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Biomedical subjects

A Cuocolo

Publications and source records attributed to A Cuocolo.

At least 145 records · Page 8Linked to original sources

Participation of endogenous catecholamines in the regulation of left ventricular mass in progeny of hypertensive parents.

To investigate whether adrenergic activity is a determinant of left ventricular hypertrophy in human hypertension, in each of 10 normotensive subjects with two hypertensive parents we have examined the relationship between changes in echocardiographic parameters of left ventricular anatomy and those in circulating catecholamine levels induced by three, 3 week periods of different sodium and potassium intakes. A high sodium-normal potassium regimen induced a significant reduction in upright plasma norepinephrine (from 599 +/- 89 to 379 +/- 45 pg/ml, p less than .01) and in posterior wall (PWT) and interventricular septal (IVST) thickness, as well as in the left ventricular mass index (LVMi). Changes in upright plasma norepinephrine concentrations correlated with those in IVST (r = .822, p less than .01) and in LVMi (r = .833, p less than .01). A low sodium-normal potassium diet resulted in increases in supine and upright plasma norepinephrine levels (from 356 +/- 44 to 488 +/- 89 pg/ml, p less than .001; and from 565 +/- 42 to 744 +/- 33 pg/ml, p less than .01) as well as increases in IVST and LVMi (from 97 +/- 7 to 107 +/- 7 g/m2, p less than .001). The changes in norepinephrine levels in supine and upright subjects correlated with changes in IVST (r = .836, p less than .01 and r = .796, p less than .01) and in LVMi (r = .931, p less than .001 and r = .947, p less than .001). No significant change in plasma catecholamine concentrations or in PWT, IVST, or LVMi was detected after a low sodium-high potassium regimen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Efficacy of a new antihypertensive agent (indenolol) assessed by ambulatory blood pressure monitoring.

The effects of two-week treatment periods with indenolol (I) and metoprolol (M) were examined by 24-hour mean blood pressure (BP) monitoring in control conditions and during exercise stress test in 7 patients with essential hypertension, using the Oxford method. Both drugs induced a significant reduction in mean BP and heart rate (HR) as compared to pretreatment values (mean BP: from 117 +/- 3 mmHg to 106 +/- 4 after I, p less than 0.05 and to 102 +/- 3 after M, p less than 0.01; HR: from 78 +/- 2 bpm to 66 +/- 2 after I, p less than 0.01 and to 67 +/- 2 after M, p less than 0.01). I and M induced a significant reduction in systolic and diastolic BP throughout the day and most of the night. During bicycle ergometer the basal and peak values of systolic and diastolic BP were significantly lower after both treatments as compared to the pretreatment values (both p less than 0.01). Our data suggest that I once a day possesses a substantial and consistent antihypertensive action, effective over most of the 24 hours.

Adrenergic beta-Antagonists↗

Regulation of left ventricular mass by endogenous catecholamines in hypertensive progeny.

In 10 normotensives with both parents hypertensive, the relationship between changes in echocardiographic parameters of left ventricular anatomy and those in circulating catecholamine levels induced by three 3-week periods of different sodium and potassium intakes were examined. A high-sodium normal-potassium regimen reduced upright plasma norepinephrine (P less than 0.01), posterior wall thickness (PWT) and interventricular septal thickness (IVST) as well as the left ventricular mass index (LVMi). Changes in upright plasma noreprinephrine correlated with those in IVST (r = 0.822, P less than 0.01) and in LVMi (r = 0.833, P less than 0.01). A low-sodium normal-potassium diet increased supine (P less than 0.001) and upright (P less than 0.01) plasma norepinephrine as well as the IVST and LVMi. The changes in supine and upright norepinephrine levels correlated with changes in IVST (r = 0.836 and r = 0.796 respectively, both P less than 0.01) and in LVMi (r = 0.931 and r = 0.947 respectively, both P less than 0.001). No significant change in any of the above parameters was detected after a low-sodium high-potassium regimen. These findings indicate that in hypertensive progeny catecholamines may play a role in the physiological regulation of left ventricular mass (LVM).

Adult↗

Effect of acebutolol on left ventricular hemodynamics and anatomy in systemic hypertension.

In 18 patients with mild or moderate essential hypertension who responded favorably to acebutolol antihypertensive therapy, echocardiography (echo) was performed in the basal condition and after 6 and 12 months of follow-up. Acebutolol induced a significant decrease in blood pressure (BP), from a basal value of 167 +/- 3/105 +/- 2 mm Hg to 138 +/- 5/90 +/- 2 mm Hg after 6 months (p less than 0.01) and to 134 +/- 3/91 +/- 3 mm Hg after 1 year (p less than 0.01), and in heart rate, from 75 +/- 3 to 63 +/- 2 beats/min after 6 months (p less than 0.01) and to 63 +/- 2 beats/min after 1 year (p less than 0.01). The decrease in BP was achieved through a decrease in cardiac output from 6.3 +/- 0.28 to 5.3 +/- 0.25 liters/min after 6 months (p less than 0.05) and to 5.32 +/- 0.2 liters/min after 1 year (p less than 0.05), which resulted from a reduction in heart rate; stroke volume did not show significant change during the treatment and left ventricular (LV) performance was improved. There was a parallel decrease in LV posterior wall and ventricular septal thicknesses and estimated LV mass. In patients with LV hypertrophy, the change in mass was significantly correlated with the change in heart rate both after 6 and 12 months of therapy (r = 0.6234, p less than 0.05 and r = 0.7121, p less than 0.05 after 6 and 12 months, respectively).

Acebutolol↗

Ouabain-induced reflex coronary vasodilatation mediated by cardiac receptors.

Experiments were performed to determine the effects of digitalis-induced stimulation of cardiac receptors on the coronary circulation. In chloralose-anesthetized dogs, left circumflex coronary artery was perfused at constant flow, and heart rate was maintained constant by electric pacing. Ouabain injection in the perfused coronary artery produced a significant decrease in coronary perfusion pressure. Epicardial application of lidocaine completely blocked the reflex response. Vagotomy also prevented this reflex response. Sympathetic blockade with intravenous guanethidine or intracoronary phentolamine partially reduced the reflex coronary vasodilatation. Intracoronary atropine also partially reduced the coronary vasodilator response to ouabain. The combined administration of guanethidine and atropine completely abolished the coronary reflex response. These data demonstrate that ouabain can evoke reflex coronary vasodilation by stimulating cardiac receptors. This reflex response is mediated by activating cholinergic vasodilator fibers and inhibiting sympathetic vasoconstrictor fibers.

Animals↗

Relationships between left ventricular mass and clinical, biohumoral and hemodynamic parameters in human hypertension.

The relationships between left ventricular mass (LVM), assessed by echocardiography, and several biohumoral and hemodynamic parameters were studied in 63 mild or moderate hypertensive patients and in an age-matched group of 23 normotensive subjects. In hypertensive patients, but not in normotensives, LVM index was significantly correlated with beta-adrenoceptor responsiveness, as evaluated by the chronotropic response to isoproterenol ( CD25 ) (r = 0.525, p less than 0.001) and with the 24-hour catecholamine urinary output (r = 0.485, p less than 0.001). Both CD25 and the catecholamine urinary output were significantly higher in the hypertensives as compared with the normotensive subjects. Moreover, left ventricular wall thickness (septum + posterior wall) was significantly correlated with CD25 and urinary catecholamines only in hypertensive patients. No significant correlation was found between LVM or wall thickness and body surface area, age, blood pressure, heart rate, cardiac output, total peripheral resistance and left ventricular systolic wall stress, whereas CD25 was correlated with urinary catecholamines only in hypertensive patients (r = 0.606, p less than 0.001). These results seem to support the hypothesis that an elevated adrenergic tone may exert a permissive role in the development of left ventricular hypertrophy in human hypertension.

Adolescent↗

Predictability of antihypertensive efficacy of selective beta 1 blockers.

The possibility that hemodynamic and biohumoral factors may help predict the antihypertensive effectiveness of selective beta 1 blockers was investigated. The effects of 3 wk of treatment with two selective beta 1 blockers, metoprolol and atenolol, were observed in 54 patients with mild or moderate essential hypertension. No significant difference between the hemodynamic effects of the two drugs was found. The percent fall in systolic blood pressure induced by the two correlated strongly with the pretreatment values of the chronotropic response to isoproterenol and with the pretreatment values of cardiac output, heart rate, and plasma renin activity (PRA). There was no correlation between the decrease in systolic blood pressure induced and initial 24-hr urinary catecholamine output, total peripheral resistance, and plasma aldosterone. Percent fall in diastolic blood pressure correlated only with the pretreatment levels of PRA. Our results support the view that the hypotensive effect of beta 1 blockers are predictable on the basis of the pretreatment values of chronotropic response to isoproterenol, PRA, heart rate, and cardiac output.

Adult↗

Haemodynamic and clinical effects of long-term treatment of essential hypertension with captopril.

Captopril, an orally active inhibitor of angiotensin converting enzyme, was administered for 12 months to 20 patients with mild or moderate essential hypertension who initially responded favourably to this pharmacological treatment. Captopril induced a significant reduction in blood pressure which remained unmodified throughout the study. This fall in blood pressure was mainly due to a significant decrease in total peripheral vascular resistance, since no change in cardiac output was observed. Simultaneously, there was no significant change in left ventricular anatomy and performance evaluated by echocardiographic technique.

Adult↗

Diltiazem in the treatment of mild or moderate essential hypertension. Comparison with metoprolol in a crossover double-blind trial.

The antihypertensive efficacy and tolerability of a calcium antagonist drug, diltiazem (60 mg q.i.d. per os), was compared with that of metoprolol (100 mg b.i.d. pr os) in a crossover, double-blind randomized trial in 20 patients with mild or moderate essential hypertension. Blood pressure and heart rate were assessed at rest and during bicycle exercise before and after four-week periods of treatment. Both metoprolol and diltiazem reduced significantly systolic and diastolic blood pressure, while heart rate decreased only after metoprolol therapy. The reduction in blood pressure and the percentage of patients who responded favorably were similar with the two drugs. Furthermore, the overall levels of blood pressure during exercise were significantly reduced by both treatments, while only metoprolol was able to reduce the maximum increase in systolic blood pressure and heart rate induced by exercise. These results suggest that the use of diltiazem may be appropriate to the treatment of patients with mild or moderate essential hypertension.

Adult↗