La Gamma-globuline chez le nourrisson et le prémature

Sans résuméSéminaire sur les Gamma-Globulines, gehalten im Dezember 1954 im Centre International de l'Infant in Paris     

Statines en prévention primaire des événements cardiovasculaires

Cardiovascular events are the second leading cause of death in France. The assessment of overall cardiovascular risk using a personalized assessment with weighting risk factors can predict the risk of cardiovascular events in ten years. The validated treatments to reduce cardiovascular mortality in primary prevention are few. The use of statins in primary prevention is discussed. We report in this review the updated conclusions from clinical trials regarding the treatment with statins in primary prevention.     

Non compaction ventriculaire isolée chez un nourrisson

Not isolated ventricular compaction cardiomyopathy is a rare deasese described both in children than in adults. It due to the interruption of the embryogenic compaction process of the normal myocardium. We report a pediatric observation of noncompaction of the left ventricle.Case reportThis is a 4-month girl who was admitted to an array of heart failure with systolic murmur to FM. Chest radiography showed cardiomegaly. The ECG showed repolarization disorder. The echocardiography objectified dilated left cavities with thickened wall and anechoic areas (sinusoidal), a mitral regurgitation GII and minimal tricuspid regurgitation.ConclusionNCVI is a rare cause of heart failure in infants. The management is based on guidelines for various clinical symptomatology. Its discovery in children should lead to screening of first-degree relative.     

Épidémiologie de la repolarisation précoce chez le jeune maghrébin

An early repolarization variant (ERV) in inferolateral leads has recently been associated with vulnerability to ventricular fibrillation. These studies have been conducted in the occidental countries. The prevalence of ERV in the population of the Maghreb is unknown. The aim of this study was to evaluate the prevalence and risk factors of ERV in a young population from Algeria.MethodsWe assessed the prevalence of ERV within a population of 441 healthy subjects (mean age 25 years) using 12-lead electrocardiography. ERV was stratified by three independent cardiologists according to the J-point elevation (≥ 0.1 mV) in the inferior, apicolateral or both leads with QRS slurring or notching.ResultsThe inferolateral ERV pattern was present in 55 subjects (12.4%). A malign ERV (> 2 mm) was present in 5 subjects (9% of ER) and ER in inferior and lateral leads in 40% of ER. An ERV pattern was more frequently associated with young age, male, bradycardia and T wave in V1 lead.ConclusionAn ERV is a common finding in a healthy Algerian young population. This prevalence seems to be more important than other studies due to young age and not to a racial difference. Our population were more at risk that other studies, and we found more T waves in V1 lead in this people, due to an ethnic particularities or a phenotypic association with the Brugada syndrome.     

Place de l’épreuve d’effort chez le sportif

Is the stress test still part of the useful examinations in the detection of risk heart disease in sports subjects? Should we continue to use it as a surveillance examination in coronary sports patients? Meta-analysis, considering a ST subshift of more than 1 mm as a criterion for positivity, underline the low prevalence of abnormal examinations and a significant rate of false-positives. But for the diagnosis of coronary artery disease, it is mainly the evolution of the ST segment to effort or recovery and the occurrence of stress arrhythmias that detect true positivity. When coronary risk is more important (presence of risk factors, resumption of sport, intense and prolonged efforts), it seems lawful to recommend such a review on a regular basis among men over 40 years of age with two risk factors but Also among veterans taking up sport after a period of prolonged inactivity. For the asymptomatic coronary athlete the stress test remains at the centre of the final decision for the resumption of a sport in competition irrespective of the method of revascularization. Of course the stress test, even inevitable, remains flawed in the detection of coronary artery disease in the asymptomatic athlete. However, it provides additional information on the condition of being maximal, and attaching importance to arrhythmias, the tensional profile and the maximum power developed in addition to the ST segment's only study.