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F Marsico

Publications and source records attributed to F Marsico.

At least 37 records · Page 2Linked to original sources
PubMed1993

[K-channel activators and cardioprotection].

The hemodynamic effects of K-channel openers suggest that these drugs should be beneficial in the management of hypertension and angina. Many experimental data have also shown that K-channel openers exert effective cardioprotection, decreasing the deleterious consequences of myocardial ischemia and limiting the damage induced by reperfusion. The mechanism of myocardial protection during ischemia is still unclear, even though there are experimental results that suggest that K-channel openers may act in the same way as preconditioning. The reduction of Ca-overload and the inhibitory effect on oxidative damage are possible explanations for the myocardial protection during reperfusion.

Humans↗
PubMed1993

[The evaluation of intracoronary stents by intravascular echography].

BACKGROUND: Intravascular ultrasound (IVUS) provides high resolution of vessel wall pathoanatomy, and because of the highly reflective nature of stent surfaces, can evaluate alterations in stent geometry. METHODS: This study was performed to assess, by IVUS stent, expansion patterns in patients undergoing implantation of metallic coronary stents, and the mechanisms of restenosis in those patients. Twenty-five patients were studied: 9 pts acutely and 16 pts at routine follow-up 5-8 months after Palmaz-Schatz stent placement. The images recorded by IVUS (25 Mhz 3.9F catheter Intertherapy Inc. California) were quantitatively analyzed for: luminal diameter (LD), luminal cross-sectional area (LA), cross-sectional diameter (SD) and area (SA), comprised by the stent struts. We used quantitative coronary angiography (QCA) (Image Comm System) to measure lumen diameter (LD) and luminal cross-sectional area (LA) in patients in whom IVUS was not performed at the moment of stent placement. These values were considered reference values of LD and LA of the stent at follow-up. RESULTS: During follow-up, patients showed a reduction of vessel lumen LD (2.09 +/- 0.17 mm) measured by IVUS, versus baseline LD (2.87 +/- 0.39 mm) measured by QCA. SD (2.76 +/- 0.31 mm) and SA (6.30 +/- 1.24 mm2) were unchanged in comparison with LD (2.87 +/- 0.39 mm) and LA (6.47 +/- 1.77 mm2) measured by QCA at the time of stent implantation. CONCLUSIONS: These data suggest that the mechanism of restenosis is due to intimal proliferation rather than stent collapse.

Angioplasty, Balloon, Coronary↗
PubMed1992

[Electric alternans of QRS: its electrophysiologic significance in narrow QRS supraventricular paroxysmal tachycardia].

The results of 22 patient's transesophageal electrophysiologic studies were analyzed to value the meaning of QRS alternans during narrow QRS tachycardia. Standard ECG showed ventricular pre-excitation in eight patients. QRS alternans were in six of them: heart rate was included between 230 and 374 m/sec (301.8 +/- 42 m/sec); in the remaining 16 patients, heart rate was included between 240 and 450 m/sec (350.0 +/- 42 m/sec). Our findings suggest that QRS alternans is related to the rate of tachycardia rather than to the presence of an accessory pathway.

Adult↗
PubMed1988

Efficacy of a new transdermal nitroglycerin patch (Deponit 10) for stable angina pectoris.

In this double-blind randomized placebo-controlled crossover study, the antianginal and anti-ischemic effect of a new transdermal system, releasing 10 mg of nitroglycerin (NTG) over 24 hours, was assessed in 19 outpatients with stable exercise-induced angina pectoris. The trial consisted of a 3-day washout: a 1-week period with verum or placebo patch followed by a second 1-week period with the other patch. During the study only sublingual NTG was allowed, and its consumption and the number of attacks recorded. Treadmill exercise tests were performed at the end of washout before patch application (baseline test) and 3 and 24 hours, respectively, after each period of 7 days of application of 1 patch daily. Systolic blood pressure and heart rate did not vary significantly at rest in the 17 patients who completed the trial. Angina was reduced 31.3% and NTG consumption 34.3% (p less than 0.01) during the week with Deponit 10 as compared with placebo. Exercise duration increased 29 and 16.1% (p less than 0.001 and p less than 0.1, respectively) at 3 and 24 hours with a verum patch as compared with placebo. ST-segment depression at comparable loads decreased 69 and 40.5% (p less than 0.01) at 3 and 24 hours, respectively, after application of Deponit. Onset of angina was delayed and maximal heart rate-blood pressure product significantly increased at 3 and 24 hours of treatment. It is concluded that Deponit 10 patch is effective in reducing anginal attacks and in increasing exercise capacity up to 24 hours after application.

Administration, Cutaneous↗
PubMed1987

[Electrophysiological effects and clinical efficacy of flecainide in childhood patients with supraventricular reciprocating paroxysmal tachycardia].

The electrophysiologic effects of intravenous (i.v.) flecainide were evaluated in 13 patients (pts) with recurrent paroxysmal supraventricular tachycardia (PSVT): 6 pts had an overt accessory pathway, 2 a concealed anomalous pathway and 5 had an idionodal reentrant tachycardia (AVNRT). Another patients with overt preexcitation underwent electrophysiologic testing as part of a diagnostic investigation for syncope. After flecainide the effective refractory period of the right atrium and retrograde AV node, and anterograde and retrograde Wenckebach point significantly increased. The drug blocked retrograde conduction on the accessory pathway in 3 pts whereas anterograde conduction was blocked in all 7 pts with overt anomalous pathway. The mean cycle length of the atrioventricular reentrant tachycardia (AVRT) and of the AVNRT increased respectively from 269 +/- 34 msec to 332 +/- 25 msec (P less than .005) and from 286 +/- 9 msec to 380 +/- 64 msec (P less than .05). After i.v. flecainide, reentrant supraventricular tachycardia was no longer inducible in pts with AVRT and 1 with AVNRT, inducible but non sustained (less than or equal to 30 seconds in duration) in 1 pt with AVRT and in 3 with AVNRT. Thirteen pts continued oral flecainide treatment for a mean of 7.2 +/- 3.6 months (range 3 to 12 months). Tachycardia recurred in all 3 pts whose arrhythmia remained inducible and sustained after i.v. flecainide, and in 1 of 10 pts whose re-entrant supraventricular tachycardia was suppressed (6 pts) or inducible but non sustained (4 pts). Thus flecainide is an highly effective and well tolerated drug for the control of PSVT in infancy. The electrophysiologic drug testing with flecainide predicts its efficacy during chronic therapy in most patients.

Adolescent↗
PubMed1986

[Electrophysiologic effects and clinical efficacy of propafenone in pediatric patients with paroxysmal supraventricular reentrant tachycardia].

Twenty patients (pts) with recurrent paroxysmal supraventricular tachycardia (PSVT), 12 female and 8 male, aged 9.8 +/- 4.7 years, underwent an electrophysiologic study (EPS) in order to assess the effects of propafenone (Pf) administered intravenously (1.5 mg/Kg in 3'). Thirteen pts (Group I) had an accessory pathway (AP) which was concealed in 5 and overt in 8 and in 12 of them an orthodromic atrioventricular reentrant tachycardia (ORT) was induced. In 5 of 7 pts (Group II) without AP an idio-nodal reentrant tachycardia (AVNRT) was induced. After Pf the sinus cycle length decreased significantly from 668 +/- 165 to 612 +/- 109 msec and PA, AH, HV intervals and QRS duration increased significantly from 35 +/- 11, 71 +/- 18, 34 +/- 6 and 73 +/- 12 to 43 +/- 11, 87 +/- 15, 39 +/- 9 and 85 +/- 10 msec respectively. The atrial and ventricular effective refractory period (ERP) increased from 216 +/- 18 and 211 +/- 19 to 227 +/- 21 and 217 +/- 21 msec respectively. The anterograde and retrograde nodal ERP and anterograde and retrograde Wenckebach point increased from 240 +/- 48, 227 +/- 28, 278 +/- 37 and 287 +/- 38 to 270 +/- 58, 330 +/- 32, 340 +/- 59 and 408 +/- 37 msec respectively. Pf terminated the tachycardia (T) in all 12 pts of Group I after prolongation of the cycle length which increased from 299 +/- 46 to 383 +/- 69 msec.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

10-year follow-up of patients with intraventricular conduction defects associated with myocardial infarction: the meaning of QRS duration.

The 10-year survival rate of 66 patients discharged after an acute myocardial infarction associated with intraventricular conduction delay is reported. The whole population under study consisted of 321 patients followed for 10 years or until death. In 46 patients (69.7%) the conduction delay was a definite complication of infarction, in 15 (22.7%) it preceded the acute event and in 5 (7.5%) the time of onset was undetermined. Mortality in the presence of a conduction delay was 74.2% in 10 years vs 39.2% in its absence (p less than .001). Death was sudden in 41.6% of fatalities when a conduction defect was present and 28% in its absence (p less than .01). The 10-year survival was 55% in patients with conduction defects and QRS less than .12 sec duration, 23.8% if QRS was between .12 and .14 sec, and 4% when QRS duration was greater than .14 sec. 72% of patients of this latter group was in NYHA class 3 or 4, whereas 70% of patients with QRS less than .12 sec and 47% of patients with QRS .12 to .14 sec were in class 1 or 2. These data show that long-term prognosis of conduction delay associated to myocardial infarction is poor and stratification of risk of death is possible among these patients on the basis of QRS duration.

Death, Sudden↗
PubMed1984

Exercise-induced arrhythmias: angiographic correlation and follow-up.

The meaning of exercise-induced arrhythmias was studied in 409 patients who underwent a maximal treadmill test, coronary and ventricular angiography and were followed for 31 +/- 10.6 months. The original population consisted of 1720 patients, of whom 520 were assigned to a group of known or strongly suspected coronary artery disease (Group I) and 1200 were assigned to a group with low likelihood of coronary artery disease (Group II). This division was based on age, history and symptoms. Two hundred and forty-seven (47.5%) patients of group I and 218 (18%) of group II developed ventricular premature beats during the exercise test or the recovery period. The test was positive in 378 (72.6%) patients of group I and in 190 (15.8%) of group II. A complete invasive angiographic study was performed in 233 (44%) patients of group I and 176 (14.6%) of group 2. Exercise-induced ventricular premature beats (VPBs) predicted neither coronary anatomy nor subsequent coronary or surgical events, but a weak relationship was observed with a lower ejection fraction among group I patients. On the other hand, a positive test was predictive of coronary anatomy in both groups and of coronary events in group I. We conclude that, despite a higher prevalence of exercise-induced ventricular premature beats among patients with definite coronary artery disease, an exercise test presenting ventricular premature beats as the only abnormality should not be classified as positive. Patients with such results require further investigation.

Arrhythmias, Cardiac↗
PubMed1984

[10-year survival after myocardial infarction. Longitudinal study of a hospital population].

In this study, 321 patients discharged from hospital after an acute myocardial infarction were followed for 10 years or until death. Death rate was 46.4% and 30.8% of all fatalities was sudden. In over 80% of the cases death was from cardiac causes and frequently occurred out of hospital. Univariate analysis showed that age, female sex, previous infarction, diabetes, heart failure during hospitalization, heart murmur, NYHA class III or IV, post-infarction angina, intraventricular conduction defects, cardiomegaly, ST displacement, were all associated with an increased death rate. A positive exercise test 6-17 months after infarction, was associated with a 4-fold mortality increase. Bypass played a minor role in this series since only 6.8% of the patients underwent this operation. A nonfatal infarction recurred in 71 patients (22.1%) with an annual rate of 2.2%. Annual death rate after the first 2 years of follow-up was 3.9%, as in most recent reports on survival after myocardial infarction.

Aged↗
PubMed1984

[Tetralogy of Fallot. Subcostal approach in bidimensional echocardiography].

We have evaluated the diagnostic accuracy of subxyphoid 2-dimensional (2-D) echocardiography in Fallot's tetralogy by employing two planes defined as left anterior oblique (LAO) and right anterior oblique (RAO), similar to the respective angiographic axial projections. Echocardiographic and angiographic findings were compared in 39 patients. The pulmonary branches, the trunk, the infundibulum, the septal defect and the aorta were identified in all cases, the pulmonary valve in 97% and associated defects in 71%. The LAO view was best suited for an overall diagnosis and for the visualization of the left pulmonary branch, of the pulmonary anulus, and of the overriding of the aorta. The RAO proved optimal for the evaluation of the right pulmonary branch, of the infundibulum and of the relationship between ventricular septal defect and adjacent structures. It is concluded that the subxiphoid approach is a valuable technique for the 2-D echocardiographic evaluation of Tetralogy of Fallot.

Child↗
PubMed1983

[Balloon occlusion aortography in the angiographic study of pulmonary atresia with interventricular defect].

Balloon aortography is a new technique for the angiographic study of pulmonary atresia with ventricular septal defect. A Swan-Ganz angiographic catheter is employed, whose balloon is inflated to stop blood flow in the descending aorta, thus ensuring the opacification of the pulmonary circulation. By this method we have studied 18 patients. Anatomic details of the pulmonary arterial circulation were obtained in all. No complications occurred. Balloon aortography is a simple and safe technique for the routine study of patients with pulmonary atresia and ventricular septal defect, whereas selective injection in collateral arteries or pulmonary veins, which carries more risk and is more complex, should be adopted only in selected cases.

Aortography↗
PubMed1983

[Prevalence of hyperkinetic arrhythmias in a healthy infantile and adolescent population: correlations between standard ECG, stress test and dynamic ECG].

We evaluated 250 males and 250 females 4 to 17.99 years old, randomly recruited among school-children. Cardiac and other diseases were excluded. All the subjects were studied with a standard ECG iun the standing and supine position for a minute. Three hundred children underwent a treadmill exercise test according to Bruce's protocol and 50 of them had a 24-hour ambulatory ECG monitoring. Sinus arrhythmia was present in 94% of the children in supine position and in 87% of them while they were standing. Only one child had atrial and ventricular premature beats. In a boy a slow ventricular tachycardia was recorded. One child had a WPW and a girl a short PR interval; both were asymptomatic. The exercise test did not induce any arrhythmias and the slow ventricular tachycardia, in the previously mentioned boy was suppressed during exercise and reappeared during the recovery period. The premature beats were greatly reduced in the child who had them during the standard ECG recording. The 24-hour ambulatory ECG monitoring showed only minor degrees of premature atrial and ventricular beats in 24% of the children studied by this method. The maximum number of premature beats was 39 in 24 hours and never exceeded the first grade of Lown's classification. We conclude that a good correlation exists among the three employed techniques in the study of the prevalence of tachyarrhythmias in healthy children. This is the first study that compares these three techniques in a pediatric population.

Adolescent↗
PubMed1982

Criss-cross heart with discordant atrioventricular connections.

A case of criss-cross heart is presented in which there was situs solitus with atrioventricular (AV) discordance and single outlet, the aorta arising from the right ventricle. Associated lesions were pulmonary atresia and ventricular septal defect. The apparently normal AV relation in the presence of a discordant AV connection can be explained by the hypothesis that an embryonic l-bulboventricular loop developed and was followed by marked counter-clockwise rotation of the ventricles.

Electrocardiography↗
PubMed1982

A case of isolated atrioventricular discordance.

A case of isolated atrioventricular discordance in situs solitus is described. The importance of a well defined situs and of the presence of both ventricles in making this diagnosis is underlined and previous published reports reviewed. It is suggested that the haemodynamic concept of isolated atrioventricular discordance cannot be described only by the spatial relation between the ventricles (isolated ventricular inversion), but it should be indicted by the pattern of the connection between various flows, as shown by hearts with a normal relation between the ventricles and crossed atrioventricular connection.

Female↗