Biomedical subjects

Elena Tortorici

Publications and source records attributed to Elena Tortorici.

3 recordsLinked to original sources

PubMed2005

Reverse ventricular remodeling and improved functional capacity after ventricular resynchronization in advanced heart failure.

BACKGROUND: Ventricular resynchronization is a non-pharmacological treatment for advanced heart failure refractory to drug therapy and with intraventricular conduction delay. We describe the time course of echocardiographic and functional recovery after resynchronization in 31 patients (mean age 67 +/- 8 years). METHODS: We evaluated NYHA class, echocardiogram, respiratory function, and cardiopulmonary test before pacemaker implantation (baseline), after 1-3 months (short-term evaluation), and 10-15 months afterwards (long-term evaluation, n = 21 patients). Mortality at 1 year was considered. RESULTS: Both at short and long-term, patients improved NYHA class, ventricular function, and ventricular volumes. Already at short-term, we observed an increase in oxygen consumption at peak exercise (12.6 +/- 0.6 vs 10.5 +/- 0.5 ml/kg/min), oxygen consumption at anaerobic threshold (9.8 +/- 0.6 vs 8.3 +/- 0.6 ml/kg/min) and oxygen pulse (8.3 +/- 0.5 vs 7.5 +/- 0.5 ml/beat). Ventilatory efficacy (VE/VCO2 slope) and alveolo-capillary diffusion (estimated by the measurement of lung diffusion capacity for carbon monoxide - DLCO) improved only at long-term (VE/VCO2: 40.7 +/- 1.6 vs 45.3 +/- 1.8; DLCO: 70.3 +/- 2.7 vs 59.4 +/- 5.9% of predicted, p = 0.05). The 1-year mortality was 9.7%. CONCLUSIONS: Ventricular resynchronization is linked to a fast and prolonged recovery of NYHA class, echocardiographic variables and stress tolerance. The improvement of indexes known to carry a prognostic value confirms that ventricular resynchronization can positively interfere with the evolution of the disease.

Aged↗

PubMed2003

Daily life blood pressure changes are steeper in hypertensive than in normotensive subjects.

Target organ damage in hypertensive patients is related to their increased average blood pressure and greater 24-hour blood pressure variability. Whether the rate of blood pressure changes is also greater in hypertension, producing a greater stress on arterial walls, is not known, however. Our study aimed at addressing this issue by computer analysis of 24-hour ambulatory intra-arterial blood pressure recordings in 34 subjects (29 males), 13 normotensive subjects and 21 uncomplicated hypertensive subjects (mean age+/-SD, 40.4+/-11.8 years). The number, slope (mm Hg/s), and length (beats) of systolic blood pressure ramps of 3 or more consecutive beats characterized by a progressive increase (+) or reduction (-) in systolic blood pressure of at least 1 mm Hg per beat were computed for each hour and for the whole 24-hour period. Twenty-four-hour average systolic blood pressure was 112.9+/-2.1 and 159.4+/-5.7 mm Hg in normotensive and hypertensive subjects, respectively. Over the 24 hours, the number and length of systolic blood pressure ramps were similar in both groups, whereas the slope was markedly different (24-hour mean+/-SE slope, 4.80+/-0.30 in normotensives and 6.50+/-0.40 mm Hg/s in hypertensives, P<0.05). Ramp slope was not influenced by age or reflex pulse interval changes, but it was greater for higher ramp initial systolic blood pressure values. Thus, in daily life, hypertensive subjects are characterized by steeper blood pressure changes than normotensives, and this, regardless of the mechanisms, may have clinical implications, because it may be associated with greater traumatic effect on the vessel walls of hypertensive patients.

Adult↗

PubMed2003

Assessment of overall blood pressure variability and its different components.

Blood pressure (BP) is characterized by continuous fluctuations, including fast changes lasting only a few seconds as well as slower and more prolonged variations, with a time constant of minutes or hours. Assessing the relative contribution of these different components to overall blood pressure variance is now possible through a number of mathematical approaches, either in the time or in the frequency domain (spectral analysis). Due to its complex nature, a precise and detailed assessment of blood pressure variability can be obtained only from the analysis of continuous, beat-by-beat, blood pressure recordings. Some information, however, can also be derived from analysis of discontinuous blood pressure tracings, such as those commonly performed in a clinical setting. This would require that attention is paid both to the quality of the recordings and to the selection of suitable analysis methods that should cope with the discontinuous nature of the measurements to be processed and to their intrinsic low sampling frequency.

Blood Pressure↗