[Prediction of intolerance to beta blocker therapy in chronic heart failure patients using BNP]. / Prédiction du risque d'intolérance du traitement bêtabloquant chez l'insuffisant cardiaque chronique par le dosage du BNP.

Beta-blocker therapy is actually recommended as first line therapy for systolic heart failure. However, beta-blocker have a low prescription rate comparatively to ACEI. Beta-blocker potential side effects as bradycardia, hypotension and especially acute decompensation could explain this under prescription. Clinical data could easily identify high-risk patients for hypotension or bradycardia but not high-risk patients for induced decompensation linked to beta-blocker therapy. BNP could identify these patients with a high sensitivity. Patients with BNP above 1000 pg/ml had a 40% risk of acute decompensation after introduction or increase of beta-blocker therapy. As a conclusion, clinicians must be very cautious for introducing or increasing Carvedilol therapy in patients with high BNP levels.

[Early postoperative constrictive pericarditis: value of echocardiography. Report of 4 cases]. / Péricardite constrictive postopératoire précoce: intérêt de l'échocardiographie. A propos de quatre observations.

In the present study, four cases of early postoperative constrictive pericarditis have been described which serve as a basis for recalling the current main echographic features of this disorder: pericardial thickening, abnormal septal movement with inspiratory expansion of the right ventricle, respiratory variations in ventricular filling, characteristic modifications in the supra-hepatic pulmonary venous flow, and pulmonary insufficiency. Some hypotheses have also been presented on the possible etiology of this disease. The necessity of making a precise and rapid diagnosis, which should also be confirmed by catheterization to ensure the appropriateness of therapy, has been emphasized. Pericardectomy can determine the long-term prognosis.