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L Angoli

Publications and source records attributed to L Angoli.

At least 37 records · Page 2Linked to original sources
PubMed1987

Myocarditis and cardiomyopathy: diagnosis by endomyocardial biopsy.

UNLABELLED: To investigate the incidence of myocarditis, 30 patients, with unexplained congestive heart failure, underwent endomyocardial biopsy. For each case three to five samples were examined on light and electron microscopy. Inflammatory infiltrates and injury to adjacent myocytes consistent with myocarditis were detected in 3 of the 30 cases (10%). Changes attributable to cardiomyopathy were found in the remaining 27 cases. Two of the three patients with biopsy-proven myocarditis were treated with prednisone and azathioprine. Their control biopsies six months later showed interstitial fibrosis and absence of inflammatory infiltrates. They clinically improved but hemodynamic and angiocardiographic patterns failed to show the expected improvement. The third patient affected by myocarditis died two weeks later. IN CONCLUSION: in our series of patients with unexplained congestive heart failure, the incidence of biopsy-proven myocarditis resulted low (10%). The results of the immunosuppressive treatment in two patients with myocarditis were unconclusive. Therefore the effectiveness of such therapy should be confirmed in a larger number of patients.

Biopsy↗
PubMed1986

Effects of diltiazem on regional coronary hemodynamics during atrial pacing in patients with stable exertional angina: implications for mechanism of action.

To investigate the mechanism of the antianginal action of diltiazem in stress-induced myocardial ischemia, we studied 12 patients with stable exertional angina and disease of the proximal left anterior descending artery by measuring great cardiac vein flow (GVCF) and calculating anterior regional coronary resistance (ARCR) during myocardial ischemia induced by atrial pacing before and after intravenous administration of diltiazem (0.25 mg/kg in a bolus dose followed by continuous infusion of 0.005 mg/kg/min). Diltiazem increased the pacing time to angina from 6.9 +/- 3.5 to 10.7 +/- 4 min (p less than .001). At peak pacing heart rate was increased after diltiazem (from 128 +/- 17 to 145 +/- 17 beats/min, p less than .005), while mean arterial pressure was decreased (from 131 +/- 19 to 113 +/- 17 mm Hg, p less than .025), leaving the double product unaltered. At peak pacing no changes were observed in GCVF (from 115 +/- 46 to 119 +/- 46 ml/min, p = NS), ARCR (from 1.3 +/- 0.4 to 1.1 +/- 0.4 mm Hg/ml/min), or myocardial oxygen consumption of the anterior region (from 14.5 +/- 4.2 to 13.4 +/- 4.7 ml/min). Reduction of myocardial oxygen demand plays a major role in the antianginal action of diltiazem in patients with stress-induced myocardial ischemia.

Adult↗
PubMed1986

Ventricular tachycardia in post-myocardial infarction patients. Preoperative and intraoperative mapping.

Ventricular tachycardia has become a relatively common complication of myocardial infarction and often is an important therapeutic problem, as it is recurrent and life-threatening. Here we report a group of 36 patients with ventricular tachycardia occurring 13 days to 30 years after a myocardial infarction. All patients were resistant to medical treatment and 34 of the 36 patients had had at least one cardiac arrest. All were candidates for surgery for their arrhythmia. The study protocol included prolonged ECG monitoring, a preoperative electrophysiological study with catheter mapping and intraoperative epicardial and endocardial mapping. A total of 52 different tachycardias were mapped in 36 patients. The procedure was facilitated by an automatic mapping device, that allowed the acquisition of 35 simultaneous signals, so that even pleomorphic ventricular tachycardias could be mapped. The information obtained from both preoperative and intraoperative maps guided surgery and restricted the extent of the surgical damage.

Adult↗
PubMed1979

Coronary arterial spasm as a cause of exercise-induced ST-segment elevation in patients with variant angina.

Four patients with variant angina pectoris exhibited reproducible exercise-induced chest pain and ST-segment elevation. Coronary arterial spasm was documented with arteriography during exercise-induced ST-segment elevation (three patients) or after intravenous administration of ergonovine maleate (one patient). Our observations show that in patients with variant angina exercise can trigger coronary arterial spasm, thus inducing anginal pain and ST-segment elevation.

Adult↗
PubMed1979

[Clinical and angiographic study and pathogenic mechanism of Prinzmetal's angina. Apropos of 31 cases].

31 patients presenting with Prinzmetal variant angina were divided into three groups according to their angiographic appearances. Group I comprised 9 patients with normal or coronary arteries with lesions less than 50% narrowing. Group II comprised 12 patients with single vessel disease. Group III comprised the other 10 patients with significant lesions on two or all three principal arteries. No clinical or electrocardiographical differences were found between the groups as to age, sex or the clinicapresentation of the chest pain. Most patients with normal or nearly normal coronary arteries had normal electrol cardiogrammes between attacjs (8 out of 9) and electrical changes mainly over the inferior wall (8 out of 9). Exercise electrocardiography reproduced ST elevation in 4 of the 9 patients but, in contrast to the patients in the other two groups, never ST depression. However, these features are not specific for patients in Group I as they were observed in 4 patients in the other two groups. Spontaneous or induced coronary spasm were observed in 27 patients, confirming its role as the mechanism of Prinzmetal angina, whatever the anatomical appearance of the coronary tree.

Adult↗
PubMed1978

[Coronary spasm on exercise. Demonstration of a case by coronary angiography].

We have seen a case with spasm of the right coronary artery coming on during exercise ergometry in the course of a coronary arteriogram. The patient had angina pectoris spontaneously and on exercise. Bicycle ergometry was repeated four times by the same method, and was positive in three; in two of these there was angina and ST elevation in II, III, aVF, and ST depression in I, aVL and V2 to V5. On one occasion the test was negative, the patient having taken a trinitrin tablet one hour before the test. Repeating the exercise test during coronary arteriography showed spasm of the right coronary artery and elevation of the segment ST in II, III and aVF; this disappeared after trinitrin treatment.

Adult↗
PubMed1978

[Reproducibility of the clinical, electrocardiographic and coronarographic aspects of spontaneous coronary spasm with the use of ergonovine maleate].

Five patients affected by angina pectoris showed a spontaneous attack of myocardial ischemia in the course of coronary arteriography examination. During the ischemic episode it was shown a severe coronary arterial spasm promptly relieved by nitroglycerin. In these patients the administration of ergonovine maleate induced the same clinical, electrocardiographic and coronariographic patterns of spontaneous ischemic episodes. These data support the hypotesis that the ergonovine maleate administration is a suitable test for detection of the vasospastic pathogenesis in acute myocardial ischemia.

Adult↗
PubMed1978

Spontaneous and provoked coronary artery spasm: are they the same?

A 44-yr-old man suffering fro exertional, emotional and spontaneous angina underwent coronary arteriography. During the examination he had a spontaneous attack of angina with ST elevation in the anterior leads. Injection of a contrast medium in the left coronary artery during pain showed marked spasm with anterior descending artery occlusion. The spasm was quickly relieved by nitroglycerin. Intravenous administration of 0.4 mg of ergonovine maleate reproduced the anginal episode with pain, ST elevation in the anterior leads and coronarographic patterns of a spasm occluding the anterior descending artery at the same level. After nitroglycerin, the pain disappeared and the electrocardiographic and coronarographic findings returned to basal conditions.

Adult↗
PubMed1977

[An evaluation of ventricular function in coronary artery disease patients using the isometric (handgrip) test (author's transl)].

Left ventricular contractile function was evaluated in twenty patients with coronary artery disease before and during handgrip by use of Vpm, VCEIO and Vmax (obtained with a simplified calculation) from high-fidelity pressure measurements. In eight patients the response to handgrip was characterized by an increase of the contractile indices accompanied by small changes of left ventricular end-diastolic pressure (not exceeding + 4 mm Hg) and was considered normal. Twelve patients who showed abnormal or pathologic reaction to isometric exercise repeated handgrip after administration of 0.4 mg of spray nitroglycerin. Thus eight patients normalized their response to exercise, while in four we observed again a pathologic reaction to handgrip. It is concluded that is a useful and simple manoeuvre for a better evaluation of left centricular function in patients with coronary artery disease; the repetition of the test after administration of nitroglycerin can be useful in identifying those patients with greatest contractile reserve.

Cardiac Catheterization↗
PubMed1977

[Effects of nitroglycerin on pressure-volume diastolic relationships of the left ventricle in patients with coronary disease].

In fifteen patients with coronary artery disease who underwent hemodynamic studies, pressure measurements and left ventricular angiography were performed prior and 5' after the administration of 0.4 mg of spray nitroglycerin (TNG). Two different expressions of left ventricular diastolic compliance (dV/dP - V at end-diastole, delta V/delta P normalized by end-systolic volume-VTS) were assessed in basal conditions and after TNG. Nitroglycerin decreased left ventricular end-diastolic pressure (control 22.7 +/- 7.6 mmHg; TNG 11.4 +/- 6.1 mmHg, p less than 0.001) left ventricular end-diastolic volume (control 138 +/- 54 ml/m2, TNG 122 +/- 54 ml/m2, p less than 0.001) and improved compliance indexes (dV/dP - VED control 1.3 +/- 0.5 10(-2)/mmHg; TNG 4.6 +/- 4.3 10(-2)/MMHg; p less than 0.01; delta V/delta P - VTS control 0.071 +/- 0.04 mmHg-1; TNG 0.170 +/- 0.14 mmHg-1, p less than 0.01). TNG decreased the average value of modulus of chamber stiffness K (control 0.031 +/- 0.009; TNG 0.028 +/- 0.008, p less than 0.02) shifting the pressure-volume curve in some patients rightward and downward. Thus the increase of end-diastolic compliance (dV/dP - VED) is due to preload reduction and in patients who presented a marked decrease in K, also to the shift of the pressure-volume relation. These effects of TNG have important implications because they permit patients with coronary artery disease to engage in a given effort at a significantly lower end-diastolic pressure, avoiding pulmonary congestion.

Adult↗