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Biomedical subjects

G Giuffrida

Publications and source records attributed to G Giuffrida.

At least 73 records · Page 4Linked to original sources
PubMed1989

Evidence for a further stimulation of atrial natriuretic factor release by atrial pacing in patients with mitral stenosis.

To investigate the release of atrial natriuretic factor (ANF) in mitral stenosis and the effect of an increased atrial contraction frequency on atrial distension and ANF secretion, we studied 14 patients [New York Heart Association (NYHA) grades II-III] in sinus rhythm, undergoing cardiac catheterization for mitral stenosis. Echocardiographic tracings, repeat determinations of mean pulmonary artery wedge pressure and blood samples from the pulmonary artery for ANF measurements were taken at baseline, during atrial pacing (125 beats/min for 5 min) and 5 min after pacing. After pacing, ANF levels rose markedly with a parallel increase in mean pulmonary artery wedge pressure and left atrial size. These data indicate that atrial pacing is capable of further stimulating ANF release, even in patients with elevated baseline ANF and left atrial pressure and an increased left atrial dimension.

Adult↗
PubMed1989

[Acute latent myocarditis appearing with ventricular fibrillation after intranasal administration of adrenaline. Description of a case].

We report a case of a 17 year old sports woman, who had a ventricular fibrillation episode with cardiogenic shock during endonasal anaesthesia containing epinephrine. She was so transferred to our department (in shock): the 2-D echo showed biventricular hypokinesia without dilatation (LVEF less than 25%). Endomyocardial biopsy performed 5 days later showed active lymphocyte myocarditis with interstitial fibrosis. There were serum antibodies anti-Echo 9 and Coxsackie B 1, 2, 3. Immunoassay, urinary catecholamines and glucagon test were normal. The clinical picture was resolved within 15 days using intravenous isoprenaline and/or dopamine initially followed by oral diuretics and digoxin; the therapy was broke off at the time of discharge. We believe that the vasoconstriction and/or the oxygen wasting effect caused by epinephrine revealed latent myocarditis which had not been shown up even by intensive physical training.

Adolescent↗
PubMed1989

[Conduction disorders in aortic periprosthetic abscesses].

Active infective endocarditis (AIE) involving native and especially prosthetic aortic valve is often complicated by conduction abnormalities. These conduction disturbances are considered to represent extension of infection from the valve to the annulus and surrounding myocardium. The authors report their experience of conduction disorders in 6/8 patients in whom the aortic prosthetic valve infection was complicated by periprosthetic abscess. They underline the importance of conduction abnormalities as early markers of severe complication in patients with AIE. In fact, their detection is a useful tool in revealing severe complications since clinical, laboratory and other noninvasive examinations do not always allow early diagnosis of the extension of infection to the surrounding myocardium.

Abscess↗
PubMed1981

His bundle electrogram recording using a multipolar electrode catheter via the arm veins.

In eighteen patients with atrioventricular conduction disturbance, His bundle electrograms were studied via the arm vein. A 6F Berkovits-Castellanos USCI hexapolar electrode catheter was introduced into the right atrium and looped across the tricuspid valve in a "golf club" shape. The main aim was to leave the two distal electrodes in contact with the atrial endocardium to perform atrial pacing, while displaying the other four electrodes along the superior angle of the tricuspid valve for proximal and distal His bundle recordings. His bundle electrograms were successfully obtained in all cases. The arm approach provides an alternate route whenever the femoral approach is not feasible. Moreover, the use of an hexapolar electrode catheter provides some practical advantages: 1) it enables atrial pacing to be performed, as well as proximal and distal His bundle recording to be obtained, by using the same multipolar electrode catheter; and 2) it allows long-term monitoring of His bundle potentials, in view of the stability of His bundle recordings. Finally, the arm approach could be the method of choice for the study of His bundle electrograms during leg supine exercise in selected patients.

Arm↗
PubMed1981

Clinical hemodynamic and angiographic findings in 94 patients with old myocardial infarction. Comparison with 79 patients with coronary artery disease and no myocardial infarction.

Clinical, hemodynamic, coronary arteriographic, and ventriculographic findings of 94 patients (pts) with coronary artery disease (CAD) and old myocardial infarction (MI) have been described and compared with those of 70 pts with CAD and no previous MI. Pts with old MI presented a more compromised functional and hemodynamic status, with a higher incidence of NYHA class III-IV pts (40%), symptoms of left ventricular (LV) failure (31%), cardiomegaly (70%), higher left ventricular end-diastolic pressure (LVEDP) (19.6 +/- 9.6 mmHg, p less than 0.05), compared with 32%, 22%, 54% and 16.0 +/- 6.8 mmHg respectively in CAD pts with no MI. MI pts presented more severe CAD, higher incidences of three vessel disease (56%, p less than .005) and of left anterior descending (LAD) (34%) and right coronary artery (RCA) (36%) occlusions, compared with 34%, 6%, and 9% respectively in pts with no MI. Furthermore, pts with old MI showed more diffused and severe LV segmental wall contraction abnormalities, with higher frequencies of LV aneurysm (31%) and of pts with asynergy of more than 2 LV segments (26%), compared with 1% and 3% respectively in pts with no MI. Within the group with old MI, LVEDP was higher in pts with anterior (A) (22.0 +/- 11 mmHg, p less than .02) and anterior ł diaphragmatic (AłD) (21.5+/- 7.9 mmHg, p less than .05) MI, compared with pts with diaphragmatic (D) MI (16.6 +/- 7.1 mmHg); furthermore, LVEDP increase was significantly correlated with the severity and the extent of LV asynergy. In A and D MI, LAD and RCA stenoses or occlusions were prevalent respectively; pts with AłD MI showed larger numbers of coronary stenosis (3.05) and occlusions (1.05) per patient. The coronary artery supplying the infarcted area showed stenosis (greater than 75%) in 95.6% and was normal in 2.2% of cases. Thus, pts with CAD and old MI, and particularly of AłD and A MI, show a more compromised hemodynamic status and more severe degrees of CAD and of LV segmental wall contraction abnormality, which are responsible for their poor prognosis, compared to pts with CAD but no old MI.

Adult↗
PubMed1981

[Iatrogenic occlusion of the anterior descending branch of the left coronary artery. Description of a case].

A 27 years old man was admitted in our Institute for exertion dyspnea, palpitation and a single syncopal attack; five months before admission he was subjected to thoracotomy for pericardial and myocardial haemostatic suture because of a slash. Clinical, phonocardiographic and echocardiographic data suggested diagnosis of combined aortic stenosis and aortic regurgitation. An anterior myocardial necrosis was in ECG and VCG, Cardiac catheterization confirmed previous report. Coronary arteriography showed total occlusion of left anterior descending artery soon after the second diagonal branch. Right coronary was undamaged. Furthermore left ventricular angiocardiography showed a changed ventricular function. The Authors point out the iatrogenic cause of the coronary occlusion; it was due to the inclusion of left anterior descending artery in the surgical myocardial and pericardial haemostatic suture and/or post-traumatic fibrosis. It is necessary to watch over the patient as the changed ventricular function can develop in an aneurismatic area.

Adult↗
PubMed1979

Hemodynamic response to exercise after propranolol in patients with mitral stenosis.

Hemodynamic response to exercise before and 10 minutes after propranolol (5 mg intravenously) was studied in 10 young patients with pure mitral stenosis who had normal sinus rhythm and no cardiac failure. After propranolol the mean heart rate and cardiac index at rest were lower than during the control state (respectively, 95 +/- 4 versus 82 +/- 3 beats/min, P less than 0.005; 3.4 +/- 0.2 versus 2.8 +/- 0.1 liters/min per m2, P less than 0.025). As a result, the mean pulmonary wedge pressure and mean mitral valve gradient at rest were lower (respectively, 22 +/- 2 versus 18 +/- 2 mm Hg, P less than 0.005; 24 +/- 2 versus 17 +/- 2 mm Hg, P less than 0.001). During exercise after propranolol the values of pulmonary wedge pressure and mitral valve gradient were lower than control values during exercise (respectively, 39 +/- 3 versus 30 +/- 2 mm Hg, P less than 0.005; 44 +/- 3 versus 32 +/- 3 mm Hg, P less than 0.005), again because of the lower heart rate and cardiac index (130 +/- 6 versus 104 +/- 6 beats/min, P less than 0.001; 4.6 +/- 3 versus 3.7 +/- 2 liters/min per m2, P less than 0.01). Left ventricular end-diastolic pressure and stroke index showed no significant changes. Thus, propranolol may benefit patients with pure mitral stenosis with sinus rhythm and no cardiac failure whose symptoms occur during those reversible conditions characterized by an increase in heart rate or cardiac output, or both.

Adult↗
PubMed1979

[The role of the platelets in myocardial infarction induced by isoproterenol in the rat (author's transl)].

The AA. suggest that the myocardial infarction induced by isoproterenol in the rat may be determined by phenomenons of intracoronaric platelets aggregation. The effects on the degree and extension of the infarctual necrotic area have been evaluated in a drug with remarkable platelets antiaggregation activity (ASL). The following parameters are considered: wet and dry weight of the organ, and tissutal CPK levels.

Animals↗
PubMed1979

[Iatrogenic ostial stenosis of the left coronary artery. Report of a case with Starr-Edwards aortic prosthesis (author's transl)].

A case of a 41 years-old-man, who had undergone surgical intervention ten years previously for aortic valve replacement in ECC with the coronary perfusion technique, is reported. This patient was studied because of the appearance of angina pectoris three months after the intervention and its progressive development. Selective left coronary angiography showed an ostial subocclusive stenosis; the run-off from the right coronary artery provided distal blood supply to the left coronary artery. A venous bypass was implanted between the aorta and the left anterior descending branch; the prosthesis was substituted because it was altered and caused hemolysis' problems. In accordance with most Authors late ostial coronary stenosis is a complication of the coronary perfusion technique, which is adopted for myocardial protection during surgical interventions for aortic valve replacement.

Adult↗