Assuntos
Anastomose Cirúrgica/métodos , Arritmias Cardíacas/prevenção & controle , Transplante de Coração/métodos , Transplante de Coração/fisiologia , Adolescente , Adulto , Arritmias Cardíacas/epidemiologia , Doenças Transmissíveis/epidemiologia , Quimioterapia Combinada , Eletrocardiografia , Feminino , Rejeição de Enxerto/epidemiologia , Cardiopatias/cirurgia , Transplante de Coração/mortalidade , Hemodinâmica , Humanos , Imunossupressores/uso terapêutico , Incidência , Masculino , Pessoa de Meia-Idade , Morbidade , Complicações Pós-Operatórias/prevenção & controle , Taxa de SobrevidaRESUMO
Azathioprine is an immunosuppressive drug occasionally indicted as the cause of some episodes of acute cholestasis. The case described confirms the possibility of acute, severe, and reversible cholestatic hepatopathy of iatrogenic (toxic rather than idiosyncratic) origin.
Assuntos
Azatioprina/efeitos adversos , Colestase/induzido quimicamente , Transplante de Coração , Adulto , Azatioprina/uso terapêutico , Ciclosporinas/uso terapêutico , Humanos , Terapia de Imunossupressão , Masculino , Prednisona/uso terapêuticoAssuntos
Soropositividade para HIV/epidemiologia , Soroprevalência de HIV , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Itália/epidemiologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
An invasive (left ventricular pressure recording) and a noninvasive technique (M-mode echocardiography) were combined during the hemodynamic study of 15 patients with various degrees of left ventricular impairment, in order to provide left ventricular function parameters independent from contrast studies. Left ventricular pressure, dimension and wall thickness changes were continuously digitized on a computer system, which was able to derive the ventricular pressure-dimension loop and to calculate the midwall equatorial stress at end-diastole and peak-systole. The parameters derived from the loop (diastolic work, net systolic work, cycle efficiency) and midwall meridional and circumferential stresses were compared with the results of contrast ventriculography and with the wall hypertrophy index. Diastolic work appeared to be correlated with the systo-diastolic volume change; systolic work correlated with the ejection fraction; the cycle efficiency was inversely correlated with both end-diastolic and end-systolic volumes and directly correlated with the hypertrophy index. Midwall stress, both end-diastolic and peak-systolic, was strongly and positively correlated with ventricular volumes, while it decreased with increasing hypertrophy. Systolic stress increased with decreasing ejection fraction. The combined echo-pressure technique, through the evaluation of the pressure-dimension loop and the calculation of wall stress, can generate data of left ventricular function that allow a more complete assessment of left ventricular impairment.
Assuntos
Pressão Sanguínea , Cardiomegalia/fisiopatologia , Ecocardiografia , Cardiopatias/fisiopatologia , Adolescente , Adulto , Idoso , Cardiomegalia/diagnóstico por imagem , Feminino , Cardiopatias/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
The AA. relate the results of an echocardiographic study carried out on some patients with mitral stenosis associated or not with mitral regurgitation or with other valvular disease. Ten patients who had to undergo to surgical commissurotomy, were studied before and in the early post-operative period. The M-mode echocardiography appeared to be always available to diagnose the mitral stenosis, but not to quantify it. On the other side the two dimensional echocardiography is proven to be a useful method in the quantitative study of the mitral area and particularly when it is applied in the evaluation of the surgical results of comparing the pre and post-operative examinations. The data obtained were analysed with statistical method.
Assuntos
Estenose da Valva Mitral/cirurgia , Adulto , Ecocardiografia , Seguimentos , Humanos , Pessoa de Meia-IdadeRESUMO
The echocardiogram is able to diagnose on which valvular leaflet or cusp the bacterial vegetations are implanted; it is also able to recognize the type of lesion (destroying vegetations, prolapsing vegetations, etc.). In our experience the echocardiographi findings were fully confirmed at surgical intervention in 12 of the 13 patients studied.
Assuntos
Ecocardiografia , Endocardite Bacteriana Subaguda/diagnóstico , Infecções Estafilocócicas/diagnóstico , Infecções Estreptocócicas/diagnóstico , Adulto , Idoso , Valva Aórtica/cirurgia , Ecocardiografia/instrumentação , Endocardite Bacteriana Subaguda/complicações , Endocardite Bacteriana Subaguda/cirurgia , Feminino , Cardiopatias Congênitas/complicações , Doenças das Valvas Cardíacas/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/cirurgiaRESUMO
2 patients, aged 8 mth and 48 yr, referred for a clinical diagnosis of ventricular septal defect, were studied by ultrasound. In both a fluttering and an anterior bowing of the systolic segment of the tricuspid valve was found, consistent with a left ventricular--right atrial communication. Diagnosis was confirmed by angiography and open-heart surgery, showing in 1 patient a supravalvular defect, and an infravalvular one in the other. The postoperative echocardiograms of the tricuspid valve were normal. Ultrasound appears to be a safe and simple method in detecting this rare cardiac abnormality.