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Biomedical subjects

U Manzoli

Publications and source records attributed to U Manzoli.

At least 55 records · Page 3Linked to original sources

Assessment of left atrial dimensions by cross sectional echocardiography in patients with mitral valve disease.

Left atrial dimensions were measured using cross sectional echocardiography in 37 patients with mitral valve disease and 30 normal subjects of similar ages. The anteroposterior (AP), superior-inferior (SI), and medial-lateral (ML) left atrial dimensions were determined at the end of ventricular systole using parasternal long and short axis and apical four chamber views (for SIa and MLa). To assess the reliability of these measurements cross sectional echocardiographic and angiographic left atrial volumes were compared in 19 patients with mitral valve disease, giving an excellent correlation. A moderate correlation was found between the anteroposterior dimension of the left atrium obtained using M mode echocardiography and that obtained using the parasternal short axis and long axis projections. In normal subjects a good correlation was found between SI and ML dimensions, while a lower correlation was found between SI and AP, and ML and AP dimensions. The SI dimension was the major axis of the left atrium and AP dimension the minor axis. In patients with mitral valve disease a good correlation was found between SI and ML dimensions, while SI and ML dimensions had a low correlation with AP dimensions. The AP dimension was the minor axis of the left atrium, while the SI and ML dimensions were not significantly different. All left atrial dimensions were significantly greater in patients with mitral valve disease than in normal subjects. Of 30 patients with at least one dimension increased, all three dimensions were abnormal in 16, two dimensions were increased in 10, and only one dimension was increased in four. AP, SI, and ML dimensions were abnormal in 25, 20, and 27 patients, respectively. Cross sectional echocardiography may provide a reliable estimate of left atrial dimensions. In patients with mitral valve disease a thorough examination of the left atrium using multiple cross sectional views is necessary to detect asymmetric left atrial enlargement and to measure the degree of left atrial dilatation.

Adult↗

Indoramin as second step therapy in the management of benign essential hypertension.

An open study was carried out to assess the efficacy of indoramin used as second step therapy in 30 patients with moderate to severe hypertension who had failed to respond adequately to monotherapy with a thiazide or beta-blocker. After a 1-week washout period, patients started treatment with 25 mg indoramin twice daily plus hydrochlorothiazide (25 mg twice daily) or propranolol (40 mg once daily). Indoramin dosage was subsequently adjusted in 25 mg steps (to maximum 150 mg daily), if necessary, at follow-up control visits every 14 days. Analysis of the results from the 22 patients who completed the 75-day study period showed that there were progressive, statistically significant reductions in systolic and diastolic blood pressure (supine and erect) to clinically acceptable levels. Heart rate also decreased significantly and this was more evident in the 7 patients treated with the combination of indoramin, thiazide plus beta-blocker. No patient had orthostatic hypotension and few side-effects were reported, although 7 patients withdrew for this reason.

Blood Pressure↗

Extension of calcific deposits in the anterior mitral valve leaflet and mitral valve stenosis severity. Use of 2D Echo parasternal long-axis view.

To evaluate the role of the extent of calcific deposits on the anterior mitral leaflet in predicting the severity of mitral valve stenosis, two-dimensional echocardiography (2D Echo) and heart catheterization data were analysed in 62 patients with mitral valve stenosis, pure or associated with trivial valve regurgitation. 50 patients had technically adequate 2D Echo. Of these, 28 had pure mitral valve stenosis. The mitral valve area was estimated from the parasternal short-axis 2D Echo projection. Using the parasternal long-axis projection, calcium deposits location and extension on the anterior mitral leaflet was examined. Patients were subdivided into the following groups: Group 0 (absence of calcium deposits = 19 patients), Group 1 (calcium on distal third of the leaflet = 19 patients), Group 2 (calcium on mid and distal segments = 11 patients), Group 3 (calcium on the entire leaflet = one patient). The extension of calcium deposits in long-axis projection was contrasted with 2D Echo mitral valve area in the 50 mitral valve patients. 2D Echo and heart catheterization derived mitral valve area were compared to each other in the 28 patients with pure mitral valve stenosis. 2D Echo mitral valve area was greater in Group 0 patients (1.8 +/- 0.4 cm2) than in Group 1 (1.4 +/- 0.4 cm2) and in Group 2 (1.1 +/- 0.3 cm2) (p less than 0.001 between the three groups). Calcific deposits were present on the anterior mitral leaflet in 30/31 patients with 2D Echo mitral valve area less than or equal to 2 cm2. However, of the 19 patients of Group 0, 13 had moderate and one severe mitral valve stenosis. In the 28 patients with pure mitral valve stenosis, 2D Echo mitral valve area was excellently correlated with Gorlin's derived mitral valve area (r = 0.90). However, in patients with extensive calcification of the anterior mitral valve leaflet (Group 2), 2D Echo mitral valve area was significantly greater than the Gorlin's derived area (1.08 +/- 0.20 cm2 versus 0.68 +/- 0.17 cm2; p less than 0.001). In four patients of Group 2, the mitral valve stenosis was moderate by 2D Echo grading and severe by heart catheterization data. Our data suggest that the study of extension of calcific deposits on the anterior mitral valve leaflet may be a complementary aid in quantifying mitral valve stenosis to the 2D Echo mitral valve area estimate, especially when the valve is severely calcified.

Calcinosis↗

[The hemodynamic effects of nifedipine in congestive cardiomyopathy (author's transl)].

The Authors present the haemodynamic effects of nifedipina (Adalat-Bayer) in nine patients with congestive cardiomyopathy. Heart rate (HR), systemic vascular resistances (SVR) and mean aortic blood pressure (MABP) were significantly modified in all nine patients following the administration of the drug. Six of them showed an increase of cardiac index (CI) and a decrease of myocardial oxygen consumption (MVO2); three of them presented a decrease of CI and an increase of MVO2. This discrepancy can be due to the different percentage of increase and to the maximal of valves of HR in the two groups. Nifedipina can be useful in the treatment of congestive cardiomyopathy with elevated STR (afterload) and peripheral hypoperfusion (more than pulmonary congestion).

Adolescent↗

[Chronobiological pattern size of cardiac rhythm (author's transl)].

The basic knowledge of statistical methods in chronobiology are exposed, for the analysis of chronobiological features of cardiac rhythm. The cosinor's method, with definition of chronobiological parameters (acrophase, mesor and amplitude) allows a microscopic approach to study of biological rhythms. The AA. relate some chronobiological studies: a) on heart rate in normal subjects and in patients with myocardial infarction (MI); b) on premature ventricular beats in MI; c) on atrial and ventricular rates in complete AV block. These results demonstrate that there is an evident circadian rhythmicity for all analyzed parameters. The AA. analyse the physiological and clinical meaning of the chronobiological approach to cardiac rhythm for the chronopharmacological and pathophysiological studies and suggests the implications in pathology of adaptation to shift work.

Circadian Rhythm↗

[Effect of potassium chloride on myocardial stimulation threshold and correlated electrophysiologic parameters (author's transl)].

The influence of KCl on different electrophysiologic parameters and myocardial stimulation threshold (MST) are considered in 9 patients with cardiac pacemaker. Reduction of MST during the diastolic period and the supernormal phase of excitability (SNP), depression of automaticity and slight bradycardia have been observed. The Authors, on the basis of kaliemia values and electrophysiologic parameters, emphasize the improvement of myocardial responsiveness when kaliemia does not exceed 6.5 mEq/l. The electrophysiologic effects of KCl are compared with those obtained in vitro on the transmembrane potential. Therapeutic effects for the treatment of arrhythmias and exit block in patients with cardiac pacemakers are considered.

Action Potentials↗

[Psychological problems of pacemaker carriers (author's transl)].

The Authors examine the peculiar psychological problems of pacemaker carriers. According to the degree of adjustment to the new clinical condition, it is possible to distinguish patients who react developing an anxious-depressive status (10-20%), those who realistically adjust to the new functional condition allowed by the pacemaker (70-80%) and those who, denying their disease, tend to overdo in their physical performance (10-20%). These characteristic psychological behaviors are examined with their family social, and physical implications. On the basis of these observations the importance of psychological support of nurses and physicians is emphasized.

Adaptation, Psychological↗