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Biomedical subjects

C Strozzi

Publications and source records attributed to C Strozzi.

At least 37 records · Page 2Linked to original sources

Vasodilator treatment for mild to moderate heart failure. Effect of Ro 12-4713, a minoxidil analogue.

18 patients (14 men, 4 women) with a mean age of 64.3 years (range 41-75) and with chronic cardiac failure, NYHA functional class 1-2 (12 cases) or 2-3 (6 cases), insufficiently responsive to digitalis and diuretics, were treated for 4 weeks with Ro 12-4713, a minoxidil-like drug. The effects were assessed at rest and during maximal exercise, each patient was his own control. All patients completed the study. The treatment did not affect the body weight, the heart rate or the blood pressure, but it should be stressed that all patients were normotensive. The ejection fraction (by 99mTc pertechnetate scintigraphy) increased from 42.0 +/- 10.0 (resting means +/- SD) to 48.9 +/- 8.7%, and from 44.7 +/- 10.1 to 57.9 +/- 8.7% (end-exercise values), both changes being significant (p less than 0.0001). The ejection rate increased in a similar manner. The resting stroke volume increase from 53.5 +/- 13.6 to 60.2 +/- 16.5 ml (p less than 0.005), but the exercise stroke volume did not increase significantly. The cardiac output increased both at rest and during exercise, but the changes did not reach statistical significance. The end-diastolic volume decreased from 132.6 +/- 126.9 +/- 47.0 to 126.9 +/- 42.3 ml (resting values), and from 151.5 +/- 44.4 to 120.6 +/- 36.6 ml (exercise), the changes being significant (p less than 0.005). The physical work capacity increased, i.e. the duration of exercise increased from 7.8 +/- 3.2 to 9.9 +/- 1.9 min (p less than 0.05) and the 'quality of life' (symptoms related to heart failure) improved (fewer symptoms) in 14/18 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Some biochemical platelet patterns in stable coronary patients.

Patients affected by stable angina pectoris whose platelets were characterized by ultrastructural alterations, were investigated in some biochemical changes of their platelets. A decrease of P.A.R. (platelet aggregate ratio), an increase of MDA production in particular conditions, nevertheless a stability of cAMP content in platelets, even after thrombin stimulation, were found.

Aged

Tiapamil in the management of supraventricular arrhythmias occurring after acute myocardial infarction.

18 patients with acute myocardial infarction and sustained supraventricular arrhythmias were treated with tiapamil, in a dose of 1 mg/kg i.v. The drug was effective, i.e., the heart rate was reduced to less than 90 beats/min in 9 of 10 patients with atrial fibrillation, in 3 of 4 patients with atrial flutter, and in 3 of 4 patients with atrial tachycardia. The peak effect was observed within 2-5 min. In cases with recurring tachyarrhythmias, tiapamil was also effective during successive administrations, the systolic blood pressure was reduced by 10-15%, but severe hypotension was not observed. In these patients, no major changes in atrioventricular or intraventricular conduction were observed. In the dose used, tiapamil was effective and well tolerated.

Aged

Antihypertensive effects of a novel peripheral vasodilator, Ro 12-4713.

The effects of Ro 12-4713, a vasodilator, on blood pressure and heart rate, were tested in 13 ambulant patients with mild to severe hypertension. The patients received Ro 12-4713 in total oral doses ranging from 1.5 to 4 mg/kg over a 3-5 day period. Standard laboratory tests were done 24 h before and after the study. Standing and supine blood pressure and heart rate were determined before, and every hour for 6-8 h after drug administration. ECGs were recorded before, during and at the end of each study day. Ro 12-4713 reduced the pretreatment standing and supine-blood pressure from 213 +/- 34/126 +/- 21 mmHg and 218 +/- 31/130 +/- 20 mmHg to 156 +/- 33/85 +/- 9 mmHg and 158 +/- 25/88 +/- 11 mmHg at the end of Day 5. Heart rate was only transiently increased in patients with pretreatment values of less than 90 beats/min. Although abnormal ECGs tended towards normalization, there were 2 cases of T-wave inversion (the patients remained asymptomatic). Raised BUN levels tended to decrease towards normal. Side effects reported spontaneously by patients (headaches, palpitations, dizziness, nausea and one case of water retention) appeared to be transient in nature. Ro 12-4713 appeared to be a very potent and long lasting antihypertensive agent, whose inherent side effects were only transient in nature.

Aged

[Aortic aneurysms as complication of bacterial endocarditis. Report of two cases (author's transl)].

The authors report on two cases, one of supravalvular aortic aneurysm and one of subvalvular aortic aneurysm. Both patients suffered from bacterial endocarditis of the aortic valve, superimposed on previous rheumatic valvular disease. The authors believe that such aneurysms represent typical though rare complication of bacterial endocarditis of the aortic valve. Subvalvular aneurysms should be the consequence of the systolic stress acting on the myocardial wall involved by endocarditis, whereas supravalvular aneurysms could result from the jet-lesion through the affected valve.

Adult

Influence of propranolol and pindolol on the haemodynamic effects of papaverine, isoprenaline and noradrenaline in hypertensive patients.

The influence of two beta-adrenoceptor antagonists, propranolol and pindolol, on the haemodynamic effects of papaverine, isoprenaline and noradrenaline was investigated in 9 male patients with first degree essential hypertension. Propranolol and pindolol were given according to a doubleblind, crossover scheme. Heart rate and blood pressure were measured before and after each treatment. Propranolol 670 microgram/kg i.v. reduced the supine and standing systolic blood pressures by 2.3% and 1.6%, respectively. Similarly, the intravenous administration of pindolol 35 microgram/kg reduced supine and standing systolic blood pressure by 5.5% and 8.3% respectively (clinically insignificant). Neither drug affected diastolic blood pressure. Following propranolol, there were moderate reduction in supine and standing heart rates, respectively by 24% and 20% (p < 0.001). Similarly, but to a lesser extent, pindolol reduced supine and standing heart rate by 12% and 17% (p < 0.001). The effects of papaverine, which, at 1.5 mg/kg i.v. reduced systolic blood pressure by 5-10% and increased heart rate by 8-15%, were not significantly influenced by the beta-blockers. The blood pressure and heart rate responses to isoprenaline, on the other hand, were attenuated or inhibited by both beta-blockers. While the beta-blockers inhibited the beta-adrenoceptor component of noradrenaline, the pressor component of noradrenaline, which is mediated through the alpha-adrenoceptors, was not influenced by propranolol, but was inhibited after pindolol. It is concluded that pindolol differs qualitatively from propranolol in that it inhibited both the alpha and beta-adrenoceptor effects of noradrenaline.

Adult

Torsades de pointes as a manifestation of mexiletine toxicity.

An episode of torsades de pointes, an unusual ventricular tachyarrhythmia, developed in a 59-year-old coronary patient who was treated with 100 mg. four times a day mexiletine orally. The PR, QRS, and QT intervals were normal. The ventricular arrhythmias resembled in part, the patient's previous ventricular premature complexes, but there were some relevant morphological differences. The plasma electrolytes were within normal limits. Mexiletine, which is chemically and electrophysiologically similar to lidocaine, probably caused this arrhythmia. Although mexiletine is a useful antiarrhythmic drug, it should be added to the list of drugs associated with atypical ventricular tachycardia.

Blood Pressure

Dimeditiapramine (Ro 11-1781), a new calcium antagonist, in the management of supraventricular tachyarrhythmias in patients with acute myocardial infarction.

18 patients with acute myocardial infarction and sustained arrhythmias were treated with a new Ca2+ antagonist, Ro 11-1781, at the dose of 1.0 mg/kg i.v. The drug was effective in reducing heart rate to less than 90 beats/min in 9/10 patients with atrial fibrillation, in 3/4 patients with atrial flutter and in 3/4 patients with supraventricular tachycardia. The peak effect was observed within 2--5 min after the intravenous administration of Ro 11-1781. In cases with recurring tachyarrhythmias, the drug was also effective in repetitive administration. Systolic blood pressure was reduced, but severe hypotension (less than 90 mm Hg) was not observed. The atrioventricular conduction in these patients remained unimpaired and asystole did not occur. The drug appears to be an effective and a well tolerated antiarrhythmic agent.

Aged

Human electropharmacology of the calcium antagonist dimeditiapramine (Ro 11-1781) in coronary patients.

The electrophysiological effect of dimeditiapramine (Ro 11-1781), a Ca2+ antagonist, was evaluated in 20 patients with coronary heart disease. Electrophysiological measurements, including sinus cycle length, sinoatrial conduction time, intra-atrial conduction time, atrial, atrioventricular, nodal and ventricular refractory periods and intraventricular conduction time were recorded before and after the intravenous administration of Ro 11-1781. At a dose which is effective against cardiac arrhythmias, Ro 11-1781 produced no statistical significant changes in the sinoatrial and intraventricular conduction time. Similarly, neither the sinoatrial nor the ventricular refractory period was affected. Ro 11-1781, however, increased the atrioventricular conduction time and decreased the systolic blood pressure to a statistically significant extent. The tolerance was very good.

Adult

Disorders in peripheral arterial system in asymptomatic elderly: plethysmographic semiology at rest, during postural, effort and pharmacological tests.

The vascular system of 30 old asymptomatic patients (average age 62.5 years) was studied by reflection plethysmography. The plethysmogram (PTG) was recorded from the forefinger of the left hand at rest, during two postural tests (+45 degrees arm-up and -45 degrees arm-down), after physical work, and during the infusion of nitroglycerin and the beta-agonist metaproterenol. 50% of the subjects presented a normal PTG under basal conditions. However, pathological PTGs were recorded after the various tests: 23.3% with the arm-up test, 6.6% with the arm-down test, 52% with the effort test, 31% with the nitroglycerin test and 73.9% with the metaproterenol test. Clearly, the effort and metaproterenol tests are pathological in the majority of cases, both tests inducing physiologically vasodilation and increase in the peripheral pulse. The arm-down test, which usually induces vasoconstriction, is almost always normal. Since the percentage of pathological responses to the nitroglycerin test is significantly smaller than that to the effort and metaproterenol tests, it is concluded that the vascular changes induced by aging are primarily functional, at least in asymptomatic subjects. Aging more negatively influences the vasodilating than the vasoconstricting ability.

Aged