[Left atrial thrombosis in patients with antiphospholipid antibody syndrome and mesenchymal abnormal septum]. / Trombosi atriale destra in paziente con sindrome da anticorpi antifosfolipidi e setto anomalo mesenchimale.

Antiphospholipid antibodies are a heterogeneous family of immunoglobulins that includes lupus anticoagulant and anticardiolipin antibodies. They are strongly associated with a clinical syndrome characterized by venous and arterial thrombosis and spontaneous fetal losses. This syndrome may be primary or else secondary to autoimmune or neoplastic diseases. The cardiovascular system is frequently involved with mitral or aortic insufficiency, juvenile myocardial infarction, and primitive pulmonary hypertension. However, the occurrence of intracardiac thrombi is rare. We describe a case of an intracardiac right atrial thrombus in a 19-year-old asymptomatic woman who was admitted in December 1998 to the Thrombosis Center owing to the finding, during routine work-up, of a prolonged activated partial thromboplastin time (71 s) and thrombocytopenia (71 x 1000/mm3), a positive antinuclear antibody test (1/320), positivity for lupus anticoagulant, and increased IgG (92 GPL-U/ml) and IgM (27 MPL-U/ml) anticardiolipin antibodies. Six months later, the patient presented with headache, edema and cyanosis of the face and jugular swelling. Transthoracic and transesophageal echocardiography revealed a right atrial mass which was clearly distinguishable from the tricuspid valve and extended to the superior vena cava. The patient was successfully submitted to surgical excision of the thrombus. Histology revealed that the mass was adherent to an abnormal septum consisting of mesenchymal tissue. Although the American Rheumatology Association criteria for the diagnosis of systemic lupus erythematosus were not fulfilled, the positivity of antinuclear antibody test is in favor of a lupus-like syndrome. The decision to opt for surgical excision of the thrombus was determined by the unclear nature of the atrial mass. It may be necessary that such patients be submitted to anticoagulant therapy for the rest of their lives or temporarily (6-12 months). This underscores the importance of the anatomical abnormality as a promoting factor. Transthoracic echocardiography (as well as transesophageal echocardiography in selected cases) must be considered as an essential component of the initial diagnostic work-up in patients presenting with antiphospholipid antibodies.

Lipoprotein (a): effect of detraining.

Plasma levels of lipoprotein (a), total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apo-protein Al and apoprotein B were evaluated for 8 long-distance runners during the XXIII New York Marathon, with blood samples being taken before and after the race, and after one month of detraining. After detraining lipoprotein (a) increased significantly both with respect to basal values and especially with respect to immediately post-race values. Negligible and predictable modifications of the other metabolic parameters evaluated, were observed. No correlation was found between lipoprotein (a) and the anthropometrical data and metabolic parameters considered.

The influence of ubiquinone (Co Q10) on the metabolic response to work.

Ubiquinone (Co Q10) is a natural substance suitable for therapeutic use in cardiology and in the treatment of some muscular diseases. It might therefore be used during strenuous exercise (as in athletic competitions), especially in the presence of metabolic modifications which may justify its use. For this purpose, we have evaluated the effect of prolonged treatment with Co Q10 (100 mg/day per os for one month) on the biological changes induced by prolonged work on an ergometer bicycle (equal to about 50% of the single VO2max per 60 m'), immediately followed by exhaustive work (25 watts increase every 2 m'). From the venous blood of 12 healthy untrained subjects (students, volunteers, mean age 25.7 and body mass index 23.3) we examined some biological parameters [free fatty acids (FFA), free glycerol, lactate, glucose, insulin, CK] before, at the end of aerobic work, at the end of exhaustive work, and after 30 and 60 m' of the recovery phase. The same indexes, measured after identical times and work, were evaluated after one month of treatment with Co Q10. The only relevant modifications observed were those concerning FFA: at the end of aerobic work and after the administration of the drug, lower levels were reached (before, 1011 +/- 329 microEq/l; after 790 +/- 392; p less than 0.05); the same trend was observed at the end of the exhaustive work (1031 +/- 320 microEq/l vs 826 +/- 387; p less than 0.05). At the subsequent times, as well as for the other biological parameters examined, we did not observe any variation before or after the period of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of anabolic steroids, testosterone, and HGH on blood lipids and echocardiographic parameters in body builders.

To evaluate the metabolic or cardiovascular effects induced by self-administration of human growth hormone (HGH) alone or combined with testosterone and anabolic steroids, we conducted a study with 15 male body builders. Of these, 8 (control group) did not take any hormonal substances; 6 (experimental group) self-administered testosterone, anabolic steroids, and HGH for 6 weeks in various dosages; 1 subject self-administered only HGH for an equal period of time. At the end of the period of treatment with the hormonal combination, the experimental group continued for 2 additional weeks with anabolic steroids and testosterone only. All maintained the same, unaltered type and intensity of training, and constant diet. Before the beginning of treatment with hormonal substances, after 6 weeks, and at the end of treatment (for a total of 8 weeks), they were tested for total and HDL-cholesterol (t-chol and HDL-chol), apolipoproteins A-1 and B (apo A-1 and B), and triglycerides (tg). Before the start and after 6 weeks, an echocardiographic examination was performed to assess left ventricular dimensions and function in all 15 body builders. The most interesting result is a significant decrease of HDL-chol and apo A-1 derived from self-administration of anabolic steroids and HGH together.