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Biomedical subjects

A Balbarini

Publications and source records attributed to A Balbarini.

At least 55 records · Page 3Linked to original sources
PubMed1990

Left ventricular aneurysm: clinical and hemodynamic data.

Clinical and hemodynamic data of 30 patients with left ventricular aneurysm (27 men, 3 women, mean age 54.9 years) were compared with those of 30 patients with previous myocardial infarction and segmental hypo- or akinesis (28 men, 2 women, mean age 51 years). In each group, 10 patients were affected by one-, two-, or three-vessel disease. A semiquantitative evaluation of collateral coronary circulation showed no significant differences between the two groups. Mean end-diastolic volume was higher in patients with left ventricular aneurysm (p less than .025, less than .05, and less than .001 in 1-, 2-, and 3-vessel disease, respectively) and ejection fraction was lower only in patients with one-, (p less than .001) and two- (p less than .05) vessel disease in comparison with patients without left ventricular aneurysm. No significant difference was evidenced in basal or isometric exercise end-diastolic pressure. The incidence of thrombosis detected by ventriculography was higher in patients with left ventricular aneurysm (33.3 vs. 6.6%). The mean duration of follow-up was 20.7 months in patients with left ventricular aneurysm and 20.6 in the control group. No significant difference was found either in mortality or in reinfarction rate as far as incidence and severity of angina. The incidence of congestive heart failure was more evident, but not significant in patients with left ventricular aneurysm. One embolic episode was present in one patient with aneurysm and intraventricular thrombosis. Left ventricular performance is influenced by an aneurysm when a limited coronary compromise is present (one- and two-vessel disease) while it is not affected in the case of a coexisting three-vessel disease.

Adult↗
PubMed1990

[Doppler echocardiography in the functional evaluation of patients with pure mitral valve stenosis].

To evaluate the utility of echo-Doppler (ED; PW, CW and color), 67 patients affected by pure mitral stenosis (20 M, 47 F, mean age 52 years) were submitted to ED examination. Right and left cardiac catheterization were performed in 20 patients within 24 hours before ED. Mitral area obtained by Doppler method (Hatle's formula) correlated highly with both echo-2 dimensional and hemodynamic area (r = 0.93, p less than 0.001; r = 0.95, p less than 0.001 respectively). It was possible to calculate systolic pulmonary pressure, in patients with tricuspid incompetence, (43.9 +/- 14.9 mmHg, range 25-80) which correlated significantly (r = 0.95, p less than 0.001) with hemodynamic data (40.2 +/- 12.7 mmHg, range 20-70). The left atrial-left ventricular pressure gradient was 15.6 +/- 6.9 mmHg, range 6-32; the mean pressure gradient was 8.4 +/- 3.7 mmHg, range 3-17; the pressure half time 170.2 +/- 62.3 ms, range 83-330. We observed different types of direction of transmitral jets: centrally directed (n = 34); forward antero-lateral wall (n = 28); toward interventricular septum (n = 5). The transmitral jets presented 4 different appearances: scimitar-shaped (n = 28); candle flame (n = 24); mushroom (n = 9); double-jets (n = 6). No correlation was observed between the different types of transmitral jets (direction and appearance) and the parameters obtained by Doppler (PW and CW): velocities, pressure half-time, gradients. Thus, Doppler echocardiography permits a complete anatomic and functional evaluation of patients with pure mitral stenosis. We have not observed any correlation between the hemodynamic data and the different types of transmitral jets visualized by color Doppler.

Echocardiography, Doppler↗
PubMed1987

Asynergy and left ventricular performance in dilative cardiomyopathy.

The purpose of this work was to evaluate the presence and importance of asynergy in dilative cardiomyopathy. A semiautomatized analysis of left ventriculograms was performed in 18 cases, the morphology of longitudinal and transverse axes time-length curves was evaluated, and mathematical indices of asynchrony and hypokinesis were defined. Ten normal subjects and 9 patients affected by aortic regurgitation were used as controls. In dilative cardiomyopathy, anomalous (polyphasic) time-length curves were present in 55% of the cases, while they were absent in aortic regurgitation and in all normal subjects but one. In addition, the asynchrony index was slightly increased and the hypokinesis index significantly increased (28.8 +/- 7.2% vs. 17.8 +/- 7.1%, p less than 0.001). A negative correlation existed between the asynchrony index and the ejection fraction (r = -0.483, p less than 0.05) and both the ejection fraction and the maximum normalized velocity of contraction were reduced in the patients with the anomalous curves (29.7 +/- 6.9% vs. 46.0 +/- 11.5%, p less than 0.01; 1.66 +/- 0.52 s-1 vs. 2.86 +/- 1.33 s-1, p less than 0.02). It was concluded that asynergy, and especially asynchrony, is frequent in dilative cardiomyopathy and it is strongly associated with a major impairment of overall left ventricular function.

Adolescent↗
PubMed1987

Platelet aggregation behaviour in patients treated with ticlopidine.

Thirty patients (18 women, 12 men) with permanent or paroxysmal atrial fibrillation were treated with a new antiplatelet drug, ticlopidine, in order to study platelet aggregation behaviour, to see whether the drug prevents thromboembolisms and to observe side-effects over a period of 6 months. A further comparative study of the effects of ticlopidine and dipyridamole + aspirin on platelet aggregation was carried out in 20 patients. All appropriate haematological parameters were tested every 3 months, while platelet aggregation curves with ADP were examined also after 15 days. At the end of the period an echocardiogram was performed to check for any sign of thrombosis. The reduction in the aggregation curves was statistically significant for all the ADP stimuli, except at low doses. In the comparison with dipyridamole + aspirin, ticlopidine gave better results; with the former there was no significant reduction in platelet aggregation. A more significant reduction was seen in patients who had showed hyperaggregation at the outset. Bleeding time was increased and platelet adhesivity was reduced. During the 6-month period a slight reduction in white blood cells and a slight increase in creatinine were observed, both remaining within the normal range. Some 33.3% of the patients experienced side-effects. No embolic event or thrombosis in the left atrium was seen. Ticlopidine seems to be an effective antiplatelet drug, especially for patients with hyperaggregation.

Adult↗
PubMed1982

Acute hemodynamic effects of Brescia-Cimino arteriovenous fistula for hemodialysis.

In ten uremic patients, who were not yet undergoing periodic hemodialysis and in whom we were creating a 1 cm, distal, side-to-side arteriovenous fistula of Brescia-Cimino type for hemodialysis, the acute hemodynamic changes of the systemic and pulmonary circulations were studied immediately after the opening of the fistula. An increase in cardiac output (Q) was observed in one patient, the other patients showing either no change or a slight reduction. In the four patients in whom the Q decreased there was a significant reduction of total blood volume (TBV) and stroke volume (SV) and an increase in systemic vascular resistance (SVR) (p less than 0.05, p less than 0.05, p less than 0.01 respectively). At the level of pulmonary circulation, in these patients a decrease in pulmonary blood volume (PBV) (mean = 20%) and a significant increase in pulmonary vascular resistance (PVR) were also observed. In five patients who had been on chronic hemodialysis and who presented the clinical picture of cardiac failure, the acute hemodynamic changes following temporary closure of the fistula (by a sphygmomanometer) were studied: a significant decrease (p less than 0.05) in Q, TBV and SV was observed. The difference between the two values of Q (i.e. fistula open and closed) was considered to indicate the magnitude of the flow across the fistula.

Adult↗
PubMed1980

Quantitative evaluation of the regional left ventricular function in normal subjects by means of cineangiocardiography.

A method for analysing left ventricular cineangiograms is described, which not only provides information on the overall ventricular performance, but also evaluates the regional contraction of the left ventricle and the related haemodynamic patterns. This simplified Chapman's method (slice method) makes it possible to calculate the end-diastolic, end-systolic volumes, the stroke volume and the ejection fraction of the zones into which the left ventricle is divided by a longitudinal and by three transverse axes, according to Herman's technique. The hemiventriculograms of 21 normal subjects in the AP projection were evaluated using this method and a 10 of them were also studied in RAO projection. A uniform left ventricular contraction pattern was found for three hemiventricles outlined by the anterolateral, lateral, and postero-medial walls (ejection fraction 71.7 +/- 5.1%, 71.6 +/- 5.9%, 70.4 +/- 5.1%, respectively), the regional and zonal ejection fraction (EFR, EFZ) being similar in both projections. The ejection fraction of the hemiventricle outlined by the septal wall was, however, lower (65.6 +/- 6.0%). The standard zonal function curves of the left ventricle in normal subjects was then calculated on the basis of the results obtained, in order to assess, by comparison, zonal function abnormalities in cardiac patients.

Adult↗
PubMed1977

[The quantitative cineangiography. Part II. Computerized analysis of the left ventricular volumes in man (author's transl)].

The values of left ventricular volumes (EDV and ESV) were determined in 35 patients with various heart diseases by computerized reading technique utilizying both the area-length and the slice methods. The data thus obtained were compared both with those derived manually and with those obtained following injection of 113mIn into the left ventricle and monitoring by external counting the dilution curve. Good agreement among the data obtained by the various methods was found. It appears, then, in the clinical practice, the computerized method has definite advantages over the others since it allows quick determination of the data and therefore examination of multiple frames.

Adolescent↗
PubMed1977

[Quantitative cineangiography. Part I. Computerized volumetry of ventricular models (author's transl)].

A computerized system for cineangiograms analysis is described. Each selected frame is displayed by a TV camera on a TV monitor, allowing the physician to draw the left ventricular contour using a light-pen. The coordinates of selected points are sent to a small size digital computer to be processed. The processing techniques are outlined, while particular evidence is given to the operating procedure. Left ventricular volume is evaluated using both area-length and slice methods. Results obtained on models yield an estimation of the accuracy of the volume measurements.

Angiocardiography↗