Biomedical subjects

J M Mallion

Publications and source records attributed to J M Mallion.

At least 73 records · Page 4Linked to original sources

PubMed1999

[Pulmonary embolism and anaphylactic shock caused by rupture of a hepatic hydatid cyst].

A 44 year old man was admitted to hospital as an emergency for shock associated with giant urticaria and atrial fibrillation. Angiography showed pulmonary embolism, and an image suggesting a hydatid cyst of the liver was observed by echocardiography in the sub-costal view, confirmed by liver ultrasonic scan and serology. After treatment with Albendazole, the cyst was removed surgically and histology showed the characteristic appearances of hydatid disease. The final diagnosis was rupture of a hydatid cyst into a sub-hepatic vein with anaphylactic shock and pulmonary embolism.

Adult↗

PubMed1999

[Compression of the renal artery by a musculo-tendinous band: an unrecognised cause of renovascular hypertension].

Stenosis of a renal artery by extrinsic compression is an uncommon cause of renovascular hypertension. In rare cases, this compression is due to the presence of fibres from the diaphragm or the psoas muscle. This aetiology should be considered when renal artery stenosis is observed in a young hypertensive patient without cardiovascular risk factors. Spiral CT scan is particularly useful for studying the relationship between the diaphragm and arterial structures. Once the diagnosis has been made, the treatment is surgical section of the fibrous tissues responsible for the compression.

Adult↗

PubMed1998

A population-based survey of drug treatment efficacy by the French National Committee for the Control of Arterial Hypertension.

To assess the adequacy of antihypertensive treatment in the French population, a survey was conducted from October 1990 to April 1991 in five French cities during sales exhibitions. A total of 7107 individuals visited the stand of the French National Committee to have their blood pressure (BP) measured. Among them, 1289 were treated hypertensive subjects fully aware of their treatment. The efficacy of antihypertensive treatment was assessed in this population. Among those hypertensive treated subjects 35 to 65 years old, 60% had a BP < 160/95 mm Hg and 27% < 140/90 mm Hg. Among those > 64 years of age, 44% had a BP < 160/90 mm Hg. In 1992, these results were included in a publication by the World Hypertension League. Data obtained with this new and interesting approach were reviewed 4 years later. The approach is inexpensive (the equivalent of US $28,000) and made it possible to directly inform thousands of people, normotensive and hypertensive, about arterial hypertension and antihypertensive drug therapy, as well as risk factors for cardiovascular disease. This kind of approach may be worth a strict evaluation, to assess whether it is really useful in improving high blood pressure control in the population.

Adult↗

PubMed1998

Twenty-four hour antihypertensive efficacy of indapamide, 1.5-mg sustained release: results of two randomized double-blind controlled studies.

The antihypertensive efficacy of a 1.5-mg sustained-release formulation (SR 1.5) of indapamide, a diuretic related to thiazide, has been pointed out by using conventional sphygmomanometric measurement 24 h after dosing in clinic, in two large European randomized, double-blind, controlled studies (2 and 3 months). One of these studies was then extended to 12 months, as a complementary open study. Quality-controlled ambulatory blood pressure monitoring (ABPM) data for a total of 216 patients from these studies are presented, including subgroups of hypertensives and responders. Indapamide SR 1.5 achieves an adequate 24-h blood pressure control by significantly reducing the 24-h, diurnal, and nocturnal blood pressures versus baseline, confirming the sphygmomanometric data. The benefit at 2 and 3 months is maintained at 1 year, which confirms the long-term efficacy of SR 1.5 mg. The trough-to-peak ratio--not previously calculated for a diuretic according to international guidelines--meets Food and Drug Administration requirements and confirms the 24-h efficacy of indapamide SR 1.5.

Adolescent↗

PubMed1998

Compliance, electronic monitoring and antihypertensive drugs.

Hypertension, even of mild-to-moderate severity, is undoubtedly a risk factor for cardiovascular morbidity and mortality. It has been well demonstrated, in numerous studies that have been subjected to meta-analysis, that the introduction of antihypertensive treatment leads to reductions in cardiovascular and cerebrovascular events. These results can be obtained with even a moderate reduction in blood pressure, of the order of 4-5 mmHg in diastolic blood pressure. However, many studies have shown that the percentage of treated hypertensive individuals who have a reduction in blood pressure to normal values of systolic blood pressure/ diastolic blood pressure (< 140/90 mmHg) is of the order of 30%. The reduction in blood pressure data are well correlated with the level of compliance. This compliance can be defined as the adherence by the patient to the directions given by the doctor for medication dosage, and this can be considered as 'good' when it is of the order of 80%. Until recently the examination of compliance relied on questioning the patient, pill counts or ultimately blood sampling for drug levels, which could be used only in research. The use of an electronic pill box with a microprocessor in the cover that records the date and hour each time the box is opened is a precise method of recording compliance. The purpose of such a method is to study overall compliance, which deteriorates as time passes and falls by approximately 50% after 1 year. However, this compliance can be modified and improved if instruction and follow-up are given to the patient. Prescription compliance can be improved by once daily dosing and by instructing for this to be taken in the morning. In contrast compliance is considerably reduced when more than two doses are to be taken each day. Using the pill counting box allows us to describe and focus on different types of patients, ranging from rigidly adherent to completely chaotic. It seems that factors such as age and activity can influence these patterns of compliance.

Antihypertensive Agents↗

PubMed1998

[Models of arterial pressure using a Windkessel type model: role of the functional arterial properties].

UNLABELLED: The Windkessel model is a linear model which does not take into account the structural and functional variations of the arteries related to the pulsatility of the blood pressure (BP) and its variations between systole and diastole. OBJECTIVE: To analyse the performance of a BP modelisation where the parameters of AC are adjusted in a dynamic fashion according to a curvilinear relationship of the arterial properties (compliance) in relationship to the BP between systole and diastole. DESIGN AND METHODS: 9 control subjects (age 25 +/- 3). The non invasive measures of the radial BP waveform (Millar tonometry) was compared to that constructed by an electric simulator reproducing the model in a sysmetrical network subdivised into 121 segments where we introduced for each subject: at cardiac level, the aortic stroke volume (Doppler echocardiography), and at the radial level, the dynamic values of compliance and diameter according to an arc-tangent model (measured by arterial echography NiUS02). RESULTS: The BP obtained by the adjusted model, where the AC parameter follows the curvilinear, relationship dV/dP measured experimentally, was not significantly different from the experimental, while in the constant model (AC at mean BP level) the systolic BP was different. CONCLUSION: This work shows in an experimental way the limits inherent in simplification in the Windkessel modelisation of the vascular system with constant parameters. It shows in a conduction artery the influence of the functional properties of the arterial wall on the level of systolic and diastolic BP.

Adult↗

PubMed1998

[A quantitative analysis of a predictive model of ambulatory blood pressure monitoring integrating physical activity recording].

OBJECTIVE: To determine how much of the variations of blood pressure during a 24 hour period could be accounted for by a change in activity using an accelerometer to detect the physical activity and establish a predictive model. MATERIALS AND METHODS: 18 healthy subjects (mean age 25 +/- 2 yrs) were studied during daily life (24 hours) twice one week apart. The systolic and diastolic blood pressure, heart rate (HR), and time of measure were recorded by ambulatory monitoring using Spacelabs (4 measures per hour). A portable digital memory device was designed for the 24 hours ambulatory monitoring of HR (ECG) and physical activity. This device consists of an ECG Holter (ELA medical model Cinesis with digital memory) and a three piezoresistive type accelerometer sensors (prototype ELA research) able to record physical activity in the 3 space dimension. RESULTS: The data of the first recording were compared to the predicated values from the application of a logarithmic model of activity to the second recording. The model then predicted 53 +/- 19% of the systolic BP values of the test day. The mean individual difference for a given time period of one hour between the measured and the predicted systolic BP from the model was 1.45 +/- 3.1 mmHg with a range of [-6.9; 3.4 mmHg]. The mean individual systolic BP difference for the same given time period of one hour but without predictive model was 1.29 +/- 10 mmHg with a range of [-28; 43 mmHg]. CONCLUSION: This study show that 3 D accelerometer is an easy tool to program individual model of ambulatory blood pressure variability. The introduction of this qualitative method seems logical in therapeutic trial.

Adult↗

PubMed1998

[The Hypertension Optimal Treatment Study: efficacy and tolerability on the 36th month].

The international, prospective, randomized HOT study was aimed at determining the influence of a targeted BP reduction on cardiovascular morbidity and mortality. Patients were randomly allocated to 3 DBP targets (< 80, < 85, < 90 mmHg). In addition, the impact of a coprescription of aspirin was studied. The BP target had to be reached within 3 months, according to a well-defined strategy : felodipine 5 mg o.d. as a 1st intention drug, 1, 2 or 3 additional drugs, if necessary, on the following steps. BP measurements were made, using an oscillometric automatic device (Hestia). From April 1992 to October 1994, 18,790 patients with an age range 50-80 years, coming from 26 countries, entered the study. The data collected on the 36th month were in agreement with those obtained on the 12th and the 24th months. Baseline DBP was reduced by 21, 23 and 25 mmHg in the 90, 85 and 80 mmHg target groups, respectively. The rate of patients whose DBP reached the target, obviously increased from the 3rd to the 12th month: from 43 to 56%, 60 to 70%, 74 to 83% in the 90, 85 and 80 mmHg, target groups, respectively. From the 2nd to the 3rd year, BP control was further improved, with a slightly higher rate of controlled patients in the elderly (age > 60 y), especially in the 80 mmHg target group. From inclusion to the 3rd month, one-drug treated patients decreased, whereas 2- or 3-drug treated patients increased. Felodipine-treated patients decreased on the 36th month, but remained over 80%. From the 6th to the 36th month, additional prescription of a betablocker or an ACE-inhibitor increased from 36 to 39%, and from 23 to 28%, respectively; moreover, the side-effects rate decreased from 10.5 to 3.6%, with a special decline in ankle edema from 4 to 1%. In conclusion, the BP reduction observed on the 36th month was of the same extent as that observed in the first months. It seems obviously possible to reach a targeted DBP and to maintain it over time, along with a good acceptability of the treatment. Targeted DBP could be more easily achieved in elderly patients, possibly due to a better drug compliance.

Aged↗

PubMed1998

[Influence of some parameters on the blood pressure reduction under treatment: experience from the Hypertension Optimal Treatment Study].

The HOT study is the largest controlled therapeutic trial conducted to date in hypertension. This international, prospective, randomised trial is designed to determine the optimal blood pressure to be obtained during treatment, in order to achieve optimal reduction of complications and cardiovascular mortality. The HOT study is conducted according to the PROBE methodology (Prospective Randomised Open Blinded Endpoints. It has three objectives: 1) to evaluate the relationship between the development of major cardiovascular events and the DBP target level (DBP < or = 90, DBP < or = 85 or DBP < or = 80 mmHg. 2) to evaluate the relationship between the development of major cardiovascular events and real DBP observed, 3) to determine whether low-dose acetylsalicylic acid (75 mg/day) provides an additional benefit in terms of cardiovascular morbidity and mortality in treated hypertensive subjects. Between April 1992 and October 1994, 18,790 patients, between the ages of 50 and 80 years (26 countries), were randomised to these 3 target DBP groups and several parameters likely to influence the blood pressure fall were identified. The reduction of DBP was all the more pronounced the higher the baseline DBP. For a baseline DBP equal to 100 mmHg, the mean fall was 18 mmHg and for a baseline DBP equal to 110 mmHg, the mean fall was 27 mmHg. Advanced age was also found to be a factor promoting reduction of DBP, which increased after the age of 65 years. Analysed in relation to the type of treatment, this more marked reduction in the elderly showed that monotherapy with a calcium channel blocker was very effective on DBP and especially after the age of 75 years. The data of the study also showed that SBP decreased in parallel to DBP, but to an even greater extent. Thus, a 10 mmHg reduction of DBP induces a reduction of SBP by approximately 20 mmHg. This reduction of SBP related to the level of DBP was even more marked the higher the baseline SBP and the higher the target DBP objective. Thus 80% of patients in the DBP < or = 80 mmHg group had an SBP < or = 150 mmHg during treatment. Among the other factors, weight appeared to clearly influence reduction of DBP, as the reduction of DBP was more marked the lower the patient's weight. In contrast, the body mass index was poorly correlated with the reduction in blood pressure. The blood pressure reduction, regardless of weight, was more marked when a stricter blood pressure objective was adopted (DBP < or = 80 mmHg). Finally, in the particular case of elderly subjects, treatment with a calcium channel blocker appeared to be very effective in reducing the blood pressure.

Aged↗

PubMed1997

Left ventricular hypertrophy and arterial hypertrophy.

In the most recent WHO recommendations of 1996 it was reiterated that the classification of HT still remains based on the actual BP figures but also on the importance of target organ lesions. Thus the study of cardiac and vascular function and in particular the presence of hypertrophy or remodeling is of importance. A limited number of studies have examined the prevalence, the association and the correlation between modifications and remodeling in the heart and in the vasculature. It is important to distinguish compliance vessels such as the carotid from resistance vessels such as the radial. For compliance vessels the prevalence of cardiac and vascular hypertrophy are nearly identical being around 5% for normotensive subjects and around 12% for hypertensive subjects. This prevalence of thickening in the intima-media is more evident in subjects with left ventricular hypertrophy (LVH). The left ventricular geometric pattern is also an element to take into account. The presence of concentric remodeling of the left ventricle without LVH has already been associated with an increase in intima-media thickness (IMT). When there is an LVH this IMT is similar in severity to the LVH and in particular concentric. For resistance vessels such as the radial artery the number of studies is limited but a significant correlation between left ventricular mean wall thickness and common carotid artery distensibility and compliance has been found. There is also a significant correlation between the radial median lumen ratio and the relative wall thickness but this correlation disappears when age and systolic BP are taken into account. Thus for this type of vessel it is too early to conclude the elements contributing to structural changes. The determinant factors for these structural changes in the heart and the carotid arteries associated with hypertension are certainly multiple be they haemodynamic, hormonal or genetic. The observation establishing an association between anomalies at cardiac and vascular level may have undoubted diagnostic, prognostic and therapeutic implications which are all intimately related and which require refinement and confirmation.

Antihypertensive Agents↗

PubMed1997

Effect of low-dose positive inotropic drugs on human internal mammary artery flow.

BACKGROUND: Dobutamine (a beta-receptor agonist), enoximone (a type III selective phosphodiesterase inhibitor), and epinephrine (an alpha- and beta-mimetic) frequently are used in the perioperative management of patients undergoing coronary artery bypass grafting. METHODS: We performed a double-blind clinical study to compare the effects on internal mammary artery free flow of low doses of these three positive inotropic drugs. Thirty patients in whom the left internal mammary artery was used for coronary artery bypass grafting were randomized into three groups. Internal mammary artery free flow and hemodynamic measurements were evaluated before and 10 minutes after the intravenous infusion of dobutamine (3 microg x kg(-1) x min(-1)), enoximone (200 microg/kg), or epinephrine (0.05 microg x kg(-1) x min(-1)). RESULTS: A significant increase in free flow occurred only in the dobutamine group (33 +/- 7.5 and 42.2 +/- 7.9 mL/min before and after drug infusion, respectively; p = 0.013). Comparison of the increase in flow between the groups, however, showed no difference. These drugs, at doses designed to produce a positive inotropic effect, caused little increase in the free flow of the internal mammary artery. CONCLUSIONS: The use of dobutamine, enoximone, and epinephrine as low-dose positive inotropic treatments in the perioperative and postoperative periods of coronary artery bypass grafting should depend on their positive inotropic effects rather than their vasodilative effects on the arterial grafts.

Adrenergic beta-Agonists↗

PubMed1997

Association between high heart rate and high arterial rigidity in normotensive and hypertensive subjects.

BACKGROUND: The dynamic elastic modulus of central arteries is very frequency-dependent Although resting heart rate is a potent independent risk factor for morbidity and mortality both from cardiovascular and from noncardiovascular disease, no link between tachycardia and arterial stiffness has ever been established. OBJECTIVE: To relate arterial stiffness to heart rate in a population with relatively low cardiovascular risk. METHODS: Pulse-wave velocity measurements and high-resolution echo-tracking techniques were used to determine the degree of arterial distension (of carotid and femoral arteries, and terminal aorta) and the velocity of the pulse wave (aorta and upper and lower limbs) at the same time as heart rate, in members of a large population of normotensive and hypertensive subjects in a multicenter study in Paris, Fleury-Merogis and Grenoble (France). RESULTS: A high heart rate was strongly associated with reduced distension and elevated pulse-wave velocity, even after adjustment for age and blood pressure. A high aortic pulse-wave velocity was also negatively associated with a low baroreflex sensitivity. The most significant associations between high heart rate and high arterial rigidity were found for the carotid artery, the thoracic aorta, and the lower limbs, but there was no significant result for the terminal aorta and the arm arteries. CONCLUSION: This study demonstrates that there is a statistically significant positive link between high heart rate and high arterial stiffness measured at the site of central and lower limb arteries. Since an elevated heart rate has been shown to be associated with cardiovascular risk, such findings may be relevant for future cardiovascular studies in epidemiology.

Adult↗

PubMed1997

Arterial mechanics predict cardiovascular risk in hypertension.

Systolic and diastolic blood pressures are the exclusive mechanical factors considered as predictors of cardiovascular risk for members of populations of normotensive and hypertensive subjects. However, if hypertension is considered as a mechanical factor acting on the arterial wall with deleterious consequences, the totality of the blood pressure curve should be considered in order to investigate the risk. The purpose of this review is to show that in addition to systolic and diastolic blood pressures, other hemodynamic indexes with particular relevance for cardiac complications and that originate from pulsatile pressure should be taken into account, namely brachial pulse pressure, pulse pressure amplification, early wave reflections, and pulse wave velocity.

Adult↗

PubMed1997

Assessment of antihypertensive effect by blood pressure monitoring: applications to bisoprolol and lisinopril in a double-blind study.

The aim of this study was to evaluate the antihypertensive effect of drugs according to the initial ambulatory blood pressure (BP) level. After a 15-day placebo run-in period, 105 patients with moderate essential hypertension (mean age, 52 years) underwent 24-h BP monitoring (spacelabs: 1 measure/15 min). Patients were subdivided into two groups: the "High" group, with 24-h mean values of systolic BP (SBP) > 137 or diastolic BP (DBP) > 87 mm Hg, and the "Low" group, with SBP < or = 137 and DBP < or = 87 mm Hg. All patients received, in a random and double-blind design, either bisoprolol (10 mg q.d.) or lisinopril (20 mg q.d.) for 8 weeks. At the end of this active treatment period, office and ambulatory BP measurements were performed. Casual measurements revealed similar BP decreases in all subgroups receiving bisoprolol and lisinopril; BP monitoring showed that the antihypertensive effect depended on the baseline mean 24-h value; -15/-12 mm Hg for bisoprolol and -18/-13 mm Hg for lisinopril in the High group; -7/-6 mm Hg for bisoprolol and -6/-6 mm Hg for lisinopril in the Low group. This study shows that the antihypertensive effect depended on initial ambulatory BP values, with a lower BP decrease in the Low group. Assessment of the antihypertensive effect on ambulatory BP is useful in clinical trials.

Adrenergic beta-Antagonists↗

PubMed1997

[Value of a predictive model of ambulatory blood pressure integrating physical activity].

OBJECTIVE: To determine how much of the variations of blood pressure during a 24 hour period could be accounted for by a change in activity and establish a predictive model. MATERIALS AND METHODS: Twenty three healthy subjects (mean age 25 +/- 2 years) were studied. The BP, heart rate (HR), and time of measure (T) were recorded by ambulatory BP monitoring using Spacelabs (4 measures per hour). At each measure the subject noted in a diary the degree of activity on a six level semi-quantitative scale. DATA ANALYSIS: A model was constructed using an analysis of covariance. Different parameters were added in succession to reach a model of the type P: P0 + A + beta + (HR-HR0) + H, were P = predicted systolic pressure, P0 = mean systolic BP over the 24 hours. A variation in systolic BP for activity level, beta = the slope of the regression between systolic BP and HR during activity A, and HR0 the mean HR during this activity. RESULTS: 1) In order to test the model, the values measured in one subject were compared to the predicted values from the model in 22 others. The procedure was then repeated for the other subjects. This common model predicted 41 +/- 21% of fluctuations in BP of the subject analysed with a range of 0 to 66%. 2) In order to refine the individual model two subjects were explored 7 times over 24 h of non consecutive days. The measures of the last recording were compared to the predicted values from the application of the model to the six preceding recordings. The model then predicted 81% and 66% of the BP values of the test day. The mean of the 24 hour individual difference over a one hour period between the measures and its predicted value by the model was 0.13 +/- 4.8 mmHg, and -0.75 +/- 7.7 mmHg. CONCLUSION: This study expresses in a quantitative fashion the importance of the level of activity in the evaluation of the level of ambulatory BP. The introduction of this method of quantification and analysis seems logical in therapeutic trial. The difference in the predictions by the model for some subjects poses the problem of uniform coding of activities and that of the recognition of other events such as stress and dreaming in sleep.

Adult↗

PubMed1997

[Long-term clinical tolerance of antihypertensive treatment during the HOT study. Groupe français de l'etude HOT].

The objective of the HOT study, an international, prospective, randomised study is to determine the optimal level of the blood pressure under treatment, in linked with the lowest cardiovascular mortality and morbidity. The target diastolic blood pressure of 80, 85 and 90 mmHg was determined at the randomisation. In order to reach the target blood pressure, a strategy of treatment was determined: the 1st step was felodipine (a long acting dihydropyridine) and the next steps (if the blood pressure reduction is not enough) propose the addition of different therapeutic classes and/or the increase of each drug doses. The available data after 2 years of the patients follow-up allow us to evaluate the incidence of the reported side effects according to the target blood pressure assigned by randomisation and the number of hypertension drugs used to reach these targets. The percentage of patients with at least one side effect at 12 and 24 months of follow-up are respectively: for the target group DBP < or = 90 mmHg: 9.2% versus 6%; for the target group DBP < or = 85 mmHg: 8% versus 4.4%; for the target group DBP < or = 80 mmHg: 7.9% versus 4.9%. The overall tolerability is not influenced by the target diastolic blood pressure but depends on the number of hypertension drugs used. At 24 months, 2.8% of patients are under monotherapy; 7% under bitherapy and 9.8% under tritherapy. The incidence of the side effects decreases after the 1st year, but slower than between the third months and the first year. There is an influence of the region on the incidence of the side effects, the south European countries describing more side effects than France or the north European countries. This seems to be linked with a perception of the side effects more than with a higher rate. In conclusion, these results confirm the possibility to reach a targeted blood pressure using a predetermined strategy without increasing dramatically the incidence of the side effects.

Antihypertensive Agents↗

PubMed1997

[HOT study: quality of the blood pressure control after 2 years follow-up. Pour le Groupe français de l'étude HOT].

UNLABELLED: The objective of the HOT study, an international, prospective, randomised study was to determine the optimal level of the blood pressure under treatment, linked with the lowest cardiovascular mortality and morbidity. The target diastolic blood pressure of 80, 85 and 90 mmHg was determined at the randomisation. In order to reach the target blood pressure, a strategy of treatment was predefined: the 1st step was felodipine (a long acting dihydropyridine) and the next steps (if the blood pressure reduction was not enough) proposed the addition of different therapeutic classes and/or the increase of the doses of each drug. The blood pressure measurements were made, using the oscillometric method (automatic blood pressure measuring device, Hestia). The quality of the blood pressure control observed in the HOT study was verified after 6 months of follow-up ("Quality of the blood pressure control in the clinical practice and in the HOT study", for the French research group of the HOT study. French hypertension meeting, Paris, December 1994). The aim of this second evaluation was to see if the quality of this control was still effective in France and for all countries after 2 years of follow-up. At the inclusion, the mean diastolic blood pressure was 106 +/- 4 mmHg in France (n = 1.574) and 105 +/- 4 mmHg for all countries (n = 18.790). The results at 24 months were the following, according to the target groups: 79.9 for the < or = 80 mmHg target group; 82.1 for the < or = 85 mmHg target and 83.6 for the < or = 90 mmHg target group. The percentages of patients who reached the target blood pressure were respectively 74; 80; 89% for the 3 target groups. The number of antihypertensive treatments needed to reach this blood pressure control slightly increased in the 3 target groups between the first and the second year with a lower rate of monotherapy and a higher rate of bi and tritherapy. But in the 80 mmHg target group (the most strict), the monotherapy was used in more than half of the patients. In comparison with all countries, France had lower number of bi and tritherapies (i.e. in the 85 mmHg target group: 38.4% of bitherapy in France versus 45.6% in all countries). CONCLUSION: after 2 years of follow-up, the quality of the blood pressure control is still good. There is a trend toward a slight increase in the number of antihypertensive drugs after the first year in the 3 target groups.

Antihypertensive Agents↗

PubMed1997

[Myocardial localization of malignant non-Hodgkin lymphoma responsive to chemotherapy].

Cardiac malignant non-hodgkinian lymphoma, which is usually asymptomatic, is observed in 15 to 25% of autopsy cases of this condition. The authors report an unusual case of myocardial lymphoma diagnosed during pulmonary oedema. Echocardiography showed left ventricular hypertrophy with increased echogenicity of the myocardial walls and marked decrease in left ventricular ejection fraction. Myocardial biopsy confirmed the diagnosis of a high grade malignant lymphoma. The disease responded to chemotherapy. Early diagnosis of myocardial involvement of a lymphoma, presenting with non-specific electrocardiographic changes, requires investigation by histological study of a myocardial biopsy. This invasive technique is justified because of its therapeutic implications.

Adult↗