[Role of non-invasive echopolycardiography in ischemic cardiopathy].
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Biomedical subjects
Publications and source records attributed to G Finardi.
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A new apexcardiographic transducer system is presented. The device features infinite time constant, absolute pressure calibration and measurement of thorax coupling pressure (PO). The sensing element is an estensimetric bridge, mounted on the internal surface of a rigid membrane, coupled to the chest by a 4 x 7 mm plastic cylinder. The system is linear within the range of 0 to 1350 mmHg; the frequency response of the transducer is linear between 0 and 3500 Hz. The electronic filtering circuits allow simultaneous output of apexcardiogram, first apexcardiographic derivative and three phonocardiographic bands. Measurements carried out on 6 volunteers using the new apparatus and a traditional transducer system demonstrate that control of the coupling pressure is necessary not only for absolute amplitude, but also for accurate amplitude ratio measurements because the transmission of pressure signal across the thorax changes with different coupling pressures.
In 25 healthy subjects aged 60-88 years (mean 74.5) and in 20 healthy subjects aged 16-32 years (mean 23.6) apexcardiographic indices were studied as a function of age. The apex cardiograms (ACG) were obtained using a non-calibrated displacement transducer. With the help of an interactive computer program, 17 ACG indices of systolic and diastolic function were computed. The indices were divided into 2 groups (according to the nomenclature proposed by their Authors): a) systolic indices: electromechanical ventricular interval q-C, systolic upstroke time C-E, time from the beginning of ventricular depolarization to the peak of the first ACG derivative q-dA/dt, time from the onset of systolic slope to the peak of first ACG derivative C-dA/dt, ejection fraction according to Antani et al. 1979 E.F.; b) diastolic indices: electromechanical atrial interval P-a, atrial wave length d.a., height of atrial wave as percent of total ACG deflection a/H, height of atrial wave as percent of total diastolic deflection a/D, ratio of the diastolic wave to the total ACG height D/H, total rapid filling cR, early filling period EFP, rapid filling period RFP, total apexcardiographic relaxation time TART, duration of diastolic period A2-C, total apexcardiographic relaxation time index TARTI and diastolic amplitude time index DATI. Several diastolic indices (a/D, a/H, TART, electromechanical atrial time) were markedly higher (p less than 0.001) or lower (TART and DATI, p less than 0.001) in the older group. Systolic indices showed less significant differences: the electromechanical interval lengthened in the older group (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
The aim of this study was to verify if in the clinical use the relationship between the morphology of the carotid pulse and of the ear densitogram was constant enough to validate the measurement of left ventricular ejection time from the ear densitogram. In 92 subjects, aged 5-84 years, carotid pulse and ear densitogram were simultaneously recorded. The ear densitogram was electronically processed with 3 different filters, in an effort to duplicate the carotid pulse and thus to facilitate the measurements of the ejection time. Mean ejection time was 265.5 +/- 24.87 msec. for carotid pulse, and 265.7 +/- 24.19, 265.2 +/- 24.25, 266.2 +/- 24.78 for the ear densitographic methods. Analysis of variance did not show any differences among the 4 methods. We conclude that quite a constant relationship between carotid pulse and ear densitogram is present in clinical measurements. Thus, the carotid pulse can be reliably substituted by the ear densitogram.
The aim of this study was to determine if kinetocardiography can detect regional abnormalities of left ventricular kinetics, as occurs in coronary patients. Kinetocardiogram, M-mode and two-dimensional echocardiograms were recorded in 33 subjects (mean age 63, range 29-75 years), who previously had a myocardial infarction. On two dimensional echocardiograms, long axis, short axis, apical 4-chamber and apical 2-chamber projections were studied. Regional contractile abnormalities were rated as hypokinesis, akinesis, dyskinesis and aneurysm. In 6 subjects two dimensional echocardiogram was normal, in 5 it showed hypokinesis with left ventricular normal dimension or dilatation, and in the remaining 22 patients various regional kinetic abnormalities were observed. The kinetocardiogram showed paradoxical systolic movements in all patients with ventricular dyssynergy and was normal in all patients with normal ventricular kinetics, with or without left ventricular dilatation and global hypokinesis. There were no correspondences between echocardiography and kinetocardiography, regarding sites and amount of abnormalities. Kinetocardiography can thus noninvasively detect qualitative left ventricular kinetics abnormalities, in patients with myocardial infarction.
A long-surviving clinical case of suspected Morquio's syndrome is described. The locomotorium (vertebral dwarfism, hyphoscoliosis, but no hypoplasia of the odontoid process of the epistropheus, platyspondylia), cardiopulmonary (aortic insufficiency, arterial calcification, varices) visual (opaque lens on right eye, sclerosis of the lenticular lamellae but no corneal opacity on left eye) acoustic (deafness) and gastroenteric systems (hepatomegaly) are analysed. No pathological granulations were noted in the leukocytes. The plasmatic lysosome enzymes were normal and alpha-fucosidase subnormal. Abnormal keratan sulphate secretion was noted in the daily urine. All this would explain the patient's long survival.
Red blood cell filtration rate was studied in patients with essential hypertension selected according to the homogeneity of parameters which could interfere with such a test. An increase of filtration time in control subjects was put in evidence both in patients without vascular complications and in patients with cerebrovascular diseases; no significant difference was seen between the two groups. The red cell filterability behavior can be correlated to hypertension and is an expression of red cell deformability alterations. The variation of this hemorheological parameter could be better defined by an improvement of the red cell filterability test and by further studies on the membrane function in essential hypertension.
In the normal young adults were studied electrical characteristics of the skin in five different regions. The results obtained have demonstrated presence of the topographic differences of the external resistance as well as capacity. It does not seem like that these differences can be correlated with the thickness at the corneal layer, but rather with the different glandular composition from one region to another and probably with the different hydration state of the skin. There were also demonstrated differences between sexes, characterized by the lower external resistance in males than in females.
Left ventricular function was studied noninvasively in a group of 35 patients with noncomplicated and complicated old myocardial infarction (MI) by means of kinetocardiography (KCG) and systolic time intervals (STI). Discriminant analysis with a group of 130 normal subjects documented that STI were significantly abnormal and that the abnormalities, i.e. prolongation of the preejection period, shortening of left ventricular ejection time and increase of PEP/LVET were more evident in patients with complicated old MI. KCG was more or less abnormal in all the patients studied, with the more striking abnormalities in those with complications. A good correlation was found between KCG and STI abnormalities. We consider that KCG is able to detect in a sensitive way abnormalities of left ventricular contraction in patients with old MI and that, most probably, alterations of STI in these patients are mainly due to incoordinate left ventricular contraction.
In view of the postulated association between plasma lipids and the development of atherosclerosis, there is growing interest in the effects of beta blockers on plasma lipids. This study was undertaken to investigate whether a nonselective beta blocker, such as mepindolol, which possesses intrinsic sympathomimetic activity, causes significant changes in serum lipids, particularly in their ditribution among the different lipoproteins. Eighteen healthy subjects, twelve males and six females, were given mepindolol orally, daily doses of 0.2 mg/kg averaging 10-15 mg. Pre- and post-treatment fasting total serum cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides were evaulated; the ratio LDL cholesterol/HDL cholesterol was also calculated. Total cholesterol did not change significantly after treatment with mepindolol (- 1.9 mg%), whereas a small and nonsignificant decrease was observed in LDL cholesterol (- 6 mg%); no change was found in HDL cholesterol (- 0. mg%). Serum triglycerides showed a significant increase (+ 20.9 mg%, p less than 0.01). Thus, the most prominent effect of even a short period of treatment with mepindolol is a net increase in serum triglyceride levels. It must be remembered that high triglyceride levels do not constitute a cardiovascular risk factor. On the other hand, no significant changes in total cholesterol, HDL and LDL cholesterol, and in LDL cholesterol/HDL cholesterol ratio were observed. The results of this study show that mepindolol, unlike other beta-blocking agents, does not affect cholesterol concentration and distribution among the lipoproteins. In particular it does not reduce HDL cholesterol, which is currently assumed to be inversely related to the development of atherosclerosis.
Number and affinity of beta-adrenoceptors in human polymorphonucleates (PMN's) have been studied in patients with essential hypertension (n = 12) and in normal subjects of the same range of age and sex (n = 16). (-)Diidroalprenolol-H3 has been utilized as ligand. Membranes preparation was performed according to Galant (5). Number of beta-adrenoceptor is significantly decreased compared with controls (p less than 0.05), both with saturation curves and Scatchard analysis. Affinity of beta-adrenoceptors toward (-)diidroalprenolol-H3 is lightly increased but not significantly. These data could be explained on the basis of the desensitization occurring in hypertensive subjects by altered plasma catecholamines level, as in experimental in vitro systems.
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Although policardiography has been in use for more than a century, only recently attention has been focused on instrumental and methodological problems of the technique. Among these, frequency response and time constant of the equipment are in first place. Time constant must be long enough to allow an accurate recording of the low and ultra-low frequency vibrations which are generated in the cardio-aorto-hemic system, in particular of those constituting the carotid pulse and the apexcardiogram. The authors stress the influence that incidental air leaks in the recording assembly, or type and size of the pickup device, have on the value of the time constant. Kinetocardiography seems preferable to apexcardiography in order to reproduce with higher fidelity absolute movements of the anterior thoracic wall in every single point.
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