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M Degeorges

Publications and source records attributed to M Degeorges.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Relationship of myocardial morphometry in aortic valve regurgitation to myocardial function and post-operative results.

In 24 patients with aortic insufficiency undergoing aortic valve replacement, a clinical and hemodynamic study was performed pre-operatively. Left ventricular biopsies were obtained perioperatively for morphometric study. No significant relations were found when morphometric data were compared to functional class, cardiothoracic radio and ECG findings. The percentage of interstitial fibrosis was not correlated with any of the measured hemodynamic parameters. Myocardial cell diameter was weakly correlated with left ventricular systolic function parameters. A decrease in the percentage of contractile material was strongly correlated with an impaired left ventricular function, assessed pre-operatively. During clinical follow-up, patients were divided into two groups: Group A (17 patients) included patients who were in class I or II of NYHA after surgery. Group B (seven patients) included patients who died or were in functional class III or IV. As compared with Group A, Group B patients had a significantly lower ejection fraction; their myocardial cell diameter was larger and the percentage of myofibrils, and the content of contractile material were significantly lower. This suggests that, in aortic regurgitation, left ventricular dysfunction is correlated with contractile material loss and not with interstitial fibrosis, and that morphometric changes are good predictors of follow-up after surgery.

Adolescent↗
PubMedDate not supplied

Ultrastructural and histological study of left ventricular myocardium in mitral stenosis. Correlations with angiocardiographic indices of left ventricular function (in 11 observations).

Left ventricular myocardial biopsies were performed during surgery in 11 patients with pure and isolated mitral stenosis. Patients had undergone a preoperative angiocardiographic study of left ventricular function. Biopsy specimens were examined with the light and electron microscope. Myocyte cell diameter was normal (20 +/- 1.6 mu). Lesions existed which were probably degenerative, including anarchy and irregularities of sarcomeres, Nemaline Myopathy-type Z line changes and alterations of intercalated discs. A moderate fibrosis was found in the interstitial spaces with very few histiocytes. The coincidence planimetry study of the interstitial spaces showed a 37 +/- 5.5% increase compared to a control group with no fibrosis (23 +/- 1.5%, p less than 0.01). The angiocardiographic indices of left ventricular function were all decreased. Only four subjects had normal left ventricular function (EF greater than or equal to 55%). Nevertheless, it was not possible to establish a significant correlation between the extent of fibrosis and the decrease of left ventricular function. Although left ventricular fibrosis could be one of the factors responsible for decreased myocardial function, it is not sufficient to explain the changes of left ventricular function which are rather frequently observed in mitral stenosis.

Adolescent↗
PubMedDate not supplied

Influence of aspirin on the hemodynamic effects of sublingual nitroglycerin.

We studied the possible interaction between aspirin and nitroglycerin (NTG) in seven healthy volunteers. Effects of NTG (0.8 mg sublingual spray) were assessed by the decrease in diastolic arterial pressure, increase in heart rate, and decrease in M-mode echocardiographic end-diastolic and end-systolic diameters of the left ventricle. Measurements were performed before and during 30 min after NTG. Plasma levels of NTG were monitored during the experimental procedure. Each of the following trials was repeated three times, in random order, in each volunteer: NTG without aspirin pretreatment, NTG 1 h after 1 g of oral aspirin, and NTG after 8 days of aspirin, 500 mg every 48 h. Aspirin at the 1-g dose level significantly increased the effects of NTG on diastolic blood pressure (p less than 0.05) and left ventricular end-diastolic (p less than 0.001) and end-systolic (p less than 0.001) diameters. Aspirin (1 g) significantly increased (p less than 0.01) mean NTG plasma levels from 0.24 +/- 0.13 ng . ml-1 (control) to 0.37 +/- 0.26 ng . ml-1. We conclude that pretreatment with 1 g of aspirin increases NTG plasma levels and therefore significantly enhances the pharmacodynamic effects of NTG.

Adult↗
PubMedDate not supplied

Nifedipine and Raynaud's phenomenon associated with connective tissue diseases.

We have evaluated the therapeutic effect of the calcium-channel blocking agent nifedipine in Raynaud's phenomenon associated with connective tissue diseases and in idiopathic digital vasospasm. Thirty patients were included in this study: Raynaud's phenomenon was associated with progressive systemic sclerosis (PSS) in ten patients, systemic lupus erythematosus (SLE) in five and rheumatoid arthritis (RA) in three; it was idiopathic (I) in twelve patients. Each patient received, in a double-blind manner and random order, on two consecutive weeks, nifedipine (20 mg three times daily) and placebo. Nifedipine proved to be effective: the mean number of digital vasospastic attacks per week decreased from 20.30 to 5.83 (p less than 0.01). The results in the SLE and RA groups were similar and were pooled. The improvement (in percent decrease) was better in the idiopathic group (90.95) than in the SLE and RA group (78.63, p less than 0.02) and the PSS group (64.02, p less than 0.01).

Adult↗