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Biomedical subjects

B Brusoni

Publications and source records attributed to B Brusoni.

At least 19 recordsLinked to original sources

[Effects of dopamine, noradrenaline and isoproterenol on pulmonary circulation in anesthetized dogs].

Experiments were performed on 19 anaesthetized open-chest dog instrumented with polyethylene catheters inserted: into the aorta, in pulmonary artery and in left atrium and with an electromagnetic flow-transducer placed around the ascending aorta in order to record : systemic arterial and pulmonary pressures, mean left auricular pressure and phasic aortic flow. Heart rate, stroke volume, total systemic and pulmonary resistance, cardiac work were moreover calculated. Each dog was given intravenously by slow infusione : Dopamine (micrograms 5--10--20/kg/min/ 5 min), Isoproterenol (microgram 0.125--0.25--0.5/kg/min/5 min) and Norepinephrine (microgram 0.25--0.5--1 /kg/min/5 min). Results obtained on systemic hemodynamics agree with those reported by many other investigators. On pulmonary circulation : Isoproterenol, at the tested doses, elicited vasodilator effects, Norepinephrine increased total pulmonary resistance but not pulmonary vascular resistance, while Dopamine did not modify or slightly reduced vascular pulmonary tone.

Animals

[Echocardiography in Ebstein's anomaly (author's transl)].

Results about an echocardiographic study of 20 patients with Ebstein's anomaly diagnosed by cardiac catheterization and angiography, are referred. In 8 patients an echocardiogram and phonocardiogram were recorded and in five patients an echocontrast examination was performed. The echocardiographic features constantly recorded in Ebstein's anomaly are represented by anterior chamber dilatation, interventricular septum paradoxical movement, anterior tricuspid leaflet wide excursion, decreased diastolic closure rate and delayed closure of tricuspid valve compared to mitral valve. The reduced left ventricular dimension and frequent incidence of "hammock-like" shape of mitral valve during systole and reduced diastolic closure rate of anterior mitral leaflet are pointed out. Possible causes of anterior chamber dilatation, of interventricular septum paradoxical motion and delayed tricuspid closure are discussed. According to the previous study no echocardiographic pattern is surely diagnostic of the disease by itself; a delayed tricuspidal closure (more than 70 msec) when associated to an anterior tricuspid leaflet wide excursion and decreased E-F slope, is of particular value for diagnosis.

Adult

Acute clinical tolerance of creatinol O-phosphate.

Acute clinical tolerance to N-methyl-N-(beta-hydroxyethyl) guanidine O-phosphate (creatinol O-phosphate, COP) was investigated in volunteer human subjects without heart or renal disease and without other serious illness. COP was administered i.v. at three different dosages, 1020 mg (group A), 2040 mg (group B) and 3060 mg (group C), in comparison with a placebo (group D). Arterial pressure, heart rate, ECG pattern and a complete blood analysis showed no change at any COP dosage, with the exception of blood phosphate, which increased in groups B and C. Cumulative urinary excretion of phosphate and creatinine and diuresis increased, whereas other urine parameters did not change. The phosphate and creatinine increases derived from the COP molecule and the increase in diuresis from a simple osmotic process required to dilute the phosphate in the tubular fluid. All these alterations were statistically significant and dose-related with COP and had been expected. COP proved to be a very well tolerated drug without any evident side effect.

Adolescent

Hemodynamic and metabolic changes induced by temporary clamping of the thoracic aorta.

Numerous authors reported a significant deterioration of heart function induced by aortic cross-clamping. Nevertheless, the aorta has been clamped during various surgical procedures without any complication. We studied the hemodynamic and metabolic variations induced by 20 min thoracic aorta cross-clamping in 6 open-chest dogs. During clamping the most striking modifications were an increase in coronary blood flow of over 65%, an increase in cardiac work of over 77% and an increase in total peripheral resistances of over 68% compared to base values. No significant variations were found in the heart rate and cardiac index. Metabolic parameters, such as O2 consumption and lactate consumption increased significantly during the clamping period. The increase in lactate consumption and the progressive and continuous improvement in oxygenation indexes (lactate/pyruvate, redox potential, excess of lactate) proved the absence of any myocardial anoxia during this period. Within 15--30 min after declamping all hemodynamic and metabolic parameters reverted to values close to basal values. These data strongly suggest that the mammalian heart can tolerate this procedure satisfactorily for a limited period of time. In clinical settings, one should consider the base conditions of the cardiovascular system before transposing these conclusions.

Animals

[The incomplete atrio-ventricular canal. Operative and long term results in 100 cases (author's transl)].

100 patients with endocardial cushion defect of the partial type underwent surgical correction between the years 1957-1975. The age of patients ranged from 3 to 57 years with a mean of 18 years. In 89 patients there was a mitral insufficiency. The repair of the mitral valve was performed in 78 patients; in 21 was repaired also the tricuspidal valve. The hospital mortality was of 8 patients. The mortality was correlated with the age of the patients, the pulmonary pressure and with the presence of malformations of the tricuspid valve. A major complication was represented by a complete atrioventricular block that occurred in 8 patients, in 5 of these the block disappeared before the dimission from the hospital. 86 patients have been followed for a period variable from 2 to 228 months and an average of 61 months. The late mortality was of 4 patients. Two patients have been reoperated of mitral valve replacement because of residual important mitral insufficiency. The phonocardiographic study, done in 50 patients, showed a presence of a holosystolic murmur in 20. The standard X-ray chest and electrocardiogram iid not show important changes between the pre and post operative examination.

Adolescent

Pharmacokinetics of deslanatoside C-3H administered parenterally to the guinea-pig, rabbit and dog.

The pharmacokinetics of Deslanatoside C-3H, a short-acting polar cardiac glycoside, were investigated in the guinea-pig, rabbit and dog, after parenteral administration. Deslanatoside C was on average 20% plasma protein-bound and had a red blood celle/plasma partition ratio of 1/9. Tissue uptake of Deslanatoside C observed in the guinea-pig seems on average to be higher than in rabbits. Among the various organs and fluids tested, the highest levels were encountered in the urine, bile and kidneys of both the guinea-pig and rabbit. The main excretory route of this glycoside was via the urine, although significant amounts were excreted via the bile in all the three species tested. Cumulative urinary excretion 24 hr after i.v. injection was 50% (75% of which in unchanged form) in the guinea-pig, 46.5% (86% of which in unchanged form) in the rabbit, and 42.9%(84% of which in unchanged form) in the dog. Among the cardiac glycosides, Deslantoside C seems to possess the highest urinary excretion rate, which has in fact also recently been confirmed in human subjects.

Animals

[Value of echocardiography in the diagnosis of dissecting aneurysm of the aorta].

A revision of 1300 echocardiograms of adults showed 14 patients whose echocardiographic diagnosis of aortic root dissecting aneurism (D.A.). Of these, 8 didn't have any anamnestic, clinical or instrumental evidence of D.A. In the other 6, admitted to our department with a suspected D.A., echocardiography proved to be useful in confirming such diagnosis in 4, in excluding it in 1, but gave a false positive diagnosis of D.A. in the sixth, affected by a diffuse carcinomatosis with pleuropericardial blood effusion. From the examination of the present experience, the Authors deem echocardiography is a useful diagnostic tool in the screening of D.A. when the following conditions are fulfilled: 1) presence of all the major criteria of Nanda and Gramiak, especially the aortic root anterior wall dilatation beyond 16 mm; 2) an almost suggestive story and clinical evidence of D.A. The usefulness of an echocardiographic pattern recently described as diagnostic of D.A. (loss of continuity between the borders of the anterior aortic wall with interventricular septum, and/or posterior aortic wall with mitral anulus) was confirmed: it was detected in 3 of the 4 D.A. patients but in none of the others. The presence of a false positive and the possibility of technical artifacts nevertheless induce caution in the interpretation of the echocardiographic pattern alone.

Adult

[The mitral prolapse syndrome. Observation of 100 cases (author's transl)].

100 patients with mitral prolapse syndrome (MPS) were studied with electrocardiogram, phonocardiogram, thorax radiography and echocardiogram. In 44 of the patients, the effort test and dynamic electrocardiogram were performed; 25 underwent hemodynamic examination, and 10 underwent selective coronarography. The most frequent symptomatologies were palpitations and vertigo; the most-registered electrocardiographic alterations were ventricular extrasystoles and altered electrical repolarization in the inferior seat. The symptomatic patients with rhythm disturbances showed reduced work capacity (RWC) with aggravation of the effort arrhythmias. The phonocardiogram showed variability of the phonoauscultatory reports, not only from patient to patient, but also in the same patient. The apicocardiogram presented a characteristic systolic re-entry which coincided with the non-ejective click. In all cases, the echocardiogram demonstrated a systolic movement backwards from the mitralic strips with different aspects. The endocavitary pressures in the studied cases were normal or only slightly altered. The left ventriculography frequently demonstrated assynergic areas, and constantly, eversion of the posterior mitralic strips in the left atrium. In most of the cases, the selective coronarography showed the absence of the ventricular atrial tract of the circumflex. The sustained role of the mixomatous degeneration in the pathogenetic mechanism of the MPS must be emphasized. The beta-blockers were the most effective drugs against arrhythmias, which in some cases showed themselves impervious to any medicinal treatment. MPS is considered a very diffuse disease which can run its course without detection or which can be accompanied by serious rhythm disturbances that can threaten the patient's life. The importance of echocardiography in the diagnosis of MPS is emphasized. The SPM patient showed undergo a series of wave tests which reveal malignant potentialities, so that the best therapeutic principles, both for the treatment and prevention of the arrhythmias, can be applied.

Adolescent