Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Dec 2000
Clinical Trial[Efficacy of colchicine in recurrent acute idiopathic pericarditis].
Acute idiopathic pericarditis is complicated by recurrence in 15 to 30% of cases. The preventive treatment of recurrences is not well codified. Aspirin, non-steroidal anti-inflammatory drugs and corticoids are the commonest prescribed treatments. ⋯ Progressive withdrawal of NSAID and steroids was obtained in 8/10 cases. The authors conclude that colchicine is useful in the prevention of recurrence of acute pericarditis. It may be proposed as treatment of choice, especially in the idiopathic forms.
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Arch Mal Coeur Vaiss · Dec 2000
[Anomalties of the interatrial septum and latent atrial vulnerability in unexplained ischemic stroke in young adults].
Seventy-four consecutive patients (18 to 55 years) underwent programmed atrial stimulation in the investigation of unexplained ischaemic stroke after a full work-up including transoesophageal echocardiography to exclude abnormalities of the interatrial septum (patent foramen ovale and/or atrial septal aneurysm). The parameters recorded during atrial electrophysiological investigation were: the effective atrial refractory period, loco-regional intra-atrial conduction, the index of latent atrial vulnerability and the inducibility by the extrastimulus technique. ⋯ Fifty two per cent of patients with an anomaly of the atrial septum had latent atrial vulnerability compared with 26% of those with normal transoesophageal echocardiography (p = 0.02). These results confirm the relationship between atrial septal anomalies and latent atrial vulnerability in unexplained ischaemic stroke of young adults.
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Arch Mal Coeur Vaiss · Nov 2000
Clinical Trial[Prolongation of the averaged QRS complex. A simple prognostic factor in patients with post-infarction bundle branch block and a history of syncope].
Patients with a history of myocardial infarction and complete bundle branch block with syncopal episodes have a high risk of sudden death: the identification of the cause of the syncope is therefore essential. The aim of the study was to assess the diagnostic value of non-invasive techniques used in the investigations of syncope: 24 hour Holter recording, high amplification ECG and measurement of left ventricular ejection fraction. The results of these investigations were compared with those of complete electrophysiological investigation evaluating atrioventricular conduction and the inducibility of tachycardia. ⋯ Uni- and multivariate analysis showed induction of ventricular tachycardia to be a significant risk factor for global mortality and sudden death but prolongation of the averaged QRS complex (> 165 msec) was also an independent risk factor of global cardiac mortality. The authors conclude that simple prolongation of the averaged QRS duration > 160 ms in patients with right bundle branch block and > 170 ms in patients with left bundle branch block after myocardial infarction and syncope is a significant poor prognostic factor. However, this sign is not predictive of sudden death.
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Arch Mal Coeur Vaiss · Nov 2000
Clinical Trial[Study of the reproducibility of cardiac output measurement during exercise in pre-pubertal children by doppler echocardiography and CO2 inhalation].
Non-invasive measurement of the cardiac output is essential in investigations of healthy children. However, the data concerning the reproducibility of the measurements are very limited. The aim of this study was to assess the reproducibility of the measurement of cardiac output during exercise by Doppler echocardiography and reinhalation of CO2 (extrapolation method). ⋯ They also demonstrate a better reproducibility of cardiac output measurement by Doppler echocardiography (coefficient of variation: 7.5% at rest and 5.2% at maximal effort) compared with reinhalation of CO2 (coefficient of variation: 16.8% at rest and 11.7% at maximal effort). Both methods showed better reproducibility on exercise, resulting from smaller variations in heart rate and stroke volume on effort than at rest. The authors conclude that Doppler echocardiography is very accurate and its simplicity makes it the method of choice in pre-pubertal children for measuring cardiac output during exercise.
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Arch Mal Coeur Vaiss · Aug 2000
[Validation of electronic automatic-measurement arterial blood pressure devices].
Validation of automatic devices for self blood pressure measurement is a necessity, as the mercury columns are no longer available. The European consensus meeting organized by the Group for blood pressure measurement and evaluation (GEM), from French Society of Hypertension held last June 1999 has defined a new international protocol for clinical validation of these devices. ⋯ The evaluation is interrupted after the 15th patient if the pre-analysis fails defined criteria. Technical supports are available: A CD-rom from French society of HTA for the training and certification of observers, a special kit for the evaluation (2 mercury column's and a double stethoscope) and a specific software for data analysis created by the GEM.