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Biomedical subjects

F Colivicchi

Publications and source records attributed to F Colivicchi.

29 records · Page 2Linked to original sources
PubMed1995

Use of [123I]MIBG to assess cardiac adrenergic innervation: experience in hypertensive cardiopathy and left ventricular aneurysms.

[123I]MIBG has been proposed as a suitable tracer of the adrenergic system of the heart. The aims of this study was to investigate the adrenergic functional status of the heart in hypertensive patients with left ventricular hypertrophy (LVH), and to evaluate the distribution of neuroadrenergic terminals in patients with left ventricular aneurysms (LVA) presenting complex arrhythmias. We studied 21 patients (4 normals, 11 with LVH and hypertension, and 6 with previous myocardial infarction, LVA and complex arrhythmias) who underwent series of [123I]MIBG planar scans (from 0.5 to 24 hours p.i.) and SPECT scans using both [123I]MIBG and 201Tl. Data quantification was performed by calculating the heart/mediastinum ratio (planar scan) and the percent uptake in 5 myocardial regions (SPECT scan). No significant differences between normals and hypertensive patients were found either in the heart/mediastinum ratio or in the regional distribution of [123I]MIBG and 201Tl. In hypertensive patients the uptake of [123I]MIBG was significantly higher than that of 201Tl in the septal wall while in the lateral and inferior walls it was significantly lower. In patients with anteroapical myocardial infarction (MI), the size of the [123I]MIBG defect was slightly smaller than the 201Tl defect; moreover a constant, severe [123I]MIBG defect was observed in the inferior walls whereas 201Tl uptake was normal. We conclude that while in hypertensive patients adrenergic innervation seems to be slightly impaired as compared to myocardial perfusion, in patients with MI a large area of functional or anatomical denervation may be detected despite the preserved perfusion and viability; this mismatch may be the trigger of complex arrhythmias.

3-Iodobenzylguanidine↗
PubMed1993

Assessment of left ventricular hypertrophy in patients with essential hypertension. A rational basis for the electrocardiogram.

There is a large body of evidence that the electrocardiogram (ECG) is insensitive in the recognition of left ventricular hypertrophy (LVH), in comparison with the echocardiogram; however, its specificity is high. In this study we further analyzed the performance of the ECG in detecting LVH in 200 consecutive patients (124 men and 76 women, mean age 50.9 years) with mild to moderate essential hypertension, using echocardiographically determined left ventricular mass (LVM) as the standard for comparison. To test the hypothesis that, owing to the high number of true positive findings, the ECG may still be useful for clinical purposes by selecting subsets of hypertensives with higher degrees of LVH, we compared the mean values of LVM index corresponding to either positive (true positive) or negative (false negative) electrocardiographic signs of LVH. In this study 69 patients (34.5%) had echocardiographic LVH, as defined by a LVM index exceeding 125 g/m2 for men and 112 g/m2 for women. Almost all criteria demonstrated high levels of specificity (> or = 89%). In the whole group the Lewis index ((RI - RIII)+(SIII - SI) > or = 17 mm) showed a slight superiority in diagnosing LVH (sensitivity = 43%) in comparison to the remaining criteria; the confidence intervals estimate of sensitivities confirmed such diagnostic superiority only with respect to those criteria with a sensitivity < or = 17%. However, the use of McNemar's test to compare sensitivities of all electrocardiographic criteria at matched specificities (> or = 95%) did not show significant differences (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Prevalence of silent ST segment depression during long-term ambulatory electrocardiographic monitoring in asymptomatic diabetic patients with essential hypertension.

Thirty-five asymptomatic diabetic patients with non insulin-dependent diabetes and mild moderate essential hypertension (18 males and 17 females, mean age 60 +/- 6 years) underwent echocardiographic examination, followed by simultaneous ambulatory blood pressure and electrocardiographic monitorings. Three hundred and sixteen significant episodes of asymptomatic ST segment depression (at least 1 mm 80 msec after the J point, lasting more than 1 min) were recorded in 21 patients (60%) with a total duration of 5637 minutes. Patients with asymptomatic episodes of ST segment depression had significantly higher values of total cholesterol (p < 0.05), LDL cholesterol (p < 0.05), Glycosylated hemoglobin (p < 0.001), left ventricular mass index (p < 0.02), mean 24-hour systolic and diastolic ambulatory blood pressure (p < 0.001), systolic (p < 0.02) and diastolic (p < 0.01) ambulatory blood pressure variability and hypertensive peaks (p < 0.05), with respect to the rest of the study population. The number of ST segment depression episodes was significantly related to total cholesterol levels (r = 0.40, p < 0.05), LDL cholesterol levels (r = 0.36, p < 0.05) glycosylated hemoglobin levels (r = 0.50, p < 0.01), left ventricular mass index (r = 0.48, p < 0.01), ambulatory systolic (r = 0.43, p < 0.01) and diastolic (r = 0.51, p < 0.01) blood pressure variability and hypertensive peaks (r = 0.50, p < 0.01). Our data suggest that haemodynamic and metabolic factors could have a relevant role in high prevalence of SMI in asymptomatic diabetic patients with EH. The evidence of SMI in these patients warrants further diagnostic work-up and prognostic assessment.

Aged↗
PubMed1992

Prevalence of left ventricular hypertrophy and cardiac arrhythmias in borderline hypertension.

Seventy-eight men with borderline hypertension according to the World Health Organization criteria underwent echocardiographic examination, followed by simultaneous ambulatory blood pressure and electrocardiographic monitorings for 24 h. The prevalence of echocardiographic left ventricular hypertrophy was 16.6% (13/78). Borderline hypertensives with left ventricular hypertrophy had more supraventricular (P less than .001) and ventricular ectopic beats (P less than .001) than normotensive controls and borderline hypertensives without cardiac involvement. Furthermore, ventricular ectopic activity was significantly related to left ventricular mass (r = 0.58, P less than .05) in borderline hypertensives showing echocardiographic evidence of left ventricular hypertrophy. Our findings suggest that noninvasive assessment of target organ status, including echocardiography, should be employed to optimize risk stratification in borderline hypertension.

Adult↗
PubMed1992

Target organ status and cardiovascular risk in borderline hypertension.

In order to assess the prevalence of target organ damage 78 men with borderline hypertension, according to the World Health Organization criteria, and 67 normotensive controls underwent echocardiographic, electrocardiographic and fundoscopic examination, followed by ambulatory blood pressure monitoring for 24 hours. Echocardiographic left ventricular hypertrophy was found in 13 borderline hypertensive subjects (16.6%), while no electrocardiographic or fundoscopic abnormalities could be detected. Our data suggest that noninvasive assessment of cardiovascular status, including echocardiography, allows recognition of a subset of borderline subjects with an increased risk for subsequent cardiac morbid events, thereby improving prognostic stratification.

Adult↗
PubMed1991

Abnormal blood pressure response to exercise in borderline hypertension. A two year follow-up study.

Twenty-eight men with borderline hypertension according to the World Health Organization criteria underwent maximal exercise testing, and then were followed for a two year period. The prevalence of abnormal blood pressure behavior during exercise was 53.58% (n = 15). During follow-up established hypertension developed in 63.33% (n = 10) of subjects with an abnormal blood pressure response to exercise, and only in 15% (n = 2) of subjects with normal blood pressure behavior. In predicting established hypertension development in a two year follow-up, maximal exercise testing has the following statistical values: sensitivity = 83.33%, specificity = 68.75%, accuracy = 75%, positive predictive value = 66.66%, negative predictive value = 84.61%.

Adult↗
PubMed1990

[Evaluation of the predictive stable hypertension validity during the ergometric test in borderline hypertension].

Aim of this study was to assess blood pressure (BP) response to exercise in borderline hypertensive subjects and to evaluate its predictive value for subsequent established hypertension development: 74 male subjects (28 borderline subjects, 26 normotensive subjects and 20 subjects with established hypertension) underwent a maximal exercise testing in the sitting position with a bicycle ergometer at the beginning of the study and then after 1 and 2 years; besides casual BP was controlled every 3 months for 2 years. Systolic BP exceeding 220 and/or diastolic BP exceeding 105 mmHg at maximal exercise and/or diastolic BP exceeding 100 mmHg at th fifth min of recovery were considered as abnormal. On the basis of BP response to exercise we divided our study group in: normotensive subjects with a normal BP response (Group A: 88%); normotensive subjects with an abnormal BP response (Group B: 12%); borderline subjects with a normal BP response (Group C: 46%); borderline subjects with an abnormal BP response (Group D:56%). At the end of a 2-year follow-up established hypertension developed in 1 subject of Group B (33%), in 2 subjects of Group C (15%) and in 10 subjects of Group D (67%); 7 subjects of Group C returned to normotension (54%). The incidence of established hypertension is significantly higher in borderline subjects with an abnormal BP response to exercise. This finding is probably due to both functional and organic factors and stresses the predictive value of exercise testing in borderline hypertension.

Adult↗
PubMedDate not supplied

[Effects of slow-release nicardipine on blood pressure, renal function and the renin-angiotensin-aldosterone system in patients with mild-to-moderate essential arterial hypertension].

The above study was intended to assess the efficacy of nicardipine in mild to moderate essential arterial hypertension and to check whether there are medium term changes in kidney function and urinary excretion of electrolytes in the course of nicardipine treatment. Twenty patients with mild to moderate essential arterial hypertension were treated daily with 40-80 mg doses of slow-release nicardipine after a wash-out period. Systolic and diastolic blood pressure was measured with traditional sphygmomanometer on entry and after 4, 8, and 12 weeks' treatment. Also, on entry and at conclusion of the study, the following parameters were measured: plasma renin activity, creatinine clearance, 24-hour urinary excretion of Na, K, Ca, and aldosterone. Nicardipine treatment was well tolerated and no significant changes of heart rate, creatinine clearance and urinary excretion of Na, K, Ca and aldosterone were observed after 12 weeks' treatment. The efficacy of nicardipine for the management of mild to moderate hypertension was thus confirmed. The absence of a natriuretic effect after 12 weeks' treatment goes to show that any diuretic action of the drug is irrelevant to its therapeutic effect which appears to be due mainly to its vasodilatory action.

Adult↗
PubMedDate not supplied

[Sublingually administered captopril versus nifedipine in hypertension emergencies].

Aim of the study was to assess the effectiveness and tolerability of sublingual captopril (SLC) versus sublingual nifedipine (SLN) in treating hypertensive emergencies. During hypertensive crises (systolic blood pressure exceeding 200 mmHg and diastolic blood pressure exceeding 115 mmHg) forty hypertensive patients received either 25 mg of SLC or 10 mg of SLN in a randomized single blind fashion. Blood pressure and heart rate were then controlled after 5, 10, 15, 20, 30, 45, 60, 120 min. and, in 18 cases, up to the 8th hour from the administration. Our results showed: 1) a satisfactory control of the hypertensive crises in 80% of patients treated with SLC with a significant blood pressure reduction after 10 min. (13/8 mmHg, p less than 0.02), while the maximum hypotensive effect was achieved after 30 min. (52/36 mmHg, p less than 0.001); SLN was able to reduce blood pressure in 90% of all the cases, with a significant reduction after 5 min. (15/11 mmHg, p less than 0.02) and hypotensive peak after 20 min (57/38 mmHg, p greater than 0.001); 2) no significant differences for hypotensive effectiveness between the two groups, but with SLC having a mildly delayed onset of action when compared to SLN; 3) antihypertensive effect lasting for about 6 hours in patients treated with SLC and blood pressure progressively raising after 4 hours in patients who received SLN; 4) a significant correlation between blood pressure reduction and blood pressure before drug administration in both groups; a significant correlation between pretreatment PRA and antihypertensive effect in the SLC group. We conclude that both drugs are effective and useful in treating hypertensive emergencies. Anyway we think that in severe forms SLN should be preferred for the shorter time preceding onset of action.

Administration, Sublingual↗
PubMedDate not supplied

Left ventricular hypertrophy and diastolic dysfunction in alcohol-associated hypertension.

In order to assess left ventricular structure and diastolic function, 50 hypertensive male subjects, 25 with and 25 without a history of alcohol abuse, and 20 normotensive male controls underwent Doppler echocardiographic examination followed by ambulatory blood pressure monitoring for 24 hours. Left ventricular mass was significantly higher in alcoholic hypertensives in relation to non-alcoholic hypertensives (p < 0.05) and normotensive controls (p < 0.001). Moreover, Doppler parameters expressing left ventricular filling pattern were significantly worse in alcoholic than in non-alcoholic hypertensives (p < 0.01). Clinic and ambulatory blood pressure were similar in alcoholic and non-alcoholic hypertensives, while mean day-time heart rate was significantly higher in alcoholics (p < 0.01). Collected data suggest that non-hemodynamic factors are probably involved in the development of cardiovascular abnormalities in hypertensive alcoholics, and that echocardiography should be employed for risk-profile definition in alcohol-associated hypertension.

Alcoholism↗