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Biomedical subjects

M Valle

Publications and source records attributed to M Valle.

At least 163 records · Page 9Linked to original sources
PubMed1978

Serum lipids in angiographically assessed coronary atherosclerosis.

Cholesterol, triglycerides, and Lp(a)/pre-beta1 lipoprotein were analyzed in 153 patients typed for liproprotien patterns. Coronary atherosclerosis was determined by selective coronary angiography and graded by a system taking into account proximal, middle and distal segments. Smoking habits, family history and hypertension were also recorded. Normal coronary arteries were encountered in 45, moderate coronary atherosclerosis (less than median score) in 50, and severe changes (greater than median score) in 58 patients. Cholesterol (P less than 0.05), positivity of Lp (a)/pre-beta1 lipoprotein (P less than 0.01), a family history of coronary heart disease (P less than 0.05), and smoking (P less than 0.01) differed between the group of normal arteries and the whole group of luminal obstructions. Serum triglycerides were not associated with coronary atherosclerosis. Cholesterol, positivity of the Lp(a)/pre-beta1 lipoprotein and a family history of coronary heart disease were also associated with the severity of the disease. Smoking was less prevalent in the group with severe changes.

Adolescent↗
PubMed1978

Response of left ventricular myocardial perfusion and cavity size to beta-blockade by acebutolol.

The effect of beta-blockade by acebutolol on global and regional myocardial perfusion (133Xenon wash-out) was studied in 10 patients with coronary artery disease. Another group of 10 similar patients was used to study the effect of acebutolol on left ventricular cavity size (metal markers--spot film camera). Global perfusion responses roughly paralleled the changes in rate-pressure variable which decreased in 8 patients and increased in 2 who had spontaneous angina pectoris. Regional perfusion decreased more in areas distal to less than 75% stenoses than in those distal to less than 75% stenoses (29 vs 12%; p = 0.10 less than 0.20). Left ventricular asynergy did not modify the response, nor did the presence or absence of collateral vessels. No evidence was found to support the thesis that beta-blockade may evoke a redistribution in perfusion which favours the potentially ischaemic areas of myocardium. Left ventricular cavity size remained unchanged after acebutolol, a cardioselective beta-blocking compound with some degree of agonist activity.

Acebutolol↗
PubMed1978

Calcification in cervical arteries in life and at autopsy.

In the clinical part of the study routine neck PA radiographs taken with the mouth open were compared with soft tissue films with the mouth closed for detection of calcification in the carotid arteries. Only 5.5% of 90 hospitalized patients showed foci of calcification in routine films. But foci of calcification were seen in 22% of the soft tissue radiographs of the whole series. In the autopsy part of the study large foci of calcification were found at the carotid bifurcations in 12 out of 20 cadavers by radiography. In an additional five cases contact radiographs also showed smaller foci of calcification. The vascular endothelium over the calcification was often ulcerated. The significance of the large arterial foci of calcification demonstrated in the neck radiographs as a sign of atherosclerosis and as a source of cerebral thromboembolism is discussed.

Adult↗
PubMed1978

Effect of beta-blockade by metoprolol on global and regional left ventricular myocardial perfusion in coronary heart disease.

Utilizing semiselective 133Xenon injections and gamma camera recording, global and regional left ventricular myocardial perfusion were recorded under the influence of beta-blockade by metoprolol in 9 patients with angiographically proven coronary artery disease. Metoprolol reduced the rate--pressure variable in every patient, the mean reduction amounting to 24% (P less than 0.01). With one exception, the global left ventricular myocardial flow followed the change in the rate-pressure variable. No significant differences were detected in the flow responses of areas distal to only moderate coronary obstructions (less than 75%) and areas distal to significant (less than 75%) obstructions. The same was true when areas of asynergic contractions were compared with areas of normal contractions, or when areas supplied by collaterals were compared with areas devoid of collateral vessels. It is concluded that the reduction in myocardial flow after metoprolol is due to the reduction of the myocardial oxygen consumption, and no redistribution of flow occurs.

Adult↗
PubMed1977

Regional myocardial perfusion abnormalities on xenon-133 imaging in patients with angina pectoris and normal coronary arteries.

With use of semiselective xenon-133 injections and gamma camera recording, myocardial scintigrams were obtained in a series of 20 patients with angina pectoris, abnormal exercise electrocardiograms and normal coronary arteries. Ten patients (Group I) exhibited localized perfusion defects and the other 10 (Group II) a hjemogenous uptake of the tracer. Group I was characterized by more past myocardial infarctions and, most significantly, by male preponderance (P less than 0.001). Computer analysis of regional xenon-133 washout curves revealed that every patient in Group I had a reduced flow rate in the area of the perfusion defect (P less than 0.001). A comparison of this group with 26 patients with similarly abnormal scintigrams but coronary arterial obstruction revealed that myocardial perfusion was 16 to 18 percent greater in the group with normal coronary arteries. In three patients of this group, myocardial perfusion rates were not augmented by atrial pacing in contrast to the response in patients with coronary arterial obstruction. The data demonstrated localized perfusion abnormalities in half of the patients with angina pectoris and normal coronary arteries and constitute evidence that a metabolic disorder is not the sole mechanism for ischemia in this syndrome.

Adult↗
PubMed1977

Lymphographic diagnosis of malignant lymphoma in the course of Sjögren's syndrome.

Three patients with Sjögren's syndrome complicated by malignant lymphoma are presented. During the benign stage, two showed non-specific hyperplastic lymph node patterns on lymphography. When the disease had become malignant, all cases revealed generalized involvement of the retroperitoneal lymph nodes. The lymphographic pattern was that of a malignant lymphoma: enlarged nodes, with a foamy, linear or reticular appearance but mostly preserved marginal sinuses. On lymphographic follow-up, the node alterations were consistent with the histological findings and the clinical status, including the therapeutic response.

Adult↗
PubMed1977

Lymphography in the assessment of mycosis fungoides.

Extracutaneous manifestations of mycosis fungoides imply a bad prognosis and are a major cause of death. Benign dermatopathic lymphadenopathy is associated with mycosis fungoides and often precedes lymphomatous infiltration. In this study, 10 patients in the early stages of mycosis fungoides underwent clinical and lymphographical examinations. In one the lymphoma was already present in lymph nodes. Six had signs of dermatopathic adenopathy which was verified by lymph node biopsy in 5. In one of these the disease later progressed to a malignant lymphoma. The frequent occurrence of lymph node involvement justifies the use of lymphography collaterally with staging laparotomy to determine the presence of pathologic retroperitoneal lymph nodes.

Adult↗
PubMed1977

Double contrast X-ray examination of stomach.

A comparison was made between three double contrast methods and the conventional method of X-ray examination of the stomach. 106 patets received ordinary barium sulphate together with effervescent granules. 119 patients were examined with a special barium sulphate preparation containing dissolved carbon dioxide (Baritop). The third group, 100 patients, received Baritop and effervescent granules, and 100 patients a conventional barium meal. The films were analyzed as to the quality of mucosal pattern demonstration, mucosal affinity of the contrast medium, and the degree of dilatation of the stomach and duo8num. In addition, the degree of interference by gas bubbles was estimated. The best results were obtained with the contrast medium containing carbon dioxide (Baritop).

Barium Sulfate↗
PubMed1976

Analysis of coronary collaterals in ischaemic heart disease by angiography during pacing induced ischaemia.

Studies were made using ordinary selective coronary angiography and angiography during ischaemia produced by right atrial pacing, on a series of 41 patients with ischaemic heart disease, to examine the response of the collaterals to the ischaemia stimulus. Regional myocardial perfusion was determined under the same circumstances by measuring regional 133Xenon washout curves. No collaterals were found in 8 patients, none of whom demonstrated collaterals when angiography was repeated during ischaemia. Eleven of the 33 patients with prepacing collaterals (33%) responded to ischaemia with an increase in the collaterals, 16 patients (49%) showed no change, 5 patients (15%) showed a decrease in the collaterals, and one patient exhibited a bidirectional change. Regional myocardial perfusion responses closely paralleled the angiographic changes, yielding suggestive evidence that the collaterals were intimately involved in the enhancement of the flow. Despite different collateral and flow responses to ischaemia, the data on exercise tolerance, left ventricular end-diastolic pressure, ejection fraction, prevalence of left ventricular asynergy, and the topographic relation between synergy and collaterals, were largely similar. The data show that in some patients the collateral circulation reacts to ischaemia by enhancement, but the functional significance of this response is obscure.

Adult↗
PubMed1976

Myocardial imaging using selective intracoronary injection of Thallium-201.

After selective coronary arteriography 150 muCi of Thallium-201 was injected into each coronary artery. Scintigraphy of the myocardium was performed about half an hour after the injection. In a series of ten patients the myocardium was clearly visualized in the gamma images. No adverse effects were noted.

Coronary Disease↗
PubMed1976

Radiologically detected collaterals and regional myocardial flow responses to ischaemia in ischaemic heart disease.

By employing 133 Xenon injections and a gamma camera recording of the initial uptake and subsequent disappearance of the tracer, regional myocardial perfusion rates were determined in 38 patients with ischaemic heart disease. Areas supplied by collaterals and areas devoid of them were analyzed separately. In addition to determining basal flow rates, the regional perfusion was studied by repeated 133Xenon scintigrams during pacing-induced ischaemia. The data were grouped and analyzed according to the visual assessment of collateral response as observed in the angiograms performed under the same circumstances. Eleven patients who did not have collaterals on their angiograms were excluded, as were three patients in whom the collaterals were supplying segments distal to only subtotal obstructions leaving 24 patients to the study proper. Angiographic appraisal disclosed two different responses to ischaemia: ten patients exhibited an increase in the collateral pattern (responders) and 14 patients showed no change or reduction in the collaterals (nonresponders). The prepacing grading of the collaterals was similar in the subgroups. Under basal conditions the regional myocardial flow rates in areas supplied by collaterals or devoid of them were roughly similar. Upon ischaemia the greatest regional flow increment occurred in the responders. The data demonstrate a reasonable agreement between the visual assessment of collateral response to ischaemia and a change in the regional perfusion. The data further indicate that similar collateral patterns observed by routine coronary angiography are not functionally equipotent.

Adult↗
PubMed1975

Changes in native coronary arteries after coronary bypass surgery. Role of graft patency, serum lipids and hypertension.

Sixty-seven patients were studied by coronary angiography early (mean 3 weeks) and late (mean 13 months) after coronary bypass surgery to assess changes in the native coronary vessels. Among the 208 nongrafted arteries progression of disease was found in 2.9 percent. In arteries that were normal before operation, the rate was 0.7 percent; in those with luminal obstructions the rate was 7.6 percent (P less than 0.05). Progression of disease occurred in 6 of the 67 patients (8.9 percent). In five bypassed arteries (5 percent), progression of disease occurred at or near the anastomotic site; in this subset the procedure was classified a technical failure. Progression of disease distal to graft insertion occurred in 2.4 percent of cases. The greatest incidence of progression took place proximal to graft insertion, in 24.2 percent of the grafted arteries. This rate differed significantly from the rate in non-grafted arteries (P less than 0.001) and in distal segments of grafted arteries (P less than 0.001). If the grafts were patent in the late control study, the progression of disease proximally occurred at a rate of 24 percent; if they were occluded, the rate was 25 percent. The data on timing of graft occlusion suggested that graft patency was related to the proximal progression. The prevalence of hyperlipidemia or hypertension did not correlate with progression of disease in any group.

Adult↗
PubMed1975

Further studies of Lp(a) lipoprotein/pre- beta1-lipoprotein in patients with coronary heart disease.

The present study of 100 patients (46 of whom were included in a previous study) with suspected or proven coronary heart disease (CHD) confirms that Lp(a) lipoprotein and pre-beta1-lipoprotein are closely related, if not identical, and that Lp(a) lipoprotein/pre-beta-lipoprotein occurs more frequently in patients with CHD than in healthy people. Analysis of this lipoprotein component may have predictive value with respect to CHD.

Adult↗
PubMed1975

Effect of aorto-coronary grafts and native vessel patency on the occurrence of angina pectoris after coronary bypass surgery.

Exercise testing of 52 patients on average 11 months after coronary bypass surgery for the relief of angina pectoris disclosed improvement in total work (P is less than 0.001), maximal tolerated load (P is smaller than 0.001), maximal heart rate (P is smaller than 0.01), and reduction of maximal ST segment depression (P is smaller than 0.001) in a group of 36 patients with all grafts patent. In another group of 16 patients with one or more grafts occluded the only significant change was a reduction in the maximal ST segment depression (P is smaller than 0.01). Early and late postoperative angiograms showed that 75 per cent of the grafts that became occluded were already closed a few weeks after operation. Occluded grafts were accompanied by persistence of collaterals, which disappeared or dimished in the majority of patients with patent grafts. Progression in native vessel lesions occurred in 40 per cent of patients. It was related to the grafting procedure (P is smaller than 0.01) but not to the state of grafts. The change in native vessels and other variables studied was equal in the patent and occluded graft groups, justifying the conclusion that graft patency was the major factor alleviating angina after operation.

Adult↗
PubMed1975

Collateral circulation before and after coronary artery reconstruction.

The changes in collateral circulation after coronary artery reconstruction were analyzed in 75 patients with 177 bypass grafts and 18 complementary gas endarterectomies. The quantity of collateral circulation was directly proportional to the degree of coronary obstruction. The changes in collateral circulation depended on the success of coronary surgery or on the progression of the disease in coronary vessels. So, when the grafts remained patent, the collaterals disappeared and when the grafts became occluded, the collateral circulation returned to the preoperative level. Progressive obstruction of the coronaries caused increased collateral circulation.

Adult↗