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Biomedical subjects

Jean-Christophe Eicher

Publications and source records attributed to Jean-Christophe Eicher.

5 recordsLinked to original sources

Low-frequency electrical stimulation increases muscle strength and improves blood supply in patients with chronic heart failure.

BACKGROUND: This study was designed to evaluate the effects of low-frequency electrical stimulation (LFES) on muscle strength and blood flow in patients with advanced chronic heart failure (CHF). METHODS AND RESULTS: Patients with CHF (n=15; age 56.5 +/- 5.2 years; New York Heart Association III - IV; ejection fraction 18.7 +/- 3.3%) were examined before and after 6 weeks of LFES (10 Hz) of the quadriceps and calf muscles of both legs (1 h/day, 7 days/week). Dynamometry was performed weekly to determine maximal muscle strength (F(max); N) and isokinetic peak torque (PT(max); Nm); blood flow velocity (BFV) was measured at baseline and after 6 weeks of LFES using pulsed-wave Doppler velocimetry of the right femoral artery. Six weeks of LFES significantly increased F(max) (from 224.5 +/- 96.8 N to 340.0 +/- 99.4 N; p<0.001), and also PT(max) (from 94.5 +/- 41.5 Nm to 135.3 +/- 28.8 Nm; p<0.01). BFV in the femoral artery increased after 6 weeks from 35.7 +/- 15.4 cm/s to 48.2 +/- 18.1 cm/s (p<0.05); BFV values at rest before and after 6 weeks of LFES did not differ significantly. CONCLUSIONS: LFES may improve muscle strength and blood supply, and could be recommended for the treatment of patients with severe CHF.

Biomarkers↗

Electrical stimulation of skeletal muscles. An alternative to aerobic exercise training in patients with chronic heart failure?

The aim of this study was to investigate whether electrical stimulation of skeletal muscles could represent a rehabilitation alternative for patients with chronic heart failure (CHF). Thirty patients with CHF and NYHA class II-III were randomly assigned to a rehabilitation program using either electrical stimulation of skeletal muscles or bicycle training. Patients in the first group (n = 15) had 8 weeks of home-based low-frequency electrical stimulation (LFES) applied simultaneously to the quadriceps and calf muscles of both legs (1 h/day for 7 days/week); patients in the second group (n = 15) underwent 8 weeks of 40 minute aerobic exercise (3 times a week). After the 8-week period significant increases in several functional parameters were observed in both groups: maximal VO2 uptake (LFES group: from 17.5 +/- 4.4 mL/kg/min to 18.3 +/- 4.2 mL/kg/min, P < 0.05; bicycle group: from 18.1 +/- 3.9 mL/kg/min to 19.3 +/- 4.1 mL/kg/min, P < 0.01), maximal workload (LFES group: from 84.3 +/- 15.2 W to 95.9 +/- 9.8 W, P < 0.05; bicycle group: from 91.2 +/- 13.4 W to 112.9 +/- 10.8 W, P < 0.01), distance walked in 6 minutes (LFES group: from 398 +/- 105 m to 435 +/- 112 m, P < 0.05; bicycle group: from 425 +/- 118 m to 483 +/- 120 m, P < 0.03), and exercise duration (LFES group: from 488 +/- 45 seconds to 568 +/- 120 seconds, P < 0.05; bicycle group: from 510 +/- 90 seconds to 611 +/- 112 seconds, P < 0.03). These results demonstrate that an improvement of exercise capacities can be achieved either by classical exercise training or by home-based electrical stimulation. LFES should be considered as a valuable alternative to classical exercise training in patients with CHF.

Bicycling↗

Bacterial endocarditis complicating mitral annular calcification: a clinical and echocardiographic study.

BACKGROUND AND AIM OF THE STUDY: Although described in a number of necropsy studies, endocarditis on mitral annular calcification (MAC) has rarely been reported during life. The study aim was to assess the frequency and specific features of bacterial endocarditis complicating MAC. METHODS: Data relating to 62 cases of infective endocarditis of the native mitral valve diagnosed with multiplane transesophageal echocardiography (TEE) over a five-year period were collected prospectively. RESULTS: Among 62 patients, 15 (24%) had vegetations originating from a calcified mitral annulus (group 1), while 47 had classic leaflet endocarditis (group 2). Group 1 patients differed significantly from group 2 patients with regard to: (i) higher incidence of diabetes mellitus and cancers; (ii) initial clinical presentation, with febrile coma or meningoencephalitis in 53% of cases; (iii) echocardiographic features, with significantly greater vegetations, presence of calcium-dense echoes within the vegetation, high frequency of ring abscess, and high frequency of para-annular ventriculoatrial leakage; and (iv) poorer clinical outcome, with 53% in-hospital mortality. CONCLUSION: MAC appears to be an underestimated predisposing factor for a particularly severe type of bacterial endocarditis. The use of multiplane TEE should improve current knowledge of this disease.

Adult↗

[Aortic dissection].

Most often revealed thanks to chest pain, acute aortic dissection must be suspected and diagnosed without losing anytime, because of their evolutive risks and their specific treatment in a specialised unit. Once the early management is over, survivers must be closely followed, specially for their blood pressure to be kept normal, and to screen for secondary complications that would require surgery. Owing to the improvement of early management and follow up, facilitated by the new non-invasive imaging techniques of the aorta, the severe prognosis of this disease has significantly improved.

Aortic Dissection↗

False Aneurysm of the Aortic Root and Right Ventricular Outflow Obstruction: An Unusual Complication of Surgically Treated Infective Endocarditis.

Aortic root abscess often complicates the course of aortic valve endocarditis. In severe cases, left ventricular-aortic discontinuity may occur, providing challenging technical problems for the surgeon. Moreover, surgical intervention sometimes takes place in a semi-emergency context, and the patches and prosthesis are sutured into friable tissues and subjected to high systemic pressures. Subsequently, paravalvular leaks and prosthesis dehiscence are not uncommon; postoperative false aneurysm of the aortic root is a much more unusual complication. We report one case of right ventricular outflow obstruction that occurred after surgical treatment of an aortic root abscess. Echocardiographic data were useful, but magnetic resonance imaging provided valuable information about the anatomic extent of the cavity. (ECHOCARDIOGRAPHY, Volume 13, January 1996)

Journal Article↗