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Biomedical subjects

A Cuocolo

Publications and source records attributed to A Cuocolo.

167 records · Page 10Linked to original sources
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[Ambulatory monitoring of left ventricular function with a radionuclide detector system].

The recent development of new radionuclide detectors allows noninvasive outpatient monitoring of left ventricular function. This study was aimed at describing a new radionuclide technique useful to monitor cardiac function and at evaluating its potential clinical applications. We studied 14 normal subjects, 30 patients with coronary artery disease and 25 patients with dilated cardiomyopathy. Left ventricular function was continuously monitored in control conditions at rest, during daily physical activity of different intensity (walking on a level surface and climbing stairs), and during bicycle exercise. Left ventricular ejection fraction (EF) variability during recording in control conditions at rest was 0.2 +/- 1.8%. A significant relationship between outpatient EF at rest and conventional equilibrium radionuclide angiography was observed (r = 0.97, n = 69, p less than 0.001). In normal subjects both daily physical activity and exercise stress test induced an increase in heart rate and EF. In patients with coronary artery disease and in patients with dilated cardiomyopathy a heterogeneous EF response was observed during physical activity and exercise stress test. Our results demonstrate that this technique can be used for the ambulatory monitoring of left ventricular function in both normal subjects and patients with different types of cardiomyopathies.

Adult↗
PubMedDate not supplied

[Myocardial scintigraphy with technetium 99m methoxyisobutylisonitrile. A comparison with coronary arteriography in patients with suspected ischemic cardiopathy].

Technetium-99m methoxy-isobutyl-isonitrile (MIBI) myocardial scintigraphy has been proposed as an alternative to Thallium 201 myocardial imaging in the evaluation of patients with coronary artery diseases. We studied 39 patients (37 men, mean age 56 +/- 9 years) with suspected coronary artery disease. All patients underwent 99mTc MIBI myocardial scintigraphy after stress and at rest. Coronary arteriography, performed within 1 month, showed significant (greater than or equal to 50%) stenosis of at least 1 epicardial coronary artery in 36 subjects. 99mTc MIBI myocardial scintigraphy exhibited 94% sensitivity (34/36 patients) and 100% specificity (3/3 subjects with normal coronary arteries). Sensitivity for individual vessel stenosis was 81% (96% for the left anterior descending artery, 65% for the circumflex artery and 79% for the right artery). Our data show that 99mTc MIBI myocardial scintigraphy is capable of evaluating patients with coronary artery diseases.

Contrast Media↗
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[Evaluation of systolic parietal thickening of the left ventricle using technetium-99m methoxy isobutyl isonitrile. Relationship with coronary anatomy].

Forty-three patients (40 men and 3 women, mean age 54 +/- 9 years) with coronary artery disease underwent 99mTc methoxy isobutyl isonitrile (sestamibi) myocardial scintigraphy and coronary arteriography. Sestamibi uptake and wall thickening index (WTI) were quantitatively evaluated in each myocardial segment. Segments were divided into group 1 (normal coronary arteries, no. = 94), group 2 (coronary artery stenosis 50-99%, no. = 79), and group 3 (coronary artery stenosis 100%, no. = 42). Group 3 segments were subdivided into group 3A (with collaterals, no. = 18) and group 3B (without collaterals, no. = 24) segments. Both sestamibi uptake and WTI were significantly lower (p < 0.01) in group 3 than in groups 1 and 2. However, only WTI was significantly reduced (p < 0.01) in group 3B vs group 3A. Diagnostic capabilities (i.e. identification of segments supplied by stenosed coronary arteries) of sestamibi uptake, WTI, and a combination of both variables with a discriminant function were compared by analysis of receiver operator characteristic curve (ROC) areas. The diagnostic capabilities of sestamibi uptake (ROC area = 0.65 +/- 0.04) were significantly lower (p < 0.05) than those of WTI (ROC area = 0.81 +/- 0.03) and discriminant function (ROC area = 0.83 +/- 0.03). In conclusion, our data suggest that combined analysis of myocardial perfusion and regional ventricular function may increase the diagnostic accuracy of sestamibi myocardial scintigraphy in identifying myocardial segments supplied by stenosed coronary arteries.

Cardiomegaly↗
PubMedDate not supplied

[Effects left ventricle asynchrony on systolic and diastolic function in patients with non-ischemic heart failure].

INTRODUCTION: The asynchrony of the left ventricle--i.e., its nonuniform contraction and relaxation--is an important factor for left ventricular function. Heart failure is often related to abnormal systolic function, sometimes associated with a diastolic dysfunction. We studied the relationship of left ventricular asynchrony to left ventricular function in patients with nonischemic heart failure. MATERIAL AND METHODS: Radionuclide angiography at rest was performed in 25 patients with nonischemic heart failure and in 26 age and sex matched normal subjects. In addition to ejection fraction and peak filling rate, two indices of left ventricular asynchrony were calculated: the coefficient of variation of regional time to end systole and the coefficient of variation of regional time to peak filling rate. These factors indicate how disperse are the regional values of time to end systole and of time to peak filling rate. In fact, the higher the value, the greater the asynchrony. RESULTS: A significant (r = .46, p < .05) inverse correlation was found between the ejection fraction and the coefficient of variation of regional time to end systole in both the normal subjects and the heart failure patients, while the ejection fraction correlated significantly (r = .46, p < .05) with the coefficient of variation of regional time to peak filling rate only in the patients. Moreover, the peak filling rate was inversely correlated (r = .57, p < .05) with the coefficient of variation of regional time to peak filling rate in the heart failure patients but not in the normal subjects. CONCLUSIONS: These results suggest that left ventricular systolic and diastolic asynchrony may contribute to impair left ventricular systolic and diastolic function in patients with nonischemic heart failure.

Adult↗