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Biomedical subjects

F Triposkiadis

Publications and source records attributed to F Triposkiadis.

45 records · Page 3Linked to original sources
PubMed1992

Retrograde nontransseptal balloon mitral valvuloplasty. Immediate results and long-term follow-up.

BACKGROUND: Percutaneous retrograde nontransseptal balloon mitral valvuloplasty is a new technique developed in our institution for opening a stenotic mitral valve. This technique is based on a new, externally steerable cardiac catheter that enters the left atrium retrogradely via the left ventricle. METHODS AND RESULTS: The technique was used in 86 consecutive patients (18 men and 68 women; mean age, 51 +/- 11 years). Dilatation of the stenotic mitral valve was achieved in 85 of the 86 patients. After the procedure, mitral valve area increased from 0.92 +/- 0.22 to 2.14 +/- 0.54 cm2 and transmitral gradient decreased from 16 +/- 6 to 5 +/- 2 mm Hg. Major complications, such as cardiac performation, embolic events, or death, were not encountered. Severe mitral regurgitation (greater than 2+) developed in three patients (3.5%). In two patients (2.4%), there was major injury of the femoral artery. The maintenance of the initial improvement was similar to that found in studies that used transseptal techniques. The restenosis rate during the 2-year follow-up was 15.4%. CONCLUSIONS: The immediate and long-term findings of this study indicate that retrograde percutaneous nontransseptal balloon mitral valvuloplasty is an effective and safe procedure with an acceptable major complication rate. Moreover, this new technique has the advantage that it does not involve puncture and dilatation of the interatrial septum, although it may occasionally lead to arterial damage. Further studies will show whether it may really be considered as an alternative method or method of choice for percutaneous balloon mitral valvuloplasty.

Adult↗
PubMed1991

The Marfan syndrome: abnormal aortic elastic properties.

Aortic distensibility and aortic stiffness index were measured at the ascending aorta (3 cm above the aortic valve) and the mid-portion of the abdominal aorta from the changes in echocardiographic diameters and pulse pressure in 14 patients with the Marfan syndrome and 15 age- and gender-matched normal control subjects. The following formulas were used: 1) Aortic distensibility = 2(Changes in aortic diameter)/(Diastolic aortic diameter) (Pulse pressure); and 2) Aortic stiffness index = ln(Systolic blood pressure)/(Diastolic blood pressure)(Changes in aortic diameter)/Diastolic aortic diameter. Pulse wave velocity was also measured. Compared with normal subjects, patients with the Marfan syndrome had decreased aortic distensibility in the ascending and the abdominal aorta (2.9 +/- 1.3 vs. 5.6 +/- 1.4 cm2 dynes-1, p less than 0.001 and 4.5 +/- 2.1, vs. 7.7 +/- 2.5, cm2 dynes-1, p less than 0.001, respectively) and had an increased aortic stiffness index in the ascending and the abdominal aorta (10.9 +/- 5.6 vs. 5.9 +/- 2.2, p less than 0.005 and 7.1 +/- 3.1 vs. 3.9 +/- 1.2, p less than 0.005, respectively). Aortic diameters in the ascending aorta were larger in these patients than in normal subjects, but those in the abdominal aorta were similar in the two groups. Linear correlations for both aortic distensibility and stiffness index were found between the ascending and the abdominal aorta (r = 0.85 and 0.71, respectively). Pulse wave velocity was more rapid in the patients than in the normal subjects (11.6 +/- 2.5 vs. 9.5 +/- 1.4 m/s, respectively, p less than 0.01). Thus, aortic elastic properties are abnormal in patients with the Marfan syndrome irrespective of the aortic diameter, which suggests an intrinsic abnormality of the aortic arterial wall.

Adult↗
PubMed1990

Mitral stenosis: left atrial dynamics reflect altered passive and active emptying.

To assess the passive and the active phases of left atrial (LA) emptying, LA volumes and function were studied in 15 patients with mitral stenosis (MS) in sinus rhythm and in 11 normal subjects (NL) with two-dimensional echocardiography with simultaneous electrocardiograms. LA and left ventricular (LV) volumes were measured with the biplane area-length method. LA maximal and minimal volumes were measured at mitral valve opening and closure, respectively. In addition, LA volume was measured at onset of atrial systole (beginning of the P wave on the electrocardiogram). LA volumes were larger in MS compared with NL; Maximal 122 +/- 65 cm3 versus 46 +/- 12 cm3, p less than 0.001; onset of atrial systole 108 +/- 63 cm3 versus 29 +/- 12 cm3, p less than 0.001; minimal 90 +/- 60 cm3 versus 18 +/- 7 cm3, p less than 0.001. LA passive emptying volume (maximal minus volume at onset of atrial systole) was not statistically different in MS compared with NL, while LA active emptying volume (volume at onset of atrial systole minus minimal) was larger in MS compared with NL (17 +/- 5 cm3 versus 11 +/- 5 cm3, p less than 0.05). The net result was normal LA total emptying volume (maximal minus minimal) MS 32 +/- 11 cm3, NL 28 +/- 5 cm3. In contrast, the LA emptying fractions were significantly decreased in MS compared with NL (passive 0.13 +/- 0.08 versus 0.39 +/- 0.1, p less than 0.0001, active 0.19 +/- 0.08 versus 0.38 +/- 0.07, p less than 0.0001, total 0.30 +/- 0.1 versus 0.62 +/- 0.07, p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Continuous electrocardiographic monitoring in patients with unstable angina pectoris: evaluation of medical treatment.

Sixteen patients under treatment for unstable angina (UA) were subjected to 24-hour Holter monitoring after having been asymptomatic for at least 12 hours. 12-lead ECGs were obtained every 4 hours and when anginal pain supervened. Six patients (37.50%) had no evidence of ischemia in the Holter recordings and in the 12.lead ECGs and reported no anginal pain; five (31.25%) reported no pain but had evidence of ischemia in the Holter recordings and five (31.25%) reported anginal pain and had evidence of ischemia both in the Holter recordings and in the 12-lead ECGs. The probability for a 12-lead ECG to record an episode of silent myocardial ischemia (SMI) was only 1.54 x 10(-5). Medical treatment using conventional criteria was successful in 11 patients (68.75%). If the results of Holter monitoring are considered, the success rate was 37.50% (6 out of 16 patients free from ischemia). We conclude that as Holter monitoring reveals the episodes of SMI, it is a better means for assessing the results of medical treatment.

Adult↗
PubMedDate not supplied

A bioequivalence study of levothyroxine tablets versus an oral levothyroxine solution in healthy volunteers.

Probably for genetic reasons a substantial part of the Greek population requires Levothyroxine treatment. Since commercially available Levothyroxine was first marketed, the manufacture and storage of the drug in tablet form has been complicated and difficult; and as cases of therapeutic failure have frequently been reported following treatment with this medicinal agent, quality control is an essential factor. Due to the unreliability of Levothyroxine-based commercial products, in the present study we decided to follow the Food and Drug Administration (FDA) guidelines*, and use a Levothyroxine solution as reference product. The bioavailability of the Levothyroxine sodium tablet formulation THYROHORMONE/Ni-The Ltd (0.2 mg/tab) and that of a reference oral solution (0.3 mg/100 ml) under fasting conditions were compared in an open, randomized, single-dose two-way crossover study. Twenty four healthy Caucasian volunteers (M/F=15/9, mean age=32.9+/-7.4yr) participated in the study. Bioavailability was assessed by pharmacokinetic parameters such as the area under plasma concentration-time curve from time zero up to the measurable last time point (AUC(last)) and the maximum plasma concentration (Cmax). Heparinized venous blood samples were collected pre-dose and up to a 48-hour period post-dose. Levothyroxine sodium in plasma samples was assayed by a validated electrochemiluninescent immunoassay technique. Statistical analysis showed that the post-dose thyrotropin-stimulating hormone (TSH) levels decreased significantly (p<0.05). Regarding Levothyroxine (T4), the point estimate of the test formulation to the reference formulation ratios (T/R) for AUC(last) and Cmax was 0.92 with 90% confidence limits (0.90, 0.94) and 0.93 with 90% confidence limits (0.91, 0.94), respectively. Regarding triiodo-L-thyronine (T3), the point estimate for the T/R ratios of AUC(last) and Cmax was 0.92 with 90% confidence limits (0.90, 0.95) and 0.94 with 90% confidence limits (0.92, 0.95), respectively. The 90% confidence limits for the pharmacokinetic parameters AUC(last) and Cmax lie within the acceptance limits for bioequivalence (0.80, 1.25), for both T3 and T4.

Administration, Oral↗
PubMedDate not supplied

Left atrial mechanical function in the healthy elderly: new insights from a combined assessment of changes in atrial volume and transmitral flow velocity.

To assess left atrial mechanical function in the elderly, 35 old (age > 70 years) and 18 sex-matched young (age < 50 years) healthy subjects were studied. Transmitral flow velocities were recorded with pulsed Doppler echocardiography. Left atrial volumes were measured echocardiographically at mitral valve opening (maximal) and closure (minimal) and at onset of atrial systole (P wave of the electrocardiogram) according to the biplane area-length method. Left atrial passive emptying was assessed with the passive emptying volume (maximal-volume at onset of atrial systole) and fraction (passive emptying volume/maximal). Left atrial active emptying was assessed with the active emptying volume (volume at onset of atrial systole-minimal) and fraction (active emptying volume/volume at onset of atrial systole) and with left atrial ejection force = 0.5.blood density.volume at onset of atrial systole.active emptying fraction.(A velocity)2/A integral. Left atrial volumes were greater in old compared with young subjects (maximal: 31 +/- 10 cm3/m2 vs 24 +/- 8 cm3/m2, p = 0.02; at onset of atrial systole: 23 +/- 8 cm3/m2 vs 15 +/- 5 cm3/m2, p = 0.0002; minimal: 13 +/- 5 cm3/m2 vs 9 +/- 4 cm3/m2, p = 0.001). Passive emptying volume and fraction were lower (7.8 +/- 1.7 cm3/m2 vs 9.2 +/- 3.2 cm3/m2 [p = 0.04] and 26.4% +/- 9.8% vs 37.9% +/- 11.2% [p = 0.003], respectively), whereas atrial ejection force and active emptying volume were greater in old compared with young subjects (6.8 +/- 3.3 kdynes/m2 vs 4.2 +/- 2.8 kdynes/m2 [p = 0.007] and 9.2 +/- 4.1 cm3/m2 vs 5.7 +/- 2.9 cm3/m2 [p = 0.002], respectively). The active emptying fraction was similar in the two groups (39.7% +/- 11% vs 38.4% +/- 13%; difference not significant). Thus advanced age is associated with depressed left atrial passive emptying function and increased left atrial volume. Left atrial dilation contributes to an increase in atrial ejection force and the amount of blood ejected during left atrial systole and may represent an important compensatory mechanism in this age population.

Adult↗
PubMedDate not supplied

Sinus node dysfunction in acute inferior myocardial infarction. Role of sinus node artery and clinical course in patients with one-vessel coronary artery disease.

To determine the role of the sinus node artery and the clinical course in postmyocardial infarction sinus node dysfunction, 27 patients with acute inferior myocardial infarction and single-vessel coronary artery disease were studied. In 13 patients (group 1) the infarct-related coronary artery was occluded proximally and in 14 (group 2) distally to the site of origin of the sinus node artery. At electrophysiology, performed 10 +/- 3 days from the acute event, basal and intrinsic heart rate were lower in group 1 compared to group 2 patients (54 +/- 4.8 vs. 69 +/- 7 beats/min, p = 0.001, and 66 +/- 7 vs. 76 +/- 8 beats/min, p = 0.006, respectively) while basal and intrinsic corrected sinus node recovery times were prolonged in group 1 compared to group 2 patients (585 +/- 49.3 vs. 324 +/- 61.3 ms, p = 0.0001, and 601 +/- 39.1 vs. 335 +/- 73 ms, p = 0.0001). During a 6-month follow-up no episodes of dizziness, syncope or angina were reported. Moreover, at the end of follow-up resting heart rate (70 +/- 11 vs. 73 +/- 7 beats/min, nonsignificant), maximal exercise heart rate (166 +/- 19 vs. 170 +/- 23 beats/min, nonsignificant), and exercise time (491 +/- 120 vs. 480 +/- 155 s, nonsignificant) were similar between the two groups and no exercise-induced ischemic ST segment depression was observed. Sinus node dysfunction in patients with inferior myocardial infarction and one-vessel disease is related to the occlusion of the infarct-related coronary artery proximal to the site of origin of the sinus node artery and is not associated with increased cardiovascular morbidity in the first 6 months from the acute event.

Adult↗