Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.16.2 (PCP)
 3,761 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Right ventricular involvement has been shown to be common in the acute phase of infero-posterior myocardial infarction. The aim of this prospective study was to assess the diagnostic and prognostic value of the different criteria obtained by clinical and paraclinical methods of investigation. Forty patients (35 men, 5 women: mean age 57,1 years) admitted consecutively with this type of transmural infarct without any other cause of acute or chronic volumic or barometric overload of the RV were investigated. In addition to clinical data, the following paraclinical investigations were carried out during the first three days of admission: ECG and vectorcardiogramme (VCG); transaminase levels (SGOT and SGPT), creatinine phosphokinase (CPK), alpha HBDH, serum creatinine, blood gases (pO2), M mode and 2 D echo, right heart catheterisation and cardiac output estimations, selective RV and pulmonary cineangiography centered on the LV in the monoplane 30 degrees LAO projection. Two groups of twenty patients were identified, comparable in age and sex, according to the angiographic extension of akinesia of the RV inferior wall: Group A: extensive akinesia (greater than or equal to 30 p. 100), Group B: very localised or no akinesia (less than 30 p. 100). Analysis of the results showed a number of features characterising patients in Group A: the high incidence of initial shock (45 p. 100 (A)/0 p. 100 (B] and signs of RV failure (85 p. 100/0 p. 100), higher SGOT, SEPT (p less than 0,05) and alpha HBDH (p less than 0,02) but not of CPK; much higher serum creatinine (p less than 0,01) and lower p02 (p less than 0,05); the ECG showed a high incidence (85 p. 100) and specificity (95 p. 100) of ST-T elevation in V3R and V4R, and also 2nd or 3rd degree AV block (60 p. 100/5 p. 100): there were no characteristic VCG changes. Catheterisation showed very significant increases (p less than 0,001) of mean RA, and RV end diastolic pressures, of the RA/mean pulmonary capillary pressure ratio and of Yu's index. There was a moderate increase in PCP (p less than 0,01), a drop in right ventricular systolic work index (RSSWI); adiastole was very common (90 p. 100) and very specific (95 p. 100); angiography showed an increase in RV end diastolic and end systolic volumes (p less than 0,05) and a fall in RV ejection fraction (p less than 0,05) but with a lot of individual variations; there were no significant differences between the two groups as regards the volumes, ejection fractions and p. 100 akinesia of the LV.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Prospective study of the diagnostic and prognostic criteria of right ventricular involvement in the acute phase of inferoposterior infarction]. 641 16

Early catheterisation was performed in 27 patients with an acute inferior myocardial infarction less than 3 days old complicated by signs of low output with right ventricular dysfunction. All patients had hemodynamic criteria of adiastole (PCP = 14.9 +/- 31 mmHg and LVEDP = 14.1 +/- 4.7 mmHg) with low cardiac output (CI = 1.41 +/- 0.32 l/min/m2). An atropine resistant bradycardia was characteristic (HR = 65 +/- 17.2/min) due to advanced or complete AV block (11 cases), sinoatrial block (3 cases, one with right atrial standstill) or sinus/parasinus rhythm (13 cases) inappropriate to the severity of their hemodynamic state. Although the prognosis based on the discriminating linear function FI = -0.427 + 0.00121 LVW - 0.00125 TPR was initially poor and predicted the death of 21 out of the 27 patients at one month, the outcome was usually favourable and only 8 patients died during the first month. Fifteen patients were treated by temporary endocavitary RV pacing. As the heart rate was increased from 53.8 +/- 11.2 to 92.4 +/- 4.9/min, the CI rose from 1.35 +/- 0.26 to 1.85 +/- 0.46 l/min/m2 (p less than 0.001) with a fall in SI from 26.7 +/- 8.3 to 20.1 +/- 5.6 ml/beat/m2 (p less than 0.005). The results were even further improved in 3 cases by sequential A-V pacing. The observed hemodynamic improvement continued during the period of pacing providing volumic expansion maintained LVEDP above 10 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The value of temporary electrosystolic pacing for treating low output in posterior necrosis with adiastole]. 641 96

A haemodynamic and M mode echocardiographic study of 57 patients hospitalised for chronic, symptomatic 2nd or 2rd degree AV block was carried out after 3 periods of pacing, each lasting 2 hours : 1) sequential AV pacing ( SAV ) with a 200 ms delay, considered as the mode of reference; 2) sequential ventriculo-atrial pacing ( SVA ) with the same sequential delay, recreating equivalent conditions of 1/1 ventriculo-atrial conduction (VAC); 3) ventricular pacing (V) recreating complete AV dissociation ( CAVD ). The pacing rate was the same for each patient (89 +/- 9/min). In comparison with SAV , SVA caused much worse haemodynamic changes than V : large increases in mean atrial pressures (+161% and +64% in RAP and PCP respectively); "canon" atrial A waves which were poorly tolerated (mean amplitude 14 mmHg and 18 mmHg on the RA and PCP waves respectively); in some cases, a large fall in blood pressure was observed due to the failure of systemic resistances to increase and compensate for the constant decrease in pump function (mean reduction of 23% of cardiac index; 29% of LV work index). These changes are much more pronounced in diseased than in healthy hearts, especially in the presence of mitral or tricuspid regurgitation. Echocardiography showed the main cause of these haemodynamic changes to be a reduction in ventricular filling with significant reductions in LV systolic and diastolic dimensions, changes in the mitral valve echos (reduction in the opening and closing velocities, delayed closure), probably related to a decrease in transvalvular blood flow, and decreased regional contractility of the interventricular septum. These observations justify an increase in the indications of modes of pacing maintaining permanent atrio-ventricular sequence (VVI pacing at slow rates; AAI pacing, DVI or DDD pacing in cases of abnormal AV conduction with VAC, especially in cases of sick sinus syndrome with permanent bradycardia). These modes of pacing are particularly beneficial when the electrical abnormality is associated with a decompensated cardiac lesion, or with decreased ventricular compliance or mitral regurgitation.
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PMID:[Hemodynamics and M mode echocardiography of the consequences of ventriculo-atrial conduction in the human]. 642 28