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Biomedical subjects

F Marsico

Publications and source records attributed to F Marsico.

At least 73 records · Page 4Linked to original sources
PubMed1979

[A bloodless evaluation of the gradient of valvular and subvalvular aortic stenosis. Correlations with the hemodynamic picture. (author's transl)].

53 patients affected by congenital valvular or discrete aortic stenosis have been evaluated in order to compare the observed gradient with the one expected according to multifactorial analysis based on electrocardiographic and auscultatory data deviced by Ellison et al. There Authors employed this formula for the evaluation of the valvular form only. In our experience all cases of valvular stenosis showing an estimated gradient less than or equal to 40 mmHg were found to have a gradient less than or equal to 40 mmHg at the catheterization. This statement is true in the discrete form as well, only if the estimated gradient was less than or equal to 30 mmHg. The regression curve between the two gradients shows a r = 0.718 (p less than 0.01); an even better correlation was found in the valvular forms (r = 0.816; p less than 0.01). These results are very useful since they allow to restrict indication to catheterization only to the cases in which the obstruction is estimated to necessitate a surgical intervention.

Adolescent↗
PubMed1977

[Uhl's anomaly: case description with hemodynamic study and autoptic report (author's transl)].

A 3 month's old baby with Uhl's disease is reported. The diagnosis was made by cardiac catheterization and angiographic evaluation of right atrial and ventricular chambers and was confirmed by autopsy and histopathological examination. The particular features which allow angiographic differentiation from Ebstein's anomaly are considered. On the grounds of anatomical, clinical, and prognostic aspects, it is proposed that the definition of Uhl's anomaly be reserved for cases in infancy only, using the term Osler's disease for adult cases.

Diagnosis, Differential↗
PubMed1976

[The vectorcardiogram of Fallot's tetralogy in the first two years of life. Qualitative and quantitative analysis (author's transl)].

36 patients, less than two years old, affected by Fallot's tetralogy were studied by vectorcardiography. The configuration of the QRS loop in the three orthogonal planes, the voltage of the 0.10 sec spatial vector, RMSV and LMSV vectors, and their azimuth and elevation were evaluated. Such data have been correlated to arterial oxygen saturation. Qualitative analysis showed a clockwise or figure eight QRS loop on the H and F planes in the great majority of cases; and only in a counterclockwise loop on the H plane was the suspicion of an arterial oxygen saturation greater than 85% especially in cases older than two months. The terminal forces of the QRS loop on the H plane were always directed under the O point, Whereas in the valvular pulmonary stenosis, terminal forces are generally superior to the O point. Quantitative analysis demonstrated the constant increase of the RMSV and the direct relationship of the LMSV to arterial oxygen saturation, and so it was the principal parameter for evaluation of the left ventricular volume and the size of pulmonary flow and the degree of pulmonary stenosis. The relationship between the azimuth of 0.01 sec spatial vector to O2 saturation was highly significant, showing a progressive anterior development of the former, as the latter increased.

Age Factors↗
PubMed1976

[The VCG in ventricular septal defect in the first two years of life. Qualitative and quantitative analyses (author's transl)].

A group of 37 patients, less than 2 years old, with a ventricular septal defect of variable degree, and a left to right shunt, were studied by vectorcardiography. The duration, the direction and the aspect of the QRS loop on the three orthogonal planes, the voltage of the 0.01; 0.02; 0.04 vectors, the right and the left maximum spatial vectors and their projection on the H and F planes were analyzed and correlated to the right ventricular systolic pressure and Qp/Qs. A clockwise or an eight-type loop on the frontal plane, regardless of RVSP, was observed; on the H plane the loop is, usually, counterclockwise when the pressure is low or medium, and can be of the eight-type but never clockwise when the pressure is systemic. Very interestingly, the quantitative analysis showed a consistent increase of the LMSV. A progressive relationship between the spatial vectors and the right ventricular pressure was noted. The diagnosis of combined ventricular hypertrophy depend upon the following findings: the majority of cases showed a large, counterclockwise and anterior QRS loop on the H with the maximum vector to the left and anteriorly; in all cases the 0.01; 0.02; 0.04 vectors were enlarged, thus warranting the diagnosis of combined ventricular hypertrophy in the first few months of life. 4 cases with low RVSP presented increased initial forces to the right and anteriorly directed, while the major portion of the loop was in the left posterior quadrant on the H plane, with a counterclockwise direction. In our view, the differential diagnosis between this type of aspect and that of diastolic overload of the left ventricle can rest only on the increased voltage of the 0,02 vector which means both systolic and diastolic overload of the right ventricle when accompanied by an increased 0.01 vector which indicates volume overload of left ventricle. Likewise only a quantitative analysis can help in differentiating a combined ventricular hypertrophy from a normal tracing in children under 6 months who show an eight-type loop on the H plane with initial and medium vectors directed anteriorly to the left and counterclockwise, and terminal vectors to the right, posteriorly and clockwise, or in those cases with an anterior clockwise loop on the H plane. Moreover, in the first month of life, the VCG of large VSD with increased pulmonary flux and pressure, can be differentiated from the normal by the QRS loop on the H plane which is clockwise, with initial vectors directed to the left and anteriorly with increased LMSV.

Age Factors↗
PubMed1975

[The vectorcardiogram in A-V canal in the first three years of life: qualitative and quantitative analysis (author's transl)].

The electrocardiograms and the vectocardiograms of 26 childrens, up to 3 years of age, affected by A-V canal, were been analyzed. The pattern of QRS loop in the 3 planes, the voltage of right maximum spatial vector (RMSV) and left maximum spatial vector (LMSV), their projection onto the horizontal (azimuth) and frontal plane (elevation) were related to right ventricular systolic pressure. The qualitative and quantitative evaluation of VCG Showed a better correlation with the haemodynamic data than the electrocardiogram. In all but 3 cases, the high frequency of superior orientation and counterclockwise rotation of QRS loop in the frontal plane was found; moreover the good correlation of right ventricular systolic pressure to the rotation of QRS loop on the horizontal plane was also confirmed. In fact, the latter was counterclockwise in the cases with a low pressure, whereas it became clockwise in those with higher pressure. Moreover a good direct correlation of the right ventricular pressure with forward orientation of LMSV on the horizontal plane was found. In differential diagnoses with other congenital heart diseases with superior orientation and anticlockwise rotation on the frontal plane, useful results were obtained by using the calculation of elevation time (the interval between point 0 and intersection of the QRS loop with the axis) which is significantly lower in the A-V canal. Terminal forces directed posteriorly and to the right and with a delay no longer than 0,03 inches do not warrant the diagnosis of left anterior hemiblock with a right bundle branch block associated. On the contrary, on the basis of anatomical and electrophysiologic studies we believe that in this disease there is an asinchrony in the activation i.e. the postero-inferior region, then the left lateral wall and finally the tree high part of right ventricle wall are sequentially activated.

Age Factors↗
PubMed1975

[Evolutive study of the VCG in the first week of the normal newborn infant (author's transl)].

The vectorial and morphological variations of the VCG (Frank method) during the first seven days of life of sixteen normal newborn infants were analyzed. A byphasic distribution of the QRS vectors in the horizontal plane was found at birth. Successive observations showed a rising of initial forces of left septal activation and a slight increase of left parietal forces. The T loop variations were more remarkable, being probably correlated with rapid postnatal hemodynamic modifications. After a few days the T loop was oriented posteriorly and to the left, not changing this direction for many year. The P loop did not differ from the adult's in the majority of cases. Sometimes it showed a figure-or-eight rotation in the horizontal plane, probably due, according to the authors, to a different pathway of atrial activation.

Age Factors↗