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Biomedical subjects

C Rapezzi

Publications and source records attributed to C Rapezzi.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Risk of obstruction of secondary vessels in coronary angioplasty].

To define the risk of side branch occlusion during percutaneous transluminal coronary angioplasty (PTCA), 99 consecutive procedures, performed on 92 patients, were examined. In 77 of them side branches existed, originating from the stenosed segment; analysis was performed on 65 successful procedures (success rate = 84.4%). The 121 side branches were divided as follows: 53 (43.8%) originating from the stenosis itself (group A), of which 32 small in size (less than 1 mm) and 21 "moderate" (greater than or equal to 1 mm); 68 (56.2%) originating in the immediate vicinity of the stenosis (group B) of which 23 small and 45 moderate. After PTCA 3 side branches were occluded (2.5%): a small 1 of group A and 2 (1 small and 1 moderate) of group B. Three side branches (2.5%) all of group B, 1 small and 2 moderate, became stenotic in their take-off. In one only patient who had a side branch occlusion a slight CK-MB elevation (25 mU/ml) occurred together with a Q wave appearance in the aVL lead. In conclusion, side branches at risk are frequently present (in our population they account for 83.7% of the patients) but the real incidence of damage of these branches after PTCA is quite low, without any considerable difference between groups A and B, and significant clinical consequences are usually rare.

Angioplasty, Balloon↗
PubMed1984

Echocardiographic evaluation of the response to afterload stress test in young asymptomatic patients with chronic severe aortic regurgitation: sensitivity of the left ventricular end-systolic pressure-volume relationship.

The detection of myocardial depression is an important goal in the management of patients with chronic severe aortic regurgitation but may be quite difficult at an early stage by the conventional basal measures of contractility. The response to afterload stress determined by angiotensin challenge and the end-systolic pressure-volume relationship was evaluated echocardiographically in 16 asymptomatic or mildly symptomatic patients with chronic severe aortic regurgitation, ages 15 to 56 years (mean 32 +/- 12). Nine normal subjects, ages 25 to 41 years (mean 31 +/- 5), served as a control group. In the group with aortic regurgitation, end-systolic dimensions were greater than 55 mm in five of 16 patients and fractional shortening was 25% or less in two of 16. In the control group angiotensin caused a decrease of stroke volume index in six out of nine patients (15% at the most) and a mild increase in three. In the group with aortic regurgitation stroke volume index decreased by 15% or more of the basal value in nine of 16 patients and increased or decreased by less than 15% in seven of 16. Ejection fraction decreased in both groups, from 61 +/- 6% to 52 +/- 7% in the control group and from 56 +/- 6% to 45 +/- 5% in the group with aortic regurgitation. Ventricular function curves were derived by relating end-diastolic volume index to stroke work index; seven of 16 patients had abnormal responses reflecting an afterload mismatch.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1981

[Precordial mapping of the QRS complex and Frank's orthogonal ECG in evaluation of the myocardial infarct area. Comparison of the 2 methods].

Precordial mapping of QRS complex is a reliable tool in attempts to quantitate infarct size in patients with acute myocardial infarction. However the recording of multiple precordial leads is an expansive and time-consuming process; the purpose of this study is to investigate the usefulness of Frank's ECG as a substitutive method of infarct sizing. In a group of patients with acute myocardial infarction of the anterior wall many repeated precordial mappings with simultaneous recording of x, y, z leads of Frank's ecg were obtained (71 observations as a whole). Parameters provided by precordial mapping [delta R, delta Q, delta R + delta Q, delta R/delta (Q + S)] and by Frank's ecg (spatial vector voltage deviation of QRS or VSDV-QRS; spatial vector area deviation of QRS or VSDA-QRS; spatial vector R wave deviation or VSDR) were correlated each other by means of linear regression analysis. delta R + delta Q correlated significantly with VSDA QRS (r = 0.54; p less than 0.001) and with VSDR (r = 0.55; p less than 0.001) as regards the total of observations. The correlation coefficient was higher (r = 0.8; p less than 0.001) if comparison between delta R + delta Q and VSDA-QRS was restricted to early 48 hours from the beginning of the symptoms. This could be explained by the greater entity of QRS complex changes in this period, compared to the subsequent course. We conclude that Frank's ecg is an useful alternative method to precordial mapping in sizing the extension of myocardial necrosis.

Electrocardiography↗
PubMed1980

[Tetralogy of Fallot associated with total anomalous pulmonary venous drainage. Case report (author's transl)].

A case of a 12 year old girl who presented tetralogy of Fallot (T. o F.) associated with Total Anomalous Pulmonary Venous Drainage (TAPVD) is described. This association is extremely rare, only four autopsied cases being reported in literature. TAPVD is associated with complex cyanotic congenital heart diseases in about one third of cases; asplenia or polysplenia are generally present. Double outlet right ventricle (DORV) is the commonest trunco-conal malformation associated with TAPVD; extremely rare is T. o F. Pulmonary outflow tract obstruction can avoid the haemodynamic consequences due to obstruction on the venous channel, or progression to pulmonary hypertension. The association of the two malformations can masquerade the clinical and Xray picture of TAPVD and make difficult the diagnosis during cardiac catheterization.

Cardiac Catheterization↗
PubMed1979

[Atrioventricular canal associated with Fallot's tetralogy. Anatomo-clinical study of 2 cases].

The Authors are examing two cases of A-V canal associated with T. of Fallot. The most important clinical aspects of this rare cardiopathy result in the following: -- the frequent coexistence with Down dyndrome; -- the ECG and VCG aspects of counterclockwise rotation of the initial vectors of QRS in the frontal plane; -- the simultaneous observation of the typical echocardiographical aspects of both kinds of cardiopathy. The injection of dye into both ventricles allows the precise diagnosis. The post-mortem study in both cases shows the morphology of A-V canal associated with the one of T. of Fallot. From the surgical point of view it is important to take into account the abnormal morphology and extension of VSD. The importance of the part that the conal cushion plays in the morphogenesis of the malformation is discussed.

Adolescent↗
PubMedDate not supplied

Left ventricular volumes in liver cirrhosis.

BACKGROUND: Patients with alcoholic cirrhosis have left ventricular dimensions similar to controls. Few data have been reported in patients with cirrhosis of viral origin. AIM: To assess left ventricular dimensions in patients with pure viral cirrhosis. PATIENTS AND METHODS: Thirty patients with virus-related cirrhosis, 23 patients with alcoholic cirrhosis and 12 healthy controls were submitted to measurement of left ventricular volumes, cardiac output, mean arterial pressure and total peripheral resistance. RESULTS: Patients with cirrhosis showed a similar increase in cardiac index and heart rate and reduction of mean arterial pressure and peripheral vascular resistance in comparison to controls, irrespective of the aetiology. Left ventricular end systolic volume index was lower (p<0.01) and ejection fraction higher (p<0.01) in virus-related cirrhotic patients [mean +/- SD, respectively 12.4+/-4.1 ml/sqm and 77.9%) in comparison both to controls (21.5+/-6.3 ml/sqm and 66.8%) and alcoholics (20.6+/-7.0 ml/sqm and 68.8%). End diastolic volume index was not significantly different between the three groups. CONCLUSIONS: Our findings indicate smaller left ventricular volumes and higher ejection fraction in pure virus-related cirrhosis than in alcoholic cirrhosis and controls. Since peripheral haemodynamics proved similar in virus- and alcohol-related cirrhosis, a subclinical alcohol cardiomyopathy may be hypothesised to account for the absence of such left ventricular pattern in alcoholic patients.

Blood Pressure↗