Biomedical subjects

B Restivo

Publications and source records attributed to B Restivo.

4 recordsLinked to original sources

PubMed1982

Persistent atrial quiescence in adult rheumatic heart disease.

The first adult patient with catheterization-proven isolated rheumatic heart disease who demonstrated the electrophysiologic findings of "persistent atrial quiescence" is described. Metabolic causes of transient atrial sequence were effectively excluded by clinical history and appropriate laboratory studies. Atrial quiescence may be the electrophysiologic expression of end-stage rheumatic atrial pathology seen only in cases of advanced, surgically uncorrected rheumatic mitral valve disease.

Adult↗

PubMed1980

Potential pitfalls of the nuclear stethoscope.

Eleven patients (three with coronary artery disease, one with mitral valve prolapse, one with atrial septal defect, two with rheumatic mitral valve disease, one with rheumatic aortic valve disease, and three normal individuals) underwent determination of global left ventricular ejection fraction (LVEF) by 1) nuclear stethoscope (cardiac probe), 2) Tc-99m-labeled-erythrocyte gated nuclear angiocardiographic gamma camera-computer techniques, and 3) single plane RAO contrast left ventriculography--all within a 6-hour period without concurrent drug intervention. In addition, global right ventricular ejection fraction (RVEF) was determined by a similar gated technique with gamma camera-computer techniques. LVEF as determined by camera-computer techniques correlated well with that of contrast ventriculography (r = 0.95) in this heterogenous group of subjects. LVEF as determined by cardiac probe correlated somewhat less well with that of contrast ventriculography (r = 0.59). Two cases are described in which, although cardiac probe data were highly reproducible, gross overestimation of the true global LVEF was thought to occur due to the malpositioning of the probe over either the right ventricle or the most contractile portion of the left ventricle in patients with coronary artery disease.

Adult↗

PubMed1980

Left ventricular dysfunction--bedside Valsalva manoeuvre.

Thirty-seven patients were evaluated before cardiac catheterisation by bedside physical examination, including Valsalva manoeuvre, to assess the value of the sphygmomanometrically determined arterial pressure responses during the Valsalva manoeuvre and to compare its sensitivity, specificity, and predictive accuracy in the detection of left ventricular dysfunction with that of the commonly used diagnostic signs including the chest x-ray. Patients not on beta-blockade treatment could be separated into three distinct arterial pressure responses detectable at the bedside which corresponded well to three statistically different groups with regard to left ventricular ejection fraction (0.29 +/0 0.11, 0.48 +/0 0.15, 0.69 +/0 0.11) and left ventricular end-diastolic pressure (38 +/- 5 mmHg, 24 +/- 10 mmHg, 14 +/- 5 mmHg) at subsequent cardiac catheterisation. In patients not on beta-blockade it was shown for the first time that (1) the height of the systolic arterial pressure overshoot was directly related to left ventricular ejection fraction and inversely related to left ventricular end-diastolic pressure, and that (2) the bedside sphygmomanometrically determined arterial pressure response during Valsalva manoeuvre provided a semiquantitative estimate of left ventricular function and was unsurpassed in its ability to do so by any of the standard diagnostic signs including the chest x-ray film.

Blood Pressure↗

PubMed1975

Adherence and blood-pressure response to hypertension treatment.

2 years of experience in the first phase of a large cooperative national hypertension programme yielded data indicating that a good level of patient adherence can be achieved and that satisfactory blood-pressure control can be maintained long term. For 116 participants, all employed persons, dropout in the first year was 20% but only 3% dropped out in the second year. At the second annual examination, 82% of those still in the programme had diastolic pressures under 90 mm Hg, with an average reduction of 18 mm Hg. Thus, nearly two-thirds (64%) of all patients originally enrolled were both active and with normal levels of blood-pressure after two years. Only 18% of active programme-treated patients had diastolic pressure 90 mm Hg or higher at the second anniversary in contrast with 33% of patients referred to their own doctors. In programme-treated patients, standard medication was used; diuretics effectively lowered blood-pressure in a third of patients, and diuretics plus reserpine were effective for another 20%. Special features of the programme included assistance to physicians by health counsellor therapists. Methods for achieving a high adherence-rate and satisfactory blood-pressure control probably have wider applicability.

Adult↗