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L Angoli

Publications and source records attributed to L Angoli.

52 records · Page 3Linked to original sources

[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

[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

[Coronary artery spasm induced by the somministration of ergonovine maleate in subjects with spontaneous angina (author's transl)].

In 6 patients affected by spontaneous angina with S-T elevation and coronariographic findings of obstruction, intravenous administration of ergonovine maleate determined the same clinical and ECG patterns of spontaneous episodes. The coronary arteriography during pain showed a marked spasm with occlusion of a large coronary vessel in four patients. In 2 patients with atypical chest pain and normal coronariogram, E.M. did not induce pain, ECG abnormality or coronariographic alterations. The role of spasm in spontaneous angina is discussed.

Adult

[Phonomechanocardiographic diagnosis of the apparently "silent" mitral valve prolapse syndrome (author's transl)].

Five cases with angiocardiographically diagnosed posterior mitral valve prolapse and without ausculatotory findings of midsystolic click or late systolic murmur were studied with phonocardiographic technique employing pharmacological tests and postural changes. A midsystolic click was thus obtained. Isoprenaline was the must helpful drug to achieve it. The accompanying electrocardiographic and coronarographic features of this syndrome are described and discussed.

Amyl Nitrite

[Coronary angiographic findings in the myocardial infarction involving the dorsal wall of the heart (author's transl)].

The Authors report the results of a coronary angiographic study in 12 patients with acute myocardial infarction in which the necrosis was extended to the dorsal wall of the heart. The electrocardiographic and vectorcardiographic criteria applied in order to assess the involvement of the dorsal wall have been those suggested by Perloff and by Hoffman and coll. and Massie and Walsh, respectively. The diagnosis of dorsal involvement has been also confirmed by the esophageal electrocardiogram. Discussing their results, the Authors consider the variants of blood supply of the posterior wall of the heart. On the basis of their angiographic findings, they underline that significant lesions of the circumflex artery, either alone or associated with narrowing of other main coronary arteries, are the most frequent finding in cases of myocardial infarction involving the dorsal wall of the heart.

Adult

[Non-transmural myocardial infarctions. Evolutive ecgraphic and angiographic clinical aspects (author's transl)].

The authors report fifty-nine cases of non-transmural myocardial infarction. The diagnosis was made on the basis of clinical electrocardiographic data and enzyme changes. The clinical course was characterized by several chest pain attacks; a transmural myocardial infarction occurred in four patients a few days after admission. Out of fifty-five patients, followed for a nineteen - months period, six died, thirty-one were asymptomatic and fourteen complained of angina. In the last group, chest pain was generally present before the non-transumural myocardial infarction. The ECG were within normal limits in thirty-seven patients. The coronarographic patterns found in fifteen patients are also described and discussed.

Alanine Transaminase

[Coronary spasm during exercise test (author's transl)].

We thought chest pain associated with ST segment elevation during exercise test in patients with not significant coronary lesions could be related to coronary spasm. Three patients with mild coronary obstructive lesions underwent coronary arteriography during exercise test. In two patients this hypotesis was supported by angiographic documentation of the coronary spasm.

Angina Pectoris