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Biomedical subjects

C Vigorito

Publications and source records attributed to C Vigorito.

At least 91 records · Page 5Linked to original sources

[The use of echocardiography for diagnosis of right ventricular hypertension (author's transl)].

Echocardiographic right ventricular wall thickness (RVWT) and right ventricular dimension (RVD) were performed in 65 patients, undergoing diagnostic heart catheterization. Patients were divided in two groups: 28 patients with right ventricular hypertension (group 1) and 37 patients with normal right ventricular systolic pressure (RVSP) (group 2). 24 patients of group 1 (85.7%) had increased RVWT and 34 patients of group 2 (91.9%) had normal RVWT. In group 1 RVSP was significantly correlated with RVWT (r = 0.92; p < 0.001); an inverse correlation was found between RVSP and RVD (r = -0.63; p < 0.001). Non significative correlations were found in group 2. Our study proves that the echocardiographic evaluation of RVWT can be helpful in separating patients with right ventricular systolic hypertension from patients with normal values of RVSP, and that a positive correlation exists between the increase of RVWT and the increase of RVSP.

Adolescent↗

[Stenosis of the common trunk of the left coronary artery. Personal experience with 17 patients].

The Authors have presented the clinical, hemodynamic, coronary arteriographic and left ventriculographic findings, and the results of medical and surgical treatment in 17 patients with main left coronary artery disease (MLCA). Clinically MLCA disease can only be suspected, in the AA's experience, if a patient presents with markedly positive exercise stress test and/or unstable angina. Coronary arteriography and left ventriculography confirmed the high incidence of associated 2-3 vessel coronary artery disease and of severe left ventricular segmental wall motion abnormalities. Surgical results and clinical follow up have indicated a better prognosis and quality of life in operated, compared with medically treated patients. Our experience confirms that MLCA disease is a dangerous clinical entity, which, when suspected, must be managed with proper indication to coronary arteriography and aorto-coronary bypass surgery, both associated, in our experience, with acceptable morbidity and mortality and good long term results.

Aged↗

Anterior S-T changes during acute inferior myocardial infarction.

We investigated the clinical course of 57 patients with acute inferior myocardial infarction as regards anterior S-T segment depression. Thirty of them showed S-T segment depression greater than or equal to 0.15 mV in at least 2 precordial leads, and 27 did not exhibit such changes. Twenty-seven patients underwent post-infarction exercise stress test. Furthermore, coronary arteriographic findings and left ventricular performance were evaluated in 8 of these patients with and in 8 without anterior S-T segment depression. Patients with anterior S-T segment depression showed greater inferior S-T segment elevation on admission ECG and deeper Q wave in lead aVF in ECG tracings recorded 1 month later. Higher incidences of in-hospital angina (10/30 vs 2/27, P = 0.01) and of late development of cardiac failure (5/21 vs 0/19, P = 0.03) were found among patients with anterior S-T segment depression. They showed a higher overall coronary score (82.4 +/- 31.0 vs 32.5 +/- 28.9, P = 0.002) and left anterior descending artery score (44.1 +/- 20.7 vs 8.5 +/- 16.1, P = 0.0009) and a reduced ventricular performance, evaluated by ventriculography score (49.5 +/- 2.7 vs 51.8 +/- 2.4, P = 0.05). A higher incidence of mitral regurgitation, secondary to papillary muscle dysfunction, was also found among patients with anterior S-T segment depression (4/8 vs 0/8, P = 0.04). Furthermore, the degree of anterior S-T segment depression in each of these subjects was closely correlated with the corresponding difference from normal ventricular score (r = 0.86, P less than 0.01). Finally, no difference between the two groups of patients was found as to incidence of positive exercise stress tests.

Coronary Angiography↗

Cardiovascular effects of histamine infusion in man.

Histamine (H) is stored in man in the cardiovascular as well as in other systems, from where it can be released under exposure to immunologic and nonimmunologic stimuli. To understand better the hemodynamic changes produced in man by endogenous H release, we infused H for 3.5-7 min at the rate of 0.4 microgram/kg/min i.v. in four patients with normal left ventricular (LV) function undergoing diagnostic cardiac catheterization. We observed a significant fall in systolic, diastolic, and mean aortic pressure, systemic vascular resistance, LV end-diastolic pressure, and stroke index, and a significant rise in heart rate, cardiac output, and LV dP/dtmax, with small changes in mean pulmonary arterial pressure and pulmonary vascular resistance. During infusion there was also a significant rise in plasma H, epinephrine, and norepinephrine. All hemodynamic changes started 1-2 min after the beginning of H infusion and reverted to normal within 5 min from the end of the infusion. Subjective complaints were mild and transient in all patients. One patient progressed from first- to third-degree atrioventricular block, with prompt recovery of 1:1 atrioventricular conduction at the end of infusion. Thus, exogenous H administration in man at the rate of 0.4 microgram/kg/min produces significant and transient hemodynamic changes, mainly represented by systemic hypotension, tachycardia, and increased LV performance. These latter can be attributed to the associated increase in sympathoadrenergic activity, although a direct cardiac effect of H cannot be excluded.

Aged↗

Direct coronary vasodilator effects of intracoronary histamine administration in humans.

Histamine is widely present in human tissues and can be released by immunologic and nonimmunologic reactions. Although several direct cardiovascular effects of histamine have been demonstrated in humans, little is known about the direct effects of histamine on the human coronary circulation in vivo. Therefore, we investigated the changes in coronary hemodynamics induced by bolus intracoronary administration of 4 micrograms of histamine to 11 patients with angiographically normal coronary arteries under continuous monitoring of R-R interval from the electrocardiogram, arterial pressure (AP), and coronary sinus blood flow (CBF), measured by thermodilution. Immediately after the end of the intracoronary histamine bolus, with R-R interval and AP unchanged, CBF increased from 144 +/- 20 to 238 +/- 27 ml/min (p less than 0.01) and coronary vascular resistance decreased from 0.7 +/- 0.16 to 0.42 +/- 0.1 mm Hg/ml/min (p less than 0.01). No change in coronary hemodynamics was observed after bolus intracoronary administration of physiologic saline. The effects of histamine on systemic hemodynamics consisted of a transient fall in AP and R-R interval, starting after the onset of changes in coronary hemodynamics. These data show that histamine possesses a direct coronary vasodilator effect in humans, independent of the determinants of myocardial oxygen consumption.

Adult↗