PubMed Health⌕ Search

Biomedical subjects

L Landucci

Publications and source records attributed to L Landucci.

3 recordsLinked to original sources
PubMed1999

Prospective evaluation of frequency and nature of transcranial high-intensity Doppler signals in prosthetic valve recipients.

BACKGROUND AND AIM OF THE STUDY: In asymptomatic prosthetic valve recipients, high-intensity transient signals (HITS) observed with transcranial Doppler (TCD) are a phenomenon of obscure clinical relevance which nature has not yet been elucidated convincingly. METHODS: Eighty-three patients without carotid disease, history of cerebrovascular accidents, and with negative preoperative TCD undergoing either valve replacement (mitral, n = 11; aortic, n = 56; mitral + aortic, n = 6; 40 mechanical prostheses, 29 biological prostheses, 10 homografts) or mitral repair (n = 10) were evaluated prospectively by means of TCD at discharge, three months and one year after surgery, to analyze the presence, incidence and characteristics of HITS. Furthermore, in 12 patients positive for HITS, TCD was repeated during a 30-min period of 100% O2 inhalation. RESULTS: Twenty-five patients (30%) were positive for HITS at all postoperative controls, although no neurological symptoms were observed. Mechanical prostheses showed a significantly higher incidence of HITS (85%) than biological prostheses (10%, p <0.001), repaired mitral valves (0%, p <0.001) and homografts (0%, p <0.001). At multivariate analysis the presence of a mechanical prosthesis was the only significant predictor of detection of HITS after valve replacement. During O2 inhalation, a significant decrease in the number of HITS per hour (55 +/- 79 versus 22 +/- 31, p = 0.002) occurred, which returned to initial values when room-air breathing was resumed. CONCLUSIONS: Prosthetic valve replacement, particularly when mechanical devices are used, is associated with the generation of HITS which persist throughout the follow up period, but remain clinically silent. The decrease of HITS during O2 inhalation strongly supports the hypothesis of the gaseous nature of such signals and confirms the validity of this method in helping to differentiate gaseous microemboli from solid microemboli in prosthetic valve recipients.

Adult↗
PubMed1987

[Technical ambulatory ECG innovations in performance evaluation].

Evaluating the performances of the instrumentation for Ambulatory ECG (AECG) analysis is a need largely recognized by both manufacturers and users. The most generally accepted method is the beat-by-beat comparison with annotated data bases, representing the different ECG abnormalities. Available data bases are aimed at arrhythmias detection evaluation, while it is recognized that the AECG ST-T changes detection has a great relevance in the analysis of ischemic heart disease. A concerted action of the European Community on Ambulatory Monitoring has been approved for achieving a comprehensive reference standard for assessing the quality of AECG instrumentation. The European project has been concentrated on the problem of ST-T analysis. An annotated data base is being developed with the contribution of european experts. A pilot study has been performed for establishing the criteria related to the development and annotation; particularly the definition of significant ST-T changes has been established. The data base will include 2-hour double channel AECG records, which contain at least one ST-T episode. Each record is annotated beat by beat according to the established scheme, identifying arrhythmic beats, rhythm changes, ST-T changes and noisy segments. A coordinating center has been established for interacting with the participating groups and for performing the operations related to the generation and management of the data base. For the time being 14 Groups of 8 Countries are participating to the annotation of the data base. A minimum number of 100 records is planned within June 1988.

Algorithms↗