Biomedical subjects

P Voci

Publications and source records attributed to P Voci.

77 records · Page 5Linked to original sources

PubMedDate not supplied

Myocardial contrast enhancement after intravenous injection of sonicated albumin microbubbles: a transesophageal echocardiography dipyridamole study.

Myocardial opacification after intravenous injection of an echo-contrast agent is a major end point in contrast echocardiography, but it has not yet been obtained in human beings. We propose transesophageal contrast echocardiography as a clinical tool for the study of myocardial perfusion in human beings. Sonicated albumin microbubbles are bright ultrasound reflectors that cross the pulmonary vasculature after intravenous injection and show physiologic transit times through tissues. Transesophageal echocardiography uses ideal transducer frequency and acoustic window for in vivo detection of sonicated albumin microbubbles. We have studied 11 patients receiving peripheral vein bolus injection of sonicated albumin microbubbles during transesophageal echocardiography at baseline and during dipyridamole infusion. Images were recorded on videotape and digitized off-line. Quantitative measurements were made on 11 normally perfused myocardial segments by tracing a region of interest of greater than 100 pixels on frozen end-systolic frames, at baseline, and during dipyridamole infusion. Transpulmonary passage with full left ventricular cavity opacification was obtained in all injections. In 8 of 22 injections there was also transient left ventricular cavity attenuation. In all patients there was a marked opacification of the left ventricular outflow tract and aortic root. At baseline, mean signal intensity in the myocardium increased from 80 +/- 37 to 117 +/- 49 IU (p < 0.05) and during dipyridamole infusion increased from 84 +/- 28 to 146 +/- 36 IU (p < 0.001). The analysis of background-subtracted data showed that mean pixel intensity increased from baseline to dipyridamole contrast injection (from 37 +/- 15 to 62 +/- 19 IU; p < 0.01). The opacification of normally perfused left ventricular myocardium is feasible during transesophageal echocardiography because there is a significant increase in signal intensity versus background intensity. During dipyridamole infusion there is a further increase in signal intensity that probably reflects pharmacologically induced increase in myocardial blood flow.

Albumins↗

PubMedDate not supplied

Spontaneous left atrial echocardiographic contrast in mitral stenosis: early disappearance after valve replacement.

We describe a patient with mitral stenosis and severely enlarged left atrium. Transthoracic echocardiography showed a false image of intraatrial thrombus, whereas transesophageal echocardiography showed massive spontaneous left atrial contrast. Intraoperative transesophageal echocardiography was performed. During cardioplegic arrest the contrast was enhanced, but it gradually and completely cleared 15 minutes after cardiopulmonary by-pass arrest. Transesophageal echocardiography is a useful technique for the study of intraatrial masses and may bring a new dimension to tissue characterization studies.

Aged↗

PubMedDate not supplied

Coronary air embolism complicating accessory pathway catheter ablation: detection by echocardiography.

Percutaneous radiofrequency catheter ablation has been recently introduced for treatment of Wolff-Parkinson-White syndrome. Access to left free-wall atrioventricular accessory pathways can be obtained either via retrograde cardiac catheterization or via the transseptal procedure, which allows ablation of the accessory pathway at its ventricular or atrial insertion, respectively. We describe a patient with Wolff-Parkinson-White syndrome in whom coronary air embolism occurred as a complication of transseptal percutaneous radiofrequency catheter ablation. The diagnosis was made by two-dimensional echocardiography showing a marked echocontrast effect in the posterior wall and in the posterior half of the interventricular septum. A grossly evident breakage of the rubber seal of the vascular sheath was supposed to be the cause of air insinuation. This report suggests that the transseptal approach should be used with caution in performing percutaneous radiofrequency catheter ablation to avoid the risk of air embolization. Two-dimensional echocardiography is an ideal tool to detect this complication.

Adult↗

PubMedDate not supplied

Cardiac involvement in Behçet's disease.

To assess the prevalence and the extent of cardiac involvement in patients with Behçet's disease and to investigate the possible causes that may predispose to this involvement, 30 patients affected by Behçet's disease and 30 normal control subjects were submitted to M-mode, two-dimensional, and Doppler echocardiographic evaluation. Moreover, antinuclear and anticardiolipin autoantibodies were determined in the sera of both patients and control subjects. Finally, HLA-B51 positivity was assessed in the patients and in a historical control group. Mitral valve prolapse was observed in 50% and proximal aorta dilatation in 30% of the patients. There was a significant difference in the rate of these abnormalities in comparison with the control group. Left ventricular function parameters were similar between the two groups. The positivity rate of antinuclear and anticardiolipin autoantibodies was very low (7%), without differences between the groups. HLA-B51 was detected in 82.7% of the patients versus 21.7% in the control group (p < 0.00001). In conclusion, this study demonstrates a high rate of cardiac abnormalities in patients with Behçet's disease.

Adult↗

PubMedDate not supplied

[Infective endocarditis. Recent progress in its epidemiology, clinical picture and therapy. Comments on cases].

Infective endocarditis (IE) may be considered as a disease in evolution because of changes occurred in the last decades in epidemiologic and clinical aspects. M-mode, two-dimensional, Doppler and color Doppler echocardiography allowed major advances in diagnosis and management of patients with IE. More recently, transesophageal echocardiography has been introduced in clinical practice with excellent results, because of unsurpassed quality of images able to early recognize small vegetations and complications of infective process. The authors report 13 cases of IE observed from March 1991 to March 1993. Streptococcus viridans was detected in 46% of cases and enterococcus species in 23%. Culture negative endocarditis represented 31% of total cases. Mitral valve was most frequently involved (67% of cases of native valves), followed by aortic valve (22%) and tricuspid valve (11%). In 30% of cases a prosthetic valve was involved. A presumed portal of entry has been identified, in 69% of cases, in oral cavity during dental procedures; in 2 cases an asymptomatic colonic carcinoma was detected. Diagnostic sensitivity of transesophageal echocardiography was 100%. Only 1 patient died during hospitalization. Cardiac surgery was performed in 4 patients (33%). The antibiotic drug teicoplanine has been successfully employed in 54% of cases.

Adult↗