[Effect of the osmolarity of contrast media on changes in myocardial inotropism. Experimental research].
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Biomedical subjects
Publications and source records attributed to O Visioli.
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In nine closed chest mongrel dogs 42 left ventricular cineangiographies for determination of left ventricular muscle mass were carried out. Buetterich's method was verified and a different procedure of calculation of myocardial wall thickens was proposed. By this method a better correlation line between calculated and weighed left muscle mass and a lower standard error of estimate is obtained.
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In dogs with experimental cardiac hypertrophy in resting conditions, coronary blood flow and myocardial O2 consumption increased proportionately to the cardiac mass; coronary flow and O2 consumption per gram of myocardium, therefore, ranged within normal values. The coronary reserve, neasured as the percentage increase in the coronary blood flow from rest till peak flow during reactive hyperaemia, was noticeably reduced, because it was partially utilized, even at rest, and consequently the possibility of an increase in flow after exercise or stress was diminished.
Three cases of aortic sinus aneurysm and three cases of prolapse and regurgitation of the aortic valve associated with ventricular septal defect are discussed from an angiographic point of view. It is pointed out that aortic regurgitation into the left ventricle might be helpful for a correct diagnosis. Aortic regurgitation, in fact, is the result of an anatomically unsupported aortic valve that becomes gradually distorted by haemodynamic influences. This pathogenetic mechanism is often found in subpulmonar and infracrestal ventricular septal defect.
Six patients showing at coronary angiography normal coronary arteries during dyastole, but a segmental constriction of the left anterior descending artery during systole, were studied. Four of these patients in which the degree of systolic artery narrowing was more evident had typical angina and positive stress test. In two of these cases, a probable idiopathic cardiac hypertrophy was present. The pathogenetic significance of the angiographic findings are discussed, on the basis of common knowledge of coronary physiology and of pathophysiology of angina with normal coronary arteries.
A programme of on-line automated analysis of ECG exercise graphs relative to the CB5 derivation is described. The various operations may be subdivided into the following phases: 1) performance; 2) mean complex; 3) identification; 4) calculation and print-out of parameters; 5) filing. Automatic analysis of exercise ECG's eliminating artifacts present in graphs and obtaining parameters that are not respectively assessable, facilitates the development of rigorously objective diagnostic guidelines. The filing of indices on magnetic tape opens the way to subsequent statistical analysis of extreme usefulness in testing extensive populations.
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The use of computers in the exercise of electrocardiography is considered. The problems related to this use concern the choice of leads, the filtration of the signal, the recognition of characteristic segments of ECG, the calculation of various indexes and their statistical evaluation for diagnostic purposes. The authors use a bipolar derivation filtered by averaging and digital filters. The characteristic points of ECG are recognized by the analysis of the curvature. The Tchebycheff coefficients of the S-T tract are evaluated; they appeared to be a very good means for judging positive and negative cases.