72 results on '"Farcot, J. -C."'
Search Results
2. Circulatory failure in acute pulmonary embolism
- Author
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Ozier, Y., Dubourg, O., Farcot, J. -C., Bazin, M., Jardin, F., and Margairaz, A.
- Published
- 1984
- Full Text
- View/download PDF
3. New Catheter-Pump System for Diastolic Synchronized Coronary Sinus Retroperfusion (D.S.R.)
- Author
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Farcot, J.-C., primary, Berdeaux, A., additional, Bourdarias, J.-P., additional, and Giudicelli, J.-F., additional
- Published
- 1984
- Full Text
- View/download PDF
4. Clinical evaluation of safety and hemodynamic effects of diastolic coronary venous retroperfusion
- Author
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Berland, J., primary, Farcot, J.-C., additional, Cribier, A., additional, Bourdarias, J.-P., additional, and Letac, B., additional
- Published
- 1986
- Full Text
- View/download PDF
5. Failure of Regional Coronary Vasodilator Drugs to Potentiate the Retroperfusion Beneficial Effect in Ischemic Myocardium in Dogs
- Author
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Berdeaux, A., primary, Farcot, J. C., additional, Giudicelli, J. F., additional, and Bourdarias, J. P., additional
- Published
- 1984
- Full Text
- View/download PDF
6. Use of Microspheres Technique to Assess Regional Myocardial Blood Flow Distribution with Coronary Sinus Retroperfusion
- Author
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Berdeaux, A., primary, Giudicelli, J. F., additional, Farcot, J. C., additional, and Bourdarias, J. P., additional
- Published
- 1984
- Full Text
- View/download PDF
7. Two dimensional echocardiography during controlled ventilation with PEEP
- Author
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Jardin, F., Farcot, J. C., Boisante, L., Sportiche, M., Curien, N., Margairaz, A., and Jardin, F.
- Published
- 1980
- Full Text
- View/download PDF
8. Two-dimensional echocardiographic evaluation of right ventricular size and contractility in acute respiratory failure.
- Author
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Jardin, F, Gueret, P, Dubourg, O, Farcot, J C, Margairaz, A, and Bourdarias, J P
- Published
- 1985
9. Two-dimensional echocardiographic demonstration of acute myocardial depression in septic shock.
- Author
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Ozier, Y, Guéret, P, Jardin, F, Farcot, J C, Bourdarias, J P, and Margairaz, A
- Published
- 1984
- Full Text
- View/download PDF
10. Influence of Positive End-Expiratory Pressure on Left Ventricular Performance
- Author
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JARDIN, F., primary, FARCOT, J. -C., additional, BOISANTE, L., additional, CURIKN, N., additional, MARGAIRAZ, A., additional, and -P BOURDARIAS, J., additional
- Published
- 1982
- Full Text
- View/download PDF
11. Mechanism of paradoxic pulse in bronchial asthma.
- Author
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Jardin, F, primary, Farcot, J C, additional, Boisante, L, additional, Prost, J F, additional, Gueret, P, additional, and Bourdarias, J P, additional
- Published
- 1982
- Full Text
- View/download PDF
12. Regional left ventricular function assessed by contrast angiography in acute myocardial infarction.
- Author
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Rigaud, M, primary, Rocha, P, additional, Boschat, J, additional, Farcot, J C, additional, Bardet, J, additional, and Bourdarias, J P, additional
- Published
- 1979
- Full Text
- View/download PDF
13. Echocardiographic evaluation of ventricles during continuous positive airway pressure breathing
- Author
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Jardin, F., primary, Farcot, J. C., additional, Gueret, P., additional, Prost, J. F., additional, Ozier, Y., additional, and Bourdarias, J. P., additional
- Published
- 1984
- Full Text
- View/download PDF
14. Cyclic changes in arterial pulse during respiratory support.
- Author
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Jardin, F, primary, Farcot, J C, additional, Gueret, P, additional, Prost, J F, additional, Ozier, Y, additional, and Bourdarias, J P, additional
- Published
- 1983
- Full Text
- View/download PDF
15. [Aortic dissection at 6 months gestation in a women with Marfan's syndrome. Simultaneous Bentall intervention and cesarean section].
- Author
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Jondeau G, Nataf P, Belarbi A, Farcot JC, Iung B, Delorme G, Gandjbakhch I, and Bourdarias JP
- Subjects
- Adrenergic beta-Antagonists therapeutic use, Adult, Aortic Dissection pathology, Aortic Aneurysm pathology, Cesarean Section, Female, Humans, Pregnancy, Pregnancy Outcome, Treatment Outcome, Aortic Dissection surgery, Aortic Aneurysm surgery, Marfan Syndrome complications, Pregnancy Complications, Cardiovascular surgery
- Abstract
A 31 year old woman with Marfan's syndrome had a dilatation of the aortic root (55-60 mm at the beginning of pregnancy). Pregnancy was continued with beta-blocker therapy and with regular echocardiographic follow-up. The aortic dilatation increased (62-65 mm) at the last control and, at the 34th week of pregnancy, the patient suffered a dissection of the ascending aorta. A caesarean section was performed with a Bentall procedure during the same operative session. The mother and baby girl are well two years later. The problems of pregnancy in patients with Marfan's syndrome are discussed.
- Published
- 2000
16. [Effects of active synchronized prolonged coronary perfusion in the animal].
- Author
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Martinot S, Farcot JC, Berland J, Franck M, Blanchard D, and Bourdarias JP
- Subjects
- Angioplasty, Balloon, Coronary, Animals, Blood Flow Velocity, Blood Pressure, Blood Transfusion, Autologous, Coronary Circulation, Coronary Vessels, Creatine Kinase blood, Disease Models, Animal, Myocardial Ischemia physiopathology, Myocardial Reperfusion instrumentation, Sheep, Time Factors, Myocardial Ischemia prevention & control, Myocardial Reperfusion methods
- Abstract
The efficacy of a system of active diastolic synchronised coronary perfusion was studied during prolonged balloon angioplasty in 8 sheep. In the first part of the study (group 1) including 5 animals, the aim was to study the effects of high and constant flow (48 ml/min) for 90 minutes perfusion on haemolysis, the arterial wall and the perfused myocardium. The second part of the study (group 2), including 3 animals, assessed whether flow adapted to the extent of the vascular bed perfused (24 to 40 ml/min) could protect the myocardium for an interval of 60 minutes. In group 1, after 90 minutes of perfusion (48 ml/min), there was no haemolysis, or jet lesion of the arterial wall distal to the catheter tip. On the other hand, the creatinine phosphokinase levels increased at the 60th minute (188 vs 119 i.u./l for controls) and at the 90th minute (238 vs 119 i.u./l; p < 0.05). Moreover, the perfused myocardium was the site of histological lesions. These observations showed myocardial changes due to the "overflow phenomenon". In group 2, the flow rate was adapted to each animal, increasing progressively until disappearance of electrocardiographic signs of ischaemia (ST elevation) and maintained for 60 minutes. No signs of haemolysis, jet lesions or myocardial changes were observed, with absence of creatinine phosphokinase elevation and histological abnormalities. These preliminary results show that the system investigated allowed myocardial protection after arterial occlusion for an interval of 60 minutes.
- Published
- 1997
17. [Synchronized anterograde perfusion during percutaneous transluminal coronary angioplasty: preliminary clinical study].
- Author
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Farcot JC, Berland J, Derumeaux G, Letac B, and Bourdarias JP
- Subjects
- Aged, Blood Transfusion, Autologous, Coronary Disease diagnostic imaging, Echocardiography, Doppler, Equipment Design, Female, Humans, Male, Middle Aged, Myocardial Ischemia diagnostic imaging, Myocardial Ischemia physiopathology, Risk Factors, Time Factors, Angioplasty, Balloon, Coronary, Coronary Disease therapy, Myocardial Ischemia prevention & control
- Abstract
A new circulatory system, "physiologic anteroperfusion system", has been developed and tested in 6 patients with significant proximal coronary artery stenosis. Prolonged and safe balloon inflation was possible without any ischemic signs. The system consists of an electronic cardiac synchroperfusor which, by activating a pulsatile unit, permits increased diastolic anteroperfusion of autologous blood under physiologic pressure through low-profile standard angioplasty catheters. This study reports the results obtained in 6 patients during proximal prolonged percutaneous transluminal coronary angioplasty. Four men and two women suffering from severe exertional angina pectoris, with normal resting left ventricular function, no collaterals and excellent apical two-dimensional four-chamber echocardiographic views were studied. After a 90 +/- 10 seconds of control occlusion under continuous monitoring of hemodynamics, electrocardiograms (3 to 4 leads), two-dimensional echo and chest pain grading, a second balloon inflation protected by the physiologic anteroperfusion system at a flow rate of 44 +/- 12 ml/min was performed for fifteen minutes. The ischemic signs present in the myocardium depending on the occluded artery were totally abolished during prolonged inflation protected by physiologic anteroperfusion system. All the patients were successfully dilated and were discharged from hospital the following morning without cardiac enzyme elevation or signs of central or peripheral hemolysis. Conclusion, in 6 patients with severe proximal coronary artery stenosis, safe prolonged proximal angioplasty without signs of ischemia was performed using a new simple physiologic anteroperfusion system, which allows active diastolic flow-pressure controlled autologous arterial blood perfusion, through standard low profile catheters.
- Published
- 1995
18. Coronary venous synchronized retroperfusion during percutaneous transluminal angioplasty of left anterior descending coronary artery.
- Author
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Berland J, Farcot JC, Barrier A, Dellac A, Gamra H, and Letac B
- Subjects
- Aged, Arterial Occlusive Diseases physiopathology, Arterial Occlusive Diseases therapy, Arteries, Catheterization, Coronary Disease physiopathology, Coronary Disease therapy, Echocardiography, Electrocardiography, Female, Hemodynamics, Humans, Male, Middle Aged, Perfusion instrumentation, Veins physiopathology, Angioplasty, Balloon, Coronary, Coronary Circulation, Perfusion methods
- Abstract
Synchronized coronary venous retroperfusion was applied and studied in 16 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) balloon dilatation of proximal left anterior descending (LAD) coronary artery stenosis. The rationale for using retroperfusion support during the PTCA-induced coronary artery occlusions was to ameliorate or prevent myocardial ischemia and possibly facilitate extension of the PTCA balloon-inflation period. After therapeutic PTCA treatment, which successfully dilated the culprit coronary artery in all 16 patients, and a 5-minute recovery period, a single retroperfusion-treated LAD occlusion (101 +/- 36 seconds) was compared with equivalent untreated control LAD occlusions (86 +/- 24 seconds) before and after the retroperfusion-supported balloon occlusion. Observations and measurements encompassed 1) ease and time of coronary sinus catheterization, 2) incidence of anginal pain during LAD occlusion, 3) electrocardiographic signs of myocardial ischemia, and 4) two-dimensional echocardiographic indexes of global left ventricular function. The coronary sinus was successfully catheterized within 139 +/- 140 seconds, and in 12 of the 16 patients, the tip of the special autoinflatable retroperfusion balloon catheter could be placed in the desired location of the great cardiac vein. The retroperfusion protocol interfered minimally with the PTCA procedure, and application of the support system had no deleterious effects. As compared with the pain reported 23 (72%) times during the 32 control LAD occlusions, only five (31%) of the patients indicated pain or discomfort during the retroperfused occlusions. Treated occlusions exhibited delayed or significantly lower electrocardiographic ST segment elevations (sum, 10.4 +/- 7.8 mm) as compared with the controls (sum, 16.2 +/- 7.9 mm and 18.8 +/- 10.6 mm; both p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1990
19. New catheter-pump system for diastolic synchronized coronary sinus retroperfusion.
- Author
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Farcot JC, Barry M, Bourdarias JP, Bardet J, Berdeaux A, and Giudicelli JF
- Subjects
- Animals, Dogs, Heart physiology, Humans, Mathematics, Myocardial Contraction, Myocardial Infarction prevention & control, Cardiac Catheterization instrumentation, Coronary Disease therapy, Perfusion instrumentation
- Abstract
Coronary retroperfusion with the object of delivering oxygenated blood to the ischemic myocardium might be defined as the process of withdrawing blood from a systemic artery and reinjecting it into the coronary sinus. A diastolic synchronized retroperfusion catheter-pump system is presented and feasibility of achieving retrograde infusion of arterial blood was tested. An autoinflatable bladder catheter was specially designed to compartmentalize the coronary sinus at onset of diastole and insure unidirectional retrograde infusion of arterial blood. Bladder deflation at onset of systole allowed coronary venous drainage. Actuation of the retroperfusion bladder catheter was obtained from an electropneumatic console triggered by the electrocardiogram. In vitro and animal studies indicate that this system converted the natural (steady) arteriovenous shunt flow into an artificially pulsed shunt flow, with maximal positive flow in diastole and trivial negative flow in systole but did not alter absolute magnitude of shunt flow. Thus, diastolic synchronized retroperfusion of arterial blood through the coronary sinus may provide temporary protection from acute myocardial ischemia.
- Published
- 1980
20. [Emergency diagnosis by two-dimensional echocardiography of septal rupture secondary to acute myocardial infarction. Apropos of 7 cases].
- Author
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Boisante L, Farcot JC, Terdjman M, Hericotte P, Fouache Y, Rigaud M, Bardet J, and Bourdarias JP
- Subjects
- Aged, Echocardiography methods, Emergencies, Heart Rupture etiology, Heart Rupture surgery, Humans, Middle Aged, Heart Rupture diagnosis, Heart Septum, Myocardial Infarction complications
- Published
- 1980
21. [Peripheral effects of nitrate compounds (author's transl)].
- Author
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Bardet J, Rigaud M, Farcot JC, and Bourdarias JP
- Subjects
- Angina Pectoris physiopathology, Arteries drug effects, Heart Failure physiopathology, Muscle, Smooth, Vascular drug effects, Myocardium metabolism, Oxygen Consumption drug effects, Veins drug effects, Nitroglycerin analogs & derivatives, Nitroglycerin pharmacology
- Abstract
Nitroglycerin primarily acts on smooth muscle fibers, and this effect is dose-dependent. High doses seem to affect mainly coronary blood flow; moderate doses act on both systemic arterial blood flow (resistance vascular bed) and return venous blood flow (capacitance vascular bed), while low doses influence only the latter. These various modes of action account for the discrepancies observed between the results of experimental studies, the final effect being the algebraical resultant of combined individual actions. In coronary insufficiency, where treatment aims at reducing myocardial oxygen consumption without lowering coronary perfusion pressure, nitroglycerin should be given in low doses. In congestive heart failure, where the primary target is reduction in preload and, consequently, heart work without excessive reduction in afterload that would result in decreased stroke index through Frank-Starling's mechanism, a detailed knowledge of the physiological mechanisms involved is required to guide nitroglycerin treatment.
- Published
- 1980
22. [8-hour hemodynamic study of 2 sustained-release nitrate derivatives. Comparative double-blind study against placebo].
- Author
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Dubourg O, Guéret P, Ferrier A, Léger P, Farcot JC, Rigaud M, Beaumont D, Bardet J, and Bourdarias JP
- Subjects
- Administration, Oral, Delayed-Action Preparations, Double-Blind Method, Female, Humans, Male, Middle Aged, Myocardial Infarction drug therapy, Placebos, Pulmonary Wedge Pressure drug effects, Time Factors, Hemodynamics drug effects, Isosorbide Dinitrate administration & dosage, Myocardial Infarction physiopathology, Nitroglycerin administration & dosage
- Abstract
The aim of this study was to evaluate the duration of the hemodynamic effects of a new slow release preparation of isosorbide dinitrate and to compare its action with placebo and a slow release nitroglycerin preparation whose hemodynamic efficacity has already been demonstrated. The study was undertaken in 30 patients admitted to the intensive care unit during the acute phase of myocardial infarction complicated by left ventricular failure less than 12 hours after the onset of the chest pain. The patient population was uniform: 24 males, 6 females, mean age 61 years. Fifteen patients had anterior infarcts and 15 posterior infarcts. The drugs were administered double blind in a randomised fashion to 3 groups of 10 patients, the initial clinical and hemodynamic characteristics of which were comparable: 10 patients received placebo (placebo group); 10 patients received slow release nitroglycerin in a 7,5 mg gelule (NTG group) and 10 patients received 40 mg slow release isosorbide dinitrate (ISDN group). The following parameters were compared: heart rate, right atrial pressure, pulmonary artery and capillary pressures, systemic arterial pressure, cardiac index and systemic and pulmonary arterial resistances. These parameters were measured before therapy, half an hour, one hour and every two hours up to the 8th hour after drug administration. All patients were in moderate left ventricular failure with an initial mean capillary pressure of 18 mmHg +/- 1,3 mmHg. In the placebo group, none of the parameters studied changed significantly during the study. Pulmonary artery pressure fell significantly by 11 p. cent in the NTG group and 7,5 p. cent in the ISDN group. Mean pulmonary capillary pressure fell progressively in both treatment groups; the change was significant compared to the placebo group from the first hour for the ISDN group, and from the second hour for the NTG group. The fall remained significant at the 8th hour for the ISDN group but not in the NTG group. Cardiac index, systemic blood pressure, systemic and pulmonary arterial resistances did not change significantly. The cardiac index remained stable in the 30 patients, but with a number of individual variations depending on initial mean pulmonary capillary pressure and the importance of its fall after nitrate administration. The authors conclude that the hemodynamic effects of slow release NTG and ISDN in the acute phase of myocardial infarction complicated by moderate left ventricular failure are comparable. Pulmonary capillary pressure was the hemodynamic parameter which underwent the greatest variation in the two treatment groups. Its fall was more prolonged in the ISDN than in the NTG group.
- Published
- 1983
23. Synchronized retroperfusion of coronary veins for circulatory support of jeopardized ischemic myocardium.
- Author
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Farcot JC, Meerbaum S, Lang TW, Kaplan L, and Corday E
- Subjects
- Animals, Assisted Circulation instrumentation, Coronary Circulation, Coronary Disease pathology, Coronary Disease physiopathology, Disease Models, Animal, Dogs, Hemodynamics, Humans, Oxygen Consumption, Perfusion instrumentation, Perfusion methods, Veins, Assisted Circulation methods, Coronary Disease therapy, Coronary Vessels
- Abstract
A retroperfusion system was developed that augments retrograde delivery of arterial blood into an acutely ischemic myocardial region during diastole and facilitates coronary venous drainage in systole. An electrocardiogram-synchronized, gas-actuated bladder pump propels retroperfusate through an autoinflatable balloon catheter whose tip is placed within the regional coronary vein that drains the ischemic myocardium. Experiments were performed in 26 closed chest dogs with 4 hour intracoronary balloon occlusion of the proximal left anterior descending coronary artery. An untreated control series consisted of 13 dogs; the remaining 13 dogs were treated with retroperfusion, which was initiated after the first hour of acute coronary occlusion. Synchronized retroperfusion resulted in a significant 37 +/- 10 per cent (mean +/- standard error of the mean) decrease in left ventricular end-diastolic pressure from 11 +/- 2 to 5 +/- 21 mm Hg, a 20 +/- 4 percent decrease in peak systolic pressure (140 +/- 7 to 110 +/- 6 mm Hg) and a 25 +/- 6 percent reduction in systemic vascular resistance (3,880 +/- 340 to 2,380 +/- 300 dynes sec cm-5). Ischemic region intracoronary S-T segment elevation decreased 40 +/- 15 percent, and potassium loss was reduced 92 +/- 22 percent. Partial pressure of oxygen measured distal to the coronary occlusion decreased 36 +/- 2 percent, suggesting oxygen delivery to and extraction by the jeopardized ischemic myocardium. Ventriculography in four dogs revealed an increase in left ventricular ejection fraction and reversal of ischemic segment dyskinesia by synchronized retroperfusion. A nitro-blue tetrazolium study of 10 excised hearts indicated that 3 hours of synchronized retroperfusion significantly reduced the size of ischemic injury to 3.3 +/- 2 percent of the left ventricle (versus 16.2 +/- 5 percent in the untreated control group). In addition, retroperfusion appeared to correct ischemic arrhythmias. The experimental data suggest that this treatment is capable of improving cardiac function and salvaging jeopardized myocardium. Clinical application is envisioned as a prompt temporary emergency support for acute and profound ischemic dysfunction not readily treatable by other interventions.
- Published
- 1978
- Full Text
- View/download PDF
24. [Update on the study of true and false left ventricular aneurysms by 2-dimensional echocardiography].
- Author
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Guéret P, Farcot JC, Bardet J, Boisante L, Dubourg O, Terdjman M, Ferrier A, Rigaud M, and Bourdarias JP
- Subjects
- Diagnosis, Differential, Heart Ventricles, Humans, Prognosis, Thrombosis diagnosis, Echocardiography methods, Heart Aneurysm diagnosis
- Abstract
2D echocardiography is a great advance in the study of left ventricular aneurysms. The wide field of visualisation and the numerous planes of examination obtained from different transducer positions allow precise spatial orientation and reliable analysis of regional wall movement. An aneurysm appears as a clear and constant bulge of a segment of left ventricular wall in both diastole and systole. Antero apical aneurysms are the commonest variety. The sensitivity and specificity of 2D echo in the detection of ventricular aneurysms are high. Thrombosis within the aneurysmal bulge may also be detected (33-38%). Pseudo-left ventricular aneurysms are easily identified as a chamber communicating with the ventricle by means of a narrow neck; the width of this neck is the main echocardiographic feature differentiating pseudo and true ventricular aneurysms. 2D echocardiography gives valuable information on the state of the remaining contractile area, an important prognostic factor when surgical resection of the aneurysm is being considered.
- Published
- 1982
25. [Acute right ventricular failure. Treatment with dobutamine].
- Author
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Jardin F, Ozier Y, Farcot JC, Bazin M, Bourdarias JP, and Margairaz A
- Subjects
- Acute Disease, Adult, Aged, Cardiomegaly drug therapy, Cardiomegaly etiology, Dobutamine administration & dosage, Echocardiography, Female, Hemodynamics drug effects, Humans, Male, Middle Aged, Perfusion, Pulmonary Embolism complications, Pulmonary Heart Disease drug therapy, Thermodilution, Catecholamines therapeutic use, Dobutamine therapeutic use, Heart Diseases drug therapy
- Abstract
Acute right ventricular failure is commonly observed during respiratory intensive care, particularly in patients suffering from massive pulmonary embolism, chronic obstructive pulmonary disease or adult respiratory distress syndrome. The haemodynamic effects of a continuous dobutamine infusion at the rate of 9.4 +/- 3.7 micrograms/kg/min were assessed in a group of 15 patients with acute and isolated right ventricular failure, as evidenced by haemodynamic and two dimensional echocardiographic measurements. This inotropic agent induced at 37% increase in mean cardiac index and a 25% increase in mean stroke index, with only a 10% increase in mean heart rate. Moreover, measurement of the right ventricular ejection fraction by a thermal dilution technique performed in 10 patients demonstrated that dobutamine consistently and significantly increased right ventricular systolic function and also significantly reduced right ventricular end-diastolic tension. In conclusion, it appeared that dobutamine was able to improve circulatory status in patients with acute right heart failure or various origins.
- Published
- 1984
26. [Left atrial myxoma diagnosed and operated after echocardiography only? (author's transl)].
- Author
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Dechy H, Debain P, Dorra M, Farcot JC, Jandin M, and Piwnica A
- Subjects
- Adult, Female, Heart Atria, Heart Neoplasms surgery, Humans, Myxoma surgery, Echocardiography, Heart Neoplasms diagnosis, Myxoma diagnosis
- Published
- 1978
27. [Bidimensional echography in the diagnosis of acute myocardial infarction and its complications in the coronary unit].
- Author
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Guéret P, Farcot JC, Ferrier A, Dubourg O, Terdjman M, Bardet J, and Bourdarias JP
- Subjects
- Coronary Care Units, Heart Aneurysm diagnosis, Heart Aneurysm etiology, Heart Rupture diagnosis, Heart Rupture etiology, Heart Septum, Humans, Myocardial Infarction complications, Papillary Muscles, Pericardial Effusion diagnosis, Pericardial Effusion etiology, Prognosis, Thrombosis diagnosis, Thrombosis etiology, Echocardiography methods, Myocardial Infarction diagnosis
- Published
- 1983
28. Aneurysms of sinus of Valsalva: two-dimensional echocardiographic diagnosis and recognition of rupture into the right heart cavities.
- Author
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Terdjman M, Bourdarias JP, Farcot JC, Gueret P, Dubourg O, Ferrier A, and Hanania G
- Subjects
- Adult, Aged, Aortic Rupture pathology, Aortic Rupture surgery, Contrast Media, Heart Atria pathology, Heart Ventricles pathology, Humans, Male, Middle Aged, Sinus of Valsalva surgery, Aortic Rupture diagnosis, Echocardiography methods, Sinus of Valsalva pathology
- Abstract
The aim of this study was to evaluate the role of echocardiography in the diagnosis of sinus of Valsalva aneurysms projecting toward the right heart cavities. Three patients who had a ruptured aneurysm of a sinus of Valsalva diagnosed by echocardiography and confirmed by catheterization underwent cardiac surgery. In two patients, the aneurysm originated from the right coronary sinus and had perforated into either the inflow or outflow tract of the right ventricle. In the third patient, the aneurysm, which originated from the noncoronary sinus, ruptured into the atrium. A fourth patient was also investigated and had an unruptured aneurysm of the right coronary sinus projecting into the right ventricular outflow tract. M-mode, two-dimensional and contrast echocardiographic studies were performed before cardiac catheterization in all patients and after surgery in three patients. M-mode echocardiography was useful only when the aneurysm had an anterior projection, whether or not the aneurysm was ruptured. Conversely, two-dimensional echocardiography was always able to identify the aneurysmal sac which appeared as an abnormal circular thin-walled structure protruding into the right heart cavities. By using multiple views, it was possible to investigate the whole abnormal structure and locate the sinus from which the aneurysm originated. The use of the echo contrast technique allowed more precise definition of the aneurysmal sac and diagnosis of a left to right shunt by demonstrating a negative contrast image in the right cavities. On the other hand, no negative contrast image was recorded in the patient with an unruptured aneurysm or in the two instances of a successful surgically reconstructed aorta.
- Published
- 1984
- Full Text
- View/download PDF
29. Two-dimensional echocardiographic assessment of left ventricular function in chronic obstructive pulmonary disease.
- Author
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Jardin F, Gueret P, Prost JF, Farcot JC, Ozier Y, and Bourdarias JP
- Subjects
- Adult, Aged, Blood Pressure, Cardiac Volume, Female, Heart Rate, Heart Ventricles physiopathology, Humans, Male, Pulmonary Wedge Pressure, Respiratory Function Tests, Cardiac Output, Echocardiography, Lung Diseases, Obstructive physiopathology, Stroke Volume
- Abstract
In 10 patients undergoing therapy for a mild exacerbation of their chronic obstructive pulmonary disease (COPD), a quantitative two-dimensional echocardiographic (2DE) study was performed together with hemodynamics to assess left ventricular (LV) function. From the 2DE examination, which was made up of parasternal, subcostal, and apical views, measurements of LV short axis end-diastolic and end-systolic areas (A) at the high papillary muscle level and long axis end-diastolic and end-systolic length (L) permitted us to calculate LV end-systolic and end-diastolic volumes (V) using the formula V = 5/6 AL. Compared with the same measurements obtained in a group of 12 normal volunteers, patients with COPD exhibited a markedly reduced LV cavity (LVES, 28.9 +/- 14.6 ml/m2 versus 51.5 +/- 11.0 ml/m2; LVEDV, 67.7 +/- 24.6 ml/m2 versus 103.2 +/- 19.9 ml/m2). An increased thickness of both left ventricular free wall and interventricular septum was also evidenced in patients with COPD. Left ventricular systolic function, assessed using both peak systolic blood pressure/end-systolic volume ratio and calculated left ventricular ejection fraction, was found to be clearly enhanced in patients with COPD. The influence of right ventricular enlargement on left ventricular diastolic function was also investigated in patients with COPD using progressive volume loading and 2DE right ventricular measurements. After a given threshold of volume loading, reduction in stroke index, opposite variations in right and left ventricular size and septal flattening, suggested the occurrence of ventricular interaction.
- Published
- 1984
- Full Text
- View/download PDF
30. [Influence of positive end-expiratory pressure ventilation on left ventricular function (author's transl)].
- Author
-
Jardin F and Farcot JC
- Subjects
- Diastole, Heart Septum physiology, Humans, Pressure, Systole, Positive-Pressure Respiration, Ventricular Function
- Abstract
During the last decade several attempts have been made to elucidate the mechanism of the fall in cardiac output observed during positive end-expiratory pressure ventilation (PEEP). some of these studies have given conflicting results, but the weight of experimental and clinical evidence available today points to a coherent physiopathology. PEEP does not alter left ventricular contractility, but it impedes left ventricular filling by reducing pulmonary venous return and left ventricular compliance. In patients under high PEEP, reduction in left ventricular distensibility results from septal shift and flattening of the left ventricle due to right ventricular overload.
- Published
- 1982
31. [Left-right shunt caused by anomalous implantation of the left coronary artery in the trunk of pulmonary artery. Detection by contrast echocardiography].
- Author
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Terdjman M, Ferrier A, Dubourg O, Guéret P, Farcot JC, Hedrich-Ameur C, and Bourdarias JP
- Subjects
- Child, Coronary Artery Bypass, Coronary Vessel Anomalies diagnosis, Coronary Vessels surgery, Echocardiography, Female, Humans, Coronary Vessel Anomalies physiopathology, Pulmonary Artery abnormalities
- Abstract
The authors describe a case of an anomalous left coronary artery arising from the main pulmonary artery in an 11 year old child suffering from chest pain on effort and with a continuous murmur in the second left intercostal space. Two dimensional echocardiography (2D E) showed dilatations of the first segment of the right coronary artery and the anomalous origin of the left main coronary artery. A peripheral injection of microbubbles showed a left-to-right shunt between the left coronary artery and the pulmonary artery. Semi-quantitative evaluation of LV regional wall motion showed abnormal contraction of the anterolateral walls. Haemodynamic, angiographic data and the operative findings confirmed the diagnosis. The abnormal coronary ostium was closed and a bypass graft from the aorta to the left anterior descending artery was performed. Clinical and echocardiographic follow-up 7 months after surgery was completely normal.
- Published
- 1985
32. Effects of full-dose heparin anticoagulation on the development of left ventricular thrombosis in acute transmural myocardial infarction.
- Author
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Gueret P, Dubourg O, Ferrier A, Farcot JC, Rigaud M, and Bourdarias JP
- Subjects
- Dose-Response Relationship, Drug, Echocardiography, Female, Heart Ventricles, Hemodynamics, Humans, Male, Middle Aged, Prospective Studies, Statistics as Topic, Heparin administration & dosage, Myocardial Infarction prevention & control, Thrombosis prevention & control
- Abstract
The incidence of left ventricular thrombosis after acute transmural myocardial infarction has been evaluated with two-dimensional echocardiography. To assess the preventive action of early anticoagulation with full-dose heparin, 90 patients, admitted within 5.2 +/- 4.6 hours after the onset of symptoms of their first episode of acute myocardial infarction (46 anterior and 44 inferior), were prospectively studied. Patients were randomly assigned either to therapeutic anticoagulation with heparin or to no anticoagulant therapy. Serial two-dimensional echocardiograms were recorded on the day of admission, the next day, days 4 to 7 and days 20 to 50 to detect left ventricular thrombus and to assess global left ventricular performance. On the first echocardiogram (10.3 +/- 8.0 hours after the onset of symptoms) no thrombus was visualized. In 44 patients with inferior myocardial infarction (23 receiving heparin and 21 not receiving heparin) no further left ventricular thrombus developed. In 46 patients with anterior myocardial infarction, 21 additional thrombi developed (45.6%) within 4.3 +/- 3.0 days after the acute event. Thrombus developed in 8 (38%) of 21 patients receiving heparin, compared with 13 (52%) of 25 patients not receiving heparin. This difference in ventricular thrombosis was not statistically significant (chi-square with the Yates correction = 0.76; NS). No difference was found between the subgroups in terms of clinical variables, infarct size, hemodynamic impairment, intensity of the inflammatory process and quantitative two-dimensional echocardiographic and cineangiographic left ventricular function. It is concluded that early anticoagulation with heparin reduced by 27% the incidence of left ventricular thrombus formation in anterior acute transmural myocardial infarction, and this relative risk reduction was not statistically significant when compared with findings in the untreated group.
- Published
- 1986
- Full Text
- View/download PDF
33. [Diagnosis of acute aortic dissection by echocardiography].
- Author
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Dubourg O, Delorme G, Guérêt P, Ferrier A, Depondt JL, Lacombe P, Farcot JC, Terdjman M, and Bourdarias JP
- Subjects
- Acute Disease, Aged, Aortic Dissection complications, Aortic Dissection diagnostic imaging, Aortic Aneurysm complications, Aortic Aneurysm diagnostic imaging, Aortic Valve Insufficiency etiology, Evaluation Studies as Topic, Humans, Middle Aged, Pericardial Effusion etiology, Radiography, Aortic Dissection diagnosis, Aortic Aneurysm diagnosis, Echocardiography
- Abstract
Until recently, the diagnosis of aortic dissection rested on aortography. The purpose of this study was to evaluate the diagnostic value of echocardiography in that disease and its ability to inform on the extent of the dissection and on the presence of associated lesions. Twenty-six patients (mean age 64 +/- 10 years) admitted for suspected aortic dissection were explored by echocardiography and the results were compared with those of angiography and/or anatomical findings. Echocardiography provided the diagnosis in 14 of the 16 patients with aortic dissection and excluded it in the remaining 10 patients. The sensitivity and specificity of the method were 87.5 p. 100 and 100 p. 100 respectively. The type of dissection was correctly determined in 90 p. 100 of the patients whose aorta had been totally explored by echocardiography. Aortic regurgitation and pericardial effusion were detected in 81 p. 100 and 50 p. 100 respectively of patients with aortic dissection. These results confirm the diagnostic value of echocardiography in dissection of the aorta. The extent of the lesion can only be evaluated when the whole of the aorta is visualized. The echocardiographic diagnosis is easier when the ascending aorta is involved (type I), while in type III aortic dissection there is a risk of missing a retrograde lesion of the aorta and confusing this type with type I. In this study two kinds of intimal flap motion were observed: in the first one the motion was independent of that of the aorta, while the second one resembled a division of the aortic, wall the motion of which is parallel to that of the aorta.
- Published
- 1988
34. [Takayasu's aortitis. Exploration of the aorta and its branches by digital angiography and cross-sectional echography].
- Author
-
Dubourg O, Thomas D, Lacombe P, Sirinelli A, Frija G, Farcot JC, Grosgogeat Y, and Bourdarias JP
- Subjects
- Adult, Constriction, Pathologic, Female, Humans, Male, Subtraction Technique, Angiography methods, Aortic Arch Syndromes diagnosis, Arteries pathology, Takayasu Arteritis diagnosis, Ultrasonography methods
- Abstract
In Takayasu's disease full radiological exploration of the arteries requires multiple injections of a contrast medium, and this would be difficult to achieve in the course of one single examination. In the present study, two non-invasive methods--digital angiography and cross-sectional echography--were used comparatively to evaluate arterial lesions in 13 ambulatory patients presenting with this disease. Conventional arteriography had previously been performed in 11 of them. The results obtained with digital angiography were considered satisfactory in 12 patients. All underwent aortic and pulmonary echography. Digital angiography and cross-sectional echography provide full, reliable and non-invasive exploration of the aorta and pulmonary artery. Echography shows abnormal thickness of the vascular walls, but the arterial branches can be explored only by digital angiography. The value of these two non-invasive methods is discussed.
- Published
- 1985
35. [Patency of the foramen ovale in paradoxical embolism. Detection by contrast echocardiography and the cough provocation test].
- Author
-
Dubourg O, Haroche G, Terdjman M, Farcot JC, Ferrier A, Gueret P, Delière T, Rigaud M, and Bourdarias JP
- Subjects
- Embolism diagnosis, Female, Heart Septal Defects, Atrial complications, Humans, Male, Middle Aged, Cough physiopathology, Echocardiography, Embolism etiology, Heart Septal Defects, Atrial diagnosis
- Abstract
Five patients with suspected paradoxical embolism were investigated for patent foramen ovale by contrast echocardiography. Right-to-left shunting was demonstrated in 3 patients: during a Valsalva manoeuvre in one and during coughing fits in all three. Patency of the foramen ovale was confirmed by cardiac catheterization in these 3 patients. In 2 patients the foramen was not patent and the diagnosis of paradoxical embolism was not confirmed. In two other patients, the right and left atrial pressures were measured simultaneously during a Valsalva manoeuvre and during coughing. The normal pressure gradient between the two atria was suppressed during the relaxation stage, resulting in decreased curvature of the interatrial septum which facilitated the flow of blood from the inferior vena cava into the left atrium. Coughing appears to be a simpler and more sensitive test than the Valsalva manoeuvre to induce transient right-to-left atrial shunting.
- Published
- 1983
36. Two dimensional echocardiographic visualization of ventricular septal rupture after acute anterior myocardial infarction.
- Author
-
Farcot JC, Boisante L, Rigaud M, Bardet J, and Bourdarias JP
- Subjects
- Aged, Cardiac Catheterization, Diagnosis, Differential, Female, Heart Murmurs, Humans, Male, Middle Aged, Time Factors, Echocardiography, Heart Septal Defects, Ventricular diagnosis, Myocardial Infarction diagnosis
- Abstract
In three consecutive cases of ventricular septal rupture after acute anterior myocardial infarction, wide angle two dimensional echocardiography readily visualized the septal defect, permitting the defect to be localized and its size estimated. In addition, negative contrast echoventriculography identified a left to right shunt at the ventricular level. The echocardiographic findings were corroborated by cardiac catheterization data in all patients, by perioperative examination in two and by postmortem findings in one patient. Postoperative echocardiographic studies afforded demonstration of the patch closing the defect. In patients with acute myocardial infarction associated with the sudden appearance of a systolic murmur, two dimensional echocardiography should be performed promptly in order to guide the diagnosis and management of these critically ill patients. In some patients with severe cardiogenic shock, in whom a favorable prognosis depends on rapid treatment, two dimensional echocardiography may allow the patient to be taken to surgery immediately without further study.
- Published
- 1980
- Full Text
- View/download PDF
37. Derangements of myocardial metabolism preceding onset of ventricular fibrilliation after coronary occlusion.
- Author
-
Corday E, Heng MK, Meerbaum S, Lang TW, Farcot JC, Osher J, and Hashimoto K
- Subjects
- Animals, Blood Pressure, Coronary Disease metabolism, Coronary Disease physiopathology, Coronary Vessels, Dogs, Electrocardiography, Heart Rate, Heart Ventricles physiopathology, Hydrogen-Ion Concentration, Lactates metabolism, Potassium metabolism, Sodium metabolism, Time Factors, Ventricular Fibrillation metabolism, Ventricular Fibrillation physiopathology, Coronary Disease complications, Myocardium metabolism, Ventricular Fibrillation etiology
- Abstract
To determine alterations in myocardial metabolism and and hemodynamics that occur within the first 30 minutes after coronary arterial occlusion, before the onset of ventricular fibrillation, measurements were compared in two series of dogs. Series A, 90 dogs that did not manifest ventricular fibrillation after coronary occlusion, were considered a control group. Series B consisted of 28 dogs that had ventricular fibrillation within 30 minutes after occlusion. All had similar comprehensive measurements completed preceding the onset of ventricular fibrillation. The animals in series B (subseuqnt fibrillation) had significantly higher heart rates before and after coronary occlusion. In this series cardiac metabolism of the occluded segment judged by transmyocardial lactate extraction, potassium balance, sodium/potassium ratio and blood pH because grossly more abnormal after coronary occlusion than in series A. In 5 animals whose measurements were obtained within 5 minutes of the onset of ventricular fibrillation, a sudden massive lactate production, potassium loss and increased acidosis of the occluded portion supervened minutes before the onset of the fatal arrhythmia. Animals with ventricular fibrillation had higher intracoronary S-T segment elevation that persisted until the onset of ventricular fibrillation. Measurements of abnormal hemodynamic function (left ventricular end-diastolic pressure, peak systolic pressure and first derivative of left ventricular pressure [DP/dt]) were not associated with an increased incidence of ventricular fibrillation. The study indicates that animals that manifest ventricular fibrillation within 30 minutes after coronary occlusion have higher preocclusion heart rates, a more severe metabolic disorder of the coronary occluded segment and more persistent intracoronary S-T segment elevation compared with animals that do not manifest ventricular fibrillation.
- Published
- 1977
- Full Text
- View/download PDF
38. Contrast echocardiographic visualization of cough-induced right to left shunt through a patent foramen ovale.
- Author
-
Dubourg O, Bourdarias JP, Farcot JC, Gueret P, Terdjman M, Ferrier A, Rigaud M, and Bardet JC
- Subjects
- Adolescent, Adult, Aged, Contrast Media, Female, Heart Septal Defects, Atrial physiopathology, Hemodynamics, Humans, Male, Middle Aged, Coronary Circulation, Cough, Echocardiography methods, Heart Septal Defects, Atrial diagnosis, Valsalva Maneuver
- Abstract
In a series of 24 consecutive patients referred to the echocardiography laboratory because of suspected patent foramen ovale, contrast two-dimensional and M-mode echocardiographic studies were performed during normal breathing and during two provocative tests: the Valsalva maneuver and cough. A right to left shunt was visualized in 8 patients during normal breathing, in 11 patients during the Valsalva maneuver and in 17 patients during the cough test. Cardiac catheterization performed in all 24 patients and postmortem examination available in 3 patients confirmed the patency of the foramen ovale in only 15 patients. In these 15 patients, echo contrast appeared in the left heart cavities in early systole and almost simultaneously with complete right heart opacification. In contrast, for the two false positive results during the cough test, ultrasound contrast appeared at any time of the cardiac cycle when the right heart cavities had been partially cleared of contrast material. Right and left atrial pressures were simultaneously measured in four patients, and the normal interatrial pressure gradient was reversed during the Valsalva maneuver and the cough test. Echocardiography during both provocative tests showed that the interatrial septum flattened or became convex toward the left atrium. The cough test appears to be more reliable and easier to perform in critically ill patients than the Valsalva maneuver for the detection of right to left shunting through a patent foramen ovale.
- Published
- 1984
- Full Text
- View/download PDF
39. [Pericarditis with recurrent cardiac compression in rheumatoid polyarthritis].
- Author
-
Evard D, Baglin A, Gueret P, Farcot JC, Rey LP, and Paolaggi JB
- Subjects
- Aged, Humans, Male, Recurrence, Arthritis, Rheumatoid complications, Cardiac Tamponade etiology, Pericarditis etiology
- Abstract
The authors report the case of seventy-two-year-old man with severe rheumatoid arthritis in whom onset of right ventricular failure led to the discovery of pericarditis. After fluid withdrawal, the anterior part of the pericardium was resected. Analysis of the fluid and histological findings suggested a rheumatoid origin. Pericarditis recurred two and a half years later causing subacute compression of the heart leading to repeated centeses in spite of corticosteroid therapy. In the terminal stage, M. tuberculosis was discovered but this finding was not confirmed subsequently. The main features of rheumatoid pericarditis are reviewed. Tuberculous pericarditis should be considered in patients under corticosteroids or immunosuppressive agents.
- Published
- 1983
40. [Quantitative semi-automatic analysis of the M mode echocardiogram].
- Author
-
Farcot JC, Boisante L, Bardet J, and Bourdarias JP
- Subjects
- Automation, Humans, Echocardiography methods
- Published
- 1981
41. [Two-dimensional echocardiography in a cardiac intensive care unit].
- Author
-
Guéret P, Dubourg O, Ferrier A, Farcot JC, Terdjman M, Delorme G, and Bourdarias JP
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Coronary Care Units, Echocardiography methods, Heart Diseases diagnosis
- Abstract
The increasing number of physicians competent to carry out emergency echocardiography, and the availability of high performance equipment, facilitated the development of this technique in the Coronary Care Unit (CCU). This paper reports our experience of 610 2D echocardiographic recordings performed on 319 patients admitted to the CCU. The quality of the recording was excellent or satisfactory in 67% of cases and mediocre in 30% of cases. In 11 patients (3%) the quality of the recording was too poor to obtain reliable data. In this group of patients, the apical 4-chamber and subcostal views seemed better than the apical 2-chamber and parasternal views. An echocardiographic diagnosis was made in 94% of cases. It contributed to the diagnostic process in 70% of cases. Of the patients studied, 54% were admitted for a recent myocardial infarction. Echocardiography was particularly useful in atypical forms or when the diagnosis was difficult. It was also helpful in detecting complications of recent myocardial infarction, the frequency of which was determined. With respect to other cardiovascular emergencies, echocardiography was determined. With respect to other cardiovascular emergencies, echocardiography was very useful in the diagnosis of dissection of the aorta, pericarditis and for assessing left ventricular function and the causal mechanism in cases of decompensated cardiac failure. The non invasive nature of the investigation allows repeated examination of the patient at the bedside and makes it a particularly valuable technique to monitor the evolution of acute cardiac conditions requiring admission to the Coronary Care Unit.
- Published
- 1986
42. Right ventricular volumes by thermodilution in the adult respiratory distress syndrome. A comparative study using two-dimensional echocardiography as a reference method.
- Author
-
Jardin F, Gueret P, Dubourg O, Farcot JC, Margairaz A, and Bourdarias JP
- Subjects
- Adolescent, Adult, Aged, Blood Pressure, Evaluation Studies as Topic, Humans, Middle Aged, Reference Values, Stroke Volume, Blood Volume, Echocardiography methods, Heart physiopathology, Respiratory Distress Syndrome physiopathology, Thermodilution
- Abstract
Measurements of right ventricular ejection fraction and volumes were obtained at bedside by the thermodilution method performed with a fast-response balloon-tipped thermistor in a group of 18 patients undergoing respiratory therapy for the adult respiratory distress syndrome (ARDS). These measurements were compared with right ventricular dimensions simultaneously obtained with two-dimensional echocardiography. A significant correlation was found between right ventricular ejection fraction by thermodilution and two-dimensional echocardiographic fractional area contraction (r = 0.74; p less than 0.001), between right ventricular end-diastolic volume by thermodilution and two-dimensional echocardiographic end-diastolic area (r = 0.70; p less than 0.001), and between right ventricular end-systolic volume by thermodilution and two-dimensional echocardiographic end-systolic area (r = 0.78; p less than 0.001). Right ventricular end-diastolic pressure, a commonly used index of right ventricular preload, did not correlate with two-dimensional echocardiographic end-diastolic area. In conclusion, the thermodilution method allowed reliable measurements of right ventricular ejection fraction and volumes at bedside in critically ill patients. Appraisal of right ventricular end-diastolic volume by this method appeared to be a better predictor of right ventricular preload than were the measurements of pressure.
- Published
- 1985
- Full Text
- View/download PDF
43. Vasodilator synchronized retroperfusion: quantitative assessment of flow-function relation in acutely ischemic canine myocardium.
- Author
-
Berdeaux A, Farcot JC, Giudicelli JF, and Bourdarias JP
- Subjects
- Acute Disease, Animals, Coronary Disease drug therapy, Dogs, Female, Male, Nitroglycerin pharmacology, Regional Blood Flow drug effects, Time Factors, Verapamil pharmacology, Coronary Disease physiopathology, Diastole drug effects, Hemodynamics drug effects, Myocardial Contraction drug effects, Perfusion methods, Vasodilator Agents pharmacology
- Abstract
To investigate whether addition of vasodilator drugs can increase the beneficial effects on the ischemic myocardium of diastolic synchronized retroperfusion (DSR), low doses of verapamil (2 micrograms/kg/min) or nitroglycerin (0.7 microgram/kg/min) were infused through DSR in open-chest dogs undergoing 180 minutes of proximal left anterior descending coronary artery occlusion. Verapamil-DSR (n = 6), nitroglycerin-DSR (n = 6) or DSR alone (n = 8, controls) were started 10 minutes after the onset of occlusion and maintained for 170 minutes. Regional myocardial blood flow (MBF) (microspheres) and left ventricular function (endocardial ultrasonic crystals) were simultaneously assessed in nonischemic and ischemic zones in the 3 groups, before and after 10 and 180 minutes of coronary occlusion. DSR alone significantly increased ischemic regional MBF, endocardial/epicardial flow ratio and endocardial segmental length shortening. Verapamil DSR increased both nonischemic and ischemic regional MBF but reduced the endocardial/epicardial flow ratio and worsened ischemic contractile function. Nitroglycerin DSR did not modify ischemic transmural flow compared with DSR alone, but abolished the beneficial endocardial/epicardial blood flow redistribution, resulting in no additional improvement of contractile function. Thus, ischemic MBF and function are not improved by addition of small amounts of verapamil or nitroglycerin to the arterial retroperfusate in this model of acute myocardial ischemia.
- Published
- 1985
- Full Text
- View/download PDF
44. Regional and global myocardial effects of intravenous and sublingual nitroglycerin treatment after experimental acute coronary occlusion.
- Author
-
Lang TW, Meerbaum S, Corday E, Davidson RM, Hashimoto K, Farcot JC, and Osher J
- Subjects
- Animals, Coronary Circulation drug effects, Dogs, Electrocardiography, Hemodynamics drug effects, Infusions, Parenteral, Lactates metabolism, Myocardial Contraction drug effects, Myocardial Infarction physiopathology, Myocardium metabolism, Nitroglycerin administration & dosage, Nitroglycerin therapeutic use, Potassium metabolism, Tongue, Heart drug effects, Myocardial Infarction drug therapy, Nitroglycerin pharmacology
- Abstract
The consequences of sublingual and intravenous nitroglycerin treatment after acute coronary occlusion were studied in 18 closed chest dogs. Intravenous (0.1 mg/min) or sublingual (0.4 mg/15 min) nitroglycerin therapy was instituted 1 hour after occlusion and the effects were observed over a period of 2 hours. Hemodynamics and global and regional cardiac function were measured in both the coronary occluded and nonoccluded segments of the left ventricle before and during coronary occlusion, and after administration of nitroglycerin. A similar nine dog control series was used to establish the significance of the measured effects of nitroglycerin. Intravenous nitroglycerin therapy after 1 hour of occlusion resulted in a marked increase in heart rate (37 +/- 12 [mean +/- standard error of the mean] percent), reduction of systolic blood pressure (9 +/- 3%), decrease in left ventricular end-diastolic and end-systolic volumes (32 +/- 5% and 34 +/- 5%), increase in coronary sinus flow (64 +/- 24%) and decrease in left ventricular stroke work (29 +/- 8%). Sublingually administered nitroglycerin produced similar trends but much less pronounced effects. However, intravenous or sublingual administration of nitroglycerin provided no improvement or caused further deterioration in ischemic region lactate extraction and potassium loss. The left ventricular ejection fraction, which was severly depressed after 1 hour of occlusion, changed minimally after administration of nitroglycerin, and there was no evidence of any correction of regional left ventricular akinesia or dyskinesia. Whereas mean systemic vascular resistance changed minimally as a result of nitroglycerin therapy, it increased 19 +/- 8% during a corresponding period of an untreated coronary occlusion series suggesting that nitroglycerin prevented an anticipated increase. Postocclusion S-T segment elevation in the electrocardiogram persisted after treatment. Our data corroborated that nitroglycerin reduced left ventricular volumes and increased coronary sinus flow; however, these improvements were accompanied by persisting metabolic and mechanical derangements in the ischemic region.
- Published
- 1976
- Full Text
- View/download PDF
45. [Two-dimensional contrast echocardiography during the drainage of hemopericardium with tamponade].
- Author
-
Dubourg O, Ferrier A, Gueret P, Farcot JC, Terdjman M, Rocha P, and Bourdarias JP
- Subjects
- Adult, Drainage, Humans, Male, Middle Aged, Pericardial Effusion therapy, Cardiac Tamponade etiology, Echocardiography methods, Pericardial Effusion diagnosis
- Abstract
In patients with cardiac tamponade, withdrawing blood during pericardiocentesis raises questions as to its origin: pericardium or cardiac cavities? These questions can be answered by bidimensional contrast echocardiography after reinjection of a few millilitres of the blood-stained fluid removed. Microcavitations surrounding the heart and vanishing within a few minutes indicate that blood comes from the pericardium. Microcavitations obscuring the right atrium or ventricle and washed away by the blood flow in a matter of seconds indicate that these cavities have been punctured.
- Published
- 1983
46. Do risk factor interventions prevent or reverse arteriosclerosis?
- Author
-
Farcot JC, Hashimoto K, Meerbaum S, and Corday E
- Subjects
- Adult, Age Factors, Aged, Coronary Disease therapy, Female, Humans, Hyperlipidemias prevention & control, Hypertension prevention & control, Male, Middle Aged, Obesity prevention & control, Physical Exertion, Research, Risk, Sex Factors, Social Class, Coronary Disease prevention & control
- Abstract
We have attempted to summarize the current controversies regarding risk factors and preventive measures for control of arteriosclerosis and coronary heart disease. Recognizing that the genesis and development of the disease process are extremely complex and the basic knowledge is limited, it is not likely that conclusive answers to questions will be forthcoming soon which will provide more effective preventive or therapeutic measures. It might be desirable to institute educational and control program aimed at curtailing, at a young age, known AS risk factors such as heavy smoking, particularly if the family history indicates severe risk. Few will question the normal approaches to the treatment of complications of coronary heart disease by control of hypertension, elevated cholesterol, and smoking. However, great caution must be exercised when trying to institute large scale modifications in prevailing life patterns, particularly when based on indefinite risk factor studies and in the face of potentially profound and frequently unknown consequences. The unknowns of atherosclerotic heart disease risk factors, coupled with uncertainties and even doubts about protracted and expensive population studies, lead us to propose an emphasis on alternate selective approaches. We strongly believe that fundamental to progress in the field of arteriosclerosis is an amplification of preventive research efforts with stronger attention focused upon influencing the atherosclerotic processes within the arterial wall. But, more immediately, we urge systematic gathering and careful evaluation of patient data in particular population subsets which exhibit and accelerated mode of arteriosclerosis. Comparative studies of patients, particularly twins, families, and ethnic populations with redilection to early or accelerated arteriosclerosis may be extremely rewarding. Our repeated review of the enormous literature suggests that worldwide collaboration is needed to perfect more meaningful protocols as well as to correlate and critically evaluate existing data provided by population studies of this insidious disease process which represents an evermounting burden to society.
- Published
- 1977
47. [Pericardial effusions (85 cases): radiological aspects (author's transl)].
- Author
-
Frija G, Bilaine J, Farcot JC, Gaux JC, and Bismuth V
- Subjects
- Acute Disease, Cardiac Volume, Cardiomegaly complications, Cardiomegaly diagnostic imaging, Humans, Pericardial Effusion complications, Pericarditis complications, Pericarditis diagnostic imaging, Radiography, Pericardial Effusion diagnostic imaging
- Abstract
A radiological study of 85 patients with acute pericarditis and effusion included a group of 35 cases observed before the introduction of ultrasonography and a second group of 50 patients in whom the presence of pericarditis had been confirmed by this investigation. The most important conclusions established were the following: --Absence of radiological signs in 55% of cases (group 1 : 46%, group 2 : 60%); normal heart size in 54% (group 1) and 78% (group 2), and increased size in 34% (group 1) and 20% (group 2). --Hilar manifestations (overlapping and obscuring of the left hilar region) in 26% of cases with a clear predominence of the left forms (14 out of 22). The cardiomegaly was not significant in 28% (group 1) and 14% (group 2). --The high frequency of pericarditis with a normal heart size has to be emphasized. The diagnostic value of hilar manifestations is also mentioned; the sign of left hilar overlapping is described in greater detail. --An overall comparison between the two groups shows, more particularly, the equal importance of left hilar manifestations for the radiological diagnosis of pericarditis. In a general way, it would appear that these hilar signs are the only elements which enable objective diagnosis of pericardial effusions on standard films.
- Published
- 1979
48. Methylprednisolone treatment in acute myocardial infarction. Effect on regional and global myocardial function.
- Author
-
Osher J, Lang TW, Meerbaum S, Hashimoto K, Farcot JC, and Corday E
- Subjects
- Acute Disease, Animals, Coronary Disease drug therapy, Coronary Vessels drug effects, Dogs, Electrocardiography, Hemodynamics drug effects, Lactates metabolism, Methylprednisolone pharmacology, Myocardial Infarction physiopathology, Myocardium metabolism, Oxygen blood, Potassium metabolism, Heart physiopathology, Methylprednisolone therapeutic use, Myocardial Infarction drug therapy
- Abstract
The effects of methylprednisolong treatment on acute myocardial ischemia were studied in nine closed chest dogs. After 1 hour of proximal occlusion of the left anterior descending coronary artery, an intravenous bolus injection (50 mg/kg body weight) of methylprednisolone was administered and its effects studied during an additional 2 hours of occlusion. After 2 hours of treatment the following significant mean alterations from levels after 1 hour of occlusion were noted: an increase of 16.7% in heart rate and decreases of 23% in left ventricular end-diastolic pressure, 32% in stroke volume, 14% in cardiac output and 37% in stroke work. Peak systolic pressure, maximal rate of rise of left ventricular pressure (dP/dt), left ventricular end-diastolic volume, systemic vascular resistance and coronary sinus blood flow changed less than 10%. Ejection fraction and regional cardiac wall motion were not improved. Metabolic dysfunction of the coronary-occluded myocardium, revealed by regional lactate as well as potassium derangements, persisted throughout the 2 hour treatment period. Comparison of these results with equivalent data from an untreated series of nine dogs with 3 hours of occlusion demonstrated no improvement in the treated series. Methylprednistone failed to restore regional cardiac metabolic and mechanical function, and treatment was associated with a further rise in S-T segment elevations. Administration of methylprednisolone after 1 hour of proximal left anterior descending coronary occlusion apparently does not reverse cardiac dysfunction in the first 2 hours of treatment.
- Published
- 1976
- Full Text
- View/download PDF
49. Effects of diastolic synchronized retroperfusion on regional coronary blood flow in experimental myocardial ischemia.
- Author
-
Berdeaux A, Farcot JC, Bourdarias JP, Barry M, Bardet J, and Giudicelli JF
- Subjects
- Animals, Coronary Vessels physiopathology, Diastole, Dogs, Electrocardiography, Heart Rate, Microspheres, Stroke Volume, Coronary Circulation, Coronary Disease therapy, Perfusion
- Published
- 1981
- Full Text
- View/download PDF
50. Influence of positive end-expiratory pressure on left ventricular performance.
- Author
-
Jardin F, Farcot JC, Boisante L, Curien N, Margairaz A, and Bourdarias JP
- Subjects
- Blood Pressure, Blood Volume, Diastole, Echocardiography, Heart Septum physiology, Hemodynamics, Humans, Myocardial Contraction, Plasma Substitutes pharmacology, Positive-Pressure Respiration adverse effects, Respiratory Distress Syndrome physiopathology, Respiratory Distress Syndrome therapy, Systole, Cardiac Output, Positive-Pressure Respiration methods
- Abstract
Although left ventricular dysfunction is common during ventilatory support with positive end-expiratory pressure (PEEP), the mechanism of this disorder remains unclear. In 10 patients with the adult respiratory-distress syndrome we studied the effects of a stepwise increase in PEEP from 0.to 30 cm H2O on left ventricular output, intracardiac transmural pressures, and two-dimensional echocardiographic measurements of left ventricular cross-sectional area at end-systole and at end-diastole. Increasing PEEP was associated with progressive declines in cardiac output, mean blood pressure, and left ventricular dimensions and with equalization of right and left ventricular filling pressures. The radius of septal curvature decreased at both end-diastole and end-systole, implying a leftward shift of the interventricular septum. At the highest PEEP, blood-volume expansion did not restore cardiac output, although left ventricular transmural filling pressures had returned to base-line values. We conclude that decreased cardiac output during PEEP is mediated by a leftward displacement of the interventricular septum, which restricts left ventricular filling.
- Published
- 1981
- Full Text
- View/download PDF
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