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Biomedical subjects

U Martini

Publications and source records attributed to U Martini.

At least 19 recordsLinked to original sources

Focal cerebral ischemia and patent cardiac foramen ovale.

By means of transthoracic contrast echocardiography, the prevalence of a patent foramen ovale (PFO) was studied, in a continuous series of 48 patients aged less than 50 years with a recent episode of acute cerebral ischemia. A PFO was found in 11 subjects (23%). In the subgroup of younger patients (aged less than 30 years), the prevalence was much higher than in those aged 30 or more (58% against 11%, p = 0.0022). In the 19 patients with clear evidence of extracardiac causal factors of cerebral ischemia, there was no PFO; of the remaining 29 subjects, a PFO was present in 11 (38%) (p = 0.0015). In conclusion, the possible presence of a PFO must be carefully investigated in subjects with cerebral ischemia aged less than 30, as well as in subjects aged between 30 and 50 in whom there is no acceptable explanation for their cerebral ischemic episode.

Adult↗

New therapeutic strategies in the management of congestive heart failure.

Congestive heart failure is a syndrome with multiple causes and manifestations. While rheumatic heart disease and hypertension are in decline, coronary artery disease is the leading cause in patients referred for evaluation of heart failure. Decrease in cardiac contractility and general neurohormonal activation, which trigger alterations in mechanical and biochemical factors in cardiac muscle and bring derangements of haemodynamics, are now considered as excessively early compensatory mechanisms which can be regarded as deleterious in patients with heart failure. Therapeutic principles illustrated in this article emphasize the importance of basic research and clinical observations derived from trials set the stage for therapeutic interventions. The approach to the patient with silent myocardial dysfunction must be treated so as to have the greatest beneficial impact on the prognosis of this disease.

Drug Therapy, Combination↗

[The effects of pharmacological treatment in asymptomatic left ventricular dysfunction].

It is clearly settled that the management of overt heart failure offers poor prognostic impact due to the advanced setting of the disease. Relief of symptoms, objective benefits, as testified by short-term hemodynamic improvements, are as a matter of fact not reliable prognostic markers. Myocardial dysfunction starts early in the natural history of many cardiac diseases, and runs through the steps of progressive wall remodeling, witnessed by quantitative and qualitative changes in cells, interstitium and connective tissue. Experimental studies offered keys to interventions modulated to oppose the pathophysiological changes present in early myocardial dysfunction. At present, medical therapy has made great strides in testing early myocardial dysfunction. Angiotensin-converting enzyme inhibitors, which retard ventricular dilatation and thus may lower myocardial oxygen consumption requirements seem to offer a unique prognostic profile. Preliminary pilot studies on them and some of many large-scale multicentre trials still in progress reached evidence that this class of drugs is by this time a cornerstone of medical therapy, useful to lower cardiac events-rate in patients with heart failure.

Adaptation, Physiological↗

[Behaviour of left ventricular systolic time intervals after isometric exercise in patients with ischemic heart disease (author's transl)].

The authors describe differences in behaviour of left ventricular systolic time intervals after isometric exercise between patients with ischemic heart disease and normal control. Isometric exercise consists of tonic hand-grip, which is to be gauged by hand-grip dynamometer for 5 minutes at 30% of the patient's maximum voluntary contraction or for 2-3 minutes at 50%. The parameters referred to are pre-ejection period and left ventricular ejection time index (PEPI, TETI), the PEP/TET ration, heart rate and arterial pressure. The authors conclude that from isometric exercise it is possible to point out the heart failure degree in patients with ischemic heart disease.

Blood Pressure↗