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Biomedical subjects

L Badano

Publications and source records attributed to L Badano.

9 recordsLinked to original sources
PubMed1992

Infective right atrial thrombus: a rare complication of total parenteral nutrition in an adult.

We describe a case of an infective right atrial thrombus, following total parenteral nutrition, in a 21-year-old woman undergoing a surgical procedure for long-standing chronic ulcerative colitis. She presented with high temperature and the illness did not respond to antibiotic therapy. A 2-dimensional echocardiogram showed a mobile right atrial mass that at surgery was identified as a thrombus. Thrombus cultures grew coagulase-negative Staphylococcus aureus.

Adult↗
PubMed1992

[Age-induced changes in the cardiovascular system in normal subjects].

To assess the effect of age on cardiac structure and function, we performed echocardiograms on 104 physically active, normal, community-dwelling volunteers (68 men and 36 women), ranging in age from 18 to 84 years and having no evidence of hypertension or cardiovascular disease. With advancing adult aging, the following were observed: a decrease in aortic compliance (r = 0.42); an increase in systolic (r = 0.61), diastolic (r = 0.24), pulse (r = 0.60) and mean (r = 0.48) arterial pressure; and a modest enlargement of aortic root (r = 0.47) and left atrial dimension (r = 0.30) were observed. Left ventricular end-diastolic volume (r = 0.25), wall thickness (r = 0.30) and mass (r = 0.37) also increased with aging, while left ventricular end-systolic volume was not age-related. Furthermore, a stepwise multivariate linear model identified the decrease in arterial compliance (R2 = 0.06; p < 0.02) and the increase in left ventricular stroke work (R2 = 0.38; p < 0.0001) as the only variables independently related to the increase in left ventricular mass that occurs with advancing age. Regarding left ventricular systolic function, aging was also related to an increase in left ventricular stroke work (r = 0.40) and ejection time (r = 0.44), while pump function, (measured as ejection fraction and cardiac index at rest), and contractility (measured by load independent end-systolic indexes) were unaffected by aging. Conversely, pulsed Doppler analysis of mitral inflow showed a significant age-related decline in the peak early filling velocity (r = -0.45) and in the ratio of early and late diastolic filling velocity (r = -0.66), while peak late diastolic flow velocity (r = 0.50), diastolic pressure half time (r = 0.34) and duration of isovolumic relaxation (r = 0.56) increased significantly with age.

Adolescent↗
PubMed1991

[Changes in modalities of left ventricular filling associated with aging in normal subjects: secondary to increase in blood pressure and left ventricular mass?].

The mechanisms by which aging alters the pattern of left ventricular diastolic filling are still uncertain. To gain more insight into this tissue, the independent contributions of age, sex, heart rate, arterial blood pressure and left ventricular mass (as well as various indexes of left ventricular morphology and function) to left ventricular diastolic filling abnormalities, were investigated by echocardiography in 81 normal subjects (18 to 84 years of age, mean 50), carefully screened to avoid the confounding effects of coronary artery disease and systemic hypertension. With advancing adult age, we found a significant increase in: body mass index (r = 0.25; p less than 0.02), systolic (r = 0.58; p less than 0.0001), pulse (r = 0.61; p less than 0.0001) and mean (r = 0.40; p less than 0.0001) arterial blood pressure; left ventricular wall thickness (r = 0.30; p less than 0.006); left ventricular mass (r = 0.32; p less than 0.004); left ventricular end-diastolic volume (r = 0.24; p less than 0.03); and peak systolic wall stress (r = 0.22; p less than 0.04). Pulsed Doppler analysis of mitral inflow showed a significant age-related decline in the peak early filling velocity (r = -0.51; p less than 0.001), and in the ratio of early and late diastolic filling velocity (r = -0.65; p less than 0.0001). Conversely, duration of isovolumic relaxation (r = 0.77; p less than 0.0001), peak late diastolic flow velocity (r = 0.39; p less than 0.001), and diastolic pressure half time (r = 0.34; p less than 0.01) increased significantly with age. "Stepwise" multivariate linear regression analyses showed that the ratio of early to late diastolic peak filling velocity was independently related only with age (R2 = 0.56; p less than 0.0001) while the isovolumic relaxation time was independently related with age (R2 = 0.48; p less than 0.0001) and duration of cardiac cycle (R2 = 0.06; p less than 0.008). Age-related changes in body mass index, blood pressure, peak meridional wall stress and left ventricular mass index did not show any independent relationship to Doppler parameters of left ventricular filling or duration of isovolumic relaxation. The results of the present study suggest that the effect of age on left ventricular filling modalities and duration of isovolumic relaxation are independent of age-related changes in blood pressure, left ventricular mass, morphology and systolic function.

Adolescent↗
PubMed1991

Concentric left ventricular wall thickening in a patient with primary hypothyroidism. Response to gradual thyroxine replacement.

Asymmetric septal thickening has been described in patients with overt myxedema, but descriptions of concentric left ventricular wall thickening in such patients are rare. Echocardiographic detection of thickened left ventricular and interventricular walls, without pericardial effusion or any other sign of cardiac involvement, in a patient with overt myxedema and primary hypothyroidism, is reported. Furthermore, this is the first case in which the timing and the extent of the response of such abnormalities to L-thyroxine replacement therapy have been serially evaluated.

Adult↗
PubMed1989

[Anatomo-functional correlations of changes in electrocardiographic repolarization in aortic and mitral valve insufficiency. Comparison of indices based on QRS voltages].

Electrocardiographic repolarization changes and voltage criteria for left ventricular hypertrophy were examined, in relation to hemodynamic, echocardiographic and angiographic data. This was done to evaluate their association with abnormalities in cardiac function and structure in 53 patients with chronic aortic regurgitation and 36 patients with chronic mitral regurgitation. No patient showed evidence of coronary artery disease. Of the patients with aortic regurgitation, the 27 patients with an abnormal repolarization pattern at ECG had worse NYHA functional class when compared to the 24 patients with normal repolarization (2.4 +/- 1 vs 1.6 +/- 0.9; p less than .01). They also had greater left ventricular dimensions (end-diastolic volume: 162 +/- 57 ml/m2 vs 109 +/- 15 ml/m2, p less than .01; end-systolic volume: 85 +/- 46 ml/m2 vs 44 +/- 31 ml/m2, p less than .01), lower left ventricular ejection fraction (.50 +/- .12 vs .63 +/- .14; p less than .01), greater left ventricular mass (170 +/- 56 gr/m2 vs 119 +/- 29 gr/m2; p less than .01) and higher end-diastolic left ventricular pressure (21 +/- 11 mmHg vs 11 +/- 8 mmHg; p less than .01). QRS voltage was less closely related to cardiac function and structure and thus, did not modify the conclusions based on repolarization findings alone. Furthermore, repolarization patterns identified patient subgroups with high or low prevalences of previously described predictors of poor surgical outcome. The presence or absence of the "strain" pattern was not related to differences in cardiac structure and function, in patients with mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Surgical results in mitral insufficiency: prognostic value of the indices of left ventricular function].

Left ventricular function is a major prognostic factor in patients with mitral regurgitation, but the ability of echocardiographic and hemodynamic parameters to predict the surgical result is controversial. We investigated the prognostic role of various pre-operative indices of left ventricular function in 23 consecutive patients who underwent successful surgical correction of chronic mitral regurgitation. At a mean follow-up of 20 +/- 16 months, patients underwent echocardiography and radio-nuclide angiography and were grouped according to the post-operative left ventricular ejection fraction. Group A was made up of 16 patients with a left ventricular ejection fraction greater than or equal to .45: they showed post-operative reduction of the left ventricular end-diastolic diameter (from 36.3 +/- 3.2 to 30.5 +/- 4.5 mm/m2; p less than .001) and of the radius/thickness ratio (from 3.5 +/- 0.6 to 2.9 +/- 0.6; p less than .01). In 7 patients (group B), post-operative left ventricular ejection fraction was less than .45 and no significant changes in the left ventricular end-diastolic diameter (from 41.5 +/- 2.7 to 36.9 +/- 6.1 mm/m2; NS) or the radius/thickness ratio (from 3.9 +/- 0.9 to 3.4 +/- 1.0; NS) were observed. During the follow-up all group A patients remained asymptomatic or minimally symptomatic, whereas 2 group B patients died of refractory left ventricular failure. Pre-operative left ventricular volumes and diameters, both at end-diastole and end-systole, were significantly greater in group B patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗