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Biomedical subjects

A Brusca

Publications and source records attributed to A Brusca.

At least 109 records · Page 6Linked to original sources
PubMed1984

[Spontaneous changes of ventricular ectopic beats in ischemic patients and subjects without other signs of cardiopathy].

Spontaneous variability of premature ventricular complexes was evaluated by 72 hour continuous ambulatory electrocardiographic monitoring in 38 patients. Nineteen patients had coronary artery disease and 19 subjects had no documented signs of cardiac disease. Using multifactorial analysis of variance we determined the minimal percent reduction of premature ventricular complexes frequency that could not be ascribed to spontaneous variability alone in both single subject and in groups of 10 and 19 individuals and analyzed the difference between the two groups of ischemic and healthy patients. Our results show that in each subject with or without coronary artery disease the minimal reduction of premature ventricular complexes is similar: 71% and 72% respectively. On the other hand when the two groups were compared the percentage of reduction was 49% in healthy subjects and 40% in patients with coronary artery disease. Spontaneous variability of premature ventricular complexes decreases as the period of monitoring lengthens; however the improvement obtained with longer electrocardiographic monitoring doesn't justify the prolongation of the examination beyond 24 hours.

Aged↗
PubMed1983

[Amiodarone in paroxysmal supra-ventricular tachycardias associated with sinus bradycardia].

The efficacy of amiodarone in the prevention of atrial tachycardia is well recognised. However, there remains some controversy over its use in patients with a basal sinus bradycardia because of the risk of further depression of sinus node function. We studied the effects of acute and chronic amiodarone therapy in 13 patients with paroxysmal supraventricular tachycardia and intercritical sinus bradycardias of between 40 and 50/min. All patients underwent electrophysiological investigation under basal conditions and after 5 mg/kg IV amiodarone. Five patients were excluded from chronic oral amiodarone therapy after IV amiodarone for the following reasons : sinus bradycardia of less than 30/min; sinus node recovery times greater than 2 s; 2nd or 3rd degree sino-atrial block. The other 8 patients were administered oral amiodarone on a long term basis. They were followed up clinically with dynamic ECGs every three months over a period of 1 to 3 years. All symptoms regressed in 6 patients. In one patient, the daily attacks of palpitations decreased to one a week. One patient did not improve. No cases of sino-atrial standstill were observed, although the sinus rate remained unchanged. The results of our study show that amiodarone may be administered for long periods in patients with sinus bradycardia and attacks of paroxysmal supraventricular tachycardia if the dynamic ECG during the waking hours shows a heart rate of no less than 40/min, and if electrophysiological investigations do not show significant depression of sinus node function after acute intravenous administration of the drug.

Adult↗
PubMed1983

[The tricuspid valve in carcinoid cardiopathy: characteristic echocardiographic aspects].

Cardiac involvement is commonly seen in the carcinoid syndrome (C.S.). However echocardiographic observations in this condition are still very scanty. In two patients with the C.S. and clinical signs of tricuspid insufficiency (plus mild pulmonic stenosis in one case) two-dimensional echocardiography showed: 1) right ventricular overload with normal left heart valves and chambers; 2) a peculiar aspect of the tricuspid valve, whose three leaflets were markedly thickened and retracted. The anterior leaflet was almost fixed in a semi-open position while the septal and posterior leaflets appeared as rigid structures fixed in an open position, extending from the annulus into the right ventricular cavity. In both cases only the posterior cusp of the pulmonary valve could be visualized. The afore-mentioned changes exactly reproduce the pathological features of the tricuspid valve in the carcinoid heart disease and so far, have not been observed in other conditions.

Adult↗
PubMed1982

Bedside evaluation of atrioventricular block with narrow QRS complexes: usefulness of carotid sinus massage and atropine administration.

Second-degree intra-His bundle block is frequently of type I (Wenckebach periods) or 2:1. In this situation, the surface electrocardiogram does not permit distinction between intranodal (atrioventricular [A-V] and subnodal (intra-His) block. This study examined the value of bedside carotid sinus massage and atropine administration in diagnosing the site of block from the standard electrocardiogram in subjects with chronic A-V block and narrow QRS complexes. Fifteen patients had intra-His bundle block and 10 had intranodal block. The combination of two tests correctly located the site of block in 22 subjects, and was noncontributory in 3. Thirteen of the 15 intra-His bundle blocks and 9 of the 10 intranodal blocks were properly identified; in three cases the results were nondiagnostic, but no wrong diagnoses were made. The noninvasive bedside method of carotid sinus massage and the use of atropine permit both the localization and the determination of the type of block in the majority of cases of second degree A-V block and narrow QRS complexes. In a proper clinical context they can obviate the need for invasive electrophysiologic studies.

Adult↗
PubMed1982

[Right atrial myxoma. Review of the literature and a case report].

On the basis of a personal observation and from a complete review of the existing literature, clinical and instrumental findings of right atrial myxoma are described. The clinical presentation appears to be rather characteristic. The presence of systemic symptoms, peripheral venous hypertension and/or right heart failure without apparent cause are a clue to the diagnosis especially in an adult woman. The presence of abnormal sounds and/or murmurs in the tricuspid area and intermittence of the signs of obstruction are further support to the diagnosis. The diagnosis can always be made non-invasively by echocardiography, though some pitfalls seem to be inherent to the M-mode technique. The accuracy of two-dimensional echocardiography in the diagnosis of the right atrial myxoma is such that no further investigations are necessary before surgery.

Echocardiography↗
PubMed1982

[Early submaximal exercise test after acute myocardial infarct. Is it a useful test?].

One hundred and twenty asymptomatic patients underwent a submaximal treadmill exercise 2-3 weeks after an acute myocardial infarction. These patients were subsequently followed from 15 to 54 months (average 2 years). Coronary events (cardiac death or angina) occurred in 14% of the patients with normal response, in 55% of those with ischemic response and in 12% of those with abnormal but non-ischemic response. The incidence of coronary events in patients with ischemic response is significantly higher than in the other two groups. However, among the patients who had a normal response, one out of seven suffered from a coronary event during the follow-up period. More than 25% of our patients with an ischemic response to the early exercise testing showed a non-ischemic response during a second one. On the other hand, more than 25% of our patients with normal early exercise test had an ischemic response when the test was performed at the end the follow-up period. Submaximal exercise testing of asymptomatic patients early after an acute myocardial infarction does not seem to be predictive of future coronary events and its long-term reproducibility is poor.

Adult↗
PubMed1980

[Serum levels and kinetics of digoxin in patients with hyperthyroidism (author's transl)].

The mechanism of reduced sensitivity to digitalis in patients with hyperthyroidism has been attributed to a change of intrinsic myocardial function and/or to altered pharmacokinetics of cardiac glycosides. Digoxin kinetics have been studied in hyperthyroid and 8 euthyroid patients after a single oral and i.v. dose at steady-state. Plasma and urinary digoxin concentrations were determined by radioimmunoassay. A significantly mean lower serum digoxin concentration was found in hyperthyroid patients, both after a single oral drug administration and at the steady-stage. A decreased digoxin absorption could not account for this finding, since both the percentage of gastrointestinal uptake of the drug and maximal serum concentration did not differ in hyperthyroid patients as compared to controls. Hyperthyroid subjects showed, on the contrary, an expended distribution volume and a significantly higher excretion, as documented by a lower drug half-life, by the increase of the elimination constant and urinary digoxin output.

Adult↗
PubMed1977

Atypical 2nd degree AV block due to bilateral bundle branch block with Wenckebach phenomenon and concealed conduction in the bundle branch system.

A case of bilateral bundle branch block is described with the following features: -- 2nd degree infranodal AV block due to bilateral, intermittently synchronous "phase 3" bundle branch block; -- occasional AV conduction failure due to concealed His bundle extrasystoles; -- right bundle branch block pattern due to retrograde activation from the left bundle branch; -- QRS complexes having normal duration due to uniform slow conduction in both bundle branches; -- Wenckebach phenomenon in the right bundle branch; -- concealed conduction in both branches. The above interpretations are based on the use of His bundle recordings, results of right atrial stimulation and of pharmacological testing. Determinations of the lengths of all H--H intervals, whether H was followed by a ventricular response or blocked, permitted insight into the mechanism of 2nd degree AV block with varying (right and left) bundle branch block.

Aged↗
PubMed1976

[Paroxysmal ventricular tachycardia with retrograde Wenckebach block and reciprocal beats (author's transl)].

A case of recurrent paroxysmal ventricular tachycardia with retrograde Wenckebach block and reciprocal beats was studied with His bundle electrogram and right ventricular stimulation. Reentry was reproduced whenever retrograde ventriculo-atrial conduction time reached a critical value. Concealed reentry was also demonstrated and shown to be responsible for the dropped beats of the Wenckebach sequence.

Bundle of His↗
PubMed1975

A multicenter double blind clinical trial on 3.4.5-trimethoxybenzoiyl-epsilon-aminocaproic acid (C-3) in acute myocardial infarction.

186 out of 391 patients with acute myocardial infarction were treated with C-3 and 205 with placebo in a multicenter, double-blind clinical trial. Ensuing complications were treated in the same way in both groups. C-3 was injected i.v. slowly at the dose of 2 g statim plus 6 g by continuous drip infusion over 24 hrs for 5 days. During treatment, clinical progress was influenced only in regard to cardiac failure since in the C-3 group the improvement was more significant than in the placebo one (P less than 0.0025). Mortality rates were 8.1% and 11.2% for the C-3 and placebo groups, respectively. The difference in mortality was significant (P less than 0.05) for patients treated with C-3 for more than 24 hours. Mortality in male patients treated with C-3 for more than 12 hours was significantly lower (P less than 0.025). In patients less than 60 years old mortality rate was significantly lower (P less than 0.05) and was more so in patients receiving C-3 for more than 12 hours (P less than 0.025). Mortality due to complications was lower in the C-3 group, with arrhythmias (9.8% vs 14.2%), cardiogenic shock (69.2% vs 75%), and cardiac failure (9% vs 19.4%). Results agree with the hypothesis that C-3 may be effective in acute myocardial infarction by improving the action of traditional antiarrhythmic drugs, and augmenting myocardial contraction energy.

Acute Disease↗