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Quantitative evaluation of myocardial ischemia using imaging methods].

Secondary prevention of myocardial infarction includes all measures likely to reduce morbidity and mortality after the infarction. It is a highly heterogeneous concept applied to a highly heterogeneous disease. The natural history of myocardial infarction, which must be known to determine the frequency of critical events and hence devise a trial, is incomplete particularly since treatment capable of altering this history (aorto-coronary bypass, thrombolysis) have been introduced. Future trials in secondary prevention of myocardial infarction must concentrate on such important questions as: can the possibilities of reperfusion be extended as regards the acute phase, and which preventive measures are useful to patients at high risk post-infarction? The A.P.S.I. study (acetolol in the secondary prevention of myocardial infarction) is an example of study aimed at answering the second question.

Angiocardiography↗
PubMed1987

[Bepridil and torsades de pointes. Apropos of 11 cases].

The authors report 11 cases of spikes occurring under bepridil treatment. It concerns an elderly population, predominantly female, receiving most of the time 300 mg of bepridil. The frequency of associated hypokalemic or arrhythmic medications is emphasized. The comparison of these results to those from other series in the literature, enables to propose precautions for the use of this molecule.

Aged↗
PubMed1987

[Pneumopathy caused by amiodarone. An often unrecognized iatrogenic entity].

Three cases of interstitial pneumopathy secondary to amiodarone are reported, in addition to almost 200 cases previously published in the literature. The main clinical, radiological, biological and evolutive characteristics are reminded in emphasizing the advantages of bronchioalveolar irrigation. Some factors seem to be predisposing, without any definite proof however. They are: high daily dosage, long term treatment, high cumulative dose, concomitant ingestion of another anti-arrhythmic medication, especially in elderly patients, and in patients who, before any treatment, presented a decreased total pulmonary capacity and a CO transfer capacity lower than 80 p. cent of the theoretical values. Discontinuation of amiodarone and administration of steroids usually produce a rapid regression of the clinical and radiological symptoms.

Aged↗
PubMed1986

[Intermittent dysfunction of a Björk-Shiley tricuspid prosthesis caused by thrombosis suspected through pulmonary scintigraphy].

Thrombosis of a Björk-Shiley tricuspid valve prosthesis was observed 4 years after its implantation. The resulting dysfunction was intermittent blocking the disc in the closed position leading to recurrent near-syncopal malaises probably due to a temporary fall in cardiac output and cerebral blood flow and a right to left interatrial shunt which was detected at pulmonary scintigraphy performed to exclude pulmonary embolism. The Björk-Shiley prosthesis was replaced with a Carpentier-Edwards n. 29 prosthesis with a good result after a follow-up of one year.

Adult↗
PubMed1986

Effects of captopril on myocardial perfusion in patients with coronary insufficiency: evaluation by the exercise test and quantitative myocardial tomoscintigraphy using thallium-201.

Nine patients with coronary insufficiency were investigated using an exercise test coupled with quantitative myocardial tomoscintigraphy with thallium-201 before and after 48 hours' treatment with captopril. After captopril treatment, an improvement in ST segment depression was noted during exercise. The quantitative tomoscintigraphy showed a reduction in the ischaemic zone with captopril during exercise. However, in three patients, although there was an overall improvement in myocardial perfusion during exercise, aggravation of wash-out was observed in some regions, reminiscent of a coronary steal effect.

Adult↗
PubMed1985

[Complications of mitral valve prolapse].

Mitral valve prolapse, usually a benign condition, is aggravated in 15% of the cases by one or the other of five different complications. Mitral regurgitation may develop progressively or abruptly following rupture of the chordae tendinae and requiring prompt surgical repair. Bacterial endocarditis has been observed in 2.9% of the cases, hence the need for preventive antibiotic therapy prior to dental treatments or surgical operations in patients with holosystolic or end-systolic mitral murmur. Among arrhythmias, only ventricular extrasystoles (which are frequent and most often occur in pairs or salvos or are polymorphous) tachycardia and ventricular fibrillation may be considered as true complications of mitral valve prolapse and should be treated initially with beta-blockers. Sudden death is the major complication encountered in 1.4 to 2.4% of the patients; particularly exposed are women around 40 years of age who previously experienced syncopes or episodes of faintness due to attacks of tachycardia or ventricular fibrillation. Ophthalmic or cerebral ischaemic accidents occur with an incidence of 3.5%; some 20 to 30% of subjects under 45 who suffer from these accidents present with mitral valve prolapse.

Arrhythmias, Cardiac↗
PubMed1985

The carotid pulse in dissecting aneurysm of the aorta.

In five patients with acute aortic type I dissection a deep early systolic notch was recorded on the carotid pulse tracing. This peculiar feature of the carotid pulse was quite comparable to the aspect of the continuous wave Doppler ultrasound recorded along the carotid arteries. It can be explained by the temporary interruption of blood flow caused by false lumen in the artery. Therefore the carotid pulse can provide to the clinician a good help to the diagnosis of aortic dissection especially in case of nontypical presentation.

Aortic Dissection↗
PubMed1985

[A case of electrically and mechanically stunned myocardium].

The authors report the case of a 72 year old patient with ECG changes of anterior myocardial infarction complicated by left ventricular failure and shock which has a favourable outcome with regression of the pathological Q waves on the 7th day. Radionuclide investigation and coronary angiography showed no myocardial sequellae and the coronary arteries appeared normal. This case, an example of stunned myocardium, confirms that severe myocardial ischaemia, even of short duration, may induce reversible but prolonged metabolic disturbances. The practical implications of this concept are discussed.

Aged↗
PubMed1985

[Outcome of patients with inoperable multivessel coronary disease].

The authors studied the clinical course of 100 patients with two or three vessel coronary artery disease who were unsuitable for surgery because of the poor quality of the distal vascular bed or excessively depressed left ventricular function. The 6 year actuarial survival was 58 per cent; 43 of the 100 patients did not present any serious cardiac events causing death or requiring further admission to hospital, over this follow-up period. The severity of the clinical course in women and the presence of heart failure prior to coronary angiography were considered to be among the most important clinical prognostic factors. On the basis of the haemodynamic survey, the probability of survival or the risk of a further coronary accident appears to depend more on the extent of the left ventricular kinetic abnormalities than on the ejection fraction or the severity of the coronary lesions.

Adult↗
PubMed1984

Coronary artery aneurysms and Kawasaki's disease in an adult.

A 28 year old man had an acute myocardial infarction and was found to have coronary artery aneurysms. These may have been caused by a previous episode of Kawasaki's disease, an entity that should be considered in adults presenting with proximal discrete coronary artery aneurysms.

Adult↗
PubMed1984

[Comparison of 14 methods for analysing left ventricle segmental kinetics by cineangiography].

Fourteen methods of analysing left ventricular wall motion on 30 degrees right anterior oblique left ventricular cineangiography were compared in 70 cases using a HP 9845 B computer. The methods included the superposition of the centres of gravity, perpendicular to the long axis, Leighton's Rickard 's, Ingels ' and others to determine the influence of the use of different anatomical points of reference on the results. A score was given for each programme in comparison with three groups of normal angiography, anterior infarction and inferior infarction limited to a single zone with no lesion on the opposite coronary artery. The score was the ratio of radial shortening of normal wall motion to that of the infarcted wall. The fourteen methods were divided into 4 groups according to the type of infarct studied (anterior or inferior) and according to the use of either percentage radial shortening or the ratio of the surfaces described by these radii and the systolic and diastolic contours. The results underlined the importance of the anatomical references : aortic orifice and apex for centering systolic and diastolic contours. The methods which did not take these factors into account or which did not correct for them in diastole and systole gave poor results. The centre of gravity of the systolic contour was also an unreliable reference point. The three methods which gave the best results, independent of the site of infarction or the method of calculation (ratio of the radii or surfaces) were all based on the long axis from the aortic orifice to the apex.(ABSTRACT TRUNCATED AT 250 WORDS)

Cineangiography↗
PubMed1984

[Results of singular valve replacement with a mechanical prosthesis or bioprosthesis in valve diseases with advanced myocardial failure].

Surgery may prolong survival in some patients in advanced cardiac failure due to valvular heart disease refractory to digitalo-diuretic and vasodilator therapy. The operative risk is high and myocardial dysfunction after surgery is also a problem. However, in some cases, surprising improvement is observed. An analysis of the principal publications in the literature on the natural history of valvular heart disease and the results of surgery in the last ten years show that: In chronic aortic valve disease complicated by congestive heart failure, the natural prognosis does not exceed 2 to 3 years in either aortic stenosis or regurgitation. On the other hand, prosthetic valve replacement is associated with a 57% 4 years survival in aortic regurgitation, and a 70% 5 years survival in aortic stenosis, but with an operative mortality of 20 to 27%. Surgery is even more valuable in acute aortic regurgitation due to endocarditis, leading to a 60% 2 years survival compared to only 6% with medical therapy alone. In chronic mitral valve disease with advanced cardiac failure, the natural prognosis does not exceed 4.5 years in mitral regurgitation, 8 years in mitral stenosis and an intermediate period in mixed mitral valve disease. On the other hand, prosthetic valve replacement with an operative risk of 21 to 26% is associated with a life expectancy of 56 to 60% at 5 years, and 46% at 10 years, operative mortality included. The surgical results depend on good myocardial protection and intensive pre-, per- and post-operative care using positive inotropic agents, vasodilators and, when necessary, intra aortic balloon pumping.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗
PubMed1984

[Long-term fate of 103 patients with auricular fibrillation lasting for over 15 days treated with cardioversion and preventive therapy].

103 patients with atrial fibrillation lasting more than 15 days were treated by cardioversion, with a return to normal sinus rhythm in 92 per cent of cases. If the atrial fibrillation recurred during the first six months, a further electric shock was given and the treated was changed or better adapted to the patient. The sinus rhythm was maintained in 85.7 per cent of patients at one year, 84.4 per cent at 2 years, 80.1 per cent at 3 years and 76.1 per cent at 4 years. The factors which predict a good result are: sex, the presence of mitral valve disease, especially when it has been operated, good tolerance of the arrhythmia and good haemodynamic status prior to the shock. The treatment used were quinidine arabogalactane sulfate (QAGS) and amiodarone. QAGS was better tolerated, while amiodarone proved to be more effective.

Adult↗