Search PubMed⌕ Search

Biomedical subjects

R Salerni

Publications and source records attributed to R Salerni.

31 records · Page 2Linked to original sources
PubMed1984

The noninvasive assessment of pulmonary capillary wedge pressure in mitral regurgitation.

The interval between the aortic closure sound and the mitral opening snap (A2-OS) has been shown to have a significant inverse correlation with pulmonary capillary wedge pressure (PCW) in mitral stenosis. The present study critically examines the relationship of several noninvasively determined diastolic intervals to PCW in patients with relatively pure mitral regurgitation (MR). Fifty-seven patients with MR of diverse etiologies were studied with echocardiograms and phonocardiograms in addition to right and left heart catheterization. Noninvasive determination of the time intervals of aortic closure sound to mitral valve opening (A2-MO), mitral D point to E point (D-E), aortic closure sound to mitral E point (A2-E), the interval from the onset of the QRS to mitral closure (Q-C), and the ratio Q-C/A2-E were compared to invasive measurements of mean PCW, the height of the V wave of PCW (PCW-V), and the ratio of PCW-V to left ventricular (LV) peak systolic pressure (PCW-V/LV). Correlation between each of the five noninvasive intervals and each of the three invasive pressure measurements was then determined. Of the noninvasive intervals studied, A2-MO had the best inverse correlation with all measures of PCW. All 18 patients having a short A2-MO (less than 40 msec) had a PCW-V of greater than or equal to 40 mm Hg and all seven patients having a long A2-MO (greater than 85 msec) had a PCW-V of less than 22 mm Hg. A2-E also had a strong inverse correlation with PCW.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Occult purulent pericarditis detected by indium-111 leukocyte imaging.

Leukocyte imaging with indium-111 is a relatively new technique which, to this point in time, has been discussed almost exclusively in the radiologic literature. Although this procedure has been used mainly to detect intra-abdominal infection, the thorax is routinely imaged along with the abdomen, and therefore detection of cardiac disease may be feasible. This case report is of a young woman after liver transplantation who developed occult purulent pericarditis initially detected by a leukocyte scan with indium-111. This case demonstrates that striking pericardial uptake on a whole-body indium-111 leukocyte scan can occur with purulent pericarditis, and it reemphasizes how insidiously purulent pericarditis may present in an immunosuppressed patient.

Adult↗
PubMed1983

Mitral valve prolapse and agoraphobia.

Of 46 female agoraphobic patients, three had definite and four had probable mitral valve prolapse--a total prevalence of only 15%. There were no significant differences between patients with mitral valve prolapse and the rest of the sample on demographic and clinical variables, nor did the groups differ significantly on measures of psychological symptoms assessed before and after treatment. These negative findings support recent reports indicating that agoraphobia associated with mitral valve prolapse may be indistinguishable from agoraphobia without mitral valve prolapse.

Adolescent↗
PubMed1978

Delayed postoperative cardiac tamponade: diagnosis and management.

Symptoms and signs of decreased cardiac output associated with an elevated venous pressure should alert one to the possibility of delayed cardiac tamponade. Enlargement of the cardiothoracic ratio shown by serial roentgenograms and demonstration of significant pericardial effusion by echocardiogram or radionuclide angiocardiography support the diagnosis. Erratic response of the prothrombin time to administration of warfarin and abnormal results of liver function test are additional clues to its diagnosis. Right heart catheterization documents the presence of tamponade and excludes other diagnostic considerations. Operative decompression of the pericardial space can be accomplished by pericardicentesis, subxiphoid pericardiotomy, median sternotomy, or thoracotomy. Hemodynamic observations following the relief of tamponade assure that an adequate therapeutic procedure has been performed.

Adult↗
PubMed1977

Pulmonary hypertension in the CREST syndrome variant of progressive systemic sclerosis (scleroderma).

Severe pulmonary hypertension without pulmonary fibrosis occurred in 10 patients with the CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, telangiectasia), reputedly a benign variant of progressive systemic sclerosis. Time from the initial symptom, Raynaud's phenomenon, to the recognition of pulmonary hypertension was as long as 40 years. Pulmonary hypertension and increased pulmonary vascular resistance was shown in all patients. Autopsy examination in three of six deaths attributable to pulmonary hypertension showed intimal proliferation with myxomatous change in the small- and medium-sized pulmonary arteries similar to changes in the digital arteries of patients with scleroderma and Raynaud's phenomenon, and interlobular renal arteries of those with "scleroderma kidney." It is concluded that the CREST syndrome is not entirely benign but may be complicated, after a long clinical course, by progressive pulmonary vascular obliteration, pulmonary hypertension, and death in the absence of significant pulmonary fibrosis.

Adult↗
PubMed1976

Sound pressure correlates of the Austin Flint murmur. An intracardiac sound study.

Mitral valve motion and pressure correlates of the Austin Flint murmur (AFM) were investigated in nine patients with aortic regurgitation using high fidelity catheter tip micromanometers and the mitral valve echocardiogram (MVE). External phonocardiography demonstrated a mid-diastolic murmur (MDM) in eight subjects and a presystolic murmur (PSM) in five. Maximum intensity of both AFM components was found in the left ventricular (LV) inflow tract; the murmur was not recordable in the left atrium (LA). In two patients, an apparent AFM was recorded in the intracardiac phonocardiogram when absent externally. Only one subject had a significant late diastolic "reversed" or LV to LA gradient; in this patient, presystolic mitral regurgitation was shown angiographically but no PSM was present and MVE revealed absence of atriogenic mitral valve re-opening. In two subjects, a PSM disappeared from the external phono when a "reversed" gradient occurred during the diastolic pause following a ventricular premature systole; this LV to LA gradient was associated with diastolic mitral regurgitation recordable in the left atrial phono. In two patients, LV inflow phono showed the MDM to begin 80-120 msec after the aortic second sound and during the D to E phase of the MVE. The rate of early diastolic mitral valve closure in patients (152 +/- 24 mm/sec) was not significantly different from 13 normals (232 +/- 10 mm/sec). With regard to the genesis of the AFM, the present study concludes: 1) diastolic mitral regurgitation plays no role, and 2) antegrade mitral valve flow is required but simultaneous retrograde aortic flow may also be necessary.

Aortic Valve Insufficiency↗
PubMed1976

Determinants of variation between Fick and indicator dilution estimates of cardiac output during diagnostic catheterization. Fick vs. dye cardiac outputs.

Simultaneous Fick and duplicate dye cardiac outputs were done in 105 patients with various cardiovascular diseases during routine cardiac catheterization. Dye was injected into the pulmonary artery and sampled from the brachial artery. Nineteen patients had mitral and/or aortic valvular regurgitation. Eighty-four per cent of the duplicate dye cardiac outputs agreed within 10 per cent variation from the line of identity, and 98 per cent were within 25 per cent. There was no systematic difference between the Fick and dye methods. Seventy-five per cent agree within 20 per cent variation from the line of identity. However, individual variation ranged from -27 to +58 per cent. There was, also, no systematic difference between Fick and dye methods either with low cardiac index or valvular regurgitation. Variation between the two methods was less with low cardiac index and greater with higher cardiac index. The variation was not increased in the presence of valvular regurgitation. The variation in the two methods could partly be explained by errors in the measurement of arteriovenous oxygen difference and oxygen consumption. When the injection is made into the pulmonary artery and sampled from the brachial artery, dye outputs are valid irrespective of the level of resting cardiac index and valvular regurgitation as long as there are enough points to draw a straight line from semilogarithmic trace of the descending limb.

Cardiac Catheterization↗
PubMed1975

Reversibility of left ventricular asynergy by nitroglycerin in coronary artery disease.

To evaluate the potential reversibility of left ventricular asynergy in patients with coronary artery disease, pre- and postnitroglycerin left ventriculography was performed in 32 subjects. In four other subjects left ventriculography was repeated without intervention of nitroglycerin. Changes in ejection fraction and percentage of systolic shortening of three minor axes from the first to the second angiogram were then calculated. Changes were not significant for the myocardial infarction group or for the control group without the intervention of nitroglycerin. Normal left ventricles showed small but significant changes (p less than 0.05). Patients with coronary artery disease but without previous myocardial infarction who demonstrated asynergy in their first angiogram showed three types of response: (1) no significant change (p less than 0.05)-irreversible asynergy; (2) significant change (p less than 0.025) with residual dysfunction-partially reversible asynergy; (3) significant change (p less than 0.001) without residual dysfunction-completely reversible asynergy. It is concluded that postnitroglycerin ventriculography is useful in assessing the reversibility of left ventricular asynergy in patients with coronary artery disease.

Adult↗
PubMedDate not supplied

Incomplete ventricular septal tear after blunt chest trauma: medical management with serial echocardiographic follow-up.

Incomplete ventricular septal tears are uncommon or probably underreported cardiac lesions caused by blunt chest trauma. This report describes two cases of incomplete ventricular septal tears that were not suspected clinically. Transthoracic and transesophageal echocardiography provided the diagnostic information in both of these cases. Despite associated valvular lesions, the patients' stable in-hospital course lead to the decision to treat them medically with no specific treatment to the incomplete ventricular septal tears. Accordingly, these two cases were observed for a mean period of 1.5 years with serial echocardiographic studies to track the natural history of these lesions. During the follow-up period, both of these cases did not manifest any changes in the extent of ventricular septal tear, septal structure, or any left-to-right shunting through the tear. There were no significant changes in left ventricular size, shape, or systolic function. Thus echocardiographic imaging proved to be useful both in initial diagnosis and follow-up.

Adolescent↗