[Myxoma of the mitral valve; apropos of 2 surgically treated cases. Review of the literature]. / Myxome de la valve mitrale; á propos de deux cas opérés. Revue de la littérature.

The authors report two cases of anterior mitral valve myxoma. This is an exceedingly rare localisation and these cases add to the other 8 previously reported cases. Intracardiac tumours and valvular endocarditis may be detected non-invasively by echocardiography but the precise diagnosis may be extremely difficult: mitral valve myxoma is an exceptionally rare condition. Treatment was surgical in both reported cases.

[Cardiac output studied by a non invasive method in hypertensive patients]. / Etude du débit cardiaque par une méthode non invasive chez des hypertendus.

We measured by thoracic bioimpedance (BoMed, NCCOM3-R7) non invasive cardiac index (CI), stroke index (SI) and systemic vascular resistance index (SVRI) in 48 hypertensive patients (OMS) compared to 30 normotensive. The mean arterial pressure (MAP) and the SVRI were significantly higher in the hypertensive group while the CI are significantly lower, as that was shown in previous invasive studies. We found an inverse correlation between age and CI (r = -.30, p < or = .05) in relation with a negative correlation between SI and age (r = -.35, p < or = .05) and no correlation between heart rate and age. Furthermore we divided normotensive and hypertensive patients in three groups of CI (low CI < 2.8 l/min/m2, 2.8 < or = normal CI < or = 4.2 l/min/m2, high CI > 4.2 l/min/m2) and in three groups of SVRI (low SVRI < 1660 Flohms/m2, 1660 < or = normal SVRI < or = 2580 Flohms/m2, high SVRI > 2580 Flohms/m2). Despite CI diminution in hypertension, high CI percentage's was the same in normotensive and hypertensive patients. In conclusion, these results confirm previous studies by using a simple, easy, non invasive and reproducible method.

[Adjustment of double-chamber pacemakers in VDD mode by measurement of thoracic electric bio-impedance]. / Réglage des stimulateurs double chambre en mode VDD par mesure de la bio-impédance electrique thoracique.

An optimal atrioventricular interval (AVI) was sought in 6 patients with a double chamber pacemaker by an non-invasive technique: measurement of stroke volume by thoracic bioimpedance. This method proved to be easy and reliable in practice when there was only one pacing spike (VDD mode). It confirmed the existence of a variable optimal AVI according to individual patients: 250 ms (3 patients), 200-250 ms (1 patient), 150 ms (1 patient), 75-100 ms (1 patient). The value of optimal AVI is unpredictable since it depends upon individual electrophysiological and hemodynamic parameters. In a patient with severe mitral incompetence, Echo-Doppler provided evidence of end-diastolic ventriculo-atrial regurgitation at middle and long AVI, while a short AVI enabled elimination of end-diastolic regurgitation and a 15.45 per cent improvement in stroke volume. In two patients with a long optimal AVI (250 ms), a programmed short AVI (75 ms) paradoxically appeared to be more favourable than a middle AVI (150 ms).

[Cardiac mass, ventricular relaxation parameters and their correlation with blood pressure during rest and ambulatory monitoring]. / Paramètres de masse cardiaque, de relaxation ventriculaire et leurs corrélations avec la pression artérielle enregistrée au repos et en ambulatoire.

UNLABELLED: A resting blood pressure (Dynamap, 8AM-8PM, one recording every 15 minutes) has been recorded among 60 patients; mean age: 51 +/- 14 years (24 females, 36 males; 3 normotensive and 57 hypertensive WHO) and a echocardiogram TM and two-dimensional with doppler in order to measure the interventricular septum thickness, Left Ventricular Posterior Wall Thickness and the left Ventricular Internal diameter with which we can calculate the myocardial mass (MM, Devereux formula) and the myocardial mass index using the body surface. Furthermore ventricular relaxation has been studied (A/E, PHT) by using doppler echocardiogram. During the same week an ambulatory blood pressure (Nippon Colin 8AM-8PM one reading every 15 minutes) has been recorded. The blood variables are the mean of the recording, systolic, diastolic, mean. We have confirmed the conclusion between blood pressure and left ventricular mass by using resting and ambulatory blood pressure recordings. But it does not exist any significant difference within we compare the correlations coefficients (Hotteling's Test with Williams modification) obtained with two devices. In revenge this difference exists with ventricular relaxation index A/E to MBP: mMBPr = 0.51, mMBPa = 0.34 (p less than 0.05), and PHT to MBP: mMBPr = 0.49, mMBPa = 0.31, (p less than 0.05) and to the SBP: mSBPr = 0.54, mSBPa = 0.35, (p less than 0.05). CONCLUSION: the relationship between blood pressure and myocardial mass and by, the heart effect from hypertension can be studied by using in any case resting and ambulatory blood pressure recordings. This will confirm the hypothesis in which the blood pressure recordings multiplication is more important than the way of recording it.(ABSTRACT TRUNCATED AT 250 WORDS)

[Blood pressure variability and morbidity]. / Variabilité tensionnelle et morbidité.

In a previous study (resting blood pressure profile, Dinamap) we have confirmed the correlations between blood pressure and left ventricular mass (myocardial hypertrophy being one of the morbidity criteria in Hypertension) and we have demonstrated the absence of significant difference (Fisher's z Test) with the results of ambulatory recordings found in literature. Furthermore, we have showed a weaker correlation between absolute variability (AV) and left ventricular mass (LVM). If indeed there exists a cause-effect relationship between the AV increase and the LVM increase, a relative independence between VA and blood pressures mean (mBP) should still be demonstrated. In order to do that we have used the factorial analysis (main components analysis) with which a small number of independent factors can be isolated from a large number of correlated variables. A resting blood pressure (Dinamap, 8AM-8PM, one reading every 15 minutes) has been recorded among 551 patients (259 females, 292 males; 109 normotensive WHO, 442 hypertensive WHO) and an echocardiogram TM and two-dimensional in order to measure the interventricular septum thickness (IVST), the posterior wall thickness (PWT) and the left ventricular internal diameter (LVID) with which we can calculate the myocardial mass (MM, Devereux formula) and the myocardial mass index (MMI) using the body surface (BS). The blood pressure variables are the means of the recordings (mBP): systolic (mSBP), diastolic (mDBP), mean (mMBP) and their standard deviations (SSD, DSD, MSD) corresponding to the AV. We have studied the heart rate (HR) with its standard deviation (HRSD) and age.(ABSTRACT TRUNCATED AT 250 WORDS)