Search PubMed⌕ Search

Biomedical subjects

M Galinier

Publications and source records attributed to M Galinier.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Complete bundle branch block during exercise test. Clinical and coronary angiographic data].

Thirty-two complete bundle branch blocks were observed during 16,500 exercise stress tests between 1973 and 1988: there were 7 right bundle branch blocks and 25 left bundle branch blocks. Exercise stress testing was indicated in 15 cases for stable angina, in 15 cases for different functional disturbances and in 2 cases as a systematic investigation. All patients underwent coronary angiography and selective left ventriculography. Right bundle branch block occurring at a heart rate of 105 +/- 25/mn were associated with typical anginal pain at the time of apparition in 5 patients. Coronary angiography showed triple vessel disease in 3 cases, double vessel disease in 2 cases and an isolated proximal lesion of the left anterior descending artery in 2 cases. Left bundle branch block occurring at a heart rate of 125 +/- 12/mn was associated with normal coronary angiography in 7 cases. Eighteen patients had pathological coronary angiogrammes with severe lesions of the left anterior descending artery. Two women suffered from chest pain when the block developed and coronary angiography was normal in one of them. During follow-up (average 62 months), 16 coronary events were observed including 2 infarcts, and 6 patients developed cardiac failure. In conclusion, complete right bundle branch block appearing during exercise stress testing was constantly associated with atherosclerotic coronary artery disease. The predictive value of complete left bundle branch block on effort was 72%. Complete left bundle branch block occurring at heart rates of less than 120/mn was frequently associated with a proximal stenosis of the left anterior descending artery.

Adult↗
PubMed1990

[Alpha-1 inhibition. Clinical studies of the efficacy and tolerability of Alpress LP in mild to moderate essential hypertension].

Alpress LP allows a continuous flow of prazosin, thanks to its new galenic form. This implies a better efficacy and less side-effects in the treatment of hypertension. Besides, prazosin being known for its favourable effect on hypercholesterolemia, Alpress LP was studied in this respect. In each of the three studies detailed thereafter, concerning hypertensive patients, proof was made of the efficacy and the good tolerance of Alpress LP, as compared to reference therapeutics given in hypercholesterolemia.

Antihypertensive Agents↗
PubMed1990

[Regression of left ventricular hypertrophy with antihypertensive treatment].

The presence of left ventricular hypertrophy (LVH) is of poor prognosis in essential arterial hypertension, but it may regress under antihypertensive treatment. Angiotensin-converting enzyme inhibitors, calcium antagonists, centrally acting antihypertensive agents and beta-blockers with low intrinsic sympathomimetic activity constantly reduce the left ventricular mass. This stands in contrast with diuretics and vasodilators which induce stimulation of the sympathetic and/or renin-angiotensin systems and usually have no effect on LVH. Animal experiments have shown that regression of LHV has no adverse effect on the myocardial changes aimed at correcting the LVH-associated abnormalities (collagen content, changes in isomyosins, density of beta-adrenergic receptors, etc.) and that it improves the coronary haemodynamics disturbed by LVH. In clinical practice, reducing the ventricular mass does not modify the left ventricular systolic function, usually improves the diastolic function precociously altered by LVH and seems to reduce the LVH-induced ventricular hyperexcitability. The regression of LVH under antihypertensive treatment should result in a lesser cardiovascular risk in hypertensive patients.

Adrenergic beta-Antagonists↗
PubMed1990

[Concentric left ventricular hypertrophy in patients with hypertension. When should ventricular hyperexcitability be searched for?].

The main objective is to determine when concentric left ventricular hypertrophy (LVH) increased ventricular ectopic activity in essential hypertension. Twenty-four hours Holter monitoring was recorded in 56 patients with essential hypertension: 20 without LVH and 36 with concentric LVH determined by echocardiography (left ventricular mass greater than 215 g). According the degree of septal thickness (ST), patients were classed in 4 groups: (formula; see text) This study allows to conclude that mean and severe concentric LVH (ST greater than or equal to 12) detected by echo are associated with a greater PVC and a higher Lown's class ventricular ectopy. The degree of ST was strong correlated with the Lown's classification (r = 0.6, p less than .0001).

Arrhythmias, Cardiac↗
PubMed1990

[Early reocclusion after in situ coronary desobstruction either with streptokinase or angioplasty during the acute phase of myocardial infarction].

The aim of this study was to assess the incidence of early reocclusion after therapeutic reperfusion of coronary arteries in acute myocardial infarction. Seventy four patients underwent intracoronary thrombolysis and 133 patients had immediate coronary angioplasty. The success rates were 70 per cent and 86 per cent respectively (p less than 0.01) and the degree of residual stenosis was 77 +/- 13 percent and 25 +/- 15 per cent respectively (p less than 0.001). The patients in whom coronary reperfusion was successful, 52 after in situ thrombolysis, 48 after angioplasty alone, and 66 after combined angioplasty and intravenous thrombolysis, underwent coronary arteriography 24 to 36 hours later. Reocclusion was asymptomatic in 46 per cent of cases (13/28) and its prevalence was 16.9 per cent: 25.5 per cent for the right coronary compared with 12.8 per cent for the left anterior descending (p less than 0.05) and 11.7 per cent for the left circumflex artery; reocclusion occurred in 8.6 per cent of patients treated before the 3rd hour compared with 22.9 per cent of patients receiving treatment after the 3rd hour (p less than 0.05). The incidence of reocclusion was 17.3 per cent after intracoronary thrombolysis and 16.7 per cent after angioplasty (angioplasty alone 18.7 per cent; associated with thrombolysis 15.2%). The degree of residual stenosis was nil after intracoronary thrombolysis and 16.3 per cent after angioplasty when the stenosis was insignificant, and 20.5 per cent and 18.8 per cent respectively with stenotic lesions greater than 50 per cent.

Adult↗
PubMed1990

[Enoximone/dobutamine comparison in chronic congestive cardiac insufficiency with low cardiac output].

In severe chronic congestive cardiac failure the physician has the choice of two families of positive inotropic agents, the direct sympathomimetics and the phosphodiesterase inhibitors. The aim of the study was to compare the efficacy and tolerance of enoximone and dobutamine in this indication. Twenty patients with severe chronic cardiac failure with a cardiac index of less than 2.2 l/min/m2 and pulmonary capillary pressure of over 20 mmHg were randomised into two groups in an open trial. One group received enoximone 50 micrograms/kg/min for 30 minutes then 10 micrograms/kg/min and the other received dobutamine 10 micrograms/kg/min. The two groups were comparable. Results were analysed 12 hours after starting therapy, well after the loading dose of enoximone and before the appearance of tolerance to dobutamine. Neither drug caused a significant change in heart rate or mean blood pressure. The pressure-rate product did not increase significantly with enoximone (+9.2% NS) in contrast with the dobutamine group in which a significant elevation was observed (+23.5%, p less than 0.05). The cardiac index increased with enoximone (+61.0%, p less than 0.01) and with dobutamine (+32.1%, p less than 0.02). This resulted mainly from an increase in the systolic index (+45.5%, p less than 0.05 with enoximone and +30.1%, p less than 0.05 with dobutamine). Pulmonary capillary pressure and total systemic resistance decreased with enoximone (-29.1%, p less than 0.001 and -36.7%, p less than 0.05 respectively) and with dobutamine (-23.4%, p less than 0.001 and -20.7%, p less than 0.05 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Can ventricular dysfunction be prevented or delayed in course?].

Left ventricular dysfunction is asymptomatic or paucisymptomatic for a long time. It would be beneficial if progression to the symptomatic stages could be prevented. This is only possible when the abnormal conditions of cardiac load or perfusion which cause the myocardial disease, can be corrected. The treatment of hypertension or valvular disease is an example of this approach. Another approach is to reduce the perverse effects of the neurohormonal adaptations to cardiac failure. The treatment of chronic myocardial infarction by angiotensin converting enzyme inhibitors is an example of this approach.

Animals↗
PubMed1990

[Pheochromocytoma: how to prevent a fatal course? A case report and review of the literature].

The authors report on one case of a female patient with adrenal pheochromocytoma which progressed rapidly, resulting in death. Stress is therefore laid on the very serious nature of this disease and the necessity of rapid detection and treatment. A diagnostic and therapeutic strategy can be established from the review of the literature, based on numerous reliable methods which are currently available.

Adrenal Gland Neoplasms↗
PubMed1989

[Alpha 2-adrenergic receptors and arterial pressure].

The aim of this work was to investigate the influence of blood pressure levels on human platelet alpha 2-adrenergic receptivity. The study was carried out on 12 mild essential hypertensive patients and 7 normotensive parkinsonians with orthostatic hypotension. Alpha 2-adrenoceptors number and affinity were determined by 3H-yohimbine binding, plasma catecholamines were measured by HPLC and adrenaline-induced platelet aggregation by turbidimetry. Results obtained were compared with those of two groups of 12 normotensive control subjects. In hypertensive patients, both platelet alpha 2-adrenoceptors (139 +/- 6 vs 176 +/- 18 fmol/mg protein) and velocity of adrenaline-induced platelet aggregation were decreased whereas plasma adrenaline and noradrenaline remained unchanged. In patients with orthostatic hypotension, there was an increased number of platelet alpha 2-adrenoceptors (313 +/- 52 vs 168 +/- 8 fmol/mg protein) associated with a significant decrease in plasma noradrenaline (62 +/- 11 vs 190 +/- 25 pg/ml). In none of the two groups of patients there was any change in receptor affinity for 3H-yohimbine. These results indicate that human platelet alpha 2-adrenoceptors levels are related to blood pressure values. Moreover, up-regulation in orthostatic hypotension and lack of down-regulation in essential hypertension suggest that only sustained abnormal plasma noradrenaline levels could allow the development of alpha 2-adrenoceptors regulatory mechanisms. These variations can represent tentative compensatory mechanisms for normalization of blood pressure levels.

Aged↗
PubMed1988

[Value of the study of circulating adrenergic receptors in the diagnosis and surveillance after surgery of pheochromocytoma].

The purpose of the study was to investigate leukocyte beta adrenoceptors and platelet alpha 2 adrenoceptors in pheochromocytoma. The study concerned nine hypertensive patients, five men and four women (aged 42 +/- 8 years) with a pheochromocytoma demonstrated by high levels of urinary catecholamines and radiological data. Catecholamine plasma levels, assayed by HPLC were wide-ranging: 10.7 to 172.8 nM for noradrenaline and 0.7 to 3.9 nM for adrenaline. In each case the number of leukocyte beta adrenoceptors sites (measured with 125 I-cyanopindolol) significantly decreased: Bmax was 20.6 +/- 2.8 versus 48.5 +/- 1.5 fmol/mg protein in controls (p less than 0.05). In contrast, the number of platelet alpha 2 adrenoceptors sites (measured with 3H-yohimbine) was not modified: 206 +/- 22.6 versus 186.0 +/- 12.1 fmole/mg protein in controls. There was no change in affinity constant (Kd), neither for beta nor alpha2 adrenoceptors. After tumor removal, there was a significant increase in beta adrenoceptor number. We conclude that down regulation occurs in vivo for beta adrenoceptors but not for alpha2 adrenoceptors and that the decrease in leukocyte beta adrenoceptor number is an interesting and suitable index in the management of pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Study of ventricular repolarization in an experimental model of arterial hypertension associated with obesity].

UNLABELLED: High fat diet (HFD) in dogs is associated with obesity and hypertension (HTN) but also with a significant and early decrease in heart rate variability (HRV). Decreased HRV has been shown to be a good predictor of sudden cardiac death due mainly to arrhythmic event. The aim of this work was to investigate the changes in ventricular repolarization through 24 hours EKG recordings in dogs with hypertension and rendered obese by 20 weeks of HFD. This was achieved through 24 hour EKG recording analysis of QT parameters. The aims of this work was i) feasibility of this method in dogs and ii) identification of potential arrhythmic risk factors that could explain overmortality during obesity. METHOD: Six dogs received a high fat diet (HFD) ad libitum during 20 weeks. A 24 hour EKG recording was realized just before and after 20 weeks of HFD. The following parameters studying QT interval were collected: QT interval lasting from the beginning of the Q wave to the apex (QTa) and to the end of the T wave (QTe), QT intervals plotted against RR intervals and two regression lines were calculated characterized by their slope and intersection with the Y axis, QT dispersion (longest minus shortest QT interval for each RR value) as well as the difference of QT interval between night and day at a fixed RR value considered as a marker of the sympathovagal balance. Our results show that HFD significantly increased body weight, blood pressure, heart rate, left ventricular mass and insulinemia. QT dispersion was increased in a non-significant manner both during day (+35%) and night (16%) for QTa and only during day for QTe (+27%). This increased dispersion of QT was not associated to any increase of QT interval. There was no effect of HFD on QT dynamicity parameter nor on the night-day difference at any RR interval from 300 to 1,300 ms. CONCLUSION: HFD tend increase QT dispersion without any effect on QT interval. These results are compatible with a heterogeneous repolarization probably related to abnormal autonomic nervous system tone. This study could partly explain occurrence of lethal arrhythmias during obesity which might lead to overmortality of obese patients. These results are different for QTa and QTe, but these two parameters are characterizing different type of ventricular cells. This study confirms the feasibility of this method in an experimental model, but results need to be validated in larger groups and in human.

Animals↗
PubMedDate not supplied

[Angiotensin receptor blockers and cardiac rhythm disorders].

Angiotension Receptor Blockers (ARB) are able to prevent the occurrence of atrial fibrillation (AF) through various mechanisms among them: neurhumoral antagonism and hemodynamic control. This occurs during arterial hypertension and chronic heart failure both diseases known to be associated with left atrial dysfunction. In the CHARM program, candesartan reduced by 20% the incidence of AF and thus also mortality and the incidence of hospitalisation for heart failure related to AF This beneficial effect is also observed with ACE inhibitors but is more important and potentated by ARB. In the Val-Heft study, valsartan on the top of standard treatment including ACE inhibitors, significantly lowered the cases of AF In hypertensive patients, ARB are more powerful than ACE inhibitors for the prevention of AF In the LIFE study, patients in the losartan arm had 33% less AF than patients from the other arm, despite treatment with atenolol and similar blood pressure reduction. Moreover ARB beside their specific effects are also able to increase efficiency of anti-arrhythmic agent; since after cardioversion patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than patients treated with amiodarone alone. Finally ARB may reduce the risk of sudden death by ventricular arrhythmias in patients with diabetes mellitus.

Angiotensin II Type 1 Receptor Blockers↗
PubMedDate not supplied

Management of heart failure in the elderly: recommendations from the French Society of Cardiology (SFC) and the French Society of Gerontology and Geriatrics (SFGG).

Heart failure, a frequent disease in the elderly, has a pejorative prognosis. Clinical diagnosis is complicated by atypical or difficult-to-interpret symptoms and by the concomitant presence of other diseases, particularly cognitive impairment, neurological disorders and diseases of the musculoskeletal system. Among the additional investigations, echocardiography remains underused. Impairment of diastolic left ventricular function is frequent. The usual laboratory tests must include calculation of the creatinine clearance, which is indispensable for dosage adjustment of certain drugs (ACE inhibitors, digoxin, spironolactone). The value of plasma natriuretic peptide assays as diagnostic tools has not been determined in elderly or very elderly populations and the plasma B-type natriuretic peptide increases with age. Comprehensive geriatric assessment is essential in order to screen for concomitant diseases and determine the patient's degree of dependence. The general objectives of treatment remain applicable to the elderly subject: improvement in the quality of life, reduction of mortality and the number and duration of hospitalisations, and slowing disease progression. In the frail elderly subject, symptom alleviation is to be the primary objective. In the absence of specific studies on elderly or very elderly subjects, most of the recommendations have been extrapolated from the data based on the evidence generated in younger populations. The dietary rules are to be more flexible than those used for younger subjects, particularly in order to prevent the risk of denutrition induced by strict salt-free diets. Special precautions for the use of heart failure drugs are due to comorbidities and the pharmacokinetic and pharmacodynamic changes related to aging. Drugs dosage increase is to be cautious and carefully monitored for adverse reactions. The therapeutic programmes in which multidisciplinary teams are involved reduce the number and duration of hospitalisations and the costs generated by the disease.

Aged↗
PubMedDate not supplied

Verapamil interacts in vitro with alpha 2-adrenoceptors but does not modify alpha 2-receptivity in vivo.

The kind of interaction of two structurally different calcium channel blockers (verapamil and nicardipine) with both alpha 2-adrenergic agonist and antagonist binding on human platelets was investigated. Only verapamil, but not nicardipine, interacted in vitro with platelet alpha 2-adrenoceptors on [3H]-yohimbine or [3H]-UK 14,304 binding. Verapamil behaves as a weak antagonist competitor for alpha 2-adrenoceptors. In patients with mild essential arterial hypertension, the number of platelet alpha 2-adrenoceptors as well as velocity of aggregatory response to adrenaline, are significantly decreased: -21 and -25%, respectively (p less than 0.05). Verapamil (120 mg t.i.d. orally during 1 month) failed to modify the platelet alpha 2-adrenoceptor number or the adrenaline-induced platelet aggregation in hypertensive patients. These results show that, although interacting in vitro, verapamil does not modify the alpha 2-adrenergic receptivity after 1 month treatment in humans.

Adrenergic alpha-Agonists↗