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Biomedical subjects

Frank F Seghatol

Publications and source records attributed to Frank F Seghatol.

3 recordsLinked to original sources

Preservation of ventricular function in amateur athletes after completion of a marathon.

BACKGROUND: Previous studies have demonstrated the development of impaired systolic function and new segmental wall motion abnormalities following completion of ultraendurance events. Limited information is available on the effect of an endurance event such as a marathon on the left ventricular indices and hemodynamics. METHODS: We examined 45 patients (26 men, 19 women with the average age of 35+/- 8 years) who successfully trained and completed the 2001 Chicago Marathon (26.2 miles). Transthoracic 2-dimensional and Doppler echocardiography (TTE) was preformed prior to the marathon (17+/-10.7 days), immediately following the marathon (71+/-42 minutes), and at follow-up (29+/-12.9 days). RESULTS: Left ventricular end diastolic volumes declined immediately post marathon and returned to baseline at the one-month follow-up. Ejection fraction was maintained and no regional wall motion abnormalities were identified at any time point. Diastolic parameters decreased immediately post marathon but returned to baseline during follow-up principally reflecting a change in volume status. CONCLUSION: Marathon running by a group of well-trained recreational athletes does not result in impairment of left ventricular systolic or diastolic function.

Adult↗

Relation between contractile reserve and improvement in left ventricular function with beta-blocker therapy in patients with heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.

Beta blockers improve left ventricular (LV) ejection fraction but patient responses are heterogenous. We investigated the role of contractile reserve (CR) in predicting beta-blocker response in ischemic and nonischemic cardiomyopathy. Resting and low-dose dobutamine echocardiograms were recorded in 32 patients with heart failure (LV ejection fraction <or=35%), 18 with ischemic cardiomyopathy (IC), and 14 with idiopathic dilated cardiomyopathy (IDC). A segment was defined as CR positive (CR+) or negative (CR-) based on response to dobutamine. Patients were then classified as CR+ or CR- based on number of improved segments (IC group) or ejection fraction improvement (IDC group) in response to dobutamine. During follow-up (2, 6, and 14 months after beta-blocker initiation), response was measured by the percent of segments showing improved contractility from baseline, ejection fraction, and wall motion score index. In the IC group, the percent of improved segments was greater at 2 and 6 months in CR+ versus CR- (70% vs 15% and 39% vs 17%, p <0.05), whereas it was greater at all periods in the patients with IDC (36% vs 9% at 2 months, 50% vs 19% at 6 months, and 63% vs 42% at 14 months, p <0.05). Findings for ejection fraction and wall motion score index were similar. Therefore, time course and magnitude of improvement in LV function in patients with heart failure receiving beta blockers are related to CR status. CR predicts a greater early response in IC, whereas it predicts a greater response at all time periods in IDC. However, even patients without CR showed improvement in LV function at 14 months.

Adrenergic beta-Antagonists↗

Appetite suppressants and valvular heart disease.

Appetite suppressants fenfluramine, dexfenfluramine, and phentermine have been used alone or in combination as an alternative to diet and surgery in the management of obesity. This therapy was halted in 1997 after reports of valvular lesions affecting almost one third of patients treated with these drugs. Fortunately, most cases of appetite suppressant-related valve disease are mild or moderate and rarely required valve repair or replacement. Follow-up studies have suggested improvement in valvulopathy after discontinuation of the treatment. The mechanism of valve disease induced by these drugs is speculative and may be related to their serotonergic effects. Echocardiographic features are similar to carcinoid heart disease and valvulopathy associated with ergot use. Most cases require only follow-up and endocarditis prophylaxis; surgery is rarely needed.

Appetite Depressants↗