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Biomedical subjects

F Fedele

Publications and source records attributed to F Fedele.

At least 127 records · Page 7Linked to original sources
PubMed1987

Left ventricular filling pattern in hypertensive patients after reversal of myocardial hypertrophy.

After treatment with alpha-methyldopa a regression of left ventricular hypertrophy, due to hypertension, has been reported in spontaneously hypertensive rats. The reduction of left ventricular mass has been associated with an increase in hydroxyproline concentration, suggesting secondary functional changes. On this basis, 12 patients with essential hypertension and echocardiographic evidence of left ventricular hypertrophy have been studied before and after a 6-month alpha-methyldopa treatment. Ten normal subjects were used as a control group. Curves of changes in left ventricular diameter and velocity curves were obtained by digitation of the M-mode endocardial echoes and the diastolic patterns were studied. Before treatment all patients, as compared to normal subjects, showed: (a) prolongation of the isovolumetric relaxation time index, with increased diameter changes; (b) reduction of diameter changes and peak velocity during the rapid filling; and (c) marked compensatory increase of diameter changes and peak velocity of the filling due to atrial systole. Left ventricular hypertrophy was reduced in 5 patients (first group) after treatment. This group showed: (a) normalization of the isovolumetric relaxation time index; (b) slight increase of diameter changes during rapid filling; (c) increased peak velocity of the rapid filling; and (d) reduction of diameter changes and peak velocity during atrial systole. No changes of functional data were observed in the other 7 patients (second group) in whom left ventricular hypertrophy was unchanged after treatment. It is shown how the reduction of left ventricular hypertrophy, per se, could induce such an improvement of diastolic function, despite the biochemical changes probably caused by administration of alpha-methyldopa.

Blood Pressure↗
PubMed1987

Coagulation contact phase factors and inhibitors in beta-thalassemia major children.

Selected hemostatic parameters of 23 children affected by beta-thalassemia major were studied and compared to an age- and sex-matched group. Plasma prekallikrein level was reduced in all patients, splenectomized or not. In splenectomized patients, platelet count and in vitro platelet aggregability were significantly increased and Protein C was slightly increased. The activated partial thromboplastin time was prolonged and the normotest reduced. Finally, a reduction in the plasma levels of fibrinogen and of vitamin K-dependent proteins, including the antithrombotic Protein C, was observed in nonsplenectomized patients. Our data indicate that the hemostatic system in patients with thalassemia major may be altered. The relationship between these laboratory changes and clinical manifestations remains to be established.

Adolescent↗
PubMed1983

[Morphologic and functional aspects of left ventricular hypertrophy evaluated by computerized echocardiography].

We have investigated the possible echocardiographic progression of left ventricular (LV) hypertrophy, in different stages of primary hypertension. Both morphological (LV mass and ratio of interventricular septal thickness to posterior wall thickness-IVST/PWT-, in M-mode) and functional data (parietal stress, duration, degree and velocity of filling in the four phases of diastole, obtained through computerised interpretation of M-mode tracings), were examined. We also tried to assess the morphofunctional differences between LV hypertrophy secondary to primary hypertension and LV hypertrophy secondary to renovascular hypertension, hypertrophic obstructive cardiomyopathy and physical training. Patients with primary hypertension were further subdivided in three groups: A) 14 patients with hypertension of less than one year's duration, B) 28 patients with long-lasting hypertension, and C) 5 patients with cardiomegaly. There was a progressive increase from controls to Group C patients of left ventricular mass (controls 171 +/- 25; Group A 168 +/- 72; Group B 253 +/- 83; Group C 439 +/- 117) and septal hypertrophy (controls IVST/PVT 1 +/- 0.1; Group A 1.2 +/- 0.2; Group B 1.4 +/- 0.3; Group C 1.5 +/- 0.1). The isovolumic relaxation period was prolonged only in Group C (controls 8.6 +/- 3.5 per cent of the diastole; Group C 15 +/- 3.5%) LV dimensions during slow filling and atrial contraction as well as filling velocity during this latter phase of the cardiac cycle were increased in Group A (7.8 +/- 2.3 and 7.3 +/- 2%; 1.2 +/- 0.6 cm/cm X sec respectively) and B (10 +/- 6 and 10.8 +/- 4%; 1.2 +/- 0.6 cm/cm X sec) compared to the controls (5 +/- 2.8 and 3.7 +/- 2%; 0.7 +/- 0.2 cm/cm X sec). The Vcf max was not significantly different in the three groups. The patients with renovascular hypertension (N = 14) could be differentiated from those with primary hypertension of Group B for a greater increase in LV mass, with concentric hypertrophy (IVST/PWT = 1.2 +/- 0.2), for a greater prolongation of IRP (16 +/- 0.6% of diastole), with increased diameter changes in this phase (displacement ratio = 3.3 +/- 2.3%, in Group B; 4.7 +/- 3.8%, in renovascular hypertension), for a normal displacement and velocity of slow and atrial filling, despite the impairment of rapid filling found in this group, too (% displacement and velocity, respectively: 19 +/- 5% and 1.8 +/- 0.6 cm/cm X sec).

Cardiomyopathy, Hypertrophic↗
PubMed1981

[Echocardiography during ergometric tests in subjects with stable effort angina (author's transl)].

The feasibility of echocardiography in detecting left ventricle wall motion abnormalities, their location and their spontaneous or therapeutic regression, was assessed performing monodimensional and two-dimensional echocardiography in 35 patients with stable effort angina, without previous AMI. A control group of 10 normal subjects was also studied. The Authors evaluated echocardiographic findings on subjects at rest, during supine bicycle exercise and after sublingual nitroglycerin administration, defining the quality of wall motion as normal, hypokinetic, akinetic or dyskinetic in M-mode, and normal or asynergic in 2-D. They also analyzed, in M-mode, some echocardiographic indices of regional left ventricle function (IVSE, PWE, VIVS, VPW, delta TS, delta TP), and, in 2-D, the percent of systo-diastolic endocardial outline changes versus standard references in 7 sectors of left ventricle (anterior, lateral, inferior, septal in short-axis, septal, postero-lateral in long-axis, and apical) by means of a HP 9845B Computer, interfaced to a Digitizer. The percentage of feasibility of exercise echocardiography has been 60% in M-Mode, and 70% in 2-D. Mono and two-dimensional findings were normal in all patients at rest, whereas, during exercise, 57% of them, in M-mode, and 88% in 2-D, showed segmental contraction abnormalities. The Authors conclude that exercise echocardiography, though technically difficult, is feasible, Both M-mode and 2-D involve peculiar advantages or disadvantages. They provide, however, a valuable tool in detecting the mechanical consequences of exercise-induced regional myocardial ischemia and may be applicable in patients with equivocal exercise test.

Adult↗