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J J Perrenoud

Publications and source records attributed to J J Perrenoud.

At least 19 recordsLinked to original sources
PubMed1996

[Cardiac insufficiency: therapeutic aspects in the elderly person].

Heart failure is at the same time a muscular and a neurohormonal disease. This explains the current therapeutic choices: in particular digitalis, ACE inhibitors, spironolactone and in certain patients even beta-blocking agents. Two different types of heart failure are distinguished today: systolic failure with pump failure and diastolic failure with deranged ventricular filling. In the elderly, the two entities occur either together or individually. A precise and early diagnosis is important for an appropriate treatment to be instituted as early as possible, even in the case of asymptomatic or subclinical heart failure.

Adrenergic beta-Antagonists↗
PubMed1993

[Postmortem diagnosis of cardiac amyloidosis in the aged. Anatomoclinical correlation].

The absence of specific clinical signs makes the diagnosis of cardiac amyloidosis difficult. Moreover, it is established that this condition, the prevalence of which increases with age, aggravates the prognosis of cardiac failure. The present study was undertaken to identify the clinical or paraclinical signs enabling more accurate diagnosis of this disease. Analysis of 2589 autopsy reports from the University Institutes of Geriatrics of Geneva between January 1972 and January 1990 recensed 58 cases of microscopic cardiac amyloidosis, but this diagnosis was not made in any of these patients before death. Of the potential indicators, the good specificity but poor sensitivity of atrial fibrillation and low voltage electrocardiogram was confirmed. On the other hand, the author's research found the association of radiological cardiomegaly and a raised erythrocyte sedimentation rate in nearly 70% of cases of cardiac amyloidosis with a false positive rate of only 10% in a control group.

Aged↗
PubMed1992

[Hypertrophic cardiomyopathy in the elderly].

An abnormal Q wave in the ECG of the elderly calls for differential diagnosis between an old myocardial infarction and left ventricular hypertrophy. The latter may be due to hypertrophic cardiomyopathy, the prognosis of which is good in the elderly. The echocardiogram is the only method which provides the correct diagnosis and helps to avoid incorrect treatment.

Aged↗
PubMed1992

[Deglutition syncope].

In cases with a history of swallow syncope, an ECG should immediately be taken during ingestion of solid or liquid food in order to determine the rhythm disturbances responsible for the syncopes. Both esophageal passage and cardiac diagnosis are indicated, since, as shown in the literature, pathologic findings are not uncommon. The triad syncope, bradyarrhythmia while swallowing is considered to be an indication for definitive electrostimulation (pacemaker implantation) unless, exceptionally, halting digitalis medication puts an end to the syncopes.

Aged↗
PubMed1988

[Ergometric evaluation of the cardioprotective effect of pindolol in coronary disease. Comparison of 2 galenic forms].

In a dose of 5 mg three times daily, the beta-blocker pindolol (Visken Sandoz) has been shown to provide protection against both the signs and the symptoms of myocardial ischaemia. The purpose of the present study was to ascertain whether the same degree of protection is provided by a single daily dose of a slow-release formulation containing 20 mg pindolol. - Twelve patients with confirmed coronary heart disease were included in the study, which was carried out using a bicycle ergometer. The exercise tests were performed 2 hours after drug administration and again immediately before the next dose was due. These times are assumed to correspond to the maximum and minimum plasma levels of pindolol respectively. - The results show no statistically significant difference between the 20 mg form of the drug once a day and the 5 mg form 3 times daily with regard to the effect on heart rate (HR), blood pressure (BP), the product of HR and BP, and S-T segment changes (Cohn score) either at rest, during maximum effort, or 3 minutes after exercise. - It is concluded that 20 mg slow-release pindolol once daily is an effective anti-anginal therapy similar in its properties to 5 mg 3 times daily.

Adult↗
PubMed1986

Interindividual pharmacokinetic and pharmacodynamic variability of different beta blockers.

Hepatic drug metabolism influenced by genetic and environmental factors is a major source of variation in the response to a number of beta-adrenoceptor antagonists. The first study described here was carried out to define the role of a genetic determinant (debrisoquine-type oxidation polymorphism) on plasma concentration of bopindolol and its pharmacological effect. Atenolol was used as a negative and metoprolol as a positive control. In a second study, the relative potency and duration of action of bopindolol were assessed in comparison to atenolol and slow-release oxprenolol. The first study was carried out using 10 healthy volunteers (6 extensive and 4 poor metabolizers), and the second study was carried out using 12 volunteers, all of whom were extensive metabolizers. Genetic polymorphism did not influence the kinetic behavior or pharmacological effects of atenolol. The elimination of bopindolol was slightly but significantly prolonged in poor metabolizers, but this did not significantly alter the cardiac effects of the drug. In the case of metoprolol poor metabolizers showed a significant prolongation of drug elimination, and this was associated with a significant prolongation of the cardiac effects of the drug. The second study revealed that, in terms of cardiac beta-adrenoceptor blockade, 1 mg bopindolol was equipotent to 100 mg atenolol or 160 mg slow-release oxprenolol and that both bopindolol and atenolol had a longer duration of action than slow-release oxprenolol. It is concluded that bopindolol is a potent beta-adrenoceptor antagonist with a very long duration of action which shows little interindividual variability.

Adrenergic beta-Antagonists↗
PubMed1984

[Congestive cardiomyopathy and pyruvate elevation in a case of Charcot-Marie-Tooth disease].

The case is reported of a patient with Charcot-Marie-Tooth disease and congestive cardiomyopathy. This is an exceptional association and suggests there could be transitional forms between Charcot-Marie-Tooth disease and Friedreich ataxia, which is frequently associated with hypertrophic cardiomyopathy. A disorder of pyruvate metabolism observed in our patient could explain both the neurologic and cardiac symptoms.

Cardiomyopathy, Dilated↗
PubMed1984

[1:1 atrial flutter in an elderly patient: one of the methods of discovering Wolff-Parkinson-White syndrome. Apropos of a case in an adult].

Atrial flutter with 1:1 atrioventricular conduction giving rise to a ventricular rhythm of 240/min in an 80 year old man was the first sign of the Wolff-Parkinson-White syndrome; all previous electrocardiogrammes had shown no evidence of pre-excitation. It was only on the fifth day of hospitalisation that the ECG showed a short PR interval with a delta wave. This case illustrates that: --all supraventricular arrhythmias with abnormally high ventricular rates (over 220/min in adults) should alert to the possibility of an accessory atrioventricular pathway; --rapid atrioventricular conduction may be the first sign of an accessory pathway; --the differential diagnosis lies between an accessory atrioventricular pathway and an atriohisian tract; --digitalis, which may shorten the refractory period of the accessory pathway, is contraindicated in patients with a Kent bundle.

Aged↗
PubMed1984

[The value of echocardiography in ambulatory practice. A 2 year follow up].

Echocardiography plays an important role in diagnostic methods in cardiology, but its real contribution to ambulatory practice has still not been defined. For this reason, we have reviewed all the echocardiograms (echo) recorded during 1979 on non-hospitalized subjects at the echo laboratory of the cardiology center at the Geneva University Hospital. From a questionnaire answered by the physicians approximatively two years after the echo recording, follow-up of the patients and clinical impact of the method have been analyzed. 220 adult patients have had an M-mode echo, 70 of them have also had a two-dimensional echo. The follow-up of 141 patients has been analyzed. Contribution to diagnosis related to the clinical indication: Group I "precise cardiopathy": well defined cardiological diagnosis obtained by the physician (152 patients). The clinical diagnosis was confirmed in 25.5 p. 100 of the patients, diagnosis was quantitatively completed in 19 p. 100 of the patients, it was partially or totally unconfirmed in 53 p. 100 of the patients. Group II "cardiopathy X": cardiac lesion suspected, but clinically not identifiable (48 patients). The echo allowed a precise diagnosis in 12.5 p. 100 of the patients, but it showed non classifiable anomalies in 25 p. 100, normal recordings in 60.5 p. 100, and technical failures in 2 p. 100 of the patients. Group III "controls": precise diagnosis already know (20 patients). The echo supplied a quantitative complement in 19 patients and allowed a new diagnosis in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗
PubMed1984

[Angiographic study of the dynamics of the interventricular septum].

The interventricular septum was studied by biventricular angiography in 52 patients divided into 4 groups: the first group consisted of 14 normal subjects; the second of 10 patients with hypertension (9 cases) or aortic stenosis (1 case); the third, of 19 patients with echocardiographic asymmetric septal hypertrophy, and the fourth, of 9 cases of cardiomyopathy with dilatation. The following parameters were measured: septal thickness at 4 different points and mean septal thickness, the height (long axis) and surface of the septum in diastole and systole. The percentage variation was calculated. There were no significant differences between Group I and II; there was a significant difference (p less than 0,01) in the variations of septal thickness of the upper segments between Group I and III. This difference remained significant (p less than 0,05) for the variations of mean thickness between Group I (-38%) and Group III (-18%). There was also a significant difference (p less than 0,05) in the variation of height between Group I (23%) and Group IV (9%). None of the variations of septal surface reached the threshold of statistical significance between the four groups. Biventricular angiography can therefore demonstrate certain abnormalities of septal motion. In asymmetric septal hypertrophy, the variations in thickness are significantly less pronounced than in normal subjects but the motion in the longitudinal axis does not differ significantly. In cardiomyopathy with dilatation, however, the variation in septal height is the most affected parameter.

Adolescent↗
PubMed1983

[Value of computer tomography compared to angiography and echocardiography in the diagnosis of intracardiac thromboses].

Until recently the only means of diagnosing intracardiac thromboses were angiography and M mode and 2D echocardiography. The aim of this study was to assess the value of CAT scanning in this field and to compare it with angiography and ultrasonography. Twenty intracardiac thromboses were studied in 19 patients by CAT scanning: 14 in the left ventricle, 2 in the right ventricle, and 4 in the left atrium, one patient having both left and right ventricular intracavitary thrombosis. M mode and 2D echocardiography and angiography were carried out whenever possible. Although for different practical reasons all patients did not undergo all three investigations, CAT scanning appeared to be the most reliable diagnostic method in intracardiac thrombosis, being more specific than either angiography and ultrasonography. In addition, the therapeutic effects of anticoagulant therapy on the thrombus can be assessed and other associated pathology such as aneurysm, pericardial reaction, dilatation of the cardiac cavities, myocardial and valvular calcification can also be demonstrated.

Adult↗
PubMed1982

Association of coarctation of the thoracic aorta with fibromuscular dysplasia of the renal arteries: a case report.

The case of a 25-year-old woman with coarctation of the thoracic aorta and combined bilateral fibromuscular dysplasia of the renal arteries is reported. Although marked hemodynamic changes induced by the coarctation were probably pre-existent, hypertension was revealed only during the last month of her first pregnancy and was spontaneously corrected 2 months post partum. Surgical treatment of the thoracic coarctation did not influence blood pressure which remained normal.

Adult↗
PubMed1982

[Value of echocardiography in the diagnosis of Uhl's disease. Apropos of a case in an adult].

Uhl's anomaly, or paper thin right ventricle is a rare congenital malformation which may present with variable degrees of hypoplasia. The most severe forms are encountered in infants and children, but a less serious form occurs in adolescents and adults which, clinically. There are a number of echocardiographic features common to both diseases but paper-thin right ventricle may be distinguished by the finding of premature opening of the pulmonary value. The increased atrial contraction in these patients with right ventricles of reduced compliance is directly transmitted to the pulmonary artery, leading to end diastolic opening of the pulmonary value before tricuspid closure. The case presented underlines the value of M mode echocardiography in the diagnosis of Uhl's anomaly and in the differential diagnosis with Ebstein's anomaly.

Diagnosis, Differential↗