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Biomedical subjects

S Repetto

Publications and source records attributed to S Repetto.

At least 55 records · Page 3Linked to original sources
PubMed1983

Transcoronary platelet thromboxane A2 formation without platelet trapping in patients with coronary stenosis-effect of sulphinpyrazone treatment.

Platelet count, and plasma thromboxane B2 (TXB2) and circulating platelet aggregates (CPA) were determined in the coronary sinus (CS), aortic bulb (AO) and cubital vein (V) in 21 patients with stable angina and in 6 control subjects before and after atrial pacing (AP). TXB2 measurements were repeated before and after AP in 6 of the 21 angina patients after 15 days' sulphinpyrazone treatment. Platelet count and CPA ratio were similar in angina patients and controls at all three sampling sites and were unchanged at AP peak. In the controls, basal TXB2 values in CS, AO and V were not significantly different and were unchanged at AP peak. In the angina patients compared with the controls, basal TXB2 values in the AO, CS and V were not significantly different whereas the CS/AO TBX2 ratio was significantly higher; at AP-induced ischaemia, CS TXB2 was significantly increased and the CS/AO TXB2 ratio was increased. A weak but significant direct correlation was found between CS/AO TXB2 ratio and coronary score. Sulphinpyrazone treatment reduced CS TXB2 levels at rest and after AP, but not the ischaemic threshold at AP.

Adult↗
PubMed1982

Assessment of diagnostic value of dipyridamole testing in angina pectoris.

In order to assess the diagnostic value of dipyridamole (D) testing, we studied the responses of 34 patients with chest pain and 10 normal subjects. Blood pressure and 12-lead ECG were recorded during and after intravenous infusion of 0.6 mg/kg dipyridamole for 10 minutes. Coronary arteriography and maximal or symptom-limited exercise tests were performed in the 34 patients with chest pain. During infusion 13 patients presented ischemic ST changes and 5 with anginal pain only. The latter group had normal coronary arteries. Among the 13 patients with ischemic ST changes, 7 had at least two critical coronary stenoses and the remaining 6 had no coronary lesions. Dipyridamole tests showed poor sensitivity (44%) and specificity (39%) with respect to coronary arteriography. The relatively high number of positive responses in subjects with normal coronary arteries indicates that the coronary steal phenomenon is not the sole cause of "ischemic" response to the drug. Indirect indexes of myocardial oxygen consumption were higher in patients with a positive response to drug infusion than in those with a negative response; however the value of rate-pressure product at infusion end never reached that observed at ischemic threshold during exercise testing in the same patient. This suggests that neither can oxygen consumption increase be considered as entirely responsible for ischemic response to dipyridamole. In conclusion dipyridamole test cannot be proposed for predicting critical coronary stenoses.

Adult↗
PubMed1982

Hemodynamic effects of ceruletide administered intravenously to coronaropathic patients.

The possible hemodynamic effects of ceruletide, administered intravenously at the dose of 1 ng/kg b.w., were studied in 9 coronaropathic patients submitted to cardiac catheterization. Ceruletide did not induce any modification of hemodynamic parameters. The only observed effect was a slight (3.7%) but statistically significant reduction of O2 saturation in the pulmonary artery.

Adult↗
PubMed1982

Limits of precordial electrocardiographic mapping in assessing anterior myocardial infarction size.

Purpose of our investigation was to ascertain whether the electrocardiographic mapping of the anterior thoracic wall can provide more precise information on the extent of an anterior myocardial infarction (MI) than the 12 conventional leads do. Thirty-seven patients were studied 1 to 72 months after an acute MI of the anterior wall. All patients underwent left heart catheterization which included selective coronary arteriography and left ventriculography, to evaluate the indication for surgery. Electromaps were obtained by means of 71 Ag-AgCl electrodes located at regular intervals on the thoracic wall (between the right midclavicular line and the left posterior axillary line). The following parameters were considered: total number of Q waves, R waves and ST elevations greater than or equal to 0.05 mV (NQ, NR, NST); the sum of Q, R and ST voltages (sigma Q, sigma R, sigma ST); the sum of Q-wave and R-wave areas (sigma aQ, sigma aR). The electrocardiographic data were correlated with the percentage of left ventricular dyssynergy (corresponding to the ratio between the length of the akinetic and/or dyskinetic portion of the left ventricular silhouette and the total enddiastolic perimeter) and with the ejection fraction obtained from the left ventricular angiograms in right anterior oblique projection. A significant but weak correlation was found only between sigma R, sigma aR and percentage of dyssynergy and between NST, sigma ST and ejection fraction. Thus the amplitude and duration values of positive activation potentials (sigma aR, sigma R) were better predictors of dyssynergy extent than the classical direct signs of necrosis (NQ, sigma Q). The poor correlation observed in our patients between ECG and angiographic data can mainly be due: a) to a lack of concordance between the dyssynergic area and the truly infarcted region; b) to the well-known limits of surface electrocardiography in defining the cardiac generator characteristics. In particular, as far as the adequacy of various ECG recording systems in determining infarct size is concerned, our study suggests that exploring a large thoracic area is not definitely more advantageous than using 12 - lead ECG, when only traditional analysis of electrocardiographic tracings is performed.

Adult↗
PubMed1981

[Multiple coronary spasms in asymptomatic patient (author's transl)].

A 46 year old asymptomatic male showed ST elevations in the inferior leads during an occasional basal electrocardiogram. During an ECG monitoring at rest a high number of transient episodes of ischemic type was noted: all were unrelated to symptoms. During the same session the ST segment changes appeared either in inferior leads or antero-lateral leads in different episodes. The coronary arteriography revealed absence of significant coronary stenosis and multivessel spasms: the episodes of ischemic ECG changes disappeared only during nifedipine therapy. After a 4 year follow up period no symptoms or coronary events occurred.

Angiography↗
PubMed1980

[Role of M-mode and 2-dimensional (sector-scan) echocardiography in studying postinfarct ventricular kinetic changes].

20 patients with previous myocardial infarction clinically suspected to have large impairment of ventricular wall kinesis were studied to evaluate the contribution of M-mode and two-dimensional echocardiography compared with the cineangiographic study in detecting left ventricular asynergy. Two-dimensional cross-sectional echocardiography yielded a satisfactory overlapping of results with ventriculography as far as left ventricular internal dimension and apical and posterior wall kinesis were concerned. The two-dimensional study proved to be an useful technique to observe the interventricular septum, in all its extension and the lateral wall as well. The M-mode technique, on the other hand, provided a reliable method, by means of the mitral valve echo, to determine the presence of elevated left-ventricular end-diastolic pressure; this was indicated by the occurrence of a B point, on the AC slope. A late opening of the mitral valve compared with the onset of left ventricular posterior wall relaxation phase, and other anomalies observed on the CD slope (SAM or pseudo-SAM), indicated pathological left ventricular kinesis. The failure of the left ventricular posterior wall to reach the septum moving the transducer from the aorta to the cardiac apex was considered indicative of apical dilatation, even if limited by a great number of false negatives. M-mode echocardiography provided also a quantitative evaluation of septal and postero-basal wall movement (particularly important from a prognostic point of view) and left ventricular end-diastolic dimension which, if corrected by body surface, resulted similar to those obtained by the two-dimensional technique. M-mode and Two-dimensional cross sectional echocardiography appeared to be complementary techniques which allow an adequate evaluation and diagnosis of left ventricular asynergy. They seem to be particularly useful to follow prospectively patients affected by myocardial infarction.

Adult↗
PubMed1979

[Carcinoid heart disease. Report of a case with triple valvular lesion (author's transl)].

A case of carcinoid syndrome, stemming from a tumor of the large intestine with hepatic metastases, is reported. Clinical features included cardiac disease with triple valvular lesion: tricuspid insufficiency with stenosis, pulmonary artery stenosis and mitral insufficiency. More recent views about the pathogenesis of the cardiac involvement in the carcinoid syndrome are reported, and the cardiac therapy is discussed.

Carcinoid Heart Disease↗