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Biomedical subjects

F Redondo

Publications and source records attributed to F Redondo.

9 recordsLinked to original sources

An assessment of wall motion, perfusion and glucose metabolism in recent myocardial infarction: a comparison in patients with and without revascularization.

The aim of this study was to compare the extent and severity of wall motion abnormalities, perfusion and glucose metabolism, in recent myocardial infarction in patients with and without revascularization. Forty-nine patients were studied (82% men; mean age 58 years) by using echocardiography, 201Tl single photon emission computed tomography (SPECT) rest and redistribution, and 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) SPECT at a mean of 9.2 days (range, 1-24 days) after myocardial infarction. Twenty-seven of the 49 patients underwent revascularization while the other 22 received medical therapy before echocardiography and studies using radionuclides. A contrast angiogram was obtained for each patient. A follow-up echocardiogram at 3 months was obtained for 44 patients. Images were read blindly, using a 17 segment model, with semi-quantitative analysis. In the whole group, the extent of hypokinesia was 15%+/-14 (mean+/-SD); the extent of mild defects was determined as 5%+/-6 by using 201Tl at rest, 6%+/-9 by using 201Tl redistribution, and 4%+/-6 by using 18F-FDG (P<0.0005, echocardiogram/radionuclides). Echocardiography showed that the extent of akinesia-dyskinesia was 16%+/-18 in revascularized patients and 28%+/-18 in non-revascularized patients (P=0.017). With regard to moderate and severe defects, 201Tl rest showed 19%+/-16 and 28%+/-17, respectively (P=0.047); 201Tl redistribution 17%+/-15 and 26%+/-15, respectively (P=0.043); and 18F-FDG 17%+/-13 and 24%+/-15, respectively (NS). In echocardiography, the extent of hypokinetic segments decreased from 16%+/-15 at baseline to 10%+/-11 at 3 months (P=0.045), in revascularized patients. It is concluded that, in recent myocardial infarction, hypokinesia extent on echocardiogram is greater than mild perfusion or metabolic defect extent, reflecting stunning and so the use of radionuclide techniques appear more accurate for defining the extent of myocardial infarction. Non-revascularized patients showed a significantly greater extent of akinesia-dyskinesia and moderate-severe perfusion defects than did revascularized patients, which can be considered a result of therapy. It is suggested that 201Tl rest perfusion be used for the assessment of myocardial infarction soon after revascularization.

Adult↗

Differences in heart transplant physiology according to surgical technique.

A new cardiac transplantation technique that preserves the shape of the left atrium and leaves the right atrium intact has been introduced. To compare the new and the standard techniques, we studied cardiac physiology with Doppler echocardiography and catheterization in 26 patients who underwent operation with the standard technique (group A) and I1 who underwent operation with the new technique (group B). Right atrial dimensions were significantly lower in group B (right atrial area index 8.4 +/- 1.5 vs 14.5 +/- 1.9 cm2/m2, p < 0.001), whereas left atrial dimensions were slightly lower (left atrial area index 10.8 +/- 2.0 vs 16.4 +/- 7.0 cm2/m2, p = 0.07). Right atrial contraction, as reflected by peak late tricuspid velocity, was greater in group B (37 +/- 15 vs 30 +/- 10 cm/sec, p < 0.05). The subsequent systolic vena caval flow-velocity integral was also greater in group B at all respiratory phases (inspiration 10.0 +/- 4.0 vs 5.2 +/- 4.0 cm, p < 0.001; expiration 4.8 +/- 1.9 vs 2.9 +/- 1.4 cm, p < 0.001; apnea 5.3 +/- 2.0 vs 2.9 +/- 1.9 cm, p < 0.001) suggesting better atrial relaxation. Filling pressures on the right side of the heart were lower in group B (mean right atrial pressure 5.5 +/- 2.4 vs 6.6 +/- 2.8 mm Hg, p = 0.1; right atrial A wave 6.0 +/- 3.1 vs 8.3 +/- 3.2 mm Hg, p < 0.01; right atrial V wave 6.8 +/- 3.1 vs 9.2 +/- 3.2 mm Hg, p < 0.01; right ventricular end-diastolic pressure 5.6 +/- 3.2 vs 7.3 +/- 2.9 mm Hg, p < 0.05); however, no significant differences were found in left ventricular end-diastolic pressure or cardiac index. We conclude that patients undergoing the new technique exhibit cardiac physiologic improvements. Follow-up study is indicated to ascertain whether this finding implies improved long-term prognosis.

Adult↗

[High-frequency audiometry: variations in auditory thresholds in the premenstrual period].

The hormonal changes that occur during the premenstrual period have been implicated as a causative factor for many psychological and physical symptoms. The present work was undertaken to determine the effect of these hormonal changes on audition. We studied 60 ears from 30 women (20-30 years old) with regular menstrual cycles and no middle/inner ear pathology. We performed audiometries one week before menstruation and one week after it, testing the range of frequencies from 250 to 16,000 Hz. After calculating the mean pre and postmenstrual threshold the results were compared using the paired < >-Student test. We found statistical significant differences in the frequencies 9,000, 10,000 and 11,200 Hz.

Adult↗

Unreliability of echocardiographic and Doppler indexes in the diagnosis of heart transplant acute rejection.

OBJECTIVE: To investigate the value of Doppler echocardiography to diagnose heart transplant acute rejection in both patients submitted to the standard surgical technique (Group A), and to a new technique that preserves the size of the left atrium and leaves the right atrium intact (Group B). METHODS: 122 Doppler echocardiographic studies and endomyocardial biopsies were performed on 27 group A and 11 group B patients. Systolic measurements included left ventricular shortening fraction, left ventricular endsystolic stress and tricuspid ring systolic displacement. Diastolic indexes investigated were left and right ventricle filling and superior vena caval flow parameters. RESULTS: As expected, right atrium was smaller in group B(p < 0.01). In group A, peak early to late mitral flow velocity increased, as did the rejection grade; whereas in group B it decreased. Pericardial effusion was seen more frequently in group B rejectors (> or = 3) than non-rejectors (63% vs 27%, p < 0.01). Right heart pressures (right ventricular end-diastolic and right atrial mean) were slightly higher for group A and B rejector patients (p < 0.05 when comparing right ventricular end-diastolic pressure in rejector to non-rejector group B patients). Left ventricular isovolumic relaxation time was reduced during subsequent rejection episodes in the same patient, but sensitivity of 15% left ventricular isovolumetric relaxation time reduction for rejection > or = 3 diagnosis was only 22% with a specificity of 73%. No significant intrapatient changes were found in other Doppler-derived systolic or diastolic indexes. CONCLUSION: Doppler echocardiography does not diagnose heart transplant acute rejection with enough reliability to avoid endomyocardial biopsies.

Acute Disease↗