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4. Transcatheter aortic valve implantation: early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry

Author

Eltchaninoff, Hélène, Prat, Alain, Gilard, Martine, Leguerrier, Alain, Blanchard, Didier, Fournial, Gérard, Iung, Bernard, Donzeau-Gouge, Patrick, Tribouilloy, Christophe, Debrux, Jean-Louis, Pavie, Alain, Gueret, Pascal, Leprince, P, Beygui, F, Collet, J-P, Himbert, D, Nataf, P, Vahanian, A, Lefevre, T, Romano, M, Eltchaninoff, H, Litzler, P-Y, Bessou, J-P, Cribier, A, Fajadet, J, Carrie, D, Berthoumieu, P, Dumonteil, N, Fournial, G, Teiger, E, Dubois Randé, J-L, Kirsch, M, Blanchard, D, Fabiani, J-N, Sudre, A, Modine, T, Dos Santos, P, Guibaud, J-P, Roques, X, Gilard, M, Boschat, J, Bezon, E, Schiele, F, Chocron, S, Meneveau, N, Bassand, JP, Rioufol, G, Obadia, J-F, Tirouvanziam, A, Roussel, J-C, Crochet, D, Collard, F, Bonnet, J-L, Cuisset, T, Wolf, J-E, Bouchot, O, Gueret, P, Pavie, A, Blanchard, D, Debrux, J-L, Donzeau-Gouge, P, Eltchaninoff, H, Gilard, M, Iung, B, Leguerrier, A, Prat, A, Tribouilloy, C, and Chevreul, K

Published
2011
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8. Late Outcomes of Transcatheter Aortic Valve Replacement in High-Risk Patients: The FRANCE-2 Registry

Author

Gilard, M., Eltchaninoff, H., Donzeau-Gouge, P., Chevreul, K., Fajadet, J., Leprince, P., Leguerrier, A., Lievre, M., Prat, A., Teiger, E., Lefevre, T., Tchetche, D., Carrie, D., Himbert, D., Albat, B., Cribier, A., Sudre, A., Blanchard, D., Rioufol, G., Collet, F., Houel, R., Dos Santos, P., Meneveau, N., Ghostine, S., Manigold, T., Guyon, P., Grisoli, D., Le Breton, H., Delpine, S., Didier, R., Favereau, X., Souteyrand, G., Ohlmann, P., Doisy, V., Grollier, G., Gommeaux, A., Claudel, J. -P., Bourlon, F., Bertrand, B., Laskar, M., Iung, B., Bertrand, M., Cassagne, J., Boschat, J., Lusson, J. R., Mathieu, P., Logeais, Y., Bessou, J. -P., Chevalier, B., Farge, A., Garot, P., Hovasse, T., Morice, M. C., Romano, M., Gouge, P. D., Vahdat, O., Farah, B., Dumonteil, N., Fournial, G., Marcheix, B., Nataf, P., Vahanian, A., Leclercq, F., Piot, C., Schmutz, L., Aubas, P., du Cailar, A., Dubar, A., Durrleman, N., Fargosz, F., Levy, G., Maupas, E., Rivalland, F., Robert, G., Tron, C., Juthier, F., Modine, T., Van Belle, E., Banfi, C., Sallerin, T., Bar, O., Barbey, C., Chassaing, S., Chatel, D., Le Page, O., Tauran, A., Cao, D., Dauphin, R., Durand de Gevigney, G., Finet, G., Jegaden, O., Obadia, J. -F., Beygui, F., Collet, J. -P., Pavie, A., Pecheux, Bayet, Vaillant, A., Vicat, J., Wittenberg, O., Joly, P., Rosario, R., Bergeron, P., Bille, J., Gelisse, R., Couetil, J. -P., Dubois Rande, J. -L., Hayat, D., Fougeres, E., Monin, J. -L., Mouillet, G., Arsac, F., Choukroun, E., Dijos, M., Guibaud, J. -P., Leroux, L., Elia, N., Descotes, Genon, Chocron, S., Schiele, F., Caussin, C., Azmoun, A., Nottin, R., Tirouvanziam, A., Crochet, D., Gaudin, R., Roussel, J. -C., Bonnet, N., Digne, F., Mesnidrey, P., Royer, T., Stratiev, V., Bonnet, J. -L., Cuisset, T., Abouliatim, I., Bedossa, M., Boulmier, D., Verhoye, J. P., Delepine, S., Debrux, J. -L., Furber, A., Pinaud, F., Bezon, E., Choplain, J. -N., Bical, O., Dambrin, G., Deleuze, P., Jegou, A., Lusson, J. -R., Azarnouch, K., Durel, N., Innorta, A., Lienhart, Y., Roriz, R., Staat, P., Fabiani, J. -N., Lafont, A., Zegdi, R., Heudes, D., Kindo, M., Mazzucotelli, J. -P., Zupan, M., Ivascau, C., Lognone, T., Massetti, M., Sabatier, R., Huret, B., Hochart, P., Pecheux, Bouchayer, D., Gabrielle, F., Pelissier, F., Tremeau, G., Dreyfus, G., Eker, A., Habib, Y., Hugues, N., Mialhe, C., Chavanon, O., Porcu, P., Vanzetto, G., Banfi C., Massetti M. (ORCID:0000-0002-7100-8478), Gilard, M., Eltchaninoff, H., Donzeau-Gouge, P., Chevreul, K., Fajadet, J., Leprince, P., Leguerrier, A., Lievre, M., Prat, A., Teiger, E., Lefevre, T., Tchetche, D., Carrie, D., Himbert, D., Albat, B., Cribier, A., Sudre, A., Blanchard, D., Rioufol, G., Collet, F., Houel, R., Dos Santos, P., Meneveau, N., Ghostine, S., Manigold, T., Guyon, P., Grisoli, D., Le Breton, H., Delpine, S., Didier, R., Favereau, X., Souteyrand, G., Ohlmann, P., Doisy, V., Grollier, G., Gommeaux, A., Claudel, J. -P., Bourlon, F., Bertrand, B., Laskar, M., Iung, B., Bertrand, M., Cassagne, J., Boschat, J., Lusson, J. R., Mathieu, P., Logeais, Y., Bessou, J. -P., Chevalier, B., Farge, A., Garot, P., Hovasse, T., Morice, M. C., Romano, M., Gouge, P. D., Vahdat, O., Farah, B., Dumonteil, N., Fournial, G., Marcheix, B., Nataf, P., Vahanian, A., Leclercq, F., Piot, C., Schmutz, L., Aubas, P., du Cailar, A., Dubar, A., Durrleman, N., Fargosz, F., Levy, G., Maupas, E., Rivalland, F., Robert, G., Tron, C., Juthier, F., Modine, T., Van Belle, E., Banfi, C., Sallerin, T., Bar, O., Barbey, C., Chassaing, S., Chatel, D., Le Page, O., Tauran, A., Cao, D., Dauphin, R., Durand de Gevigney, G., Finet, G., Jegaden, O., Obadia, J. -F., Beygui, F., Collet, J. -P., Pavie, A., Pecheux, Bayet, Vaillant, A., Vicat, J., Wittenberg, O., Joly, P., Rosario, R., Bergeron, P., Bille, J., Gelisse, R., Couetil, J. -P., Dubois Rande, J. -L., Hayat, D., Fougeres, E., Monin, J. -L., Mouillet, G., Arsac, F., Choukroun, E., Dijos, M., Guibaud, J. -P., Leroux, L., Elia, N., Descotes, Genon, Chocron, S., Schiele, F., Caussin, C., Azmoun, A., Nottin, R., Tirouvanziam, A., Crochet, D., Gaudin, R., Roussel, J. -C., Bonnet, N., Digne, F., Mesnidrey, P., Royer, T., Stratiev, V., Bonnet, J. -L., Cuisset, T., Abouliatim, I., Bedossa, M., Boulmier, D., Verhoye, J. P., Delepine, S., Debrux, J. -L., Furber, A., Pinaud, F., Bezon, E., Choplain, J. -N., Bical, O., Dambrin, G., Deleuze, P., Jegou, A., Lusson, J. -R., Azarnouch, K., Durel, N., Innorta, A., Lienhart, Y., Roriz, R., Staat, P., Fabiani, J. -N., Lafont, A., Zegdi, R., Heudes, D., Kindo, M., Mazzucotelli, J. -P., Zupan, M., Ivascau, C., Lognone, T., Massetti, M., Sabatier, R., Huret, B., Hochart, P., Pecheux, Bouchayer, D., Gabrielle, F., Pelissier, F., Tremeau, G., Dreyfus, G., Eker, A., Habib, Y., Hugues, N., Mialhe, C., Chavanon, O., Porcu, P., Vanzetto, G., Banfi C., and Massetti M. (ORCID:0000-0002-7100-8478)

Abstract

Background Transcatheter aortic valve replacement (TAVR) has revolutionized management of high-risk patients with severe aortic stenosis. However, survival and the incidence of severe complications have been assessed in relatively small populations and/or with limited follow-up. Objectives This report details late clinical outcome and its determinants in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. Methods The FRANCE-2 registry prospectively included all TAVRs performed in France. Follow-up was scheduled at 30 days, at 6 months, and annually from 1 to 5 years. Standardized VARC (Valve Academic Research Consortium) outcome definitions were used. Results A total of 4,201 patients were enrolled between January 2010 and January 2012 in 34 centers. Approaches were transarterial (transfemoral 73%, transapical 18%, subclavian 6%, and transaortic or transcarotid 3%) or, in 18% of patients, transapical. Median follow-up was 3.8 years. Vital status was available for 97.2% of patients at 3 years. The 3-year all-cause mortality was 42.0% and cardiovascular mortality was 17.5%. In a multivariate model, predictors of 3-year all-cause mortality were male sex (p < 0.001), low body mass index, (p < 0.001), atrial fibrillation (p < 0.001), dialysis (p < 0.001), New York Heart Association functional class III or IV (p < 0.001), higher logistic EuroSCORE (p < 0.001), transapical or subclavian approach (p < 0.001 for both vs. transfemoral approach), need for permanent pacemaker implantation (p = 0.02), and post-implant periprosthetic aortic regurgitation grade ≥2 of 4 (p < 0.001). Severe events according to VARC criteria occurred mainly during the first month and subsequently in <2% of patients/year. Mean gradient, valve area, and residual aortic regurgitation were stable during follow-up. Conclusions The FRANCE-2 registry represents the largest database available on late results of TAVR. Late mortality is largely related to noncardiac

Published
2016

10. Randomised comparison of coronary stenting with and without balloon predilatation in selected patients

Author

Breton, H Le, Boschat, J, Commeau, P, Brunel, P, Guard, M, Breut, C, Bar, O, Geslin, P, Tirouvanziam, A, Maillard, L, Moquet, B, Barragan, P, Dupouy, P, Grollier, G, Berland, J, Druelles, P, Rihani, R, Huret, B, Leclercq, C, and Bedossa, M

Subjects
Coronary heart disease -- Care and treatment, Stent (Surgery) -- Methods, Health, Care and treatment, Methods
Abstract

Abstract Background--The SWIBAP (stent without balloon predilatation) prospective randomised trial was designed to compare direct coronary stenting with stenting preceded by lesion predilatation with an angioplasty balloon. Objective--To determine the [...]

Published
2001

12. [Acute pericarditis: results of a survey of treatment practices of cardiologists]

Author

Jc, Cornily, Le Gal G, Tn, Tram-Lebaillif, Martine Gilard, Boschat J, Jj, Blanc, Calvez, Ghislaine, Service de Cardiologie (BREST - Cardio), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)

Subjects
Anti-Inflammatory Agents, Ibuprofen, MESH: Hospitalization, Surveys and Questionnaires, Humans, Pericarditis, Practice Patterns, Physicians', MESH: Aspirin, MESH: Pericarditis, MESH: Physician's Practice Patterns, MESH: Humans, MESH: Middle Aged, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Aspirin, MESH: Questionnaires, Middle Aged, MESH: Ibuprofen, Hospitalization, MESH: France, MESH: Colchicine, MESH: Platelet Aggregation Inhibitors, MESH: Anti-Inflammatory Agents, Acute Disease, MESH: Acute Disease, France, Colchicine, Platelet Aggregation Inhibitors, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; UNLABELLED: Benign acute pericarditis is a common disorder. Although, at first glance, its management appears well defined, the guidelines issued by professional societies with respect to optimal treatment and length of its administration remain vague. METHODS: a brief, anonymous questionnaire probing into treatment practices was sent in April 2005 to all cardiologists of Brittany. RESULTS: we collected 164 analyzable questionnaires out of 248 submitted (66%). The initial investigations in presence of acute pericarditis included an electrocardiogram in 100% of cases, an echocardiogram in 95%, and screening biochemistry in 93% of cases. Systematic hospitalisation was advised by only 24% of cardiologists. Aspirin was prescribed as first choice treatment in 92.5% of cases. Duration of treatment recommendations varied widely, from 21 days by 14% of cardiologists. Hospital-based cardiologists were more likely to systematically hospitalise their patients than outpatient practice-based physicians (79.5% versus 5.1%; p

Published
2006

13. [Coronary prosthesis implantation. Immediate and mid-term results]

Author

Jp, Elkaim, Moal G, Martine Gilard, Jobic Y, Etienne Y, Mansourati J, Jj, Blanc, and Boschat J

Subjects
Male, Myocardial Infarction, Coronary Disease, Middle Aged, Coronary Angiography, Prognosis, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Treatment Outcome, Humans, Female, Stents, Aged, Retrospective Studies
Abstract

The aim of this study was to evaluate the clinical events occurring after coronary stenting in a series of 318 consecutive patients treated in 1997. Hospital follow-up was by gathering all the data in the hospital record and medium-term follow-up was performed by questionnaire filled with the help of the patient, the attending physician and the referring cardiologist. The primary clinical success rate was 95.6% and the clinical follow-up rate was 98.7%. The follow-up period was at least 16 months (mean 22 +/- 6 months). The restenosis rate was 15% in the remaining population (318-7 deaths and 4 lost to follow-up) and 47% in the population undergoing control coronary angiography. No major clinical cardiac events (death, myocardial infarction or revascularisation) were observed in 80.5% at 1 year and 79% at 22 months. Twenty per cent of the remaining population had no non-invasive paraclinical investigations for myocardial ischaemia after coronary stenting. These results are comparable to those of the literature, indicating excellent feasibility of this technique and the fact that, programmed or not, coronary stenting is a safe procedure confirming its value in what has become everyday practice. Nevertheless, this experience did highlight certain lapses in medical follow-up and patient information.

Published
2001

14. Registry of transcatheter aortic-valve implantation in high-risk patients

Author

Gilard, M., Eltchaninoff, H., Iung, B., Chevreul, K., Fajadet, J., Leprince, P., Leguerrier, A., Lievre, M., Prat, A., Teiger, E., Lefevre, T., Himbert, D., Tchetche, D., Carriè, D., Albat, B., Cribier, A., Rioufol, G., Sudre, A., Blanchard, D., Collet, F., Dos Santos, P., Meneveau, N., Tirouvanziam, A., Caussin, C., Guyon, P., Boschat, J., Le Breton, H., Collart, F., Houel, R., Delpine, S., Souteyrand, G., Favereau, X., Ohlmann, P., Doisy, V., Grollier, G., Gommeaux, A., Massetti, Massimo, Massetti, Massimo (ORCID:0000-0002-7100-8478), Gilard, M., Eltchaninoff, H., Iung, B., Chevreul, K., Fajadet, J., Leprince, P., Leguerrier, A., Lievre, M., Prat, A., Teiger, E., Lefevre, T., Himbert, D., Tchetche, D., Carriè, D., Albat, B., Cribier, A., Rioufol, G., Sudre, A., Blanchard, D., Collet, F., Dos Santos, P., Meneveau, N., Tirouvanziam, A., Caussin, C., Guyon, P., Boschat, J., Le Breton, H., Collart, F., Houel, R., Delpine, S., Souteyrand, G., Favereau, X., Ohlmann, P., Doisy, V., Grollier, G., Gommeaux, A., Massetti, Massimo, and Massetti, Massimo (ORCID:0000-0002-7100-8478)

Abstract

Transcatheter aortic-valve implantation (TAVI) is an emerging intervention for the treatment of high-risk patients with severe aortic stenosis and coexisting illnesses. We report the results of a prospective multicenter study of the French national transcatheter aortic-valve implantation registry, FRANCE 2.

Published
2012

15. [Evaluation of carotid intima-media thickness in patients with severe aortic stenosis. Thrombosis group study in eastern Brittany]

Author

Mansourati J, Bressollette L, Chappuis L, Oger E, Martine Gilard, Boschat J, and Jj, Blanc

Subjects
Male, Ultrasonography, Doppler, Duplex, Carotid Arteries, Predictive Value of Tests, Diagnostic Techniques, Cardiovascular, Humans, Female, Aortic Valve Stenosis, Middle Aged, Coronary Angiography, Tunica Intima, Aged
Abstract

Coronary angiography is a recommended investigation in the preoperative assessment of aortic valve replacement for aortic stenosis in the absence of a reliable non-invasive diagnostic method. Ultrasonographic quantification of carotid artery intima-media thickness, being correlated to the severity of coronary atherosclerosis, could therefore be useful in the screening of coronary artery disease in severe aortic stenosis. The authors studied a group of 100 patients (69.5 +/- 8.5 years: 64 men) with severe aortic stenosis. A control group of 45 patients with coronary artery disease without valvular disease (69.5 +/- 6 years: 30 men) was used for reference. Significant coronary artery disease was found in 21 of the 100 study cases. The average intima-media thickness was 0.608 +/- 0.090 mm. There was no significant difference in intima-media thickness between the coronary and non-coronary patients of the study group (0.612 +/- 0.094 mm and 0.607 +/- 0.094 mm respectively). It was, however, significantly greater in the control group patients compared with the 21 coronary patients in the study group (0.699 +/- 0.082 mm and 0.612 +/- 0.094 mm; p = 0.0004). Finally, 71.1% of patients in the control group had atheromatous carotid artery plaques compared with 59% in the study group (p = 0.005). The measurement of carotid intima-media thickness does not allow detection of coronary patients in severe aortic stenosis. The finding of a lower intima-media thickness in this population compared with coronary patients without valvular disease suggests that aortic stenosis may have a protective effect on the wall thickness of carotid arteries.

Published
1998

16. [Myocardial infarction caused by acute left main coronary artery occlusion. Apropos of 4 cases and review of the literature]

Author

Martine Gilard, Bouquin V, Boschat J, Provost K, Jobic Y, Jm, Larlet, Guillo P, and Jj, Blanc

Subjects
Adult, Male, Intra-Aortic Balloon Pumping, Coronary Thrombosis, Myocardial Infarction, Middle Aged, Coronary Angiography, Fatal Outcome, Heart Block, Postoperative Complications, Treatment Outcome, Humans, Stents, Angioplasty, Balloon, Coronary, Emergencies, Follow-Up Studies
Abstract

Between 1979 and 1996, 4 acute occlusions of the left main coronary artery (LMC) were treated by primary transluminal coronary angioplasty. They were 4 men with a mean age of 43 +/- 5 years, admitted to hospital less than 8 hours after the clinical onset of symptoms of anterior myocardial infarction in Killip class 4 with complete right bundle branch block on the initial electrocardiogramme. All cases had a previous history of unstable angina over 2 to 15 days. Angioplasty was undertaken immediately in view of the haemodynamic instability. The coronary circulation was of a dominant right coronary type in the 4 cases: significant stenoses were discovered after recanalisation, on the left anterior descending artery (LAD) in 2 cases and the circumflex or marginal arteries in 3 cases. The right coronary artery was atheromatous in all cases but without significant stenosis. Angioplasty was completed by implantation of a stent in 3 cases (LAD : 1 case, LMC : 2 cases). The outcome was rapidly fatal in 3 cases. Only one patient survived 6 months in functional class 3. These results show that myocardial infarction due to occlusion of the left main coronary artery is a very severe condition which justifies rapid recanalisation. Primary angioplasty with stent implantation in an immediate therapeutic option which enables the patient to survive the acute stage, though only in a limited number of cases.

Published
1998

17. [Angiographic course over 10 years of giant aneurysm of the circumflex artery]

Author

Maheu B, Martine Gilard, Guillo P, Jobic Y, Mansourati J, Etienne Y, Jj, Blanc, and Boschat J

Subjects
Male, Time Factors, Coronary Aneurysm, Humans, Middle Aged, Coronary Angiography
Abstract

Pathological dilatations of the coronary arteries are not exceptional and are called megadolichoartery, aneurysm or ectasia. Cases of marked arterial dilatation, although much rarer, are regularly reported following their discovery due to the impressive angiographic, echocardiographic or autopsy findings. However, their course, particularly in the long term, remains unclear. The authors report the case of a patient with a very large spindle-shaped aneurysm of the circumflex artery whose course was able to be followed over a period of ten years on three successive angiographic assessments performed for clinical coronary events. This follow-up was dominated by thrombosis of the aneurysm, extension of the aneurysmal disease and severe deterioration of left ventricular function.

Published
1997

18. [Angioplasty and coronary restoration using the internal mammary artery]

Author

Ja, Barra, Bezon E, Mondine P, Kara Terki A, Youssef Y, Boschat J, and Martine Gilard

Subjects
Adult, Male, Angioplasty, Calcinosis, Humans, Coronary Disease, Female, Coronary Artery Disease, Endarterectomy, Middle Aged, Internal Mammary-Coronary Artery Anastomosis, Aged
Abstract

A technique of coronary surgical angioplasty is described. At the level of the stenosis the arteriotomy of the coronary artery is closed with the internal thoracic artery giving an enlargement patch effect. The major surface of the atherome plaque is excluded from the lumen of the anastomosis and put outside the suture line. The origins of the collateral arteries are kept in the vascular lumel. So the new remodeled coronary artery is formed with a small gutter of native coronary artery and the whole surface of the internal thoracic artery wall. In some cases it is useful to associate a limited endarterectomy to the angioplasty. Sixty-six surgical angioplasties have been done in extensive coronary disease. Operative mortality was 5.4% and myocardial infarction 5.4%.

Published
1995

19. Poster Session 4

Author

Tada, H., primary, Yamasaki, H., additional, Sekiguchi, Y., additional, Igarashi, M., additional, Kuroki, K., additional, Machino, T., additional, Yoshida, K., additional, Aonuma, K., additional, Heinzel, F. R., additional, Forstner, H., additional, Lercher, P., additional, Bisping, E., additional, Rotman, B., additional, Fruhwald, F. M., additional, Pieske, B. M., additional, Dabrowski, R., additional, Kowalik, I., additional, Borowiec, A., additional, Smolis-Bak, E., additional, Trybuch, A., additional, Sosnowski, C., additional, Szwed, H., additional, Baturova, M. A., additional, Lindgren, A., additional, Shubik, Y. V., additional, Olsson, B., additional, Platonov, P. G., additional, Van Den Broek, K. C., additional, Denollet, J., additional, Widdershoven, J., additional, Kupper, N., additional, Allam, R., additional, Allam, R. A. G. A. B., additional, Galal, W. A. G. D. Y., additional, El-Damnhoury, H. A. Y. A. M., additional, Mortada, A. Y. M. A. N., additional, Jimenez-Candil, J., additional, Martin, A., additional, Hernandez, J., additional, Martin, F., additional, Gallego, M., additional, Martin-Luengo, C., additional, Quintanilla, J. G., additional, Moreno Planas, J., additional, Molina-Morua, R., additional, Archondo, T., additional, Garcia-Torrent, M. J., additional, Perez-Castellano, N., additional, Macaya, C., additional, Perez-Villacastin, J., additional, Saiz, J., additional, Tobon, C., additional, Rodriguez, J. F., additional, Hornero, F., additional, Ferrero, J. M., additional, Ito, K., additional, Date, T., additional, Kawai, M., additional, Hioki, M., additional, Narui, R., additional, Matsuo, S., additional, Yoshimura, M., additional, Yamane, T., additional, Tabatabaei, N., additional, Lin, G., additional, Powell, B. D., additional, Smairat, R., additional, Glockner, J. F., additional, Brady, P. A., additional, Fichtner, S., additional, Czudnochowsky, U., additional, Estner, H., additional, Reents, T., additional, Jilek, C., additional, Ammar, S., additional, Hessling, G., additional, Deisenhofer, I., additional, Shah, D. C., additional, Kautzner, J., additional, Saoudi, N., additional, Herrera, C., additional, Jais, P., additional, Hindricks, G., additional, Neuzil, P., additional, Kuck, K. H., additional, Wong, K. C. K., additional, Jones, M., additional, Qureshi, N., additional, Muthumala, A., additional, Betts, T. R., additional, Bashir, Y., additional, Rajappan, K., additional, Vogtmann, T., additional, Wagner, M., additional, Schurig, J., additional, Hein, P., additional, Hamm, B., additional, Baumann, G., additional, Lembcke, A., additional, Saad, B., additional, Slater, C., additional, Oliveira, L. A., additional, Elias, R., additional, Camiletti, A., additional, Moura, D., additional, Maldonado, P., additional, Camanho, L. E., additional, Bulava, A., additional, Hanis, J., additional, Sitek, D., additional, Novotny, A., additional, Chik, W. B., additional, Lim, T. W., additional, Choon, H. K., additional, See, V. A., additional, Mccall, R., additional, Thomas, L., additional, Ross, D. L., additional, Thomas, S. P., additional, Chen, J., additional, De Bortoli, A., additional, Rossvoll, O., additional, Hoff, P. I., additional, Solheim, E., additional, Sun, L. Z., additional, Schuster, P., additional, Ohm, O. J., additional, Ardashev, A. V., additional, Zhelyakov, E., additional, Rybachenko, M. S., additional, Konev, A. V., additional, Belenkov, Y. U. N., additional, Gunawardene, M., additional, Chun, K. R. J., additional, Schulte-Hahn, B., additional, Windhorst, V., additional, Kulikoglu, M., additional, Nowak, B., additional, Schmidt, B., additional, Albina, G. A., additional, Rivera, R. S., additional, Scazzuso, F., additional, Laino, R. L., additional, Giniger, G. A., additional, Arbelo, E., additional, Calvo, N., additional, Tamborero, D., additional, Andreu, D., additional, Borras, R., additional, Berruezo, A., additional, Brugada, J., additional, Mont, L., additional, Stefan, L., additional, Eisenberger, M., additional, Celentano, E., additional, Peytchev, P., additional, Bodea, O., additional, Geelen, P., additional, De Potter, T., additional, Oliveira, M. M., additional, Silva, N., additional, Cunha, P. S., additional, Feliciano, J., additional, Lousinha, A., additional, Toste, A., additional, Santos, S., additional, Ferreira, R. C., additional, Matsuda, H., additional, Harada, T., additional, Soejima, K., additional, Ishikawa, Y., additional, Mizukoshi, K., additional, Sasaki, T., additional, Mizuno, K., additional, Miyake, F., additional, Adragao, P. P., additional, Cavaco, D., additional, Miranda, R., additional, Santos, M., additional, Morgado, F., additional, Reis Santos, K., additional, Candeias, R., additional, Marcelino, S., additional, Zoppo, F., additional, Grandolino, G., additional, Zerbo, F., additional, Bertaglia, E., additional, Schlueter, S. M., additional, Grebe, O., additional, Vester, E. G., additional, Miracle Blanco, A. 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I., additional, Escobales, N., additional, Crespo, M., additional, Banchs, H. L., additional, Sciarra, L., additional, Bloise, R., additional, Allocca, G., additional, Marras, E., additional, Lioy, E., additional, Delise, P., additional, Priori, S., additional, and Calo', L., additional

Published
2011
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20. [Elastic recoil after transluminal coronary angioplasty; implications of clinical and angiographic data]

Author

Boschat J, Salaun G, Martine Gilard, Jobic Y, Genet L, Etienne Y, Cornec P, and Penther P

Subjects
Adult, Male, Time Factors, Myocardial Infarction, Myocardial Ischemia, Coronary Disease, Middle Aged, Coronary Angiography, Angina Pectoris, Humans, Female, Angina, Unstable, Angioplasty, Balloon, Coronary, Aged
Abstract

Secondary elastic recoil after transluminal coronary angioplasty is a constant and immediate phenomenon after successful coronary angioplasty. It was studied by quantitative coronary angiography in 75 consecutive patients undergoing transluminal coronary angioplasty. This procedure was performed on lesions presumed to be responsible for the clinical presentation. The population was divided into 3 groups: stable angina (25 patients), unstable angina (25 patients) and recent post-infarction ischaemic syndromes (25 patients). There were 57 men and 18 women (mean age 59 +/- 11 years) with 31 left anterior descending (LA), 29 right coronary (RC) and 15 left circumflex (Cx) dilatations. The lesions dilated were eccentric in 29 cases and calcified in 37 cases whereas only one thrombus was detected at coronary angiography. The elastic recoil appreciated 10 mn after the last balloon inflation was 0.97 +/- 0.28 mm for the whole population. There was no significant difference between the 3 groups studies (respectively 0.94 +/- 0.24 mm; 0.96 +/- 0.26 mm; 0.99 +/- 0.33 mm). This appeared to be greater than the RC (1.06 +/- 0.30 mm) with respect to the Cx (0.86 +/- 0.23: p0.02) or LAD (0.92 +/- 0.25 mm: p0.04). Overall, a balloon to vessel diameter ratio1 and a lesion length10 mm were parameters predicting greater secondary elastic recoil (p0.07 and p0.001 respectively), whereas the degree of eccentricity only played a role in the post-infarction ischaemic syndromes and calcification only in unstable angina (p0.01 and p0.001 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1994

22. [Evaluation of the normal bioprosthetic Intact aortic valve by Doppler echocardiography]

Author

Etienne Y, Jobic Y, Genet L, Ja, Barra, Boschat J, Martine Gilard, Penther P, and Jj, Blanc

Subjects
Bioprosthesis, Analysis of Variance, Aortic Valve, Heart Valve Prosthesis, Humans, Blood Flow Velocity, Echocardiography, Doppler, Follow-Up Studies
Abstract

The Medtronic Intact is a recently commercialized porcine bioprosthesis. Its function and ultrasonic characteristics have not been widely studied. The authors performed a prospective Doppler echocardiographic study of 38 patients with Intact bioprosthesis (n. 19:1, n. 21:10, n. 23:9, n. 25:14, n. 27:3, n. 29:1) implanted in the aortic position and without clinical signs of dysfunction over a period of 8 +/- 5 months after surgery. The following parameters were measured: maximum and mean velocities, maximum and mean transprosthetic pressure gradients, permeability index (PI) or the ratio of subaortic to transprosthetic velocities, and the effective prosthetic surface area (S) calculated using the continuity equation. The PI and S were calculated by two methods, the first using the ratio of maximum velocities (PI1 and S1) and the second using the ratio of the velocity-time integrals (PI2 and S2). The global results were: Vmax 2.65 +/- 0.4 m/s range 1.9 to 3.7 m/s), maximum pressure gradient 29 +/- 9 mmHg (range 15-55 mmHg), mean pressure gradient 16.8 +/- 5.6 mmHg (range 9-32 mmHg), PI1 37.8 +/- 4.5 p. 100 (range 26-48%), PI2 39.1 +/- 5.5 p. 100, S1 1.25 +/- 0.19 cm2 (range 0.96-1.7 cm2) and S2 1.29 cm2 +/- 0.17 cm2. Minimal central prosthetic valve regurgitation was observed in 2 cases (5%). No correlations were found between the size of the prosthesis and blood flow velocities, pressure gradients or permeability indices. On the other hand, a correlation was observed between S and the size of the prosthesis (r = 0.88, p less than 1.10(-6) (S1); r = 0.80, p less than 1.10(-6) (S2)).(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1990

23. [Left auricular hypertrophy in aortic stenosis in adults]

Author

Boschat J, Le Mehaute H, Le Potier J, Roriz R, Martine Gilard, Bergez C, Etienne Y, Jj, Blanc, and Penther P

Subjects
Male, Electrocardiography, Hemodynamics, Calcinosis, Humans, Cardiomegaly, Female, Aortic Valve Stenosis, Middle Aged, Ultrasonography
Abstract

Left atrial hypertrophy (LAH) was noted from the electrocardiograms of 72 of 98 adult patients (81%) who underwent hemodynamic evaluation of calcified aortostenosis (CAS). The relations between LAH and clinical, echographic and hemodynamic findings are specified. The frequency of LAH was not higher in cases of a history of hypertension, angina pectoris, lipothymia or exercise-induced syncope. In contrast, dyspnea was more frequently associated with LAH (84%) than not (17%). An approximately linear relation was seen between LAH and the mean pulmonary capillary pressure, the mean rate of circumferential decrease (RCF), the coefficient of muscle rigidity (ks of Mirsky), the left ventricular mass (LVM) and the left ventricle-aorta gradient. LAH is, therefore, a frequent sign in patients presenting CAS. Its origin is multifactorial, with a predominance of increased mean capillary pressure in cases of clinical signs of poor safety.

Published
1990

24. [Anterior interventricular revascularization using the internal mammary artery. Short and medium-term follow-up of 140 patients]

Author

Mansourati J, Jj, Blanc, Jp, Salaun, Forneiro I, Genet L, Boschat J, Martine Gilard, Etienne Y, Penther P, and Deredec D

Subjects
Adult, Male, Time Factors, Myocardial Revascularization, Humans, Coronary Disease, Female, Postoperative Period, Middle Aged, Internal Mammary-Coronary Artery Anastomosis, Aged, Follow-Up Studies
Abstract

Between February 1983 and June 1987, 140 patients underwent surgery for anterior interventricular revascularization using the left internal mammary artery (the right had been used once). Operative mortality was 3.5%, but this value decreased to 2.2% when the familiarization period for the technique was taken into account. 112 patients were monitored for at least 11 months, and 85 of these accepted an angiographic examination at the end of the follow-up period. No graft was occluded. Only two were thin due to an inadequate stenosis of the anterior interventricular septum. One graft was 90% stenosed at its anastomosis. Moderate competitive flux was noted in five cases. These results are in agreement with published findings, and comparison with literature reports confirms that the internal mammary artery is superior to the saphenous vein as graft material.

Published
1990

28. Postinfarction atrioventricular septal rupture

Author

Jobic, Y., primary, Verdun, F., additional, Guillo, P., additional, Bezon, E., additional, Gilard, M., additional, Etienne, Y., additional, Dewilde, J., additional, Barra, J.-A., additional, Blanc, J.-J., additional, and Boschat, J., additional

Published
1997
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30. Management of cardiac arrest caused by coronary artery spasm: epinephrine/adrenaline versus nitrates.

Author

Kiss G, Corre O, Gueret G, Ba VN, Gilard M, Boschat J, and Arvieux CC

Abstract

BACKGROUND: Cardiopulmonary resuscitation guidelines imply the use of epinephrine/adrenaline during cardiopulmonary arrest. However, in cardiac arrest situations resulting from coronary artery spasm (CAS), the use of epinephrine/adrenaline could be deleterious. METHODS AND RESULTS: A 49-year-old patient underwent an emergency coronarography with an attempt to stent the coronary arteries. Radiologic imaging revealed a positive methylergonovine maleate (Methergine, Novartis Pharmaceuticals, East Hanover, NJ) test, with subocclusive CAS in several coronary vessels leading to electromechanical dissociation. Cardiopulmonary resuscitation was performed, and intracoronary boluses of isosorbide dinitrate were given to treat CAS. Epinephrine/adrenaline was not administered during resuscitation. Spontaneous circulation was obtained after cardioversion for ventricular fibrillation, and the patient progressively regained consciousness. CONCLUSION: Resuscitation guidelines do not specify the use of trinitrate derivatives in cardiac arrest situations caused by CAS. The pros and cons of the use of nitrates and epinephrine/adrenaline during cardiac arrest caused by CAS are analyzed in this case report. [ABSTRACT FROM AUTHOR]

Published
2009
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35. Evaluation of left ventricular function and mitral regurgitation during left ventricular-based pacing in patients with heart failure.

Author

Etienne, Yves, Mansourati, Jacques, Touiza, Abdelkader, Gilard, Martine, Bertault-Valls, Valérie, Guillo, Philippe, Boschat, Jacques, Blanc, Jean Jacques, Etienne, Y, Mansourati, J, Touiza, A, Gilard, M, Bertault-Valls, V, Guillo, P, Boschat, J, and Blanc, J J

Subjects
LEFT heart ventricle, HEMODYNAMICS, CONGESTIVE heart failure, POSITRON emission tomography, RADIOISOTOPES, ECHOCARDIOGRAPHY
Abstract

Background: Beneficial effects of left ventricular (LV)-based pacing on acute hemodynamic parameters were reported in several series, but only a few studies examined the long-term effects of this new pacing procedure.Aims: To assess long-term effects of permanent LV-based pacing on LV function and mitral regurgitation (MR) in patients with refractory congestive heart failure (CHF).Methods: A prospective evaluation of LV function and MR was performed in 23 patients with severe but stable CHF and left bundle branch block (mean QRS: 186+/-31 ms) by radionuclide and echocardiographic techniques at baseline and 6 months after implantation of a permanent LV-based (LV alone: 13 patients; biventricular: 10 patients) pacemaker programmed either in a DDD mode (sinus rhythm; n=14) or in a VVIR mode (atrial fibrillation; n=9).Results: Compared to baseline, the 6 months follow-up visit demonstrated a significant increase in radionuclide derived LV ejection fraction from 23.3+/-7 to 26.2+/-7% (P<0.01) and in echocardiographic LV fractional shortening from 13+/-4 to 16+/-6% (P<0.05), without any change in cardiac index, a significant decrease in LV end-diastolic diameter (from 73.2+/-6 to 71.2+/-7 mm; P<0.05), end-systolic diameter (from 63.6+/-6 to 60.2+/-8 mm; P<0.05) and color Doppler MR jet area (from 11.5+/-6 to 6.6+/-4 cm(1); P<0.001). A comparison of patients with LV pacing alone and patients with biventricular pacing showed similar beneficial effects of pacing on MR severity in the two subgroups and a non-significant trend for a better improvement of LV function during biventricular pacing.Conclusion: Thus, in patients with severe CHF and left bundle branch block, permanent LV-based pacing may significantly improve LV systolic function and decrease MR. [ABSTRACT FROM AUTHOR]

Published
2001
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36. Left ventricular-based pacing in patients with chronic heart failure: comparison of acute hemodynamic benefits according to underlying heart disease.

Author

Mansourati, Jacques, Etienne, Yves, Gilard, Martine, Valls-Bertault, Valérie, Boschat, Jacques, Benditt, David G., Lurie, Keith G., Blanc, Jean-Jacques, Mansourati, J, Etienne, Y, Gilard, M, Valls-Bertault, V, Boschat, J, Benditt, D G, Lurie, K G, and Blanc, J J

Subjects
HEART failure patients, HEMODYNAMICS, CARDIAC pacing, CORONARY angiography, DILATED cardiomyopathy, ATRIAL fibrillation, DIGITALIS (Drug), ACE inhibitors, HEART failure treatment, BUNDLE-branch block, COMPARATIVE studies, CORONARY disease, HEART ventricles, HEART failure, RESEARCH methodology, MEDICAL cooperation, RESEARCH, EVALUATION research, TREATMENT effectiveness
Abstract

Background: Acute left ventricular-based pacing has been shown to improve hemodynamics in patients with severe heart failure and left bundle branch block (LBBB). However, it is not known whether the cause of the underlying heart disease influences the potential effect of left ventricular-based pacing.Objectives: The aim of this study was to determine whether beneficial hemodynamic effects of acute left ventricular-based pacing in severe chronic heart failure are dependent on underlying heart disease.Methods: After coronary angiography, patients with severe heart failure and LBBB were separated into two groups: dilated (25 patients; 20 male) and ischemic cardiomyopathy (21 patients; 20 male). Hemodynamic parameters were evaluated at baseline and during left ventricular-based pacing.Results: Improvement in hemodynamic parameters were similar in both groups, during acute left ventricular pacing (changes expressed in percentage): pulmonary capillary wedge pressure, -16+/-15% vs. -14+/-10%; V wave amplitude, -25+/-18% vs. -21+/-17%; and biventricular pacing, -15+/-15% vs. -11+/-11% and -23+/-18% vs. -16+/-18%, respectively.Conclusion: Underlying heart disease does not influence the response to acute left ventricular-based pacing in patients with severe heart failure and LBBB. This finding provides support for including all patients with enlarged heart and heart failure in future studies evaluating left ventricular-based pacing. [ABSTRACT FROM AUTHOR]

Published
2000
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38. Doppler echocardiographic evaluation of valve regurgitation in healthy volunteers.

Author

Jobic, Y, Slama, M, Tribouilloy, C, Lan Cheong Wah, L, Choquet, D, Boschat, J, Penther, P, and Lesbre, J P

Abstract

OBJECTIVE--To study the prevalence and the characteristics of physiological valve regurgitation. DESIGN--Pulsed wave Doppler echocardiography, continuous wave Doppler echocardiography and Doppler colour flow mapping were performed prospectively in healthy volunteers. SETTING--Echocardiography laboratory in a city hospital. PATIENTS--32 consecutive healthy volunteers (age 21-49 years, mean age 29.4). MAIN OUTCOME MEASURES--Identification of regurgitation with colour Doppler flow mapping and measurement of the jet area, jet length, and maximal velocity of the regurgitation. RESULTS--Regurgitation was recorded at the pulmonary (100%), tricuspid (100%), mitral (56%), and aortic valves (6%). The velocity of pulmonary and tricuspid regurgitation was similar to that predicted from the pressure gradient calculated from the Bernoulli equation. The jet area and jet length were generally small. CONCLUSION--Trivial regurgitation from the pulmonary, tricuspid, and mitral valves is common in healthy people. It is important to take such regurgitation into account when valve disease is diagnosed. [ABSTRACT FROM PUBLISHER]

Published
1993
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39. Menopause and myocardial infarction

Author

Jean-François Morin, Penther P, J Clavier, Boschat J, and Blanc Jj

Subjects
Adult, medicine.medical_specialty, Arteriosclerosis, Age at menopause, Menopause, Premature, Myocardial Infarction, Coronary Disease, Sex Factors, Internal medicine, Tobacco, Humans, Medicine, Statistical analysis, Myocardial infarction, Risk factor, Aged, business.industry, Smoking, Age Factors, Obstetrics and Gynecology, Middle Aged, medicine.disease, Coronary heart disease, Menopause, Plants, Toxic, Cardiology, Female, Factor Analysis, Statistical, business, Recent myocardial infarction
Abstract

Age and circumstances of menopause (natural or artificial) are detailed in 104 cases of recent myocardial infarction (MI). The results of this study with statistical analysis show no correlation between the age at menopause and the age at onset of MI; so, for this study, an early menopause, cannot be considered, whatever circumstances, as a risk factor for coronary heart disease.

Published
1977

40. Constrictive perivenous mesh prosthesis for preservation of vein integrity

Author

Barra, J.A., Volant, A., Leroy, J.P., Braesco, J., Airiau, J., Boschat, J., Blanc, J.J., and Penther, P.

Abstract

Saphenous veins undergo dramatic morphologic changes when used as coronary bypass grafts, and careful preparation of the graft alone is inadequate in preventing these changes. In this study, the use of a constrictive mesh for vein graft was evaluated. Fourteen sheep were subjected to a 5 cm resection of the carotid artery. Six sheep (Group A) received a jugular vein interposition graft, and the other eight sheep (Group B) received a jugular vein graft on which the constrictive mesh had been applied. The diameter of grafts in Group A was 14 ± 1 mm compared with 7 ± 0.5 mm for Group B (p = 0.05). The animals were put to death 4 months later. Scanning electron microscopy showed a disruption of the endothelial lining in Group A and a normal endothelium in Group B. Microscopy showed a statistical difference between Groups A and B regarding regularity and thickness of the intimal hyperplasia. Group B showed a moderate and regular intimal thickening and increased vasa vasorum. This indicates that distention and subsequent damage of the vein graft may be minimized by use of a constrictive mesh. Saphenous grafts surrounded by this constrictive mesh were inserted in four patients. Vein diameters were, respectively, 5, 4.3, 3.5, and 3.5 mm before meshing. After insertion in the mesh, vein diameters were 4.3, 3.5, 2.8, and 2.5 mm, respectively. Angiography performed 2 months later showed patent grafts of regular caliber.

Published
1986
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41. [Narrow and calcified aortic valve stenosis in subjects in their 8th and 9th decades. An anatomic study of 64 cases]

Author

Penther P, Boschat J, Etienne Y, Le Potier J, and Martine Gilard

Subjects
Aged, 80 and over, Male, Aortic Valve, Heart Valve Diseases, Calcinosis, Humans, Mitral Valve, Mitral Valve Stenosis, Female, Aortic Valve Stenosis, Tricuspid Valve, Tricuspid Valve Stenosis, Aged
Abstract

Anatomical data obtained from 64 patients aged from 70 to 86 years with calcified and tight aortic orifice stenosis (functional area less than 1 cm2) were divided into three types according to the macroscopic appearance of the aortic valve: (1) tricuspid valve without commissural fusion: 44 cases (18 men, 26 women, mean age 76 years); (2) tricuspid valve with commissural fusion: 12 cases (8 men, 4 women, mean age 72 years); (3) calcified congenital bicuspid valve: 8 cases (6 men, 2 women, mean age 73 years). Thus, the distribution of patients by sex became the same starting from the eighth decade of life. Calcified aortic orifice stenosis (CAOS) of degenerative origin was the most common lesion (69 p. 100), with a strong female predominance. There were several differences between degenerative CAOS and bicuspid valve stenosis on the one hand and aortic orifice stenosis with commissural fusion on the other hand. In the first group, calcification did not involve the free edge of the aortic cusps, large calcifications of the mitral ring were extremely frequent, and there was little or no aortic regurgitation. Moreover, the aortic ring clearly was wider in cases with bicuspid valve. In patients with degenerative CAOS and bicuspid valve, attempts at digital dilatation by the left ventricular route succeeded in most cases in obtaining a fairly important widening of the aortic orifice by compression and/or disruption of the valvular calcium deposits, without causing significant regurgitation of injuring the valve; the cusps recovered some mobility.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1988

42. [Hemodynamic effects of intravenous magnesium sulfate in man]

Author

Boschat J, Martine Gilard, Etienne Y, Roriz R, Jobic Y, Penther P, and Jj, Blanc

Subjects
Adult, Magnesium Sulfate, Injections, Intravenous, Hemodynamics, Potassium, Humans, Blood Pressure, Magnesium, Stroke Volume, Cardiac Output, Middle Aged
Abstract

The haemodynamic effects of a single 3 g dose of magnesium sulfate administered by slow (1 min) intravenous injection were evaluated in 16 patients with coronary disease about to be explored by coronary arteriography. The haemodynamic effects were transient, with maximal values at the end of the injection and return to baseline values within less than 3 min. They consisted of peripheral vasodilatation with a decrease in systolic aortic pressure (128 +/- 18 mmHg versus 113 +/- 17 mmHg, p less than 0.05), an increase of cardiac index (3.0 +/- 0.4 versus 3.8 +/- 0.06 1/min/m2, p less than 0.001) and a fall in peripheral arterial resistance (1168 +/- 203 versus 919 +/- 29 dyn/s/cm-5, p less than 0.01). This action was accompanied by a moderate increase in contractility (Vmax) (1.63 +/- 0.34 versus 1.87 +/- 0.47 CIR/s, p less than 0.01) without changes in the relaxation index T (37 +/- 8 versus 67 +/- 9 s-1, NS), but with concomitant increase in heart rate (80 +/- 12 versus 67 +/- 10 beats/min, p less than 1.10(-4]. It is concluded that the haemodynamic effects of magnesium sulfate are moderate and transient and that this substance can be used safely as antiarrhythmic agent, even in case of marked deterioration of the left ventricular function.

Published
1989

43. [Electrophysiological effects of intravenous magnesium sulfate in man]

Author

Etienne Y, Jj, Blanc, Jy, Grall, Boschat J, Martine Gilard, Jf, Houël, and Penther P

Subjects
Adult, Male, Electrocardiography, Magnesium Sulfate, Erythrocytes, Injections, Intravenous, Potassium, Humans, Female, Heart, Magnesium, Middle Aged, Aged
Abstract

Magnesium salts have been used for many years to correct a wide variety of arrhythmias. A few experimental studies have been devoted to their electrophysiological effects, but these remain poorly documented in man, hence this study. An electrophysiological investigation was conducted in 24 patients before, and immediately after a bolus intravenous injection of magnesium sulphate in doses of 1.5 g to 12 patients (group I) and 3 g to 12 other patients (group II), followed by a continuous infusion at the rate of 1 mg/min. The drug had no influence on heart rate, duration of QRS, QT and QTc intervals and ventricular refractory period. A small, but statistically significant prolongation of HV (from 57 to 59 ms, p less than 0.05) was observed in group II. Analysis of the results in group I revealed a moderate but significant prolongation of the PR and AH intervals. The electrophysiological effects were distinctly more pronounced in group II patients, with significant prolongation of: PR and AH intervals, effective refractory period of the right atrium and AV node, Wenckebach's point, corrected sinus node recovery time and sinoatrial conduction time. These results demonstrate that magnesium sulphate principally acts on the sinus node, the AV node and the atrium, suggesting a blocking effect on calcium channels.

Published
1987

44. Comparative haemodynamic effects of dobutamine and isoproterenol in man

Author

J.P. Bourdarias, M Rigaud, Boschat J, J Bardet, A Ferreira, and Rocha P

Subjects
Chronotropic, Inotrope, Adult, Male, medicine.medical_specialty, Cardiac output, Hemodynamics, Blood Pressure, Critical Care and Intensive Care Medicine, Catecholamines, Heart Rate, Internal medicine, Dobutamine, Heart rate, medicine, Humans, Cardiac Output, Aged, Heart Failure, business.industry, Mean Aortic Pressure, Isoproterenol, Middle Aged, medicine.disease, Heart failure, Anesthesia, Cardiology, Drug Evaluation, Female, Vascular Resistance, business, medicine.drug
Abstract

Dobutamine was infused at a rate of 8 mcg/kg/min in 17 patients with or without congestive heart failure. Cardiac output increased from an average 2.92 to 4.45 1/min/m2(p less than 0.001) with no change in mean aortic pressure (93.4 to 97.8 mmHg) and only a slight increase in heart rate (78 to 87 beats/min). Left ventricular end-diastolic pressure decreased from an average 19 to 13.7 mmHg (p less than 0.01). Peak left ventricular dp/dt was doubled (1147 to 2370 mmHg/sec, p less than 0.001) and Vmax increased from 1.08 to 2.18 circ/sec (p less than 0.001). In 10 patients given equi-inotropic doses (100 per cent increase in peak dp/dt) Isoproterenol produced a greater increase in cardiac output (71 percent) than Dobutamine /51 percent). Isoproterenol caused mean aortic pressure to fall significantly (8 percent) while no change was noted with Dobutamine. Accordingly, peripheral vascular resistances were reduced to a greater extent with Isoproterenol than with Dobutamine (p less than 0.05). Mean pulmonary arterial pressure decreased significantly (25 +/- 5.9 to 22 +/- 5.7 mmHg, p less than 0.05) with Isoproterenol infusion and remained unchanged with Dobutamine infusion. Dobutamine increased both stroke work (57 percent) and minute work (83 percent). With Isoproterenol however, only minute work was significantly increased (90 percent). Dobutamine therefore is a potent inotropic drug, with mild chronotropic and peripheral vascular effect and may be valuable in the management of severe heart failure not associated with hypotension.

Published
1977

45. Regional left ventricular function assessed by contrast angiography in acute myocardial infarction

Author

M Rigaud, Boschat J, J Bardet, Jean-Pierre Bourdarias, Rocha P, and Jean-Christian Farcot

Subjects
medicine.medical_specialty, Contrast angiography, Cardiac Catheterization, Ejection fraction, Ventricular function, business.industry, Angiocardiography, Myocardial Infarction, Shock, Cardiogenic, Contrast ventriculography, medicine.disease, Myocardial Contraction, Perimeter, Physiology (medical), Internal medicine, medicine, Cardiology, Humans, In patient, Myocardial infarction, Wall motion, Cardiology and Cardiovascular Medicine, business
Abstract

The relationship of segmental left ventricular (LV) wall motion abnormalities to LV function 2-6 days after acute transmural myocardial infarction (MI) was investigated in 45 patients by quantitative contrast ventriculography. Patients were divided into four classes according to the MIRU criteria. Segmental wall motion was assessed by determining the percentage of systolic shortening (deltaS) along nine hemiaxes and the extent of akinetic or dyskinetic abnormally contracting segments (% ACS) expressed as a percentage of end-diastolic perimeter. When compared with that in 17 normal control-subjects, the LV end-diastolic volume was increased only in patients in class III and class IV; the LV end-systolic volume increased progressively from normal through class IV. Ejection fraction had a negative linear correlation with %ACS (r = 0.97). The size of ACS was larger in anterior (34 +/- 14%) than in inferior MIs (23 +/- 7%), resulting in greater LV dysfunction. However, for a comparable size of ACS, infarct location alone did not influence LV function parameters. In the noninfarcted zone, deltaS was increased when the size of ACS was less than 25% and reduced when the size of ACS was greater than 25%. Thus, the size of ACS is a major determinant of LV dysfunction in acute MI. The compensatory mechanisms operate either through an augmented mechanical function of residual myocardium when the infarct is small, or through the Frank-Starling mechanism when the infarct is large.

Published
1979

46. [Calcified aortic valve stenosis in adults. Analysis of supra- and infra-hissian conduction disorders]

Author

Jj, Blanc, Mahe M, Genet L, Mansourati J, Jp, Salaun, Martine Gilard, Boschat J, Etienne Y, and Penther P

Subjects
Adult, Male, Bundle of His, Adolescent, Calcinosis, Aortic Valve Stenosis, Middle Aged, Syncope, Electrocardiography, Dyspnea, Heart Block, Humans, Female, Aged
Abstract

The association of intraventricular or atrio-ventricular conductive disorders with a calcified aortic stenosis, is a classical notion demonstrated by the close anatomical relationships between aortic valve and conduction pathways. These conductive disorders have been, for quite some time, analyzed on standard electrocardiograms, but, since a few years, the recording of the bundle of His potential has become the technique of choice. However, studies regarding this subject are few, based on very small and sometimes heterogeneous groups of patients. Sixty six consecutive patients hospitalized for a narrow aortic stenosis have agreed to be subjected, before valve replacement, to a recording of the bundle of His potential. Thirteen of them (19.7%) show a HV interval exceeding 55 ms or a pathological H deflexion (twisted and lasting 35 ms). None of the pre-operative parameters that were analyzed (black-out, left ventricular function, ventriculo-aortic gradient, calculated valvular area, magnitude of valvular and ring calcifications), seem correlated with the increased HV interval. These results cross-check those reported in most of the literature.

Published
1989

47. [Radioisotope and ultrasonic diagnosis of a localized form of infarction of the right ventricle]

Author

Songy B, Etienne Y, Martine Gilard, Boschat J, Jj, Blanc, Pp, Morin, and Penther P

Subjects
Male, Heart Ventricles, Myocardial Infarction, Humans, Radionuclide Imaging, Aged, Ultrasonography
Abstract

We are reporting the case of a localized form of right ventricle infarction. The right catheterization, on which the diagnosis usually rests, is completely normal. Cardiac gamma-angiography and bi-dimensional sonography demonstrate, on the contrary, a localized dyskinesis of the inferior wall of the right ventricle which is not dilated and retains its ejection fraction. The failure of right catheterization in the diagnosis of infarction of the right ventricle is usually attributed to hypovolemia or a delay in the performance of the catheterization, which is not the case here. Therefore, this case demonstrates the existence of infarction of the right ventricle without total diastolic or systolic dysfunction, the diagnosis of which may be made with isotopic and sonographic methods.

Published
1987

50. [Intracardiac ectopic thyroid]

Author

veronique kerlan, Jobic Y, Boschat J, Ja, Barra, Penther P, and Jp, Bercovici

Subjects
Heart Neoplasms, Heart Ventricles, Thyroid Gland, Humans, Female, Choristoma, Middle Aged, Cardiomyopathies
Abstract

Intracardiac ectopic thyroid tissue was removed in a 51 years old woman, after echography has discovered a tumor in the right ventricle. There was a normal thyroid gland in the neck and thyroid function tests were normal. Intra-cardiac ectopic thyroid tissue is very rare; it is due to an abnormality of embryological development, when thyroid anlage is in close contact with the embryonic heart.

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