Biomedical subjects

C Forleo

Publications and source records attributed to C Forleo.

23 records · Page 2Linked to original sources

PubMed1997

[Value of peak oxygen consumption during exercise for the prognostic stratification of patients with severe systolic dysfunction of the left ventricle].

We sought to assess the prognostic value of peak exercise oxygen consumption (peak VO2) in patients with severe left ventricular systolic dysfunction and mild to moderate symptoms of chronic heart failure. We focused on 1-year mortality. We prospectively studied 77 patients with left ventricular ejection fraction (EF) < or = 25% and NYHA functional class I/II (61%) or III (39%). All patients underwent cardiopulmonary exercise test, two-dimensional echocardiography and 24-hour Holter monitoring. Examined variables were age, etiology, NYHA functional class, EF, peak VO2, and presence of nonsustained ventricular tachycardia. Overall 1-year mortality rate was 23%. At univariate analysis, age > or = 60 years, ischemic etiology, and peak VO2 < 14 ml/kg/min were significantly associated with mortality. At multivariate analysis, peak VO2 was the most powerful predictor of death (p = 0.0001). In the subgroup of patients with a peak VO2 < 14 ml/kg/min, the actuarial 1-year mortality rate was 56%. One additional patient underwent heart transplantation because of severe hemodynamic deterioration. By contrast, in the subgroup of patient with a peak VO2 > 14 ml/kg/min, 1-year mortality rate was 11%. This study provides evidence that patients with severe left ventricular dysfunction and mild to moderate symptoms of chronic heart failure can be accurately stratified into subgroups with strikingly divergent prognosis by an objective criteria such as peak VO2.

Analysis of Variance↗

PubMed1996

Effects of nadolol and its combination with atrial pacing on rate-enhanced ventricular premature complexes.

To explore the role of heart rate in the genesis of ventricular premature complexes whose incidence increases when the length of the preceding cardiac cycle decreases, we analyzed the effect of nadolol alone and together with atrial pacing in 4 patients. Nadolol lengthened the RR cycle and suppressed ventricular premature complexes; atrial pacing, restoring the baseline RR cycle lengths, led to the reappearance of ventricular premature complexes, suggesting the major role of heart rate.

Adult↗

PubMed1996

Short- and long-term reproducibility of time and frequency domain heart rate variability measurements in normal subjects.

OBJECTIVE: To obtain data relating to the reproducibility of the time and frequency domain measurements obtained from 10-min ECG recordings. METHODS: Eighteen normal volunteers underwent evaluations of time and frequency domain heart rate variability 2 weeks and 7 months after baseline analysis. The time domain parameters were mean NN, the standard deviation of NN intervals, the percentage of successive NN intervals > 50 ms and the root mean square successive difference of NN intervals. The frequency domain evaluations (total power, low frequency, and high frequency) were made by means of both the Fast Fourier Transform algorithm (FFT) and the autoregressive method (AR) from 10-min ECG recordings made under three different conditions: rest, controlled respiration, and after a passive head-up tilt test. Reproducibility was evaluated by means of the interclass correlation coefficient (ICC), comparing baseline values with the results obtained at the second week and the seventh month. Time domain evaluation were also made from 10-min ECG. RESULTS: All of the time domain measurements had an ICC > or = 0.75, except for the standard deviation of NN intervals, which had an ICC of 0.57. The frequency domain parameters obtained by means of either FFT or AR showed similar reproducibility. Low frequency was reproducible under all three conditions, total power only at rest, and high frequency only during controlled respiration. CONCLUSION: The reproducibility of frequency domain parameters depends on the analysed condition. These results are of primary importance when the effects of drugs or other interventions on heart rate variability are under investigation.

Adult↗

PubMed1996

[Medium-term clinical experience with automatic transvenous defibrillators implanted in the chest area without subcutaneous electrodes].

From March 1992 to April 1996 a pectoral biphasic transvenous implantable cardioverter defibrillator without subcutaneous leads was implanted in 35 patients with life threatening ventricular tachyarrhythmias. Mean age was 58 +/- 9 years; 23 patients had coronary artery disease, 10 non ischemic dilated cardiomyopathy and 2 arrhythmogenic right ventricular dysplasia. All were in NYHA functional class I and II and 4 in class III: mean ejection fraction was 35 +/- 12%. The mean duration of the implantation procedure was 85 +/- 35 min. The mean defibrillation threshold, measured in 23 active-CAN devices was 8.8 +/- 5 J. There were no operative complications except in one case of transient ischemic electromechanical dissociation. The mean hospital stay from the time of implant to predischarge evaluation was 6.2 +/- 2 days. The average follow-up period was 18.5 +/- 11 months. Two patients had non sudden and non arrhythmic cardiac death in the third and sixth month, respectively. In 19 patients 171 implantable cardioverter defibrillator interventions were reported: in 5 patients five inappropriate interventions were reported and in the remaining 14 were reported: 35 ventricular fibrillation and 131 ventricular tachycardia. The short duration of the procedure, brief hospitalization with very low perioperative morbidity, high efficacy and low mid-term complications give a new image to this therapeutic option.

Adult↗

PubMed1987

[The Italian Group for the Study of Streptokinase in Myocardial Infarct: Study of electrocardiographic changes].

The twofold purpose of the ECG sub-group study of G.I.S.S.I. (Gruppo Italiano per lo Studio della Streptokinasi nell'Infarto miocardico) is to evaluate whether exist different ECG evolution in pts with AMI treated with streptokinase (SK YES) and/or with coronary reperfusion (early CK peak) with respect to pts non treated with streptokinase (SK NO) and/or without coronary reperfusion (late CK peak) and to establish whether the ECG is useful to recognize the patients in which reperfusion occurs. Among 365 pts randomized for G.I.S.S.I., 209 pts with first myocardial infarction, admitted within 6 hours from the onset of pain, alive for at least 24 hours, were included. 98 were SK YES and 111 SK NO: 48 cases (group A) had the CK peak before 15th hour; 59 cases (group B) had the CK peak between 15th and 21th hour: 102 cases (group C) had the CK peak after 21th hour. In all the patients ECG was analyzed on admission and thereafter at 3rd, 6th, 9th, 12th, 24th hours and on 2nd, 3rd, 7th and 14th days. RESULTS--Anterior myocardial infarction--SK YES pts had in respected to SK NO pts a significantly lower sum of ST elevation on anterior leads (sigma ST increases V1-V6) at all times after admission starting from 6th hour. A similar behaviour was observed in groups A and B in respect to group C. SK YES pts when compared to SK NO pts had an earlier loss of the sum of R wave in anterior leads (sigma RV1-V6), although the difference was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Trials as Topic↗