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Biomedical subjects

E Boni

Publications and source records attributed to E Boni.

53 records · Page 3Linked to original sources
PubMed1986

Comparison of captopril and digoxin in mild to moderate heart failure.

Captopril 25 mg every 8 hours for 1 month appeared to improve dynamic effort tolerance and cardiac function under the stress of isometric exercise in patients with chronic heart failure, functional class II-III NYHA. The improvement was comparable to that obtained in the same subjects with digoxin 0.25 mg once a day given for a similar period of 1 month. Therefore, captopril with its lower toxicity and wider therapeutic range, might be considered as a valid alternative to digoxin for treatment of patients in sinus rhythm with mild to moderate heart failure.

Adult↗
PubMed1985

Possibility of cardiac output monitoring from the intra-arterial blood pressure profile.

A method for estimating cardiac output (CO) from the intra-arterial blood pressure profile ("contour method") was tested in 8 patients: 6 with essential hypertension, 1 with a pheochromocytoma and 1 with orthostatic hypotension. CO (1/min) was derived by the following formula: PSA (1+St/Dt) X HR 10(-3), where PSA is the area under the systolic portion of the pressure curve, St is the systolic and Dt the diastolic time, X is a correction factor, HR is the heart rate and 10(-3) is a conversion factor from ml/min to 1/min. The "contour method" was compared to the thermodilution CO method. The correlation between the 2 methods was highly significant: the r value in all patients during different conditions (supine, tilt, dynamic and static exercise) ranged from 0.91 to 0.97 with an intercept close to 0 and a slope close to 1. These results indicate that CO is properly measured from the intra-arterial blood pressure profile by the "contour method". A continuous hemodynamic monitoring can be derived applying the "contour method" to the intra-arterial blood pressure profile obtained with the Oxford technique.

Adrenal Gland Neoplasms↗
PubMed1985

Autonomic nervous system control of heart rate in essential hypertension.

In order to evaluate the role of the autonomic nervous system in controlling heart rate (HR) in essential hypertensive patients (EH), we studied 13 untreated EH, WHO I-II, aged 21-68 years, and 10 normotensive subjects (N), aged 20-68 years. The average variation of heart period (VHP) during regular breathing was used as an index of parasympathetic control of HR. Measurements were carried out supine and during tilting, before and after propranolol (0.15 mg/kg intravenously). A sympathetic control index of HR was derived from the ratio HR before/HR after propranolol. A parasympathetic control index of HR was also obtained from the ratio HR before/HR after atropine (0.03 mg/kg intravenously). The VHP was constantly lower in EH than N (P < 0.001) before and after propranolol, supine and standing. The parasympathetic control index of HR was significantly higher in EH (P < 0.001). A significant negative correlation was found between VHP and the parasympathetic control index (r = -0.73) plotting together all values found in EH and N. The sympathetic control index of HR did not differ between EH and N. These results indicate a lower parasympathetic influence on HR in this group of EH compared with N, while sympathetic control was similar in the two groups. This difference in vagal control of HR persists in the presence of increased sympathetic activity (tilting) and after beta-blockade.

Adult↗
PubMed1985

Continuous haemodynamic ambulatory monitoring in essential hypertension.

Haemodynamic ambulatory monitoring was derived from the intra-arterial blood pressure (BP) profile in 10 patients with essential hypertension. Stroke volume (SV) was computed beat by beat according to the following formula: X x PSA x (1 + St/Dt), where X is a correction factor, PSA is the area under the systolic portion of the pressure curve, St is the systolic and Dt the diastolic time. The X value was obtained in each patient by predetermining SV by thermodilution and solving the previous formula by X. The correlation between SV calculation and SV measured independently by thermodilution was highly significant: r values ranged from 0.85 to 0.92 (intercepts close to 0 and slopes close to 1) during different situations (supine, tilt, dynamic and static exercise). In five patients continuous haemodynamic ambulatory monitoring was obtained by applying the formula above to the intra-arterial tracing recorded with the Oxford technique. A computer program was developed in order to get BP, heart rate (HR), SV, cardiac output (CO) and total peripheral resistance (TPR) simultaneously. In these patients, the morning increase of BP was determined by an increase of both CO and TPR. Stroke volume increased slightly during the night, probably as a consequence of a reduced HR.

Adult↗
PubMed1985

[Hypotension during ventricular pacing. A study of the vagal reflex component].

It has been suggested that hypotension during ventricular pacing (V) could be caused by a parasympathetic vasodilating reflex. In order to evaluate this hypothesis, we studied 10 patients who had wide fluctuations of arterial pressure during V. Intra-arterial pressure, right atrial pressure, EKG and cardiac index (thermodilution) were determined in the following conditions: basal rhythm (B), V, atrioventricular pacing (A-V) and ventricular-atrial pacing (V-A). The same investigations have been carried out in the same conditions (B,V,A-V,V-A) after atropine 0.03 mg/Kg intravenously. The arterial blood pressure during V decreased markedly simultaneously with the appearance of cannon waves in the right atrial pressure tracing. During A-V the arterial pressure remained stable at the highest level observed during V. The start of V-A pacing induced a marked drop of arterial pressure, which, however, gradually increased to a level slightly lower than during A-V pacing. After atropine the arterial blood pressure during V decreased again in all patients concomitantly to the appearance of cannon waves in the atrium as before atropine. The values of arterial blood pressure during B, A-V and V-A were not different from those measured before atropine. Therefore, an increase of parasympathetic activity during V is not responsible for the wide fluctuation of arterial blood pressure. A possible role of sympathetic failure must be considered.

Adult↗
PubMed1984

Efficacy of low-dose captopril given twice daily to patients with essential hypertension uncontrolled by a beta blocker plus thiazide diuretic.

Thirty-two patients with moderate to severe essential hypertension whose supine diastolic blood pressure (SDBP) was greater than or equal to 95 mm Hg following 2 weeks' treatment with the optimal dosage of beta blocker-diuretic combination were randomly assigned to the addition of either captopril 25 mg or 50 mg b.i.d. After 6 weeks' treatment, if patients were not normalized (SDBP less than 95 mm Hg), the dose of captopril was doubled for a further 6 weeks. The addition of captopril led to a significant fall in standing and supine diastolic and systolic blood pressure at the end of the sixth and twelfth week of treatment. There was no difference in the change in blood pressure between the two groups. At the end of the study SDBP was normalized in 66% of patients and a further 12.5% had their SDBP reduced by greater than 10%. Captopril 25 or 50 mg administered twice daily proved to be a very effective antihypertensive agent when added to a beta blocker-diuretic combination in patients resistant to optimal doses of these drugs.

Adult↗
PubMed1984

[Continuous 24-hour registration of intra-arterial pressure in basal states and during therapy with a fixed slow-release oxprenolol-chlorthalidone combination, administered once a day].

Intra-arterial 24 hour blood pressure (BP) recording (OXFORD MEDILOG) was carried out in 10 patients with essential hypertension, 6 males and 4 females, aged between 41 and 58 years, 3 at WHO stage 1 and 7 at stage 2, in basal conditions and after 6 weeks of treatment with a fixed combination of 160 mg of slow-release oxprenolol and 20 mg of chlorthalidone per tablet (tb). The fixed combination was given once daily, in the morning, at the dosage of 1 tb, which was increased to 2 tbs o.d. after the first 2 weeks in 6 patients. Computer calculated mean BP and heart rate (HR) values from each consecutive hour of the day were obtained in all patients. Hourly trend of BP and HR were plotted and circadian variations were thus determined. Treatment with fixed combination o.d. significantly reduced systolic and diastolic BP, compared to pretreatment values, throughout of the 24 hours (p less than 0.01; p less than 0.001), without altering the circadian rhythm. Before and after 6 weeks of treatment, a bicycle exercise test was performed in 8 patients, who reached 85% of the maximal predicted HR. Pretreatment resting mean BP (+/- SD) was 190 +/- 31/108 +/- 10 mmHg (HR: 68 +/- 9 b/min) and those during the last minute of exercise 242 +/- 29/125 +/- 5 mmHg (HR: 147 +/- 13 b/min); posttreatment resting BP was 161 +/- 20/88 +/- 7 mmHg (HR: 58 +/- 7 b/min) and at peak exercise, 212 +/- 16/106 +/- 7 mmHg (p less than 0.025 for the systolic pressure; p less than 0.001 for the diastolic pressure).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Angiotensin-converting enzyme inhibition, catecholamines and hemodynamics in essential hypertension.

Captopril was given to 15 unselected patients with essential hypertension (WHO II) at a dose range of 300 to 600 mg/day. Hemodynamic indexes (thermodilution) as well as levels of plasma norepinephrine, epinephrine, renin activity and aldosterone were determined simultaneously at the end of 2 weeks of placebo and after 8 weeks of captopril treatment. Systolic and diastolic arterial pressures were reduced significantly by treatment both supine (p less than 0.0025) and standing (p less than 0.0025). The diastolic arterial pressure was normalized (less than 95 mm Hg) in five patients and significantly reduced in four, whereas six patients were considered poor responders (mean arterial pressure decrease 10 mm Hg or less). The decrease in arterial pressure correlated significantly with the reduction in total peripheral resistance (r = 0.71), whereas cardiac index did not change and stroke index increased because of a slight decrease of heart rate. Plasma and urinary norepinephrine and epinephrine did not change during treatment. Moreover, the response of both heart rate and plasma catecholamines to upright posture was not altered by captopril treatment. Plasma renin activity increased and plasma aldosterone concentration decreased during treatment. These results suggest that inhibition of converting enzyme activity by captopril induces a reduction in arterial pressure through a reduction in total peripheral resistance. There was no evidence of an appreciable reduction in sympathetic nervous system activity during therapy.

Adult↗
PubMed1982

Aortic rigidity and plasma catecholamines in essential hypertensive patients.

Aortic rigidity, plasma noradrenaline and adrenaline, and hemodynamic parameters were measured in 48 essential hypertensive patients, 25 younger than 45 (Group I) and 23 of 45 years and over (Group II). Aortic rigidity was determined by the ratio of pulse pressure over stroke volume. Aortic rigidity and hemodynamic parameters were also determined after combined alpha-beta receptor blockade induced by Labetalol (mg 100 IV) or by Propranolol (mg 10 IV) plus Phentolamine (mg 10 IV). The aortic rigidity index was significantly higher in Group II, systolic arterial pressure being significantly higher. All other data, including plasma noradrenaline and adrenaline, were not significantly different in the two groups. In Group II a significant correlation (r = 0.62) was noted between aortic rigidity indexes and plasma noradrenaline values. The alpha-beta receptor blockade induced a decrease of aortic rigidity particularly in Group II, owing to a more marked decrease of systolic arterial pressure. A highly significant correlation was noted in Group II between the changes in aortic rigidity index and the basal plasma noradrenaline levels (r = 0.81). Therefore, the aortic rigidity in essential hypertensive patients older than 45 is influenced by the sympathetic nervous system activity, as judged by plasma noradrenaline levels. This influence seems related to an increase with age of aortic responsiveness to sympathetic stimulation.

Adult↗
PubMed1982

Adrenergic activity in systolic hypertension.

Basal hemodynamics and plasma catecholamines were measured in 10 patients with systolic hypertension, 7 males and 3 females, aged 38-69 years (Group 1), and in 10 patients with systolic and diastolic hypertension, 7 males and 3 females, aged 40-65 years (Group 2); the same measurements were repeated after acute pharmacological alpha and beta-blockade with Labetalol, 100 mg iv, or Propranolol, 10 mg iv, plus Phentolamine, 10 mg iv. In patients of Group 1 plasma noradrenaline was inversely related to systolic arterial pressure and to stroke index and was directly related to heart rate. In patients of Group 2 plasma noradrenaline was directly related to systolic arterial pressure. After acute alpha and beta-blockade the degree of reduction of systolic arterial pressure was directly related to basal plasma noradrenaline in both groups; systolic arterial pressure was reduced to normotensive levels in 5 patients of Group 1 who had high basal plasma noradrenaline values. These results confirm some of our previous findings and suggest that in some patients with systolic hypertension adrenergic activity is increased and may have a significant role in maintaining high blood pressure values.

Aged↗
PubMedDate not supplied

Effect of enalapril at rest and during isometric and dynamic exercise in essential hypertensive patients.

Vasodilator drugs reduce peripheral vascular resistance but lead to a secondary baroreflex-mediated chronotropic effect. After angiotensin-converting enzyme inhibition, blood pressure falls without associated tachycardia. In a previous study it was observed that enalapril increased vagal tone in essential hypertensive patients. In order to evaluate the effect of enalapril on sympathetic stimulation 10 mild to moderate hypertensive patients were studied during static (hand grip) and dynamic exercise (bicycle ergometer), after 2 weeks of placebo and after 1 month of treatment with 20-40 mg enalapril once daily. Enalapril significantly reduced blood pressure and the rate-pressure product at rest and at peak dynamic exercise. There was no effect on supine and maximal heart rate. Enalapril also significantly reduced blood pressure during hand grip, but did not interfere with the rate of the increase. Thus, enalapril does not seem to interfere with sympathetic adaptation to stress.

Adult↗
PubMedDate not supplied

[The use of human fibrin glue in retropubic adenectomy by the Millin's technique].

The authors take into consideration the use of human fibrin glue as a completion of the retropubic adenomectomy according the classic Millin technique. Human fibrin glue is applied on the suture line of the prostatic capsule and in the retropubic space. The Authors compare two series of ten operated with and without the use of this biological glue.

Aged↗