Showing papers by "Maurizio Galderisi published in 1994"

Cardiac abnormalities in young women with anorexia nervosa.

Abstract: OBJECTIVE--To identify the characteristics of cardiac involvement in the self-induced starvation phase of anorexia nervosa. METHODS--Doppler echocardiographic indices of left ventricular geometry, function, and filling were examined in 21 white women (mean (SD) 22 (5) years) with anorexia nervosa according to the DSMIII (Diagnostic and Statistical Manual of Mental Disorders) criteria, 19 women (23 (2) years) of normal weight, and 22 constitutionally thin women (21 (4) years) with body mass index < 20. RESULTS--13 patients (62%) had abnormalities of mitral valve motion compared with one normal weight woman and two thin women (p < 0.001) v both control groups). Left ventricular chamber dimension and mass were significantly less in women with anorexia nervosa than in either the women of normal weight or the thin women, even after standardisation for body size or after controlling for blood pressure. There were no substantial changes in left ventricular shape. Midwall shortening as a percentage of the values predicted from end systolic stress was significantly lower in the starving patients than in women of normal weight: when endocardial shortening was used as the index this difference was overestimated. The cardiac index was also significantly reduced in anorexia nervosa because of a low stroke index and heart rate. The total peripheral resistance was significantly higher in starving patients than in both control groups. The left atrial dimension was significantly smaller in anorexia than in the women of normal weight and the thin women, independently of body size. The transmitral flow velocity E/A ratio was significantly higher in anorexia than in both the control groups because of the reduction of peak velocity A. When data from all three groups were pooled the flow velocity E/A ratio was inversely related to left atrial dimension (r = -0.43, p < 0.0001) and cardiac output (r = -0.64, p < 0.0001) independently of body size. CONCLUSIONS--Anorexia nervosa caused demonstrable abnormalities of mitral valve motion and reduced left ventricular mass and filling associated with systolic dysfunction.

Early changes of the arterial carotid wall in uncomplicated primary hypertensive patients. Study by ultrasound high-resolution B-mode imaging.

Abstract: Arterial hypertension is frequently responsible for arteriosclerotic damage in the carotid region. Nevertheless, there is as yet no general agreement that hypertension is correlated with lesions detected by noninvasive means in the carotid arteries. We studied, by noninvasive echotomographic technique, 70 uncomplicated primary hypertensive individuals without clinically evident end-organ complications and 30 normotensive matched control subjects to detect early lesions of carotid arteries. The presence of other cardiovascular risk factors was assessed, and heart structure and function were studied by echocardiography. Although hypertensive individuals were comparable to control subjects for other risk factors, they showed a marked increase in the thickness of the intimal-medial complex of the carotid wall (0.71 +/- 0.4 versus 0.56 +/- 0.2 mm, P < .001 in the right carotid and 0.83 +/- 0.3 versus 0.58 +/- 0.2, P < .003 in the left), in left ventricular mass (203 +/- 52 versus 176 +/- 37 g, P < .05), and in the prevalence of definite plaques of the carotid wall, both monolaterally and bilaterally (P < .003 by chi 2 test). Among the different factors contributing to the increase in thickness of the carotid artery wall, standing blood pressure, serum triglycerides, and age were found to be the best predictors (they accounted for about 16% of the variability, P < .005). These results indicate that carotid arteries of hypertensive individuals undergo degenerative changes, just as shown for hypercholesterolemic and diabetic patients in other studies. This supports the use of B-mode ultrasound imaging to detect early involvement of the carotid region before the appearance of any end-organ damage of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Reduction of left ventricular mass by short-term antihypertensive treatment with isradipine: a double-blind comparison with enalapril.

Abstract: The aim of the present study was to evaluate the effect of dihydropyridine calcium antagonist isradipine on left ventricular (LV) structure and function in patients with essential hypertension. Cuff blood pressure and Doppler echocardiographic variables were assessed in 26 patients with mild to moderate hypertension (diastolic blood pressure range 95-110 mmHg) before and after 12 weeks of therapy with either isradipine 5 mg daily or enalapril 20 mg daily. The study was of double-blind, parallel design, with a placebo run-in period of 15 days. Three subjects withdrew from isradipine treatment because of flushing and 2 from enalapril treatment due to cough before completing the study. Both drugs significantly reduced cuff systolic and diastolic blood pressure (p < 0.001) without affecting heart rate. By virtue of the decrease in both septal wall (p < 0.01) and posterior wall thicknesses (p < 0.05), isradipine treatment produced a significant reduction in LV mass adjusted for height (p < 0.001) in comparison with placebo; also LV end-systolic dimension showed a slight decrease (p < 0.05). Enalapril induced a similar reduction in LV end-systolic dimension (p < 0.05) but the changes of wall thickness and LV mass did not reach statistical significance. In conclusion, our results indicate that isradipine treatment improves LV systolic function and causes a significant reduction in LV mass. This reduction is observed early in the course of antihypertensive treatment and is effective in both patients with and without LV hypertrophy.

Cardiac abnormalities inyoung women with anorexia nervosa

Abstract: Objective-To identify thecharacteristics ofcardiac involvement intheself-induced starvation phaseofanorexia nervosa. Methods-Dopplerechocardiographic indices ofleft ventricular geometry, function,andfilling wereexaminedin21 whitewomen (mean(SD)22(5)years) withanorexia nervosaaccording tothe DSMIII (Diagnostic and Statistical ManualofMentalDisorders) criteria, 19 women (23(2)years) ofnormalweight, and22constitutionally thinwomen (21 (4)years) withbodymassindex<20. Results-13 patients (62%)hadabnormalities ofmitral valve motioncompared withonenormalweightwomanandtwo thinwomen (p< 0-001) v bothcontrol groups).Left ventricular chamber dimension andmassweresignificantly less inwomenwithanorexia nervosa than ineither thewomenofnormalweightor thethinwomen,evenafter standardisationforbodysizeorafter controlling for bloodpressure. Therewerenosubstantialchangesinleftventricular shape. Midwall shortening asapercentage ofthe values predicted fromendsystolic stress was significantly lowerinthestarving patients thaninwomenofnormalweight: whenendocardial shortening wasusedas theindexthisdifference wasoverestimated.Thecardiac indexwasalsosignificantly reducedin anorexianervosa because ofalowstroke indexandheart rate. Thetotal peripheral resistance was significantly higher instarving patients thaninbothcontrol groups.The left atrial dimension wassignificantly smaller inanorexia thaninthewomenofnormal weightandthethinwomen,independently ofbodysize. Thetransmitral flow velocity EIAratio wassignificantly higher inanorexia thaninboththecontrol groupsbecause ofthereduction ofpeak velocity A. When datafromallthree groups werepooled theflowvelocity EIA ratio wasinversely related toleft atrial dimension(r= -043,p < 0.0001) and cardiacoutput(r= -0-64,p < 0.0001) independently ofbodysize. Conclusions-Anorexia nervosacaused demonstrable abnormalities of mitral valve motionandreduced left ventricular massandfilling associated withsystolic dysfimction.