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Biomedical subjects

C Vassanelli

Publications and source records attributed to C Vassanelli.

68 records · Page 4Linked to original sources
PubMed1979

[Postinfarction left ventricular aneurysm. A method for volume determination and its correlation with hemodynamic and angiographic parameters (author's transl)].

On the hypothesis that encroachment on left ventricular performance by postinfarction aneurysm (An) is related to its size, a method was investigated for the measurement of aneurysmal dimensions. On radioopaque plastic casts grossly ellipsoidal in shape with addition of masses in different position to simulate aneurysms, satisfactory data for volume calculation were obtained by the association of the ellipsoid formula applied to the contractile portion with the formula of the hemispheroid applied to the aneurysmal section, the difference between real and calculated volumes being not more than +/-5%. In 100 Pts. with previous myocardial infarction, showing at ventriculography akinetic-diskinetic segments of the left ventricular wall, the absolute volume of An and its percentage value of the total left ventricular volume (V An%) were measured. A statistical correlation was studied with other hemodynamic and angiographic parameters of left ventricular function. Cardiac index and angiographic stroke volume decreased with increasing V An%, but with a low correlation, of no statistical significance; only for An with a volume of 60% or more C.I. and SV were constantly reduced. The LVEDP, higher than normal in 80% of the cases, rose with increasing V An%, but with a correlation of low statistical significance. The EDV increased progressively and significatively with increasing V An%, resulting therefore in relation with the extension of noncontracting segment.

Angiocardiography↗
PubMed1979

[Post-extrasystolic potentiation for the study of regional left ventricular asynergy (author's transl)].

In 120 P. with ischemic heart disease, left ventricolar wall motion was analyzed from the left ventriculogram in a regular sinus beat as compared to the first beat following one or more premature ventricular contractions (PExP). The response of asynergic segment to PExP was determined with a qualitative as wall as a quantitative technique. Of a total of 225 asynergic segments, 62% showed a positive response to PExP. In the absence of pathologic Q waves in the electrocardiogram, the response was positive in 77% and negative in 23% of the cases. In the presence of Q waves, PExP was present only in 33% of the cases (p less than 0.001). In respect to the severity of asynergy, 68% of 145 hypokinetic segments and 52% of 80 akinetic-dyskinetic segments responded to PExP; in the presence of pathologic Q waves, the number of positive responses decreased to 36% in the case of segmental hypokinesis, and to 31% in the case of more severe asynergy. The study of PExP has appeared as an useful diagnostic technique, capable of detecting a residual myocardial function in left ventricular asynergic segments, even in the presence of electrocardiographic signs of infarction.

Adult↗
PubMed1975

[Intra-aortic balloon counterpulsation: first clinical experiences (author's transl)].

Three cases of acute myocardial infarction treated with intra-aortic balloon counterpulsation (IABP) are reported. In the first patient cardiogenic shock and pulmonary oedema were the complicating features; the second one had pulmonary oedema refractory to medical treatment. Both patients promptly improved, shock and heart failure having been reverted to clinically satisfactory conditions. Nevertheless the first patient could not be weaned efficiently and died on the sixth admission day. A huge myocardial involvement was found autoptically. The second patient died on the third day mainly because of a haemorrhagic complication. The third patient started the treatment with IABP at the 68th hour because medically unresponsive left heart failure and persisting ECG signs of widespread myocardial ischemia. Improvement of haemodynamic parameters and disappearance of subepicardial lesion were achieved. Eventually this patient was discharged on the usual rehabilitation regimen.

Acute Disease↗
PubMed1975

[Coronarographic evaluation of dystrophic cardiomiopathy (author's transl)].

A 22 year old man with Duchenne's progressive muscular dystrophy is presented. Because of electro-and vectorcardiographic features compatible with ischemic heart disease, coronary angiography was performed in order to rule out obstructive coronary disease, which has been excluded in our case. The coronary tree presented the same characteristics of idiopathic primitive cardiomyopathy. The authors assert that the coronary arteriography is a necessary complement to the diagnosis of Duchenne's muscular dystrophy.

Cardiomyopathies↗
PubMedDate not supplied

Evaluation of apolipoproteins A-I and B as markers of angiographically assessed coronary artery disease.

The aim of this study was to evaluate the ability of plasma levels of apo A-I and apo B to discriminate between male patients with and without angiographically determined coronary artery disease (CAD) in comparison to the levels of cholesterol, HDL-cholesterol and triglycerides. The plasma apo A-I and B levels were measured by a radial immunodiffusion assay that made use of well characterized monoclonal antibodies. Univariate statistical analysis showed that the mean values for HDL-cholesterol and apo A-I were significantly lower in patients with single-, double- and triple-vessel disease than in the control subjects. The mean values for plasma cholesterol and apo B were significantly higher in the group with double- and triple-, but not single-vessel disease, than in the group without CAD. No statistically significant difference among groups was found for plasma triglyceride values. Since the considered variables failed to assess the severity of the disease, as determined by the number of vessels involved, the 3 groups of patients with CAD were combined into one group. A multiple logistic analysis, performed in order to assess the independent role of the variables and to estimate the corresponding odds ratio, indicated an independent association of HDL-cholesterol, apo A-I and apo B with CAD. When the multiple logistic analysis was repeated with a stepwise procedure, only apo A-I and B entered into the model. The results of our study indicate that plasma levels of apo A-I and B are more useful than plasma lipid in detecting the presence or absence of coronary artery disease in a group of male patients undergoing coronary angiography.

Adult↗
PubMedDate not supplied

[Return to work and cardiovascular status after myocardial infarction].

110 male subjects, under 60, admitted for myocardial infarction in 1980 and 1981, have been considered. 85 answers to the questionnaire, sent by post have been obtained, 6 pertaining to patients who died in the meanwhile. Among the 79 living patients who replied, 57 (72.1%) had resumed work within the average time of 4.8 months (min. 0.5-max. 12). Return to work has been significantly higher among self-employed people than employees; only 15 subjects had changed job or task. The subjective rating of the actual health status, two years after the infarction, has been satisfactory in 90.5% of cases, in spite of 56.5% complaining of heartburn, 38.1% of dyspnea and 35.7% of palpitation. The work-load has been rated as tiring only by 12.6% of them, while 65.6% have maintained unchanged their work capacity. Electrocardiographic monitoring (by the Holter method), during a normal workday, showed no significant differences between working and retired subjects and, also, in work and normal activity periods. 19 subjects (47.5%) presented ventricular arrhythmias, in 12 cases at high risk, most of them being unaware of it. These arrhythmias were more frequent during wake periods, but not strictly connected to the type and the quality of the work activity. The patients subjected to rehabilitation showed no differences in the cardiovascular patterns during the ergometric test and ECG monitoring when compared to those not subjected to rehabilitation.

Adult↗