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J Elaerts

Publications and source records attributed to J Elaerts.

At least 91 records · Page 5Linked to original sources
PubMed1988

Diagnostic value of stress radionuclide angiography in coronary artery disease: a comparison of different interpretation criteria.

In order to compare different criteria in the interpretation of stress radionuclide angiography (SRNA) 96 patients with suspected coronary artery disease (CAD) were investigated by both SRNA and coronary arteriography. The result of coronary arteriography was taken as the gold standard for the diagnosis of CAD. Left ventricular ejection fraction (LVEF) was measured at each step of the stress study using the equilibrium radionuclide technique. The diagnostic value of eight interpretation criteria based on the evolution of global LVEF during stress were compared with each other, using the ROC technique. The best diagnostic criterion proved to be the normalized increase of LVEF proposed by Goris. The most commonly used criteria, LVEF increase and LVEF measured at maximal exercise, were not optimal. In the whole population of patients, the best criterion had a sensitivity of 85% for a specificity of 80% and a specificity of 83% for a sensitivity of 80%. In the population, following exclusion of patients with preceding myocardial infarction, the specificity was 74% for a sensitivity of 80% and a sensitivity of 74% for a specificity of 80%. Thus, the choice of interpretation criteria is very important in order to optimize the sensitivity and specificity of this diagnostic test.

Angina Pectoris↗
PubMed1988

[Aortic dissection with normal aortography and x-ray computed tomography. A diagnostic trap not to be ignored].

We are reporting the case of a 63 y.old patient whose initial clinical examination and ultrasonographic data had led to the diagnosis of acute aortic dissection. Only an emergency surgical procedure was able to confirm the diagnosis, after failure of angiography and CT-scan to do so. In the light of this example, we are presenting a reminder of the sensitivity of various paraclinical examinations, classically accepted to establish this diagnosis.

Aortic Dissection↗
PubMed1988

[Floating thrombus of the right atrium in acute pulmonary embolism. Clinical, echocardiographic aspects and therapeutic sequelae].

The performance of a systematic sonocardiography in all our patients hospitalized since January 1985 for pulmonary embolism, has enabled to discover five cases of floating thrombus of the right atrium. Three patients presented an abnormal auscultation, with one of them presenting a tricuspid wedge syndrome. On the sonogram, the aspect of the thrombus, "coil or ball-shaped", floating in the atrial cavity, sometimes prolapsed through the tricuspid valve, associated with the signs of a pulmonary heart, enables to rule out other right intraatrial masses. Pulmonary angiography seems contra-indicated because of the risk of embolus of this thrombus, the migration of which may be fatal. Embolectomy, under extra-corporeal circulation (heart-lung pump) with examination of the right cavities appears to be the treatment of choice.

Acute Disease↗
PubMed1986

Comparison of phase analysis with factor analysis in equilibrium gated radionuclide angiography.

This study is the intercomparison of phase analysis (PA), factor analysis of dynamic structures (FADS) and Karhunen-Loeve analysis (KLA) in the diagnosis of regional wall motion abnormalities, RWMA, of the LV. One hundred and twenty eight patients with proven or suspected CAD have been investigated by both X-ray angiography and radionuclide equilibrium angiography performed in the LOA view. FADS and KLA are performed twice, once on the whole-image (WI-FADS, WI-KLA), and once on the LV ROI (LV-FADS, LV-KLA) as suggested by Pavel. Resulting images and factors are interpreted by a well trained observer. In an attempt to quantify LV-FADS images, two numeric parameters, P1 and P2, are defined. They measure the relative weight of the so-called ventricular factor for 2 and 3 factor analysis, respectively. A ROC curve is calculated for each method, taking X-ray angiography as the gold-standard. The areas under the ROC curves are estimated by the maximum likelihood method and are compared using a test described by Hanley which takes into account the correlation between the responses. The areas are: 0.90 for PA, 0.84 for WI-FADS, 0.86 for LV-FADS, 0.83 for WI-KLA, 0.86 for LV-KLA, 0.65 for P1 and 0.72 for P2. The observed differences are significant (at 5% level) between PA and WI-FADS and between FA and WI-KLA; whereas they are not between PA and LV-FADS, between PA and LV-KLA and between LV-FADS and LV-KLA. The diagnostic value of the two numeric parameters is poor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

The objective evaluation of the phase image: a comparison of different automated methods.

One hundred and twenty eight patients with suspected or proven CAD were investigated using both X-ray ventriculography and equilibrium gated radionuclide angiography. In order to diagnose regional wall motion abnormalities, the parametric images obtained by Fourier analysis of the radionuclide images were analysed by different automated methods based on the measurement of the homogeneity of the phase values within the LV ROI. The effect of a diastolic frames exclusion, smoothing the original data, weighting the phase histogram, using Bacharach's error corrected phase distribution functions, using different descriptors of the spread of the phase histograms or distribution functions were tested. Using the results of the X-ray examination as the gold standard, ROC curves were plotted for each method. The ROC curves were modelled by a binormal model using the maximum likelihood method. Statistical tests were applied on the area under the ROC curves. The results show that the diagnostic value of the automated methods depends mainly on the way the histograms or distribution functions are described and to a lesser extent on the type of histograms or distribution functions used. The best result is obtained after smoothing, diastolic frames exclusion, weighting the phase histogram by the amplitude and describing it by its standard deviation. Nevertheless, this result is not significantly different from the result obtained by visual analysis of the phase and amplitude images.

Adult↗
PubMed1984

A new method for objective evaluation of cardiac parametric images.

A new method for analyzing cardiac parametric images is introduced. Its original feature is the representation of local heart motion in a polar coordinate plane which makes the integration of the information contained in three parametric images possible. These images are calculated using first harmonic Fourier filtering and are the maximum volume image, the local ejection fraction image, and the phase image. The last two parametric images are considered as the complex ejection fraction parametric image which is described by a 2D distribution in the complex plane. This method is a generalized 2D version of the well-known phase histogram method. By segmenting the complex plane in which this representation is made, four indexes are defined called the index of hypokinesia, the index of asynergy, the mean phase shift in asynergic regions, and the mean ejection fraction in asynergic regions. The values of those indexes are used to assess the degree and extent of regional wall motion abnormalities. An automated classification as normal, hypokinetic, akinetic, slightly dyskinetic, and strongly dyskinetic made on the basis of the values of those indexes has been compared with a visual classification made by three observers in 219 studies. ROC curves show a good agreement between the automated and visual methods. This new method provides an efficient means of automatically classifying cardiac studies.

Cardiac Output↗
PubMed1982

[Predictive value of the exercise test for multivessel disease after initial myocardial infarction].

The extent of coronary artery disease after primary myocardial infarction is an important prognostic factor. The predictive value of exercise electrocardiography for multivessel disease was assessed by comparison with coronary angiography in a series of 100 patients. In the group of patients with primary anterior infarction (n = 48), 37.5% had positive exercise ECGs. Coronary angiography showed 62.5% single vessel disease. In multivessel disease, the sensitivity of exercise ECG was 78% and specificity 86%. The predictive value of a positive test was 78% and, for a negative test, 86%. In primary inferior infarction (n = 52), positive exercise ECGs were recorded in 48% of cases. Coronary angiography showed 48% multivessel disease. In multivessel disease, sensitivity of exercise ECG was 92% ans specificity 93%. The predictive value of a positive test was 92% and of a negative test, 93%. Therefore, exercise ECG gives a more precise prediction of the extent of coronary artery disease after primary inferior infarction than after primary anterior infarction. However, it is not an ideal guide for the choice of patient for coronary angiography because of its poor predictive value in cases of anterior infarction, and because of the high incidence of multivessel disease in patients with primary inferior infarcts. Nevertheless, it is of great prognostic value with regards to the eventual course of the coronary disease.

Adult↗
PubMed1979

[Treatment of functional tricuspid insufficiency by a valvuloplasty with a flexible linear reducer].

Valvuloplasty with preservation of the valvular apparatus is the treatment of choice in functional tricuspid incompetence (FTI). A new method of valvuloplasty has been developed using a flexible linear reducer (FLR); its insertion is simple and without risk to the Bundle of His. It is made of sections of elastomere covering a dacron core. The principle of the FLR is reduction of the tricuspid annulus leaving the septal leaflet free. It is a simple method which allows individual variations in the zone reduced (usually involving the anterior and inferior leaflets) and in the size of the reduction at each point. The excellent results at medium term in 20 patients with tricuspid FLR lead us to recommend widening the surgical indications for correction of FTI especially in cases where signs of right ventricular failure have been observed.

Adult↗
PubMed1979

[Cardiac manifestations of pheochromocytoma. Anatomo-clinical study].

Cardiomyopathy induced by catecholamines, first demonstrated in the animal is also observed in clinical medecine either after infusion by vasopressor drugs or during the course of pheochromocytoma. The clinical presentation is varied and may often deceive: acute coronary insufficiency, arrhythmia, heart failure, and, above all, cardiogemic shock. The authors emphasise the importance of considering the diagnosis of "adrenergic myocarditis" in such situations as well as in cases of pheochromocytoma, for which the only cure is ablation of the tumour.

Adrenal Gland Neoplasms↗
PubMed1976

[Femoral nerve paralysis complicating anticoagulant treatments. A propos of 3 cases].

The authors report 3 new cases of femoral nerve paralysis complicating anticoagulant treatment. The first sign was pain, the neurological signs occurred later and the patient usually recovered but recovery was sometimes incomplete. The pathogenesis is not clear : a muscle hematoma, ischemia of the nerve trunk, and intraneural hemorrhage are the commonest theories.

Aged↗
PubMed1976

[Echocardiographic aspects of the atrio-ventricular canal].

The authors report their experience of echocardiography in cases of atrio-ventricular canal in the light of 9 cases which were studied by time-movement and 2-dimensional echography. In cases if ostium primum, the essential findings are: diastolic juxtaposition of the mitral valve to the left side of the septum, its multiple-echo appearance during systole, and the abnormal movement of the ventricular septum. In cases of complete atrio-ventricular canal, two main types are found. In the first, the echos of the atrio-ventricular valve are confused with those of the interventricular septum during diastole; in diastole, the septum disappears, one valve moves anteriorly into the right ventricle, and the other moves posteriorly into the left ventricle. In the second type, the appearances are those of a single valve which is situated within the left ventricle during systole, and which 'crosses' the interventricular septum to gain the right ventricle during diastole. The interpretation of these findings is difficult. It becomes clearer, however, when it is realised that the plane of incidence of the ultrasonic waves is not perpendicular to the plane of movement of the atrio-ventricular valve. The authors' conculsion is that echocardiography is a method of diagnosings atrio-ventricular canal defects, bud does not allow the anatomical type to be defined.

Child↗
PubMed1972

[Harmless murmurs].

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Arteriosclerosis↗
PubMedDate not supplied

Floating right heart thrombi and pulmonary embolism: diagnosis, outcome and therapeutic management.

The aim of this study was to analyze clinical and echographic findings and to assess therapeutic management in 14 floating right atrial thrombi diagnosed with systematic echocardiography in 200 consecutive patients with proven pulmonary embolism. Auscultatory findings were abnormal in 7 cases, 4 of them showing signs of tricuspid obstruction. Echocardiography displayed a mobile ovoid, polycyclic or worm-like right atrial mass, always associated with signs of cor pulmonale. Four patients (29%) died, 2 of them before any treatment could be started. Regarding the remaining 10 patients with favorable outcome, surgical embolectomy was carried out in 7. Our data suggest that echocardiographic examination is necessary in all suspected pulmonary embolisms and has to be done quickly for emergency treatment in patients with floating right atrial thrombus.

Adult↗
PubMedDate not supplied

[Vascular effects of neurokinins in humans].

Neurokinins (mainly substance P and neurokinin A) are released by sensitive nerve fibres. These fibres have been found in the vascular wall of arteries and veins of many vascular regions, particularly in nasal mucosa vessels, temporal and coronary arteries and saphenous veins. Substance P causes vascular relaxation by stimulating NK1 endothelial receptors. This relaxant effect is mediated, according to the vessels, by nitric oxide (NO), prostanoids or endothelium-dependent hyperpolarizing factor (EDHF). Capsaïcin, which induces the release of neurokinins, and neurokinin A can cause contractions of some vascular preparations, suggesting the existence of smooth muscle NK2 receptor associated with contraction. The vasodilatation induced by substance P injection appears reduced in patients with cardiovascular risk factors. The clinical development of specific neurokinin receptor antagonists may give the opportunity to specify the role of neurokinins in systemic vascular diseases. The results already obtained after repeated local applications of capsaïcin (to reduce local levels of neurokinins) in vasomotor rhinitis and urticaria suggest that the vascular effects of neurokinins may participate in the clinical expression of these diseases.

Blood Vessels↗