L'image du mois: un serpent en liberté.ANCION, Arnaud ; MARCHETTA, Stella ; BERTHE, Christian et alin Revue Médicale de Liège (2011) Detailed reference viewed: 18 (3 ULg) Full Recovery of Contraction Late after Acute Myocardial Infarction: Determinants and Early PredictorsLancellotti, Patrizio ; Albert, Adelin ; Berthe, Christian et alin Heart (2001), 85(5), 521-6 OBJECTIVES: To assess the relative value of electrocardiographic, echocardiographic, angiographic, and in-hospital therapeutic indices for predicting late functional recovery after acute myocardial ... [more ▼] OBJECTIVES: To assess the relative value of electrocardiographic, echocardiographic, angiographic, and in-hospital therapeutic indices for predicting late functional recovery after acute myocardial infarction, and to determine the variables associated with absence of recovery, partial recovery, and full recovery. DESIGN: Prospective observational follow up study. SETTING: Teaching hospital. PATIENTS: 74 consecutive patients with a first uncomplicated acute myocardial infarct. INTERVENTIONS: Dobutamine-atropine stress echocardiography was performed mean (SD) 5 (2) days after the acute event. Quantitative angiography was available in all patients before hospital discharge. A follow up resting echocardiogram was obtained 12 (2) months later. RESULTS: Functional recovery (partial, n = 18; full, n = 27) was observed in 45 of the 74 patients. Recovery was associated with earlier thrombolytic treatment (p = 0.008), earlier peak concentration of creatine kinase (p = 0.009), greater contractile reserve (p = 0.0001), non-Q wave acute myocardial infarction (p = 0.002), and more frequent elective angioplasty of the infarct related vessel (p = 0.0004). Three independent variables were selected stepwise from multivariate analysis for predicting late recovery: contractile reserve (chi(2) = 24.2, p < 0.0001); non-Q wave infarction (chi(2) = 15.7, p = 0.0001); and the time from symptom onset to thrombolysis (chi(2) = 4.94, p = 0.026). Three independent variables predicted full recovery: contractile reserve (chi(2) = 17.2, p = 0.0001); non-Q wave infarction (chi(2) = 10.1, p = 0.0016); and elective angioplasty of the infarct related artery (chi(2) = 4.53, p = 0.033). Only contractile reserve (chi(2) = 17.0, p < 0.001) was selected from the multivariate analysis for its ability to distinguish between partial recovery and absence of recovery. CONCLUSIONS: Late recovery of contraction relates to earlier treatment, which is associated with lower infarct size unmasked by a non-Q wave event and the presence of contractile reserve. Elective coronary angioplasty of the infarct related artery before hospital discharge is associated with full recovery. [less ▲] Detailed reference viewed: 16 (2 ULg) Haemodynamic Alterations During Ischaemia Induced by Dobutamine Stress TestingPIERARD, Luc ; Berthe, Christian ; Albert, Adelin et alin European Heart Journal (1989), 10(9), 783-90 To identify the haemodynamic response to ischaemia induced by dobutamine stress testing, 15 patients with a first acute myocardial infarction underwent right-sided heart catheterization during dobutamine ... [more ▼] To identify the haemodynamic response to ischaemia induced by dobutamine stress testing, 15 patients with a first acute myocardial infarction underwent right-sided heart catheterization during dobutamine stress cross-sectional echocardiography. Haemodynamic variables and echocardiography were recorded at rest and during dobutamine infusion at each dose from 5 to a maximum of 40 micrograms kg-1 min-1. Ischaemia was diagnosed by cross-sectional echocardiography if asynergy appeared in at least two ventricular segments other than the area of acute myocardial infarction. Ischaemia was absent in six patients (group I) and identified in nine (group II). Response curves for each haemodynamic variable in the two groups were compared by applying Zerbe's method. The response curves were similar in the two groups for heart rate, arterial, right atrial, pulmonary arterial and pulmonary artery wedge pressures. The response curves were significantly different in groups I and II for thermodilution cardiac output, stroke volume and systemic vascular resistance (P less than 0.05). An increase in stroke volume was observed at low dosage of dobutamine in both groups. From low to maximum dose, stroke volume remained unchanged in group I and was significantly decreased in group II. Ischaemia induced by dobutamine stress testing leads to a decrease in stroke volume with no change in pulmonary artery wedge pressure. [less ▲] Detailed reference viewed: 7 (0 ULg) Thrombolysis in anterior myocardial-infarction-effect onregionnal viability studied with positron emission tomography; ; Pierard, Luc et alin Circulation (1987), 76(4), 5 Detailed reference viewed: 7 (4 ULg) Viabilité myocardique après infarctus du myocarde traité par fibrinolyse: évaluation directe par tomographie à émission de positons combinant une étude régionale de la perfusion et de la captation glucidique; ; Pierard, Luc et alPoster (1987, September) Detailed reference viewed: 27 (5 ULg) Thrombolysis in anterior myocardial infarction: effect on regional viability studied with positon emission tomography; ; Pierard, Luc et alin Circulation (1987), 76(suppl.IV), 5 Detailed reference viewed: 5 (1 ULg) |
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