Biomedical subjects
Publications and source records attributed to F Leonardo.
Increased sympathetic drive in symptomatic menopausal women was reduced after estrogen replacement therapy for 4 months, which has a potentially beneficial effect on cardiovascular functions.
Women receiving estrogen replacement therapy after menopause have a reduced risk of cardiovascular and cerebrovascular mortality when compared to untreated controls. Estrogens are thought to protect women primarily through an effect on lipid metabolism. However estrogen-induced increase of HDL-cholesterol and decrease of total and LDL-cholesterol appear to account only in part for the protective effect of ovarian hormones. Direct effects of estrogens on the arterial wall appear to contribute to the over-all cardiovascular benefits.
Cor triatriatum is a rare cardiac anomaly which can be congenital or acquired in origin. Congenital cor triatriatum is due to an alteration of the common pulmonary vein resorption and therefore the left atrium is divided into two chambers, a proximal one, in communication with the pulmonary veins, and a distal one, in communication with the mitral valve orifice. The diagnosis is usually made at birth, but in rare cases, when the communication between the two chambers is wide and the patient is asymptomatic, the lesions may be diagnosed incidentally during a routine echocardiographic examination. We report a 32-year-old man, admitted to our hospital with a diagnosis of aortic insufficiency, in whom echocardiography revealed the presence of cor triatriatum. The patient underwent aortic valve replacement and resection of the atrial membrane. Histology of the aortic valve revealed myxoid degeneration of the spongiosa.
BACKGROUND: Paroxysmal supraventricular tachycardia (SVT) in premenopausal women is often judged to be related to anxiety, and may be associated with the menstrual cycle. The aim of this study was to determine whether a cyclical variation of episodes of SVT exists and to correlate such variation with cyclical variation in plasma ovarian hormones. METHODS: 26 women (mean age 36 [SD 8] years; with paroxysmal SVT were screened; those with regular menses who experienced at least three episodes of paroxysmal SVT in two consecutive 48-hour ambulatory ECG recordings were included. 13 patients (aged 32 [6] years) met these criteria. Patients underwent 48-hour ambulatory ECG monitoring and determination of plasma concentrations of oestradiol-17 beta and progesterone on day 7, 14, 21, and 28 of their menstrual cycle. FINDINGS: An increase in the number and duration of episodes of paroxysmal SVT was observed on day 28 as compared to day 7 of the menstrual cycle. A significant positive correlation was found between plasma progesterone and number of episodes and duration of SVT (5.6 [2.2] ng/mL; r=0.83, p=0.0004; and r=0.82, p=0.0005), while a significant inverse correlation was found between plasma oestradiol-17 beta and number of episodes and duration of SVT (155 [22] pg/mL; r=0.89, p<0.0001; and r=0.81, p=0.0007). INTERPRETATION: Women with paroxysmal SVT and normal menses exhibit a cyclical variation in the occurrence of the arrhythmia with their menstrual cycle. There is a close correlation between the episodes of paroxysmal SVT and the plasma concentrations of ovarian hormones. These data suggest that changes in plasma levels of ovarian hormones (and their interaction) may be of importance in determining episodes of arrhythmia in such patients. The mechanisms of these effects are unknown.
This paper reviews the evidence regarding the cardioprotective effects of oestrogen replacement therapy in postmenopausal women. Oestrogens have been shown to improve serum lipid profiles, carbohydrate metabolism, and insulin sensitivity; prevent the formation and development of atherosclerotic plaque; reduce blood pressure and plasma fibrinogen levels; and favourably affect overall cardiac function. Thus, oestrogen replacement therapy may prevent or inhibit the progression of existing coronary disease, and may also have a protective effect against acute cardiovascular and cerebrovascular ischaemic events.
This paper reports a group's experience in treating a case of excretory tract rupture caused by a renal colic. After careful analysis and description of this case as well as related literature analysis, they have hypothesised the dynamic physiopathological events involved in this case. In addition, they have offered clinical considerations in preventing and detecting the development of such a lesion.
Palpitation is an unpleasant awareness of an abnormal beating of the heart. This symptom may be brought on by a variety of cardiac disorders, such as cardiomyopathy, valvular heart disease, and coronary artery disease, but the most common cause is primary cardiac arrhythmias. Several noncardiac disorders may also cause palpitations, and in this case are an effect of the disease upon cardiac rhythm. Palpitations occur frequently in women at all ages, especially during the luteal phase of the menstrual cycle, during pregnancy, and during the perimenopausal period. Palpitations occurring at young age and associated with fast heart rate are frequently due to Wolff-Parkinson-White syndrome or other forms of re-entrant tachycardia, and may require catheter ablation. A correlation between ovarian hormones and occurrence of paroxysmal supraventricular tachycardia has recently been reported in female patients with normal menstrual cycles; palpitations are frequently reported in cases of mitral valve prolapse, whereas episodes of paroxysmal supraventricular tachycardia reported during pregnancy may be due to mechanical stimuli or to a suggested arrhythmogenic effect of pregnancy. Palpitations during the perimenopausal period are usually benign and seem to be related to the increased sympathetic activity caused by the menopause. Although the vast majority of palpitations are benign and need not be treated, an electrophysiological study is indicated for those patients who have a documented episode of palpitation associated with syncope or with a pulse that is inappropriately rapid during symptoms. The treatment of palpitations due to cardiac arrhythmias is dependent upon the kind of arrhythmia detected during either invasive or noninvasive electrophysiological studies.