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Biomedical subjects

F Pivotti

Publications and source records attributed to F Pivotti.

25 records · Page 2Linked to original sources
PubMed1984

Compliance with cardiac rehabilitation in the elderly.

To evaluate the compliance of the elderly with cardiac rehabilitation (CR) after myocardial infarction, 370 consecutive patients greater than or equal to 65 years of age, admitted to our Coronary Care Unit over a period of 2 years, were examined: 48 died in the hospital, 34 were transferred to other wards and 29 were unable to perform a submaximal exercise test before discharge. Out of the remaining 259 patients, 43 began the CR and 32 completed it with a good outcome. Eleven patients interrupted the CR because of associated diseases. A social investigation was carried out on 83 of the 259 patients discharged from our ward. In addition to associated diseases and an extremely low exercise tolerance (41% of cases), the lack of participation was due to socioeconomic problems (9.5%), to lack of motivation (52.3%) and to inadequate information (38.1%). Nevertheless, 76% of patients indicated that they attained their previous way of life in a relatively short period of time. It is concluded that: CR is useful in patients who complete it; low compliance is due mainly to medical problems and lack of motivation; better information might slightly increase the compliance in our Center; most patients can, in any case, reach their previous way of life. It is debatable whether CR is advisable in old age, or should be directed towards selected groups of patients.

Aged↗
PubMed1983

[Early exercise test after myocardial infarct: prognostic stratification].

Exercise testing in myocardial infarction before discharge has been used for treatment and exercise prescription in the post-hospital phase. Aim of this study was to investigate the prognostic significance, within one year after the infarction, of submaximal exercise testing before discharge. 428 patients performed the test 14.5 days after the acute episode and were followed for 12 months. The following variables were examined: heart rate, blood pressure, rate-pressure product at maximum exercise, total work and reasons for stopping the test (fatigue, submaximal HR, BP greater than or equal to 200/110, hypotension, ischemic or arrhythmic response). Two events were considered: 1) non fatal reinfarction; 2) cardiac death. Two methods of multivariate analysis (Cox's model regression analysis and discriminant analysis) were used. None of the considered variables was found to be predictive of non fatal reinfarction. According to Cox's model total performed work and hypertensive response were found to be predictive of cardiac death, while using discriminant analysis only total work had a predictive value (discriminant function: L = 0.00094 X total work performed + 1.48643; p less than 0.01). In detail, the higher the total work, the better the probabilities of survival, while in patients who stopped the test because of hypertension, the probabilities of cardiac death were lower. Exercise testing performed in uncomplicated myocardial infarction before hospital discharge provides, the basis for a more rational management of patients in the post-infarction phase, and contributes to identify a subset of high-risk patients.

Aged↗
PubMed1982

[Comparison of dynamic electrography and stress test in the diagnosis of ventricular arrhythmias in the early phase of myocardial infarction].

UNLABELLED: Ventricular premature beats are probably important in the prognostic evaluation after acute myocardial infarction and may allow a better management of these patients. The purpose of this study was to compare the sensitivity of two methods exercise testing - ET - and ambulatory electrocardiographic monitoring - AM - detecting potentially dangerous ventricular arrhythmias and to evaluate their prognostic value. Sixty-four patients have been studied (53 males and 11 females); their mean age was 61 years. They underwent ET and AM before discharge (mean 13.9 days) and were followed for a period of 12 months. CONCLUSIONS: -- ET and AM are useful to detect ventricular arrhythmias; -- AM is the most sensitive method; -- there are no significant differences between the two methods in the diagnosis of major arrhythmias; -- the combined use of the two methods has a greater sensitivity; -- late mortality is not higher in the patients who have suffered from major arrhythmias in the acute phase of the disease.

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PubMed1979

[Early exercise testing after myocardial infarction (author's transl)].

203 patients suffering from acute myocardial infarction performed a cycloergometric submaximal exercise test before leaving hospital. The causes for stopping the test were fatigue or submaximal heart rate (24,1%), angina (14,2%), ischaemic S-T changes (28,08%), arrhythmias (4,9%) and changes of blood pressure (17,2%). No important complications were observed. The test proved useful for the definition of more objective criteria in order to prescribe an individualized rehabilitation programme. Above all it was possible to prescribe treatment which would not have otherwise been prescribed at the time of discharge. The short term prognostic value is not, however quite clear as yet.

Angina Pectoris↗
PubMed1978

[Pathological observations on patients carrying pacemakers and clinical consequences. Reports of 105 observed cases (author's transl)].

In subjects carrying pacemakers, the catheter-electrode can induce, over a period of time, specific modifications at the level of the veins and the heart. The organism reacts to extraneous bodies with adhesive and sometimes thrombotic phenomena. The latter can occasionally be the cause of a pulmonary embolism (8 cases out of 105) or more rarely, the seat of a mycotic infection (one case). In the casuistry are included two cases of the complete perforation of the right ventricle (one of which was fatal) and four cases of partial perforation; in another subject a papillary muscle was perforated. Finally, one case of endocarditis was noted, the so called traumatic type, of the tricuspid valve.

Cardiovascular System↗