Clinical trials with long-term treatment of pulmonary hypertension due to lung disease

Many drugs have been tested for the treatment of pulmonary hypertension of different origins, but even the acute effects are controversial and side-effects are frequently important. In a few studies, vasodilators have been used in the long-term treatment of chronic pulmonary hypertension related to chronic lung disease (calcium channel blockers, hydralazine, nitrates); here, also, the results are inconstant and the side-effects are sometimes major. No vasodilator specific for the pulmonary circulation is presently available.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Physiologie cardio-respiratoire

3ème Candidature3ème Tirageinfo:eu-repo/semantics/publishe

EXERCICE ET PNEUMOPATHIES CHRONIQUES

Unfortunately, the situation in the chronic lung diseases is highly complex. Dyspnea, which is often responsible for impeding the excertions of the patient with chronic lung disease - as pain impedes the exertions of the coronary patient - only allows a relatively maximal oxygen consumption. The techniques of extrapolation are not more permissible in pathological conditions. On the other hand, and it is here that the pneumatological problem is peculiar, the mechanisms subjacent to the diminution in physical capacity are complex, often intricate, and difficult to clarify. The term 'chronic pneumopathy' covers a large group of diverse physiopathological conditions which not only make the interpretation of results difficult but still do not permit the allotment of specific pictures for each of them. At the very heart of a clinical condition that is apparently well defined there may be numerous and diverse functional disturbances. Thus the introduction of exercise tests into pneumology - if it is felt to be necessary because of the insufficient predictive value of the functional tests in sleep, if worked out on their own - always delayed, and the literature only brings us into this sphere (by comparison with cardiology, for example) some fragmentary data, hitherto inadequate and often controversial.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Contribution à l'étude de la circulation pulmonaire en clinique

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

NICHTINVASIVE DIAGNOSTIK DER PULMONALEN HYPERTENSION: EINE WHO-STUDIE

In the detection of pulmonary hypertension, especially that of only moderate extent usually associated with chronic obstructive lung disease, noninvasive methods, applied individually, are usually of insufficient accuracy. Accordingly, the World Health Organization undertook a prospective study in which several noninvasive methods were employed together in order to improve the diagnostic accuracy. The examinations analyzed encompassed chest roentgenography, electrocardiography, vectorcardiography, mechanocardiography, echocardiography, myocardial scintigraphy and ventriculography and pulmonary scintigraphy. From the chest X-ray, the size of the main pulmonary artery, the transpulmonary artery distance and the size of the right descending pulmonary artery were analyzed; correct identification of patients with or without pulmonary hypertension was achieved in only 40%. With respect to the electrocardiogram, the number of false negative and false positive findings renders this method of negligible usefulness. Mechanocardiography proved technically difficult and incurred inconsistencies in interpretation such that this method was only rarely useful in the diagnosis of pulmonary hypertension. The same held true for the use of echocardiography since it is technically difficult to obtain adequate imaging in patients with overinflated lungs and the pulmonic valve can only be visualized in about 50% of the patients. Right ventricular systolic time intervals would be of interest but their measurement can only be accomplished in a small number of patients. Myocardial scintigraphy with thallium-201 may render indirect evidence of pulmonary hypertension if the right ventricular wall can be visualized; this is the case in 80% of patients in whom mean pulmonary artery pressure exceeds 30 mm Hg but only in 56% of those with mean pulmonary artery pressures between 21 and 30 mm Hg. The radionuclide ventriculogram could not establish a clear relationship between the right ventricular ejection fraction and the pulmonary artery pressure. In a multicenter study subsequently undertaken by the World Health Organization to elucidate the use of noninvasive methods, since their individual application has not led to meaningful detection of pulmonary hypertension, analysis of their combined use is being carried out to determine if more accurate identification of patients can be achieved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Contribution à l'étude de la circulation pulmonaire en clinique

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

LE VENTRICULE GAUCHE DANS LES BRONCHOPNEUMOPATHIES CHRONIQUES OBSTRUCTIVES

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Travaux pratiques de physiologie cardio-respiratoire

3e candidature en médecineinfo:eu-repo/semantics/publishe

Travaux pratiques et démonstrations de physiologie cardio-respiratoire

Deuxième édition 1975-1976 deuxième tirage 1976-1977info:eu-repo/semantics/published

Present and future of cardiac rehabilitation

SCOPUS: NotDefined.jinfo:eu-repo/semantics/publishe