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Biomedical subjects

J C Fouron

Publications and source records attributed to J C Fouron.

At least 109 records · Page 6Linked to original sources
PubMed1983

Influence of age on wall thickness, cavity dimensions and myocardial contractility of the left ventricle in simple transposition of the great arteries.

This study was carried out to establish a reference table of echocardiographic values for the left ventricle of simple d-transposition of the great arteries (d-TGA) and to determine at what age left ventricular dimensions in these patients become different from those of a normal population. Fifty-three patients with d-TGA and normal pulmonary pressure and 395 normal children ages 1 day to 10 years were studied by M-mode echocardiography. Results show that in d-TGA, left ventricular systolic and diastolic internal diameters are normal at birth. After 1 month, however, both diameters were below normal and despite a progressive increase with age, the mean values were always below normal. The mean posterior wall thickness of patients with d-TGA was also normal at birth but did not increase with age (2.3 mm in diastole and 4.3 mm in systole) and became significantly thinner than normal at 10 months of age in diastole and 7 months in systole. Septal thickness of patients with d-TGA did not differ from that of the control group. The shortening fraction and mean velocity of circumferential fiber shortening were significantly greater in d-TGA at all ages. Left ventricular measurements related to age are presented and should be of help in interpreting M-mode echocardiograms of patients with d-TGA.

Age Factors↗
PubMed1983

A comparison of blood viscosity between the adult sheep and newborn lamb. The role of plasma and red blood cell type.

Adult sheep and newborn lamb blood viscosity (Vc) have been compared by taking into account not only the hematocrit, but also the type of the red cells (adult or fetal) in the circulation and the plasma Vc. At all shear rates studied the whole blood Vc of the adult was higher than that of the newborn. Plasma Vc was 1.58 +/- 0.18 centipoises in the adult compared to 1.21 +/- 0.19 in the newborn group (P less than 0.001). The mean relative apparent viscosity (whole blood Vc/plasma Vc) was higher in the newborn although the difference was not significant.

Animals↗
PubMed1983

The effect of high or low oxygen affinity red cells on tissue oxygenation and myocardial function in hypoxic newborn lambs with or without hypercapnia.

In order to compare high and low oxygen affinity blood under conditions of severe respiratory failure, the effects of a high or low P50 were evaluated in two groups of newborn lambs (P50, 20 mmHg versus 30 mmHg), under conditions of hypoxic hypoxia (Fio2, 10%) and hypercapnic hypoxia (Fio2, 10% and Fico2, 10%). Data on cardiovascular function, blood gas parameters, and tissue oxygenation were collected under normoxic conditions and during severe hypoxia. During hypoxic hypoxia, a higher arterial oxygen content was noted in the high affinity group throughout the experiment; however, there were no significant differences detected in the remainder of the parameters studied. During hypercapnic hypoxia, the position of the oxygen dissociation curve did not cause any significant differences. When, however, hypercapnic hypoxia was compared to hypoxic hypoxia, there was a significant increase in cardiac output and myocardial contraction during hypercapnia.

Animals↗
PubMed1982

Blood viscosity during the neonatal period: the role of plasma and red blood cell type.

Adult and newborn infant blood viscosity have been compared, taking into account not only the hematocrit, but also the type of red blood cells (fetal or adult) in the circulation and the plasma viscosity. At all shear rates studied, the viscosity of the adults' blood was higher than that of the newborn infant. At shear rates of 11.5 and 46 second-1, an increase in the hematocrit influences the viscosity of neonatal and adult blood similarly. At 115 and 230 second-1, the rise in hematocrit was associated with a greater increase in viscosity in the presence of fetal red blood cells, probably because of their lesser deformability. Plasma viscosity was 1.18 +/- 0.17 centipoises in the newborn compared to 1.36 +/- 0.10 in the adult group (P less than 0.001). The relative apparent viscosity (apparent viscosity/plasma viscosity) was higher in the neonate at a hematocrit of 65% (P less than 0.05). In normal conditions, blood viscosity is lower in the neonatal period because of a lower plasma viscosity.

Adult↗
PubMed1982

Hang-out time of pulmonary valve in d-transposition of great arteries.

Recently it has been shown that in patients with transposition of the great arteries the isometric relaxation time of the left ventricle could be negative in the presence of normal pulmonary artery pressure. In order to find an explanation for this apparently paradoxical situation, it was decided to evaluate the importance of the delay of closure of the pulmonary valve in 15 patients with transposition of the great arteries. This delay is called the hang-out time. The hang-out time was found to correlate inversely with the isometric relaxation time as well as with the pulmonary artery systolic (r = -0 . 70) and mean pressures. A weaker correlation was found between the isometric relaxation time and the time of mitral valve opening. These results show that in transposition of the great arteries with normal pulmonary artery pressure, the pulmonary valve has a prolonged hang-out time, to the extent that it frequently closes after the opening of the mitral valve, explaining the negative isometric relaxation time found in these cases. This finding may help in the non-invasive assessment of the pulmonary vascular resistance of patients with transposition of the great arteries.

Child, Preschool↗
PubMed1982

Cardiac dimensions and myocardial function of infants with congenital hypothyroidism. An echocardiographic study.

This study was undertaken to evaluate the cardiac dimensions and various indices of myocardial function, determined by echocardiography, in a group of 12 infants with congenital hypothyroidism. Left ventricular systolic and diastolic dimensions, posterior wall thickness, enddiastolic and systolic volumes were all significantly lower in the hypothyroid infants compared with 25 normal infants of the same age. No pericardial effusion was found. Hypothyroid infant had a lower heart rate with a reduced cardiac output. The mean velocity of circumferential fibre shortening and the shortening fraction of the left ventricle were normal. The pre-ejection period of the left ventricle (PEP), however, was abnormally prolonged as well as the ratio PEP over left ventricular ejection time (PEP/ET). This ratio correlated inversely with the end-diastolic volume, suggesting that the increased PEP/ET could be partly the result of decreased preload.

Cardiac Volume↗
PubMed1982

[Neonatal electrocardiographic manifestations of congenital hypothyroidism. Correlation with echocardiographic data].

Twelve infants, average age 5, 4 weeks (range 3 to 8 weeks) with congenital hypothyroidism were studied. In addition to routine evaluation including plasma T3, T4 and TSH estimation and the establishment of a clinical index of hypothyroidism on electrocardiogram and an echocardiogram were performed. The following variables were analysed: heart rate, QRS axis in the frontal plane, PR interval in Lead II, corrected QT interval in V5, amplitude of the P waves in Lead II, R waves in V3R, V1, V5 and V6; S waves in V1, V2 and V4 and T wave in V6. The ventricular activation time in V5 and QRS duration in V3R, V1 and V6 were also measured. The presence of pericardial effusion, left ventricular posterior wall and septal thickness, and left ventricular internal diastolic and systolic dimensions were determined by echocardiography. The following conclusions were drawn: 1. The ECG of hypothyroidism in the neonatal period is characterised by the low amplitude of the left ventricular potentials while increased conduction times were much less evident; 2. Only the sum of R + S in V2, the amplitude of the T wave in V6 and increase in QRS duration in V3R were influenced by severity of hypothyroidism; 3. Left ventricular microvoltage is not due to pericardial effusion which was absent in all our cases.

Congenital Hypothyroidism↗
PubMed1982

Renal transplantation and cardiac function in pediatric patients.

Nine pediatric patients underwent echocardiographic evaluation prior to and after renal transplantation. Prior to transplantation parameters of cardiac contractility such as mean velocity of circumferential fiber shortening, ejection time, ejection fraction and shortening fraction were within the normal ranges for the age group. Post transplantation there was a significant decrease in heart rate and cardiac index. In addition a dramatic increase in hemoglobin levels was observed. The improvement in circulating hemoglobin levels rather than the removal of uremia appears to be the dominant beneficial result in improving cardiovasuclar hemodynamics.

Adolescent↗
PubMed1981

Effect of fetal or adult red cells on tissue oxygenation and myocardial function in normoxemic newborn lambs.

Twelve newborn lambs less than 48 hr old had their high oxygen affinity blood exchanged for low-affinity fresh adult blood. Tissue oxygenation, hemodynamic status, blood gases, and myocardial function were compared before and after the exchange transfusion. The P50 was increased from 18 to 29 mm Hg after exchange transfusion; pH and hemoglobin levels remained constant; and there was no change in myocardial function, arteriovenous O2 content difference, O2 consumption, or cardiac output. However, mixed venous PO2 was significantly increased with low affinity red cells (33 versus 23 mm Hg).

Animals↗
PubMed1981

Oxygenation in anemic newborn lambs with high or low oxygen affinity red cells.

Experiments to determine the effect of the oxygen-hemoglobin dissociation curve on oxygen delivery during neonatal anemia, were carried out on 15 sedated and ventilated lambs less than 48 hr of age. Eight of the animals were exchange transfused with adult blood. The P50 of the exchange transfused group was 32.1 mm Hg (low O2 affinity) compared to 19.4 mm Hg for the controls (high O2 affinity). The animals were made anemic by isovolumic exchange transfusions with plasma. At different levels of hemoglobulin defined as mild (8 mg/100 ml), moderate (6 mg/100 ml), and severe (4 mg/100 ml) anemia, tissue oxygenation, hemodynamic status, and blood gases were compared. Mixed venous PO2 was significantly lower in the high affinity group throughout this study. Cardiac output was significantly greater in the low affinity group during severe anemia. Oxygen consumption remained stable in the low affinity group, but decreased significantly in the high affinity group when the anemia was severe. The data indicate that during severe anemia, blood with a high P50 is more capable of adequately oxygenating tissues than that with a low P50.

Anemia, Neonatal↗
PubMed1981

Palliative surgery in tetralogy of Fallot.

Because much controversy surrounds the palliative surgical treatment of young children with tetralogy of Fallot the authors review their experience over 13 years with two procedures--the Blalock-Taussig operation and the Waterston shunt. Blalock shunts were performed 195 times in 172 patients; 147 had a single Blalock anastomosis which carried them through the critical period and allowed for later correction of the tetralogy. Thrombosis of the Blalock anastomosis occurred in two patients in the early postoperative period. In 23 patients a second shunt was necessary after the first Blalock shunt became inadequate in spite of being patent. The age of the children ranged from 2 weeks to 9 years, 74% being operated upon under the age of 2 years. There were four early deaths (2%) and five late deaths (2.5%) in this group. Of the last 91 consecutive patients operated upon between Sept. 1, 1972 and June 30, 1980 none have died. Between September 1968 and June 1980, 14 patients with tetralogy of Fallot underwent a Waterston shunt. Their ages ranged from 2 days to 4 years. Six patients were younger than 35 days at the time of operation. There were two operative deaths in this group. The Waterston shunt carries a high risk and is reserved for the occasional patient who needs palliation during the first weeks of life and in whom the anatomy of the subclavian artery does not favour a good Blalock-Taussig shunt. The Blalock-Taussig operation is preferred because it is safe and gives good sustained clinical results. The mortality was much lower than previously reported. The growth of the pulmonary arteries was good in most patients. The Blalock shunt did not increase the pulmonary resistance and it did not influence the operative mortality.

Child↗
PubMed1980

Relation between isovolumic relaxation period of left ventricle and pulmonary artery pressure in d-transposition of the great arteries.

The study aimed to identify the best echocardiographic time interval (systolic or diastolic) for assessing pulmonary artery pressure in children with d-transposition of the great arteries. Echocardiograms were performed in 21 children with d-transposition of the great arteries within 48 hours of cardiac catheterisation. None of the children had had a Mustard procedure. Twenty-four recordings were obtained, three patients having been catheterised twice. Highest correlations were found for the ratio of the isovolumic relaxation time over the ejection time of the left ventricle (IRT/LVET) to the systolic pressure in the pulmonary artery and also between IRT/LVET and the difference between mean pulmonary artery pressure and mean left atrial pressure. All patients with a negative IRT/LVET ratio had a pulmonary systolic pressure lower than 35 mmHg and a mean pulmonary pressure lower than 25 mmHg. In patients with d-transposition, a negative IRT/LVET ratio appears to be a reliable indication of normal pressure in the pulmonary circulation. Serial echocardiographic studies for the follow-up of patients with d-transposition should include measurement of the time of relaxation of the left ventricle.

Blood Pressure↗
PubMed1980

Isovolumic contraction time of right ventricle in d-transposition of great arteries.

The pre-ejection period of the right ventricle in d-transposition of the great arteries is known to be prolonged, compared with the same interval of the left ventricle of normal subjects. In the present study, the echocardiographic measurement of the components of the pre-ejection period of the right ventricle of 14 patients with d-transposition of the great arteries shows that the isometric contraction time of the right ventricle in d-transposition of the great arteries is similar to the same interval calculated on the left ventricle of 76 normal children of comparable age. On the other hand, the electromechanical delay was significantly greater for the right ventricle of d-transposition of the great arteries than for the left ventricle of the normal subjects. It is concluded that the prolonged pre-ejection period of the right ventricle in d-transposition of the great arteries is not the result of right ventricular dysfunction but solely of a longer electromechanical delay.

Adolescent↗
PubMed1980

[Aneurysm of the ductus arteriosus. Apropos of case operated on with success].

A 6 week old baby was operated on successfully for removal of an aneurysm of the ductus arteriosus. The aneurysm, absent at the age of 12 days, developed progressively during the closure of the ductus. The only suggestive symptom was a haemoptysis. The radiological appearances were characteristic. The authors discuss the physiopathology, clinical presentation and radiological appearances of this lesion.

Ductus Arteriosus, Patent↗
PubMed1979

Echocardiographic manifestations of persistence of the right sinus venosus valve.

The echocardiographic features of a neonate born with a persistent right sinus venosus valve are presented. Because surgical correction of this serious anomaly may be possible, the diagnosis should be made soon after birth. An echocardiogram suggesting a right atrial myxoma, an unlikely finding in a neonate, should be an important clue to the diagnosis of this anomaly.

Echocardiography↗
PubMed1978

Red cell oxygen affinity in fetal sheep: role of 2,3-DPG and adult hemoglobin.

Studies were carried out during fetal life in sheep to determine the relationship of 2,3-diphosphoglycerate (DPG), the intracellular red cell and extracellular pH, and the switchover to adult hemoglobin synthesis in regulating the position of the fetal red cell oxygen-affinity curve in utero. Adult hemoglobin first appeared near 120 days of gestation. The mean oxygen tension at which hemoglobin is half saturated (P50) prior to 120 days of gestation remained constant at 13.9 +/- 0.3 (SD) Torr and then increased gradually as gestation continued, reaching 19 Torr at term. During the interval of fetal life studied, the level of DPG was 4.43 +/- 1.63 (SD) micromol/g Hb and the deltapH between plasma and red blood cells was 0.227 +/- 0.038 (SD); neither was affected by gestational age. The decrease in the red cell oxygen affinity after 120 days of gestation ocrrelated with the amount of adult hemoglobin present in the fetus (r = 0.78; P less than 0.001). This decrease can be attributed only to the amount of the adult-type hemoglobin present, and not to DPG, or to changes in the deltapH between plasma and red blood cells, because both remained stable during the last trimester.

Animals↗