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Biomedical subjects

A Soricelli

Publications and source records attributed to A Soricelli.

At least 19 recordsLinked to original sources
PubMed1995

Dobutamine echocardiography predicts improvement of hypoperfused dysfunctional myocardium after revascularization in patients with coronary artery disease.

BACKGROUND: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either necrotic or viable hibernating myocardium. The accuracy of inotropic stimulation in identifying hypoperfused, reversibly dysfunctional myocardium has not been extensively investigated. METHODS AND RESULTS: Eighteen patients with stable chronic coronary artery disease underwent, while off drugs, quantitative 201Tl single-photon emission computed tomography after rest injection (2 to 3 mCi), two-dimensional echocardiography at rest and during dobutamine (5 to 10 micrograms/kg per minute i.v.), and radionuclide angiography. Single-photon emission computed tomography and echocardiography at rest were repeated 34 +/- 10 days after coronary revascularization, and radionuclide angiography was repeated 45 +/- 13 days after revascularization. Resting hypoperfusion was defined as 201Tl uptake < 80% of maximal activity. Systolic function was scored from 1 (normal) to 4 (dyskinesia), and functional improvement was defined as a score change > 1 grade. Of 79 dysfunctional hypoperfused segments, 48 (61%) improved function after revascularization. In 42 (88%) of these latter segments, function had improved during dobutamine. Conversely, systolic function after revascularization did not improve in 31 segments, and in 27 (87%), it had not improved during dobutamine. Functional improvement after revascularization was observed in 42 (91%) of 46 segments manifesting an improvement during dobutamine as opposed to 6 (18%) of 33 segments that did not improve during dobutamine. Resting 201Tl uptake (% of maximal activity) before revascularization (65 +/- 9%) significantly increased at follow-up in segments where function improved (70 +/- 12%, P < .005), whereas it did not change significantly in segments with unchanged systolic function after revascularization (from 57 +/- 13% to 60 +/- 17%, P = NS). In 10 patients with prerevascularization ejection fraction < 45%, left ventricular ejection fraction significantly increased from 36 +/- 7% before revascularization to 42 +/- 7% at follow-up (P < .05). CONCLUSIONS: Inotropic stimulation using dobutamine echocardiography identifies hypoperfused reversibly dysfunctional myocardium. Functional improvement during dobutamine is highly predictive of improvement after revascularization.

Aged↗
PubMed1995

Effect of adenosine on cerebral blood flow as evaluated by single-photon emission computed tomography in normal subjects and in patients with occlusive carotid disease. A comparison with acetazolamide.

BACKGROUND AND PURPOSE: Acetazolamide is commonly used with single-photon CT to assess the cerebrovascular reserve in patients with internal carotid artery stenosis or occlusion. In this study we wanted to evaluate the effects of adenosine, a well-known vasodilatatory compound with a short biological half-life, on brain circulation in humans and compare the results with those of acetazolamide. METHODS: Acetazolamide (1 g) and adenosine (140 micrograms/kg per minute) were injected intravenously on different days in 6 normal subjects and 6 patients: 4 with unilateral stenosis, 1 with bilateral stenosis, and 1 with complete occlusion of the internal carotid artery. Changes in regional cerebral blood flow relative to that of the cerebellum (cortico/cerebellar ratios) from resting conditions were evaluated by 99mTc-hexamethylpropyleneamine oxime and single-photon emission CT. RESULTS: The measured blood flow ratios increased significantly in the normal group 20 minutes after acetazolamide injection in several cortical and subcortical regions, as well as at the 4th minute of a 6-minute adenosine infusion. Regional cerebral blood flow ratio values were higher after adenosine than after acetazolamide in both cortical (frontal and parietal) and subcortical (thalamus and basal ganglia) regions. In 4 of the 6 patients the side-to-side asymmetry increased from the basal resting condition after the injection of acetazolamide and even more so after the injection of adenosine. CONCLUSIONS: Adenosine infusion causes vasodilation of cerebral arteries and can be used for the investigation of cerebrovascular perfusion capacity in patients with carotid occlusive disease. One advantage in the use of adenosine over acetazolamide is the possibility of interrupting the test with reversal of clinical symptoms or patient discomfort within a few minutes.

Acetazolamide↗
PubMed1995

Enhanced detection of viable myocardium by technetium-99m-MIBI imaging after nitrate administration in chronic coronary artery disease.

UNLABELLED: The aim of this study was to assess whether nitrate administration improves the imaging capabilities of 99mTc-MIBI tomography in detecting viable myocardium in coronary artery disease (CAD). METHODS: Thirty-one patients with angiographically proven CAD and chronic LV dysfunction (ejection fraction 39% +/- 9%) underwent two 99mTc-MIBI studies on separate days: one under rest conditions and the other after nitroglycerine (0.005 mg/kg per os) administration. Within 1 wk, all patients also underwent rest-redistribution 201Tl imaging. Eight patients were also studied by echocardiography before and 5 +/- 3 mo after coronary revascularization. RESULTS: On resting 99mTc-MIBI images, 302 segments had normal uptake, 183 segments had moderately reduced uptake and 197 had severely reduced uptake. Of the segments with severely reduced uptake, 54 (27%) had increased uptake after nitroglycerine and were viable on 201Tl images. Of the 143 (73%) segments with severely reduced 99mTc-MIBI uptake and no change after nitroglycerine, 81% were nonviable on 201Tl images. In the eight patients studied before and after revascularization, 87% of segments with reversible 99mTc-MIBI defects and abnormal LV function demonstrated functional recovery after revascularization, whereas 89% of segments with irreversible 99mTc-MIBI defects did not. CONCLUSION: In patients with chronic ischemic LV dysfunction, nitrate administration improved the detection of severely hypoperfused but still viable myocardium on 99mTc-MIBI images.

Coronary Circulation↗
PubMed1995

Myocardial viability index in chronic coronary artery disease: technetium-99m-methoxy isobutyl isonitrile redistribution.

UNLABELLED: The purpose of this study was to evaluate whether an additional redistribution image after a rest 99mTc-MIBI injection enhances detection of viable myocardium and predicts functional recovery after coronary revascularization in patients with chronic coronary artery disease (CAD). METHODS: Thirty-one patients (29 men, mean age 55 +/- 10 yr) with proven CAD and left ventricular (LV) dysfunction (ejection fraction 39% +/- 9%) underwent resting 99mTc-MIBI tomography with initial (1 hr) and delayed (5 hr) images. Within 1 wk of MIBI imaging, all patients underwent rest-distribution 201Tl imaging. Eight patients also underwent two-dimensional echocardiography before and 5 +/- 3 mo after coronary revascularization. RESULTS: On the initial 99mTc-MIBI images, 302 myocardial segments were normal, 183 showed moderate and 197 severe reduction of tracer uptake. Of these 197 segments, 47 (24%) demonstrated increased tracer uptake (> or = 10% versus initial) on delayed images (from 43% +/- 8% to 60% +/- 8%, p < 0.001) and were considered as showing 99mTc-MIBI redistribution. These 47 segments were observed in 20 (65%) patients in whom 201Tl images detected viable myocardium in the same segments. In the eight patients studied before and after revascularization, 83% of segments with 99mTc-MIBI redistribution and abnormal LV function showed functional recovery after revascularization, while 96% of segments without 99mTc-MIBI redistribution did not show functional recovery. CONCLUSION: Resting 99mTc-MIBI redistribution frequently occurs in patients with chronic CAD. Acquisition of 99mTc-MIBI redistribution images enhances detection of viable myocardium and predicts functional recovery after revascularization.

Coronary Disease↗
PubMed1995

Correlative morphologic and functional imaging for diagnosis, staging and follow up in AIDS: an overview.

The immunocompromised patient can be affected by different opportunistic infections and tumors, that can involve all organ systems, and particularly, the central nervous system, the respiratory system, the gastrointestinal tract. The extreme variability of AIDS presentations requires a specific preparation and cooperation between the different diagnostic imaging specialists and a close collaboration with the clinicians. With AIDS, different morphologic and functional imaging techniques can be used for detection of disease sites, assessment of the extent of the disease and monitoring of disease changes over time and response to treatment. The complexity of AIDS presentations is such that full integration of the complementary information obtained with different techniques could be most useful. Image registration (coregistration, fusion) indicates approaches where precise spatial cross-references are obtained, in order to combine the information acquired with different imaging modalities, in particular by blending morphologic CT/MRI data with functional SPET/PET data. In this paper, an overview of the developments in the field of "image fusion" follows some comments on the results of morphologic and functional assessment of brain, chest and abdominal diseases in the course of AIDS, as illustrative examples of the potential benefits of multimodality image correlation.

AIDS-Related Opportunistic Infections↗
PubMed1995

Technetium-99m-tetrofosmin regional myocardial uptake at rest: relation to severity of coronary artery stenosis in previous myocardial infarction.

UNLABELLED: The aim of this study was to assess the potential role of 99mTc-tetrofosmin cardiac tomography in detecting totally occluded or severely stenosed coronary arteries. METHODS: Thirty-three patients (32 men, 1 woman; mean age, 52 +/- 9 yr) with chronic coronary artery disease (CAD) and left ventricular dysfunction (ejection fraction 40% +/- 12%) underwent resting 99mTc-tetrofosmin SPECT and coronary arteriography within 2 wk. Regional distribution of 99mTc-tetrofosmin activity was compared with the coronary anatomy. Tracer uptake was quantitatively analyzed in 22 segments for each patient. The activity in each segment was expressed as a percent of the peak activity. RESULTS: A significant relationship between the degree of coronary artery stenosis and 99mTc-tetrofosmin uptake was observed (p = -0.64, p < 0.001). Technetium-99m-tetrofosmin uptake was lower (p < 0.001) in segments with 100% coronary occlusion with poor collateral flow (53% +/- 17%) compared to segments supplied by a vessel with 50%-99% coronary stenosis (75% +/- 20%) or a normal noncritically stenosed artery (85% +/- 10%). Furthermore, 99mTc-tetrofosmin uptake was lower (p < 0.01) in segments with 100% coronary occlusion with poor (53% +/- 17%) compared to those with good collateral flow (70% +/- 20%). CONCLUSION: These results demonstrate that quantitative analysis of resting 99mTc-tetrofosmin regional uptake detects the majority of segments supplied by occluded coronary arteries with poor collateral flow and suggest that this tracer may be helpful in the diagnosis of acute myocardial infarction.

Adult↗
PubMed1994

Adenosine technetium-99m-methoxy isobutyl isonitrile myocardial tomography in patients with coronary artery disease: comparison with exercise.

UNLABELLED: We compared the results of adenosine and bicycle exercise 99mTc-methoxy isobutyl isonitrile (MIBI) myocardial SPECT in 22 patients (18 males and 4 females, mean age 51 +/- 11 yr) with angiographically documented coronary artery disease (CAD). METHODS: All patients were submitted on separate days to three intravenous injections of 99mTc-MIBI (20 mCi); one at rest, one during exercise and one during adenosine (140 micrograms/kg per min for 6 min with injection of 99mTc-MIBI at 4 min). A total of 484 myocardial segments were quantitatively analyzed. RESULTS: Adenosine induced a significant increase of heart rate (94 +/- 16 bpm at peak versus 70 +/- 13 bpm at rest, p < 0.01). Systolic and diastolic blood pressure were not significantly different after adenosine infusion compared to rest. In all segments, a significant relationship between exercise and adenosine 99mTc-MIBI uptake was observed (r = 0.90, p < 0.0001). Concordance between the two studies for identification of perfusion status was observed in 438 (90%) of the 484 segments (kappa value of 0.81). Agreement on localization of the perfusion defect to a specific vascular territory was 92%. CONCLUSION: Despite different hemodynamic effects, adenosine and exercise 99mTc-MIBI SPECT imaging provide similar information in the diagnosis and localization of CAD.

Adenosine↗
PubMed1991

Relative protection from cerebral atherosclerosis of young patients with homozygous familial hypercholesterolemia.

It is well known that hypercholesterolemia is correlated with coronary atherosclerosis, but no definite information is available on its association with cerebrovascular atherosclerosis. We studied 10 young patients (age 3-32 years) with homozygous familial hypercholesterolemia (FH), together with 3 normal relatives as healthy controls. Extra- and intracranial Doppler examination, MRI and cerebral blood flow by SPECT and 99mTc-HM-PAO were performed on all. Six out of 10 patients already had signs and symptoms of coronary heart disease, but all patients were free from ischemic brain lesions, as small as detectable at MRI, and had normal cerebral blood flow. Two patients presented significant stenosis of the carotid arteries at Doppler examination. Young patients with homozygous FH have early and clinically evident coronary atherosclerosis, while overt disease in the cerebral district is delayed despite the extremely elevated plasma cholesterol concentration. This was also confirmed by the autopsy of two patients, who died after the study and whose cerebral arteries were totally free from atherosclerotic lesions. The age, at which flow-reducing atherosclerotic lesions develop in hypercholesterolemic patients, differs with regard to the arterial district involved.

Adolescent↗
PubMed1991

Effect of acute administration of L-acetyl carnitine on cerebral blood flow in patients with chronic cerebral infarct.

The effect of L-acetyl carnitine (L-AC) on cerebral blood flow (CBF) was evaluated in 20 patients with chronic cerebrovascular disease, who suffered an ischaemic stroke at least 6 months before the study. All patients performed a CT scan and were investigated with xenon-133 by brain dedicated single photon emission computed tomography (SPECT, Tomomatic 32, Medimatic Inc., Copenhagen). A single high dose (1.5 g) of L-acetyl carnitine was intravenously administered to 10 patients, while sodium acetate as placebo was injected to 10 other subjects. Cerebral blood flow (ml/min x 100 g) was evaluated before and 45 min after the injection. No changes were observed after placebo injection (43 +/- 12 ml/min x 100 g versus 43 +/- 10 ml/min x 100 g). CBF increased (from 42 +/- 9 ml/min x 100 g to 46 +/- 9, P less than 0.05) in both ipsilateral and contralateral hemisphere, the ischaemic area, but not in the stroke corresponding zone. It was concluded that L-acetyl carnitine at the i.v. dosage of 1.5 g acutely enhanced CBF in patients with chronic cerebral infarct.

Acetylcarnitine↗
PubMed1991

Mixed transcortical aphasia: clinical features and neuroanatomical correlates. A possible role of the right hemisphere.

This paper reports the clinical features of 2 patients affected by mixed transcortical aphasia. Both of them had extensive damage of the left hemisphere. Cerebral blood flow measurement showed a marked decrease in left-hemisphere flow. In particular, speech areas were found to be morphologically and functionally damaged. The present findings, together with a critical review of the literature, served as a starting point for a discussion of linguistic features, diagnostic criteria and classical neuroanatomical interpretation of mixed transcortical aphasia. The possible contribution of the right hemisphere in determining this aphasic syndrome is suggested.

Aged↗
PubMed1990

Cerebral blood flow in patients with chronic cerebrovascular disease: effect of acetyl L-carnitine.

The effect of acetyl-L-carnitine on cerebral blood flow was evaluated in ten patients with cerebrovascular disease, who suffered an ischaemic stroke at least six months before the study. All patients performed a computerized tomograph scan and were investigated by Xenon 133 using a brain dedicated Single Photon Emission Computerized Tomography. Acetyl-L-carnitine was administered intravenously (i.v.) at a dosage of 1.5 g. Cerebral blood flow (ml/min. 100 g) was evaluated before and 45 min after the injection. Cerebral blood flow improved in both the ispilateral and controlateral hemisphere of the ischaemic area, but not in the stroke corresponding zone. It is concluded that acetyl-L-carnitine at a dosage of 1.5 g i.v. improves cerebral blood flow in patients with cerebrovascular disease.

Acetylcarnitine↗
PubMed1987

Cerebral blood flow in thalamic aphasia.

A 59-year-old man is reported, who became aphasic after left thalamic infarction, shown by CT. His speech was fluent, with reduced voice volume, impaired auditory and reading comprehension, verbal paraphasias but intact repetition skills. A single photon emission computed tomography (SPECT) scan to measure regional cerebral flow (rCBF) showed a reduction of flow in the parietotemporal areas of the left hemisphere. It is suggested that thalamic aphasia could result from structural subcortical damage with a homolateral functional cortical deficit leading to the specific aphasic disturbance.

Aphasia↗
PubMed1980

[Effect of atropine on hypophyseal gonadotropins in the basal condition and under GnRH stimulation].

The Authors have tested serum levels of LH and FSH in 10 healthy males after stimulation test with GnRH preceded by administration i.m. of 1 mg. of atropine 10' and 1 hour before the test, to examine some interferences of the drug on ipophisary gonadotropins. Atropine has no effect on LH and FSH release because there are no differences between mean values of the hormones during the test with and without atropine, at any time it is administered. All the data obtained have been controlled with Student's "t" test.

Adult↗
PubMed1980

[Effects of pentobarbital on serum PRL and TSH in the basal condition and under TRH stimulation in man: preliminary note].

The Authors have tested serum levels of PRL and TSH in six healthy males, anaesthesized with 20 mg./Kg. body weight of pentobarbital with and without stimultion with TRH. PB has no effect on serum levels of TSH but there is an inhibition of PRL release 180', 240' and 360' after the administration of the drug. The AA. have found no effects of PB on the stimulation test with TRH. All the data obtained have been examined with Student's "T" test.

Adult↗
PubMed1980

[Effects of pentobarbital on serum levels of LH and FSH, in normal conditions and after GnRH stimulation: preliminary report].

The authors have tested serum levels of LH and FSH in healthy males anaesthetized with 20 mg/Kg body weight of pentobarbital, and stimulation test with GnRH. LH has reached levels higher than the stimulation test has been practised in the anaesthetized volunteers than in subjects awakes. The AA. have also showed that there is no effect on psychic stress and of atropine, used as preanaesthetic drug, on serum levels of the pituitary hormones. At the end, PB has no effect on serum levels of FSH.

Adult↗