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Biomedical subjects

R Crepaz

Publications and source records attributed to R Crepaz.

22 records · Page 2Linked to original sources

[Preclinical changes in left ventricular function in myotonic muscular dystrophy. Value of the isovolumetric index].

Nine patients, 7 males, 2 females, mean age 36 years, with myotonic muscular dystrophy who had no cardiac symptoms underwent M-mode echocardiography (e.), systolic time intervals (STI) measurement by simultaneous recordings of the electrocardiogram, phonocardiogram and carotid arterial pulse, and single-pass radionuclide angiocardiography (RNA) in order to assess the left ventricular function. The ejecting phase indexes measured by echocardiography (fractional shortening, mean velocity of circumferential fiber shortening) were slightly depressed in 1 case and an abnormal PEP/LVET ratio was found in 3 cases. The ejection fraction measured by radionuclide angiocardiography was abnormal in 1 case who showed a diffuse hypokinesia. The IVI%, a new isovolumic phase index obtained by echocardiography, was abnormal in all patients. It is concluded that the IVI% seems more sensitive than the ejecting phase indexes calculated by echocardiography or radionuclide angiocardiography and the PEP/LVET ratio in detecting abnormalities of left ventricular function in patients with myotonic muscular dystrophy and no clinical signs of heart disease.

Adolescent

[Value of mono- and bi-dimensional contrast echocardiography in the diagnosis of inter-atrial defect with left-to-right shunt].

Thirteen patients with atrial septal defect (ASD), 12 ostium secundum type, 1 ostium primum type and left-to-right shunt were studied by M-mode and two-dimensional echocardiography and then by intravenous contrast study. Diagnostic confirmation was obtained in 12 cases by cardiac catheterization and angiocardiography. The purpose of the study was to assess the value of contrast echocardiography in the diagnosis of ASD without pulmonary hypertension, since it is known that the standard echocardiographic investigation is rather unsatisfactory in this type of malformation. M-mode echocardiography with contrast injection has been diagnostic in 12 cases (92.3%), by visualising contrast echos in the mitral tunnel. The overall reliability of the two-dimensional contrast-echocardiography was reduced in our cases by a fairly high number of inaccurate results. The right to left shunting of injected contrast does not seem to depend on the haemodynamic parameters considered, such as right atrial pressure, right ventricular end-diastolic pressure, pulmonary artery pressure, and pulmonary arteriolar resistance.

Adult

Cardiovascular effects of high-dose growth hormone treatment in growth hormone-deficient children.

Growth hormone (GH) hypersecretion is associated with an increased incidence of cardiac hypertrophy and subclinical abnormalities of left ventricular (LV) function. The unlimited availability of biosynthetic GH has led to progressively increased dosage when treating GH-deficient children, raising the question of its cardiovascular effects during long-term therapy. We compared 22 children (8 girls, 14 boys), mean age 12.1 years (range 3-17 years) with GH deficiency who were receiving chronic GH treatment (GH group) with 22 normal controls matched for sex and body size in order to evaluate: (1) LV volume, mass, and systolic function by two-dimensional guided M-mode echocardiography; (2) LV diastolic function by pulsed-wave Doppler sampling of the transmitral flow; and (3) cardiac output and systemic vascular resistance by Doppler echocardiography. All patients had been on chronic GH therapy for 13.8 +/- 7.6 months (range 5-30 months) with an average dose of 0.95 +/- 0.12 IU/kg per week (range 0.69-1.17 IU/kg per week). Blood pressure did not differ between the two groups. LV volume, mass, ejection fraction, and mean velocity of circumferential shortening did not differ significantly between the GH group and controls; nor did the peak- and end-systolic meridional stress. All patients had a normal contractile state as estimated by the relation between mean velocity of circumferential shortening and end-systolic meridional stress. The LV filling parameters did not differ between the two groups, and there was no difference in cardiac index and systemic vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent