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Biomedical subjects

L Adinolfi

Publications and source records attributed to L Adinolfi.

At least 19 recordsLinked to original sources
PubMed2006

Oesophageal acid exposure and altered neurocardiac function in patients with GERD and idiopathic cardiac dysrhythmias.

BACKGROUND: Oesophageal sensory stimuli alter neurocardiac function through autonomic reflexes. AIM: To evaluate in patients with idiopathic supraventricular cardiac dysrhythmias and gastro-oesophageal reflux disease (GERD) whether GE reflux alters neurocardiac function and the effect of acid suppression on cardiac symptoms. METHODS: Thirty-two patients (13 females and 19 males; age: 20-69 years) with dysrhythmias plus GERD, and nine patients (five females and four males; age: 43-58 years) with GERD only, underwent simultaneous 24-h pH-metry and ECG monitoring. Power spectrum analysis of heart rate variability (PSHRV) was obtained with both its low frequency (LF, sympathetic modulation) and high frequency (HF, vagal modulation) components. Hourly mean oesophageal pH and LF/HF ratio were correlated. A 3 months full-dosage PPI therapy (esomeprazole 40 mg/day) was prescribed. RESULTS: In 18 (56%) of the 32 patients with dysrhythmia and in none with GERD only, a significant (P < 0.05) correlation between oesophageal pH and LF/HF ratio (oesophagus-heart correlation) was observed. A significant reduction of cardiac symptoms after PPI therapy was observed only in these patients (13/16 vs. 4/11, P < 0.01). CONCLUSIONS: This study has identified a subgroup of dysrhythmic patients in whom the oesophageal acid stimulus elicited cardiac autonomic reflexes. In these patients acid suppression seems to improve GERD and cardiac symptoms.

Adult↗
PubMed1993

Effects of short-term oral digoxin on left ventricular diastolic filling in patients with ventricular dysfunction. An echo-Doppler study.

34 patients with ventricular dysfunction (18 in NYHA class II and 16 in NYHA class III heart failure) whose clinical status was stabilized by diuretics and systemic vasodilators, entered a randomized trial to compare the effects of short-term oral digoxin and active placebo on left ventricular diastolic function, non invasively evaluated by echo-Doppler transmitral left ventricular filling flow. At baseline patients were subdivided by reversal--the ratio of peak early (E) and late (A) transmitral filling velocities--E/A < 1 (group I) or normal--E/A > or = 1 (group II) echo-Doppler E/A ratio; group II exhibited a shorter deceleration time (125 +/- 20 ms vs 198 +/- 38 ms, p > 0.05) and isovolumic relaxation time (64 +/- 15 ms vs 93 +/- 10 ms; p < 0.05) as well as a higher peak E velocity (85 +/- 28 cm/s vs 54 +/- 20 cm/s; p < 0.05), ("restrictive" left ventricular filling pattern). After 4 weeks, no changes in all echo-Doppler parameters were noted in group I in response to either oral digoxin or active placebo. Clinical amelioration (defined as reduction by at least one functional class) was observed in 3 patients after digoxin.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1989

[Electrocardiographic findings in a school-age population using a computerized system: calculation of standard norms for heart rate and PR, QRS, and QT intervals].

We evaluated some ECG parameters (HR, P-R, Q-R-S, Q-T) in a healthy school-age population. One-thousand-eight-hundred and ninety children ranging in age from 5 to 12 coming from different zones of the city of Naples were studied. On physical examination all subjects were free from cardiac disease. A computerized ECG (Muse 12SL System Marquette) was performed on every subject. One-hundred and seventy-four of the 1890 children were excluded from statistical analysis because of ectopic rhythm (junctional rhythm or wandering pacemaker) or poor quality of the recording. Of the 1716 children included in the study, 837 were male and 879 were female. The computerized ECG 12SL System Marquette registers an ECG record consisting of all 12 classical ECG leads acquired simultaneously over a 10 second period. Each individual complex can be analyzed in all leads by the computer. An interpretation using this extended record, along with an ECG record of conventional length, is presented to the physician for review. The first step in computerized ECG analysis is Q-R-S identification, then P wave identification, beat classification, rhythm analysis, morphology analysis, complex alignment and computation of median complex. All parameters were divided for sex and age and gathered into tables. The variability of P-R, Q-R-S, Q-T versus HR were also evaluated. The following conclusions were drawn: 1) Sex is a very important variable in the parameters examined. Males have a much slower HR, greater Q-R-S duration, and longer Q-T interval when compared to females. 2) As age increases, HR slowly decreases, while P-R, Q-R-S and Q-T intervals increase.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1988

Heart rate, PR, and QT intervals in normal children: a 24-hour Holter monitoring study.

A dynamic electrocardiographic Holter monitoring study was performed in 32 healthy children (20 males and 12 females, age range 6-11 years old), without heart disease, according to clinical and noninvasive instrumental examination. We evaluated atrioventricular conduction time (PR), heart rate (HR), and QT interval patterns defining the range of normality of these electrocardiographic parameters. The PR interval ranged from 154 +/- 10 ms (mean +/- SD) for HR less than or equal to 60 to 102 +/- 12 ms for HR greater than or equal to 120 (range 85-180). The absolute mean HR was 87 +/- 10 beats/min (range 72-104), the minimum observed HR being 61 +/- 10 (range 51-79), the maximum 160 +/- 20 beats/min (range 129-186). Daytime mean HR gave a mean value of 93 +/- 10 (range 71-148), while during night hours it was 74 +/- 11 (range 54-98). The minimum QT interval averaged 261 +/- 10 ms for HR greater than 120 and the maximum 389 +/- 9 ms for HR less than or equal to 60; the corresponding mean value of QTc (i.e., QT corrected for HR) ranged from 388 +/- 8 for HR less than or equal to 60 beats/min to 403 +/- 14 ms for HR greater than 120 beats/min. The results of the present study provide data of normal children which can be readily compared against those of subjects in whom cardiac abnormalities are suspect or patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1987

Non-invasive electrophysiological evaluation of calcium antagonist long-term therapy.

The evaluated effects of oral administration of verapamil, diltiazem, and nifedipine in patients with first degree A-V block by using a new noninvasive technique: signal averaged ECG. The study group consists of 5 females and 3 males ranging from 52 to 70 years old. All patients showed a first degree A-V block at surface ECG and an abnormal A-V time (suprahisian lengthening) during signal averaged ECG (SAECG). Verapamil 240 mg/daily, diltiazem 180 mg/day and nifedipine 30 mg/day were given separately for a week followed by a wash out period of 5 days before giving next drugs. An ECG and SAECG were performed before and after every administration. PR, A-H and H-V interval were evaluated in every recording. Verapamil and diltiazem induced a significant lengthening of A-V conduction (PR increase was 15.4% and 15.1%, respectively). No significant modification appeared after nifedipine. Our data, using a noninvasive technique, agreed with values of previous invasive evaluations. We suggest precaution in using verapamil and diltiazem in patients with BAV 1 degree and advise a selective use of calcium antagonist therapy.

Aged↗
PubMed1987

Amiodarone treatment in cardiac preexcitation syndrome: use of signal averaged electrocardiogram.

Amiodarone effectiveness to prevent reentrant arrhythmia in Wolff-Parkinson-White (WPW) syndrome is well known. Authors tried to evaluate the results of long-term therapy in a group of 11 patients (mean age 39 +/- years) suffering from WPW syndrome. Before amiodarone treatment, a conventional ECG and a high resolution ECG (a new noninvasive technique) were performed in order to define Hisian activity. After 50 days of therapy (600 mg daily for the first week, 400 mg daily for the second week, 200 mg daily for 5 days in the following period), a second recording revealed the evidence a a lengthening of PR segment (p less than 0.05) and a disappearance of delta wave (1 patient) and arrhythmia. Before treatment, His deflection was defined only in 2 patients. After amiodarone therapy the H-V time was clearly evaluated in 9 patients. Probably the drug has induced a lengthening of AV node refractoriness and primarily an increase of accessory pathway refractoriness.

Adolescent↗
PubMed1985

[Ventricular tachycardia].

Various electrocardiographic forms of ventricular tachycardia are described. After a discussion of the different pathogenetic mechanisms about this arrhythmia, the various types of pharmacological and electrical treatment are examined.

Amiodarone↗
PubMed1985

Non-invasive assessment of electrophysiological effects of histamine infusion in man.

The electrophysiological changes induced by sequential infusion of histamine (H) (0.4 and 1.0 mcg/kg/min for 10 min each) were investigated by conventional ECG and High Resolution ECG (H.R.ECG). The latter permits external non-invasive recording of the potentials generated in the cardiac conduction system. H was infused i.v. in 5 normal volunteers with a mean age of 30 years. H infusions were begun with 0.4 mcg/kg/min and continued for 10 min. After a 60 min recovery period a second 10 min infusion (1 mcg/kg/min) was administered. In man H produced a dose-dependent increase in heart rate, a significant depression of the ST-T complex, and a depression in STJ point. The QRS complex duration was unmodified. H.R.ECG showed significant changes in the morphology and voltage of the atrial activity. The electrophysiological effects disappeared within a few minutes after discontinuing the infusions of H.

Adolescent↗
PubMed1985

Non-invasive evaluation of the isovolumic relaxation period during dynamic and isometric exercise.

The purpose of the study was to evaluate non-invasively the response of the isovolumic relaxation period to different types of exercise--dynamic supine bicycle exercise (DSBE) and handgrip (HGP), in a selected healthy population. From simultaneous echo-polygraphic recordings, obtained in 30 young subjects at rest, during submaximal DSBE, during one minute of HGP (75% of maximal heart rate) and in the recovery period, the true isovolumic relaxation period (IRP) was determined. Systolic (SBP) and diastolic (DBP) blood pressure, aortic closing pressure (AoCP) and heart rate (HR) were also recorded. HR increased more markedly in DSBE (delta HR = +85% at peak load) than in HGP (delta HR = +29% at peak), while a greater rise of DBP (delta DBP = +25%) was observed in HGP. IRP shortened at both exercises as the workload progressively increased, with a maximum decrease by 54% in DSBE and by 42% in HGP. Moreover, at both exercises, an exponential correlation between IRP and HR was found. Correlating IRP with HR and AoCP by multiple regression analysis, it was found that IHP in HGP was equally affected by HR and AoCP, while during DSBE heart rate had a greater influence than AoCP.

Adolescent↗
PubMed1983

Prolonged Q-T interval syndrome presenting as idiopathic epilepsy.

We report the case of a 4 1/2-year-old girl admitted to our Hospital because of repeated tonic convulsions. These attacks were triggered by noxious stimuli as well as by emotional stress. Since patient's history was not typical of idiopathic epilepsy, and several electroencephalograms failed to reveal any abnormality, a cardiac basis for the clinical picture was suspected. Resting electrocardiograms and 48-hour ECG recording showed a prolonged Q-T interval, usually responsible for severe cardiac arrhythmias (e.g., ventricular fibrillation or "torsades de pointe"). In our patient the neurologic paroxysmal symptomatology, wrongly considered as idiopathic epilepsy, should be interpreted being due to the underlying cardiac abnormality.

Arrhythmias, Cardiac↗
PubMed1983

Systolic time-interval evaluation by thermistor plethysmography during uninterrupted dynamic stress test in normals and in patients with coronary artery disease.

18 patients with coronary artery disease (CAD) and 21 normal subjects underwent a triangular bicycle exercise test. Systolic time intervals (STI) were calculated at rest and every 2 min during exercise. Under resting conditions, STI were similar in the two groups. During exercise, the ejection time index (ETI), i.e. left ventricular ejection time (LVET) corrected for HR, rose significantly more in CAD patients, as compared to normals. Pre-ejection period (PEP) was also differently affected by exercise in CAD patients, who showed a more shortened PEP (p less than 0.001) in the early stage of dynamic stress. PEP/LVET ratio, which in the control group decreased continuously, in CAD patients fell during exercise at lower work loads (p less than 0.001), whilst rose during strenuous exercise. Finally, significant differences (p less than 0.001) were found in the percent change (% delta) PEP/LVET ratio between the two groups during the early phase of exercise, in which no superimposition of single values was present. Therefore, this last parameter seems the most reliable to differentiate clearly CAD patients from normal subjects, but its use must be limited at early exercise.

Adult↗