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Biomedical subjects

A Manari

Publications and source records attributed to A Manari.

At least 19 recordsLinked to original sources
PubMed2005

Early evaluation of coronary microcirculation by echocardiography with contrast medium in patients with acute myocardial infarction treated with primary percutaneous transluminal coronary angioplasty.

AIM: In about 30% of patients with ST elevated myocardial infarction (STEMI), in which a TIMI 3 flow is obtained in the infarct related artery (IRA) after primary percutaneous transluminal coronary angioplasty (PTCA), it's not possible to obtain a good perfusion of coronary microcirculation (no reflow). Aim of the study is to estimate the prognostic value of microcirculation study by echocardiography with contrast medium (MCE) within 48 h from procedure and to point out if there're clinical or procedural factors correlated with no reflow. METHODS: From February 2002 to June 2003 we have analyzed the integrity of microcirculation by MCE in patients with STEMI treated with PTCA. We have included in this study 62 patients with anterior myocardial infarction (MI) (first event), within 12 h from symptoms onset, with great echocardiographic window and TIMI 3 flow in the IRA after PTCA, excluding shock. We have obtained the evaluation of myocardial perfusion by MCE within 48 h from the treatment. We have used Sonovue as contrast medium, infused through peripheral vein. In each patient we have measured: perfusion index (PI) (sum of single segments scores divided by total number of myocardial segments) and regional perfusion index (RPI) (number of normal perfused segments between the diskinetic ones divided by diskinetic segments). RPI varies from 0 to 1: when >0.5 it has been considered index of good perfusion. Ejection fraction (EF) and wall motion score index (WMSI) have been calculated within 48 h and at 6 weeks follow up. ST resolution (STR) has been evaluated at 90 min from procedure and it was considered significant when >70%. RESULTS: Patients have been divided into 2 groups by myocardial perfusion: group R (33 patients with RPI>0.5) and group NR (29 patients with RPI =/<0.5). The 2 groups were similar for age (group R: mean age 61 years old; group NR: mean age 64 years old, P=n.s.), glycoprotein inhibitors use (group R 90%, group NR 97%, P=n.s.), diabetes (group R 12%, group NR 17%, P=n.s.), hypertension (group R 22%, group NR 23%, P=n.s.), incomplete revascularization (group R 12%, group NR 10%, P=n.s.). Group NR has shown a major women percentage (33%) than group R (9%) P=0.026. In group R we have appreciated a trend to a major percentage of TIMI 2-3 flow preprocedure (66% vs 36%, P=n.s.), a shorter ischemic time (209 min vs 258 min, P=n.s.) and a major STR at 90 min (72% vs 53%, P=n.s.), not statistically significant. Echocardiographic analysis and MCE show a better myocardial perfusion in group R (RPI 0.7 vs 0.14 and PI 0.96 vs 0.86, P<0.0001); better left ventricular kinetics at 6 weeks follow up (EF 54.2% vs 50.8%, P=n.s. and WMSI 1.07 vs 1.2, P=0.014) but not in the acute phase (EF 46.8 vs 42.9 and WMSI 1.3 vs 1.34, P=n.s.) 30 days mortality is similar in the 2 groups (both 3%). CONCLUSIONS: Myocardial perfusion evaluation correlates with left ventricular contractility measured at 6 weeks from acute MI, but doesn't correlate with contractility in the acute phase or 30 days mortality.

Angioplasty, Balloon, Coronary↗
PubMed1996

[Acute myocardial infarction in pregnancy in a patient with pseudoaneurysm of the left main coronary artery].

Myocardial infarction during pregnancy is a rare event and it can be associated both with obstructive coronary artery disease and with functional conditions such as vasospasm. We report a 28-year-old woman without coronary artery disease risk factors, who suffered a Q infarction at 38th week of gestation, complicated by ventricular fibrillation. A healthy child was delivered by cesarean section and the woman made a full recovery. A coronary pseudoaneurysm was detected angiographically, suggesting an initial spontaneous coronary artery dissection followed by ectatic evolution. Coronary dissection associated with coronary vasospasm should be kept into account as etiopathogenetyc mechanisms of acute myocardial infarction.

Adult↗
PubMed1990

[Effects of hypertrophy on cardiac systolic and diastolic performance in athletes with mild hypertension].

Aims of the study has been the evaluation of morphological and functional aspects of left ventricle in subjects undergoing mild hypertension and sport adaptation effects. These evaluations have been carried out by Echo-Doppler both at rest and during sharp increase in after load induced by isometric stress. Together with the morphological parameters represented by mass index and by radius to thickness ratio, we have studied stroke volume and transmitral flow pattern assessing the maximum flow velocity during rapid filling phase (E), during atrial contraction phase (A) and their ratio (E/A). We have studied 31 male subjects from 39 to 60 (average 47) exercising twice or three times a week (in the main, aerobic sports such as road cycling). They were subdivided into two groups, the first included 16 subjects with mild hypertension (AP = 155 +/- 9/97 +/- 5 mmHg) the second included 15 normotensive subjects without known pathologies, comparable for age and body surface (AP = 125 +/- 15/77 +/- 10 mmHg). Hypertensive subjects exercising regularly, showed a mass index (164 +/- 42 g/m2) significantly higher than the controls (139 +/- 35 g/m2, P less than 0.01) but they ke a normal filling pattern at rest and similar stroke volume values. During isometric exercise instead, the velocities of E and A waves showed a different trend in the two groups with a higher reduction in E/A ratio in hypertensive subjects. The per cent decrease in this ratio turned out to be 15% in the control group and 33% in hypertensive subjects (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Non-fistulized aneurysm of the right sinus of Valsalva. Pre- and postoperative echocardiographic aspects].

The case considered concerns as 57 year-old patient who was submitted for heart tests because of a slight diastolic aortic murmur and hypertension. Echocardiographic investigation diagnosed an aneurysm of the sinus of Valsalva. The patient underwent a surgical intervention to reconstruct, on a dacron piece, the right sinus of Valsalva from which the aneurysmal cavity originated, retaining the aortic valve. After a short description of the etiology and the natural history of this condition we explain the importance of echocardiographic tests for the diagnosis and post-operative follow-up of these patients who run a high risk of severe and often lethal complications.

Aortic Aneurysm↗
PubMed1987

[Malfunctioning of the Meadox bioprosthesis placed in mitral position. Description of 2 clinical cases].

The Meadox valve, made up by a single bovine pericardial leaflet fixed in glutaraldehyde, is a "new-generation" bio-prostheses. In two patients those bio-prostheses revealed early malfunction with abnormal stretching of the valvular tissue. In both cases the beginning symptom was a strong fremitus caused by the vibration, during systole, of valvular leaflet. In the first case mechanical solicitation onsed partial laceration of valvular leaflet with subsequent regurgitation into the left atrium and cardiac failure. In both cases, the evaluation by Doppler Echocardiography and polygraphic examination, allowed the diagnose of malfunction which was confirmed at surgery. The replacement of a new prosthesis was successful in both cases.

Bioprosthesis↗
PubMed1981

Methodology for identification of serum middle molecules.

Filtration through membranes with different nominal cut-off was used for isolation of middle molecule fractions from uremic serum. Comparison was made with test substances which in gel filtration did not show a regular relationship between molecular weight and partition coefficient. The XM50 membrane (cut-off 50,000 D) showed the highest permeability to middle molecules (greater than 84%) whereas CF50 (same cut-off) retained middle molecules to some extent if filtration was carried out only once. The UM05 membrane (cut-off 500 D) was highly permeable for small molecules less than 300 D, intermediary permeable for molecules between 300 and 1000 D and retained molecules between 1,100 and 1,350 D more efficiently. It is concluded that filtration through membranes is a suitable method for identification of middle molecules.

Chromatography, Gel↗
PubMed1981

Vascular stability and middle molecules removal in hypertonic haemodiafiltration.

Hypertonic haemodiafiltration is a simultaneous hypertonic (delta 550, Na 275mEq/L) low volume (7.2 litres) haemofiltration and hypotonic (delta 282) short time (180') haemodialysis. Reduction of the predialysis body pool of MM (-48 per cent) and small molecules (-33 per cent) was obtained. No relationship between vascular stability and MM removal was observed. However, a net UF of 20.5ml/min and a greater removal of solutes up to 1500 daltons mw were obtained with a three hours thrice weekly dialysis programme.

Anuria↗
PubMedDate not supplied

[A 'lucky' patient].

A 72-year-old male diabetic patient admitted to our operative unit of nephrology and dialysis underwent hemodialytic treatment because of rapidly progressive renal failure. A moderate hypertensive state was associated to nephrotic proteinuria and microematuria. Renal angiography showed a severe stenosis of the right renal artery and a smaller left kidney. Right renal artery stenting induced a significant reduction in serum creatinine (Cr) and the patient discontinued with the dialytic treatment.

Acute Kidney Injury↗