[Cardiac output studied by a non invasive method in hypertensive patients].

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 = -.

[Adjustment of double-chamber pacemakers in VDD mode by measurement of thoracic electric bio-impedance].

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).

[Cardiac mass, ventricular relaxation parameters and their correlation with blood pressure during rest and ambulatory monitoring].

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.

[Blood pressure variability and morbidity].

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.

[Relationship between heart mass and semi-ambulatory pressure profiles].

This work was undertaken with 420 patients (90 normotensives: casual blood pressure less than or equal to 140/90 mmHg and 330 hypertensives) in which was recorded a semi ambulatory blood pressure profile (Dinamap 8AM-8PM, a reading every fifteen minutes). On the same day an echocardiogram was performed. We have correlated the left ventricular mass, the left ventricular mass index, the interventricular septum, the left ventricular cavity volume and the left ventricular posterior wall with casual blood pressure, average daily blood pressure standard deviation and variation coefficient for mean blood pressure, systolic blood pressure and diastolic blood pressure.

[Arterial pressure--self measurement. Recommendations. French Society for Arterial Hypertension--the Measurement Group].

Self-measurement of blood pressure has become widespread in recent years. It may be defined as the measurement of arterial pressure by a conscious and free-willed subject. Self-measurement must remain a medical procedure, which means that doctors should be able to advise their patients (a) on the type of apparatus they should purchase and get validated at regular intervals; (b) on the method of using the apparatus in practice, and (c) on the circumstances, conditions and numbers of measurements to be performed.

[Blood pressure variation].

A blood pressure profile at rest was recorded in 2,000 patients (1,069 females, 931 males) by DINAMAP 845 (from 8 AM to 8 PM. a record every fifteen minute). The limit between normotensive and hypertensive patients in this settled by WHO (BP = 160/95 mmHg).

[Study of the placebo effect by the pressure profile method].

The effect of one tablet of placebo daily for 8 days on blood pressure was studied in 90 hypertensive patients, using the blood pressure profile method, with a 12-hour recording period (from 8 a.m. to 8 p.

[Analysis of 1,400 blood pressure profiles].

Hypertension may be defined by 3 criteria obtained by indirect, non invasive, automatic measurement of blood pressure using the DINAMAP device analyses the profile obtained over a 12 hour period (one recording every fifteen minutes): percentage of abnormal values (BP greater than 160/95 mm Hg), average values of systolic, diastolic and mean BP, variability (standard deviation of means), The analysis was based on 1,400 profiles recorded from 174 normotensive and 1,226 hypertensive patients. The following observations were made: the largest group was that of patients with predominantly diastolic hypertension under 60 years of age (81.3 p.

[Delayed filling of the anterior interventricular artery. Apropos of 9 cases].

Selective coronary angiography has shown that typical angina pectoris may occur in the absence of atheromatous coronary stenosis. Other causes of these attacks of pain have been found: coronary spasm, small vessel disease, abnormal dissociation of haemoglobin or metabolic disturbances of the myocardial cell. Of all the patients undergoing coronary angiography in 1984 at the Centre Cantini, 9 had no classical coronary lesions but delayed filling of the left anterior descending artery.

[Large right intracardiac thrombus cause of recurrent pulmonary embolism. Apropos of a case of favourable course].

Echocardiography may be used in patients presenting with pulmonary embolism to visualise the right heart. The authors report the case of a patient who had recurrent pulmonary embolism. Echocardiography demonstrated a large, mobile thrombus moving freely through the tricuspid valve.

Effect of a new calcium antagonist, tiapamil, in hypertension of the elderly.

The antihypertensive effect of a single oral dose of tiapamil (450 mg) and placebo were compared in a single blind randomized cross-over study in 10 71-86 year old hypertensive patients. Blood pressure (BP) and heart rate (HR) were recorded every 15 min for 12 h by an automatic device. Tiapamil led to a decrease in mean daytime systolic (SBP) and diastolic (DBP) BP from 171 +/- 12/98 +/- 10 mm Hg to 159 +/- 11/90 +/- 9 mm Hg (P less than 0.

[Arterial hypertension induced by a nasal decongestant. Value of the use of an automatic and programmable recording technic].

The case of a twenty-three-year-old woman with spasmodic coryza in whom the overuse of a nasal decongestant resulted in arterial hypertension is reported. The relationship between the treatment and the occurrence of hypertension is firmly established. The original feature of this case is the use of the technique for monitoring the blood pressure and heart rate, before and after the treatment had been discontinued, which ascertained the hypertension, making it appear as an experimental model.

[Abnormalities of insulin secretion in coronary patients. Apropos of 67 cases].

The curve of blood insulin levels recorded during the oral provoked hypoglycaemia test (OPHG) was studied in 67 proven coronary patients. None of the curves obtained was normal. The abnormalities found in this way are of two types: either a hypoinsulinaemic response, with a high non-retarded peak (type 1) or a high retarded peak (type 2), or else a hypoinsulinaemic response, with a flat curve (type 3) or a very small late peak (type 4).

Effect of atenolol, a new cardioselective beta-blocker, on plasma renin activity in treatment of hypertension.

Atenolol, a cardioselective beta-blocking drug, was prescribed in doses of 100 mg b.i.d.

[Treatment of rhythm disorders by fenoxedil hydrochloride].

Fenoxedil chlorhydrate (FC), which is used as a treatment for cerebral circulatory failure and peripheral vascular disease, has been given to 100 patients with a cardiac arrhythmia: atrial fibrillation (78 cases), atrial flutter (4 cases), atrial tachysystole (2 cases), ventricular extrasystoles (12 cases), and supraventricular extrasystoles (4 cases). FC has been prescribed alone, or as a complement to current anticoagulant or digitalis treatment; combination with prenylamine, amiodarone, dysopyramide or a drug of the quinidine group must always be avoided, and the potassium level checked and corrected if necessary before treatment. In 78 cases of atrial fibrillation, the authors found that sinus rhythm was restored in 58 (74.

[Electrophysiologic study of fenoxedil chlorhydrate].

Electrophysiologic studies were carried out on 10 patients before and during therapy by Fenoxedil Chlorhydrate a new anti-arrhythmic drug, to determine the effects on cardiac conduction. Fenoxedil Chlorhydrate produces a constant alteration of intra-nodal conduction. Modification of sinus function are less evident.

[Sinus arrest: severe complication of intravenous lidocaine].

Sinus arrest occured after intravenous administration of Lidocaine in therapeutic disage in a patient with coronary artery disease and sinus node disease. This complication of Lidocaine, though rare (this case is the fourth of the literature), induces to use this drug carefully in patients with sinus node disease. Temporary pacing is recommended if Lidocaine must be used in this group of patients.