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Biomedical subjects

F Pennestri

Publications and source records attributed to F Pennestri.

25 records · Page 2Linked to original sources

Extension of calcific deposits in the anterior mitral valve leaflet and mitral valve stenosis severity. Use of 2D Echo parasternal long-axis view.

To evaluate the role of the extent of calcific deposits on the anterior mitral leaflet in predicting the severity of mitral valve stenosis, two-dimensional echocardiography (2D Echo) and heart catheterization data were analysed in 62 patients with mitral valve stenosis, pure or associated with trivial valve regurgitation. 50 patients had technically adequate 2D Echo. Of these, 28 had pure mitral valve stenosis. The mitral valve area was estimated from the parasternal short-axis 2D Echo projection. Using the parasternal long-axis projection, calcium deposits location and extension on the anterior mitral leaflet was examined. Patients were subdivided into the following groups: Group 0 (absence of calcium deposits = 19 patients), Group 1 (calcium on distal third of the leaflet = 19 patients), Group 2 (calcium on mid and distal segments = 11 patients), Group 3 (calcium on the entire leaflet = one patient). The extension of calcium deposits in long-axis projection was contrasted with 2D Echo mitral valve area in the 50 mitral valve patients. 2D Echo and heart catheterization derived mitral valve area were compared to each other in the 28 patients with pure mitral valve stenosis. 2D Echo mitral valve area was greater in Group 0 patients (1.8 +/- 0.4 cm2) than in Group 1 (1.4 +/- 0.4 cm2) and in Group 2 (1.1 +/- 0.3 cm2) (p less than 0.001 between the three groups). Calcific deposits were present on the anterior mitral leaflet in 30/31 patients with 2D Echo mitral valve area less than or equal to 2 cm2. However, of the 19 patients of Group 0, 13 had moderate and one severe mitral valve stenosis. In the 28 patients with pure mitral valve stenosis, 2D Echo mitral valve area was excellently correlated with Gorlin's derived mitral valve area (r = 0.90). However, in patients with extensive calcification of the anterior mitral valve leaflet (Group 2), 2D Echo mitral valve area was significantly greater than the Gorlin's derived area (1.08 +/- 0.20 cm2 versus 0.68 +/- 0.17 cm2; p less than 0.001). In four patients of Group 2, the mitral valve stenosis was moderate by 2D Echo grading and severe by heart catheterization data. Our data suggest that the study of extension of calcific deposits on the anterior mitral valve leaflet may be a complementary aid in quantifying mitral valve stenosis to the 2D Echo mitral valve area estimate, especially when the valve is severely calcified.

Calcinosis↗

[Bidimensional echocardiographic findings in a case of arrhythmogenic dysplasia of the right ventricle].

In a 50-year-old man presenting with dyspnoea and palpitations, cardiomegaly, incomplete right bundle branch block and bursts of ventricular tachycardia, Two-Dimensional Echocardiography revealed an impressive enlargement of the right ventricle, particulary in the outflow tract. Arrhythmogenic right ventricular dysplasia was suggested and confirmed by right ventricular angiography and electrophysiologic study. We emphasize the role of Two-Dimensional Echocardiography in the appropriate planning of cardiac catheterization for a definitive diagnosis of arrhythmogenic right ventricular dysplasia.

Arrhythmias, Cardiac↗

[Echocardiographic evaluation of myocardial infarct patients undergoing rehabilitation].

29 patients with a recent myocardial infarction underwent a M-mode echocardiographic study before and after an ergometric training in order to study the training effects on the left ventricular function and on the cardiac chambers dimensions. 25 patients in the same clinical conditions and no trained acted as a control group and were evaluated with the same procedure. Our results show, in the trained group, a significant reduction of the diastolic (-5.6%) and systolic (-6.5%) diameters of the left ventricle and of the diameter of the left atrium (-7.5%). Moreover we observed an improvement of the left ventricular kinesis, as showed by the increased systolic movement of left posterior wall and of the interventricular septum and by the increased ventricular performance, as it results from increased systolic movement of the aortic root. In the control group no significant variation of the examined data was observed. The reduction of the diameters and the improvement of the kinesis and of ventricular performance could be explained by the reduced after-load and it shows the presence of direct beneficial effects of the exercise training on the heart, consisting both of improved cardiac mechanics and of a reduced MVO2.

Adult↗

[Comparison between holter dynamic ECG and exercise stress test in the evaluation of ventricular arrhythmias in patients with ischaemic heart disease (author's transl)].

The Authors have examined the possibility for diagnostic and prognostic value of exercise stress test and of dynamic ecg in the identification of ventricular ectopic activity which represent a factor risk of sudden death. 41 male patients with IHD and Myocardial Infarction were given exercise stress test and Holter monitoring according to the usual methods. Both methods were useful to identify Pts with arrhythmias. The total incidence of ventricular ectopic beats was 78% with Holter and 46% with exercise test. Holter monitoring showed a major possibility to detect high degree arrhythmias (39%) against 9% of exercise test. Two methods are not comparable, not it was possible to demonstrate statistically significant incidence of ventricular ectopics with respect to the localization of M.I. 90% of Pts with positive exercise test (angina and/or ecg alterations) showed ventricular ectopic beats against 45% of Pts with negative exercise test. The association of ventricular ectopic beats in Holter and positive response to exercise test is highly predictable of sudden death. The results of investigation suggest the opportunity to evaluate Pts with MI by both methods, dynamic ecg and exercise stress test.

Adult↗

[The exercise stress test in patients with intraventricular conduction troubles (author's transl)].

The results of exercise stress test in 86 patients with intraventricular conduction troubles (BBBand or Emiblock) are discussed in order to asses the meaning of exercise induced ECG alterations and possibly of an etiopathogenetic interpretation. The AA. examined the following parameters during stress test and recovery: max heart rate, percent of teoric max heart rate, max BP, max heart rate x BP product, AQRS at rest and during recovery immediately after exercise test, QRS duration, ST depression, T amplitude. The majority (91,67%) of isolated RBBB patients had negative test; 30,43% of RBBB + LAEmiblock patients had ECG signs and clinical symptoms of myocardial ischemia. In LBBB patients the test was considered positive only if present ST depression and precordial pain. The AQRS tends during exercise to the right; in the 60% of RBBB + LAEmiblock patients it can be seen a tendency to left axis deviation; the amplitude of T-wave is increasing in more than 50% in LBBB. The conclusions are that in patients with intraventricular conduction troubles the interpretation of results is always difficult; the presence of clinical symptoms like precordial pain may give an aide when associated to the ECG variations.

Adolescent↗