51
|
Denolle T, Azizi M, Massart C, Zennaro MC. [Itraconazole: a new drug-related cause of hypertension]. Ann Cardiol Angeiol (Paris) 2014; 63:213-215. [PMID: 24952675 DOI: 10.1016/j.ancard.2014.05.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 05/14/2014] [Indexed: 06/03/2023]
Abstract
Itraconazole is a triazole agent used in the treatment of fungal infections and in some metastatic cancers. Its use has been associated with cardiovascular adverse events and particularly heart failure with preserved ejection fraction. We report the case of a 68-year-old male patient with a well-controlled hypertension treated with irbesartan 150mg/day since 2007. He developed a pulmonary aspergillosis on post-tuberculosis cavitary lesions treated in July 2011 with itraconazole 200mg/day. Early 2012, his antihypertensive treatment had to be gradually increased to a quadritherapy and his blood pressure was at 157/78mmHg at home. Hypokalemia was observed on several occasions as well as edema of the lower limbs. Plasma renin and plasma and urine aldosterone concentrations on treatment not interfering with the renin angiotensin system were low, associated with normal serum and urine cortisol, ACTH, SDHA and DOC, BNP and creatinine concentrations. Plasma itraconazole values were much above the therapeutic range. Left ventricular ejection fraction was preserved. There were no adrenal or renal artery abnormalities at the CT scan. Three months after stopping itraconazole, hypokalemia and edema disappeared and blood pressure was normalized with less treatment. Plasma renin and aldosterone concentrations were normalized. He had a pulmonary lobectomy for his pulmonary aspergillosis. Itraconazole may induce a resistant hypertension with low renin. The mechanisms of this adverse effect of itraconazole remain unknown.
Collapse
|
52
|
Azizi M, Bahrieniain SA, Baghdasarians A, Emamipur S, Azizmohammadi Z, Qutbi SM, Javadi H, Assadi M, Asli IN. The role of cognitive group therapy and happiness training on cerebral blood flow using 99mTc-ECD brain perfusion SPECT: a quasi-experimental study of depressed patients. Nuklearmedizin 2014; 53:205-10. [PMID: 24823430 DOI: 10.3413/nukmed-0632-13-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 04/16/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The purpose of this study is to investigate the impact of cognitive group therapy and happiness training objectively in the local cerebral blood flow of patients with major depression (MD). PATIENTS, MATERIAL, METHODS The present research is semi-experimental to pre- and post-test with a control group. Three groups were formed, and this number was incorporated in each group: 12 patients were chosen randomly; the first group of depressed patients benefited from the combination of pharmacotherapy and sessions of cognitive group therapy; the second group used a combination of pharmacotherapy and sessions of happiness training; and a third group used only pharmacotherapy. We compared cognitive-behavioural therapy and happiness training efficacy with only pharmacotherapy in MD patients. We performed brain perfusion SPECT in each group, before and after each trial. RESULTS The study was conducted on 36 patients with MD (32 women and 4 men; mean age: 41.22 ± 9.08; range: 27-65 years). There were significant differences regarding the two trial effects into two experimental groups (p < 0/001) before and after trials, while such differences were not significant in the control group (p > 0.05). In addition, there was significant difference among the regional cerebral blood flow in the frontal and prefrontal regions into two experimental groups before and after trials (p < 0/001), while such differences were not significant in the control group (p > 0.05). CONCLUSION This study demonstrated decreased cerebral perfusion in the frontal regions in MD patients, which increased following cognitive group therapy and happiness training. Because of its availability, low costs, easy performance, and the objective semi-quantitative information supplied, brain perfusion SPECT scanning might be useful to assess the diagnosis and therapy efficacy. Further exploration is needed to validate its clinical role.
Collapse
|
53
|
Sapoval M, Azizi M. Renal artery denervation for the treatment of resistant hypertension. Update after Medtronic announcement that its Symplicity HTN3 study failed to meet its primary efficacy end point. Diagn Interv Imaging 2014; 95:353-4. [DOI: 10.1016/j.diii.2014.02.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
54
|
Gligorov J, Janus N, Daniel C, Beuzeboc P, Ray-Coquard I, Rey JB, Jouannaud C, Spano JP, Thery JC, Morere JF, Goldwasser F, Mir O, Scotté F, Oudard S, Azizi M, Dorent R, Deray G, Launay-Vacher V. Abstract P3-15-06: Results of the MARS study on the management of antiangiogenics’ renovascular safety in breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p3-15-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Anti-VEGF drugs (AVD) are widely used in cancer patients (pts). Hypertension (HTN) and proteinuria (Pu) are class-side-effects of AVD, related to the inhibition of the VEGF pathway. The MARS study has been conducted to assess the renovascular tolerance of these drugs in the clinical setting.
Methods:
This multicentric, prospective, observational study evaluated the renovascular safety of AVD in pts naive from any AVD, conducted in 7 centres in France, from 2009 to 2012, with a follow-up (f/u) of 1 year. Data collected included: gender, age, serum creatinine (SCr), diabetes, HTN, hematuria (Hu) and dipstick Pu, at baseline and at each visit.
Results:
1124 cancer pts were included; 402 breast cancer (BC) pts received bevacizumab (1st line: 14.4%; median durations of treatment: months)). Median age at inclusion was 55 years (19-65). Visceral, bone and cerebral metastasis frequencies were 74.7, 5.1 and 2.5%, respectively. HTN prevalences: 12.4%. Baseline renal assessment retrieved: Pu 23.9%, Hu 16.2%, mean aMDRD 96.4 ml/min/1.73m2 and 14 pts with aMDRD<60. The incidence of de novo Pu and HTN during f/u was 61.7 and 16.8% (Table). 69.7% of pts with Pu at inclusion improved or remained stable. Among pts with de novo Pu, 75.7% afterwards improved/normalized. No grade 4 Pu has been reported. Renal function remained stable with a mean aMDRD of 96.2 at the end of f/u. 7.4% had grade 2-3 SCr increase (no grade 3-4). No thrombotic micro-angiopathy (TMA) was reported.
Conclusion:
These results on the renovascular safety of bevacizumab in BC pts showed that 1) TMA is rare, 2) Grade 3 Pu developed in 4.6% of pts, with no grade 4, 3) less than 17% developed HTN, and 4) aMDRD was stable. Furthermore, in case of a renovascular effect, investigators followed the recommendations from the French Society of Nephrology (Halimi JM. Nephrol Ther 2008) and no treatment withdrawal for unmanageable renovascular toxicity occurred.
Renovascular effects in MARS breast cancer patients treated with bevacizumabRenovascular effectsPrevalence at inclusionIncidence during follow-up (de novo**)Pu* (All grades)23.9%61.7%Pu* (Grade 1)22.2%47.1%Pu* (Grade 2)1.7%10.0%Pu* (Grade 3)0.0%4.6%Pu* (Grade 4)0.0%0.0%Hypertension12.4%16.8%Hu* (All Hu)16.2%42.1%Hu* (Traces/+)11.7%33.2%Hu* (++)2.6%6.3%Hu* (+++)1.9%2.6%SCr increase* (All grades)-80.0%SCr increase* (Grade 1)-68.6%SCr increase* (Grade 2)-7.1%SCr increase* (Grade 3)-0.3%*NCI-CTC v4; **de novo = patients with no event at inclusion and who presented an event during follow-up.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-15-06.
Collapse
|
55
|
Mirault T, Frank M, Pernot M, Couade M, Tanter M, Niarra R, Azizi M, Albuisson J, Jeunemaitre X, Messas E. Lack of systolic arterial stiffening in vascular Ehlers-Danlos syndrom. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.4540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
56
|
Beaussier H, Coudore F, Bobrie G, Peyrard S, Tran L, Bezie Y, Azizi M, Boutouyrie P. CPC-065 How to Assess Medication Adherence Among Patients with Resistant Hypertension Treated with Two Different Pharmacological Intensification Strategies. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
57
|
Launay-Vacher V, Janus N, Daniel C, Rey JB, Ray-Coquard I, Gligorov J, Spano JP, Thery JC, Jouannaud C, Goldwasser F, Mir O, Morere JF, Oudard S, Azizi M, Dorent R, Deray G, Beuzeboc P. Abstract P5-17-04: Management of Antiangiogenics' Renovascular Safety in breast cancer. Subgroup and intermediate results of the MARS Study. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p5-17-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Hypertension (HTN) and proteinuria (Pu) are class-side-effects of anti-VEGF drugs (AVD), related to the inhibition of the VEGF pathway. The MARS study has been conducted to assess the renovascular tolerance of these drugs in the clinical setting.
Methods: The MARS study is a multicentric prospective observational study of the renovascular safety of AVD in AVD-naive patients. in 7 centres from 2009 to 2011. There was no intervention on the choice of the AVD. Data collected included: gender, age, serum creatinine (SCr), diabetes, HTN, hematuria (Hu) and dipstick Pu. This sub-group analysis presents the intermediate results for the first 184 patients with breast cancer (BC) receiving bevacizumab who completed the 1-year follow-up (f/u) (out of 337 BC patients in total).
Results: All these 184 patients received bevacizumab (mean and median durations of treatment: 7.8 and 8 months, respectively). Median age at inclusion was 60 years. Bone, visceral and cerebral metastasis frequencies were 75.0, 52.2 and 7.1%, respectively. Diabetes and HTN prevalences were 4.3% and 10.3%, respectively. Baseline renal assessment retrieved: Pu 13.0%, Hu 8.2%, mean aMDRD 98.8 ml/min/1.73m2 and 1.1% had aMDRD<60. The incidence of de novo Pu during f/u was 16.3% (Table). 58.3% of patients with Pu at inclusion improved. Among patients with de novo Pu, 42.3% afterwards improved/normalized. No grade 3/4 Pu has been reported and no hematuria. 12.7% developed HTN. In addition, renal function decreased by −3.4 ml/min/1.73m2/year and 4 patients had aMDRD<60 at the end of f/u. 33.2% increased their SCr: 27.7% grade 1, 4.9% grade 2, and 0.5% grade 3. All patients with grade 2–3 returned to normal or grade 1 during f/u. No thrombotic micro-angiopathy has been reported.
Conclusion: These results show that 1) No thrombotic micro-angiopathy remains rare, 2) Pu developed in 16.3% of patients, with no grade 3/4, 3) less than 13% developed HTN, and 4) renal function was only slightly impaired with transient elevations in SCr. Furthermore, in case of a renovascular effect, investigators followed the recommendations from the French Society of Nephrology (Halimi JM et Al. Nephrol Ther 2008) and no treatment withdrawal for unmanageable renovascular toxicity occurred.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P5-17-04.
Collapse
|
58
|
Aminifard MH, Aroiee H, Azizi M, Nemati H, Jaafar HZE. Effect of Humic Acid on Antioxidant Activities and Fruit Quality of Hot Pepper (Capsicum annuumL.). ACTA ACUST UNITED AC 2012. [DOI: 10.1080/10496475.2012.713905] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
59
|
Azizi M, Steichen O, Frank M, Bobrie G, Plouin PF, Sapoval M. Catheter-based radiofrequency renal-nerve ablation in patients with resistant hypertension. Eur J Vasc Endovasc Surg 2012; 43:293-9. [PMID: 22237510 DOI: 10.1016/j.ejvs.2011.11.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2011] [Accepted: 11/28/2011] [Indexed: 01/13/2023]
Abstract
This review aims to describe the role and the results of catheter-based renal nerve ablation for the treatment of resistant hypertension. Despite the availability of multiple classes of orally active antihypertensive treatments, resistant hypertension remains an important public health issue in 2012 due to its prevalence and association with target-organ damage and poor prognosis. The failure of purely pharmacological approaches to treat resistant hypertension has stimulated interest in invasive device-based treatments based on old concepts. In the absence of orally active antihypertensive agents, patients with severe and complicated hypertension were widely treated by surgical denervation of the kidney until the 1960s, but this approach was associated with a high incidence of severe adverse events and a high mortality rate. A new catheter system using radiofrequency energy has been developed, allowing an endovascular approach to renal denervation and providing patients with resistant hypertension with a new therapeutic option that is less invasive than surgery and can be performed rapidly under local anaesthesia. To date, this technique has been evaluated only in open-label trials including small numbers of highly selected resistant hypertensive patients with suitable renal artery anatomy. The available evidence suggests a favourable blood pressure-lowering effect in the short term (6 months) and a low incidence of immediate local and endovascular complications. This follow-up period is, however, too short for the detection of rare or late-onset adverse events. For the time being, the benefit/risk ratio of this technique remains to be evaluated, precluding its uncontrolled and widespread use in routine practice.
Collapse
|
60
|
Zanoli L, Savard S, Bozec E, Bobrie G, Jeunemaitre X, Azizi M, Frank M, Castellino P, Plouin P, Laurent S, Boutouyrie P. P4.12 COMMON CAROTID ARTERY WALL SUBCLINICAL LESIONS ARE PRESENT IN SUBJECTS WITH RENAL FIBROMUSCULAR DYSPLASIA. Artery Res 2012. [DOI: 10.1016/j.artres.2012.09.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
61
|
Azizi M, Ghani A, Ebadi T, Crockett S. THE EX SITU COMPARISON OF TWO IMPROVED ST. JOHN'S WORT (HYPERICUM PERFORATUM) CULTIVARS WITH AN IRANIAN WILD POPULATION. ACTA ACUST UNITED AC 2011; 925:163-170. [DOI: 10.17660/actahortic.2011.925.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
62
|
Mohammadi Ziarani G, Badiei AR, Azizi M. The one-pot synthesis of 14-aryl-14H-dibenzo[a,j]xanthene derivatives using sulfonic acid functionalized silica (-Pr-) under solvent free conditions. SCIENTIA IRANICA 2011; 18:453-457. [DOI: 10.1016/j.scient.2011.05.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
|
63
|
Volpe M, Azizi M, Danser AHJ, Nguyen G, Ruilope LM. Twisting arms to angiotensin receptor blockers/antagonists: the turn of cancer. Eur Heart J 2010; 32:19-22. [DOI: 10.1093/eurheartj/ehq382] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
|
64
|
Nemati H, Nazdar T, Azizi M, Arouiee H. The effect of seed extraction methods on seed quality of two cultivar's tomato (Solanum lycopersicum L.). Pak J Biol Sci 2010; 13:814-20. [PMID: 21313905 DOI: 10.3923/pjbs.2010.814.820] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In order to compare of different methods and identify the optimum condition for tomato seed extraction, factorial experiments with 3 replications was conducted. In the first experiment, pulp of two tomato cultivars (Faraon, Dominator) were fermented at two temperatures (25, 35 degrees C) and six periods (24, 48, 72, 96, 120, 144 h). The germination of seeds in laboratory as well as seedling emergence and preliminary growth in greenhouse were studied and measured. The results showed that effect of cultivar on traits (except of seedling emergence) was significant. Also the effect of temperature of fermentation, duration of fermentation and also interaction effects of them on seed germination were significant. Totally seed quality decreased with increasing temperature and duration of fermentation and the fermentation duration from 24 to 48 h at temperature 25 degrees C, is recommended. In the second experiment, tomato seeds were extracted by HCL (pH was arranged to 1, 2, 3 for 10, 20, 30 min), H2SO4 (pH was arranged to 1, 2, for 15, 30 min), Sodium carbonate (5, 10% for 24 and 48 h) and fermentation. Percentage germination, germination rate, length of radicle and length of plumule were used for seed quality assessment. The results showed that interaction effect between pH and duration of HCL treatments was significant for seed germination (percentage and rate) and there was an interaction effect between concentration and duration for germination rate in alkali treatments. Different extraction methods had not detrimental effect on percentage germination, but acid treatments produce very bright clean seeds in compare to other treatments.
Collapse
|
65
|
Oroojalian F, Kasra-Kermanshahi R, Azizi M, Bassami M. Phytochemical composition of the essential oils from three Apiaceae species and their antibacterial effects on food-borne pathogens. Food Chem 2010. [DOI: 10.1016/j.foodchem.2009.11.008] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
66
|
Hulot JS, Wuerzner G, Bachelot-Loza C, Azizi M, Blanchard A, Peyrard S, Funck-Brentano C, Gaussem P. Effect of an increased clopidogrel maintenance dose or lansoprazole co-administration on the antiplatelet response to clopidogrel in CYP2C19-genotyped healthy subjects. J Thromb Haemost 2010; 8:610-3. [PMID: 20040040 DOI: 10.1111/j.1538-7836.2009.03729.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
67
|
Pham I, Wuerzner G, Richalet JP, Peyrard S, Azizi M. Endothelin receptors blockade blunts hypoxia-induced increase in PAP in humans. Eur J Clin Invest 2010; 40:195-202. [PMID: 20415698 DOI: 10.1111/j.1365-2362.2010.02254.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Activation of the endothelin-1 (ET-1) pathway may be involved in hypoxia-induced pulmonary vasoconstriction, increase in pulmonary pressure and high altitude pulmonary oedema. Thus, we investigated the effect of the ETA/ETB receptor antagonist, bosentan, on pulmonary artery systolic pressure (PASP) in healthy subjects (n = 10). DESIGN We used a double-blind, placebo-controlled, randomized, cross-over design to study the effects of a single oral dose of bosentan (250 mg) on PASP after 90-min-exposure to normobaric hypoxia (FiO(2) = 0.12). We measured PASP and cardiac output by echocardiography, systolic arterial blood pressure, arterial O(2) saturation (SaO(2)), and blood gases at rest and during a sub-maximal exercise. RESULTS PASP in normoxia at rest was 23.5 +/- 2.7 and during exercise 39.8 +/- 11.6 mmHg (P < 0.0001). During the placebo period, hypoxia induced a significant decrease in SaO(2), PaO(2) and PCO(2) and increase in pH. PASP at rest increased significantly: 32.1 +/- 3.5 mmHg (P < 0.001 vs. normoxia). Bosentan significantly blunted the hypoxia-induced increase in PASP: bosentan: 27.0 +/- 3.3 mmHg, P = 0.002 vs. placebo at rest, but not during exercise: bosentan 39.8 +/- 11.6 vs. placebo 43.0 +/- 8.5 mmHg, ns. Bosentan had no effect on the hypoxia-induced changes in blood gases, or on cardiac output and systolic arterial blood pressure, which were not modified by hypoxia. CONCLUSION A single oral dose of bosentan blunted an acute hypoxia-induced increase in PASP in healthy subjects, without altering cardiac output or systemic blood pressure.
Collapse
|
68
|
Zarei M, Azizi M, Bashiri-Sa Z. Studies on Physico-Chemical Properties and Bioactive Compounds of Six Pomegranate Cultivars Grown in Iran. ACTA ACUST UNITED AC 2010. [DOI: 10.3923/jftech.2010.112.117] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
69
|
Azizi M, Farzad S, Jafarpour B, Rastegar M, Jahanbakhsh V. INHIBITORY EFFECT OF SOME MEDICINAL PLANTS' ESSENTIAL OILS ON POSTHARVEST FUNGAL DISEASE OF CITRUS FRUITS. ACTA ACUST UNITED AC 2008. [DOI: 10.17660/actahortic.2008.768.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
70
|
Abstract
Cardiac resynchronization therapy (CRT) is a new method for the correction of inter- and/or intraventricular conduction delays of patients with heart failure. The long-term impact of CRT on central hemodynamics is not fully characterized. We performed complete right heart catheterization studies in 31 patients receiving a CRT device pre and 6 months after implantation. Most of the patients improved in their NYHA stage, their LVEF, and in parallel showed reduced right atrial (RA) pulmonary artery (PA) and pulmonary capillary wedge (PCW) pressures and pulmonary vascular resistance both at rest and at 25 watts. In addition, we found a reduction in heart rate accompanied by an increased mean arterial pressure both at rest and at 25 watts. Accordingly, brain natriuretic peptide levels (BNP) were lowered. It was concluded that, besides other well-known effects on ventricular coordination, central hemodynamics after 6 months were improved during CRT.
Collapse
|
71
|
Azizi M, Nägele H. Inappropriate shock during left ventricular threshold measurement in a patient with coexisting ICD and a biventricular pacemaker. Herzschrittmacherther Elektrophysiol 2007; 18:101-4. [PMID: 17646942 DOI: 10.1007/s00399-007-0563-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Accepted: 02/23/2007] [Indexed: 05/16/2023]
Abstract
Cardiac resynchronization therapy (CRT) using coronary sinus (CS) leads for biventricular stimulation is an established method for the therapy of congestive heart failure (CHF) in the case of inter- or intraventricular conduction delays. There are some patients having two separate devices: an ICD and a biventricular pacemaker. This case report describes an unusual interaction of these systems: an inappropriate VVI defibrillator shock during left ventricular threshold measurement in a biventricular pacemaker implanted on the other side.
Collapse
|
72
|
Nägele H, Hashagen S, Azizi M, Behrens S, Castel MA. Analysis of terminal arrhythmias stored in the memory of pacemakers from patients dying suddenly. ACTA ACUST UNITED AC 2007; 9:380-4. [PMID: 17434892 DOI: 10.1093/europace/eum040] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS Stored electrograms or marker channels are available in most of modern cardiac pacemaker models. We sought to analyse these information to uncover terminal events of pacemaker patients dying suddenly. Method and results We made post-mortem pacemaker (PM) interrogations in 19 patients dying suddenly out of hospital between the years 1997 and 2005 (mean age 59 +/- 13 years, 90% males). The systems had activated arrhythmia monitoring algorithms. Indications of pacing were sick sinus syndrome in seven, AV-block in five, and heart failure due to asynchrony in seven cases. The interrogated pacemakers were CHORUS 7034 (n = 12), CONTAK TR (n = 2), and INSYNC III (n = 5). For interpretation stored marker channels and electrograms were analysed. The mean observation time after PM implantation prior death was 2.11 +/- 1.44 years, the mean left ventricular ejection fraction from the last available echo examination in the year prior death was 27.5 +/- 8%, mean age was 63 +/- 12 years. In 17/19 cases (89%), a tachycardia (most likely ventricular tachycardia) was found correlating to the time of death. The mean cycle length of the terminal arrhythmia was 307 +/- 144 (250-344) ms, corresponding to a heart rate of 195 +/- 95 (174-240) bpm. We found no evidence of specific pacemaker-related problems such as electronic failure, battery depletion, or undersensing. CONCLUSIONS Post-mortem analysis of arrhythmia monitoring of pacemaker patients revealed tachycardias (most likely ventricular tachycardia) to be related to sudden death. These findings give some insight in mechanisms of terminal events in this group.
Collapse
|
73
|
Nägele H, Azizi M, Hashagen S, Castel MA, Behrens S. First experience with a new active fixation coronary sinus lead. Europace 2007; 9:437-41. [PMID: 17449876 DOI: 10.1093/europace/eum061] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Coronary sinus (CS) lead implantation is a technically challenging procedure owing to variable vein anatomies and a high dislocation rate. Therefore, CS lead technology has undergone evolutionary changes during the last 10 years. The mode of fixation has been a passive one up to now. We want to describe our first clinical experience with the newly available active fixation lead 4195 in terms of dislocation rate and stability of thresholds compared with conventional models. METHODS AND RESULTS From 1999 to February 2007, we implanted 403 CS leads in 368 patients. Leads were categorized into three different groups on the basis of their fixation mechanism: straight (Easytrak I and Situs OTW; n = 54), curved (Attain 4193 and 4194, Corox, Aescula, Situs ULD; n = 308), and active (Attain 4195; n = 41). Operative and follow-up data were prospectively noted and checked for significance between groups during the first 3 months after implantation. Kaplan-Meier analysis of long-term lead function was also performed. Straight and curved CS leads suffered from significantly more dislocations compared with active fixation (P < 0.001). The active fixation lead (4195) has a stable threshold over time compared with a significant rise after 24 h and thereafter in straight (62%) and curved leads (20%). However, retraction of an active fixation CS lead may be a difficult issue as outlined in two cases requiring pullback of a 4195 lead owing to phrenic nerve stimulation (one unsuccessful despite vigorous traction). CONCLUSION The active fixation lead 4195 using retention lobes yielded stable thresholds over time and seems to be superior to conventional leads in terms of dislocation. However, extraction may be a difficult or even impossible task.
Collapse
|
74
|
Perdu J, Boutouyrie P, Bourgain C, Stern N, Laloux B, Bozec E, Azizi M, Bonaiti-Pellié C, Plouin PF, Laurent S, Gimenez-Roqueplo AP, Jeunemaitre X. Inheritance of arterial lesions in renal fibromuscular dysplasia. J Hum Hypertens 2007; 21:393-400. [PMID: 17330059 DOI: 10.1038/sj.jhh.1002156] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We have previously shown that patients with renal fibromuscular dysplasia (FMD) have asymptomatic carotid lesions and that familial forms may occur. The objective of this study was to test whether carotid lesions could be detected in relatives of familial cases. High-resolution echotracking of the carotid artery was performed in 47 relatives of 13 cases from six families. This non-invasive investigation led to a semiquantitative arterial score that was compared with that obtained for 47 controls matched for age and sex and that for 125 sporadic cases. Familial resemblance was tested by using a generalized estimating equation approach taking into account the clustering of scores in families. As expected, FMD cases had a significantly higher score than controls (4.02 vs 2.52, P<10(-5)). Familial cases were not significantly different from sporadic cases. Of interest, the 47 apparently healthy relatives of familial cases had also a high carotid score (4.17), very significantly higher than that of controls (2.52, P<10(-5)) even though lower than the corresponding index FMD cases (4.81, P=0.01). Segregation analysis showed that 52% of the descendants of subjects with a score >4 had a score >4, a proportion consistent with autosomal-dominant transmission of the trait. Altogether these results strengthen the hypothesis of renal FMD being a systemic arterial disease and argue for a familial resemblance that may be due to a major genetic effect. The carotid score obtained by high-resolution echotracking may provide a non-invasive surrogate marker for renal FMD of potential value for use in linkage strategies on large pedigrees.
Collapse
|
75
|
Nägele H, Behrens S, Hashagen S, Azizi M. RHABDOMYOLYSIS AFTER ADDITION OF DIGITOXIN TO CHRONIC SIMVASTATIN AND AMIODARONE THERAPY. ACTA ACUST UNITED AC 2007; 22:195-200. [PMID: 17708069 DOI: 10.1515/dmdi.2007.22.2-3.195] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rhabdomyolysis is a well known side effect of statin therapy. Several drugs may increase its risk by drug-drug interactions. In particular, patients with heart disease receive more and more different compounds to cope with all the pathomechanisms involved and may therefore be of high risk for side effects. We report a case of rhabdomyolysis in a patient with heart failure on a multi-drug regimen caused by a drug interaction between chronic statin therapy (simvastatin), amiodarone and newly administrated digitoxin. The patient recovered fully after cessation of simvastatin therapy, the other drugs were given continuously. Potential mechanisms of this event are discussed. Most interesting in this case is that rhabdomyolysis occurred only after starting digitoxin after long-term therapy with the statin.
Collapse
|