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Biomedical subjects

A Anselmi

Publications and source records attributed to A Anselmi.

At least 19 recordsLinked to original sources

Impaired coronary and myocardial flow in severe aortic stenosis is associated with increased apoptosis: a transthoracic Doppler and myocardial contrast echocardiography study.

OBJECTIVE: To test the hypothesis that impaired coronary and myocardial blood flow are linked with increased myocyte apoptosis, thus establishing a link between pressure overload and left ventricular (LV) remodelling. METHODS AND RESULTS: Peak diastolic coronary blood flow velocity (CBFV) was evaluated at transthoracic Doppler echocardiography, and signal intensity (SI) and the rate of SI rise (beta) were measured at myocardial contrast echocardiography in 11 patients with severe aortic stenosis and LV hypertrophy. In the same patients, biopsies were obtained from the anterolateral LV free wall during surgery and analysed for cardiomyocyte apoptosis. LV mass corrected CBFV (CBFVI) was significantly lower in patients than in controls (median 0.100 cm.g/s (interquartile range 0.07-0.115) v 0.130 cm.g/s (0.130-0.160), p = 0.002). Similarly, SI*beta was significantly lower in patients than in controls (11 1/s (8-66) v 83 1/s (73-95), p = 0.001). Apoptotic rate was increased in aortic stenosis more than 100-fold versus controls (1.2% (0.8-1.4) v 0.01% (0.01-0.01), p < 0.001) and inversely correlated with lower CBFVI and SI*beta (r = -0.77, p = 0.001 for both). CONCLUSIONS: Patients with severe aortic stenosis and LV hypertrophy have impaired myocardial perfusion, which is associated with enhanced cardiomyocyte apoptosis. Impaired myocardial perfusion and the ensuing oxygen demand-supply imbalance may, at least partially, be responsible for increased apoptosis and possible transition to heart failure, thus establishing a link between pressure overload, LV remodelling, and heart failure.

Aged↗

[Comparison of mechanical and manual anastomoses in emergency gastric resection].

Hundred and twenty-one patients underwent emergency subtotal gastrectomy for complications related to peptic ulcer (86) and malignant diseases (35). According to the type of anastomosis performed (manual or mechanical) patients were divided into two groups: 81 with hand-sutured anastomoses (double layer) and 40 with stapled anastomoses. The latter were more commonly used in the Roux-en-Y reconstruction and Billroth 1 gastrectomy. Median operating time (192' versus 190'), hospital stay (15.2 versus 13.5 days), postoperative complications (38% versus 32.5%) and anastomotic or duodenal stump leakage (7.4% versus 5%) showed no significant difference between groups. Therefore, in emergency subtotal gastrectomy mechanical anastomoses allow to obtain results comparable to the more used manual ones.

Adult↗

Primary cardiomyopathy in identical twins.

Seventeen year old identical twin brothers with no family history of cardiopathy began experiencing palpitations almost simultaneously. In both, examination revealed marked cardiomegaly and hypokinesia of the ventricular walls, and clinical and radiologic signs of progressive cardiac failure developed a few days later. Both boys died suddenly, 49 days and 5 months, respectively, after the initial examination. Electrocardiographic and vectorcardiographic studies revealed a severe intraventricular conduction disturbance that coincided with histologic changes in the myocardial tissue, including profuse interstitial fibrosis, hypertrophy and degeneration of the myocardial fibers, aberrant arrangement of the muscular fibers and considerable alteration of the structure of cardiac tissue. In the absence of hereditary and chromosomal factors, and excluding possible viral intervention during fetal life, it is believed that a teratogenic factor can produce the structural alterations of the tissue and derangement of the fibers observed in these hearts. The irregular contractions of the heart at the level of the net-like meshwork, disarrangement of myocardial fibers, and adaptative mechanisms of the heart inherent in the destruction of the contractile tissue contributed to the functional cardiac disorders that resulted in congestive heart failure and sudden death in these twins.

Adolescent↗

Physiopathology of Chagas' heart disease: correlations between clinical and experimental findings.

In penetrating the heart and developing in it, Trypanosoma cruzi produces an immunoallergic reaction that leads to changes in the histological structure of the myocardium; these changes alter the fundamental properties of the heart, causing fundamental dynamic disorders and morphological changes in the organ.In Chagas' cardiomyopathy, the velocity of impulse propagation diminishes in the auricular and ventricular musculature, altering the activation mechanism, this being shown by changes in the P-wave and in ventricular focal blocks.The functional refractory period (FRP) is shortened in the auricular and ventricular tissue and constitutes, together with changes in conductivity, the physiopathological basis that explains the circus movement-the fundamental factor of the arrhythmias of this stage of the disease. Localization of the inflammation in the A-V conduction system increases the duration of the FRP, producing all types of A-V block.The oedema and the cellular interstitial infiltration seen during this acute phase reduce the distensibility of the fibres; this, in turn, limits their contractility, producing a decrease in systolic volume and an increase in the final diastolic pressure in the chambers of the heart-fundamental factors in reducing kinesia and in increasing the heart's volume.In the chronic phase, destruction of the contractile tissue and fibroblastic proliferation bring into play compensatory mechanisms that maintain the strength of cardiac contractions; the elongation of the fibres and the nature of the dynamic pressure-volume curves explain the dilatation of the chambers of the heart and the dynamic changes seen in this phase of the disease.

Acute Disease↗

Effect of Peruvosid (CD412) on excitability and functional refractory period of atrial and ventricular tissues in cardiomyopathy caused by Trypanosoma cruzi.

Attempts were made to produce myocarditis by Trypanosoma cruzi inoculation in healthy dog puppies 6 to 8 weeks old. Significant electrocardiographic abnormalities were produced, coinciding with interstitial inflammatory processes in the cardiac tissue and with degenerative changes in the myocardial fibres. In puppies showing these changes, profound changes in the excitability and the functional refractory period of the atrial and ventricular muscular tissue were observed. The administration of Peruvosid in doses of 0.0240 to 0.0647 mg./kg. tended to diminish the excitability, previously increased by the inflammatory process, at the same time increasing the functional refractory period duration which had previously been shortened. The fact that Peruvosid corrects these fundamental factors in the genesis of cardiac arrhythmias suggests that the drug may be useful in the treatment of cardiac insufficiency produced by Chagas' myocardiopathy, in which arrhythmias are one of the basic characteristics.

Animals↗