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Biomedical subjects

A Sturani

Publications and source records attributed to A Sturani.

At least 37 records · Page 2Linked to original sources

Evidence of parasympathetic activity of the angiotensin converting enzyme inhibitor, captopril, in normotensive man.

Captopril (50 mg orally) produced a significant fall in systolic and diastolic blood pressure in six normotensive sodium replete subjects, without a rise in heart rate. On captopril, there was no change in the expected normal increase in heart rate on standing. Supine plasma noradrenaline was not reduced by captopril and normal postural increases were maintained. Atropine (0.04 mg/kg i.v.) reduced the difference in blood pressure change between captopril and placebo. Facial immersion in water produced a bradycardia. This change was abolished by atropine and attenuated both by captopril and edrophonium (10 mg i.v.), a cholinesterase inhibitor. Lying down after 6 min standing produced an immediate transient tachycardia, which was abolished by atropine and attenuated by captopril. Blood pressure and heart rate rose after a cold pressor test on both captopril and placebo. The tachycardia during the Valsalva manoeuvre was inhibited by edrophonium and to a lesser extent by captopril. The effects of captopril and edrophonium were additive. Parasympathetic activity of captopril may contribute to its haemodynamic profile.

Adult↗

Effect of bromocriptine treatment on prolactin, noradrenaline and blood pressure in hypertensive haemodialysis patients.

Bromocriptine (2.5 mg/day orally) produced a significant fall in supine mean arterial pressure in nine hypertensive haemodialysis patients with high serum prolactin levels, without causing significant changes in heart rate. On bromocriptine, there was a significant decrease in the mean value of both serum prolactin and plasma noradrenaline, without significant changes in the mean value of plasma renin activity. A significant relationship was found between the changes in supine plasma noradrenaline and the changes in supine mean arterial pressure induced by bromocriptine. The increase in mean arterial pressure in response to the tilt test was greater on bromocriptine than on placebo although the changes in plasma noradrenaline were reduced by bromocriptine. Similar results were observed during the cold pressor test. These findings suggest that the arterial pressure-lowering effect of bromocriptine is related to the reduction in sympathetic out-flow. The parallel decrease in serum prolactin raises the question of the possible involvement of dopaminergic mechanisms in the development of hypertension in our patients. Moreover, bromocriptine seems to enhance the vascular response to endogenous noradrenaline.

Adult↗

Failure of naloxone in reversal hemodialysis-induced hypotension.

In 5 uremic patients the role of opioid peptides in dialysis-induced hypotension was investigated through the administration of naloxone. An intravenous bolus injection of 1 mg of naloxone was administered immediately before starting a routine hemodialysis session and was repeated when the patients' systolic arterial pressure sank below 90 mm Hg. In our patients, naloxone had no effect on the resting arterial pressure or on dialysis-induced hypotension.

Blood Pressure↗

Parasympathetic activity assessed by diving reflex and by airway response to methacholine in bronchial asthma and rhinitis.

It has been suggested that airway hyperreactivity in asthma is associated with increased parasympathetic tone. We have accordingly assessed parasympathetic responsiveness in five groups of subjects (17 normal controls, 8 patients with extrinsic rhinitis, 6 with intrinsic rhinitis, 10 extrinsic asthmatic patients, 7 intrinsic asthmatic patients) by examining their responses to both diving reflex and methacholine inhalation challenge. The mean fall in heart rate during the diving test was significantly greater in asthmatic subjects than in normal controls and in patients with rhinitis. The diving-induced bradycardia was significantly greater in intrinsic than in extrinsic asthmatic subjects. There was a good correlation between the drop in heart rate during diving test and the provocation dose of methacholine producing a 45% decrease in specific airway conductance both in patients with rhinitis and in asthmatic patients. There was a less good correlation between diving response and clinical severity score in the same asthmatic patients. These results indicate that intrinsic asthma is associated with a marked degree of cholinergic hyperreactivity. The diving test seems to provide an accurate method for the analysis of the parasympathetic system in asthma.

Adult↗

Plasma noradrenaline and blood pressure in uremia.

To evaluate a possible correlation between sympathetic activity and blood pressure in uremia, catecholamines and blood pressure were determined in 81 uremic patients. In 34 of these 81 patients, thyroid hormones were also measured. In 16 patients on maintenance dialysis, a longitudinal study was performed to compare long-term blood pressure and catecholamine variations. No correlation was found between mean blood pressure and noradrenaline in the 81 patients as a whole, but when male and female patients were evaluated separately, a significant correlation was found in the former group. In the 34 patients, a correlation between mean blood pressure and noradrenaline was found only when hypothyroid patients were excluded. Variations in mean blood pressure induced by chronic dialysis were related to noradrenaline changes in the 16 patients studied. In conclusion, sympathetic activity seems to be correlated to blood pressure in uremic patients.

Adolescent↗

Effect of eosinophilia on the heterogeneity of the anticoagulant response to heparin in haemodialysis patients.

The anticoagulant response to heparin was determined, during haemodialysis, in a group of seven patients with eosinophilia and in a control group. The heparin half-life was similar in the two groups, but the heparin effect index was lower in patients with eosinophilia. The dose-response curve showed a reduced sensitivity to heparin in patients with eosinophilia. In patients with eosinophilia a significant reduction in eosinophil count was observed during cuprophan dialysis, but not during polyacrylonitrile dialysis. The hyposensitivity to heparin might be related to eosinophil degranulation, during cuprophan dialysis, with release of a major basic protein that neutralises heparin.

Adult↗