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Biomedical subjects

G Cocco

Publications and source records attributed to G Cocco.

At least 73 records · Page 4Linked to original sources
PubMed1982

Electrophysiologic changes after tiapamil in coronary and noncoronary patients.

26 patients who had undergone right heart catheterization were enrolled in the study. The average age was 51.7 +/- 15 years. Half the patients showed coronary artery disease at selective coronary angiography. His bundle recordings and atrial pacing were performed before and 10 min after 1 or 1.5 mg/kg i.v. tiapamil. In addition, arterial blood pressure was recorded. P-R interval increased from a mean value of 153 +/- 36 to 168 +/- 49 ms (p less than 0.05) due to an increase in the A-H time from 88 +/- 19 to 97 +/- 23 ms (p less than 0.05). Arterial blood pressure and heart rate decreased significantly. These changes were more pronounced in patients with coronary artery disease. In the groups with the higher dosage, the differences from the control values were greater than in the patient groups receiving 1.0 mg/kg. Sinus node recovery time tended to increase in all groups but the differences did not reach significance. Patients with the 'sick sinus syndrome' were not studied.

Adult↗
PubMed1982

Antiarrhythmic effects of tiapamil on exercise-induced arrhythmias in patients with coronary artery disease.

57 patients were admitted to the study, 3-6 weeks after acute myocardial infarction. They received either placebo or 1 mg/kg tiapamil intravenously according to a randomized, double-blind procedure. The study had two objectives: (a) to assess the effect of tiapamil on work tolerance and exercise-induced myocardial ischemia: (b) to demonstrate possible antiarrhythmic effects against exercise-induced arrhythmias. The duration of exercise and physical work capacity increased slightly in both groups, these effects, however, not reaching statistical significance. On the other hand, the number of exercise-induced extrasystoles did not change significantly under placebo but decreased from 30.9 to 14.8 beats/min after tiapamil (p less than 0.01). No side effects were observed. While the hemodynamic effects of tiapamil in patients with coronary artery disease are yet to be elucidated, our findings confirm the efficacy of this calcium antagonist against exercise-induced ventricular premature beats in patients with coronary artery disease.

Adult↗
PubMed1982

Antagonism of aldosterone in normal subjects by Ro 12-2503 and spironolactone.

The potency and efficacy of a single dose of a new aldosterone antagonist, potassium 17 a-hydroxy-6 beta, 7 beta-methylene-3-oxo-D-homo-17a alpha-pregna-4,16-diene-21-carboxylate (Ro 12-2503), in reversing the renal effects of exogenous aldosterone were compared to those of spironolactone, and placebo. The study was performed according to double-blind and crossover procedure in six healthy male subjects. Both drugs, spironolactone and Ro 12-2503, did not completely antagonize the effects of aldosterone. The efficacy of Ro 12-2503 in terms of the urinary Na+/K+ ratio and the urinary Na+ concentration was less than that of spironolactone. Spironolactone produced a slightly greater natriuresis, but the difference was not significant. The method described, based on standard bioassay techniques permits a comparison of the two drugs, and may prove useful in the screening and evaluation of aldosterone antagonists.

Adult↗
PubMed1981

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↗
PubMed1981

Serial M-mode echocardiography in evaluation of the cardiovascular effects of tiapamil and their relationship to plasma levels in patients with coronary heart disease.

Tiapamil (Ro 11-1781) is a new calcium antagonist. Several investigators have reported about its efficacy against cardiac arrhythmias and angina pectoris. However, there was no study that assessed a possible relationship between hemodynamic effects and plasma concentration. Our study was aimed to investigate any possible relationship between cardiovascular effects of tiapamil and its plasma concentration. We selected 8 coronary; patients (6 males and 2 females) with a mean age of 61.9 yr and a mean weight of 70.9 kg. Tiapamil was administered per os at the dose of 250 mg t.i.d. for 4 consecutive days. Hemodynamic data were obtained by means of echocardiography, ECG and sphygmomanometry. Plasma concentrations of Ro 11-1781 and its major metabolites were measured by means of high pressure liquid chromatography. With tiapamil, the morning systolic BP fell from 130.6 +/- 19.5 (mean +/- SD, pretreatment) to 114.4 +/- 18.2 mm Hg on day 4, the change being clinically and statistically significant (P less than 0.02 by paired t-tests). Diastolic BP and HR remained unchanged. LVEDD and LVESD were not affected to any relevant extent, but VCF was significantly (P less than 0.05) and persistently increased. Tiapamil was well absorbed, but large interindividual variations were observed. As a general rule, no direct relationship between plasma concentrations and hemodynamic effects could be demonstrated. However, the number of patients is too small to allow general conclusions. At the above dose, tiapamil did not elicit any clinically detectable negative inotropic or negative chronotropic effect, probably because of its lowering effect on systolic BP.

Aged↗
PubMed1981

[Management of supraventricular and ventricular arrhythmias with the intravenous administration of the calcium antagonist Tiapamil (Ro 11-1781) (author's transl)].

27 cardiac patients with a mean age of 58.5 years (S.D. +/- 9.43) were treated in the coronary care unit with tiapamil, a new Ca2+ antagonist, by intravenous infusion. The following arrhythmias were identified: ventricular premature complexes (VPCs, Lown class 3--5) in 15 patients, supraventricular premature complexes (SVPCs) in 6 patients, and mixed VPCs (Lown grade 5) plus SVPCs in 6 patients. ECGs and hemodynamic parameters were continuously monitored prior to, during and up to 24 hours after the therapy. In patients with VPCs, the median frequency of VPCs decreased from 612.0 to 64.0 at the 3rd hour of therapy (p less than 0.01). Between the 13th and the 24th hour after tiapamil, without therapy the median VPCs increased to 459.0. The median "VPCs/sinusal" beats ratio was decreased from 0.125 to 0.0108 (p less than 0.01) at the 3rd hour and returned to 0.1029 from the 9th to the 20th hour after stopping tiapamil. The results in the patients with SVPCs, or with VPCs + SVPCs were similar. Tiapamil did not affect the central venous pressure and decreased the median blood pressure from 130/80 to 110/75 mm Hg (p less than 0.10). The effects of tiapamil against all types of cardiac arrhythmias can therefore be defined as good. 1/27 patients presented hypotension that required therapy with dopamine, and mild subjective complaints (mainly headache) were reported in 6 patients. No complications occurred. The results show that tiapamil is effective both against SVPCs and VPCs, and thus its spectrum of action differs from that of other Ca2+ antagonists.

Adult↗
PubMed1981

Immunological effects induced by biological natural aerosols (pollen and spores).

Pollen and spores are natural biological aerosols, mostly wind transported. Most of them are deposited within the upper respiratory tract. Only such particles with a diameter from 0,5-5 mu are believed to reach the alveoli. Most pollen do not deposit into the lower airways because their diameter is larger than 10 mu. Therefore, the mechanism of pollen induced asthma seems to be obscure. This phenomenon might be explained by some hypotheses. It could be possible that particles produced as natural biological aerosols with a size distribution smaller than pollens cause the asthma. Another version explaining the pollen induced asthma may arise from the fact, that pollen grains pass the digestive tract and involve the lung via bloodstream. In view of the fact that reflex action releases a bronchoconstriction has led to the conclusion that pollen grains contracted the mucosa of the upper airways induce the obstruction of the bronchi.

Aerosols↗
PubMed1980

Antiarrhythmic effect of the calcium antagonist tiapamil (Ro 11-1781) by intravenous administration in patients with coronary heart disease.

Twenty coronary patients with a median age of 76 years were treated in the coronary care unit with tiapamil, a new Ca2+ antagonist, by intravenous infusion (until December, 1979, the generic name was dimeditiapramine). The following arrhythmias were identified: atrial fibrillation with ventricular rate greater than 95 beats/min (5 patients); supraventricular premature complexes (SVPC) (4 patients); and ventricular premature complexes (VPC), Lown grades 2-4 (15 patients). Electrocardiograms and hemodynamic parameters were continuously monitored prior to, during, and after the therapy. In patients with atrial fibrillation, sinus rhythm was not restored, but tiapamil decreased the ventricular rate by 54%. In patients with VPC, the median frequency of VPC decreased from 310.5 before tiapamil to 32.5 beats/h at the fourth hour of therapy (p less than 0.01). The median ectopic/sinus beat ratio decreased from 0.083 (pretreatment) to 0.008 at the fourth hour of infusion (p less than 0.10). In one of the patient with an insufficient decrease in the number of VPC, the VPOC changed from class 4a (pretreatment) to class 2 (during the therapy), returning to class 4a after the infusion was stopped. Tiapamil reduced the median systolic and diastolic blood pressures by 8.3 and 7.1%, respectively (p less than 0.05), the third hour. Hypotension and bradycardia were observed in 5/20 patients. The results show that tiapamil is effective against both supraventricular and ventricular arrhythmias, and thus its spectrum of action differs from that of other calcium antagonists.

Adult↗
PubMed1980

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↗
PubMed1980

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↗