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E Vitolo

Publications and source records attributed to E Vitolo.

At least 37 records · Page 2Linked to original sources
PubMed1980

[Electrocardiographic exercise test in assessment of hemodynamic patterns of mitral stenosis (author's transl)].

An ECG exercise test was performed in 36 patients with mitral stenosis, all in sinus rhythm and without digitalis therapy. In 21 subjects (group I = 58.6%) the test was negative, in the other 15 (group II = 41.7%) ischemic abnormalities of the ST segment were recorded during exercise; the mean value for the age is the same in both groups. All patients underwent cardiac catheterization; pulmonary pressure--and in 15 patients also cardiac output with thermodilution technique--were measured at rest and during the same exercise used for the ECG test. No relationship was found between ECG response and pulmonary capillary pressure (PCP), neither at rest nor during exercise, while exercise pressure values were well correlated with those at rest. The group I cardiac index (IC) and systolic index (IS) are significantly higher than in group II; the difference is remarkably more evident for the same indexes recorded during exercise, with splitting values, between the two groups, of 5000 ml/min/m2 for IC and 40 ml/beat/m2 for IS. Heart rate changes induced by exercise were similar in both groups, thus confirming the importance of the behaviour of output indexes. It is therefore possible to identify in mitral disease hemodynamic patterns due to different grouping of pathological features above (PCP) and below (IC) the valvular stenosis. Various hypothesis could be made in order to interpret the relationship between cardiac output and ischemic response to exercise. Anyway our results indicate that exercise ECG test is a non invasive technique useful to identify, among patients affected by mitral stenosis, those with a low IC and, mainly, those in whom this parameter fails to increase adequately with exercise.

Adult↗
PubMed1980

[Role of M-mode and 2-dimensional (sector-scan) echocardiography in studying postinfarct ventricular kinetic changes].

20 patients with previous myocardial infarction clinically suspected to have large impairment of ventricular wall kinesis were studied to evaluate the contribution of M-mode and two-dimensional echocardiography compared with the cineangiographic study in detecting left ventricular asynergy. Two-dimensional cross-sectional echocardiography yielded a satisfactory overlapping of results with ventriculography as far as left ventricular internal dimension and apical and posterior wall kinesis were concerned. The two-dimensional study proved to be an useful technique to observe the interventricular septum, in all its extension and the lateral wall as well. The M-mode technique, on the other hand, provided a reliable method, by means of the mitral valve echo, to determine the presence of elevated left-ventricular end-diastolic pressure; this was indicated by the occurrence of a B point, on the AC slope. A late opening of the mitral valve compared with the onset of left ventricular posterior wall relaxation phase, and other anomalies observed on the CD slope (SAM or pseudo-SAM), indicated pathological left ventricular kinesis. The failure of the left ventricular posterior wall to reach the septum moving the transducer from the aorta to the cardiac apex was considered indicative of apical dilatation, even if limited by a great number of false negatives. M-mode echocardiography provided also a quantitative evaluation of septal and postero-basal wall movement (particularly important from a prognostic point of view) and left ventricular end-diastolic dimension which, if corrected by body surface, resulted similar to those obtained by the two-dimensional technique. M-mode and Two-dimensional cross sectional echocardiography appeared to be complementary techniques which allow an adequate evaluation and diagnosis of left ventricular asynergy. They seem to be particularly useful to follow prospectively patients affected by myocardial infarction.

Adult↗
PubMed1977

[A contribution to ergometric tests in the definition of gravity of mitral stenosis. The importance of the behavior of the left ventricular function, not always correlation to hemodynamic alterations above the valve (author's transl)].

An attempt to evaluate the severity of the valvulopathy was performed in 50 patients with pure mitral stenosis, 36 females and 14 males, by a haemodynamic study and by an exercise test. In 76% of the cases, electrocardiographic "ischemic" abnormalities were observed during the exercise test; after the exclusion of patients over 45, and patients with atrial fibrillation and/or digitalis treatment, a high frequency (63,15%) of electrocardiographic ischemic changes with effort is still observed. No correlations between the result of the exercise test either with pulmonary pressure values, or with other haemodynamic data (cardiac index and pulmonary vascular resistances) were demonstrated. The electrocardiographic abnormalities induced by exercise in these patients are discussed; the authors conclude that this behaviour under effort is significant for the importance of the impairment of the left ventricle function in mitral stenosis.

Adult↗