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Biomedical subjects

A Giunta

Publications and source records attributed to A Giunta.

At least 91 records · Page 5Linked to original sources
PubMed1983

Systolic time-interval evaluation by thermistor plethysmography during uninterrupted dynamic stress test in normals and in patients with coronary artery disease.

18 patients with coronary artery disease (CAD) and 21 normal subjects underwent a triangular bicycle exercise test. Systolic time intervals (STI) were calculated at rest and every 2 min during exercise. Under resting conditions, STI were similar in the two groups. During exercise, the ejection time index (ETI), i.e. left ventricular ejection time (LVET) corrected for HR, rose significantly more in CAD patients, as compared to normals. Pre-ejection period (PEP) was also differently affected by exercise in CAD patients, who showed a more shortened PEP (p less than 0.001) in the early stage of dynamic stress. PEP/LVET ratio, which in the control group decreased continuously, in CAD patients fell during exercise at lower work loads (p less than 0.001), whilst rose during strenuous exercise. Finally, significant differences (p less than 0.001) were found in the percent change (% delta) PEP/LVET ratio between the two groups during the early phase of exercise, in which no superimposition of single values was present. Therefore, this last parameter seems the most reliable to differentiate clearly CAD patients from normal subjects, but its use must be limited at early exercise.

Adult↗
PubMed1983

Exercise induced ventricular arrhythmias. Angiographic correlation with the severity of coronary artery disease.

We correlated the incidence and degree of exercise induced ventricular arrhythmias (EIVA) with the angiographic severity of coronary artery disease (CAD) in 162 patients with a history of stable effort angina, all showing a positive exercise stress test for myocardial ischemia and a greater than or equal to 70% stenosis of a major coronary artery. Patients were grouped according to the following criteria: presence of electrocardiographic evidence of old transmural myocardial infarction (MI), number of significant coronary stenoses and number of left ventricular (LV) areas showing abnormal segmental wall motion (ASWM). The incidence of EIVA in patients with multivessel CAD was higher than in patients with single vessel CAD, but this difference was not statistically significant. The number of LV areas with ASWM was better correlated with the frequency of EIVA, which was 20.0% in patients with normal LV wall motion, 31.2% in patients with 1 area of ASWM, 54.0% in patients with 2 areas of ASWM (p less than 0.005 vs normal LV wall motion), 74.1% in patients with 3 or more areas of ASWM (p less than 0.001 vs normal LV wall motion and 1 area of ASWM), and 81.8% in patients with LV aneurysm (p less than 0.001 vs normal LV wall motion and 1 area of ASWM, p less than 0.005 vs 2 areas of ASWM). Patients with old MI showed a significantly higher incidence of EIVA than those without MI (p less than 0.001), but this difference was due to the more severe LV asynergy in the MI group. In conclusion, our results show that, in a selected population of patients with CAD, the incidence of EIVA correlates better with the extent of LV segmental wall motion abnormalities than with the number of diseased coronary arteries or the presence of an old transmural MI.

Adult↗
PubMed1982

[Influence of myocardial infarct on ventricular arrhythmias during the exercise test. Study in patients with stable angina of effort].

The incidence of ventricular arrhythmias observed during exercise (EVA) was correlated with the presence of previous myocardial infarction (IM) and angiographic severity of coronary artery disease (CAD) in 162 patients (pts.) with stable angina on effort, who had a positive stress test and greater than 70% stenosis of a major coronary artery. Our study population was divided in two groups: the first was composed of 95 pts. with previous MI, the second of 67 pts. without previous MI. Pts. of both groups were subdivided according to severity of CAD and to presence and degree of abnormal segmental wall motion (ASWM). In the MI group only 11.5% of pts. had single vessel disease, and 86.3% had ASWM. In pts. without MI 28.6% had single vessel disease; ASWM was found in 59.7% (p less than 0.001 vs MI pts.). Pts. with MI showed a higher incidence of EVA than pts. without MI (60% vs 32.8%, p less than 0.001). In both groups EVA were more frequent among pts. with double, triple vessel and main left CAD, than in pts with single vessel disease, but the difference was not significant. In general, EVA were found to correlate better with the number of areas with ASWM: in both groups significant differences of EVA frequency were found when pts. with normal left ventricular function were compared to those with more severe ASWM, while no difference was found between pts with and without MI who had the same degree of CAD. The most severe EVA (Tilkian's classification), were found in pts with a previous MI and a high ASWM score. In conclusion, our results show that a previous MI affects the development of EVA in pts. with stable effort angina. However EVA seem to be better correlated with the severity of LV impairment than with the extent of CAD.

Adult↗
PubMed1981

Echocardiographic evaluation of acute administration of oxyfedrine in patients with coronary artery disease.

In order to assess the effects of oxyfedrine in ischaemic heart disease, echocardiographic evaluation of left ventricular function was performed 2,5,10,15 and 20 minutes after the intravenous administration of 12 mg oxyfedrine in 15 patients with coronary artery disease without angiographic abnormalities of left ventricular wall motion. The following parameters were measured: heart rate, mean arterial blood pressure, internal dimension in diastole (LVIDd) and in systole (LVIDs) of the left ventricule and the percentage shortening of the LVID (%LVID). There was a significant increase in %LVID (peak 10 minutes after drug administration; p less than 0.001) indicating improved left ventricular function, associated with slight changes in pre-load (LVIDd) and in heart rate, and no variation in mean blood pressure. No abnormalities of contraction were observed after the administration of oxyfedrine. These results suggest that oxyfedrine exerts a direct positive inotropic effect of the myocardium in patients with significant coronary artery stenoses.

Aged↗
PubMed1981

Non-invasive evaluation by thermistor plethysmography of left ventricular performance during dynamic exercise. Comparison with echocardiography.

The purpose of this study was to evaluate the reliability of two non-invasive techniques (STI and echocardiography) in assessing cardiovascular response during exercise. STI were obtained using a new carotid pulse transducer (thermistor pulse) proved to be reliable in exercise recording. The study population included 12 male rowers (age 15-20 years), who performed supine bicycle exercise; STI and echocardiographic recording of left ventricle were simultaneously obtained at rest and continuously throughout the exercise period. A negative linear correlation (r=-0.782; p less than 0.001) was found between PEP (pre-ejection period) and %LVID (fractional shortening of left ventricle), reliable indexes of cardiac contractility measured by the two techniques. A lower, but significant correlation (r=0.643; p less than 0.001) was present between ETI (left ventricular ejection time corrected by heart rate) and SV (stroke volume) indexes of pump function. The present study shows that STI measured with this new technique, can be employed in evaluating left ventricular function in those patients in whom a good echocardiogram is difficult to record during exercise.

Adolescent↗
PubMed1981

Severity of mitral regurgitation assessed by echocardiography. Reliability and limitations.

To assess whether echocardiography may represent a useful mean to evaluate the degree mitral regurgitation (DR), left ventricular diastolic internal dimension (LVIDd), left atrial dimension (LAD), and velocity of circumferential fiber shortening (Vcf) were compared to DR assessed by left ventriculography in 48 patients with primary (n = 21) and cardiomyopathic (n = 27) valvular incompetence. In patients with good left ventricular contractility, i.e. with Vcf values above 1.02, a significant positive linear correlation was found between LVIDd and DR (LVIDd = 5.38 + 0.45DR; r = 0.72; p less than 0.001). In contrast, in patients with depressed left ventricular function, i.e. with Vcf values below 1.02, LVIDd did not correlate to DR. In either group LAD and Vcf did not correlate to DR. Thus, echocardiography may provide useful semiquantitative information concerning DR only in patients with preserved left ventricular performance.

Cardiomegaly↗
PubMed1981

[Influence of left ventricular volume changes induced by Valsalva maneuver on R wave amplitude (author's transl)].

Exercise-induced changes of R wave amplitude (delta R) during exercise has been employed to improve the reliability of stress testing in detecting patients with coronary artery disease. Several authors postulated that delta R are related to changes of ventricular volumes. Furthermore Valsalva Maneuver (VM) is able to induce a decrease of left ventricular volumes induced by VM and the variations of R wave. Echocardiographic method was used to determine left ventricular volumes and R wave amplitude changes were evaluated by Frank's lead. Our findings suggest that R wave amplitude changes are not related to variations of cardiac volume. Electrophysiological mechanisms of delta R need further investigation.

Adolescent↗
PubMed1981

[Effect of age on heart rate and systolic time intervals in children, adolescents and young adults (author's transl)].

Study was performed to assess if the increase of age can affect heart rate (HR) and systolic time intervals (STI) in a population of children, adolescents and young adults. We made polygraphic recordings in 66 normal subjects (5-25 years old) and regression equations were obtained for STI and age, HR and age and STI and HR. We found a significant relationship of HR and STI with age. Equally STI were correlated with HR. PEP/LVET ratio was unaffected by age or HR. We considered moreover mean values of HR and STI in four age-groups (5-10, 11-15, 16-20, 21-25). Data comparison showed higher LVET and lower HR in elder subjects. These had moreover higher PEP versus younger groups. The Authors believe that the relationship of HR, STI and age, undemonstrated by several other studies, can be found if we consider a large of age. Because other authors studied a little range of age, our demonstration of no statistically significant different values of HR and STI between 5-10 and 11-15 groups, authorize us to consider that the effect of age is highly significative on HR and STI among children, adolescents and young adults.

Adolescent↗
PubMed1980

[The use of echocardiography for diagnosis of right ventricular hypertension (author's transl)].

Echocardiographic right ventricular wall thickness (RVWT) and right ventricular dimension (RVD) were performed in 65 patients, undergoing diagnostic heart catheterization. Patients were divided in two groups: 28 patients with right ventricular hypertension (group 1) and 37 patients with normal right ventricular systolic pressure (RVSP) (group 2). 24 patients of group 1 (85.7%) had increased RVWT and 34 patients of group 2 (91.9%) had normal RVWT. In group 1 RVSP was significantly correlated with RVWT (r = 0.92; p < 0.001); an inverse correlation was found between RVSP and RVD (r = -0.63; p < 0.001). Non significative correlations were found in group 2. Our study proves that the echocardiographic evaluation of RVWT can be helpful in separating patients with right ventricular systolic hypertension from patients with normal values of RVSP, and that a positive correlation exists between the increase of RVWT and the increase of RVSP.

Adolescent↗
PubMed1979

The role of zinc in total parenteral nutrition.

Zinc deficiency was observed in an infant receiving total parenteral nutrition (TPN) for chronic untractable diarrhoea. Clinical findings included low zinc plasma levels, skin lesions and loss of all the advantages of TPN such as weight gain, serum proteins and albumin increase and normalization of intestinal mucosa. Oral administration of zinc sulphate was the decisive factor making possible both the improvement of clinical and laboratory findings and alimentation by natural route.

Chronic Disease↗