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Biomedical subjects

P Penther

Publications and source records attributed to P Penther.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Calcifications of the trunk of the left coronary artery in coronary disease. Anatomical study].

Calcification of the left main coronary artery (LCA) was found, with an equal sex distribution, in 30 out of 145 patients (21%) at autopsy. A series comprising 68 males and 77 females in whom death resulted from myocardial infarction (111 cases) or ischaemic heart disease (34 cases). The condition is rare before the sixth decade but becomes more frequent after the seventh decade of life. The incidence was the same in lethal anterior and posterior infarction (15% and 16% respectively). It was more common in ischaemic heart disease (38%, p less than 0,005). Significant narrowing of the LCA was found in 26 cases (87%) but this was only less than 70% in 11 cases. When the total number of LCA stenoses (calcified and non calcified: 39 cases) was considered, only two thirds had associated calcification. This was, therefore, only a moderately sensitive index of LCA stenosis. Calcification, nearly always circumferential, was usually situated on the second portion of the LCA. Its division was involved in all cases, the calcification extending to the initial segments of the left anterior descending artery (LAD) and left circumflex artery (CX). Calcification of the LCA was always associated with calcification of the LAD, 78% of which had stenotic lesions. Calcification of the CX and right coronary arteries was practically constant, the average percentages of occlusion being 72% and 68% respectively. On anatomical criteria, myocardial revascularisation surgery could only have been proposed in about 20% cases, and this would only rarely have been total. It is concluded that calcification of the LCA usually corresponds at least anatomically, to severe, diffuse multivessel coronary artery disease.

Aged↗
PubMed1981

[Coronary disease in homozygous twins. Respective roles of heredity and environment].

Two 44 year old female homozygote twins presented with cardiac ischaemia due to coronary atheroma, at 39 years of age and 43 years of age, respectively. The coronary risk factors (hypertension, cigarette smoking, hypercholesterolaemia, obesity, oral contraception) were comparable in both cases. Although presenting at different times, the electrocardiographic changes were in the same territory and coronary angiography showed a similar anatomical and lesional distribution. The literature is reviewed with respect to these cases to try to determine the respective roles of heredity and the environment in the initiation and progression of coronary atheroma.

Adult↗
PubMed1980

[Recent myocardial infarction. Study of sinus function].

The ECGs of 70 consecutive patients hospitalised for a first transmural myocardial infarction (MI) (28 anterior, 42 posterior) were analysed prospectively and systematically during the acute phase. Endocavitary electrophysiological studies (EEP) were performed on the 21st day. The following conclusions were drawn: --Sinus bradycardia in the acute phase was observed in 18 cases (26 p. 100). Its cause is uncertain and its occurrence has no relation to the site of infarction. The single case of sinoatrial block (SAB) was recorded in a patient with a posterior MI. --EEP were normal in 18 patients who had sinus bradycardia during the acute phase; EEP was clearly pathological in the case with SAB. --There was no statistical difference in the incidence of pathological EEPs (p greater than 0,05) in anterior (4 out of 28 patients) and posterior (5 out of 42 patients) MI.

Adult↗
PubMed1979

[Left ventricular cineangiography in the convalescent phase of a 1st myocardial infarct. Influence of coronary lesions].

80 patients with a primary myocardial infarction (32 anterior and 48 posterior) underwent cardiac catheterisation and angiography (coronary arteriography and selective left ventricular cineangiography) within 12 months of infarction. Analysis of the results of catheterisation and angiography showed: -- Diffuse coronary artery narrowing to be more frequent in patients with posterior infarction. Significant stenosis of the left anterior descending artery was observed in half these cases; -- No correlation between the results of cardiac catheterisation and the distribution of the coronary artery lesions. Changes of ventricular contraction are essentially related to the infarct size and much less to the quality of the healthy myocardium as far as can be appreciated by the usual haemodynamic methods in both anterior and posterior myocardial infarction.

Adult↗
PubMed1979

[Acute posterior myocardial infarction involving the right ventricle. Anatomical study].

Thirty patients who died in the acute phase of an inaugural posterior myocardial infarction were classified in two groups: group A, 14 cases, and group B, 16 cases without extension to the right ventricle. The autopsy examination showed the following differences. In group A: 1. The right coronary artery (RCA) gave off the posterior descending artery in all cases; 2. The RCA had diffuse atheromatous change in 10 cases (p less than 0,05); 3. Total occlusion of the RCA by thrombosis was constant (p less than 0,01) and was always proximal to or near the origin of the right marginal artery (p less than 0,001); 4. Postero-septal extension was constant and nearly always transmural (p less than 0,001).

Adult↗
PubMed1978

[Posterior mycardial infarction with or without the initial complication of atroventricular block. Short and long term comparative clinical study (author's transl)].

Comparison of the short term clinical course of 2 groups of patients who had suffered a first posterior myocardial infarction complicated during the acute phase (group A) by 2nd or 3rd degree atrioventricular block, or free of such a complication (group B), confirmed two classical concepts: the onset of this complication in one case out of five and a two-fold increase in mortality when it occurs. In the mid- and long term, however, the course is relatively similar in both groups, which do not differ initially in terms of average age, sex distribution nor the usual risk factors of coronary artery disease. In addition, the absence of sudden deaths in group A would suggest that AV block is a definitively regressive complication.

Acute Disease↗
PubMed1978

[Anterior and posterior myocardial infarct: clinical comparative study on its outcome].

A comparison of the short and long term outcome in two groups of patients admitted to hospital during the acute phase of their first myocardial infarction, an anterior group (123 cases) and a posterior group (147 cases) has produced the following results:--an immediate mortality which was significantly higher (identical cause of death) in the anterior infarct group (22.8%) than in the posterior infarct group (11.6%): p less than 0.02;--a very similar long term mortality (5 to 6% per year) in the two groups (the main causes for which cannot be equated) despite the fact that the initial destruction of muscle was usually greater when the infarct had been anterior. These results seem to lead to the following conclusion: a better overall prognosis seems to be related to efforts to limit the extent of an infarct, especially when it is anteriorly situated; sometime after the infarct, it is also linked to the improvement in vascularity of the regions which are not involved, especially in cases of posterior necrosis.

Acute Disease↗
PubMed1978

[Effort electrocardiography and coronary arteriography following a 1st myocardial infarction. Critical study of the effort test].

Sixty-five patients, convalescent from a first myocardial infarction (anterior in 24 cases; inferior in 41 cases), underwent an effort electrocardiogram on a treadmill and coronary arteriography. In the anterior infarcts, coronary arteriography showed single vessel disease (anterior descending artery) in 54% of cases and double or triple vessel disease in the others. The effort test was positive in only 25% of patients with an anterior infarct. The presence of stenotic lesions of the circumflex artery and/or right coronary artery was unsuspected in 63% of patients. In the inferior infarcts, there was a significant stenosis of the anterior descending artery in 51% of the cases. The effort test was positive in 54% of patients and in 77% of those the anterior descending artery showed a significant stenosis. The appearance (or increase) of ST elevation greater than or equal to 1 mm in the leads facing the infarcted zone was an indication of more severe deterioration in left ventricular function as shown by a more marked reduction in ejection fraction and a more extensive akinetic region. The co-existence of ST elevation in the leads facing the infarcted zone and of ST depression greater than or equal to 1 mm in the reciprocal leads always indicated that another major vessel was involved, but this was only found in 25% of cases in this series.

Angiography↗
PubMed1978

[Paroxysmal junctional tachycardia with simultaneous supra-nodal and infra-nodal 2/1 block].

It is rare to find 2:1 second degree block in paroxysmal junctional tachycardia. In the case described, atrial stimulation at 200/mn during supra-ventricular tachycardia triggered off simultaneous atrio-ventricular and ventriculo-atrial block. This unusual occurrence was very useful because it localised the re-entry circuit to the junctional region by excluding possible accessory pathways.

Aged↗
PubMed1978

[Complete bundle-branch block and myocardial infarct. Natural history. Comparative study].

Myocardial infarction (MI), (and especially anteriorly situated necrosis) was complicated by complete branch block (CBB) in 9.7% of cases (45 patients out of 462). A comparison of the short- and long-term outcome in two groups of patients (group A: 45 cases of MI complicated by CBB; group B: 45 cases of MI with no atrio-ventricular or intra-ventricular conduction defects) showed that there was a much bigger immediate mortality in group A, which was not changed by temporary cardiac pacemaking, and depended on the extent of myocardial destruction. A study of the long-term outcome showed that there were more deaths in group A (recurrence of MI, intractable cardiac failure). However, the incidence of sudden death was equal in the two groups (group A 15%, group B 13%), and there was no obvious explanation in the absence of electrocardiographic tracings. Therefore this study lends no support to the argument which favours prophylactic implantation of a cardiac pacemaker during the course of MI complicated by CBB.

Adult↗