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Biomedical subjects

S Cuminetti

Publications and source records attributed to S Cuminetti.

11 recordsLinked to original sources
PubMed1992

[The antianginal effects of a new delayed-release formulation of diltiazem in patients with stable angina pectoris: its evaluation by the ergometry test and dynamic electrocardiogram].

The antianginal efficacy and duration of action of slow-release (SR) diltiazem were evaluated in 12 patients with stable angina. Patients underwent maximal symptom limited bicycle exercise testing and 24-hour Holter monitoring at the end of 1-week placebo run-in phase and after 1-month therapy with either placebo or SR-diltiazem (120 mgs bid) using a placebo controlled, double-blind, randomized cross-over trial. No concomitant antianginal therapy, except sublingual nitroglycerin, was allowed during the trial. Exercise testing was performed 3 and 12 hours after drug administration. Blood samples were obtained for the determination of diltiazem plasma concentrations. After diltiazem administration, peak exercise duration increased significantly in comparison both with placebo and the run-in phase: from 292 +/- 48 to 378 +/- 113 s at 3 hours and from 286 +/- 59 to 366 +/- 109 s 12 hours after drug administration. Similarly, ST depression time increased from 240 +/- 59 to 374 +/- 123 s at 3 hours and from 231 +/- 57 to 332 +/- 123 s 12 hours after diltiazem. No significant changes of heart rate, blood pressure and double product were detected. Diltiazem plasma concentrations averaged, respectively, 175 +/- 86 pg/ml and 109 +/- 43 pg/ml 3 and 12 hours after its administration. No correlation was found between plasma concentrations and antianginal effects of diltiazem. At 24 hours Holter monitoring, SR-diltiazem induced a significant decrease of mean heart rate with a reduction in the number and duration of ischemic episodes.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1991

[The acute, chronic continuous after treatment and chronic intermittent with a variable therapeutic window (4 and 6 hours) hemodynamic effects induced with transdermal nitroglycerin in patients with congestive heart failure].

The aim of this study was to assess the minimum time interval necessary to avoid the development of tolerance during nitroglycerin patch application. We studied 24 patients, aged 23 to 73 years, with ischemic or idiopathic dilated cardiomyopathy (LV EF less than 0.40) and stable clinical conditions during 30 days before the study. All patients had significant reduction of systemic and pulmonary arterial pressure after sublingual nitroglycerin. After the hemodynamic assessment of the response to the first dose of the nitroglycerin patch, the patients were randomized to 1 of 3 chronic treatment groups: continuous patch application (Group A), intermittent application with 4 hours intervals (Group B), intermittent application with 6 hours intervals (Group C). All patients were studied by right heart Swan-Ganz catheterization; the hemodynamic response to a 10 mg multilayer matrix nitroglycerin patch was assessed before and every hour, in the next 4 hours, after both the first application of the patch and after 1 month of therapy; after chronic intermittent therapy, hemodynamic parameters were also measured 24 hours after drug withdrawal. Hemodynamic parameters were significantly changed after the first nitroglycerin patch application: particularly, mean systemic arterial (MAP), right atrial (RAP) and pulmonary wedge pressures (PWP) declined from 96 +/- 10, 8.9 +/- 1.8 and 20.1 +/- 5 to 81 +/- 6, 4.7 +/- 1.5 and 12.2 +/- 3 mmHg (-15.6, -47.2 and -59.3%, respectively); systemic vascular resistance (SVR) and heart rate (HR) were reduced from 1645 +/- 121 to 1288 +/- 89 dyne.s.cm-5 and from 85 +/- 7 to 81 +/- 7 b/min; lastly, cardiac index (CI), stroke volume (SVI) and stroke work index (SWI) increased from 2.3 +/- 0.3, 28.2 +/- 5 and 28.7 +/- 9 to 2.7 +/- 0.3 l/min/m2, 33.3 +/- 5 ml/min/m2 and 31.5 +/- 8 g.m/m2 (+17.4, 18.1 and 9.7%). After 1 month of either continuous or intermittent patch application with 4 hours intervals, hemodynamic parameters returned to control values with no significant change after patch application. In contrast, after intermittent patch application with 6 hours intervals, a persistent hemodynamic response to nitroglycerin patches was still present.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Cutaneous↗
PubMed1986

Left ventricular dysfunction versus paravalvular leak in patients with mitral disc prostheses.

UNLABELLED: Left ventricular dysfunction and prosthesis malfunction are the main causes of hemodynamic deterioration following prosthetic mitral valve replacement. The aim of this study is to reassess the usefulness of a combined echo-phonocardiographic technique to differentiate these different situations in order to select medical or surgical treatment in patients with a mitral disc prosthesis. Two patient groups were studied. The first group consists of five patients with paravalvular leak (PL), surgically or pathologically verified. Second group: nine patients with left ventricular failure (LVF) and normal functioning prosthesis. The diastolic diameter of the left ventricle (LV) was significantly increased in the LVF group compared with the PL group. A protodiastolic hump was present in four cases of PL. The variability of the interval between A2 and the mitral valve opening (delta A2-MVO) was less than 30 msec in the LVF group and greater than 30 msec in the PL group. The interval between A2 and maximal LV posterior wall (A2-PW) exceeded 60 msec in the PL group and was shorter than 60 msec in the LVF group. IN CONCLUSION: the echo-phonocardiographic technique, especially when by using two newly proposed parameters, seems to be very useful to discriminate between PL and LVF.

Adult↗
PubMed1980

[Computer analysis of the vectorcardiogram].

A computer method analysing Frank VCG recorded on rest and on exertion, is presented. Electrical noises due to exercise are eliminated by averaging 8 complexes. The pattern-recognition of every wave is carried out by analysing a particular function obtained by translating the X, Y, Z leads on the line joining the T-P, P-Q, ST and subsequent T-P segment. The following parameters are evaluated: maximal and mean vector, linear, areolar and tangential (our original method) spatial velocity, half-area vector, area described by the spatial vector and oriented according to X, Y, Z polarity.

Diagnosis, Computer-Assisted↗
PubMed1980

[The atrial vectorcardiogram at rest and during exercise. Comparison, by computerized analysis, of normal subjects and patients with mitral stenosis].

This study on rest and exercise atrial vectorcardiogram (Frank method) was carried out on a group of 27 healthy volunteers (Group A) and on a group of 24 patients with mitral stenosis (Group B). All 51 subjects were women. Our original program was performed using a Hewlett Packard 2100 computer. The pattern recognition of every wave was carried out by analysing a particular function obtained by translating the X, Y, Z leads on the line joining the T-P, P-Q, ST segments. In the group B on rest a significant correlation between atrial vectorcardiogram parameters and pulmonary capillary wedge pressure was not present. Between both group A and B the vectorcardiographic data were greatly superposables. It is difficult, because of the great interindividual variability of results obtained, to have very discriminant vectorcardiographic parameters between group A and group B on rest and during exercise, performed in the supine position with a bicycle ergometer. In the both groups A and B the exercise induces a significant increase of spatial magnitude of maximal P xyz vector (max P xyz) and maximal P amplitude on frontal and sagittal planes, with P loop shifting towards a vertical position. The following significant results were observed only in group B of mitral patients: 1) an increase of P wave duration; 2) an increase of the interval between the two peaks of P wave (measurable only in group B); 3) an increase in the amplitude and backward rotation of max P xyz azimuth and of the maximal vector backward directed on horizontal (H) plane; 4) an increase of P loop linear, tangential and areolar velocities. The P loop anterior and posterior area on H plane and of the spatial P xyz vectors changes during exercise were directionally similar in the normal group and in the patients with mitral stenosis. These results suggest a little diagnostic power of the P wave area changes during exercise. In both groups maximal atrial T vector increases with exertion, but only in group B migrates backward on H plane, suggesting an atrial gradient directed towards the left atrium.

Adult↗