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Marcel Peltier

Publications and source records attributed to Marcel Peltier.

9 recordsLinked to original sources
PubMed2006

Prognostic value of preoperative atrial fibrillation in patients with aortic stenosis and low ejection fraction having aortic valve replacement.

Aortic valve replacement in severe aortic stenosis (AS) with a low left ventricular ejection fraction (EF) is associated with high perioperative mortality. The aim of this study was to assess the prognostic value of preoperative atrial fibrillation (AF) in patients with AS and low EFs who undergo aortic valve replacement. Eighty-three consecutive patients with severe AS (area <1 cm2) and low EFs (< or =35%) were prospectively included. Perioperative mortality was 12%. Twenty-nine patients (35%) had preexisting paroxysmal or permanent AF. Perioperative mortality was higher in the AF group than in the non-AF group (24% vs 5.5%, p = 0.03). Preoperative AF was identified as an independent predictor of perioperative mortality (odds ratio 7.5, 95% confidence interval 1.19 to 47.06, p = 0.03). Five-year overall survival was lower in the AF group than in the non-AF group (47% vs 77%, p = 0.0017). Associated multivessel coronary artery disease and preoperative AF were identified as 2 independent predictors of overall mortality. In conclusion, in patients with AS with low left ventricular EFs, preoperative AF is associated with higher operative risk and lower postoperative survival. The presence of AF in patients with severe AS and low EFs should be taken into account for operative risk stratification, along with low pressure gradient and associated multivessel coronary artery disease.

Aged↗
PubMed2005

Validation of echocardiographic and Doppler indexes of left ventricular relaxation in adult hypertensive and normotensive rats.

This study was performed to validate echocardiographic and Doppler techniques for the assessment of left ventricular (LV) diastolic function in spontaneously hypertensive rats (SHR) and normotensive Wistar rats. In 11 Wistar rats and 20 SHR, we compared 51 sets of invasive and Doppler LV diastolic indexes. Noninvasive indexes of LV relaxation were related to the minimal rate of pressure decline (-dP/dt(min)), particularly isovolumic relaxation time (IVRT), the Tei index, the early velocity of the mitral annulus (E(m)) using Doppler tissue imaging, and early mitral flow propagation velocity using M-mode color (r = 0.28-0.56 and P < 0.05-0.0001). When the role of systolic load was considered, the correlation between Doppler indexes of LV diastolic function and relaxation rate [(-dP/dt(min))/LV systolic pressure] improved (r = 0.48-0.86 and P = 0.004-0.0001, respectively). Similarly, Doppler indexes of LV diastolic function and the time constant of isovolumic LV relaxation (tau) correlated well (r = 0.50-0.84 and P = 0.0002-0.0001, respectively). In addition, eight SHR and eight Wistar rats were compared; their LV end-diastolic diameters were similar, whereas the SHR LV mass was greater. Furthermore, IVRT and Tei index were significantly higher and E(m) was lower in SHR. Moreover, tau was higher in SHR, demonstrating impaired LV relaxation. In conclusion, LV relaxation can be assessed reliably using echocardiographic and Doppler techniques, and, using these indexes, impaired relaxation was demonstrated in SHR.

Animals↗
PubMed2004

Monitoring of respiratory variations of aortic blood flow velocity using esophageal Doppler.

OBJECTIVE: The purpose of this study was to determine whether monitoring of respiratory changes in aortic blood flow velocity, recorded by esophageal Doppler, could be used to detect changes in volume depletion. DESIGN: Animal study. ANIMALS AND INTERVENTIONS: After general anesthesia and tracheotomy, ten New Zealand female rabbits, weighing 4-4.5 kg were studied under mechanical ventilation at a fixed tidal volume; during this time 5-ml blood samples were withdrawn (in increments up to a total of 30 ml) and then retransfused. MEASUREMENTS AND RESULTS: At each step, systolic (SBP), diastolic (DBP), pulse (PP) pressures and maximum descending aortic blood flow (V) were recorded. Respiratory changes of V (DeltaV), SBP (DeltaSBP) and PP (DeltaPP) were calculated as the difference of maximal and minimal values divided by their respective means and expressed as a percentage. The amount of blood withdrawn correlated negatively with SBP, DBP, PP and V and positively with DeltaSBP, DeltaPP and DeltaV. Among these parameters, DeltaV correlated best with the amount of blood withdrawn ( r=0.89, p<0.001) and it was the most accurate index of volume depletion. CONCLUSION: Monitoring of the respiratory variation in V, calculated by esophageal Doppler technique, seems to be a highly accurate index of blood volume depletion and restitution.

Analysis of Variance↗
PubMed2004

Assessment of the physiologic significance of coronary disease with dipyridamole real-time myocardial contrast echocardiography. Comparison with technetium-99m sestamibi single-photon emission computed tomography and quantitative coronary angiography.

OBJECTIVES: The purposes of this study were to test whether quantitative real-time myocardial contrast echocardiography (RT-MCE) can detect coronary disease during pharmacologic stress and to compare this approach with single-photon emission computed tomography (SPECT). BACKGROUND: Assessing myocardial perfusion during stress is important for the diagnosis and risk stratification of patients with coronary disease. METHOD: Thirty-five patients referred for coronary angiography underwent RT-MCE and technetium-99m methoxyisobutylisonitrile (MIBI) SPECT at baseline and after 0.84 mg/kg dipyridamole. The modalities of RT-MCE and SPECT were analyzed both qualitatively and quantitatively. For this purpose, myocardial flow reserve was calculated from microbubble replenishment curves, and regional MIBI uptake was measured on circumferential profiles. Segments and vascular territories were categorized into five groups with increasing stenosis severity by quantitative coronary angiography. RESULTS: With dipyridamole, beta and A x beta increased in all but the highest stenosis severity group. The increase in beta and A x beta was significantly lower in territories supplied by stenotic arteries than in those supplied by arteries with <50% stenosis. Graded decreases in beta and A x beta reserves were noted with increasing stenosis severity. Using the cutoff value of 2.00 for beta reserve, quantitative RT-MCE correctly identified 97% of the territories supplied by significant stenoses and 82% of those supplied by normal arteries. In contrast, quantitative SPECT correctly identified only 71% of the territories supplied by significant stenoses and 81% of those supplied by normal arteries. CONCLUSIONS: This study shows that RT-MCE, with dipyridamole, can define the presence and severity of coronary disease in a manner that compares favorably with quantitative SPECT.

Adult↗
PubMed2003

The CHARM programme.

Explore the source record for details and available documents.

Adrenergic beta-Antagonists↗
PubMed2002

Assessment of myocardial blood flow using myocardial contrast echocardiography.

Advances over the past 10 years have enabled the widespread use of myocardial contrast echocardiography (MCE) to assess myocardial perfusion. This assessment is critical in evaluating the severity of coronary artery disease and the efficacy of pharmacologic, mechanical, or surgical interventions. MCE measures myocardial blood flow (MBF) by investigating flow velocity and myocardial blood volume. Although there are potential limitations to the use of MCE for determining MBF, its use is feasible in the experimental laboratory and in the clinical environment.

Animals↗
PubMed2002

Elevated serum lipoprotein(a) level is an independent marker of severity of thoracic aortic atherosclerosis.

STUDY OBJECTIVE: Lipoprotein(a) (Lp[a]) level is a risk factor for ischemic heart disease, cerebrovascular disease, and peripheral vascular disease. However, few data are available concerning the relationship between Lp(a) level and severity of thoracic aortic atherosclerosis. We hypothesized in this transesophageal echocardiography (TEE) study that Lp(a) level is a marker of severity of thoracic aortic atherosclerosis. DESIGN: Cross-sectional study. SETTING: University hospital. PATIENTS: Risk factors, coronary angiographic features, and TEE findings were analyzed prospectively in 119 patients with valvular disease. MEASUREMENTS AND RESULTS: The following risk factors were recorded: age, gender, hypertension, smoking, lipid parameters, diabetes, body mass index, and family history of coronary artery disease. Serum levels of Lp(a) were measured for each patient. By univariate analysis, age, diabetes, hypertension, smoking, Lp(a), total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels were significant predictors of thoracic aortic atherosclerosis. There was a positive and significant correlation between the Lp(a) levels and the score of severity of thoracic aortic atherosclerosis (p = 0.0001). Multivariate regression analysis revealed that Lp(a) was an independent predictor of severity of thoracic aortic atherosclerosis (p = 0.0001). CONCLUSION: This prospective study indicates that serum Lp(a) level is an independent marker of severity of thoracic aortic atherosclerosis detected by multiplane TEE. These findings emphasize the role of Lp(a) as a marker of atherosclerotic lesions in the major arterial locations.

Adult↗