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Biomedical subjects

F Chiarella

Publications and source records attributed to F Chiarella.

53 records · Page 3Linked to original sources
PubMed1986

[Left ventricular diastolic function in type I diabetes. A longitudinal echocardiographic study].

The present study was performed to assess the extent of left ventricular diastolic abnormalities and their possible progression with time in patients with type I (insulin dependent) diabetes. Two echocardiographic examinations were performed at an interval of 5 years in 18 study patients. Left ventricular diastolic function was assessed by computer digitized analysis of the M-mode echocardiographic tracings. During the study period all patients remained in satisfactory metabolic control and without retinopathy. Twelve normal subjects, matched for age and sex, were used as control group. Peak rate of left ventricular posterior wall excursion and the peak rate of increase in left ventricular internal dimensions were significantly reduced in patients with diabetes (14.12 +/- 2.5; 16.48 +/- 3.9 cm/sec) compared with controls (17.25 +/- 2.8; 20.41 +/- 3.6 cm/sec) (p less than .005; p less than .01). In addition time to peak rate of increase in left ventricular internal dimensions, isovolumic relaxation index and isovolumic relaxation time were significantly prolonged in patients with diabetes (63.66 +/- 16.5; 23.9 +/- 9; 72.7 +/- 14 msec) compared to controls (46.83 +/- 9.8; 13.4 +/- 4; 61.1 +/- 12 msec) (p less than .005; p less than .001; p less than .05). In the study patients, no relation was found between the extent of diastolic abnormalities and age, duration of the disease and insulin dosage. The extent of left ventricular diastolic dysfunction did not show significant changes during follow-up. Our results indicate that diastolic abnormalities are common in patients with type I diabetes and are not related to the duration of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus, Type 1↗
PubMed1985

Unusual distribution of left ventricular hypertrophy in obstructive hypertrophic cardiomyopathy: localized posterobasal free wall thickening in two patients.

Two patients with hypertrophic cardiomyopathy and a previously unreported distribution of left ventricular hypertrophy are described. Each patient showed substantial wall thickening that was confined to the posterobasal segment of the left ventricular free wall, as well as evidence of dynamic subaortic obstruction. This observation emphasizes the fact that hypertrophic cardiomyopathy is characterized by a broad morphologic spectrum. Furthermore, it demonstrates a unique circumstance in which left ventricular outflow tract obstruction may occur in the absence of anterior and basal septal hypertrophy.

Adult↗
PubMed1985

Diastolic abnormalities in patients with hypertrophic cardiomyopathy: relation to magnitude of left ventricular hypertrophy.

To investigate the relationship between diastolic abnormalities and left ventricular hypertrophy, 52 patients with hypertrophic cardiomyopathy (HCM) and 22 normal subjects were studied with digitized M mode echocardiography and two-dimensional echocardiography. Echocardiographic indexes of diastolic function were compared in patients with different extent of left ventricular hypertrophy. Time interval from minimum left ventricular internal dimension to mitral valve opening and time to peak rate of increase in left ventricular internal dimension were significantly prolonged (80 +/- 31 and 100 +/- 37 msec, respectively) in patients with HCM and the most extensive left ventricular hypertrophy compared with those in patients with mild left ventricular hypertrophy (59 +/- 25 and 74 +/- 34 msec, respectively; p less than .01). Furthermore, peak rate of posterior wall diastolic excursion was significantly reduced in those patients with HCM and posterior wall hypertrophy (8.3 +/- 4.0 cm/sec) compared with that in patients with HCM but normal posterior wall thickness (11.2 +/- 3.4 cm/sec; p less than .002). However, abnormal M mode echocardiographic indexes of diastolic function were also identified in a substantial proportion of patients (i.e., 73%) with HCM and only mild left ventricular hypertrophy. In these patients, time interval from minimum left ventricular internal dimension to mitral valve opening (59 +/- 25 msec), peak rate (12 +/- 4 cm/sec), and time to peak rate of increase in left ventricular internal dimension (74 +/- 34 msec) were significantly different from normal (25 +/- 12 msec, 21 +/- 3 cm/sec, and 49 +/- 12 msec, respectively; p less than .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Prognostic significance and natural history of left ventricular thrombi in patients with acute anterior myocardial infarction: a two-dimensional echocardiographic study.

Fifty-eight patients with transmural anterior myocardial infarction were prospectively studied with serial two-dimensional echocardiography to determine the clinical implications and prognostic significance of detection of left ventricular thrombus during acute myocardial infarction, the incidence of systemic embolization, and the possible occurrence of spontaneous regression of left ventricular thrombi. Patients were not treated with anticoagulants or platelet inhibitors during the acute phase of infarction or during follow-up. Two-dimensional echocardiograms were obtained within 24 hr of myocardial infarction, every 24 hr until day 5, every 48 hr until day 15, and every month for a follow-up of 2 to 11 months (mean 7), in the surviving patients; a total of 774 echocardiograms were obtained. Left ventricular thrombi were identified in 24 (41%) of the 58 study patients, and developed within 48 hr of infarction in 11 of these patients. Ten (91%) of the 11 patients with early thrombus formation died during hospitalization or during follow-up, while only two (15%) of the 13 who developed a thrombus after 48 hr of infarction died (p less than .005). Incidence of Killip class III or IV, total lactic dehydrogenase values, and extent of wall motion abnormalities were significantly higher in patients who developed a thrombus within 48 hr of infarction than in patients without thrombus. On the other hand, in patients who developed a thrombus after 48 hr of infarction, these parameters were not significantly different from those in patients who did not develop a thrombus. Spontaneous regression of thrombi was documented in three (20%) of the 15 patients who survived the acute phase of myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Myxoid degeneration with prolapse and dystrophic calcification of the annulus fibrosus of the mitral valve. Pathological and clinical survey.

Two degenerations of the mitral valve apparatus, namely myxoid degeneration of the mitral cusps and necrosis with subsequent calcification of the annulus fibrosus, are extensively reviewed and discussed. Both lesions are mainly noticed in elderly patients, with the possible exception of systemic dystrophies of the connective tissue associated with metabolic disorders. The clinicopathological correlations of several cases are reported, with special emphasis on modern diagnostic procedures and their wide anatomic spectrum.

Adult↗
PubMedDate not supplied

Role of echocardiography in the assessment of left ventricular thrombus embolic potential after anterior acute myocardial infarction.

The contribution of cardiac ultrasound in assessment of the embolic potential of left ventricular thrombi after anterior acute myocardial infarction was verified in a prospective study of serial echocardiograms (mean, 18.9 examinations per patient) obtained over a long-term period (1-72 months; mean, 38±12). The study population comprised 222 patients (162 men; age, 64±11 years) with a first anterior acute myocardial infarction, treated with thrombolysis (group A) or receiving no antithrombolic therapy (group B). Embolism occurred in a total of 12 patients (11 with a left ventricular thrombus; p<0.005) and was more frequent in group B (10 patients; p<0.04). Predictors of embolism were the absence of thrombolysis, detection of a left ventricular thrombus, protrusion or mobility of the thrombus, and morphologic changes in the thrombus over time. Patients in group A had a lower incidence of each of these predictors, and a higher thrombus resolution rate. An appropriate echocardiographic protocol is crucial to assessment of the embolic potential of left ventricular thrombi after anterior acute myocardial infarction and may help to identify candidates for aggressive antithrombotic therapy (c)2001 CHF, Inc.

Journal Article↗
PubMedDate not supplied

[Effects of cimetidine on the cardiovascular system of normal subjects].

The effect of cimetidine on the cardiovascular system of normal subjects has been assessed. Eight healthy subjects were submitted to i.v. infusion on 200 mg of cimetidine in 2'; at a second stage, five of these were treated with placebo in equal volume and infusion speed. Polygraphic (LVET, PEP, PEP/LVET, triple product) and echocardiographic (systolic volume, cardiac capacity, velocity, circumferential shortening and ejection fraction) parameters were considered and heart frequency and arterial pressure measured. Measurements were carried out prior to infusion and for periods subsequent to the end of infusion. The results showed a statistically significant reduction only in heart frequency, triple product and cardiac output of subjects treated with cimetidine; no modifications were observed in subjects treated with placebo. It is concluded that cimetidine changes in heart frequency and its related parameters.

Adolescent↗