ABSTRACT
UNLABELLED: The aim of this study was to determine the relations between myocardial revascularization therapy--coronary artery bypass graft (CABG) and coronary angioplasty (PTCA)--and ventricular potentially malignant arrhythmia (VPMA) (coupled VPC, VPC > 10/hour, NSVT--Morganroth classification), in patients (pts) with stable CAD. METHODS: 765 patients with stable angina and ventricular potentially malignant arrhythmia were evaluated angiochoronarographically, echographically, by programmed electrical stimulation (PES), standard ECG, Holter ECG, radiologically, and by stress test. From 765 patients with CAD and VPMA 169 pts. (22.9% of cases) were revascularized, 77 pts. (10.06% of cases) by CABG surgery and 82 pts. (10.71% of cases) by PTCA with or without stenting. RESULTS: From pts. with inducible sustained ventricular tachycardia by programmed electrical stimulation PES + (129 pts. 16.86% of cases), 19 pts. (2.5% of cases) were with CABG vs 9 pts. (1.17% of cases) with PTCA (p > 0.05). In 333 pts. with arrhythmogenic myocardic ischemia detected by Holter ECG/24 hours (Holter +) the distribution of myocardial revascularization was similar (40 pts., 5.22% of cases with CABG vs 46 pts., 6.01% of cases with PTCA) (p > 0.05). The study included 225 pts. with positive stress test, 45 pts. were revascularized, 18 pts. (2.35% of cases) with CABG and 27 pts. (3.52% of cases) with PTCA (p > 0.05). Revascularized pts. represent an increased percent with prior myocardial infarction in the subgroup with CABG vs. PTCA (39% of cases, p < 0.05 vs. 25% of cases, p < 0.05). Revascularized pts. presented similar distributions of VPMA in subgroups with CABG and PTCA. CONCLUSIONS: VPMA was not influenced by myocardial revascularization, CABG or PTCA, the incidence being similar (50.94% vs 47.2%; p < 0.05) with pts. drug treated.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Artery Bypass , Coronary Artery Disease/physiopathology , Coronary Artery Disease/therapy , Tachycardia, Ventricular/therapy , Adult , Aged , Cardiovascular Agents/therapeutic use , Cohort Studies , Coronary Artery Disease/complications , Electrocardiography , Female , Humans , Male , Middle Aged , Stents , Tachycardia, Ventricular/complications , Tachycardia, Ventricular/diagnosis , Treatment OutcomeABSTRACT
BACKGROUND: Percutaneous transcatheter occlusion with ethanol injection of septal arteries is an efficient treatment procedure of hypertrophic obstructive cardiomyopathy (HOCM). The aim of our study is to evaluate the feasibility and efficiency of septal artery embolization with microcoils. METHODS: The microcoils were delivered through the guide-wire lumen of a 2mm-diameter coaxial balloon positioned inside the target vessel as distally as possible. One or more 0.018"-straight microcoils (Hilal straight coils, Cook, USA) were used for each target vessel until complete flow obstruction was noted. The intraventricular pressure gradient was measured before, during and after the procedure. Septal branch occlusion was finally documented by coronary angiography. RESULTS: We treated 7 patients (pts) (male: 5 pts; mean age: 48 (10 years). All patients were symptomatic (NYHA class 3 or 4). The target vessels were successfully occluded in all patients, without complications. Moderate pain was recorded during and after the procedure and the CK level increased five- to ten-fold. The pressure gradient diminished during the procedure from 72 +/- 21 mm Hg to 30 +/- 15 mm Hg. The number of coils delivered ranged from 3 to 7 / patient. The embolized septal branches: 1 vessel in 5 patients; 2 vessels in 1 patient; 3 vessels in 1 case. After the procedure the pressure gradient, evaluated by transthoracic echocardiography, was 34 +/- 16 mm Hg and 42 +/- 12 mm Hg at 3 month-follow-up. Clinical improvement was recorded in all patients after the procedure (NYHA class 1 or 2). Temporary pacing was necessary in 3 patients during and immediately after the procedure but no patient needed permanent pacing. CONCLUSIONS: Microcoil embolization is an efficient and safe approach for transcatheter ablation of septal hypertrophy in HOCM. This technique induced myocardial necrosis without the toxic effects of alcohol, reducing the risk of complications (permanent pace-maker implantation, ethanol flow to other myocardial regions).
ABSTRACT
Forty patients with centrofacial lentiginosis have been studied. A greater than normal number of bone abnormalities, malformations due to dysraphia, endocrine dysfunctions, and neurological diseases, but not psychiatric impairment, were found.
Subject(s)
Facial Dermatoses , Lentigo , Adolescent , Adult , Bone and Bones/abnormalities , Child , Facial Dermatoses/complications , Facial Dermatoses/diagnosis , Female , Humans , Lentigo/complications , Lentigo/diagnosis , Male , Mental Disorders/complications , Spinal Dysraphism/complicationsABSTRACT
In a group of 120 mental patients, the authors found obvious camptodactyly in 65 patients (46%), especially in psychopaths, neurotics and related conditions. Clinical, psychological, radiological and laboratory investigations were carried out in 25 of these cases. The disease was accompanied by disorders of glucose metabolism, endocrine abnormalities, EEG and bone abnormalities together with arthrosis. The mental disorder, causing an inability to return to work, attracted our attention to the series of abnormalities found in these subjects investigated.
Subject(s)
Fingers , Hand Deformities, Acquired , Mental Disorders/complications , Metabolic Diseases/complications , Adult , Female , Humans , Male , Middle AgedABSTRACT
A marked camptodactylia, or a mere suggestion of it, was found in 91 (56; 5%) of 161 mentally ill patients, particularly in psychopaths, neurotics and patients in a neurotic state. Clinical, psychological, radiological and biological investigations were carried out in 33 patients. The camptodactylia was frequently associated with distrubances of the carbohydrate metabolism, especially with spontaneous hypoglycemias, as well as arthrotic skeletal changes. The mental disease, which had resulted in incapacity for work, had made us aware of the diversity of the anomalies in our patients.
Subject(s)
Finger Joint , Adolescent , Adult , Arthritis, Rheumatoid/complications , Child , Disability Evaluation , Endocrine System Diseases/complications , Female , Glucose Tolerance Test , Hand Deformities, Acquired/complications , Hand Deformities, Acquired/etiology , Humans , Hypoglycemia/complications , Male , Mental Disorders/complications , Mental Disorders/diagnosis , Middle Aged , RomaniaABSTRACT
The authors present the results of an investigation on 39 cases of centrofacial lentiginosis. Eleven patients urged to be examined because of their alarming health condition, and 28 cases were found out following an inquiry within some collectivities. With centrofacial lentiginosis the cutaneous hereditary polydysplasia (characterized by typical lentigines), the dysraphic state and neuro-psychic troubles are usual and awaken the interest of the radiologist due to the frequency of various dysmorphoses, growth disturbances and a trend for arthrosis. The radiologist has to pay a due attention to these aspects representing as many manifestations of a disease of a hereditary-family type since a possible centrofacial lentiginosis also means a possible disabling potential associated with education and vocational training problems.
