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Biomedical subjects

L Mangiardi

Publications and source records attributed to L Mangiardi.

52 records · Page 3Linked to original sources

[The tricuspid valve in carcinoid cardiopathy: characteristic echocardiographic aspects].

Cardiac involvement is commonly seen in the carcinoid syndrome (C.S.). However echocardiographic observations in this condition are still very scanty. In two patients with the C.S. and clinical signs of tricuspid insufficiency (plus mild pulmonic stenosis in one case) two-dimensional echocardiography showed: 1) right ventricular overload with normal left heart valves and chambers; 2) a peculiar aspect of the tricuspid valve, whose three leaflets were markedly thickened and retracted. The anterior leaflet was almost fixed in a semi-open position while the septal and posterior leaflets appeared as rigid structures fixed in an open position, extending from the annulus into the right ventricular cavity. In both cases only the posterior cusp of the pulmonary valve could be visualized. The afore-mentioned changes exactly reproduce the pathological features of the tricuspid valve in the carcinoid heart disease and so far, have not been observed in other conditions.

Adult↗

Left ventricular emptying dynamics in patients with asymmetric septal hypertrophy and concentric hypertrophic cardiomyopathy.

We studied the dynamics of left ventricular (LV) emptying in 8 patients with asymmetric septal hypertrophy (ASH), 6 patients with concentric hypertrophic cardiomyopathy (CHC), and 6 normal controls. Four patients with ASH had resting systolic gradients greater than 20 mmHg, all had significant post premature ventricular contraction (PVC) systolic pressure gradients. LV volume (V) was obtained by frame-by-frame analysis of cineangiograms. End-diastolic volume was similar for all groups; end-systolic volume was significantly less in ASH and CHC patients than in normals. Maximum dV/dt was similar in ASH and CHC, and significantly greater than normals. Total systolic contraction time (SCT), i.e., time from peak volume to last cine frame at minimum volume, was similar for all groups, but the time required to eject 90% of stroke volume (90%T), as a fraction of SCT, was shorter for ASH (0.52 +/- 0.07) and CHC patients (0.51 +/- 0.05) than normals (0.67 +/- 0.07) (p less than 0.05 vs myopathy groups). In the sinus beat following a PVC, however, this ratio decreased significantly in normals and CHC patients, but did not change in ASH patients. We conclude that ASH and CHC have similar exaggerated systolic LV ejection dynamics in the basal state; the failure of ASH patients with post-PVC systolic outflow gradient to reduce 90% T/SCT post PVC may reflect obstruction to LV emptying.

Cardiac Output↗

Atypical 2nd degree AV block due to bilateral bundle branch block with Wenckebach phenomenon and concealed conduction in the bundle branch system.

A case of bilateral bundle branch block is described with the following features: -- 2nd degree infranodal AV block due to bilateral, intermittently synchronous "phase 3" bundle branch block; -- occasional AV conduction failure due to concealed His bundle extrasystoles; -- right bundle branch block pattern due to retrograde activation from the left bundle branch; -- QRS complexes having normal duration due to uniform slow conduction in both bundle branches; -- Wenckebach phenomenon in the right bundle branch; -- concealed conduction in both branches. The above interpretations are based on the use of His bundle recordings, results of right atrial stimulation and of pharmacological testing. Determinations of the lengths of all H--H intervals, whether H was followed by a ventricular response or blocked, permitted insight into the mechanism of 2nd degree AV block with varying (right and left) bundle branch block.

Aged↗

[Paroxysmal ventricular tachycardia with retrograde Wenckebach block and reciprocal beats (author's transl)].

A case of recurrent paroxysmal ventricular tachycardia with retrograde Wenckebach block and reciprocal beats was studied with His bundle electrogram and right ventricular stimulation. Reentry was reproduced whenever retrograde ventriculo-atrial conduction time reached a critical value. Concealed reentry was also demonstrated and shown to be responsible for the dropped beats of the Wenckebach sequence.

Bundle of His↗