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Biomedical subjects

V Palazzuoli

Publications and source records attributed to V Palazzuoli.

At least 19 recordsLinked to original sources

[The evaluation of the antiarrhythmic activity of L-carnitine and propafenone in ischemic cardiopathy].

In order to evaluate a possible antiarrhythmic action of L-carnitine (C) in ischemic heart disease, 30 patients (20 males, 10 females, average age 64 years +/- 11) with ischemic heart disease who at examination with 24-hour dynamic ECG showed extrasystolic ventricular multifocal arrhythmia with a mean hourly rate of > 300 were randomized into three groups, the first of which was given a daily oral dose of 6 g C in three divided doses; groups 2 and 3 were given propafenone (P), 900 mg daily in three divided doses. After one week, all patients were again submitted to 24-hour dynamic ECG after which treatment was continued for another week as follows: group 1 continued on C (6 g daily), group 2 continued on P (900 mg daily), group 3 continued on P (900 mg daily) plus C (6 g daily). At the end of the second week, a further 24-hour ECG was performed the results of which showed that L-carnitine can significantly reduce the antiarrhythmic activity of the ischemic myocardium. In addition, at the end of the second week, a further significant reduction of the number of premature beats compared to the first week was found in patients for whom L-carnitine had been added to propafenone treatment.

Aged

[The association of amlodipine with isosorbide-5-mononitrate in the treatment of ischemic-hypertensive cardiopathy].

Every form of therapy must always aim at obtaining maximum benefit with minimum use of drugs; also for the purpose of ensuring maximum patient compliance. With this end in mind, 21 patients with ischemic heart disease and arterial hypertension were divided into three groups of seven subjects each and submitted to different drug treatments with single daily doses: group 1 received isosorbide-5-mononitrate (60 mg), group 2 amlodipine (10 mg), and group 3 a combination of both drugs at the same dosage, for four weeks. Statistical analysis showed blood pressure values to have been significantly reduced in subjects receiving amlodipine both alone and in combination (p less than 0.05) while no significant variation was observed (p = n.s.) in those treated with isosorbide-5-mononitrate only. A significant reduction of diastolic blood pressure (p less than 0.05) occurred only in patients talking the combination. No significant changes of heart rate (p = n.s.) were observed in any of the groups. Tests at the cycling ergometer revealed increased in any of the groups. Tests at the cycling ergometer revealed increased maximal effort tolerance for all three groups but the increase was more marked in patients taking the combination (who from 130 +/- 10 Watt increased to 160 +/- 20 Watt). This was confirmed also by the reduced consumption of trinitrine capsules which diminished in groups 1 and 2 from an average of 5/week to 2/week but was completely abolished in group 3. Also ST depression was significantly reduced (p less than 0.05) only in this latter group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Arrhythmias from swallowing].

We describe the case of a 51-year old, non cardiopathic patient, with recurrent attacks of supraventricular tachycardia induced by swallowing. In the existing literature we found several descriptions of hypokinetic arrhythmias, easily explained by a mechanism of vagal inhibition. The cases of predominantly hyperkinetic arrhythmias, however, are much less common. In these patients the origin of the disease seems to be due to sympathetic oesophageal fibers and superior and medium cardiac nerves. In the present case, as in the others reported in the literature, the drug of choice seems to be Amiodarone which appears to be the most effective in preventing tachyarrhythmias caused by swallowing.

Amiodarone

[Captopril and hypertensive cardiopathy : therapeutic effects and hormonal changes].

The effect of a single oral dose (50 mg) of captopril was studied in 12 hypertensive patients divided into 2 groups: 6 had a normal hemodynamic profile; the other 6 had NYHA class III or IV heart failure. Medical history and clinical and laboratory investigation showed that the heart failure was due exclusively to arterial hypertension. Mean arterial pressure (MAP), aldosterone, plasma renin activity (PRA) and atrial natriuretic factor (ANF) were followed for 4 hours after administration of captopril. MAP values showed a similar decrease in the 2 groups but the variations in the 3 hormones were much greater in the second group. This group showed higher basal levels of PRA, aldosterone and ANF; after stimulation PRA increased sharply preceded by a substantial decrease in aldosterone and ANF. To explain this phenomenon, the Authors propose that the liver of the patients with heart failure is unable to rapidly compensate the reduction in synthesis of angiotensin II caused by the drug with a corresponding increase in angiotensinogen production; the consequent sharp drop in plasma aldosterone would lead to a rise in renin production by the kidney. The arteriolar and venous vasodilatation induced by the ACE-inhibitor, would explain the drop in intra-atrial pressure with reduced plasma levels of ANF. The decrease in ANF could also be caused by the inhibition of the renin-angiotensin system of the heart leading to improved blood supply and hence myocardial contractility.

Aged

[Dilated cardiomyopathy secondary to idiopathic hypoparathyroidism in adults. Description of a case].

The authors report the clinical history of a 56-year-old man with cardiomyopathy due to undiagnosed hypocalcemia. Heart dilation and hypokinesia were assessed by echocardiography. Cardiac failure was refractory to digitalis preparations and to diuretics. The restoration of serum calcium to normal levels obtained with adequate therapy dramatically improved the motion of ventricular walls and decreased the size of the left ventricle. The pathogenetic mechanisms of hypocalcemic cardiomyopathy are discussed and the importance of considering the possibility of hypocalcemia when dealing with the differential diagnosis of cardiomyopathies is underlined. In the presence of hypocalcemic cardiomyopathy, the correction of calcium deficiency with calcitriol is the treatment of choice.

Cardiomyopathy, Dilated

QRS changes in direct fetal electrocardiogram during uterine overstimulation; report of four cases.

Four cases are presented in which increased QRS complex voltages or deviation of the mean electrical axis were observed in the fetus by direct fetal electrocardiogram (ECG) during delivery under anaesthesia. There was transformation of the initial QRS aspect before delivery. These changes were only observed when large doses of oxytocin (20 IU in 500 ml) were used after Pentothal administration in deliveries in which other fetal ECG alterations (bradycardia, ST changes, T inversion) and/or low pH values had been observed. In case 1 there were ST level changes, inversion of the T wave and transformation of the QRS complex from RS to Rs. Case 2 showed a change from RS to QR type complex associated with repolarization defects. In cases 3 and 4, ST level changes, inversion and increased QRS complex voltages were observed. We checked that the modifications observed were not due to changes in position of the fetus during recording. It is thought that the acute redistribution of the fetal blood volume due to oxytocin overstimulation in fetal hearts with hypoxic signs may lead to compensatory mechanisms such as tachycardia, increased contractile activity (higher QRS) and functional predominance of one side of the fetal heart (deviation of the electrical axis) subjected to sudden load.

Adult

[Echocardiographic diagnosis of left ventricular myxoma. Description of a case and review of the literature. Myxomas of the left ventricle].

A case of left ventricular myxoma diagnosed by echocardiography and successfully removed by left ventriculotomy is reported. This is a 21 year old male, with the few symptoms which simulating an hypertrophic cardiomyopathy in contrast to the large size of the tumour. It is possible that myxomas are responsible for sudden death. Therefore, in presence of new cardiac signs kind and relevance, the possibility of a myxoma should be considered. The diagnosis can be easily ruled out (or confirmed) by echocardiography, which represents a valuable tool in the diagnosis of myxomas.

Adult

Myxoma of the left ventricle.

We report a case of left ventricular myxoma in a 19-year-old man which presented as intermittent aortic valve obstruction. Echocardiography provided a comprehensive diagnosis, and excision through a left ventriculotomy was safely accomplished.

Adult

[On the behavior of the atrioventricular valves in AV blocks. Polygraphic and echocardiographic study].

By means of echocardiography, phonocardiography and jugular venous pulse recording, we have investigated 8 patients with atrio-ventricular conduction disturbances of various degrees: 4 with a first-degree AV block; 3 with complete heart block; 1 with type 1, 2nd degree AV block. The pattern of mitral valve motion at M-mode echocardiography suggests that the leaflets of the atrioventricular valves are definitively closed in diastole, only by the ventricular contraction. The simultaneous recording of echocardiogram and phonocardiogram in complete heart block seems to indicate that the increased intensity of the first heart sound is not always due to the increased velocity of valve closure, but also to the sudden vibration of the atrial floor, which is put under undue tension by the simultaneous atrial and ventricular contraction.

Echocardiography

[Various lipoprotein fractions and their relation to ischemic heart disease].

In a study carried out on over 700 patients with three different manifestations of aterosclerosis (cerebrovascular, coronary and peripheral), we could not find any statistically significant difference between the total cholesterol and triglyceride concentration in these three groups. Also, there was o difference in cholesterol and triglyceride levels between these three groups and 200 normal subjects. The same held true when we compared a selected group of 76 patients with ischaemic heart disease who had no other risk factor, with a group of 80 control subjects. On the contrary, when we compared several fractions of serum lipoproteins and the ratios of apolipoprotein A to Apolipoprotein B, LDL Cholesterol to HDL Cholesterol, and total Cholesterol to HDL Cholesterol of the two groups, the differences were statistically significant. We conclude that when other risk factors are excluded, the protein component, rather than the lipid component of the plasma lipoproteins correlates the presence of coronary artery disease.

Apolipoproteins