Search PubMed⌕ Search

Biomedical subjects

M Gheorghiade

Publications and source records attributed to M Gheorghiade.

142 records · Page 8Linked to original sources
PubMed1981

[Echocardiography for the evaluation of tricuspid atresia. II. Analysis of the left ventricular function (author's transl)].

Twenty-five patients with tricuspid atresia, ranging in age between 2 months and 23 years, previously morphologically studied, were assessed by M-mode echocardiography with regard to left ventricular function. Fifteen of them underwent palliative cardiac surgery (systemic-pulmonary anastomosis). Thirty normal subjects, same age and sex, were selected as controls. Patients with tricuspid atresia had a significant increase of left ventricular dimensions and mass and significant decrease of shortening fraction and ejection fraction. The left ventricular pre-ejection/ejection ratio (LPEP/LVET) was significantly higher in patients with tricuspid atresia compared to normals. In patients without surgical shunt there was no significant correlation between Qp/Qs determined by oximetry and the end-diastolic dimension and left ventricular function parameters. In patients with surgical shunt a significant correlation was found between ejection fraction, shortening fraction, systolic time intervals and Qp/Qs. Qp/Qs significantly correlated with end-diastolic dimension. Shortening fraction and ejection fraction were higher in patients with satisfactory systemic saturation, while left ventricular mass was increased in patients with longstanding surgical shunt. These data suggest that patients with tricuspid atresia, with or without surgical shunt, may present with a decreased left ventricular function, early detectable by echocardiography.

Adolescent↗
PubMed1979

[Morpho-functional assessment of endocardial cushion defect by single crystal and two-dimensional echocardiography (author's transl)].

24 patients with various forms of endocardial cushion defect, ranging in age from 8 months to 22 years, were studied by single crystal (M-mode) and two-dimensional (2-D) echocardiography. In all of them diagnosis was confirmed by cardiac catheterization and angiocardiography, in 8 of them at surgery and in 3 of them at autopsy. From the morphologic point of view, 2-D echocardiography appeared to integrate M-mode recording in the structural definition of atrioventricular valves and in a better differentiation of complete atrioventricular canal. M-mode scanning right atrium-left ventricle, transverse projection by multiscan and long-axis and apical projections by sector-scanner were the most diagnostic projections. From the functional point of view, in patients with complete right bundle branch block (QRS greater than 120 msec), right ventricular isovolumetric contraction time appeared an useful alternative of sysn three patients, in whom these parameters couldn't be used, a qualitative judgement was possible on the basis of the absence of a wave and the presence of a midsystolic closure of pulmonary valve.

Adolescent↗
PubMedDate not supplied

Antithrombotic therapy in atrial fibrillation: a review of randomized trials with special reference to the Stroke Prevention in Atrial Fibrillation II (SPAF II) Trial.

Nonvalvular atrial fibrillation is common and is associated with a high risk of system embolism. Recently, several large randomized trials have been completed that have established the efficacy of antithrombotic therapy for both primary and secondary prevention of systemic thromboembolism with an acceptable rate of bleeding complications in these patients. This section of clinical trials review summarizes data from all published randomized trials of antithrombotic therapy in atrial fibrillation. The efficacy of aspirin versus warfarin is analyzed. The role of clinical and echo-cardiographic findings to stratify patients is also highlighted. The Stroke Prevention in Atrial Fibrillation II trial is discussed in detail.

Atrial Fibrillation↗
PubMedDate not supplied

Amiodarone therapy in chronic heart failure and myocardial infarction: a review of the mortality trials with special attention to STAT-CHF and the GESICA trials. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina.

Amiodarone appears to reduce sudden death in patients with left ventricular dysfunction resulting from an acute MI or a primary dilated cardiomyopathy, particularly if complex ventricular arrhythmias are present. Amiodarone's beneficial effect on mortality in these patients could be unrelated to its antiarrhythmic effects. Multiple factors could account for the improvement in mortality such as the drug's antiischemic effects, neuromodulating effects, its effect on left ventricular function and on heart rate. Moreover, patients with LV dysfunction who have survived an episode of sudden death would potentially benefit from amiodarone therapy. Future trials are needed to determine the precise subsets(s) of patients who would benefit from the drug and the most efficacious dosing regimen for the drug. Based on available data, amiodarone is the only antiarrhythmic agent which has not been shown to increase mortality in patients with chronic heart failure.

Amiodarone↗
PubMedDate not supplied

Role of antiarrhythmic agents after myocardial infarction with special reference to the EMIAT and CAMIAT trials of amiodarone. European Myocardial Infarct Amiodarone Trial. Canadian Amiodarone Myocardial Infarction Trial.

The role of antiarrhythmic agents in the post-MI patients has been investigated for several years. Recently, clinical trials have assessed the effects of amiodarone in the post-MI population. The Basel Antiarrhythmic Study of Infarct Survival (BASIS) trial showed a reduction in total mortality, sudden death, and life-threatening ventricular arrhythmias with amiodarone therapy. The European Myocardial Infarct Amiodarone Trial (EMIAT) did not show a mortality benefit, but amiodarone was associated with fewer antiarrhythmic deaths. The Canadian Amiodarone Myocardial Infarction Trial (CAMIAT) showed no significant impact on mortality, but arrhythmia deaths and resuscitated cardiac deaths were reduced. Amiodarone therapy after MI should be reserved for the treatment of symptomatic or sustained ventricular arrhythmias. The current data do not support routine use of amiodarone in all patients after MI.

Amiodarone↗
PubMedDate not supplied

Antiplatelet and anticoagulant therapy in the prevention of thromboemboli in chronic heart failure.

Thromboembolism is an important complication in patients with heart failure. Several recent clinical trials have established the efficacy of anticoagulant therapy in patients with heart failure and atrial fibrillation. There is renewed interest in examining the role of antiplatelet and anticoagulation therapy in patients with heart failure in sinus rhythm. There is a need to identify patients at risk for thromboembolism in heart failure. However, there are data to suggest that occult thromboembolic events may contribute to disease progression, ischemic events, and sudden cardiac death. This review summarizes the incidence, potential mechanism, and therapeutic approaches for management of thromboembolism in heart failure.

Anticoagulants↗
PubMedDate not supplied

Intravenous therapy for chronic heart failure exacerbations.

Chronic heart failure (HF) will be the disease of the new millennium. The last decade has seen major developments in the management of HF, with beta-blockers and ACE inhibitors becoming the cornerstones of therapy by virtue of the reductions in total mortality. However, significant gaps remain. Hospitalization for exacerbations of HF are frequent and account for more than 6 million hospital days from this disease related group. Although a variety of intravenous (IV) agents are available for the management of exacerbations of HF, readmission rates are as high as 20%-47% at 6 months. Acute IV therapy for acute decompensation of chronic HF consists of inotropic agents most of which also have vasodilator properties, vasodilator, and diuretics. In addition, there are newer agents in various developmental stages, especially, calcium sensitizing drugs, vasopressin receptor antagonists, and natriuretic peptides. Despite the multiplicity of agents, there are no well designed, randomized, placebo controlled trials to guide IV inpatient therapy for HF exacerbations. (c)1999 by CHF, Inc.

Journal Article↗
PubMedDate not supplied

Tricuspid valve replacement for cardiogenic shock after acute right ventricular infarction.

A 66-year-old man had an acute inferior wall myocardial infarction complicated by hypotension, high-grade atrioventricular block, and distended neck veins, suggesting associated right ventricular infarction. He failed to respond to volume loading, intra-aortic balloon counterpulsation, and pharmacologic afterload reduction. Cardiac catheterization five days after the infarction disclosed severe tricuspid regurgitation and a hemodynamic pattern resembling pericardial constriction. Emergency tricuspid valve replacement was dramatically successful.

Acute Disease↗