Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0264733 (ventricular dilatation)
 2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since several methods based on doppler-echocardiography have been suggested to quantify aortic valve regurgitation, we compared two of these methods--left ventricular diastolic jet mapping and evaluation of blood flow in the descending aorta--with the results of left heart catheterization in 82 patients with aortic regurgitation. The invasive quantification rested on the degree of left ventricular opacification after contrast injection into the supra-sigmoid aorta, the results being classified into 3 grades. Left ventricular mapping was carried out using pulsed doppler ultrasound by the apical route; results were expressed as 3 grades of increasing severity. Blood flow in the aorta was recorded using pulsed doppler velocimetry by the suprasternal route at the level of the aortic isthmus where we measured the diastolic to systolic velocity integrals ratio (D/S). Apical mapping could be performed in 81 of the 82 patients, whereas suprasternal planimetry could be performed in only 56 patients (68 p. 100). Mapping provided good correlations with catheterization in 65 patients (80 p. 100); discordances were observed mainly in patients with aortic leakage due to prosthetic valve dysfunction (4/8 prosthetic valves) or with major left ventricular dilatation (found in 7 out of 9 cases of underestimation of leakage by the doppler system). The D/S ratio values obtained by the suprasternal route ranged from 16 to 28 p. 100 for mild angiographic leakage, from 34 to 66 p. 100 for moderate leakage, and from 52 to 155 p. 100 for severe leakage. "Borderline" values of 30 and 60 p. 100 respectively enabled the various degrees of aortic regurgitation to be separated. Despite their limitations, the non-invasive methods used in combination are effective in quantifying aortic regurgitation in most cases; mapping offers the advantage of simplicity: the suprasternal study is more accurate but cannot be performed in all patients.
Arch Mal Coeur Vaiss
PMID:[Pulsed Doppler echography in the quantification of aortic insufficiency in adults]. 250 92

It is important to know the natural evolution of the changes in left ventricular dimensions and contractility in AR if one wishes to determine the critical echocardiographic values at which LV function starts to deteriorate. This was the aim of our echocardiographic study of 90 patients with chronic pure AR in whom we analysed the changes in LV dimensions, mass and contractility for 11 to 84 months (average 34.6 months). The patients were divided into 2 groups according to the degree of ventricular dilatation (delta DD): Group A: delta DD less than 30% (58 patients), Group B: delta DD greater than 30% (32 patients). The annual mean increase in diastolic and systolic LV dimensions and myocardial mass in each group was: 1.5 mm vs 3.2 mm (p less than 0.02); 0.9 mm vs 4.1 mm (p less than 0.003), 14 g vs 24 g (p = 0.07 NS) respectively. The parameters of the systolic function were normal in Group A (EF = 68 +/- 8% and % FS = 38 +/- 6%) and decreased in Group B (EF = 58 +/- 13%, % FS = 32 +/- 9%). A significant annual decrease of the mean values of these parameters was only observed in patients of Group B (EF = 1.8% per year; % FS = -1.2% per year). These results are on average of unequal individual variations: variations of DD or EF greater than the variability due to the reproducibility of the method were only observed in 43 patients. The number of patients in whom echocardiographic changes were observed was comparable in Groups A and B.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1985 Nov
PMID:[Median-term course of left ventricular effects in aortic insufficiency. Echocardiographic study of 90 patients]. 293 8

Cardiac failure caused by high doses of amphetamine-like drugs is rare. We report a case of decompensated congestive cardiomyopathy occurring in a 29 year old woman addicted to clobenzorex (Dinintel). This patient had been taking 5 to 7 capsules per day for 5 years. No other cause of cardiac failure was detected. A rapid improvement was obtained by digitalis and diuretic therapy; no further episodes of cardiac failure were observed after one year. However, the drug could not be completely withdrawn and echocardiography has shown increasing left ventricular dilatation. The possible mechanisms of amphetamine induced myocardial toxicity are discussed and the analogy with the group of adrenergic cardiomyopathies is underlined.
Arch Mal Coeur Vaiss 1986 Apr
PMID:[Congestive cardiomyopathy in addiction to clobenzorex, an anorexigenic drug]. 309 Sep 71

The aim of this study was to assess the outcome of 79 patients operated for chronic, pure, severe aortic incompetence with little or no symptoms (Grades I or II of the NYHA Classification). The average age of the patients was 42 years (range 14 to 76 years) and the average follow-up period was 59.4 months (range 3 to 190 months). The preoperative left ventricular volumes on angiography were: end diastolic volume 224 +/- 47 ml/m2, end systolic volume 121 +/- 39 ml/m2. The ejection fraction was 48 +/- 10 p. 100. Forty two mechanical prostheses and 37 bioprostheses were implanted. There were no operative deaths. The 8 year survival rate was 87 p. 100. Ninety four per cent of the survivors remained asymptomatic; 91 p. 100 have had no thromboembolic complications and 90 p. 100 have not been reoperated. The incidence of myocardial dysfunction was 8.8 p. 100 during this period. The most significant poor prognostic factor was a preoperative ejection fraction of less than 40 p. 100. These results show that early surgery in patients with aortic incompetence and little or no symptoms has a low operative risk and a low incidence of late myocardial dysfunction despite severe left ventricular dilatation with decreased left ventricular function.
Arch Mal Coeur Vaiss 1987 Jan
PMID:[Results of valvular replacement in chronic or paucisymptomatic aortic insufficiency. Apropos of 79 patients]. 310 94

Changes in left ventricular function were evaluated in twelve patients with aortic valve stenosis and in eleven patients with aortic valve regurgitation in order to find out whether the results obtained soon after aortic valve replacement persisted over a long period. All patients had been provided with a St-Jude Medical valve. Evaluation included electrocardiography, radiography of the chest, phonocarotidography and echocardiography and was performed preoperatively, then three months and five years on average in each patient after surgery. In patients with aortic valve stenosis, the left ventricular mass clearly regressed during the first three months (p less than 0.01) and continued to regress, albeit not significantly, over five years. In patients with aortic valve regurgitation, the left ventricular volume and mass regressed significantly during the first three months and remained normal for five years. No significant variation in systolic performance was observed in both groups. In spite of good overall results, 26 p. 100 of the patients had an unfavourable long-term outcome as they developed major left ventricular dilatation. Nos prosthesis dysfunction was observed, and the St Jude Medical valve caused little obstruction. Thus, with this little obstructive prosthesis the postoperative improvement obtained persisted for five years in most cases of aortic valve stenosis or regurgitation.
Arch Mal Coeur Vaiss 1988 Apr
PMID:[Development of left ventricular function following aortic valve replacement]. 313 9

The M mode echocardiographic recordings of 52 normal mitral bioprostheses (NMB), 7 pathological mitral bioprostheses (PMB), 30 normal aortic bioprostheses (NAB) and 10 pathological aortic bioprostheses (PAB) were reviewed. In normal bioprostheses a significant correlation was observed between the echocardiographic and the "specified" diameters, the diastolic and systolic slopes and the amplitude of anterior motion of the support. In NMB, the end-systolic diameter of the left ventricular outflow tract depended on the "specified" diameter of the bioprosthesis. Paradoxical septal motion was observed in 78 p. 100 of cases. In PMB, the velocity of anterior leaflet opening was significantly increased (p less than 0.001). The end-diastolic internal left ventricular dimension was also increased (p less than 0.01). A significant correlation was found between left ventricular fractional shortening and maximal leaflet separation (p less than 0.05). Normal septal motion was more common (p less than 0.05). In 5 cases of prosthetic valve dysfunction with mitral regurgitation the maximal leaflet separation was greater than normal (p less than 0.001), the diastolic slope of the support was increased (p less than 0.05) and diastolic vibrations of thickened irregular leaflets were observed. Systolo-diastolic vibrations with chaotic leaflet motion were characteristic of cusp tear and/or eversion. Stratified echos behind a support with reduced leaflet excursion was observed in one case of partial thrombosis: a thickened systolic echo with reduced diastolic excursion was observed in a case of degenerative stenosis. The review of 10 PAB showed a reduced amplitude of systolic excursion of the anterior support in cases of aortic regurgitation (p less than 0.05). Systolic vibrations of the cusp were not specific and were observed in normal cases. In severe valvular regurgitation mitral and/or septal diastolic fluttering was observed. Systolic excursion of the cusps was reduced in cases of relative stenosis due to an inappropriately small sized bioprosthesis. Thickening of the diastolic cusp echos was observed in cases of degenerative stenosis. Ventricular dilatation and reduced septal and free wall motion were dysfunction.
Arch Mal Coeur Vaiss 1985 Apr
PMID:[Aortic and mitral valve bioprostheses. Normal and pathological M mode echocardiographic aspects]. 392 85

One hundred and six patients fulfilling accepted diagnostic criteria for Kawasaki disease (90 p. 100 of French-Canadian origin) were evaluated with serial electrocardiograms and echocardiograms (M mode and two-dimensional). Half of the patients (53) had cardiovascular manifestations at one time during their illness. Thirty-one had abnormal electrocardiograms: non specific ST and T wave changes inferiorly (27), prolonged QT intervals (6), first degree AV block (3). M mode echo was abnormal in 31 cases showing: slight pericardial effusion (17), flat septal movement (11), left ventricular dilatation (4), decrease of shortening fraction (2). Seven patients (6.4 p. 100) presented fusiform coronary aneurysm detected in 6 by two-dimensional echography (with angiographic confirmation) and at autopsy in another. M mode echo and electrocardiogram abnormalities were transient in the great majority of patients disappearing during an average follow-up period of 10 months. Coronary aneurysm had disappeared at the end of follow-up in two patients, regressed in three and remained identical in another. There were no relations between severity of clinical symptoms, electrocardiographic or echocardiographic (M mode) abnormalities and the development of coronary aneurysm. Serial studies with two-dimensional echo should be done in every patient with this disease for early detection and follow-up of coronary aneurysm.
Arch Mal Coeur Vaiss 1985 May
PMID:[Kawasaki's disease. Epidemiological aspects and cardiovascular manifestations. Apropos of 106 cases]. 392 13

The authors report the case of a baby in whom an ectopic left coronary artery arising from the pulmonary artery was suspected on clinical and, in particular, electrocardiographic criteria. M mode echocardiography showed left ventricular dilatation with reduced shortening fraction of the LV internal diameter. 2D echocardiography with a mechanical sector scanner demonstrated the left coronary artery arising from the pulmonary artery. The short axis view of the basal vessels in the left parasternal incidence visualised 2 cm of the left coronary artery arising from the posterior part of the pulmonary artery.
Arch Mal Coeur Vaiss 1983 May
PMID:[Left coronary artery arising from the pulmonary artery. Demonstration by 2-dimensional echocardiography]. 641 Oct 37

This study was undertaken to test the validity of methods of evaluating ventricular tachycardia and in therapeutic surveillance. One hundred and thirty nine patients aged 16 to 84 years, with and without severe ventricular arrhythmias (ventricular tachycardia, VT, and fibrillation, VF) were divided into two groups after clinical, echocardiographic and 24 hour Holter investigations: Group I comprised 26 patients with a least one documented attack of VT or VF; Group II comprised 113 patients without these arrhythmias, who complained of dizziness, syncope, and/or their ECG showed a conduction defect, and so electrophysiological investigation was undertaken. A protocol of ventricular stimulation was undertaken in addition to the usual measurements of conduction times, comprising incremental ventricular stimulation from 100 to 200/min, single and paired extrastimulus in sinus rhythm and during ventricular pacing at rates of 100 and 150/min, the first extrastimulus being programmed 10 ms after the end of the ventricular effective refractory period. Excluding bundle to bundle reentry, the following results were obtained: In Group I: VT was triggered 16 times (61,5 p. 100), and in 4 of these cases VF occurred and required defibrillation. Ten patients had previous myocardial infarction; 5 patients had left ventricular dilatation. In 2 cases runs of 3 or 4 VES were recorded. No arrhythmia could be induced in 8 cases (30,8 p. 100); 5 of these patients had apparently normal hearts. In Group II: VT (greater than 5 VES) was triggered in 22 cases (19,5 p. 100) and in 4 cases this degenerated to VF requiring defibrillation. 11 patients had apparently normal hearts; 6 patients had left ventricular dilatation and 4 patients had previous myocardial infarction. 1 to 4 repetitive VES were observed in 67 cases (59,3 p. 100): the heart was judged to be normal in all patients except those with previous infarction. No correlation was established between the ability to induce VT and age, syncope, or ECG changes (especially bundle branch block). However, a correlation was found between the induction of VT and underlying cardiac disease and the method of induction of VT; in Group II, all episodes of VT were triggered by delivering paired ventricular extrastimuli on a background paced rhythm. These results show that repetitive ventricular responses can easily be triggered and that this has no pathological significance.(ABSTRACT TRUNCATED AT 400 WORDS)
Arch Mal Coeur Vaiss 1984 Mar
PMID:[Results of the systematic application of ventricular stimulation methods]. 642 12

The aim of this study was to assess the result of surgical repair of Fallot's tetralogy (FT) and to advise physical and sporting activities. Thirty-two patients (20 boys and 12 girls) underwent correction of FT either before 4 years of age (14 cases) or after (18 cases). The patients were assessed on average 7.5 years postoperatively (range 4 to 13 years). All but one were class I of the NYHA classification. Radiological cardiomegaly was observed in 3 cases (CTI greater than 0.55). Sinus rhythm was present in all cases: 27 out of 30 had complete right bundle branch block without bifascicular block. Holter monitoring was performed in 22 cases: occasional monomorphic VES (1 to 15/hour) were observed in 7 cases. Frequent polymorphic VES were observed during exercise in one adult. Echocardiography and cardiac catheterization revealed pulmonary regurgitation and right ventricular dilatation in over half the cases, with an infundibular aneurysm in 2 cases and a residual pressure gradient of 55 and 66 mmHg in 2 other cases requiring reoperation. Left ventricular function was satisfactory in all cases. Treadmill exercise testing was performed in 28 patients. However, for statistical analysis 12 boys aged 7 to 15 years were compared with 11 controls of the same age. There was a significant decrease in maximal O2 consumption, of CO2 excretion, of ventilation, of heart rate, of work developed and total work in the operated patients. Clinical assessment and complementary investigations are essential 5 to 10 years after correction of FT to detect latent abnormalities and to better advise patients on physical and sporting activities.
Arch Mal Coeur Vaiss 1984 May
PMID:[Long-term evaluation, physical and sports activities after correction of Fallot's tetralogy]. 642 51


<< Previous 1 2 3 4 5 Next >>