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Biomedical subjects

F Loperfido

Publications and source records attributed to F Loperfido.

At least 73 records · Page 4Linked to original sources
PubMed1983

Spontaneous closure of ventricular septal defect in a case of double outlet right ventricle.

A 5 year old child, previously diagnosed as having tetralogy of Fallot, was admitted to hospital in severe congestive heart failure. The electrocardiogram showed left anterior hemiblock and incomplete right bundle-branch block, neither of which was previously present. The child died in intractable congestive heart failure and the necropsy showed a double outlet right ventricle with complete spontaneous closure of the subaortic ventricular septal defect by fibrous tissue. The possible mechanism involved in the production of this unusual complication of double outlet right ventricle is discussed, together with an explanation for the electrocardiographic changes.

Child, Preschool↗
PubMed1983

Assessment of left atrial dimensions by cross sectional echocardiography in patients with mitral valve disease.

Left atrial dimensions were measured using cross sectional echocardiography in 37 patients with mitral valve disease and 30 normal subjects of similar ages. The anteroposterior (AP), superior-inferior (SI), and medial-lateral (ML) left atrial dimensions were determined at the end of ventricular systole using parasternal long and short axis and apical four chamber views (for SIa and MLa). To assess the reliability of these measurements cross sectional echocardiographic and angiographic left atrial volumes were compared in 19 patients with mitral valve disease, giving an excellent correlation. A moderate correlation was found between the anteroposterior dimension of the left atrium obtained using M mode echocardiography and that obtained using the parasternal short axis and long axis projections. In normal subjects a good correlation was found between SI and ML dimensions, while a lower correlation was found between SI and AP, and ML and AP dimensions. The SI dimension was the major axis of the left atrium and AP dimension the minor axis. In patients with mitral valve disease a good correlation was found between SI and ML dimensions, while SI and ML dimensions had a low correlation with AP dimensions. The AP dimension was the minor axis of the left atrium, while the SI and ML dimensions were not significantly different. All left atrial dimensions were significantly greater in patients with mitral valve disease than in normal subjects. Of 30 patients with at least one dimension increased, all three dimensions were abnormal in 16, two dimensions were increased in 10, and only one dimension was increased in four. AP, SI, and ML dimensions were abnormal in 25, 20, and 27 patients, respectively. Cross sectional echocardiography may provide a reliable estimate of left atrial dimensions. In patients with mitral valve disease a thorough examination of the left atrium using multiple cross sectional views is necessary to detect asymmetric left atrial enlargement and to measure the degree of left atrial dilatation.

Adult↗
PubMed1983

Extension of calcific deposits in the anterior mitral valve leaflet and mitral valve stenosis severity. Use of 2D Echo parasternal long-axis view.

To evaluate the role of the extent of calcific deposits on the anterior mitral leaflet in predicting the severity of mitral valve stenosis, two-dimensional echocardiography (2D Echo) and heart catheterization data were analysed in 62 patients with mitral valve stenosis, pure or associated with trivial valve regurgitation. 50 patients had technically adequate 2D Echo. Of these, 28 had pure mitral valve stenosis. The mitral valve area was estimated from the parasternal short-axis 2D Echo projection. Using the parasternal long-axis projection, calcium deposits location and extension on the anterior mitral leaflet was examined. Patients were subdivided into the following groups: Group 0 (absence of calcium deposits = 19 patients), Group 1 (calcium on distal third of the leaflet = 19 patients), Group 2 (calcium on mid and distal segments = 11 patients), Group 3 (calcium on the entire leaflet = one patient). The extension of calcium deposits in long-axis projection was contrasted with 2D Echo mitral valve area in the 50 mitral valve patients. 2D Echo and heart catheterization derived mitral valve area were compared to each other in the 28 patients with pure mitral valve stenosis. 2D Echo mitral valve area was greater in Group 0 patients (1.8 +/- 0.4 cm2) than in Group 1 (1.4 +/- 0.4 cm2) and in Group 2 (1.1 +/- 0.3 cm2) (p less than 0.001 between the three groups). Calcific deposits were present on the anterior mitral leaflet in 30/31 patients with 2D Echo mitral valve area less than or equal to 2 cm2. However, of the 19 patients of Group 0, 13 had moderate and one severe mitral valve stenosis. In the 28 patients with pure mitral valve stenosis, 2D Echo mitral valve area was excellently correlated with Gorlin's derived mitral valve area (r = 0.90). However, in patients with extensive calcification of the anterior mitral valve leaflet (Group 2), 2D Echo mitral valve area was significantly greater than the Gorlin's derived area (1.08 +/- 0.20 cm2 versus 0.68 +/- 0.17 cm2; p less than 0.001). In four patients of Group 2, the mitral valve stenosis was moderate by 2D Echo grading and severe by heart catheterization data. Our data suggest that the study of extension of calcific deposits on the anterior mitral valve leaflet may be a complementary aid in quantifying mitral valve stenosis to the 2D Echo mitral valve area estimate, especially when the valve is severely calcified.

Calcinosis↗
PubMed1983

[Bidimensional echocardiographic findings in a case of arrhythmogenic dysplasia of the right ventricle].

In a 50-year-old man presenting with dyspnoea and palpitations, cardiomegaly, incomplete right bundle branch block and bursts of ventricular tachycardia, Two-Dimensional Echocardiography revealed an impressive enlargement of the right ventricle, particulary in the outflow tract. Arrhythmogenic right ventricular dysplasia was suggested and confirmed by right ventricular angiography and electrophysiologic study. We emphasize the role of Two-Dimensional Echocardiography in the appropriate planning of cardiac catheterization for a definitive diagnosis of arrhythmogenic right ventricular dysplasia.

Arrhythmias, Cardiac↗
PubMed1982

The evaluation of left and right ventricular hypertrophy in combined ventricular overload by electrocardiography: relationship with the echocardiographic data.

The electrocardiographic and echocardiographic (M-mode) data were analyzed in 29 patients affected by mitral or combined mitral and aortic valve disease and with hemodynamically documented biventricular overload. No electrocardiographic parameter significantly correlated with the left ventricular internal dimension at end diastole (LVIDd), the left posterior wall (LVPW) thickness and the left ventricular mass (LV mass). A significant correlation was observed between the R/S ratio in V1 and V2, the rV1 and either the end-diastolic right ventricular internal dimension (RVIDs) or the pulmonary artery systolic pressure (PASP). The R/S ratio greater than or equal to 1 in V1 was the most sensitive among the conventional electrocardiographic criteria of right ventricular enlargement. Three groups of patients were selected on the basis of RVIDd and LV mass: Group A included nine patients with right ventricular dilatation and normal LV mass; Group B included ten patients without right ventricular dilatation and with increased LV mass; Group C included ten patients without right ventricular dilatation and with normal LV mass. The R/S ratio in V1 was significantly greater in patients in group A than in those in groups B or C. No electrocardiographic parameter was found to be significantly different between groups B and C. When only LV mass was considered (independently from RVId and PASP), no electrocardiographic parameter differentiated patients with LV mass greater than 203 g from those with LV mass less than 203 g. We conclude that in patients with biventricular overload secondary to acquired valvular disease: 1) the electrocardiographic diagnosis of left ventricular enlargement is unreliable; and 2) the R/S ratio in V1 is the most sensitive parameter to predict right ventricular enlargement or severe pulmonary hypertension.

Cardiomegaly↗
PubMed1982

Familial hypertrophic cardiomyopathy: vectorcardiographic findings in echocardiographically unaffected relative.

The electrocardiographic and vectorcardiographic (Frank system) features of the first degree relatives of subjects with documented familial hypertrophic cardiomyopathy were analysed. A total of nine affected members and 29 relatives were examined in four families. THe subjects were considered to be affected when the septal to free posterior wall thickness ratio exceeded 1.3 at M-mode echocardiography. Four relatives had asymmetric septal hypertrophy. Among 25 relatives without evidence of asymmetric septal hypertrophy, two over 20 years and 10 under 20 years of age showed increased voltage of QRS anterior forces (Qz amplitude greater than 0.80 mV) on the orthogonal electrocardiogram. The vectorcardiographic data of the relatives under 20 years of age without evidence of asymmetric septal hypertrophy (18 subjects) were compared with those of 38 normal control subjects of comparable age range. The young relatives without disproportionate septal hypertrophy had significantly greater Qz amplitude and Q/Rz ratio than the normal control subjects. In contrast, the echocardiographic data were not significantly different. We suggest that the electrocardiographic finding of abnormal anterior forces in one or more first degree relatives of subjects with documented hypertrophic cardiomyopathy may constitute a valuable aid in ascertaining the genetic transmission of the disease and in recognising affected members without echocardiographic evidence of hypertrophic cardiomyopathy.

Adolescent↗
PubMed1982

[Contribution of bidimensional echocardiography to the diagnosis of left atrial enlargement].

In 64 consecutive subjects (age range 17-69 years) we compared the antero-posterior (A-P) size of the left atrium estimated by M-mode and wide-angle two-dimensional echocardiography (short and long axis parasternal views). M-mode A-P diameter correlated both with short (r = 0.82) and with long (r = 0.76) axis A-P diameter. Subsequently we quantitatively analysed by two-dimensional echocardiography A-P, cranio-caudal (C-C) and latero-lateral (L-L) left atrial dimensions in 20 patients with mitral valve disease (age range 24-66 years) and in 24 normal subjects of comparable age range. Subjects with mitral valve disease had significantly higher A-P (P less than 0.001), C-C (P less than 0.02) and L-L (P less than 0.001) left atrial dimensions than normal controls. Both in normals and in mitral valve disease patients C-C was the view that showed the largest atrial diameter. Left atrial shape was however more spherical in mitral valve patients. Of these 7/20 (35%) had abnormal A-P diameter compared to the normal subjects. Patients with abnormal L-L and C-C left atrial dimensions were 9/20 (45%) and 7/20 (35%). Five of the patients with increased L-L size had a normal A-P diameter. Our results demonstrate the usefulness of wide-angle two-dimensional echocardiography in the assessment of the left atrial enlargement, especially in patients with negative or borderline M-mode echocardiographic data.

Adolescent↗