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Biomedical subjects

A Rolli

Publications and source records attributed to A Rolli.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Validity and limits of invasive pharmacological tests in the treatment of malignant ventricular hyperkinetic arrhythmias].

Programmed stimulation can now be safely performed for the evaluation of therapy for recurrent ventricular tachyarrhythmia. The initiation of ventricular tachycardia appears closely related to its actual spontaneous clinical occurrence. Serial electrophysiologic studies can be performed and are effective in prospectively evaluating the response to antiarrhythmic drugs. The efficacy of therapy based on the results of programmed stimulation appears to be good. On the other hand, Amiodarone can be effective in the chronic treatment as well as in patients with ineffective acute drug test.

Adult↗
PubMed1982

[Electrophysiological effects of lidocaine on the QRS and ST segment during acute myocardial infarct. Evaluation with thoracic electromaps].

We have evaluated the effects of lidocaine on the main haemodynamic parameters, the QTc interval, the ST segment elevation (sigma ST) and the R wave sum (Max sigma pos), studied by automatic recording of thoracic maps, in 9 patients with acute anterior myocardial infarction, admitted to the CCU within 6 hours from pain onset. Lidocaine has been given at the dosage of 2 mg/kg as an i.v. bolus, followed by continuous infusion at 2 mg/min. Haemodynamic parameters, QTc interval and ECG maps have been recorded before and after 5, 15 and 30 min from the beginning of the therapy. Heart rate, systolic and diastolic arterial pressure and cardiac output have not been significantly affected by Lidocaine. The QTc interval has showed a significant reduction of the control ECG from 0.364 +/- 0.059 sec to 0.352 +/- 0.051 at 5 min, 0.353 +/- 0.053 at 15 min and 0.0355 +/- 0.058 sec and 30 min (P less than 0.05). The sigma ST segment decreased significantly after Lidocaine at 5 and 15 min. (from 126 +/- 26 mV to 109 +/- 23 mV and to 112 +/- 23 mV; P less than 0.01 and, respectively, P less than 0.025), whereas at 30 min. sigma ST was not different from control value. There were no significant changes of max sigma pos. Lidocaine did not significantly modify the main haemodynamic determinants of oxygen consumption. We therefore believe that the observed reduction of ST segment elevation was not caused by a decrease of the ischemic damage but was probably due to a primary electrophysiological effect. This drugs, which affects in a different way the action potentials of normal and ischemic cells, could abolish their differences, thus reducing the systolic current of injury.

Aged↗
PubMed1981

[Comparative study of the anti-arrhythmic activity of mexiletine and lidocaine in ventricular hyperkinetic arrhythmias].

The present study has been carried out on 50 patients admitted to C.C.U. for cardiovascular diseases of various ethiology (44 patients with ischemic heart disease) who required antiarrhythmic theory for different types of ventricular arrhythmias: monofocal ventricular extrasistoles greater than 6/min, bigeminal ventricular extrasistoles, polifocal and/or repetitive ventricular tachycardias. The patients have been randomly allocated into two groups of 25 subjects: the first one has been treated with Mexiletine and the second with Lidocaine. In Mexiletine treated group the following results have been obtained: 19 excellent (76%), 4 good (16%) and 2 ineffective (8%). In Lidocaine treated group: 11 excellent (44%), 5 good (20%) and 9 ineffective (36%). Statistical analysis by chi square test has shown significant prevalence of favourable results in Mexiletine treated patients (p less than 0.02; X(2) = 5.33). Moreover, in relation to the type of arrhythmias, Mexiletine succeded in a greater number of cases of complicated ventricular extrasistoles (bigeminal, polifocal and/or ripetitive) and in ventricular tachicardias. Mexiletine also has induced significant reduction of QTc and significant increase of cardiac rate, whereas it did not affect significantly the PR interval and blood pressure. None of these parameters has been influenced significantly by Lidocaine. Side effects have been similar for both drugs and generally mild. On the basis of results and in accord with the electrophysiological properties, the Authors discuss the possible mechanism of action and the role of Mexiletine in the treatment of ventricular arrhythmias particularly those complicating acute phase of myocardial infarction.

Aged↗
PubMed1981

[Treatment of acute myocardial infarction with verapamil. Hemodynamic effects and electrical changes studied by body surface maps (author's transl)].

The effects of Verapamil on main haemodinamic parameters and on Max sigma pos., sigma Q15, Max sigma pos./Max sigma neg. and sigma ST, studied by automatic recording of thoracic maps, were evaluated in 11 patients with acute myocardial infarction within 6 hours from pain onset. Verapamil was given at the dose of 0.1 mg/Kg followed by infusion of 0.035 mg/min. Hemodynamic measurements were made before and 15 minutes after Verapamil; the maps were recorded before and 5, 15 and 30 minutes after Verapamil. Heart rate and sistolic arterial pressure were reduced, though not significantly: right atrial pressure, pulmonary pressures and capillary pulmonary pressure remained unchanged. On the contrary, the reduction of diastolic arterial pressure (from 94 +/- 4.2 to 88 +/- 4.5 mmHg; P less than 0.05) and of cardiac index (from 3.1 +/- 0.11 to 3 +/- 0.11; P less than 0.05) was important. Max sigma pos. increased after 15 minutes from 11619 +/- 1970 to 12349 +/- 2151 microV (P less than 0.01), but il decreased after 30 minutes to 11037 +/- 2042 microV (P less than 0.05). Max sigma pos./Max sigma neg. ratio increased significantly after 5 and 15 minutes. Sigma Q15 increased significantly only after 30 minutes (from 7198 +/- 1643 to 8688 +/- 1541 microV; P less than 0.05). Sigma ST showed a transient, non significant increase after 5 minutes, but decreased significantly after 30 minutes (from 76664 +/- 19505 to 67157 +/- 18581 microV; P less than 0.05). The results show that Verapamil does not cause worsening of main haemodinamic parameters during acute, non complicated myocardial infarction and reduces significantly ST segment elevation. The Authors discuss also a possible electrophysiological effect of Verapamil on action potential of ischemic cells, responsible for early increase of sigma ST observed in some patients.

Aged↗
PubMed1980

[Changes on release of MB isoenzyme of creatine kinase by propranolol in acute myocardial infarction (author's transl)].

MB isoenzyme of creatine kinase was measured every 3 hours during the first 24 hours of admission to C.C.U. and successively every 4-6 hours in the next 24-48 hours in 42 patients with acute transmural myocardial infarction. The pain-C.C.U. admission time interval was less than 6 hours in all cases. 22 patients were treated by propranolol (2 mg bolus followed by 0.1 mg/Kg/die for the next 48 hours in continuous i.v. infusion), 20 patients served as a control. Cumulated activity, peak plasma value, rate of release and total duration of release of MB-CK did not differ significantly between the two groups. In patients treated within 3 hours from pain onset (n = 12) cumulated activity, peak plasma value and rate of release of MB-CK were significantly inferior than control group. In patients treated between the 3rd and 6th hour from pain onset (n = 10) the total duration of release of isoenzyme was significantly prolonged. No treated patients developed clinical or radiologic signs of cardiac insufficiency. The incidence of ventricular arrhythmias was 17% in the treated group vs. 62% in the control group (P < 0.05). The data show that propranolol, if started early in the course of acute myocardial infarction, reduces significantly infarct size and slows down the evolution of necrotic process.

Clinical Trials as Topic↗
PubMed1980

[Ischemic and non ischemic electrophysiologic changes during selective coronary arteriography. Their role in the pathogenesis of the electrocardiographic changes and arrhythmias (author's transl)].

The results of a study made in mae recording the right ventricular monophasic action potential (RV MAP) by suction electrocatheter during coronary arteriography (35 cases) are reported. Normally, when no coronary spasm is present, coronary arteriography provokes a prolongation of MAP of the myocardial diffusion of the contrast medium. On the contrary in five cases, in which right coronary spasm occurred, modifications of a clear ischemic pattern were seen: a shortening of the RV MAP phase 2 in two cases; a reduction of the amplitude and rate of the RV MAP phase 0 in one case; both shortening of total duration of RV MAP and changes of its 0 phase in other two cases. The Authors compare these clinical observations with the experimental data and discuss the role of these different electrophysiological alterations in the pathogenesis of the electrocardiographic changes and arrhythmias.

Adult↗
PubMed1976

[On 23 cases of postinfartual interventricular septal rupture surgically treate. Immediate e long term results (author's transl)].

An experimental study on myocardial viability after acute occlusion of the left anterior descending coronary artery (LAD) for period of six hours is described. For this study 24 adult dogs were used in which an acute myocardial infarction for an area of 20-30% of left ventricul were obtained with ligatures completely occluding the LAD and his collaterals. Following ligature release, on the LAD only, ECG, BP, VCP and histology were studied with the general clinical conditions. The Authors affirm that clinical and ECGraphic data became worse after reperfusion; instead histological data show the possibility of recovery of many muscolar cells of ischemic and neighbouring areas.

Animals↗
PubMed1976

Experimental revascularization of acute myocardial infarction. III: Correlation between the behaviour of the free nucleotide acid solubles and some aliphatic biogenic amines.

Free nucleotide, polyamine and nucleic acid synthesis was studied in myocardial acute ischemia and reperfusion. An early stimulation of biosynthesis of these compounds was observed during ischemia, than later, a remarkable decrease of their specific radioactivity appeared. Reperfusion experiments cause a significant increase of nucleic acids and related compound biosynthesis. The results indicate that the biochemical mechanism of myocardial protein synthesis, under our experimental conditions are not irreversibly damaged by ischemia. In fact, the reperfusion causes a remarkable recovery of nucleic acid, free nucleotide and polyamine specific radioactivity. The changes during the period of infarction and subsequent reperfusion show that polyamines play a key role in myocardial ischemia and reperfusion.

Animals↗
PubMedDate not supplied

[Effect of cardiopulmonary bypass on serum digoxin concentration (author's transl)].

The use of digitalis following cardiopulmonary bypass is studied by digitalemia's radioimmunoassay. The Authors does not find relation between digitalis and post operative arrhytmias. They think digitalis's tolerance is very good but suggest that further studies are necessary to state the correct use of the drug after open heart surgery.

Cardiopulmonary Bypass↗
PubMedDate not supplied

[Treatment of inflammatory complications of permanent implanted pacemakers].

The Authors report an experience of 165 patients who underwent to implantation of artificial pacemaker from January 1973 to December 1974 and report 16 cases of infection. They consider many surgical and biologic factors that can have caused uprinsing of infection. The Authors report the therapeutic treatment the patients underwent and conclude that the best treatment is the implantation, to another seat, of new pacemaker.

Aged↗
PubMedDate not supplied

[Experimental revascularization of acute myocardial infarct].

Late clinical and istological changes. The Authors studies clinical and istological changes in dogs underwent to actue myocardial ischemia and follow revascularization after six hours. The experience infer that while clinical and ECGraphic changes had a patency grow worsing after revascularization, istological changes presents a reduction of necrotic area with functional improvement of little myocardial areas strictly interested by ischemia.

Acute Disease↗