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Biomedical subjects

A Venco

Publications and source records attributed to A Venco.

At least 73 records · Page 4Linked to original sources

[Functional anatomy of the left ventricle in hypertensive subjects. Correlations with the clinical severity of hypertension].

Using computerized M-mode echocardiography we have investigated 58 hypertensive subjects in order to assess whether a correlation could be demonstrated between left ventricular changes induced by hypertension and age of the patients, the duration and severity of hypertension, and damage to other target organs. Various morphological changes of the left ventricle were detected: 14 patients (24%) had concentric hypertrophy of the left ventricle, 12 (20%) had asymmetric septal hypertrophy, 5 (8%) had dilated left ventricle without hypertrophy. Left ventricular mass was increased, when compared to normal controls in 24 patients (41%). With respect to functional abnormalities, the peak lengthening rate of left ventricular dimension in diastole was decreased (+dD/dt less than s-1) in 25 patients (43%). Eight of these patients (14%) also had depressed peak shortening rate of left ventricular diameter in systole (-dD/dt less than 1.9 s-1). Hypertensive retinopathy was present in 23 patients (39%) and impairment of renal function in 8 (14%). Left ventricular mass and systolic and diastolic parameters of left ventricular function did not correlate significantly either with the age of the patients, or with the duration and severity of hypertension, or with the damage present in target organs other than the heart. Left ventricular mass was inversely correlated with the index of left ventricular relaxation (r = -0.53; P less than 0.001), whereas neither the latter nor left ventricular mass were correlated with peak systolic stress. Instead, peak systolic stress was inversely correlated with peak shortening rate of left ventricular diameter, an index of systolic function (r = -0.50; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Improved left ventricular function after short-term treatment with fructose-1,6-diphosphate: echocardiographic study in chronic ischemic heart disease and idiopathic dilated cardiomyopathy.

The effect of fructose-1,6-diphosphate (FDP) on left ventricular function was assessed in seven patients with chronic ischemic heart disease and eight patients with idiopathic dilated cardiomyopathy. In a crossover study design each patient received 10 gm of FDP or saline placebo intravenously for three days. An M-mode echocardiographic assessment of left ventricular (LV) function was made before and after each treatment period. After FDP treatment, LV end-diastolic and systolic dimensions showed a 6% reduction (P less than 0.01), while peak lengthening rate of LV dimension in diastole and peak shortening rate of LV dimension in systole increased 17% and 10%, respectively (P less than 0.05). There was evidence that FDP was more effective in the patients with ischemic heart disease than in the patients with cardiomyopathy.

Aged↗

Echocardiographic features of hypertensive-diabetic heart muscle disease.

Computerized M-mode echocardiography was used to evaluate left ventricular anatomy and function in 20 patients with hypertension and diabetes mellitus, without signs of overt heart disease. A similar study was performed in 20 patients with hypertension of similar severity and duration and in 20 normal subjects. Mean posterior wall thickness and mean septal thickness were increased in hypertensive patients compared to normal (p less than 0.001), but diabetic patients had thicker septa with respect to nondiabetics (p less than 0.05). All hypertensive-diabetic patients had reduced peak lengthening rate and/or peak velocity of posterior wall thinning. Six of them also had reduced peak Vcf and/or peak velocity of posterior wall thickening. Only 9 of the 20 patients with hypertension alone had abnormal diastolic function; 4 out of these 9 also had abnormal systolic function. We conclude that diabetes causes more severe impairment of left ventricular function in patients with a similar degree of hypertension. The more consistent abnormalities are reduced rate of dimension increase during filling and slower wall thinning, suggesting impaired left ventricular relaxation and distensibility.

Adult↗

Effect of indenolol treatment on beta-adrenergic receptors of polymorphonucleates in essential hypertension.

Indenolol is a new antihypertensive agent, whose beta 1-adrenoceptor antagonist properties combined with beta 2-adrenoceptor agonist properties have been shown by experimental studies in animals. Our previous work reported that in vivo beta-adrenoceptor blocking drugs markedly increase the beta-adrenoceptor (BAR) number, without increasing BAR affinity. The aim of this study was to evaluate BAR density and affinity before and after indenolol therapy in membranes of polymorphonucleates (PMN) of patients with essential hypertension. Polymorphonuclear binding parameters were studied in 12 hypertensives (WHO stages I and II) after 14 days of placebo and after 21 days of indenolol therapy (120 mg once daily orally). Indenolol did not increase BAR number but significantly decreased (P less than 0.01) BAR affinity. On the basis of these data it is concluded that indenolol does not induce the same changes in PMN's BAR as previously observed with oxprenolol, propranolol and labetalol. This phenomenon may account for the absence of rebound effect after withdrawal of indenolol in hypertensives.

Adrenergic beta-Antagonists↗

Computerized echocardiographic study of left ventricular function and cardiodynamic investigation with a new antihypertensive agent (indenolol).

Indenolol hydrochloride is a recently introduced antihypertensive substance. Although it has beta-adrenoceptor blocking activity, its action is due to total peripheral resistance reduction. We investigated the effects of indenolol therapy on left ventricular performance in 15 patients with essential hypertension. Assessments were made using systolic time intervals and computerized echocardiography. The echocardiographic and mechanocardiographic tracings were recorded three times: at the beginning of the trial, after seven days of placebo, and after three weeks of indenolol treatment. The indenolol therapy significantly decreased (P less than 0.001) systolic and diastolic blood pressures and heart rate in all patients, both in supine and standing positions. After three weeks of treatment, systolic time intervals and echocardiographic determinants of left ventricular function were substantially unchanged in comparison with the basal and placebo evaluations. We conclude that indenolol exerted a marked effect on chronotropism but no demonstrable negative effect on inotropism in patients with essential hypertension. No clinical signs of heart failure were recorded. Side effects were absent, and patient compliance was good in all cases.

Adult↗

Ventricular septal rupture after myocardial infarction: diagnosis by two-dimensional and pulsed Doppler echocardiography.

Rupture of the ventricular septum in the acute phase of myocardial infarction (MI) requires prompt recognition for correct management. The 2-dimensional and pulsed Doppler echocardiographic findings are reported from 11 patients with ventricular septal (VS) rupture. VS rupture was confirmed by cardiac catheterization in 9 patients, surgery in 4 patients and necropsy examination in 3 patients. Two-dimensional echocardiography (echo) directly visualized the rupture in 7 patients and assessed the size and location of an associated aneurysm in 10. In all patients, M-mode pulsed Doppler echo allowed detection of the left-to-right shunting due to VS rupture, but failed to indicate the rupture site. M-mode pulsed Doppler echo was reliable for detecting VS rupture after MI. Conversely, 2-dimensional echo was less effective in the direct visualization of the rupture, but provided anatomic and functional information that was useful in medical and surgical management. Thus, the techniques are complementary and should be used in combination for the assessment of VS rupture in acute MI.

Adult↗

Kinetocardiographic detection of ventricular dyssynergy after myocardial infarction. Correlations with two-dimensional echocardiography.

The aim of this study was to determine if kinetocardiography can detect regional abnormalities of left ventricular kinetics, as occurs in coronary patients. Kinetocardiogram, M-mode and two-dimensional echocardiograms were recorded in 33 subjects (mean age 63, range 29-75 years), who previously had a myocardial infarction. On two dimensional echocardiograms, long axis, short axis, apical 4-chamber and apical 2-chamber projections were studied. Regional contractile abnormalities were rated as hypokinesis, akinesis, dyskinesis and aneurysm. In 6 subjects two dimensional echocardiogram was normal, in 5 it showed hypokinesis with left ventricular normal dimension or dilatation, and in the remaining 22 patients various regional kinetic abnormalities were observed. The kinetocardiogram showed paradoxical systolic movements in all patients with ventricular dyssynergy and was normal in all patients with normal ventricular kinetics, with or without left ventricular dilatation and global hypokinesis. There were no correspondences between echocardiography and kinetocardiography, regarding sites and amount of abnormalities. Kinetocardiography can thus noninvasively detect qualitative left ventricular kinetics abnormalities, in patients with myocardial infarction.

Adult↗

Relation of kinetocardiogram to systolic time intervals in patients with old myocardial infarction.

Left ventricular function was studied noninvasively in a group of 35 patients with noncomplicated and complicated old myocardial infarction (MI) by means of kinetocardiography (KCG) and systolic time intervals (STI). Discriminant analysis with a group of 130 normal subjects documented that STI were significantly abnormal and that the abnormalities, i.e. prolongation of the preejection period, shortening of left ventricular ejection time and increase of PEP/LVET were more evident in patients with complicated old MI. KCG was more or less abnormal in all the patients studied, with the more striking abnormalities in those with complications. A good correlation was found between KCG and STI abnormalities. We consider that KCG is able to detect in a sensitive way abnormalities of left ventricular contraction in patients with old MI and that, most probably, alterations of STI in these patients are mainly due to incoordinate left ventricular contraction.

Adult↗

[Echocardiographic diagnosis of left atrial thrombosis (author's transl)].

70 consecutive patients undergoing heart surgery for mitral valve disease were studied: at operation 6 of them exhibited left atrial thrombi (LAT). Dimension of the thrombi varied from a hazel-nut to an orange, 4 of them adhered to the posterior atrial wall, 2 of these obliterated the left atrial appendage, one partially and the other totally, invading also the left atrial cavity as far as mitral orifice. In 5 cases LAT appeared of old onset, possibly with recent apposition; in one case the thrombus was mainly recent. All the cases had been assessed preoperatively using M-mode and two-dimensional echocardiography: the diagnosis of LAT was made in 5 pts, the only thrombus missed was the one located in the left atrial appendage. Angiocardiography was performed in 4 pts, showing left atrial thrombi in one case. Two-dimensional echocardiography (2D E) demonstrated a high sensitivity by revealing LAT in 5 cases out of 6, with good definition of shape and location. The LAT appeared as echoproducing masse with well defined borders and "muscle" density in 4 cases; in 3 they were seen protruding into the atrial cavity and in one case they were seen located above the posterior mitral leaflet. M-mode revealed multiple echoes parallel to the posterior atrial wall in the first 3 cases, whereas in the fourth it provided no particular finding for the diagnosis. In the only case of recent onset LAT, 2DE showed a single strong echo, parallel to the posterior atrial wall both in long and short-axis views, separated from the atrial wall by an echo-free space of 1.5 cm. Similar features resulted at the M-mode echocardiography. In conclusion, 2DE with gray-scale has an high sensitivity for detecting LAT, in particular when thrombi are old and located in the left atrial cavity. Recent onset thrombi are more difficult to demonstrate and it is possible that the "fresh" component of an old thrombus is missed.

Adult↗

[Human cytomegalovirus and congestive cardiomyopathy (author's transl)].

Congestive cardiomyopathy in 3 cases, in which occurrence of human Cytomegalovirus (CMV) infection was demonstrated, is described. In all cases significant rise in total CMV antibodies and in early antigen-antibodies was found: CMV was also isolated from urine and saliva in one, a 13 years old boy, and only from urine in the others two patients, 20 and 26 old men. Immunoglobulin M was raised only in the first case, in which CMV infection was likely in act: instead in the others two CMV infection was late primary or recurrent. The possibility of CMV infection as etiological agent of dilatative cardiomyopathy with congestive heart failure in this 3 cases is, in our opinion, strongly suggestive.

Adolescent↗