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Biomedical subjects

S Iliceto

Publications and source records attributed to S Iliceto.

At least 127 records · Page 7Linked to original sources
PubMed1985

Detection of coronary artery disease by two-dimensional echocardiography and transesophageal atrial pacing.

Two-dimensional echocardiography was performed at rest and during rapid transesophageal atrial pacing in 85 patients undergoing coronary arteriography for evaluation of chest pain. Transesophageal atrial pacing was performed with 10 ms pulses of 6 to 27 mA intensity; the rate was progressively increased up to 150 beats/min. Four patients were excluded: two because atrial capture was not achieved and two because of chest discomfort induced during transesophageal atrial pacing. Of the remaining 81 patients, 56 had significant coronary artery disease (greater than or equal to 75% stenosis of at least one major coronary vessel) and 25 had no significant coronary artery disease; 25 of the 56 patients with coronary artery disease had no wall motion abnormalities at rest. The test was considered positive if wall motion abnormalities were detected during pacing. Wall motion abnormalities occurred in 3 of 25 patients without coronary artery disease (specificity 88%) and in 51 of 56 patients with coronary artery disease (sensitivity 91%). Wall motion abnormalities developed in 20 of the 25 patients with coronary artery disease and normal regional wall motion at rest (sensitivity 80%); sensitivity for one, two and three vessel disease was 85% (17 of 20 patients), 94% (15 of 16 patients) and 95% (19 of 20 patients), respectively. In patients without coronary artery disease, wall motion score was 18 at rest and 17.7 +/- 0.9 during pacing (p = NS). In patients with coronary artery disease, wall motion score decreased from 15.2 +/- 3.6 at rest to 11.6 +/- 4.1 during pacing (p less than 0.001). In patients with coronary artery disease and normal regional wall motion at rest, wall motion score decreased from 18 at rest to 14.4 +/- 3.1 during pacing (p less than 0.001). Thus, two-dimensional echocardiography during transesophageal atrial pacing appears both sensitive and specific in detecting patients with coronary artery disease. This new procedure is a feasible and reliable alternative to exercise two-dimensional echocardiography.

Adult↗
PubMed1985

[Evaluation of the ejection fraction using 2 simplified echocardiographic methods in patients with ischemic heart disease and left ventricular asynergy].

UNLABELLED: This study was undertaken to assess the reliability of two simplified echocardiographic methods (Method A and B) in evaluating ejection fraction (E.F.) in patients with left ventricular wall motion abnormalities (WMA). Method A was obtained with a microprocessor that allows the superimposition of a calibrated ellipse to left ventricular end-diastolic and end-systolic silhouettes; the shape of the ellipse was modified to obtain the best superimposition of the ellipse outline to the endocardium. E.F. was then obtained with the formula: VD-VS/VD where VD and VS were the ellipse volumes at end-diastole and end-systole. In method B E.F. was obtained averaging 3 regional E.F. obtained with a longitudinal axis and 3 different transverse diameters. In a group of 40 patients with WMA and excellent 2D echo images the correlation between echocardiographic and angiographic values was r = 0.76 for method A and r = 0.92 for method B. Method B was also tested in a group of 25 consecutive unselected patients with left ventricular WMA; in this group the correlation with angiographic values of E.F. was r = 0.84. IN CONCLUSION: in patients with WMA method B must be preferred because it is easier to perform and presents a better correlation with angiographic data than method A.

Adult↗
PubMed1985

[Spontaneous echocontrastography. Analysis of 50 cases, review of the literature and a proposal for its classification].

Spontaneous echocontrastographic effect (SEE) is sometimes detected in cardiac chambers. In order to propose a classification of the phenomenon we reviewed our series of 50 patients with SEE. We detected three type of SEE: type I, II, III. Type I was characterized by the presence of low amplitude echoes with slow and irregular motion in a cardiac chamber, in some cases the cloud of echoes had not defined borders (type IA), in other cases the cloud had well defined borders and was attached to a mural thrombus (type IB). Type II was characterized by the presence of echoes moving quickly across the mitral valve toward the left ventricle apex. Lastly, type III was characterized by the presence of microbubbles slowly and chaotically moving in right cardiac chambers. Type I SEE was detected only in patients with clinical conditions (mitral stenosis, congestive cardiomyopathies) characterized by slow intracardiac flow; type II was detected in 3 patients with mitral prosthesis, in 3 with constrictive pericarditis and 1 with severe aortic insufficiency. Lastly, type III was detected in 5 patients with tricuspid insufficiency.

Adolescent↗
PubMed1985

[Diagnosis of ischemic cardiopathy by 2-dimensional echocardiography carried out after the bicycle ergometry test in the supine position: feasibility, sensibility and specificity].

We performed two dimensional echocardiography (2D ECO) after bicycle exercise obtained in supine position in 80 patients undergoing coronary angiography for the evaluation of chest pain. Adequate 2D images after exercise were recorded in 64/80 (80%) patients (pts). Forty pts had significative coronary artery disease (CAD), 24 had no CAD. Twenty-three CAD pts had left ventricle wall motion abnormalities (WMA) at rest; 17 pts had 1-, 11 2- and 12 3-vessels disease. The test was considered positive if WMA were present after exercise. Thirty-two CAD pts and 1 pt without CAD had WMA after exercise, thus sensitivity and specificity were, respectively, 80% and 96%. In 1-, 2- and 3-vessels disease pts, sensitivity was, respectively, 71%, 91% and 83%. WMA were observed after exercise in 9/17 (53%) pts without WMA at rest. 2D Echo obtained after bicycle exercise performed in the supine position is a feasible, sensitive and specific technique to detect CAD.

Coronary Disease↗
PubMed1984

Detection of atrial septal defect by right sternal border echocardiography.

The atrial septum can be visualized by right sternal border 2-dimensional echocardiography (2-D echo). To evaluate the usefulness of this approach in the evaluation of atrial septal defect (ASD), 50 patients who underwent cardiac catheterization were studied by 2-D echo. Twenty-one patients (Group A) had ASD (3 ostium primum, 18 ostium secundum) and 29 (Group B) had mitral valve disease and an intact atrial septum. Subcostal and right sternal border approaches were used to visualize the atrial septum. Both approaches identified the 3 cases of ostium primum ASD; secundum ASD was identified using the subcostal approach in 11 patients and using the right sternal border approach in 13. In 15 patients the ASD was imaged at least by 1 of the 2 approaches. Two-dimensional contrast echocardiography showed a positive or negative contrast effect in 13 of 18 cases (12 with standard approaches, 11 with right sternal border approach). In all patients in Group B, the right sternal border approach showed an intact atrial septum. Thus, the right sternal border approach is a useful approach that increases the sensitivity of 2-D echo in the diagnosis of ASD.

Adolescent↗
PubMed1984

Two-dimensional echocardiographic recognition of complications of cardiac invasive procedures.

Two-dimensional echocardiography allowed prompt recognition of a major complication of a cardiac invasive procedure in 6 patients. In 5 cases, a preinvasive echocardiographic study was available for comparison. In 1 patient with perforation of the ventricular septum by a temporary pacemaker, the catheter was visualized as it passed through the ventricular septum, with the tip located against the left ventricular posterolateral wall. In another patient, the intimal flap caused by aortic dissection after left-sided heart catheterization was clearly visualized. In 2 patients with hemopericardium secondary to cardiac perforation during right-sided cardiac catheterization, 2-dimensional echocardiography revealed pericardial effusion not noted in studies performed before the invasive procedure. Two patients in whom hemopericardium occurred from injury by the pericardiocentesis needle also were studied by 2-dimensional echocardiography. Postpericardiocentesis images revealed new intrapericardial abnormalities (a thrombus-like mass and fibrinous strands) not present in the echocardiographic studies performed before pericardiocentesis. Real-time 2-dimensional echocardiography appears to be a good tool in the recognition of the emergencies secondary to cardiac invasive procedures.

Adult↗
PubMed1984

Diagnosis of aneurysm of the thoracic aorta. Comparison between two non invasive techniques: two-dimensional echocardiography and computed tomography.

In order to assess the respective values of two-dimensional echocardiography (2D echo) and computed tomography (CT) in the evaluation of aneurysms of the thoracic aorta, 14 patients with angiographically proven aneurysms of the thoracic aorta (three of which were dissecting aneurysms) were studied. The entire thoracic aorta was visualized in 10/14 patients by 2D Echo and in all patients by CT. An intimal flap was recognized by 2D echo in each case with a dissection whereas such a recognition was never possible with CT. CT identified calcification of the wall of an huge aneurysm of the ascending aorta in one case and a thrombotic stratification in the lumen of the descending thoracic aorta in another case; both abnormalities were missed by echocardiography probably because of inappropriate gain setting. In conclusion, 2D Echo and CT are both useful in the evaluation of aneurysms of the thoracic aorta; 2D echo appears to be superior in the recognition of an intimal flap due to dissection whereas CT allows a better recognition of the configuration, extension and tissue modifications of the aneurysm.

Adult↗
PubMed1984

[Spontaneous microcavitations in the right cardiac chambers. Microcavitations in the right sections].

Spontaneous echocardiographic contrast has been occasionally detected in the left ventricle of patients with mitral valve prosthesis. Only one case has been so far described in which spontaneous microbubbles have been detected in the right ventricle. We report the clinical and echocardiographic findings of five patients in whom spontaneous echocardiographic contrast was detected in right cardiac chambers: one patient had pulmonary embolism, three patients had mitral valve disease and tricuspid regurgitation, one patient had a congestive cardiomyopathy. These microbubbles can be produced by gas development due to lateral pressure drop secondary to tricuspid regurgitation or to gas absorbed from the intestine, that reach the heart through shunts between the portal and the systemic veins.

Adult↗
PubMed1984

[Abnormal intracavitary dynamic echoes. I. An in vitro study].

We performed in vitro experiments to study blood echodensity during stasis or slow flow rate. Quantitative and qualitative evaluation of water, blood, plasma and washed red cells at different dilutions (1:5, 1:10, 1:20, 1:50) were made. Two 2D echo equipments (2,5,-3,5 Mhz) were utilized. No echoes were observed in water and plasma. Blood was strongly echogenic. A progressive reduction of the echodensity of washed red cells was observed with increasing dilution. We conclude that scattering of ultrasound by blood, during stasis or slow flow, can be detected utilizing commercially available echocardiographic systems; red cells may represent the scattering agent.

Blood Flow Velocity↗
PubMed1984

[Abnormal intracavitary dynamic echoes. II. In vivo study].

UNLABELLED: Dynamic intracavitary echoes (DIE's) suggesting regional stasis of blood, were detected in 17 patients (pts) (6 with mitral stenosis, 1 with mitral prosthesis, 5 with congestive cardiomyopathy, 5 with left ventricular aneurysm). DIE's were observed in the left atrium in all pts with mitral stenosis and in the patient with a prosthetic valve, in the left ventricle in the remaining pts. In 5 pts a thrombus was detected in the cardiac chamber in which DIE's were observed. In 4 pts direct inspection (at surgery or autopsy) of the cardiac chamber in which DIE's were detected revealed the presence of non-coagulated blood. All pts with DIE's in the left atrium were in atrial fibrillation. In one case with mitral stenosis DIE's disappeared after commissurotomy. IN CONCLUSION: DIE's suggesting regional stasis of blood may be detected in pts with clinical conditions characterized by slow cardiac flow; this phenomenon may be caused by red cell aggregation occurring in those conditions.

Adolescent↗