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Biomedical subjects

M Degeorges

Publications and source records attributed to M Degeorges.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Chronic aortic and mitral valve regurgitation. Effects of isosorbide dinitrate on systolic function and passive elastic properties of the left ventricle (author's transl)].

A haemodynamic and cineangiographic study was conducted in 20 patients with chronic aortic regurgitation alone or associated with mitral regurgitation before and during i.v. administration of isosorbide dinitrate 5 mg/hour. Freedom from coronary disease had been ascertained. The heart rate and aortic pressure (initially normal), cardiac index (initially low), pulmonary pressures and pulmonary and systemic resistances (slightly raised initially) remained unchanged. On the other hand, the left ventricular (LV) filling pressure, distinctly raised before treatment, was reduced by 17% (p less than 0.05). There was also a 10% reduction in LV end-diastolic volume (from 204 +/- 60- cm3.m2 to 184 +/- 56 cm3,m2; p less than 0.001) and a 14% reduction in LV end-systolic volume (from 104 +/- 39 cm3.m2 to 89 +/- 40 cm3.m3; p less than 0.001). LV geometry, stroke volume and regurgitation volume were unmodified. There was a significant improvement in ventricular function indices, globally reduced before treatment: + 8% for the fiber shortening amplitude (p less than 0.025), + 6% for the ejection fraction (p fiber shortening (p less than 0.01), and + 15% for the ESP: ESV ratio (p less than 0.05). The passive elasticity indices, all increased before treatment, also improved. It is concluded that isosorbide dinitrate improves LV systolic and diastolic functions in patients with chronic valve disease.

Adolescent↗
PubMed1982

[Controlled study of nifedipine in the treatment of Raynaud's phenomenon].

In each of the 16 patients included in our first study [6 idiopathic Raynaud's phenomenon (I), 4 associated with systemic lupus erythematosus (SLE) and 6 with progressive systemic sclerosis (PSS)] digital vasospasm could be reproduced by immersion of both hands in cold water (4 degree C). Each patient received in a double-blind manner and random order on two consecutive days, the calcium-channel blocking agent nifedipine (20 mg) and placebo. Nifedipine protection against vasospasm provoked by cold water (4 degrees C) was considered good or excellent in 14 of the 16 patients (p less than 0.001 versus placebo). In the second study, 30 patients [12 I, 10 PSS, 5 SLE and 3 rheumatoid arthritis (RA)] received in a double blind manner and random order, on two consecutive weeks, nifedipine (20 mg 3 time daily) and placebo. The improvement with nifedipine (in percentage of the decrease of the number of vasospastic attacks) was 90.95 in the 1 group, 78.63 SLE and RA and 64.02 in PSS (p less than 0.01). An open study during 3 months has confirmed the effectiveness of nifedipine (10 mg 3 times daily). The improvement was 88.92 in the 1 group, 76.33 in SLE and RA and 59.16 in PSS, 7 out of 30 patients stopped the treatment because of side effects (headache, flush, nausea, oedema of the ankles). Thus nifedipine appears to be extremely useful in the treatment of Raynaud's phenomenon.

Adult↗
PubMed1982

[Angioscintigraphy in venous pathology. Comparison of isotope angioscintigraphy and radiologic examination].

Results of vascular radiology and isotope examinations were compared in 48 patients with suspected ileocaval lesions (37 cases) or affections of the veins of the upper limb or superior vena cava (11 cases). Isotopic examination, which can be performed in ambulatory patients, respects normal hemodynamic conditions, is painless, and can be repeated, was found to give valid results, positive correlations with radiological investigation findings being present in 43 cases. Lack of correlation in the remaining 5 patients could have resulted from the period of time elapsed between the two examinations or the techniques employed during each investigation.

Diagnosis, Differential↗
PubMed1981

[Not Available].

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Cardiology↗
PubMed1981

[Clinical application of the alkalosis induction test for coronary artery spasm].

Alkalosis was used for stress testing for coronary artery spasm in 70 patients (average age: 56 years) with resting angina. A rapid intravenous infusion of an alkaline buffer (THAM) immediately followed by 5 minutes' maximal ventilation increased the arterial pH to 7.67 +/- 0.5. Anginal pain and ECG changes were observed in 24 Patients, with ST elevation in 10 cases and ST depression in 14 cases. The ischaemic changes occurred during hyperventilation in 16 cases and in the 3 minutes following the test in 8 cases. The heart rate increased from 66 +/- II to 71 +/- 14 bpm (p less than 0,01) but systolic blood pressure fell from 139 +/- 12 to 130 +/- 12 mm Hg during hyperventilation; there was no significant change in the rate-pressure product (1130 +/- 1750 to 8990 +/- 2690). In all cases, the angina and ischaemic changes regressed after intravenous Trinitrin. Coronary angiography was performed in 56 patients: in the 24 patients with positive responses (Group I) and in 30 of the 46 patients with negative responses (Group II). Significant coronary artery narrowing (greater than 70%) was observed in 21 patients of Group I: in the 3 patients without coronary lesions an intravenous injection of 0.4 mg methylergometrine provoked coronary spasm. In Group II, significant narrowing was demonstrated in 18 patients: in the 12 other patients, coronary spasm could not be induced by methylergometrine. Therefore, in the absence of organic coronary lesions, an excellent correlation has been shown between the alkalosis and methylergometrine tests. This stress test was repeated in 16 of the 24 patients in Group I one hour after administration of 20 mg of Nifedepine: the test was negative in all cases. We conclude that the alkalosis test could be useful in the coronary care unit as a stress test for coronary spasm to determine the antianginal treatment of choice and to evaluate its efficacity.

Coronary Angiography↗
PubMed1981

Hemodynamic and cineangiographic study before and after mitral valvuloplasty (Carpentier's technique).

Hemodynamic studies were performed in 26 patients 2-60 months after mitral valvuloplasty (average 14 months). All patients but one had an annular deformity requiring prosthetic ring annuloplasty. In addition, 25 patients had prolapsed leaflet or restricted leaflet motion requiring specific techniques of repair. All patients were asymptomatic after operation. Significant residual mitral insufficiency was present in only five patients. Roentgenograms showed a reduction in cardiothoracic ratio, from 0.62 +/- 0.07 preoperatively to 0.53 +/- 0.06 postoperatively (p less than 0.001). Mean pulmonary artery pressure decreased from 30 +/- 12 mm Hg to 18 +/- 6 mm Hg (p less than 0.001) and cardiac index returned to normal (2.7 +/- 0.7 1/min/m2 vs 3.1 +/- 0.7 1/min/m2, p less than 0.02). Angiocardiographic studies showed that end-diastolic volume index returned to normal (148 +/- 41 cm3/m2 vs 89 +/- 23 cm3/m2, p less than 0.001), with significant decreases in end-systolic volume index ( 63 +/- 27 cm3/m2 vs 43 +/- 16 cm3/m2, p less than 0.001), left ventricular mass (114 +/- 28 g/m2 vs 88 +/- 20 g/m2, p less than 0.001), ejection fraction (58 +/- 11% vs 52 +/- 11%, p less than 0.02) and mean velocity of fiber shortening (1.19 +/- 0.36 circ/sec vs 1.01 +/- 0.24 circ/sec, p less than 0.05). We conclude that mitral valvuloplasty provides good and stable midterm results and that the operation should be performed before irreversible myocardial lesions occur.

Adolescent↗
PubMed1981

[Calcifications of the mitral valve ring. A clinico-pathological study of 14 cases (author's transl)].

This study of 14 cases, found in 130 autopsies of people died in a Department of Cardio-vascular diseases, emphasizes the frequency of this lesion (10 p. 100) often ignored. Elderly people over 75 years are affected and twice more female than male. Grossly, this abnormality, responsible of a constant mitral insufficiency, is in the posterior cusp attachment at the junction with the ventricular wall. The atrial surface and the line of cusp apposition, commissures and chordae are respected. The main lesions associated with it are left ventricular hypertrophy, coronary and systemic atherosclerosis and most often aortic degenerative calcification, described by Monckeberg, in 50 p. 100 cases. Microscopically, calcifications are surrounded by fibrosis with non specific moderate inflammatory changes. Clinically mitral ring calcification must be searched in case of conduction disturbances of systolic murmurs by left anterior oblique radiography and above all by echocardiography. Except conduction disturbances, complications are infrequent and only seen in advanced lesions. No abnormality of calcium or lipid metabolisms is noted. In agreement with other studies, this one emphasizes the usefulness of echocardiographic diagnosis and the necessity to separate this geriatric entity from advanced post rheumatoid type lesions.

Aged↗
PubMed1981

[Conservative surgery of the mitral valve. Pre- and post-operative hemodynamic and angiographic study of 20 cases].

Twenty patients with pure or prevalent mitral regurgitation, undergone mitral valve conservative surgery according to the Carpenter-technique from 1975 to 1979, have been studied. There are 19 women and 1 man, mean age of 25 years (range 11 to 65); 18 had a rheumatic fever; 2 had a mitral valve prolapse due to a degeneration of collagen within the central core of the cordae tendineae, which was the primarily responsible for cordae rupture in 1 case. The clinical and hemodynamic features were severe in a 50 per cent of cases (8 patients in N.Y.H.A. functional class III; 3 in class IV); there was pure mitral regurgitation in 12, combined mitral stenosis and regurgitation in 8; tricuspidalic regurgitation which needed annuloplasty in 5 patients. All the patients have been studied by hemodynamic and angiocardiographic study before and an average of 14 months after surgical treatment. Surgical conservative technique of mitral valve is described; the results are analyzed. All the patients are in N.Y.H.A. functional class I, 14 months after surgical valve therapy. In three cases, a systolic 3/6 murmur which was present immediately after surgical treatment and that not increased in time, remains. EKG left overload is still present in 2 cases; Heart-Chest ratio decreases in all the patients (range 0,61 to 0,51). Atrial fibrillation is present in 6 patients. Hemodynamic findings show: Pulmonary Systolic Pressure (PSP) decreases (45 +/- 4 to 27 +/- 1); Mean Pulmonary Capillary Wedge (PCW) pressure decreases (19 +/- 1 to 11 +/- 1); Total Peripheral Resistance (TRP) (2023 +/- 112 to 1595 +/- 70 dynes sec cm--5), Total Pulmonary Resistances (TPR) (742 +/- 89 to 351 +/- 36), Pulmonary Arterial Resistances (PArtR) (344 +/- 51 to 133 +/- 18 dynes sec cm--5), and Left Ventricle Diastolic Pressure (LVEDP) (12 +/- 1 to 8 +/- 1 mmHg) normalize. The Ejection Fraction (EF) decreases at the most operative control after surgery in 11 patients (56 +/- 3 to 50 +/- 1). Angiographic study shows no regurgitation in 4 patients, a least regurgitation in 13 cases and there is a 2/4 regurgitation in 3 cases only. The AA. have got to an excellent result in 17 patients; a 2/4 degree angiographic regurgitation persist in 3 cases, although a clear clinical improvement. The AA. consider of great utility this surgical valvular management according to a critical review of the efficacy and stability of the results.

Adolescent↗
PubMed1980

[Localizations of Takayasu's disease (author's transl)].

Localizations of Takayasu's disease are described and discussed in relation to 10 cases. The affection causes panaortitis which produces stenosis, or less often dilatation, of the thoracic and/or abdominal aorta, and stenosis of occlusion of the arteries arising from the aorta. Lesions of the aortic arch and superior aortic branches, mainly subclavian and carotid, are the most frequently observed form of the disease, but coronary stenosis and aortic incompetence are sometimes noted. Lesions in the descending thoraco-abdominal aorta are frequently present, and stenosis and occlusion of the renal arteries are usually associated with the abdominal aortitis. Stenosis of the terminal aorta and iliofemoral axes is a more rare occurrence. The association of lesions in the aortic arch and its branches, and the descending aorta and its branches, was found in about 2/3rds of cases. Pulmonary arteries are affected in about half the cases according to recent reports.

Adult↗
PubMed1980

[Myocardial scintigraphy].

Myocardial scintigraphy may be performed at rest or after stress testing using potassium-like cations, labeled metabolites or infarct-fixing tracers. It is an in vivo method of studying myocardial ischaemia and infarction and may provide diagnostic information when other techniques fail. The diagnostic possibilities of myocardial scintigraphy have been increased by the introduction of tomographic techniques and new radioisotopes with very short half lives.

Coronary Disease↗
PubMed1980

[Study of shunts using isotopic technics].

Isotopic techniques and in particular 99m Tc sequential angiography are accurate methods of assessing left-right and right-left intracardiac shunts. The results obtained are so reliable that these methods have become the investigation of choice for diagnosis and follow-up of intracardiac shunts in children and young adults, for post-operative control of repaired septal defects and for rapid diagnosis of asymptomatic murmurs. Radio-isotope methods are more accurate than oxymetry and in addition scintigraphy using a scintillation camera outlines the cardiac cavities and the site of left-right shunts may be localised in most cases. These methods have the advantage of being quick, non-invasive and less irradiating than oxymetry or conventional contrast angiography. The recent introduction of isotopes with very short half lives and radioactive gases probably heralds new advances in an already proven field.

Adult↗