Search PubMed⌕ Search

Biomedical subjects

M Bory

Publications and source records attributed to M Bory.

At least 127 records · Page 7Linked to original sources

[The intravenous nitroglycerin test during coronary angiography].

The effects of intravenous nitroglycerin (Lenitral) on the calibre of coronary arteries and their lesions was studied in 100 consecutive patients undergoing coronary angiography. The coronary arteries were divided into segments (3 for the right coronary, 2 for the left anterior descending, and 2 for the circumflex artery). 510 segments were assessed (279 normal, and 231 pathological). The diameter of each was measured through the mid point before and after injection of a bolus of 0.3 mg nitroglycerin. The calibre of the coronary segments increased in 325 cases (63.7%). In 49 cases, the increase was greater than 50%. It remained the same in 151 cases (29,6%) and decreased in 84 cases (6,7%). The average increase in calibre was 16% (p less than 0.01). This had little relation to the artery under study, the location of the segment or whether the segment was pathological or normal. However, two findings were of interest: - the percentage of segments which increased their calibre was significantly higher in the normal segments (191 out of 279 cases, 68%) than in the pathological segments (134 out of 231 cases, 58%) (p less than 0.01). - Coronary lesions may change in appearance: images of stenosis or obstruction completely regressed in 4 cases, the degree of stenosis seemed to increase in 11 cases because of dilatation of the coronary vessel proximal and distal to the narrowing, and distal vessels appeared much more dilated in 5 cases. The factors which seem to affect the vasomotor response are multiple, and include the state of the arterial wall, the presence of vasodilatation or vasoconstriction prior to injection and the mode of administration of the nitroglycerin. The test should be performed by intravenous or intracoronary injection at the end of coronary angiography so as not to mask spastic phenomena. Some errors in the interpretation of the degree of stenosis or the quality of the distal post-stenotic coronary bed could thus be avoided.

Blood Pressure↗

[Comparative study of three oral nitrate derivatives. A hemodynamic assessment in 10 patients with chronic heart failure (author's transl)].

The efficacy of three long-acting, orally administered nitrate derivatives was assessed in 10 patients with chronic heart failure. The compounds were: isosorbide dinitrate (ID) 5 mg, nitroglycerin microcapsules (NGMC) 7.5 mg and pentaerythritol tetranitrate (PETN) 160 mg. Pulmonary blood pressures were measured at regular intervals until the 6th hour following oral administration of all three compounds successively to 7 patients and of two compounds (ID and NGMC) to 3 patients. In addition, a hemodynamic study was performed in 3 of these patients while under placebo. The results showed a significant decrease in pulmonary artery diastolic pressure with all three compounds. The effects appeared after 30 minutes with ID and NGMC and after 1 hour with PETN. They lasted 1 hour with ID and 3 to 4 hours with NGMC and PETN. Maximal effect occured at 1 hour with ID (-28%; p < 0.001), at 1.5 hour with NGMC (-18%; p (< 0.01) and at 3 hours with PETN (-21%; p <0.01).

Administration, Oral↗

[Value of continous electrocardiography (Holter monitoring) in mitral valve prolapse].

Twenty three patients with mitral valve prolapse underwent ambulatory 20 to 24 hour electrocardiography to study the incidence and severity of ventricular arrhythmias. These arrhythmias were found in 20 cases (87 p. 100). Ventricular extrasystoles were usually grouped (14 cases) causing doublets in 8 cases and bursts of ventricular tachycardia in the 6 others. The importance of the information obtained by Holter monitoring should not detract from the value of the standard resting electrocardiogramme. In fact, there appears to be a good correlation between the severity of the ventricular arrhythmia and the presence of ST changes over the postero-inferior zones. These abnormalities were never present in patients without ventricular extrasystoles but on the other hand they were observed in 5 of the 6 patients with ventricular tachycardia. From a practical point of view this may represent a simple means of identifying patients at high risk of dangerous arrhythmias.

Adolescent↗

[Painless ST elevation with syncope. Diagnosis by continuous electrocardiography].

The aetiology of syncope in a 53 year old man was discovered on continuous ambulatory electrocardiography. A ventricular arrhythmia associated with ST elevation was recorded. It proved resistant to medical therapy and a double aorto-coronary bypass graft was performed. Post-operative Holter monitoring showed surgery to have been effective.

Arrhythmias, Cardiac↗

Treatment of venous thrombosis and pulmonary embolism by streptokinase.

We applied the standard treatment with streptokinase to 52 cases of deep venous thrombosis and 35 cases pulmonary embolism. Angiography demonstrated total lysis of the clot 22 times, partial lysis 42 times, and no lysis 23 times. The absence of lysis was more frequent in venous clots than in pulmonary clots. Early treatment was more effective, achieving complete lysis in 21 of 22 cases. Nevertheless, in deep venous thrombosis, late treatment can result in partial lysis and set an important venous junction free. With the standard treatment, the biologic controls showed good lysis in 75% of the cases, insufficient lysis in 15%, and no lysis in 10%. The extent of the thrombosis is an important point. The clot was totally lysed in 9 of 10 cases of localized deep venous thrombosis. In patients with pulmonary embolism, about 30% of the obstructed surface is cleared. Nevertheless, in such cases we must take into consideration not only the nonperfused pulmonary area, but also the venous starting point of the clot.

Adult↗

[Criteria of prognosis in apparently primary hypokinetic myocardiopathies (prospective study of 60 cases)].

The fate of 60 cases of apparently primary cardiomyopathy were studied by angiocardiography and coronary arteriography over a 2 to 6 year period, with a mean of 4 years. Correlations were established between the clinical, paraclinical, haemodynamic and angiocardiographic findings on the one hand, and the quality and length of survival on the other. Among the criteria leading to an improved prognosis, the most precise was the left ventricular ejection fraction.

Adolescent↗

[Effects of intravenous trinitrine on myocardial function in left ventricular insufficiency].

The effects of intravenous trinitrin on myocardial function have been studied in 40 patients with heart failure (26 cases of coronary artery disease and 14 of apparently primary cardiomyopathy). Each patient had measurements made of left ventricular pressure, of cardiac output by the dye dilution method, of volume, of the left ventricular ejection fraction, and of the segmental parietal kinetics by means of left side ventriculography both before and after trinitrin. The following results were obtained after injection of trinitrin:--no change in rhythm and cardiac index;--an almost constant decrease in left ventricular end diastolic pressure (38 cases out of 40);--a decrease in arterial pressure and ventricular volume in about two thirds of cases;--improvement of the ejection fraction (25 cases out of 40), and of segmental parietal kinetics (26 cases out of 40) in the left ventricle. These findings were equally true in the patients with coronary artery disease and in the cardiomyopathies. In the light of these results, it appears that when used in left ventricular failure, trinitrin almost always decreases the load, but improves ventricular kinetics only in two thirds of cases, while it has no influence on cardiac output. In addition, given the difficulties in establishing a standard dose of trinitrin, the authors discuss the methods of establishing the optimal dose.

Blood Pressure↗

[Streptokinase in the treatment of deep venous thrombosis and pulmonary embolism].

Fifty-two deep venous thromboses and 35 pulmonary emboli were treated by Streptokinase administered in accordance with a standard protocol. Radiological examinations revealed total lysis of clots in 22 cases, partial lysis in 42 and failure in 23. The latter more commonly involved venous clots than pulmonary emboli. Early treatment was more effective (21 total lyses out of 22) than late treatment. However, in venous thrombosis, late treatment may give partial lysis and free important venous junctions. With standard treatment, lysis was biologically correct in 70 p. 100 of cases. It was inadequate in 20 p 100 of cases and nil in 10 p. 100 of cases. The results could thus have been improved by treatment established and adjusted in the light of laboratory results. The extent of the thrombosis played an important role. Total lysis was obtained in 9 out of 10 cases of localised deep venous thrombosis. In pulmonary embolism there was an average gain of approximately 30 p. 100 in obstructed surface area. However, in these latter cases, it is important to take into account not only the pulmonary surface area obstructed but also the origin of the clots.

Adult↗

[Alcoholic cardiomyopathies (author's transl)].

In 108 patients suffering from congestive type cardiomyopathy, there were 42 alcoholics and 66 non-alcoholics. Comparisons between the two groups were made on the basis of clinical data, paraclinical investigations and prognosis. It was possible to distinguish an alcoholic cardiomyopathy which differs from primary cardiomyopathies by the greater severity of the clinical picture and a gloomier prognosis.

Adolescent↗