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Biomedical subjects

A Caobelli

Publications and source records attributed to A Caobelli.

11 recordsLinked to original sources

[Hypercalcemia and changes in cardiac rythm].

Holter's test was performed in eight patients with advanced breast cancer and paraneoplastic hypercalcemia. In spite of several reports of cardiac arrhythmias, none were found in these patients.

Adult↗

[Acute and chronic effects of verapamil on indices of systolic and diastolic function of the left ventricle in patients with hypertrophic cardiomyopathy].

The aim of this study has been the analysis of acute and chronic effects of Verapamil on resting left ventricular (LV) systolic and diastolic function indices derived from ECG gated radionuclide Angiocardiography (GRA) in patients (pts) affected by Hypertrophic Cardiomyopathy (HCM). 18 pts with HCM were imaged in basal conditions (twice in two different days) and after i.v. infusion of Verapamil 0.1 mg/kg (1st acute test); than chronic oral treatment of Verapamil (240 mg/die) was started. Three months later 14 pts were studied again, during oral chronic therapy and after a second administration of Verapamil i.v. 0.1 mg/kg (2nd acute test). After acute infusion we observed a significant increase of the peak filling rate (PFR) (from 3.3 +/- 0.9 to 3.51 +/- 0.71 EDV/sec, P less than 0.01) and a shortening of the time to PFR (from 188.1 +/- 24.9 to 165 +/- 30 msec, P less than 0.005). No significant variations of the contribution of atrial systole to the ventricular filling (AS) (from 17.03 +/- 5.96 to 18.15 +/- 6.91%), of the heart rate (from 70 +/- 12 to 69 +/- 12 bat/min), and of systolic function indices, ejection fraction (EF) (from 74.4 +/- 9.7 to 74.30 +/- 10.02), peak ejection rate (ER) (from 4.17 +/- 0.92 to 4.10 +/- 0.9), ejection time (ET) (from 307.4 +/- 46.4 to 322.22 +/- 48.6) were noticed. After chronic oral therapy we observed a significant shortening of the time to PFR (from 197.5 +/- 16.7 to 182.8 +/- 13.7 msec, P 0.01), while the remaining indices of diastolic function we analyzed (PFR from 3.2 +/- 0.6 to 3.3 +/- 0.8 EDV/sec; AS from 17.1 +/- 4.9 to 17.1 +/- 6.6%), the systolic function indices (EF from 74.4 +/- 10.5 to 75.4 +/- 9.4%; ER from 4.2 +/- 0.8 to 4.2 +/- 0.6 EDV/sec; ET from 309.6 +/- 48.5 to 308.9 +/- 40.5 msec) and the heart rate (from 67.7 +/- 8 to 66 +/- 8) were not modified. If a 30 msec time to PFR variation was considered significative (confidence limit of 95% between absolute changes measured on two basal studies) the 1st acute test was predictive of chronic efficacy in 10/14 (71%) pts. Four of five pts in which a shortening of TTPFR was observed during the 2nd acute test, showed the same effect with a higher chronic dose of Verapamil (360 mg/die). Our results suggest that Verapamil after acute or chronic treatment improves diastolic filling of LV, without worsening systolic indices.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

[Evaluation of the interventricular septum in left bundle branch block using basal echocardiography (M-mode) and myocardial stress scintigraphy (thallium-201)].

In thirty-six consecutive subjects, with left bundle branch block (LBBB) of the interventricular septum (IS), septal perfusion and/or viability was verified by M-mode echocardiography and by stress redistribution 201 TI-scintigraphy. After the early systolic "dip", a characteristic pattern of interventricular septum in left bundle branch block, we observed: a) an anterior paradoxical movement (A-type) during the ejection phase in 5 subjects; b) hypokinetic posterior movement (B-type) in 10 subjects and c) a normal motion (C-type) in 21 subjects. All the subjects with an A-type paradoxical anterior motion of the interventricular septum, showed a persistent defect of T1 uptake both during exercise and after redistribution. Of 31 patients with posterior interventricular septum motion (B and C types), 21 showed normal septal TI uptake and 10 reversible, exercise-induced perfusion defect, with complete redistribution on scintigrams at rest. In conclusion the analysis of our data demonstrates that in patients with left bundle branch block 1) the motion of the interventricular septum is not merely due to the anomalous electrical activation, but to other different factors, such as the anatomical and functional changes underlying the conduction pathology, 2) an A-type motion by M-mode echocardiography is highly predictive of interventricular septum damage.

Adult↗

[Correlation between results of bicycle stress test and coronaric arteriography. Study of 153 patients (author's transl)].

In 153 patients the results of bicycle stress test were compared with data obtained from coronaric arteriography. There were corresponding results from both tests in most cases. There are other discrepancies which cannot be explained by defining the stress test as "unspecific" or "not very sensitive". In fact, each time, time differences can be referred, besides method limits, to particular physio-pathological stages of the coronaric disease (collateral circulation, Prinzmetal angina) or they can be considered completely independent of the coronaric disease (myocardial disease without coronaric disease, enzymatic defects; haemoglobinic alterations, etc.). The two tests have different indications, but they can also complementary information.

Adolescent↗

[Morpho-functional changes of left ventricle produced by sublingual nitroglycerin (author's transl)].

Two successive left ventriculargraphs [in basal conditions and after Nitroglycerin (TNG)] were performed with the same technical procedures in 20 patients before coronary arteriography. End-diastolic and end-systolic volumes and ejection fraction were studied following Greene's modified method. Diastolic and systolic ventricular projected images were divided into four zones and their variations were evaluated after TNG. Two patients did not show any significant abnormality (pseudoangor); two others suffered from cardiomyopathy (myocardosis) with mitral regurgitation and no coronary artery disease; two had restrictive cardiomyopathy. Fourteen had a coronary artery disease: seven of them had signs of end-systolic mitral regurgitation. End-diastolic and end-systolic volumes decreased and ejection fraction increased after TNG in all of these cases except in the two suffering from cardiomyopathy (ESV increased and EF decreased). Mitral regurgitation disappeared in all of them. In patients with coronary artery disease and mitral regurgitation the volume variations were slighter, and the increase of EF was larger than in the other cases. Finally, a decrease in asynergic and hypokinetc zones was observed, whereas no variations were seen in diskinetic zones. TNG can improve left ventricular kinetics by decreasing the pre-load, the after-load and myocardial oxygen consumption. Demonstration of this improvement could be of prognostic value.

Administration, Oral↗

Prinzmetal's variant angina: clinical, angiographic and pathologic correlations in two typical cases.

ECG and cinecoronary angiography of two patients with Prinzmetal's variant angina are reported. A pathologic study was performed on both. In one case, a transient luminal obstruction of the left circumflex coronary artery became apparent during selective coronary arteriography. Histologic examination of the corresponding coronary segment revealed a severe concentric atherosclerotic process with a normal-sized muscular layer, so that the angiographic transient occlusion might be attributed to an arterial spasm. In the second case no angiographic narrowings were demonstrated by cinecoronary angiography. Nevertheless, histologic examination revealed significant obstructive atherosclerotic narrowing in some coronary segments. It is suggested that atherosclerotic disease may be present also in cases with variant angina who have apparently normal coronary angiograms.

Autopsy↗