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Biomedical subjects

A Binda

Publications and source records attributed to A Binda.

At least 19 recordsLinked to original sources
PubMed1997

Influence of residual ischaemia on heart rate variability after myocardial infarction.

Despite the growing evidence for the positive predictive value of depressed baroreflex sensitivity and/or reduced heart rate variability after myocardial infarction, the mechanisms involved in these autonomic alterations are not fully understood. Specifically, the possible influence of residual ischaemia has not been assessed. To address this problem we studied the spectral analysis of heart rate variability in 21 patients with a first myocardial infarction in whom the only clinical correlate was the presence of residual ischaemia, as documented by the positive response to both an exercise stress test and an echocardiographic stress test. Data from these patients were compared with those obtained in a group of postmyocardial infarction patients similar for several risk factors, age, site of myocardial infarction, but without residual ischaemia. Patients positive for residual ischaemia had lower power in the whole spectrum (1146 +/- 158 vs 1631 +/- 159 ms2, P = 0.032) as well as in the low and high frequency bands of heart rate variability. A nocturnal increase in high frequency was observed in those without residual ischaemia (from 167 +/- 35 to 242 +/- 51 ms2, +45%, P = 0.034), but not in those with residual ischaemia (from 111 +/- 19 to 141 +/- 29 ms2, +27%, ns). Thus, residual ischaemia reduces heart rate variability after myocardial infarction. The autonomic effects of residual ischaemia probably contribute to its negative prognostic value after myocardial infarction.

Adult↗
PubMed1997

Neuropsychological deficits in asymptomatic atrial fibrillation.

OBJECTIVE: To assess the preclinical effects on cognitive functions of nonrheumatic atrial fibrillation (NRAF) in patients with negative history for cerebrovascular disease. MATERIALS AND METHODS: The study included 37 consecutive patients with chronic (n=16, mean age 65.3+/-6.6 years) or paroxysmal (n=21, mean age 58.3+/-9.5 years) NRAF and an equal number of control subjects in sinus rhythm, who were matched for age, education and presence of hypertension. A comprehensive neuropsychological battery including tests of attention, memory, language and visuospatial skills was administered. RESULTS: Patients with chronic NRAF showed significantly poorer performances in tasks exploring attention and verbal memory functions, while the paroxysmal group was significantly impaired in a long-term memory task. The neuropsychological findings were confirmed excluding from both groups patients with CT evidence of cerebrovascular damage. A small subgroup of patients was also submitted to cerebral MRI. CONCLUSION: Neurologically asymptomatic NRAF is related to a subclinical but significant impairment in attention and memory. These deficits could be produced by minor ischemic lesions due to microembolization, or by diffuse hypoxic damage due to hypoperfusion.

Adult↗
PubMed1991

Plasmid vectors for selecting IS1-promoted deletions in cloned DNA: sequence analysis of the omega interposon.

We have constructed two plasmid vectors which allow selection for in vivo deletions within cloned DNA fragments. The plasmids are derivatives of pBR322 which carry the Escherichia coli rpsL (strA) gene, known to confer a dominant streptomycin (Sm)-sensitivity phenotype to the host cell, and a copy of the IS1 transposable element. Sm-resistant strains that harbor these plasmids display sensitivity to Sm. Spontaneous IS1-promoted deletions across the rpsL gene can be isolated simply by selection for Sm resistance. Hence, nested sets of deletions of a cloned DNA can be obtained and sequenced with an IS1-specific primer. Using this approach, we have determined the complete nucleotide sequence of the omega interposon [Prentki and Krisch, Gene 29 (1984) 303-313].

Amino Acid Sequence↗
PubMed1991

Cardiac alterations in 36 consecutive patients with idiopathic haemochromatosis: polygraphic and echocardiographic evaluation.

Thirty-six consecutive patients with idiopathic haemochromatosis (IH) were studied by electrocardiography (ECG), polygraphy, M-mode and 2-D echocardiography and Doppler-echocardiography. No significant correlations were found between ECG, PEP/LVET ratio and echocardiographic measurements. Left ventricular (LV) enlargement with impaired LV systolic function was present only in three patients (5.5%), of whom two died during iron-depleting therapy because of cardiovascular complications. Compared with controls, echocardiographic abnormalities were significantly more frequent and marked in subjects with higher iron overload than in those in whom it was lower. Ten patients were studied before and after iron depletion, nine of whom had only mild echocardiographic abnormalities at baseline examination. Significant reduction of end-diastolic thickness of the interventricular septum and LV mass (P less than 0.01 and less than 0.02 respectively) was observed. Also the end-diastolic thickness of the LV posterior wall and the end-systolic diameter of the left atrium reduced although not to a significant degree. The increased thickness of ventricular walls without impairment of LV systolic function is probably the first and still reversible cardiac alteration due to iron deposition in the myocardium. Later, with increasing iron overload, LV function becomes impaired and dilated cardiomyopathy develops. Early diagnosis and treatment of IH cardiopathy is needed before irreversible cardiac damage occurs.

Adult↗
PubMed1990

Ubidecarenone in the treatment of mitochondrial myopathies: a multi-center double-blind trial.

Forty-four patients with mitochondrial myopathies were treated with Ubidecarenone (CoQ10) for 6 months in an open multi-center trial. No side effects of the drug were observed. Sixteen patients showing at least 25% decrease of post-exercise lactate levels were selected as responders. Responsiveness was apparently not related to CoQ10 level in serum and platelets or to the presence or absence of mtDNA deletions. The responders were treated for a further 3 months with CoQ10 or placebo in the second blind part of the trial; no significant differences were observed between the 2 groups. It is not clear why CoQ10 had therapeutic effects in some patients and not in others with the same clinical presentation and biochemical defect, and we failed to identify candidate responders before treatment. At the dose of CoQ10 used in this study (2 mg/kg/day) the therapy requires a long administration time before a response is seen.

Blood Platelets↗
PubMed1988

Myocardial hydatid cyst ruptured into the pericardium: cross-sectional echocardiographic study and surgical treatment.

We describe a patient with a large intramyocardial hydatid cyst lying in the postero-lateral segment of the left ventricle near the atrioventricular groove level which ruptured into the pericardial sac, resulting in cardiac tamponade. Cross-sectional echocardiographic examination from a modified four-chamber apical view showed the multiloculated cyst and the breach connecting it to the pericardial sac, allowing for the definitive diagnosis and indication for emergency cardiac surgery. The risks of pericardiocentesis and invasive diagnostic procedures could thus be avoided.

Adult↗
PubMed1988

Clinical and biochemical correlations in mitochondrial myopathies treated with coenzyme Q10.

We tested the efficacy of coenzyme Q10 (ubidecarenone, CoQ10) therapy in patients with Kearns-Sayre syndrome and other mitochondrial myopathies with chronic progressive external ophthalmoplegia (CPEO). We treated seven patients for 1 year with daily oral administration of 120 mg of CoQ10. Throughout the treatment most of our patients showed a progressive reduction of serum lactate and pyruvate levels following standard muscle exercise and generally improved neurologic functions. The ECG and echocardiogram showed no significant changes in our patients. None of our patients showed any improvement in ptosis and CPEO.

Adolescent↗
PubMed1984

Hemodynamic evaluation by M-mode echocardiography in acute myocardial infarction.

We assessed the relationship between echocardiographic and hemodynamic parameters in 28 patients with documented acute myocardial infarction (AMI), who underwent M-mode echocardiography and Swan-Ganz catheterization during the same hospitalization. Patients with valvular heart disease were excluded from the study. On mitral valve echogram, DE interval was measured and the area enclosed by mitral valve echogram during DE interval (DE subarea ) was calculated in each echocardiogram. DE subarea /DE interval ratio was computed for each measurement set. Hemodynamic parameters were obtained in the usual fashion. Patients with pulmonary artery wedge pressure (PWP) less than 18 mm Hg showed a DE interval markedly longer than patients with PWP greater than 18 mm Hg: 81.72 +/- 15.23 vs 55.12 +/- 9.85 msec (p less than 0.001). Patients with cardiac index greater than 2.2 L min-1 m-2 had a DE subarea /DE interval ratio greater than patients with cardiac index less than 2.2 L min-1 m-2: 0.169 +/- 0.035 vs 0.094 +/- 0.017 dm2 sec-1 (p less than 0.001). Echocardiographic and hemodynamic data were then correlated in the whole study group, and it was found that DE interval was significantly (p less than 0.001) and inversely correlated to PWP; stroke index more than cardiac index was correlated (p less than 0.005) both to DE subarea /DE interval ratio and to DE interval itself; DE interval was not affected by heart rate. We were able to categorize the patients into four subsets on the basis of echocardiographic measurements. Our findings suggest the possibility of providing, through M-mode echocardiography, a noninvasive and accurate evaluation of PWP and stroke index.

Adult↗
PubMed1981

[The permanent electrostimulation with ventricular programmable pacemaker (author's transl)].

The purpose of this study is to evaluate the directions, reliability and long-term results of ventricular programmable pacemakers (PPM's). One hundred and ten PPM's, types Cordis and Medtronic, were implanted in 60 patients (pts) with intermittent or paroxysmal 2 degrees, 3 degrees a-v block and in 50 pts with S.S.S., mostly symptomatics, with a follow-up of 45 months. We did not observe either spontaneous or wrong reprogrammations nor circuit failure. In 92% of pts with Omni-Stanicor Cordis PM's, the stimulation was effective at the "lower" current amplitude, hence a longer life of the generator. Eighteen pts (16.3%) needed to raise ventricular rate (average 65 bpm): 6 pts for dizziness, syncopes or cardiac failure; 2 pts to control ventricular arrhythmias; 10 pts for a stable bradycardia lower than 50 bpm. In 11 pts with bradyarrhythmia due to S.S.S., cardiac output (CO) was measured both with thermodilution and echocardiography ("mitral valve echogram", being "r" of the two methods = 0.92), in spontaneous rhythm (63.3 +/- 3.13 bpm) and increasing artificially heart rate to 74.8 +/- 3.0 bpm; CO decreased from 4.65 +/- 0.13 l/min to 3.58 +/- 0.09 l/min, likely for the loss of atrial pumping. Similar results were obtained in other pts evaluated only with echocardiographic method after PM implantation: some of these underwent a further echocardiographic haemodynamic evaluation after 15 days of constant ventricular pacing at a mean rate of 75 bpm, with a different behaviour among them. This emphasizes the utility of PPM's in preserving spontaneous rhythm until bradycardia reaches dangerous levels and also the usefulness of echocardiography to evaluate, haemodinamically, the paced patient's ventricular performance.

Adult↗
PubMed1981

[Echocardiographic recognition of Valsalva aneurysm. A case report (author's transl)].

M-mode echocardiography has proved in these last years to be a reliable method for the recognition and evaluation of several cardiac diseases, both congenital and acquired. The following is a case we have examined in which M-mode echocardiography has allowed us to diagnose a Valsalva sinus aneurysm combined with a bicuspid aortic valve causing a valvular steno-insufficiency. We discuss the genesis of an echogram situated in the left ventricular outflow tract. A very similar image had been ascribed in the past to the rupture of an aneurysm into the interventricular septum, which caused a filling of the septum itself in diastole and therefore the echogram described above. On the basis of two-dimensional echocardiography, angiography and the autoptic report we could exclude this hypothesis in our case. We suggest that the image might be due to a prolapse of the valvular leaflet in the left ventricular outflow tract and/or to the prolapse of the aneurysm itself in the tract between the valvular leaflet and the interventricular septum.

Adult↗
PubMed1980

[Echocardiographic evaluation of cardiac output in patients with acute myocardial infarction (author's transl)].

Echocardiography is a non invasive technique particularly useful to assess both hemodynamics and left ventricular performances; different methods have been proposed to evaluate echocardiographically the cardiac output. The aim of this work is to suggest a new method (planimetry of the area enclosed by echoes from the mitral valve) stating its advantages and limits and to test three already known methods (cubes method, method of Lalani and Lee, method of Rasmussen and coll.) comparing them to thermodilution. In 24 patients admitted in our Coronary Care Unit for acute myocardial infarction 30 measurements have been performed simultaneously with echocardiography and thermodilution. Statistical analysis (correlation coefficient with the method of the square minimums and Student's 't') of the results has shown that the cubes method is unprecise (P = NS) and unbiased (d = 0.97 +/- 15.46); Lalani-Lee method is unprecise (P = NS) and biased (d = 9.64 +/- 21.36) by a systematic underestimate error concealed by the poor precision; Rasmussen and coll. method is precise (P < 0.01) but biased (d = --3.03 +/- 5.5), the systematic mistake being entirely due to the group of patients with abnormal hemodynamics. Our method is precise (P < 0.01) and unbiased (d = --0.04 +/- 9.62) in patients both with normal and abnormal hemodynamics. Therefore this method offers the following advantages: 1) it is unbiased, even in the presence of abnormal left ventricular performance; 2) it is sufficiently precise, having a correlation coefficient with thermodilution of r = 0.80; 3) it measures directly the amount of flow due to the atrial systole; 4) the measurement is rapid and hardly biased by the reader.

Acute Disease↗
PubMedDate not supplied

[Control of anticoagulant therapy with coumarin derivatives. Evolution of the tests used and their standardization].

Levels of hypocoagulabity induced with coumarin derivatives (aconocoumarin) were determined in 10 patients Quick's test was used to calibrate commercially available thromboplastin reagents against a reference reagent. The results were then standardised in the form of a correct prothrombin ratio. It was found that comparable results could be obtained, even with poorly sensitive thromboplastins, by determining a thromboplastin sensitivity index and using it to convert the prothrombin ratio obtained with each thromboplastin into a "correct" ratio, i.e. one that allowed for the depressed sensitivity of the thromboplastin concerned. It was found that thrombotest was more sensitive than the commercial thromboplastins; it was also superior to the reference reagent in expressing the level of drug-induced hypocoagulability. Attention is drawn to the soundness of expressing prothrombin times in terms of the correct ratio to cut out the effect of variations in sensitivity on the part of commercial thromboplastins. At the same time, stress is laid on the superiority of thrombotest in the monitoring of oral anticoagulant therapy.

Acenocoumarol↗