Biomedical subjects
Publications and source records attributed to S De Servi.
Chest pain induced by ergometrine was associated with ST depression and subsequent elevation in anterior leads in a 42-year-old man suffering from angina at rest. Coronary arteriography during the attack showed that coronary arterial spasm of different degrees was responsible for chest pain and both types of electrocardiographic abnormality.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The effects of atrial pacing (A.P.) on the myocardial balance of inorganic phosphate (Pi) were studied in 11 patients with coronary atherosclerosis and pacing-induced angina (Group C) and in 5 normal subjects (Group N). During A.P. in group C 64% of patients had myocardial loss of Pi, statistically significant (p less than 0,025) always with concomitant reduced myocardial extraction or production of lactate, but only 70% of patients with reduced myocardial extraction or production of lactate had myocardial loss of Pi. In only 1 p. of group N myocardial loss of Pi with normal lactate extraction was observed. These data show that during pacing-induced ischemia there is a negative myocardial balance of Pi, that can be used as a metabolic indicator of ischemia, but less reliable than lactate reduced extraction or production.
Explore the source record for details and available documents.
Five patients affected by angina pectoris showed a spontaneous attack of myocardial ischemia in the course of coronary arteriography examination. During the ischemic episode it was shown a severe coronary arterial spasm promptly relieved by nitroglycerin. In these patients the administration of ergonovine maleate induced the same clinical, electrocardiographic and coronariographic patterns of spontaneous ischemic episodes. These data support the hypotesis that the ergonovine maleate administration is a suitable test for detection of the vasospastic pathogenesis in acute myocardial ischemia.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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.
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.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fifty patients who suffered from an acute myocardial infarction at age 40 or below and underwent coronary arteriography, were studied from 8 to 184 months after the infarction (mean follow-up 56 months). Hyperlipidaemia (60%) and cigarette-smoking (82%) were the most common risk factors, while hypertension and diabetes mellitus were found in 10% of all patients. Thirty-seven patients had two or more risk factors. Preinfarction angina was present in 7 subjects. Death rate was 14% within five years and was related to the severity of symptoms. Out of the patients with normal coronary arteriogram (6 patients) or with a single vessel disease 21 were free of angina and 30 did not suffer a reinfarction. Out of 17 patients with two or more coronary vessel disease, angina was present in 14 and reinfarction was seen in 5.