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C Palombo

Publications and source records attributed to C Palombo.

83 records · Page 5Linked to original sources
PubMedDate not supplied

Increased sensitivity of flow detection in the left coronary artery by transesophageal echocardiography after intravenous administration of transpulmonary stable echocontrast agent.

Transesophageal echocardiography (TEE) combined with color and pulsed Doppler allows a noninvasive assessment of flow in the proximal anterior descending coronary artery (LAD). The aim of this study was to assess whether the peripheral administration of a transpulmonary stable echocontrast agent with prolonged in vivo stability may improve the feasibility and accuracy of coronary flow detection by TEE Doppler. In 12 out of 14 consecutive patients undergoing routine diagnostic TEE examination, color-coded images of left main coronary artery (LM) and the origin of the LAD and circumflex artery (CXA), as well as spectral Doppler signals from the LAD, were evaluated before and after intravenous injection of SHU 508 A. After administration of echocontrast material, the coronary Doppler signal (both color-coded and spectral) was enhanced for approximately 100 seconds. The length and diameter of color-coded flow increased significantly in the LM, LAD, and CXA. (The length of color-coded flow before and after injection of contrast material were the following: in LM 0.94 +/- 0.44 versus 1.39 +/- 0.52 cm, p < 0.001; in LAD 0.68 +/- 0.36 versus 1.20 +/- 0.41 cm, p < 0.001; and in CXA 0.54 +/- 0.20 versus 1.06 +/- 0.86 cm; in this artery, color-coded flow was visualized only in six patients before and 11 patients after injection of contrast material. The corresponding values for the diameters of color-coded flow in LM were 0.36 +/- 0.08 versus 0.46 +/- 0.09 cm, p < 0.001; in LAD 0.29 +/- 0.07 versus 0.41 +/- 0.1 cm, p < 0.002; and in CXA 0.26 +/- 0.05 versus 0.40 +/- 0.04 cm.) By pulsed Doppler, significant increments in peak diastolic (47.8 +/- 21.3 versus 37.2 +/- 14.5 cm/sec, p < 0.05), mean diastolic (37.4 +/- 14.7 versus 27.9 +/- 8.4 cm/sec, p < 0.005), mean systolic flow velocity (23.2 +/- 6.8 versus 19.0 +/- 4.7 cm/sec, p < 0.005), and diastolic (11.0 +/- 3.9 versus 7.7 +/- 3.0 cm, p < 0.001) and total flow integral (16.8 +/- 5.3 versus 10.5 +/- 4.6 cm, p < 0.001) were observed. By contrast, peak systolic velocity did not increase. However, the systolic component of coronary flow, detectable in 7 out of 12 patients before injection of contrast material, became detectable in all 12 patients after injection of contrast material.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMedDate not supplied

Kidney scintigraphy after ACE inhibition in the diagnosis of renovascular hypertension.

Suppression of the renin-angiotensin system (RAS) by angiotensin converting enzyme (ACE) inhibition may induce renal failure in patients with bilateral renal artery stenosis. Recent scintigraphic studies with the glomerular tracer technetium-99m-diethylenetriaminepenta-acetate (99m-Tc DTPA) indicate that in patients with unilateral renal artery stenosis, glomerular filtration rate (GFR) may be markedly reduced in the affected kidney after inhibition of ACE. This finding reflects the important role of the RAS in maintaining GFR (by increasing postglomerular resistance) in states of low renal perfusion pressure. Preliminary observations suggest that this scintigraphic test might be useful in the detection of renovascular hypertension.

Captopril↗
PubMedDate not supplied

Left ventricular mass in borderline hypertension, assessed by echocardiography. Relationships with resting and stress blood pressure.

The relationship between clinical measurement of blood pressure (BP) and left ventricular hypertrophy in arterial hypertension appears to be weak in most studies. On the contrary, stronger correlations with target organ damage in general, and left ventricular hypertrophy in particular, have been reported for blood pressure measurements obtained by ambulatory monitoring; this finding may indicate a possible role for blood pressure response to naturally occurring stresses in determining left ventricular hypertrophy. Aim of this study was to investigate, in 18 patients with borderline arterial hypertension, the relationships between echocardiographically assessed left ventricular mass and, respectively, casual BP and BP responses to some standardized stress tests. Only three patients had a diastolic wall thickness of the interventricular septum and of the posterior wall greater than or equal to 1.2 cm and none had a pathologically increased left ventricular mass index. The following statistically significant correlations were found: casual diastolic BP vs. left ventricular mass index (r = 0.53, p less than 0.02), systolic BP response to bicycle exercise test vs. left ventricular mass index (r = 0.55, p less than 0.05). Multiple regression analysis showed that almost fifty percent of the variability of left ventricular mass index could be predicted by these two BP measurements. These findings suggest that besides the chronically increased afterload, also the transient hypertensive responses to naturally occurring physical stresses may have a role in determining the extent of cardiac structural changes in borderline hypertensive patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMedDate not supplied

[Transesophageal echocardiography in resuscitation. Indications and presentation of various clinical cases].

The diagnostic potential of Transesophageal Echocardiography (TEE) is well established in patients with suspicion for some life-threatening diseases as cardiogenic cerebral embolization, aortic dissection, intracardiac or thoracic masses, acute valvular dysfunction or sepsis of undetermined origin, which represent a relevant part in the activity of Intensive Care Units (ICU). Thus, an increasing role of TEE may be foreseen in this arena, also due to some of the known odds of ultrasound techniques compared to other imaging tools like CT scan or MRI (lower cost and beside availability). The aim of the present paper is to briefly review the main indications for TEE in ICU, and to report on some illustrative cases from our experience of I year in this field. Twenty-eight seriously-ill patients referred to our ICU between December 1991 and December 1992 were investigated for 1 of the following diagnostic problems: a) chest trauma with suspicion for aortic dissection and/or mediastinal bleeding; b) sepsis of undetermined origin; c) cerebral transient ischemic attack or stroke; d) assessment of cardiac function in potential heart donors. TEE was performed by means of commercially available instruments (either Hp Sonos 1500 or Esaote Sim 7000 Color Flow Mapping), with conventional monoplane probe or so-called wide-angle, "panoramic" probe, respectively. In most of the patients studied, TEE provided either unique or complementary, diagnostically useful, information. By panoramic approach, which yields imaging field up to 270 degrees, a comprehensive visualization of the heart, aorta and mediastinal structures was possible.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Dissection↗