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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cardiovascular accidents are the commonest cause of death in patients on intermittent haemodialysis. Our study concerns 158 adult patients in terminal renal failure who were treated by periodic dialysis; it was carried out at Necker Hospital between January 1967 and December 1970. Between these dates, 35 patients died, 17 of the deaths being due to unequivocal or probable cardiovascular complications. The diagnosis of cerebrovascular accident was made in 13 cases. The mean age of the patients who died was 38 years. Fatal cerebrovascular accidents occurred especially during the first 12 to 24 months of treatment. The incidence of fatal vascular accidents is greatest in patients who were hypertensive at the beginning of periodic dialysis, and who remained so after six months of dialysis. Our study has therefore shown that hypertension in patients on chronic haemodialysis is a major vascular risk factors; other risk factors, especially metabolic ones, may also play a part.
Arch Mal Coeur Vaiss 1978 Jul
PMID:[Arterial hypertension and mortality due to cardiovascular complications in patients on chronic hemodialysis]. 10 Nov 77

Two groups of 10 patients with left ventricular failure during the acute phase of myocardial infarction were studied. One group were given phentolamine, the other trinitrin. The infusion rate was regulated so that the heart rate was not increased by more than 10 beats per minute, and to obtain a pulmonary arterial diastolic pressure less than 18 mmHg with a mean systemic arterial pressure remaining greater than or equal to 80 mmHg. The dose of phentolamine was 5 +/- 3 mcg/kg/mn, but using trinitrin the initial optimal dose of 0.39 +/- 0.22 mcg/kg/mn had to be progressively increased during the first 24 hours. The haemodynamic study done before treatment and after an hour at the optimal infusion rate showed that, for a similar reduction in the pulmonary arterial diastolic pressure, the mean systemic arterial pressure was reduced less by trinitrin than by phentolamine, while the stroke work index was not appreciably altered by either drug. In patients with low systemic arterial pressure, trinitrin appears to be preferable and warrants use after the possible setting up of circulatory assistance by aortic counter-pulsation.
Arch Mal Coeur Vaiss 1978 Nov
PMID:[Comparison of the effects of phentolamine and trinitrine in the treatment of left ventricular failure during the acute phase of myocardial infarct]. 10 76

In the present work with radiocardiography the change of pulmonary capillary pressure as well as cross correlations of stroke index, cardiac index, pulmonary blood volume, pulmonary arterial pressure and pulmonary dispersion volume which reflects pulmonary capillary volume have been studied during muscular exercise. With increase in cardiac output the mathematical estimation showed decrease in pulmonary capillary pressure while stroke index, pulmonary blood volume and pulmonary dispersion volume increased. The pulmonary arterial pressure also rose but this increase was insignificant. The estimated decrease in pulmonary capillary pressure might be due to decreased resistance, a consequence of recruitment of new capillaries and of increase of cross sectional area of pulmonary vasculature. The radiocardiographic method used here appears to be suitable in exercise studies, and it may further be applicable in clinical studies, e.g. in evaluation of left ventricular failure.
Arch Mal Coeur Vaiss 1979 Feb
PMID:[Pulmonary capillary pressure and the exercise test]. 10 94

Hemodynamics and right (RV) and left (LV) ventricular performances of anaesthetized, closed-chest animals were studied in normal control dogs (N) and in dogs with aortic insufficiency (AI), the latter intervention being performed 33 months before verification. In dogs with AI, LV was hypertrophied (N = 49.6 +/- 6.3 g; AI = 98.7 +/- 10.1, p less than 0.001); forward stroke volume was slightly decreased (N = 20.0 +/- 2.2 ml; IA = 14.6 +/- 5.4 ml, p = NS);LV and diastolic pressure was increased (N = 9.4 +/- 1.4 mmHg; IA = 16.7 +/- 2.9, p less than 0.05); both RV and LV myocardial performace index (e.g. dP/dt max, peak VCE, Vmax) were normals. Relative pressure/velocity of shortening and wall stress/velocity of shortening relationships, however, were decreased, when measured during L.V. isovolumetric beats. LV stiffness of arrested heart was increased in proportions with hypertrophy extent. Thus, myocardial performance of chronically volume-overloaded heart appears to be depressed before the stage of the circulatory failure.
Arch Mal Coeur Vaiss 1976 Aug
PMID:[Anomalous ventricular contractile performance in experimental chronic aortic insufficiency in the dog]. 13 37

A retrospective study allowed us to examine 23 cases with aneurysm of the left ventricle. The aneurysm was discovered incidentally in 6 patients, and as a result of cardiac symptoms in an other 14. The diagnosis made following a cerebrovascular accident and an episode of ventricular tachycardia respectively in two cases. Radiological and electrocardiographical investigation revealed the classical findings in 21 cases, while inflammatory changes were also present in 19. Tuberculosis was found to coexist in 4 patients, and was suspected in a further 4. The aetiology of these aneurysms has remained obscure until now. We feel that a debilitating conditions such as tuberculosis or late pregnancy, or perhaps a change in cardiac function, might lead to the development or enlargement of a sub-annular aneurysm in a predisposed subject. One of our patients presented with an apical aneurysm of the left ventricle in association with a complete situs inversus. A further patient had sustained a severe precordial ingiury 10 years previously, and 2 others had a past history of rheumatic joint disease many years previously. It appears to us that cases with calcification have a better prognosis.
Arch Mal Coeur Vaiss 1977 Feb
PMID:[Left ventricular aneurysm in the young African. Apropos of 23 cases]. 40 89

Eight patients with chronic congestive cardiac failure secondary to ischaemic heart disease performed submaximal supine exercise before and after 5 mg sublingual isosorbide dinitrate (ISDN) at the time of cardiac catheterisation. Exercise before ISDN produced a poor response in left ventricular performance. After ISDN this response was significantly improved. Compared with the control exercise period cardiac index (CI) increased from mean 2.9 to 3.5 l/mn/m2 (p = less than 0.0025), stroke volume index (SVI) from mean 24 to 29 ml/m2 (p = less than 0.0005) and left ventricular stroke work index (LVSWI) from mean 22 to 28 g-m/m2 (p = less than 0.0025). Although ISDN reduced LVEDP significantly at rest, there were associated small but significant falls in CI, SVI and LVSWI. The improvement in exercise cardiac index was related to the ejection fraction, or the ejection fraction of the contractile section where a left ventricular aneurysm was present. ISDN may be effective in improving exercise tolerance in ambulant patients with chronic congestive cardiac failure.
Arch Mal Coeur Vaiss 1978 Mar
PMID:Haemodynamic effects of isosorbide dinitrate in patients with congestive cardiac failure at rest and during submaximal supine exercise. 41 97

We measured by thoracic bioimpedance (BoMed, NCCOM3-R7) non invasive cardiac index (CI), stroke index (SI) and systemic vascular resistance index (SVRI) in 48 hypertensive patients (OMS) compared to 30 normotensive. The mean arterial pressure (MAP) and the SVRI were significantly higher in the hypertensive group while the CI are significantly lower, as that was shown in previous invasive studies. We found an inverse correlation between age and CI (r = -.30, p < or = .05) in relation with a negative correlation between SI and age (r = -.35, p < or = .05) and no correlation between heart rate and age. Furthermore we divided normotensive and hypertensive patients in three groups of CI (low CI < 2.8 l/min/m2, 2.8 < or = normal CI < or = 4.2 l/min/m2, high CI > 4.2 l/min/m2) and in three groups of SVRI (low SVRI < 1660 Flohms/m2, 1660 < or = normal SVRI < or = 2580 Flohms/m2, high SVRI > 2580 Flohms/m2). Despite CI diminution in hypertension, high CI percentage's was the same in normotensive and hypertensive patients. In conclusion, these results confirm previous studies by using a simple, easy, non invasive and reproducible method.
Arch Mal Coeur Vaiss 1992 Aug
PMID:[Cardiac output studied by a non invasive method in hypertensive patients]. 148 36

The purpose of the study was to interpret the acute improvement in left ventricular (LV) filling induced by a new calcium channel blocker (SR 33 557) using Doppler echocardiography. Thirteen patients, 29 to 68 years old (mean 52) with mild to moderate hypertension were examined by Doppler echocardiography before and 4 hours after treatment (SR 33 557: 300 mg). The LV filling parameters, E, A, A/E, VTIM, VTIA, VTIA/VTIM, pressure half time (PHT) and isovolumic relaxation time (IRT) were measured. An index of left atrial pressure was obtained by measuring the mean pulmonary arterial pressure (PAP). The following hemodynamic parameters were also obtained: systolic blood pressure (SBP), heart rate (HR), PR interval (PR), stroke volume (SV) at aortic origin, total systemic resistances (TSR), pulse wave velocity (PWV) at thoracic descending aorta, LV end systolic stress (ESS), LV geometry (thickness/radius: th/r) and systolic function indices: mean VCF and contractility (mean VCF-ESS relationship). Following acute treatment, E and VTIM increased, A, VTIA and PHT did not change, and A/E, VTIA/VTIM ans IRT decreased, both significantly (p < 0.05). PAP did not change, HR, SBP, TSR, PWV, ESS decreased and PR increased both significantly (p < 0.05). LV geometry and systolic function did not change. No significant relationship was found between LV filling changes and changes in hemodynamic parameters. In conclusion, the acute increase in early LV filling induced by the calcium blocker treatment may be interpreted as the consequence of the improvement in LV relaxation in the absence of any change in left atrial pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1992 Aug
PMID:[Apropos of acute changes in left ventricular filling induced by antihypertensive treatment]. 148 37

Syst-Eur is a multicentre placebo-controlled outcome trial, designed by the European Working Party on High Blood Pressure in the Elderly (EWPHE), to investigate the effect of antihypertensive treatment on the incidence of stroke in elderly patients with isolated systolic hypertension (ISH). Eligible patients must be at least 60 years old and have a systolic blood pressure averaging 160-219 mmHg with a diastolic blood pressure less than 95 mmHg. The present paper in an interim report on the first 316 patients randomized into this trial. The placebo (N = 170) and active treatment (N = 146) groups were similar at randomization with respect to age (73 +/- 8 years; mean +/- standard deviation), sitting blood pressure (178 +/- 12/85 +/- 7 mmHg), percentage men (34%) and percentage of patients with cardiovascular complications (29%). After randomization blood pressure fell more (p < 0.001) on active treatment than in the placebo group (19 +/- 20/6 +/- 10 mmHg versus 7 +/- 19/1 +/- 10 mmHg for the sitting blood pressure). This first interim report on the Syst-Eur trial demonstrates that a multinational trial in elderly patients with ISH is feasible and that a significant blood pressure difference between the 2 treatment groups can be achieved and maintained. New centres are being recruited in order to randomize a total of 3,000 patients.
Arch Mal Coeur Vaiss 1992 Aug
PMID:[SYST-EUR: a multicenter trial of treatment of systolic hypertension in aged subjects. An initial report]. 148 67

Systemic embolism secondary to chronic atrial fibrillation usually affect the cerebral circulation. The risk of a cerebrovascular accident in patients with chronic atrial fibrillation, irrespective of the aetiology, is 1.8 to 7.5 times that of the general population. The embolic risk is 18 times greater in patients with atrial fibrillation related to the rheumatic heart disease. The risk of patients under 60 years of age with idiopathic atrial fibrillation does not seem to be different to that of the general population. The risk of early recurrence of embolism in the first 30 days ranges from 8 to 15%. The risk of late recurrence varies but seems to be higher than that of the general population. The prognosis of embolic cerebrovascular accidents is poor with a 20% mortality rate. The benefits of preventive therapy of embolism with oral anticoagulants have been clearly established in rheumatic atrial fibrillation and in other indications. In non-valvular atrial fibrillation the benefits have to be compared with the risks of treatment. The incidence of hemorrhage due to anticoagulant therapy is between 3 and 5% per year per patient (about 1% of severe haemorrhage). Three randomised studies of primary prevention have shown a significant reduction of the embolic risk in non-valvular atrial fibrillation treated by warfarin compared to patients on placebo. Only one study has shown a significant reduction of the embolic risk in patients under 75 years of age with non-valvular atrial fibrillation treated with 325 mg/day of aspirin. However, anticoagulant therapy does not seem necessary in carefully selected patients under 60 years of age with idiopathic atrial fibrillation (less than 5% of all patients).
Arch Mal Coeur Vaiss 1992 Mar
PMID:[Embolic complications of chronic atrial fibrillation]. 157 9


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