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Biomedical subjects

F Della Rovere

Publications and source records attributed to F Della Rovere.

11 recordsLinked to original sources
PubMed1994

Relation between ECG strain pattern and left ventricular morphology, left ventricular function, and DPTI/SPTI ratio in patients with aortic regurgitation.

The relative contributions of left ventricular structural changes, dysfunction, and subendocardial ischemia in determining electrocardiographic repolarization abnormalities were assessed in 53 patients with chronic, pure aortic regurgitation and no evidence of coronary artery disease. Thirty-six patients with an abnormal electrocardiographic pattern of repolarization showed larger end-diastolic (154 +/- 46 vs 120 +/- 32 mL/m2; P < .001) and end-systolic (80 +/- 40 vs 52 +/- 30 mL/m2; P = .016) volumes, higher end-diastolic pressure (22 +/- 11 vs 15 +/- 10 mmHg; P = .021), lower ejection fraction (52 +/- 12 vs 59 +/- 13%; P < .05) and greater mass (168 +/- 48 vs 140 +/- 44 g/m2; P < .05) of the left ventricle compared to 17 patients with normal repolarization. Furthermore, patients with repolarization abnormalities also showed higher peak meridian (217 +/- 68 vs 153 +/- 92 Kdyne/cm2; P < .001) and circumferential (358 +/- 110 vs 259 +/- 153 Kdyne/cm2; P < .001) stress and a more spherical shape (end-diastolic shape: 1.4 +/- 0.1 vs 1.5 +/- 0.2, P = .046; end-systolic shape: 1.7 +/- 0.3 vs 1.9 +/- 0.3, P = .026) of the left ventricle. Patients with secondary repolarization abnormalities were also older than patients with normal repolarization (56 +/- 10 vs 40 +/- 11 years; P < .001). However, the diastolic pressure-time index/systolic pressure-time index, which is an estimate of the myocardial oxygen supply-to-demand ratio, was similar in both groups of patients (0.74 +/- 0.3 vs 0.8 +/- 0.2; P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Emergency surgical treatment for total left main coronary artery occlusion. A report of 2 cases.

Treatment of total left main coronary artery occlusion is rarely reported (84 chronic and acute cases in the world literature), due to the high mortality rate from massive myocardial infarction. Acute occlusions have been treated with intracoronary streptokinase, with percutaneous transluminal coronary angioplasty, or with both. To date, there has been no report of successful surgical revascularization in an acute case. We present 2 cases of surgically treated patients who survived total left main coronary artery occlusion that appears to have been acute, or acutely evolving. Both patients had an 80% or greater stenosis of the right coronary artery, yet have remained in New York Heart Association functional class I or II postoperatively. We attribute this not only to the aggressive surgical approach, which enabled reperfusion to be achieved within 2 hours of total occlusion, but to the protective effect in these patients of right coronary-to-left anterior descending collaterals.

Aged↗
PubMed1989

[Anatomo-functional correlations of changes in electrocardiographic repolarization in aortic and mitral valve insufficiency. Comparison of indices based on QRS voltages].

Electrocardiographic repolarization changes and voltage criteria for left ventricular hypertrophy were examined, in relation to hemodynamic, echocardiographic and angiographic data. This was done to evaluate their association with abnormalities in cardiac function and structure in 53 patients with chronic aortic regurgitation and 36 patients with chronic mitral regurgitation. No patient showed evidence of coronary artery disease. Of the patients with aortic regurgitation, the 27 patients with an abnormal repolarization pattern at ECG had worse NYHA functional class when compared to the 24 patients with normal repolarization (2.4 +/- 1 vs 1.6 +/- 0.9; p less than .01). They also had greater left ventricular dimensions (end-diastolic volume: 162 +/- 57 ml/m2 vs 109 +/- 15 ml/m2, p less than .01; end-systolic volume: 85 +/- 46 ml/m2 vs 44 +/- 31 ml/m2, p less than .01), lower left ventricular ejection fraction (.50 +/- .12 vs .63 +/- .14; p less than .01), greater left ventricular mass (170 +/- 56 gr/m2 vs 119 +/- 29 gr/m2; p less than .01) and higher end-diastolic left ventricular pressure (21 +/- 11 mmHg vs 11 +/- 8 mmHg; p less than .01). QRS voltage was less closely related to cardiac function and structure and thus, did not modify the conclusions based on repolarization findings alone. Furthermore, repolarization patterns identified patient subgroups with high or low prevalences of previously described predictors of poor surgical outcome. The presence or absence of the "strain" pattern was not related to differences in cardiac structure and function, in patients with mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Surgical results in mitral insufficiency: prognostic value of the indices of left ventricular function].

Left ventricular function is a major prognostic factor in patients with mitral regurgitation, but the ability of echocardiographic and hemodynamic parameters to predict the surgical result is controversial. We investigated the prognostic role of various pre-operative indices of left ventricular function in 23 consecutive patients who underwent successful surgical correction of chronic mitral regurgitation. At a mean follow-up of 20 +/- 16 months, patients underwent echocardiography and radio-nuclide angiography and were grouped according to the post-operative left ventricular ejection fraction. Group A was made up of 16 patients with a left ventricular ejection fraction greater than or equal to .45: they showed post-operative reduction of the left ventricular end-diastolic diameter (from 36.3 +/- 3.2 to 30.5 +/- 4.5 mm/m2; p less than .001) and of the radius/thickness ratio (from 3.5 +/- 0.6 to 2.9 +/- 0.6; p less than .01). In 7 patients (group B), post-operative left ventricular ejection fraction was less than .45 and no significant changes in the left ventricular end-diastolic diameter (from 41.5 +/- 2.7 to 36.9 +/- 6.1 mm/m2; NS) or the radius/thickness ratio (from 3.9 +/- 0.9 to 3.4 +/- 1.0; NS) were observed. During the follow-up all group A patients remained asymptomatic or minimally symptomatic, whereas 2 group B patients died of refractory left ventricular failure. Pre-operative left ventricular volumes and diameters, both at end-diastole and end-systole, were significantly greater in group B patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Evaluation of the seriousness of aortic valve stenosis: calculation of the valvular area or peak? Reliability of Hakki's formula].

The severity of aortic valve stenosis should be assessed by means of the calculation of the valvular area; on the other hand, the routine use of the Gorlin's formula for the aortic area is laborious and time consuming. Recently Hakki proposed a simplified formula (area = cardiac output/square root gradient) for the calculation of valvular areas. This method does not require the assessment of the systolic ejection time or the transvalvular flow; furthermore, the peak systolic gradient instead of the mean gradient may be entered into the formula. We have evaluated the reliability of this formula on 83 patients with aortic valve stenosis either pure or with absent to mild aortic incompetence (angiographically first degree maximum). Twenty-eight patients had isolated aortic stenosis, 55 had associated mitral stenosis and/or mitral or tricuspid regurgitation. Our results show a good correlation between the values of valvular areas obtained by Hakki's formula and those obtained by Gorlin's formula (r = 0.90 in the first group and r = 0.91 in the second group of patients). On the contrary we observed a poor relationship between the peak systolic gradient and the valvular area, with a considerable scatter of the data, especially for low values of peak systolic gradient. We therefore conclude that the assessment of the aortic valve stenosis must be based on the estimation of the valvular area; in our hands the Hakki's formula has proven to be easy and sufficiently reliable for routine diagnostic studies.

Adolescent↗
PubMed1984

[Corrected transposition of the great vessels in the adult. Presentation of a case simulating ischemic cardiopathy].

We report the clinical and laboratory findings in a 58 years old woman with corrected transposition of the great arteries (CTGA), who that presented typical angina pectoris. The diagnosis of ischemic heart disease was supported by the history of a previous myocardial infarction. Other findings were a systolic murmur of mild mitral regurgitation, left bundle branch block and enlarged left ventricle on the chest X-ray. Cardiac catheterization showed a corrected transposition of the great arteries (L-malposition with situs solitus); left and right coronary arteries were free of luminal stenosis. We suggest therefore that anginal chest pain may be due to myocardial ischemia induced by discrepancy between myocardial oxygen consumption and coronary blood flow. This complication may occur in patients with corrected transposition of great arteries surviving in adulthood.

Angina Pectoris↗
PubMed1984

[Development of a method for the quantitative evaluation of the regional kinetics of the left ventricle].

Segmental wall motion abnormalities of the left ventricle frequently occur in ischemic heart disease. An objective, quantitative method is required to ensure the reproducibility of the assessment of left ventricular regional function, especially in evaluating the changes induced by diagnostic and therapeutic interventions. In 32 normal subjects we obtained 30 degrees right anterior oblique left ventriculograms and developed a method based on the following observations. The method should reflect the symmetric uniform motion of the left ventricular silhouette. Only actual contractile motion should be taken into account; therefore, rotatory and translational motion should be compensated for. Passive systolic movement of aortic and mitral valves accounts for the contraction of neighbouring myocardial segments. Left ventricular wall excursion is most often measured by a coordinate system: since the cavity of the left ventricle becomes relatively longer during systole, left ventricular walls contract neither toward a single central point nor toward the long axis; therefore the appropriate origin of the coordinate system will be a segment. Furthermore, as more elongated left ventricular end-diastolic silhouettes appear to show a greater extent of systolic lengthening (we show evidence of this), the length of the segment must be related to the end-diastolic shape. The basic steps of the method are: 1) identification of a symmetry line, from the aortic mid-point to the apex, by connecting the mid-point of 19 diameters perpendicular to the long axis; 2) roto-translation of the end-systolic silhouette so that the end-systolic apex and aortic mid-point lie on the symmetry line.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart↗
PubMedDate not supplied

Hemoglobin oxidative stress in cancer.

The role played by free radicals in carcinogenesis and their relationships with antioxidant pool and cancer have already been shown. Free radicals induce increased membrane permeability through membrane lipid peroxidation, protein oxidation and histamine release from mast cells. Free radicals also cause oxyhemoglobin oxidative stress which increases methemoglobin and hemichromes. For this reason, we studied the in vitro formation of methemoglobin at 0' and 90', dosed following the HPLC method, after oxidative stress of blood by means of acetylphenylhydrazine in 40 subjects with cancer and 40 healthy donors. The results showed that methemoglobin formation was highly significant in tumors as compared to controls (P < 0.0001). The statistical analyses we carried out showed that metHb formation is not affected by age, sex, smoking habit, red blood cell number, Hb, Ht or tumor staging. This makes us believe that free radicals alter erythrocyte membrane permeability and predenaturate oxyhemoglobin so that erythrocyte membrane becomes more susceptible to new oxidative stress. This caused the abnormal response we found. Our results clearly underline the role played by free radicals in tumorous disease and provide a successful and easy method to detect early, even in a pre-clinical stage, the presence of tumorous alterations in the human body.

Adult↗
PubMedDate not supplied

Free radical erythrocyte damage in tumoral disease assessed by He-Ne laser and optical microscope through "Heinz Bodies" method.

Results obtained from blood sample readings by optical microscopy and He-Ne laser (lambda = 630.1 mW), have confirmed the reduction in Heinz Bodies (HB) formation time and the Transmittance Reduction Degree (TRD), in malignancies. The results of spectrometric readings in colorectum polyposis, (TRD = 0.07) and fibrocystic mastopathy (TRD = 0.08) gave results overlapping with controls (TRD = 0.08). In neoplasias, the early HB formation in erythrocytes observed by optical microscope corresponded to TRD increase = 0.17 (P < 0.01). TRD increase was statistically significant (P < 0.01), as well as the reduction in the time of HB appearance (< 0.01). The relationship between optical and laser readings was exponential in tumors, while it was linear in controls, in polyposis and mastopathies. The values of the correlation coefficients obtained by both methods were significant (P < 0.01) for all the studied groups. Moreover, these research data further support the existence, even in the earlier stages of the disease, of the labile state of the red cell membrane due to strong lipid peroxidation by FRs.

Erythrocytes↗