[Atrial septal defect type ostium secundum at the age of 40 or more. Apropos of 86 cases with hemodynamic exploration].

The authors propose a haemodynamic classification for ASD, taking into account the very frequent drop in systemic blood pressure which is observed in this disease in elderly people. The authors examine the clinical signs and the clinical course in terms of this haemodynamic classification and they stress the mitral abnormalities and the arrhythmias. 56% of patients were followed up for a mean of 6 years for non-operated patients and almost 10 years for operated patients.

Myocardial hypertrophy, rate of change of free wall thickness and directional components of ventricular power in man.

The diastolic (Vd) and systolic volumes, the average free wall diastolic thickness (hd) and left cardiac cavity pressures were determined in 25 subjects using monoplan angiography. Ten subjects presented a normal angiogram (NA), 5 a myocardiopathy with predominant dilatation (MCD), 4 a myocardiopathy with predominant non obstructive hypertrophy (MCH), and 6 a volume overload (VO). All the subjects had a normal coronary-cineangiogram.

Detection of residual myocardial function in acute transmural infarction using postextrasystolic potentiation. A computerized angiographic study.

Twelve subjects without clinical or hemodynamic heart failure, admitted for a first untreated anterior transmural myocardial infarction, were evaluated within the first 24 hours after the onset of symptoms. Pulmonary angiography was performed while a right ventricular extrastimulus was delivered every fourth beat at 50% of the RR interval to systematically analyze the basal and the postextrasystolic left ventricular frames. Left ventriculograms were quantitatively processed to determine the ejection fraction (EF) and the percentage of the end-diastolic circumference showing hypokinetic (%HK) or akinetic (%AK) areas.

["Windkessel" and coronary debit].

The aim of this study was to support the hypothesis that aortic distensibility, resulting in a Windkessel effect of the high pressure compartment, may influence coronary blood flow, principally in the subendocardial layers. A hydraulic model of the arterial circulation including a branch representing the coronary circulation, was constructed. A pump giving pulsed flow with ejection parameters and cycle adjusted so as to produce almost physiological pressure curves, was used.

[Ventricular tachycardia in bursts. Electrophysiological and therapeutical study].

22 patients with salvoes of ventricular tachycardia were investigated electrophysiologically and pharmacologically to determine the mechanism of the arrhythmia. The appearance of the ventricular complexes was suggestive of a septal origin. The arrhythmia appeared to occur and regress within precise limits of sinus rhythm.

Differences in dynamic characteristics of the peripheral arteries in normal and hypertensive subjects.

Spontaneous variations of arterial cross section were recorded with impedance rheography (2 MHz) in 20 non-hypertensive subjects and in 23 patients with essential hypertension. The following parameters were measured in both groups: systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiac period (Tc), intrinsic arteria period (Ta) and the ratio of Tc/Ta. Ta and Tc/Ta were significantly different in both groups (p < 0.

[Pregnancy in women wearing a heart valve prosthesis: 5 case histories (author's transl)].

The study of a personal series of five pregnancies and the review of 130 cases published enabled us to recall the physiological, clinical and therapeutic sides of the "pregnancy-heart valve prothesis" combination. Maternal mortality remains at 3%; morbidity, essentially in the form of haemorragic or thrombo-embolic accidents, comes to 45%. We insist on the importance of a pregnancy planned and accepted both by the cardiologist and the obstetrician as contraception is a difficult problem with these patients, classical oestroprogestative methods and intra-uterine devices being too much of a risk.

[Angiographic frame-by-frame computerized evaluation of overall and regional left ventricular wall motion (author's transl)].

This paper describes a semi-automated quantitative method to evaluate left ventricular overall and regional wall motion. Left ventricular (LV) outlines are digitized on a frame-by-frame basis using a sonic graf/pen interfaced with a 9845 HP minicomputer. A high fidelity simultaneous LV pressure recording is also digitized.

[Multicenter epidemiological survey of primary myocardiopathies. Apropos of 380 cases].

A retrospective study of adult congestive cardiomyopathy was carried out; the admission criteria being heart failure with cardiomegaly after the exclusion of known causes of heart failure. Coronary artery disease was excluded by forming two sub groups, one with proven normal coronary arteries at angiography or autopsy and the other with only assumedly normal coronary arteries. The results concern the study of the incidence of this disease which has been regularly seen over the last 10 years in departments with a large number of referrals of cardiomyopathy.

[Acute myocarditis simulating myocardial infarct with regressive heart failure].

Two patients were hospitalised with severe heart failure and hypotension thought initially to be due to acute anterior myocardial infarction because of very suggestive electrocardiographic appearances. Heart failure rapidly regressed in both cases. The young age of these two patients, the pyrexia, rapid and total regression of the ECG appearances, the absence of atheromatous lesions at coronary angiography and clinical cure with a follow-up of 10 years in one of the cases, were factors in favour of the diagnosis of acute myocarditis.

Multilevel block in the atrioventricular node during atrial tachycardia and flutter alternating with Wenckebach phenomenon.

The electrocardiograms of 100 patients with rapid and regular PP intervals during atrial arrhythmias (because of atrial tachycardia or flutter, or pacing) were examined for periods of irregular atrioventricular conduction. This irregular conduction corresponds to an alternating Wenckebach phenomenon, of a type that can be determined from simple rules. The different types of conduction encountered in different patients and the changes seen in the same patient suggest that the atrioventricular node functions physiologically with 3 levels of sequential block.