[Comparison of 14 methods for analysing left ventricle segmental kinetics by cineangiography]. / Comparaison de 14 méthodes d'analyse de la cinétique segmentaire du ventricule gauche par cinéangiographie.

Fourteen methods of analysing left ventricular wall motion on 30 degrees right anterior oblique left ventricular cineangiography were compared in 70 cases using a HP 9845 B computer. The methods included the superposition of the centres of gravity, perpendicular to the long axis, Leighton's Rickard 's, Ingels ' and others to determine the influence of the use of different anatomical points of reference on the results. A score was given for each programme in comparison with three groups of normal angiography, anterior infarction and inferior infarction limited to a single zone with no lesion on the opposite coronary artery. The score was the ratio of radial shortening of normal wall motion to that of the infarcted wall. The fourteen methods were divided into 4 groups according to the type of infarct studied (anterior or inferior) and according to the use of either percentage radial shortening or the ratio of the surfaces described by these radii and the systolic and diastolic contours. The results underlined the importance of the anatomical references : aortic orifice and apex for centering systolic and diastolic contours. The methods which did not take these factors into account or which did not correct for them in diastole and systole gave poor results. The centre of gravity of the systolic contour was also an unreliable reference point. The three methods which gave the best results, independent of the site of infarction or the method of calculation (ratio of the radii or surfaces) were all based on the long axis from the aortic orifice to the apex.(ABSTRACT TRUNCATED AT 250 WORDS)

[Complications of idiopathic mitral valve prolapse. Prevention and treatment]. / Complications du prolapsus valvulaire mitral idiopathique. Prévention et traitement.

Mitral valve prolapse is the most common form of heart disease, as it occurs in 4 to 6 per cent of the population. It has a benign course in the majority of cases, but 5 types of severe complication can occur in 15 per cent of cases. Mitral incompetence occurs in 14.8 per cent of cases. It may develop gradually or suddenly, following rupture of the chordae, which requires rapid surgical repair. Mitral valve prolapse is complicated by infectious endocarditis in 2.9 per cent of cases, hence the need for antibiotic prophylaxis prior to dental treatment or surgery in patients with a pan-systolic or end-systolic murmur. The only arrhythmias which should be considered as complications and treated as such are frequent ventricular extrasystoles of more than 30 per hour, usually associated with bigeminy, runs or polymorphism, ventricular tachycardia and ventricular fibrillation. Treatment consists, primarily, of beta-blockers. Sudden death is of course the major complication, occurring in 1.4 to 2.4 per cent of cases. The patients at risk of this complication are middle-aged women (40 years) with a past history of syncope or faintness due, in most cases, to episodes of ventricular tachycardia or ventricular fibrillation. Apart from arrhythmia, coronary artery spasm has also been found to be a cause of sudden death in these patients. Transient or definitive ocular and cerebral ischaemic episodes can also complicate mitral valve prolapse. Mitral valve prolapse is found in 20 to 30 per cent of patients with neurological accidents before the age of 45. Preventative treatment consists of anti-platelet aggregation agents and anticoagulants in recurrent cases.

[Visual complications of mitral leaflet prolapse (author's transl)]. / Complications visuelles des prolapsus de la valve mitrale. Deux observations.

Among ten patients with acute ischemic cerebral accident and mitral leaflet prolapse, two women presented with visual disturbances consistent with embolism in the ophthalmic or posterior cerebral circulation. These observations emphasize the importance of thorough cardiovascular assessment in all patients with acute cerebral or ocular ischemia, and we suggest that echocardiography should be part of routine investigation of such patients.