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C Richard Conti

Publications and source records attributed to C Richard Conti.

At least 19 recordsLinked to original sources
PubMed2005

Use of cardiac resynchronization therapy to optimize beta-blocker therapy in patients with heart failure and prolonged QRS duration.

A retrospective analysis was performed on 52 patients with heart failure to determine the change in beta-blocker therapy after cardiac resynchronization therapy (CRT). After 6 months of CRT, the number of patients receiving beta-blocker therapy increased from 36 to 44, with improved clinical outcomes and larger beta-blocker doses, indicating that these 2 therapies may work together to improve outcomes by allowing the use of larger doses of beta blockers while correcting ventricular dyssynchrony.

Adrenergic beta-Antagonists↗
PubMed2005

An update on enhanced external counterpulsation.

The development of advanced revascularization techniques has resulted in the growth of a subset of patients with coronary artery disease who are nonrevascularizable and are considered to have refractory angina. Enhanced external counterpulsation (EECP) has been developed for the management of these patients with chronic, refractory disease. Evidence has shown that through improvement of vascular endothelial function and recruitment of collateral vessels, EECP provides many clinical benefits. These patients experience sustained decreases in angina, improvement in exercise time, improved myocardial perfusion, and enhanced quality of life. Furthermore, EECP appears to be safe and effective in the treatment of angina in patients with impaired systolic function and has similar potential in patients with congestive heart failure.

Angina Pectoris↗
PubMed2005

Cardiovascular risk profiles around the world.

In summary, the world is in trouble, but simple lifestyle modifications and drugs available to modify risk can change the picture dramatically. Unfortunately, if obesity persists, as it seems to be doing in our young people, there may come a time when our children's children and their children die at an earlier age than their parents.

Adult↗
PubMed2005

Current Nonpharmacologic Management of Coronary Artery Disease: Focus on External Counterpulsation.

The basic principle of enhanced external counterpulsation (EECP) is diastolic augmentation of arterial pressure, lowering of systolic arterial pressure along with increasing venous return. EECP is a noninvasive procedure involving sequential inflation and rapid deflation of compressive cuffs wrapped around the patient's calves, thighs, and lower abdomen, timed to the cardiac cycle using the electrocardiogram. Theoretically, this should result in decreased myocardial oxygen demand and an increased coronary blood flow. Long-term benefits may be the result of the opening of dormant coronary collateral circulation, but this is theory and not proven. Extracardiac factors, such as peripheral arterial stiffness, endothelial dysfunction, and elevated myocardial oxygen demand, are also the therapeutic targets for EECP. There is some evidence that long-term benefits may be the result of a training effect due to 35 1-hour diastolic inflations at 300 mm Hg and systolic deflations of the compressive cuffs. To date, the extracardiac effects of EECP have received little attention and peripheral vascular adaptations to EECP have not been investigated. EECP, by promoting lower-extremity arterial "run-off" and intermittent reactive hyperemia in the legs with each inflation/deflation cycle of the compressive cuffs, may improve peripheral vascular function, thus inducing changes in peripheral vascular biology that will reduce ventricular work and myocardial oxygen demand in patients with coronary artery disease similar to that of exercise. At the University of Florida, this therapy is used for patients with chronic stable angina who are refractory to medical therapy and are not candidates for a revascularization procedure. The treatment does take time (35 once-a-day 1-hour treatments), and not all patients are candidates for the procedure. For example, patients with severe peripheral vascular disease, severe hypertension, thrombophlebitis, markedly irregular heart rhythm, and severe aorta insufficiency are excluded. Approximately 75% of patients report improvement (ie, a decrease in symptoms and an increase in exercise duration). Our results are such that this management strategy does deserve consideration in patients with persistent chronic stable angina on maximum medical therapy who are not candidates for revascularization and are unhappy with their lifestyle.

Journal Article↗
PubMed2004

When should patients with chest pain be referred for coronary angiography?

When evaluating patients with possible coronary artery disease, it is necessary to combine physiologic assessment (measurements of ischemia) with anatomic pathologic assessment (coronary angiography). Coronary angiography currently is the only way to assess the anatomic pathology of the coronary circulation with precision. When it is combined with ventriculography and tests for myocardial ischemia, one can make clinical decisions related to the significance of the coronary artery disease observed. Common sense really demands that coronary angiography is only indicated when the information derived from this diagnostic procedure will facilitate therapeutic decisions in the individual patient.

Chest Pain↗
PubMed2004

Quiet! Hospital zone.

Explore the source record for details and available documents.

Health Facility Environment↗
PubMed2004

Thrombolytic therapy in morbidly obese patients.

Most of the concern about dosing thrombolytic agents as presented in the literature is related to the lower weight groups and the increased incidence of bleeding in this patient population. Not much is known or written about what dose of thrombolytic therapy should be used in the grossly obese patient with an AMI. Although it may be uncommon to have a morbidly obese patient with an AMI, it does occur. Perhaps body weight doesn't matter since we are really dosing the clot and not the body, but, as far as I can discern, there are no data regarding dosing of thrombolytic drugs to guide the clinician managing these patients.

Body Weight↗
PubMed2004

Attilio Maseri.

Professor Attilio Maseri is a clinical investigator with a remarkable track record of innovative research who, by changing traditional paradigms, contributed to shape new diagnostic techniques in pathophysiologic thinking. His research has been characterized by challenging the generalizations of accepted "wisdom" which did not offer satisfactory explanations for the observations he made in his clinical practice. The results of his clinical investigations have contributed greatly to the opening of new avenues of research and patient management in the field of ischemic heart disease. His clinical and research experiences are catalogued in 740 pages of his single-authored textbook Ischemic Heart Disease. A Rational Basis for Clinical Practice and Clinical Research. This book chronicles Maseri's novel unifying vision of ischemic heart disease. In 2001, Professor Maseri left Catholic University in Rome to take on bigger challenges in Milan where he is now functioning as Professor of Cardiology at the University Vita-Salute San Raffaele and Director of the Cardio-Thoracic and Vascular Department of the San Raffaele Scientific Institute. His research interests include application of molecular biology, differential gene expression profiling, and clinical cardiovascular research such as molecular mechanisms of coronary instability and molecular mechanisms of negative and positive ventricular remodeling. Professor Attilio Maseri will be remembered as a thoughtful clinician, a mentor for many whose academic careers have blossomed, and a careful clinical investigator whose innovative research in ischemic heart disease will set the highest standards for those who follow in his giant footsteps. On a personal note, I first met Attilio Maseri, his wife Francesca, and their son Filippo at the 1976 Pisa conference. What transpired at that conference influenced my own career and stimulated my continued interest in ischemic heart disease as well as my enthusiasm for the international aspects of cardiovascular medicine. I consider myself fortunate to be a friend of Attilio Maseri and to have benefited from my associations with him, both professionally and personally.

Cardiology↗