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Biomedical subjects

P Benussi

Publications and source records attributed to P Benussi.

At least 19 recordsLinked to original sources
PubMed2003

Relationship between diabetes mellitus and degree of coronary artery disease in uraemic patients investigated with coronary angiography.

Prevalence of cardiovascular disease is high in diabetic patients on renal replacement therapy (RRT); therefore we examined the role of diabetes mellitus on determining the degree of coronary artery stenosis. Twenty-five patients underwent coronary angiography, 12 were awaiting kidney transplantation and the examination was performed regardless of cardiac symptoms, 13 were affected by ischaemic heart disease (IHD). Diabetic and nondiabetic status together with the other risk factors for cardiovascular disease such as age, sex, length of time on RRT, smoking and elevated phosphorus levels history, clinical diagnosis of IHD, cerebrovascular and peripheral vascular disease, mean blood pressure, cholesterol, triglycerides, calcium, phosphate, albumin, haemoglobin, haematocrit and weekly dose of erythropoietin were derived from clinical records. All investigated parameters were matched in diabetic (group 1, n=10) and nondiabetic patients (group 2, n=15) and showed no differences. Clinical evidence of IHD was detected in 80% of patients in group 1 and 46% in group 2 and the percentage of patients on the renal transplant waiting list was not statistically different in the two groups (30 vs 60%). In 60% of patients in group 1 there were 3 or more stenotic lesions equal or greater than 75% of normal reference segment in the major coronary arteries, whilst in 53% in group 2 there were no haemodynamically significant narrowings. Narrowing percentage of the coronaries in group 1 and 2 were: right coronary artery 83 +/- 30 vs 32 +/- 41 (p<0.05), left anterior descending artery 80 +/- 25 vs 44 +/- 34 (p<0.05), left circumflex artery 46 +/- 37 vs 18 +/- 29 (p=0.05) respectively. Our study confirms that IHD is a clinical feature of uraemic diabetic patients and that diabetes is the main cardiovascular risk factor for determining the degree of coronary stenosis.

Aged↗
PubMed1993

Left ventricular dysfunction following transient ischaemia induced by transluminal coronary angioplasty. Beneficial effects of calcium antagonists against post-ischaemic myocardial stunning.

Acute and severe ischaemia is followed by depression of myocardial contractility during reperfusion; return to full recovery might take a long time. This phenomenon, termed myocardial stunning, has been extensively demonstrated in experimental studies and in different clinical settings. The beneficial effects of calcium antagonists in preventing post-ischaemic myocardial stunning have been tested in experimental studies, showing that when administered before or during ischaemia, they inhibit post-ischaemic myocardial dysfunction. The present study was undertaken to verify the possible occurrence of myocardial stunning following transient ischaemia induced by coronary angioplasty. The aim was also to evaluate the possible protective effects of calcium antagonists (nisoldipine) and nitrates against myocardial stunning in patients with coronary artery disease undergoing routine coronary angioplasty (PCTA) with prolonged inflation. The study included 25 patients, aged between 40 and 69 years, with exercise-induced angina and single vessel disease. The stenosis was severe (80% to subtotal occlusion), localized on the left anterior descending artery, but without collaterals at coronary angiogram. All patients had normal left ventricular (LV) overall function and normal systolic thickening of the anterior wall supplied by the diseased artery. Our data suggest that post-ischaemic myocardial stunning is not only an experimental curiosity, but that it does occur in different clinical settings. Calcium antagonists (i.e. nisoldipine), when added before or during ischaemia, seem to prevent myocardial stunning. These findings confer a potential role to these agents in the treatment of post-ischaemic myocardial dysfunction.

Adult↗
PubMed1992

Myocardial stunning following coronary angioplasty: protective effects of calcium-channel blockers.

The beneficial effects of calcium-channel blockers against myocardial stunning have been tested in experimental studies, showing that, when added before or during ischemia, a protective effect against postischemia stunning is achieved. The present study was undertaken to test and compare the protective effect of calcium antagonists [nisoldipine (NIS) and nifedipine (NIF)] and nitrates (NIT) against myocardial stunning in patients with coronary artery disease undergoing percutaneous transluminal coronary angioplasty (PTCA) with prolonged inflation as PTCA represents a model of induced acute and severe ischemia for a brief period and might cause myocardial stunning. The study included 30 patients between the ages of 42 and 67 years, all with exercise-induced angina and single-vessel disease, with severe stenosis (80% to subtotal occlusion) localized on the left anterior descending artery and with the absence of collaterals on the coronary angiograms. Moreover, all patients had normal left ventricular (LV) overall function, as well as normal systolic thickening of the anterior wall, supplied by the diseased artery. Patients were randomized to a pre-PTCA treatment with NIT, 80-120 mg/day (10 patients), NIF, 40-60 mg/day (10 patients), and NIS, 10-20 mg/day (10 patients). Pre-PTCA treatment was initiated 7 days before the procedure and continued after. During the PTCA, at the first balloon inflation, an additional dose of 300 micrograms of NIT was injected into the left anterior descending artery through the balloon catheter in the patients in the NIT group, as well as 0.2 mg of NIF in NIF group patients and 0.05 mg of NIS in NIS group patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Direct visualization of aorto-coronary bypass grafts by two-dimensional echocardiography: a new clinical application.

An attempt was made to assess noninvasively the patency of aorto-coronary bypass grafts by two-dimensional echocardiography (2-D echo) in 21 patients who underwent myocardial revascularization. Fifteen patients had one graft while the other six had two grafts. All 21 patients underwent angiography 6-18 months after operation. A day before angiography a 2-D echo was performed with the aim of visualizing the bypass grafts. In 18 patients with 23 grafts (13 with 1 graft and 5 with 2 grafts) it was possible to visualize the tract of the graft by 2-D echo; 16 were judged patent on 2-D echo and confirmed by selective angiography, while 5 grafts were considered occluded both on 2-D echo and angiography. The other 2 grafts were considered to be occluded on 2-D echo but angiographic control displayed their patency. In 3 patients 2-D echo failed to visualize grafts that were patent angiographically. These data must be considered preliminary and need validation in a larger number of patients. However it is reasonable to conclude that 2-D echo has a reliable capacity to predict graft patency. Such an application may be of value in sequential control of patients with aorto-coronary bypass surgery, especially when combined with other clinical and/or technical data.

Adult↗
PubMed1987

Two-dimensional echocardiography in the diagnosis of intracardiac masses: a prospective study with anatomic validation.

The accuracy of two-dimensional echocardiography in the detection of intracardiac masses was verified in 334 patients who underwent cardiac catheterization in our laboratory over 21 consecutive months. A complete two-dimensional echocardiographic (2DE) examination was performed a day before catheterization. The presence or absence of a mass was verified at surgery in 77 patients who successively underwent mitral or aortic valve replacement (51), left ventricular aneurysmectomy with or without myocardial revascularization (25), and resection of atrial myxoma (2). In 32 patients 2DE revealed the presence of a mass-left or right atrial thrombi in 12, left atrial myxoma in 2, left ventricular thrombi in 16, and endocardial vegetations in 2. The other 45 patients were free of intracardiac masses on 2DE. Anatomic verification at surgery revealed the presence of an intracardiac mass in 34 patients. In 30 (true positives) of these, 2DE revealed the mass as well, and in 4 (false negatives) the presence of a mass had not been identified by 2DE. In 2 patients (false positives) the predicted mass was not found at surgery. Absence of a mass was correctly predicted by 2DE in 41 patients (true negatives). Thus 2DE detected intracardiac masses with sensitivity of 88.2% and a specificity of 95.3%. We recommend that 2DE be performed in all patients prior to hemodynamic study and/or cardiac surgery to enable safer management of patients with intracardiac masses during cardiac catheterization and/or cardiac surgery.

Adult↗
PubMed1986

[Hemodynamic status in liver cirrhosis with portal hypertension: a retrospective study on 49 patients].

The Authors report on the data obtained and their evaluation by means of analysis of seven variables and four indices, in 49 cirrhotic patients with portal hypertension and in 10 control patients. Haemodynamic analysis offers the possibility of identifying the dynamic transition stages of a response to stress showing varying degrees of compensation and establishing categories of patients on the basis of cardiovascular and metabolic parameters in relation to liver damage. The Authors, according to Siegel studies, retain that this is a valid method which enables us to obtain useful information on the haemodynamic status of the cirrhotic patient with portal hypertension.

Angiography↗
PubMed1980

[Acute changes of the mechanical function of the ischaemic left ventricle by sublingual nifedipine (author's transl)].

In 20 patients, who had undergone a routine cardiac catheterization for the evaluation of anginal syndrome, some parameters of mechanical function of left ventricle (LV) were evaluated before and after left ventriculography was performed. Then, the same parameters were also measured, in identical technical conditions, after the administration of 20 mg of sublingual nifedipine (NIF). After NIF a significant decrease (P < 0.01) in left ventricular systolic and diastolic pressure, aortic diastolic pressure and left ventricular enddiastolic and endsystolic volumes was observed; while, heart rate, dP/dt max, stroke volume and ejection fraction were significantly increased (P < 0.01). Evaluation of LV segmental wall motion, after NIF, revealed no changes of wall motion in normal areas or in those with akinesis or dyskinesis; while, 68% of the areas with slight hypokinesis and 55% of those with severe hypokinesis were significantly improved after NIF (P < 0.005). Thus, we concluded that NIF does not cause a depression of LV mechanical function. The improvement of LV wall motion displayed by the areas with a transitory ischemic damage could be attributed to the reduction in preload and, more significantly, in afterload induced by NIF.

Administration, Oral↗
PubMed1977

Circadian variations of blood pressure in patients with different degrees of hypertension. Changes induced by hypotensive treatment.

Arterial pressure was continuously recorded for 24--48 h in 3 normotensive subjects and in 60 hypertensive patients. The greatest variations occurred in those with labile, mild or moderate hypertension compared to those with severe hypertension or normal blood pressure. Atenolol (100-200 mg) administered once or twice daily produced a significant reduction of arterial pressure and a smaller response to the cold pressor test, hand grip and step test in patients with established hypertension, but little change in those with labile hypertension. The evening dose was not followed by a decrease in pressure greater than that observed without treatment, but determined a smaller rise on awaking.

Adolescent↗