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Biomedical subjects

P Sangiorgio

Publications and source records attributed to P Sangiorgio.

13 recordsLinked to original sources
PubMed1992

[The clinical and prognostic significance of symptomatic and silent ischemia on the exercise test in patients with a prior myocardial infarct].

The aim of the study was to assess clinical/prognostic significance of exercise-induced ischemia in patients with healed myocardial infarction. From May 1988 to January 1991, 777 consecutive patients underwent a symptom-limited (Bruce protocol) treadmill test at least 1 year after myocardial infarction. Clinical and ergometric data were entered in a prospective way in our data base. The exercise-test was positive in 231 out of 777 patients and 2 different subgroups were retrospectively identified depending on criteria of interruption: 156 patients with painless exercise-ST depression; 75 patients with painful exercise-ST depression. The main results (mean +/- SD) were analyzed with Student t test and chi 2 test. Patients with silent ischemia had longer exercise duration (547 +/- 153 s versus 395 +/- 173 s; p < 0.001) and higher double product (22.98 +/- 0.5 versus 19.71 +/- 0.4; p < 0.001) than symptomatic patients. Ischemic threshold was lower (double product: 17.98 +/- 0.4 versus 21.22 +/- 0.4; p < 0.001 with onset of ST depression at 297 +/- 148 s versus 448 +/- 147 s; p < 0.001) and time to ST normalization was longer (368 +/- 155 s versus 234 +/- 212 s; p < 0.001) in patients with painful ischemia. Patients with angina and ST depression had significantly higher prevalence of downsloping ST depression in the recovery phase (68% versus 37%; p < 0.001) and a higher prevalence of treadmill exercise score indicating high risk (49% versus 3.2%; p < 0.001). The 2 groups when compared with 99 patients with negative test post-AMI were significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Felodipine in chronic stable angina: a randomized, double-blind, placebo-controlled, crossover study.

To investigate the antianginal efficacy and tolerability of felodipine, a new dihydropyridine calcium antagonist, 20 patients with stable exertional angina, not completely controlled by beta-blocker monotherapy, entered a randomized, double-blind, placebo-controlled, crossover study. Patients on standard beta-blocker therapy, who had at least 3 weekly anginal episodes and a reproducible exercise test (stopped for angina and ECG signs of ischaemia) at the end of 2 weeks placebo treatment, were eligible for the study. They were randomized to one sequence of treatment: felodipine 5 mg twice daily for 2 weeks followed by placebo for a further 2 weeks, or vice versa. Beta-blocker treatment was unchanged throughout the study. A treadmill test was carried out at the end of each crossover period, 2-4 h after drug administration. The number of anginal attacks and nitroglycerin consumption was recorded on a diary card. At rest, felodipine significantly (P less than 0.05) reduced standing systolic but not diastolic blood pressure. Heart rate was not modified by the active treatment. At ischaemic threshold and at peak exercise, heart rate, systolic blood pressure and rate-pressure product remained unchanged. Exercise duration was increased by felodipine (P less than 0.01) and maximal ST change was reduced (P less than 0.01). Time to 1 mm ST depression was prolonged non-significantly by felodipine (basal 5.7 +/- 1.5, felodipine 7.4 +/- 2.0, placebo 6.6 +/- 1.5 min). The number of patients who stopped exercise due to angina and ST change was 20/20 at baseline, 16/20 with placebo and 10/20 with felodipine. Felodipine significantly reduced weekly anginal episodes (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Experiences with coronarography using digital technics].

The authors report their experience with the application of digital techniques to coronary angiography, over the past 2 years. One hundred and fifty coronary angiographies were performed, with excellent results. Indications for surgical by-pass arose for 64 patients, 35 of whom have already undergone surgery. Coronary angioplasty procedures (PTCA) were needed in 13 cases; on 12 the procedure has already been carried out. The difficulty to provide the cardiac surgeon with images in movement has been overcome by recording the images passing on the TV monitor directly on a professional magnetic tape. On the basis of our initial experience, we may affirm that the application of digital techniques to coronary angiography does not modify the technical approach to the exam and, therefore, does not reduce its invasiveness. On the other hand, the examination can be performed using the software commonly found in many units used for digital angiography. From a morphological point of view, the images seem to be superimposable to the conventional ones, especially since sequences of 25 images/second can be acquired with a 512 matrix. The potentials of digital techniques to provide functional data and information on anatomic lesions are very interesting, even though they are still to be fully demonstrated.

Angiography, Digital Subtraction↗
PubMed1989

[Gallopamil in stable effort angina. Effects of 2 different dosages].

The effects of gallopamil, a calcium channel blocker methoxy derivative of verapamil, recently introduced into clinical use in Germany, were evaluated in 20 patients with stable exertional angina. Two different dosages of the drug were used: 25 mg tid and 50 mg tid. It was observed that both dosages improved exercise tolerance (355 +/- 95 sec after placebo; 462 +/- 78 sec, p less than 0.01 and 511 +/- 97 sec, p less than 0.01 after the two doses) while the time taken to produce ischemia (-1 mm ST depression) was significantly prolonged only by the higher dose of the drug (204 +/- 101 sec after placebo; 324 +/- 135 sec after gallopamil 150 mg, p less than 0.05). Both dosages of gallopamil caused a significant reduction in the double product in the first phases of the exercise (double product 3 degrees min of exercise x 10(2): 173 +/- 140 after placebo; 153 +/- 34, p less than 0.05 and 145 +/- 30, p less than 0.05 after the two doses), while they did not affect this parameter at the end of the exercise. Our data seem to confirm that gallopamil works through a lowered myocardial metabolic demand as a consequence of the reduction of the afterload. Both dosages of the drug decreased the number of episodes of angina, but the higher dose was more effective. The drug is safe and well tolerated. All patients completed the study. Furthermore, no particular haemodynamic problems were observed.

Adult↗
PubMed1987

Effects of different sodium intakes on the antihypertensive and renal effects of single oral doses of nifedipine in hypertensive patients.

The aim of this study was to investigate whether the antihypertensive and renal effects of Ca2+ antagonists are related to the sodium state of the patients. For this purpose, in a group of 11 patients with essential hypertension we have compared the blood pressure lowering effects of a single oral dose of nifedipine before (100 mmol Na+/day and 40 mmol K+/day) and after sodium depletion (20 mmol Na+/day and 40 mmol K+/day: each period was of 6-8 day duration). During the normal sodium diet nifedipine significantly lowered supine blood pressure (from 185 +/- 13/107 +/- 7 to 161 +/- 13/100 +/- 7 mm Hg, p less than 0.001) and induced a significant rise in Na+ excretion (from 52 +/- 10 to 94 +/- 13 mmol/6 h) and in urine volume (from 520 +/- 80 to 947 +/- 120 ml/6 h; p less than 0.01). Sodium depletion significantly lowered supine blood pressure (152 +/- 12/95 +/- 9 mm Hg, p less than 0.001); nifedipine caused a further and significant blood pressure reduction (142 +/- 11/90 +/- 8 mm Hg, p less than 0.01), but only a minor and not significant increase in sodium excretion (from 10 +/- 2 to 22 +/- 5 mmol/6 h) and urine volume (from 338 +/- 76 to 463 +/- 94 ml/6 h). Our data suggest that the natriuretic action of calcium antagonists is not relevant to their antihypertensive effect.

Administration, Oral↗
PubMed1986

Antihypertensive and renal effects of tertatolol, a new beta-blocking agent, in hypertensive patients.

Tertatolol, a new nonselective beta-adrenoceptor blocker, was administered to 11 hypertensive patients in a short-term study. Systolic and diastolic blood pressure and heart rate were significantly decreased when compared to the placebo period: in spite of that glomerular filtration rate and renal plasma flow were unchanged. The administration of metoclopramide (a dopaminergic receptor antagonist) caused a significant reduction of renal plasma flow and a significant rise of renal vascular resistances during placebo, but no change during tertatolol therapy. A possible interference of tertatolol on dopaminergic receptors is discussed as the mechanism responsible for the unmodified renal plasma flow despite the significant blood pressure lowering with tertatolol.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Combined digoxin-molsidomine therapy in congestive heart failure following acute myocardial infarction.

The acute hemodynamic effects of combining administration of digoxin (DIG)(0.01 mg/kg intravenously) with molsidomine (MLS)(4 mg sublingually) were compared with those of DIG and MLS considered alone in 12 patients with congestive heart failure following acute myocardial infarction. The patients were classified into two subgroups, A (cardiac index [CI] less than or equal to 2.2 L/min/m2 and B (CI greater than 2.2 L/min/m2), to verify differences between the responses to the three drug regimens. MLS significantly reduced systolic blood pressure from 121.2 +/- 12.3 (mean +/- SD) to 111.7 +/- 10.9 mm Hg (p less than 0.01) after 60 min, mean right atrial pressure (RAP) from 6.2 +/- 3.6 to 2.4 +/- 2.1 mm Hg (p less than 0.0001), mean pulmonary arterial pressure (PAP), left ventricular filling pressure (LVFP) from 20.6 +/- 2.1 to 12.2 +/- 2.8 mm Hg (p less than 0.0001), and pulmonary vascular resistance (PVR). Left ventricular stroke work index (LVSWI) significantly increased after 60 min. DIG induced a significant reduction in heart rate, RAP, PAP, and LVFP from 20.1 +/- 2 to 14.3 +/- 2.7 mm Hg (p less than 0.0001) after 90 min. Stroke volume index (SVI) increased from 24.7 +/- 4.2 to 27.7 +/- 3.1 ml/beat/m2 (p less than 0.001) and LVSWI from 25.9 +/- 7.2 to 31.9 +/- 5.4 g X m/m2 (p less than 0.0001). The combination of DIG and MLS produced a reduction in RAP, PAP, and LVFP greater than that achieved with either agent alone, with a further shift of the ventricular function curve to the left, thereby leading to an improvement in cardiac performance.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗