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Biomedical subjects

N De Luca

Publications and source records attributed to N De Luca.

78 records · Page 5Linked to original sources

Disopyramide and mexiletine: which is the agent of choice in the long term-oral treatment of lidocaine-responsive arrhythmias? Efficacy comparison in a randomized trial.

Forty patients with serious lidocaine-responsive ventricular arrhythmias were randomly assigned to treatment with either oral disopyramide (100 mg 4 times daily) or mexiletine (200 mg 4 times daily) for 3 weeks. A satisfactory arrhythmias control (greater than 75 % reduction of premature ventricular complexes per minute as compared to the control period prior to lidocaine administration) was achieved in 19 patients in the mexiletine group and in 16 in the disopyramide treated patients. Furthermore, disopyramide failed to maintain the reduction of the number of ventricular extrasystoles per minute obtained with lidocaine, while mexiletine succeeded. Finally, the number of ventricular extrasystoles per minute in the mexiletine treated group was significantly lower than in the other group. Gastrointestinal disturbances were more frequent during mexiletine administration.

Arrhythmias, Cardiac↗

Indenolol: a new antihypertensive agent: efficacy, toxicity, and hemodynamic effects in a crossover double-blind study with metoprolol.

The antihypertensive efficacy of a new agent, indenolol, was compared with that of the well-established antihypertensive drug, metoprolol, and its hemodynamic effects were investigated using echocardiography. Eighteen hypertensives completed a double-blind, crossover, randomized study using indenolol and metoprolol. Two four-week courses with indenolol or metoprolol were preceded and followed by a two-week placebo period; the total duration of the study was 14 weeks. Indenolol proved to be significantly more effective than metoprolol in decreasing blood pressure values at rest (P less than .05). Furthermore, three patients that failed with metoprolol were successfully treated with indenolol. Both drugs induced a significant decrease in cardiac output that was mediated mainly through a reduction in heart rate, because stroke volume, left ventricle circumferential fiber shortening velocity, and ejection fraction were not significantly reduced by either drug. However, after indenolol, a significant direct relationship was found between the basal values of both cardiac output (r = .809) and total peripheral resistance (r = .800), and the reduction of these parameters. On the contrary, after metoprolol only, the correlation between the basal value of cardiac output and its reduction was significant (r = .790).

Adolescent↗

High resolution computed tomography (HRCT) assessment of beta 2-agonist induced bronchodilation in chronic obstructive pulmonary disease patients.

The evaluation of airway obstruction reversibility in chronic obstructive pulmonary disease (COPD) patients is currently performed by means of an indirect assessment of drug inducing variations in pulmonary function tests. Imaging techniques, especially high resolution computed tomography (HRCT), usually provide a complete evaluation of lung parenchyma (bronchial and vascular structures), but so far they have never been applied to visualize the effects on the bronchopulmonary tree of some pharmacologic stimuli (beta 2 adrenergic agonist), currently used in clinical practice to disclose the presence of airway reversibility. In order to assess the possible role of HRCT in this setting, five COPD patients have been subjected to a double functional radiologic evaluation before and after salbutamol-induced broncho-dilation, with a rigorous assessment of bronchial diameter changes by means of "bronchus-vessel" ratio, currently used for diagnosing bronchiectasis in COPD patients. The results of this experimental study enable us to visualize drug induced broncho-dilation, with a direct assessment of airway reversibility in these patients, and to show a good correlation between functional and HRCT findings, raising the possibility of evaluation COPD patients with abnormal spirometric results or with early signs of lung involvement.

Administration, Inhalation↗

[Beyond cholesterol levels: new therapeutic indications of statins].

Cardiovascular diseases represent the major cause of morbility and mortality in industrialized countries, even if the incidence is quite different between each other. In the last years the knowledge of molecular mechanisms, which are responsible of progression of atherosclerosis vascular disease and of its complications such as coronary heart disease, has been particularly improved. At this regard new pharmacological compounds are introduced in clinical practice improved efficacy and effectiveness and, among these ones, thanks to statins a significative reduction in primary endpoint (i.e. reduction in incidence of stroke, total and cardiovascular mortality) has been already demonstrated. This effectiveness seems to be due by acting directly on the vascular atherosclerotic plaque independently from the reduction of blood cholesterol level which, on the contrary, may be involved in the progression of atherosclerotic vascular process.

Animals↗