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Biomedical subjects

B Magnani

Publications and source records attributed to B Magnani.

At least 163 records · Page 9Linked to original sources
PubMed1989

[Analysis of the diastolic function of the left ventricle by Doppler echocardiography in athletes engaged in competitive sports activities].

In order to assess left ventricular diastolic function in elite athletes we studied 24 athletes (mean age 21 +/- 5 years) with the echo-Doppler technique. The control group consisted of 14 healthy males (mean age 24 +/- 6 years) and 99 patients (mean age 50 +/- 14 years) with primary or secondary left ventricular hypertrophy. The following variables were calculated: age, systolic and diastolic blood pressure, septal and posterior wall thickness, left ventricular volume and dimensions, myocardial mass index and mass/volume ratio, left ventricular end-systolic and peak systolic stress, RR interval, isovolumic relaxation time (IVRT), early (E) and late (A) peak flow velocity, E/A ratio, time and rate of deceleration of early diastolic flow. Compared with the normal subjects significant differences were observed with regard to systolic blood pressure, left ventricular wall thickness, myocardial mass, mass/volume ratio and peak systolic stress in the athlete group. In spite of a noticeable increase in myocardial mass indexes, all the diastolic function parameters were normal in the athletes. In this group a linear positive correlation between rapid filling indexes, ventricular mass and mass/volume ratio exists. These correlations are not present in the patients group. Moreover a linear negative correlation between RR interval and late diastolic flow velocity was found. In conclusion, the global diastolic ventricular function, evaluated with the echo-Doppler technique, is normal in athletes in spite of an increase in ventricular mass. Th early diastolic flow velocity is in direct proportion with mass increase and may represent one of the physiological mechanisms of the athlete heart adaptations.

Adolescent↗
PubMed1989

[Paroxysmal atrial fibrillation: study of the pattern of onset using dynamic electrocardiography].

UNLABELLED: We have examined 24 hours ECG Holter recordings of 22 patients without any organic heart disease and with recurrent episodes of paroxysmal atrial fibrillation (PAF) to check the possible sympatho-vagal influence on spontaneous initiation. Patients were divided into 3 groups according to average heart rate (HR) during the 24 hours recording and to the mode of onset of the arrhythmia: sympathetic (only diurnal episodes, HR greater than or equal to 75 b/min before the onset of the episode, average 24 hours HR greater than or equal to 80 b/min, progressive or sudden shortening of sinusal cycle before the onset), vagal (only nocturnal episodes, HR less than or equal to 60 b/min before the onset, average 24 hours HR less than or equal to 60 b/min, progressive or sudden lengthening of sinusal cycle before the onset of the episode) or "others" who did not show the aforementioned characteristics. RESULTS: there are not only 2 types of patients under prevalent sympathetic or vagal control but even patients who show mixed patterns; in the sympathetic group there are significant differences between ectopic atrial beats (EAB) that start a PAF and isolated EAB in: prematurity index (0.51 +/- 0.11 vs 0.45 +/- 0.07; p less than 0.001) coupling time (381 +/- 36 ms vs 419 +/- 48 ms; p less than 0.005), sinus cycle length (PP) before the onset of the arrhythmia (761 +/- 192 ms vs 950 +/- 175 ms; p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Idiopathic restrictive cardiomyopathy: clinical, hemodynamic, histologic and prognostic profile].

Idiopathic restrictive cardiomyopathy is a rare myocardial disease characterized by restrictive physiology without a specific histologic basis. To assess its clinical, hemodynamic, morphologic and prognostic details we retrospectively evaluated all the patients hospitalized in our Institute from 1974 to 1988. Nine patients, aged 42 +/- 16 years, M/F ratio = 0.29, who represent 64% of all the restrictive myocardial diseases biopsied were identified. Severe cardiac heart failure (3-4 NYHA) and arrhythmias (ventricular and supraventricular) were extremely common. The electrocardiogram showed several non specific signs: low voltage of QRS in peripheral leads (4/7), pseudo-infarctional aspects (3/7), mono or biventricular hypertrophy (3/7) disturbance of ventricular conduction (3/7), aspecific abnormalities of ventricular repolarization (3/7). All patients showed a prolonged QTc. M-mode and 2-dimensional echocardiography demonstrated in 6 cases biatrial enlargement, normal or slightly enlarged ventricles, normal or moderately depressed fractional shortening; biventricular concentric hypertrophy was detected in 3 cases, asymmetrical septal hypertrophy in 1. Five patients showed pericardial effusion. Cardiac catheterization disclosed an increase of left and right ventricular end-diastolic pressures (8/8) with a dip-plateau pattern and/or characteristic W waveform in the atrial pressure tracing (9/9). Passive pulmonary hypertension was detected in 6/9 cases. The cardiac index was decreased in 4/8 cases. Left ventricular angiography showed mitral regurgitation in 5/8 patients, tricuspidal in 5/8. Ejection fraction was decreased in 3/8 cases. Endomyocardial biopsy showed interstitial fibrosis (8/9), cellular hypertrophy and/or nuclear alterations (7/9), slight endocardial thickening (2/9). At a mean follow-up of 22 +/- 15 months 3 patients died and 2 underwent heart transplantation. In conclusion idiopathic restrictive cardiomyopathy is one of the most frequent forms of restrictive myocardial diseases in our geographic area. Severe congestive heart failure and arrhythmias are extremely common. The disease can be suspected by clinical, electrocardiographic and echocardiographic features, but the final diagnosis requires cardiac catheterization and endomyocardial biopsy. Prognosis is severe and heart transplantation must be considered in the cases with severe heart failure.

Adolescent↗
PubMed1989

[Clinical characteristics and prognostic factors in chronic heart failure secondary to primary dilated cardiomyopathy and ischemic heart disease].

Natural history and prognostic factors in chronic congestive heart failure were investigated in 141 patients (100 males and 41 females), aged 58 +/- 14.5 years, who were hospitalized between 1981-1985. Heart failure was due to idiopathic dilated cardiomyopathy in 79 patients and ischemic heart disease in 62 patients. The following parameters were examined: sex, age, etiology, NYHA functional class, mean arterial blood pressure, heart rate, presence of 3rd heart sound, atrial fibrillation and left ventricular conduction delay, plasma sodium, echocardiographic shortening fraction, and treatment with vasodilators. Mean follow-up was 31 +/- 19 months. Overall survival was 83% at 1 year, 58% at 3 years and 49% at 5 years. No difference in mortality was evident between the two etiological groups, while the data on the cause of death showed a significant difference: sudden death was prevalent in the patients with ischemic disease (50% vs 24%), intractable heart failure predominated in patients with idiopathic dilated cardiomyopathy (69.7% vs 42.8%) (p less than 0.05). The multivariate analysis with the Cox model resulted in a negative prognostic significance of the male sex (p less than 0.02), III and IV NYHA functional class (p less than 0.04), heart rate at rest greater than 85 b/min (p less than 0.002) and the presence of left ventricular conduction delay on standard ECG (p less than 0.001).

Adolescent↗
PubMed1989

[Multiple coronary fistulas to the left ventricle. An unusual cause of myocardial ischemia].

Diffuse communications between the left coronary artery and the left ventricular cavity were found in a 54-years-old man presenting with angina pectoris and reversible ischemia documented on stress Thallium scintigraphy. During atrial pacing the patient experienced chest pain which was accompanied by lactate production. Atenolol, but not nifedipine, did ameliorate the symptoms. The anatomical types and the embriogenesis of coronary microfistulas along with possible mechanisms of ischemia are discussed.

Angina Pectoris↗
PubMed1989

[Visceral and ocular Larva migrans: epidemiologic study, clinical and immunologic findings on 20 cases, adult and child].

The authors report a case-study of 20 subjects affected by visceral Larva migrans (VLM) and ocular Larva migrans (OLM). Of the 20 patients, 11 were male, and 9 female (mean age: 45 years); 7 were children, from 1 to 8 years old. Seventeen patients presented clinical and bio-humoral features which could be correlated with VLM syndrome; alongside cases with clearly suggestive symptomatology, in some patients the infection by Toxocara sp. was found to show few or minor symptoms, or even to be asymptomatic and occasionally it was suspected because of a marked peripheral eosinophilia. In 3 cases the infection was exclusively ocular. So far as immunology is concerned, serological tests confirmed in all 20 cases the clinico-epidemiological and/or bio-humoral suspicion; in particular the ELISA IgG test showed high titres in 16 cases, while the RAST showed significant levels of specific IgE in 17 cases. From the therapeutic point of view, the subjects treated were exclusively those presenting a manifest clinical picture: in 5 patients the first choice drug was thiabendazole, with clinical cure in only 2 cases; diethylcarbamazine resolved the clinico-parasitological picture in 1 case; 1 patient is still under treatment with albendazole.

Adult↗
PubMed1989

[Electrocardiographic, clinical and prognostic evaluation of sustained ventricular tachycardia in acute and chronic ischemic heart disease].

We retrospectively evaluated 48 patients with sustained ventricular tachycardia (STV), in whom a 12 lead ECG had been recorded during arrhythmia, considering two groups: pts. with acute or subacute myocardial infarction (MI group = 15 pts.) and pts. with chronic post infarction ischemic heart disease (CPIIHD group = 33 pts.). The electrocardiographic patterns in the basal ECG and during SVT (16 SVT in the MI group, 40 in the CPIIHD group) as well as the in-hospital and long-term prognosis were evaluated. The two groups were comparable as far as mean age, site of acute or previous infarction, and baseline ECG parameters are concerned. QTc values greater than 440 msec were present in 64.5% of the cases. The ECG recording during SVT showed longer duration of QRS in CPIIHD group (171 +/- 39 msec) versus MI group (140 +/- 25 msec) (p less than 0.005). In comparison to basal ECG, Q waves in the SVT recording were in the same site (47.2%) or in a wider site (38.1%), rarely (10.9% of the cases) there was a discordance between the two tracings. In-hospital mortality was 40% (6/15 pts.) in MI group, related to severe hemodynamic impairment, 15.1% (5/33 pts.) in CPIIHD group. During the follow-up (mean 38.4 months) survival in CPIIHD group was 89.3% at 12 months, in MI group 88.9% at 12 months. In CPIIHD patients SVT was recurrent in 60.6% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

[Percutaneous pulmonary valvuloplasty. Immediate results and a follow-up: clinical, Doppler and hemodynamic evaluation].

The purpose of this investigation was to evaluate the efficacy and follow-up results of balloon dilation angioplasty for valvular pulmonary stenosis. Percutaneous dilation was performed on 25 patients with pulmonary stenosis (aged 1 month to 69 years, mean = 15 years). In all cases, a single balloon was used. The pressure gradients across the pulmonary valve were estimated by continuous wave Doppler (CWD) and catheterization before and after dilation. The peak systolic gradients obtained by both techniques both pre- and post-angioplasty were compared. There was good linear correlation between the catheter pressure gradient and the pressure gradient estimated by Doppler (r = 0.78). The mean pre-angioplasty gradient of 82 +/- 33 mmHg (range 40-180) was reduced to 29 +/- 12 mmHg (range 17-50). The mean right ventricular systolic pressure of 110 +/- 33 mmHg decreased to 52 +/- 13 mmHg post-angioplasty. An excellent linear correlation was found between the pre-dilation gradient and the right ventricular systolic pressure drop (r = 0.94). During the procedures no complications were noted, 30 hours after dilation a 6 months old child suffered of stroke with transient hemiparesis. Follow-up pressure gradient estimations by Doppler echocardiogram were obtained in all patients between 3 months and 42 months (mean = 12.4 months); in 4 cases the catheterization was performed. Mean follow-up gradient was 33 +/- 11 mmHg (range 15-55). In a 18 months old child was detected a severe pulmonary restenosis 12 months after dilation; a second successful dilation was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Converting enzyme inhibition and heart failure.

Angiotensin converting enzyme inhibitors are known to improve cardiac performance in patients with severe heart failure, and are probably safer and more effective than other vasodilators. Less is known about their effects in mild and moderate heart failure. Results at one year are presented about an ongoing double-blind, placebo-controlled parallel-group study on 94 outpatients in New York Heart Association functional class II and III. After a three-week period during which appropriate doses of digoxin were administered and a stable response to exercise was obtained, diuretic therapy was withdrawn if in use and captopril or placebo treatment was assigned randomly. The assessment of patients was performed by symptom history, clinical examination, New York Heart Association functional class, chest radiograph, 12-lead electrocardiogram, 24-hour Holter monitoring, M-mode echocardiography, and bicycle exercise at the time of random selection and at specified times during a two-year follow-up. Preliminary data after one year suggest that patients receiving placebo may have a greater tendency to need diuretics and may improve New York Heart Association functional class less often than those receiving captopril. No statistically significant treatment differences were found for the noninvasive test results. Detailed analysis suggests that treatment with an angiotensin converting enzyme inhibitor may be more advantageous than that with placebo for some groups of patients. Investigations are under way to determine which patients might benefit most from angiotensin converting enzyme inhibitors.

Captopril↗
PubMed1988

Haemodynamic effects of short term intravenous amiodarone for hypertrophic cardiomyopathy.

The haemodynamic effects of an intravenous amiodarone infusion (5 mg/kg for 10 minutes) were measured in ten patients with hypertrophic cardiomyopathy (two with a left ventricular outflow gradient at rest) five, 15, and 30 minutes after drug administration. Mean (SD) pulmonary capillary wedge pressure rose significantly at five and 15 minutes (from 12.3 (6.2) mm Hg to 17.6 (9.2) and to 16.2 (8.6] with a subsequent tendency to fall to control values at 30 minutes. Mean right atrial and right ventricular end diastolic pressures increased from 3.6 (1.8) mm Hg to 7.3 (3.1) and from 6.3 (2.4) to 9.8 (3.2) mm Hg respectively at 30 minutes. The increase in filling pressures was paralleled by a decrease of left ventricular max dP/dt from 1522 (414) to 1372 (327) to 1316 (338) and to 1326 (379) five, 15, and 30 minutes after infusion. Despite this slight negative inotropic effect, cardiac index and stroke volume index were unchanged or slightly increased, possibly because of the decrease in systemic vascular resistance (from 1326 (330) dyn s cm-5/m2 to 1152 (285]. In both patients with outflow gradient the pressure gradient at rest decreased (from 110 to 65 and from 85 to 65 mm Hg) through a reduction of left ventricular systolic pressure. Thus short term intravenous infusion of amiodarone is safe in patients with hypertrophic cardiomyopathy. The main changes were a mild depression of ventricular contractility, which was well tolerated and adequately compensated for by a decrease in afterload.

Adult↗
PubMed1988

[Coronary angioplasty in the aged].

The safety and clinical efficacy of percutaneous transluminal coronary angioplasty (PTCA) in elderly patients has not been established. PTCA was attempted in 34 patients aged 65 or more (mean age 67.4). Patients were referred for angioplasty because of significant symptomatic ischemic heart disease with either stable, unstable angina or chest pain after myocardial infarction. Primary success was achieved in 29 patients (85.3%). Significant complications were encountered in three patients (8.8%): two emergency surgical procedures (5.8%), one transmural infarction (3%). In two patients (5.8%) the PTCA failed because the balloon dilating catheter didn't cross the tight stenosis. Follow-up data (mean 13.8 +/- 10.3 months) are available: 22 (73.4%) are asymptomatic. A clinically apparent recurrence occurred in 8 patients (26.6%). Coronary angiography was performed in 19 patients (63.3%) 6.3 +/- 2.4 months after PTCA. Angiographic restenosis occurred in 10 patients (52.6%). All patients with restenosis were ridilated with completely success. In conclusion, PTCA can be performed in elderly patients with a good success rate, an acceptable complication rate, a relatively low clinically apparent recurrence rate, and should be considered as a therapeutic modality for selected geriatric patients.

Age Factors↗