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S Muzzupappa

Publications and source records attributed to S Muzzupappa.

8 recordsLinked to original sources
PubMed2002

Analysis of cardiac left-ventricular volume based on time warping averaging.

The cardiac left-ventricular (LV) volume signal, obtained by acoustic quantification, is affected by noise and respiratory modulation, resulting in a large beat-to-beat variability that affects the computation of LV function indices. A new method is proposed to improve the evaluation of LV indices by applying a signal averaging technique based on dynamic time warping to consecutive LV volume waveforms. Volume signals obtained from ten normal young (NY) subjects (mean age +/- SD: 25+/-5 years) were used to evaluate the performance of this algorithm. To evaluate its clinical utility, the effects of ageing and pharmacologically induced changes on LV function were assessed by studying, respectively, ten normal (N) adult subjects (age 64+/-8 years) and ten patients with dilated cardiomyopathy during a control and low-dose dobutamine (10 microg kg(-1) min(-1)) study. Indices of LV function were highly consistent, with a variability of less than 8%, even when only 16 beats were averaged, independently of their selection inside the whole recording. When compared with beat-to-beat measures, the averaging of 16 beats significantly reduced (by more than 50%) the interbeat variability of all indexes. Expected alterations in both diastolic and systolic function were evidenced both with ageing (peak filling atrial contraction and ejection rates: from 275+/-77 mls(-1), 76+/-30 ml s(-1) 230+/-70 mls(-1), respectively, in NY, to 160+/-33 mls(-1), 125+/-39 mls(-1), 163+/-54 mls(-1) in N) and with dobutamine (peak filling and ejection rates from 160+/-72 mls(-1) and 183+/-86 mls(-1) respectively, in control, to 253+/-75 mls(-1) and 251+/-105 mls(-1) with dobutamine). Signal averaging with time warping allows fast and improved assessment of LV function.

Aging↗
PubMed2001

A case of subannular aortic aneurysm detected by transoesophageal echocardiography.

Subvalvular aortic aneurysm is a cardiac abnormality extremely uncommon in white adult patients. Accurate diagnosis can be made by transoesophageal echocardiography which is the modality of choice for non-invasive recognition of aortic and subaortic abnormalities. In this report we describe, in a 47-year-old white man with subvalvular aortic aneurysm associated to aortic bicuspid valve, the echocardiographic diagnosis and cardiac intervention of aortic valve replacement with surgical obliteration of the orifice. A good surgical result was confirmed by an echocardiographic transthoracic examination performed after 6 months.

Aortic Aneurysm↗
PubMed2000

Diet therapy for rheumatoid arthritis. A controlled double-blind study of two different dietary regimens.

OBJECTIVE: To evaluate the effects of a diet therapy in patients with rheumatoid arthritis (RA). METHODS: Fifty RA patients entered a 24-week double-blind, randomised, controlled-study of two different dietary regimens (an experimental diet high in unsaturated fats, low in saturated fats with hypoallergenic foods vs. a control well-balanced diet). The primary end points of the study were 20% and 50% improvement in disease activity according to composite symptoms (Paulus index) of arthritis. Other end points were the other measures of disease activity at 12 and 24 weeks of diet treatment. RESULTS: The 2 groups were comparable at inclusion. Diet treatment was well tolerated and the rate of drop-outs was low. Percentage of patients with global 20 or 50% response didn't differ between experimental and control group after the 24-week of diet treatment. The experimental diet group did better for all the variables considered but only four variables (Ritchie's index, tender and swollen joints, and ESR) reached a statistical difference by multivariate analysis. Adjusting these data for weight variations, the number of tender joints (p=0.014) and ESR (p=0.025) were still statistically significant. CONCLUSIONS: Dietary manipulation, either by modifying food supplements or by reducing weight, may give some clinical benefit although no significant improvement can be observed assessing the results with a composite index.

Adult↗
PubMed2000

Evaluation of respiratory influences on left ventricular function parameters extracted from echocardiographic acoustic quantification.

This study was designed to assess, using the echocardiographic acoustic quantification technique, the influence of respiration on left ventricular (LV) function and its modifications connected with the ageing process, quantifying in a non-invasive way the respiratory contribution to the LV volume variability. An automated algorithm is applied to extract the beat-to-beat measurements of LV function parameters from the LV volume signal, obtained from recordings lasting a few minutes. Mean values, amount of variability and spectral content were studied in a population of 17 normal young (mean age 25 +/- 1 years) and 12 normal old (mean age 64 +/- 2 years) subjects. Mean values of the beat-to-beat measurements of LV function parameters were able to point out alterations connected with the ageing process in peak filling rate, peak atrial filling rate and peak ejection rate. Spectral analysis, applied to the extracted variability series, displayed a predominance of the high-frequency (HF) component corresponding to respiration in all LV function parameters; moreover, age related changes of HF variability were observed in peak ejection rate. The HF power spectrum component of beat to beat series extracted from the LV signal can provide a non-invasive assessment of the fluctuations in ventricular parameters associated with respiration.

Adult↗
PubMed2000

Lamotrigine-induced lupus.

A 57-year-old woman was under treatment for epilepsy with lamotrigine 2 mg/kg/d since 1996. In April 1998 she was admitted to the Rheumatology Unit for arthralgias affecting the small joints of the hands, wrists and knees, erythematosus skin rash and myalgias. She referred a vascular abnormality at the hands exposed to cold, compatible with Raynaud's phenomenon. Serum antinuclear antibodies (ANA) were positive (1:320, speckled pattern); moreover, a positivity for anti-Ro/SSA was observed. Rheumatoid factor was negative, serum complement was normal. LAC and anticardiolipin antibodies were negative. Drug-related lupus diagnosis was made with resolution of symptoms and gradual normalisation of positivity of ANA and anti-Ro/SSA upon lamotrigine withdrawal. To our knowledge, this is the first case report of an association between lamotrigine and the onset of SLE (systemic lupus erythematosus).

Antibodies, Antinuclear↗
PubMed2000

Evaluation of cardiac abnormalities and embolic sources in primary antiphospholipid syndrome by transesophageal echocardiography.

OBJECTIVE: Valvular lesions are frequently present in Primary Antiphospholipid Syndrome (PAPS) patients using transthoracic and/or transesophageal echocardiography. The aim of this study was to describe the prevalence of cardiac abnormalities (valvular thickening and/or regurgitation) or potential embolic sources (spontaneous echocontrast and/or vegetations) in PAPS patients. METHODS: Multiplane transesophageal echocardiography was performed consecutively on 40 PAPS PATIENTS: 17 of them with thrombocytopenia, 27 with at least one thromboembolic event (stroke, transient ischaemic attack, arterial and/or venous thrombosis, pulmonary embolism) and 14 with recurrent fetal loss. DESIGN: Cardiac involvement (cardiac abnormalities and/or embolic sources) was present in 33/40 (82%) of PAPS patients. According to aCL titer these lesions were revealed in 17/24 (71%) of patients with aCL < or = 40 GPL-U, while these lesions were present in 100% of patients with aCL > 40 GPL-U. Three patients presented mitral stenosis and 3 non-infective valve masses or vegetations. Embolic sources were found in 4/24 (17%) patients with aCL < or = 40 GPL-U, while they were observed in 6/16 (37%) of patients with titer of aCL > 40 GPL-U (chi2 = 10.03, P < 0.01). Regression analysis showed a positive correlation between mitral valve thickening and aCL antibodies titer (r = 0.5; P < 0.001). CONCLUSIONS: Valvular lesions are commonly found in PAPS patients. Our data showed a significant correlation among aCL titer, mitral leaflets thickening and thromboembolic events.

Adult↗
PubMed1994

[Multiplanar transesophageal echocardiography in a case of hypernephroma].

A 78-year-old man admitted to our hospital with signs and symptoms of right ventricular failure, consisting of severe edema of the scrotum and the penis, ankle edema, hepatomegaly, and a history of asthenia associated with a recent weight loss. Two-dimensional echocardiography showed an intracavitary mass in the right atrium and a moderate pericardial effusion; the remaining structures were normal. To better define the origin of this mass, transesophageal echocardiography was performed. The mass extended from the inferior vena cava with no sites of attachment to the atrial wall. The mass was elongated, mobile, with a triangular termination near the tricuspid valve, without signs of right ventricular obstruction. An abdominal-pelvic CT scan demonstrated the origin of the mass at the superior pole of the left kidney extending through the renal vein and the inferior vena cava into the right atrium. The mass was surgically removed and the pathological examination revealed a renal cell carcinoma (hypernephroma) of the clear cells subtype. After surgery, the patient did well with the resolution of the picture of right ventricular failure.

Aged↗