PubMed Health⌕ Search

Biomedical subjects

A Lucatti

Publications and source records attributed to A Lucatti.

15 recordsLinked to original sources
PubMed1996

Changes in effective aortic valve area during ejection in adults with aortic stenosis.

Measurements of valve orifice area in aortic stenosis are based on the assumption that orifice area remains constant throughout ejection and is independent of transvalvular gradients and flow. Recent studies, however, have suggested that the calculated valve area of calcific aortic stenosis may change in different flow conditions. Therefore, we tested the hypothesis that in vivo effective orifice area of a stenotic aortic valve changes continuously during ejection, which would make a single area measurement a potentially inadequate indicator of the severity of the stenosis. Doppler measurements of flow velocity in the ascending aorta and in the left ventricular outflow tract at peak velocity, at half-peak velocity during acceleration (midacceleration), and at half-peak velocity during deceleration (mid-deceleration) were obtained in 26 patients with aortic stenosis (mean gradient 50 +/- 19 mm Hg and effective aortic orifice are 0.7 +/- 0.3 dcm2) and in 14 normal subjects of similar age and gender, to calculate instantaneous effective aortic orifice area at midacceleration, at peak velocity and at mid-deceleration. In the 26 patients with aortic stenosis, aortic valve area at midacceleration was 84 +/- 15% of valve area at peak velocity (p < 0.0001), and valve area at mid-deceleration was 113 +/- 17% of that measured at peak velocity (p < 0.01). Conversely, in normal subjects, aortic valve area remained constant during ejection and was 97 +/- 5% and 99 +/- 6% of valve area at peak velocity, respectively, at midacceleration and mid-deceleration (p > 0.05). In addition, in patients with aortic stenosis the percentage of change in effective aortic valve area from midacceleration to mid-deceleration varied widely, from -17% to +49% (mean change +26 +/- 14%). There was no relation between percentage of change in effective valve area and mean transaortic gradient (r = 0.05; p = 0.30) or effective valve area at peak velocity (r = -0.11; p = 0.14). Our results indicate that effective aortic valve area continues to change during ejection in patients with aortic stenosis, and that the magnitude of this change is independent of the usual indexes of severity of the stenosis. Conversely, effective aortic valve area remains constant during ejection in normal subjects.

Aged↗
PubMed1994

Relation between ECG strain pattern and left ventricular morphology, left ventricular function, and DPTI/SPTI ratio in patients with aortic regurgitation.

The relative contributions of left ventricular structural changes, dysfunction, and subendocardial ischemia in determining electrocardiographic repolarization abnormalities were assessed in 53 patients with chronic, pure aortic regurgitation and no evidence of coronary artery disease. Thirty-six patients with an abnormal electrocardiographic pattern of repolarization showed larger end-diastolic (154 +/- 46 vs 120 +/- 32 mL/m2; P < .001) and end-systolic (80 +/- 40 vs 52 +/- 30 mL/m2; P = .016) volumes, higher end-diastolic pressure (22 +/- 11 vs 15 +/- 10 mmHg; P = .021), lower ejection fraction (52 +/- 12 vs 59 +/- 13%; P < .05) and greater mass (168 +/- 48 vs 140 +/- 44 g/m2; P < .05) of the left ventricle compared to 17 patients with normal repolarization. Furthermore, patients with repolarization abnormalities also showed higher peak meridian (217 +/- 68 vs 153 +/- 92 Kdyne/cm2; P < .001) and circumferential (358 +/- 110 vs 259 +/- 153 Kdyne/cm2; P < .001) stress and a more spherical shape (end-diastolic shape: 1.4 +/- 0.1 vs 1.5 +/- 0.2, P = .046; end-systolic shape: 1.7 +/- 0.3 vs 1.9 +/- 0.3, P = .026) of the left ventricle. Patients with secondary repolarization abnormalities were also older than patients with normal repolarization (56 +/- 10 vs 40 +/- 11 years; P < .001). However, the diastolic pressure-time index/systolic pressure-time index, which is an estimate of the myocardial oxygen supply-to-demand ratio, was similar in both groups of patients (0.74 +/- 0.3 vs 0.8 +/- 0.2; P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Doppler echocardiographic evaluation of the new mechanical bileaflet Sorin Bicarbon valve prosthesis compared with St. Jude Medical].

BACKGROUND: Despite the Bicarbon valve has been marketed for more than two years, no systematic Doppler evaluation of its normal functioning has yet been published. Therefore, the aims of this study were to establish the normal flow characteristics for the Bicarbon bileaflet prosthetic heart valve and to compare them with those obtained from the St. Jude Medical valve prosthesis. METHODS: Doppler echocardiographic characteristics of normally functioning Bicarbon prostheses were prospectively assessed in 76 consecutive patients (44 males and 32 females, mean age 60 +/- 10 years) with 79 valves in mitral (n = 29) and aortic (n = 50) position whose function was considered normal by clinical and echocardiographic evaluation. In addition, Doppler characteristics of the Bicarbon valves in aortic position were compared to those of 27 normal functioning St. Jude Medical implanted during the same period. RESULTS: For the mitral valve prostheses, we found non significant difference among prosthesis sizes in terms of transprosthetic gradients or pressure half time. Peak and mean gradients were similar in the 27-mm and 31-mm size valves (from 11 +/- 4 to 11 +/- 2 mm Hg and from 5 +/- 2 to 5 +/- 1 mm Hg, respectively; p = NS for both). Similarly, the pressure half time was similar in the 27-mm and in the 31-mm size valve (85 +/- 16 and 76 +/- 13 msec; p = NS). Conversely, for the aortic valve prostheses, there was a significant decrease in transprosthetic gradients and an increase in effective orifice areas as prosthesis size increased. Mean gradient was 13 +/- 1 mm Hg in 19-mm size valves, and it decreased to 6 +/- 2 mm Hg in the 29-mm size. Effective prosthetic valve area calculated using the continuity equation, ranged between 1.0 +/- 0.3 cm2 for 19-mm size valves to 3.5 +/- 0.7 cm2 for 29-mm size. With analysis of variance, effective prosthetic aortic valve area differentiated various valve sizes (F = 23.3; p < 0.0001) better than peak (F = 3.2; p = 0.017) or mean (F = 4.19; p = 0.0035) gradients alone did. Furthermore, effective prosthetic aortic valve area correlated better than peak and mean gradients with prosthetic size (r = 0.87, r = -0.58 and r = -0.57; respectively). In addition, peak and mean transprosthetic gradients and effective prosthetic aortic valve areas did not show any statistically significant difference between the Bicarbon and the St. Jude Medical valves in aortic position, either in 19 and 21 mm (25 +/- 8 mm Hg, 13 +/- 4 mm Hg, 1.3 +/- 0.3 cm2 and 32 +/- 11 mm Hg, 17 +/- 6 mm Hg, 1.2 +/- 0.4 cm2, respectively; p = NS), or in 23 and 25 mm (21 +/- 8 mm Hg, 11 +/- 4 mm Hg, 2.1 +/- 0.5 cm2 and 24 +/- 11 mm Hg, 12 +/- 5 mm Hg, 1.8 +/- 0.4 cm2, respectively; p = NS) or in 27 and 29 mm (12 +/- 2 mm Hg, 7 +/- 1 mm Hg, 2.8 +/- 0.9 cm2 and 16 +/- 5 mm Hg, 7 +/- 2 mm Hg, 2.6 +/- 0.4 cm2, respectively; p = NS). CONCLUSIONS: This study suggest that the Bicarbon valve prosthesis offers relatively little resistance to forward flow except at a small anulus diameter. Furthermore, these is no statistically significant difference between the Bicarbon and the St. Jude Medical in aortic position with regard to early hemodynamic performances.

Aged↗
PubMed1992

Infective right atrial thrombus: a rare complication of total parenteral nutrition in an adult.

We describe a case of an infective right atrial thrombus, following total parenteral nutrition, in a 21-year-old woman undergoing a surgical procedure for long-standing chronic ulcerative colitis. She presented with high temperature and the illness did not respond to antibiotic therapy. A 2-dimensional echocardiogram showed a mobile right atrial mass that at surgery was identified as a thrombus. Thrombus cultures grew coagulase-negative Staphylococcus aureus.

Adult↗
PubMed1992

[Age-induced changes in the cardiovascular system in normal subjects].

To assess the effect of age on cardiac structure and function, we performed echocardiograms on 104 physically active, normal, community-dwelling volunteers (68 men and 36 women), ranging in age from 18 to 84 years and having no evidence of hypertension or cardiovascular disease. With advancing adult aging, the following were observed: a decrease in aortic compliance (r = 0.42); an increase in systolic (r = 0.61), diastolic (r = 0.24), pulse (r = 0.60) and mean (r = 0.48) arterial pressure; and a modest enlargement of aortic root (r = 0.47) and left atrial dimension (r = 0.30) were observed. Left ventricular end-diastolic volume (r = 0.25), wall thickness (r = 0.30) and mass (r = 0.37) also increased with aging, while left ventricular end-systolic volume was not age-related. Furthermore, a stepwise multivariate linear model identified the decrease in arterial compliance (R2 = 0.06; p < 0.02) and the increase in left ventricular stroke work (R2 = 0.38; p < 0.0001) as the only variables independently related to the increase in left ventricular mass that occurs with advancing age. Regarding left ventricular systolic function, aging was also related to an increase in left ventricular stroke work (r = 0.40) and ejection time (r = 0.44), while pump function, (measured as ejection fraction and cardiac index at rest), and contractility (measured by load independent end-systolic indexes) were unaffected by aging. Conversely, pulsed Doppler analysis of mitral inflow showed a significant age-related decline in the peak early filling velocity (r = -0.45) and in the ratio of early and late diastolic filling velocity (r = -0.66), while peak late diastolic flow velocity (r = 0.50), diastolic pressure half time (r = 0.34) and duration of isovolumic relaxation (r = 0.56) increased significantly with age.

Adolescent↗
PubMed1991

[Changes in modalities of left ventricular filling associated with aging in normal subjects: secondary to increase in blood pressure and left ventricular mass?].

The mechanisms by which aging alters the pattern of left ventricular diastolic filling are still uncertain. To gain more insight into this tissue, the independent contributions of age, sex, heart rate, arterial blood pressure and left ventricular mass (as well as various indexes of left ventricular morphology and function) to left ventricular diastolic filling abnormalities, were investigated by echocardiography in 81 normal subjects (18 to 84 years of age, mean 50), carefully screened to avoid the confounding effects of coronary artery disease and systemic hypertension. With advancing adult age, we found a significant increase in: body mass index (r = 0.25; p less than 0.02), systolic (r = 0.58; p less than 0.0001), pulse (r = 0.61; p less than 0.0001) and mean (r = 0.40; p less than 0.0001) arterial blood pressure; left ventricular wall thickness (r = 0.30; p less than 0.006); left ventricular mass (r = 0.32; p less than 0.004); left ventricular end-diastolic volume (r = 0.24; p less than 0.03); and peak systolic wall stress (r = 0.22; p less than 0.04). Pulsed Doppler analysis of mitral inflow showed a significant age-related decline in the peak early filling velocity (r = -0.51; p less than 0.001), and in the ratio of early and late diastolic filling velocity (r = -0.65; p less than 0.0001). Conversely, duration of isovolumic relaxation (r = 0.77; p less than 0.0001), peak late diastolic flow velocity (r = 0.39; p less than 0.001), and diastolic pressure half time (r = 0.34; p less than 0.01) increased significantly with age. "Stepwise" multivariate linear regression analyses showed that the ratio of early to late diastolic peak filling velocity was independently related only with age (R2 = 0.56; p less than 0.0001) while the isovolumic relaxation time was independently related with age (R2 = 0.48; p less than 0.0001) and duration of cardiac cycle (R2 = 0.06; p less than 0.008). Age-related changes in body mass index, blood pressure, peak meridional wall stress and left ventricular mass index did not show any independent relationship to Doppler parameters of left ventricular filling or duration of isovolumic relaxation. The results of the present study suggest that the effect of age on left ventricular filling modalities and duration of isovolumic relaxation are independent of age-related changes in blood pressure, left ventricular mass, morphology and systolic function.

Adolescent↗
PubMed1991

Concentric left ventricular wall thickening in a patient with primary hypothyroidism. Response to gradual thyroxine replacement.

Asymmetric septal thickening has been described in patients with overt myxedema, but descriptions of concentric left ventricular wall thickening in such patients are rare. Echocardiographic detection of thickened left ventricular and interventricular walls, without pericardial effusion or any other sign of cardiac involvement, in a patient with overt myxedema and primary hypothyroidism, is reported. Furthermore, this is the first case in which the timing and the extent of the response of such abnormalities to L-thyroxine replacement therapy have been serially evaluated.

Adult↗
PubMed1985

[Evaluation of left ventricular ejection fraction in coronary disease patients by the gated blood pool method and cineangiography. Critical analysis of divergences between the 2 methods].

In order to assess the reliability of left ventricular ejection fraction as estimated by gated blood pool method, radionuclide angiography (LAO) and single plane (RAO) contrast cineangiocardiography were performed within 14 days in 60 patients with coronary artery disease. The mean value of radionuclide ejection fraction was found to be 55 +/- 16%; contrast cineangiographic ejection fraction was 57 +/- 15%; r = 0.92. In 23 patients with previous anterior myocardial infarction gated blood pool method was found to underestimate left ventricular ejection fraction when compared with contrast cineangiography. The observed underestimation was wide significant in 11 patients with previous anterior infarction, low (less than 50%) radioisotopic ejection fraction and septal akinesia and/or apical dyskinesia; radionuclide ejection fraction = 33 +/- 8%; contrast cineangiographic ejection fraction = 42 +/- 9%; r = 0,76. This study confirms that the values of left ventricular ejection fraction as estimated by gated blood pool method in coronary patients are quite reliable; moreover, the intrinsic variability of the data is low. This may be not true in patients with previous anterior myocardial infarction. The Authors discuss the possible causes of disagreement between radioisotopic and contrastographic ejection fraction in patients with previous anterior infarction and poor left ventricular function: physical problems of measuring ejection fraction by gated blood pool in dilated ventricles; possible mistakes in evaluating blood pool due to the low mobility of the blood mass nearest to the scintillation camera; inhability of contrast cineangiography in RAO to recognize the interventricular septum and evaluate its kinetic abnormalities; unreliability of the geometrical model of revolution elypsoid in calculating end-systolic volumes in ventricles with abnormal wall-kinesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Cineangiography↗
PubMedDate not supplied

[Ventricular arrhythmia in a group of patients with hypertrophic cardiomyopathy].

A possible connection between M-mode echocardiographs and the incidence of ventricular arrhythmias was investigated in a group of patients with hypertrophic cardiomyopathy. No single echocardiographic parameter could identify the patients with serious ventricular arrhythmias. Multivaried discriminatory analysis revealed the extent of the septal excursion, the telediastolic thickness of the interventricular septum, the E-F incline and the dimension of the left atrium as the most significant echocardiographic features identifying patients with serious ventricular arrhythmias.

Adult↗
PubMedDate not supplied

[Evaluation of the cardiovascular effects of the beta-blockader atenolol].

The beta-blocking action of 100 mg per diem Atenol was evaluated in 8 patients with conditions requiring treatment with a beta-blocking drugs (ischaemic cardiopathy, arterial hypertension, hypertrophic myocardiopathy). Ergometer bicycle exertion tests were used to evaluate the extent of Atenol's beta-blocking action (in basal condition, 3 and 24 hours after administration of the drug) as well as Holter type dynamic ECG recordings (basal and under treatment). The drug significantly reduced cardiac frequency and arterial pressure both at rest and under exertion. It also significantly reduced average hourly and daily cardiac frequency as shown by dynamic ECG. No side effects of the drug were observed.

Adult↗
PubMedDate not supplied

[Arrhythmias in mitral prolapse patients].

An ECG at rest, a cycloergometric exertion test and a 24 hour dynamic ECG were conducted on 16 patients with mitral prolapses in order to reveal the incidence of arrhythmias. High grade ventricular arrhythmias (3, 4a, 4b) were observed in 5 patients (31%), and minor arrhythmias (grades 1 and 2) in 7 (44%), while 4 patients (25%) showed no ventricular arrhythmia. Complex supraventricular arrhythmias were recorded in 2 patients (12.5%) extrasystolic supraventricular arrhythmias in 5 (31%). In all cases, the dynamic ECG was shown to be significantly more sensitive to the presence of arrhythmias. There was found to be little correlation between symptoms reported by the patients and arrhythmia identified.

Adult↗