4 results on '"beta-blocker"'
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2. Cardiomyopathie cirrhotique : une entité spécifique
- Author
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Brondex, A., Arlès, F., Lipovac, A.-S., Richecoeur, M., and Bronstein, J.-A.
- Subjects
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CIRRHOSIS of the liver , *CARDIOMYOPATHIES , *HEMODYNAMICS , *HEART abnormalities , *VASODILATION , *PERITONEOVENOUS shunts - Abstract
Abstract: Cirrhosis is a frequent and severe condition, which is the late stage of numerous chronic liver diseases. It is associated with major hemodynamic alterations characteristic of hyperdynamic circulation and with a series of structural, functional, electrophysiological and biological heart abnormalities termed cirrhotic cardiomyopathy. The pathogenesis of this syndrome is multifactorial. It is usually clinically latent or mild, likely because the peripheral vasodilatation significantly reduces the left ventricle afterload. However, sudden changes of hemodynamic state (vascular filling, surgical or transjugular intrahepatic porto-systemic shunts, peritoneo-venous shunts and orthotopic liver transplantation) or myocardial contractility (introduction of beta-blocker therapy) can unmask its presence, and sometimes convert latent to overt heart failure. Cirrhotic cardiomyopathy may also contribute to the pathogenesis of hepatorenal syndrome. This entity has been described recently, and its diagnostic criteria are still under debate. To date, current management recommendations are empirical, nonspecific measures. Recognition of cirrhotic cardiomyopathy depends on a high level of awareness for the presence of this syndrome, particularly in patients with advanced cirrhosis who undergo significant surgical, pharmacological or physiological stresses. [Copyright &y& Elsevier]
- Published
- 2012
- Full Text
- View/download PDF
3. Traitement médical des troubles du rythme.
- Author
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Dinanian, S.
- Subjects
MYOCARDIAL depressants ,ELECTRIC countershock ,ATRIAL fibrillation ,CATHETER ablation ,ANTICOAGULANTS ,CARDIOMYOPATHIES - Abstract
Copyright of EMC-Cardiologie-Angeiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2005
- Full Text
- View/download PDF
4. L’évaluation des déterminants des paramètres hémodynamiques centraux à l’aide de la cohorte populationnelle CARTaGENE
- Author
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Goupil, Rémi and Troyanov, Stéphan
- Subjects
Pression pulsée centrale ,Central pulse pressure ,Augmentation index ,Bêtabloqueurs ,Pression artérielle centrale ,Central hemodynamic parameters ,Paramètres hémodynamiques centraux ,Chronic kidney disease ,Hypertension ,Insuffisance rénale chronique ,CARTaGENE ,Beta-blocker ,Index d’augmentation ,Central blood pressure - Abstract
Les maladies cardiovasculaires ont un impact considérable sur la vie des Canadiens, et de nombreux efforts ont permis d’identifier différents facteurs de risque associés à cette condition. L’hypertension artérielle représente un de ces facteurs modifiables les plus importants. Quoique l’hypertension est définie à l’aide de mesures de pression artérielle en périphérie, il devient de plus en plus apparent que la mesure de pression centrale et de ses composantes auraient des avantages au niveau de la prédiction de la survenue d’événements cardiovasculaires. Le présent mémoire vise à mieux caractériser deux déterminants de cette pression centrale, le traitement antihypertenseur à base de bêtabloqueurs et l’insuffisance rénale chronique précoce. En utilisant les données recueillies dans la banque de données populationnelle CARTaGENE, il a été possible à l’aide d’analyses statistiques par appariement basé sur le coefficient de propension de démontrer que l’utilisation d’agents antihypertensifs de type bêtabloqueurs était associée à un profil hémodynamique central défavorable. Ainsi, les individus recevant ces agents avaient une pression centrale et une amplification artérielle plus élevées que des individus du groupe contrôle apparié et ce, malgré une pression périphérique identique. Cet effet semblait être incomplètement expliqué par la réduction du rythme cardiaque associé à l’utilisation de bêtabloqueurs. Aussi, il a été démontré que l’insuffisance rénale chronique de stade 3 (débit de filtration glomérulaire estimé entre 30 et 60 mL/min/1.73m2) n’était pas associée à une élévation des paramètres hémodynamiques centraux, contrairement à ce qui avait déjà été décrit chez des individus avec insuffisance rénale chronique plus avancée. De plus, le niveau d’albuminurie ne serait également pas associé à un changement du profil central dans un sous-groupe de la cohorte CARTaGENE., Cardiovascular diseases have a large impact on Canadian’s lives, and throughout the years, several risk factors associated with this condition have been identified. Hypertension represents an important of the modifiable risk factors. While high blood pressure is usually defined using peripheral blood pressure measurements, it has recently been shown that measurements of the central blood pressure and its components are more precise predictors of incident cardiovascular events. The thesis aims at better characterising mainly two determinants of central blood pressure: beta-blocker use for the treatment of hypertension and early chronic kidney disease. Using data from the CARTaGENE populational cohort and propensity score matching techniques, it was shown that beta-blockers use in the treatment of hypertension are associated with an unfavorable central hemodynamic profile. Hence, individuals receiving these agents had higher central blood pressures and arterial amplification than individuals of the matched control group, despite identical peripheral blood pressures. This effect was mostly, but not only, explained by the associated reduction of the heart rate. It was also shown that stage 3 chronic kidney disease (estimated glomerular filtration rate between 30 and 60 mL/min/1.73m2) was not associated with an increase in central hemodynamic parameters, unlike what was previously shown in individuals with more advanced chronic kidney disease. Furthermore, albuminuria was not associated with detrimental changes in the central hemodynamic profile in a subset of CARTaGENE.
- Published
- 2016
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