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Biomedical subjects

F Galetta

Publications and source records attributed to F Galetta.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Fibrinogen as a cardiovascular risk factor].

Fibrinogen is a globulin of hepatic synthesis necessary for the coagulative process and is considered a risk factor of atherosclerosis disease. The increase in plasma fibrinogen seems to play an important role in the atherosclerosis disease and actually it represents a major, independent risk factor that should be considered for screening programs aimed at identifying individuals at high risk for cardiovascular disease. In the present review we'll propose to summarize current pharmacological knowledge, the relationship between fibrinogen and the best known cardiovascular factors like smoking and hypercholesterolemia. Furthermore we'll show the main mechanisms which make hyperfibrinogenaemia a pathogenetic factor of atherosclerosis. Lastly we analyse the possible fibrinogen lowering therapy.

Adult↗
PubMed1995

[Ultrasonic evaluation of early atherosclerotic damage in patients with type 1 diabetes mellitus].

UNLABELLED: The aim of this study was to evaluate the influence of metabolic control on the development of atherosclerotic lesions in type 1 insulin-dependent diabetic patients (IDDM). MATERIALS AND METHODS: Twenty-eight well controlled IDDM patients, without known risk factors or clinical evidence of cardiovascular disease, together with 28 age-matched healthy controls spontaneously underwent high-resolution echographic evaluation of carotid femoral arteries. A global score of atherosclerotic damage as been assigned to the four investigated vessels on the basis of 1-6 scale, which takes into account most important ultrasound atherosclerotic lesion found in every artery. RESULTS: Diabetic and healthy controls differed significantly as regard to medio-intimal carotid thickness (p < 0.001), but were similar as for score of atherosclerotic damage. CONCLUSIONS: Our results suggest that, in spite of a carotid wall medio-intimal thickness more pronounced in IDDM patients, well controlled IDDM is associated with atherosclerotic damage almost identical to that of healthy age-matched controls.

Adolescent↗
PubMed1995

[Cardiovascular effects of autonomic neuropathy in insulin-dependent diabetes mellitus].

The present study was designed to evaluate whether autonomic diabetic neuropathy is a marker of severe cardiovascular disease. We recruited three groups of 12 patients each with the same age, sex and body weight distribution: Group DAN + (diabetics with neuropathy), Group DAN- (diabetics without neuropathy) and Group C (healthy control group). The patients underwent two-dimensional color Doppler echocardiography and maximal electrocardiographic exercise test by cycloergometer (multistage program with 25 W increments 3 min steps). Cardiovascular autonomic function was evaluated by Ewing's tests (heart rate and blood pressure measurement during lying to standing, deep breathing, handgrip isometric stress test and Valsalva manoeuvre). Heart rate and blood pressure proved to be significantly higher in the Group DAN+, than in the other groups, either at baseline or during stress test. Only 33% of DAN+ patients proved to reach 100 W during stress test, compared to 82% of DAN- and 87% of control subjects. No DAN+ patients reached 125 W, compared with 45% of DAN- and 58% of Group C patients. Echocardiographic examination showed normal left ventricular systolic function in all groups, without any significant difference in ventricular dimensions, and impaired left ventricular diastolic function in DAN+ patients, compared to Group C subjects (peak E 66.75 +/- 8.36 vs 73.49 +/- 12.53 cm/s; peak A 72.1 +/- 13.42 vs 59.75 +/- 13.26 cm/s; E/A 0.84 +/- 0.21 vs 1.38 +/- 0.15 and isovolumetric relaxation time 101 +/- 21 vs 70 +/- 17 ms). Our data suggest that diabetic autonomic neuropathy is a marker of reduced exercise tolerance and of diastolic left ventricular dysfunction.

Adult↗
PubMed1994

[Therapy of arterial hypertension associated with acute stroke. Current trends and problems].

Acute stroke may cause hypertension and actually available devices for non-invasive blood pressure monitoring make it possible to study short-term variability of pressure in this condition, in order to settle a more rational diagnostic and therapeutic approach. In our experience blood pressure variability has shown to be greater in thrombo-embolic, than haemorrhagic stroke. This outcome contributes to explain literature disagreement on benefits of antihypertensive therapy and suggests the need for blood pressure monitoring in every trial, that wants to evaluate with satisfactory reliability the antihypertensive treatment in ischaemic stroke. As to antihypertensive drugs to be used in stroke patients, we prefer antiadrenergics, because hypertension in this clinical condition is due to adrenergic overactivity. Our preliminary experience with a centrally acting antiadrenergic drug (clonidine) has shown its ability not only to reduce blood pressure, but also blood pressure variability in ischaemic stroke.

Acute Disease↗
PubMed1994

[Effects of rehabilitation on cardiovascular autonomic function in ischemic cardiopathy].

METHODS: Twenty patients with uncomplicated myocardial infarction randomized in two groups (group 1 and 2) of ten patients were investigated. Only group 1 trained four months according to a protocol of rehabilitation, whereas patients of group 2 followed their usual activity (control group). The autonomic cardiovascular function was estimated by Ewing's tests, that evaluate the variations of heart rate and blood pressure during deep breathing. RESULTS: Our data showed an increase of parasympathetic tone in group 1 (Valsalva ratio 1.55 +/- 0.28 vs 1.36 +/- 0.28, p < 0.01; variation in heart rate during deep breathing 17.3 +/- 4.6 vs 13.3 +/- 4.2). The sympathetic activity tests showed no significant difference after training. On the other hand, group 2 showed no significant difference in sympathetic and parasympathetic activity. CONCLUSIONS: In patients with uncomplicated myocardial infarction physical training increases the parasympathetic activity; as shown in the literature, such an increase can have clinical and prognostic importance, since improves cardiac performance and reduces the risk of sudden death from arrhythmic events.

Aged↗
PubMed1994

[Arterial pressure variability in the acute phase of a cerebral stroke].

OBJECTIVE: Acute stroke may cause hypertension and recently available devices for noninvasive blood pressure monitoring make it possible to study short-term variability of pressure in this condition. DESIGN AND METHODS: Eight patients (5 males, 3 females, mean age 66 +/- 12 years) with haemorrhagic stroke and 13 male patients (mean age 73 +/- 10 years) with thrombo-embolic stroke underwent 24-hour blood pressure monitoring in the acute stage by the Takeda Medical 2420 (A&D Co., Japan), programmed to measure blood pressure every 10 min during day-time and 15 min during night-time. Blood pressure variability was measured by the variability coefficient (standard deviation/24 h mean). The diagnosis was confirmed in all cases by Computed Tomography scanning. Statistical differences between groups were evaluated by Student's "t" test for independent samples. RESULTS: In haemorrhagic stroke the mean of variability coefficient proved be 10.7% for systolic and 12.8% for diastolic blood pressure, whereas in thromboembolic stroke it was 14.1% for systolic and 17.7% for diastolic blood pressure. The difference between means was statistically significant (p < 0.02 for systolic and p < 0.01 for diastolic blood pressure). CONCLUSIONS: Blood pressure variability is greater in thrombo-embolic, than haemorrhagic stroke. The hypervariability can be misleading in judging the hypertensive state in this condition.

Acute Disease↗
PubMed1994

[Effects of pravastatin on serum lipids, apoproteins, and lipoprotein (a) in primary hypercholesterolemia].

The efficacy of pravastatin as reducing plasma cholesterol, LDL-CH and Apo B is widely proved. Other molecules within the Apolipoprotein family are recently emerging to have a predictive and/or causative role in atherosclerosis such as particularly Lp(a). The aim of this study was to evaluate the effects of pravastatin therapy in patients affected by primary hypoercholesterolemia on apoprotein and Lp(a) plasma levels. We investigated the effects of pravastatin on 15 patients, seven female and eight male patients, mean age 50.23 +/- 17.2 (range 21-71 years) with primary hypercholesterolemia, of which 7 patients affected by familial hypercholesterolemia and 8 patients by polygenic hypercholesterolemia, were selected. Five weeks after suspension of lipid-lowering drugs and on a normocaloric-fat diet, were given 20 mg pravastatin/day for 12 weeks. The following parameters were measured basally, on the 6th week and the 12th week on pravastatin therapy and after five weeks from drug withdrawal: cholesterol (CH), triglicerides (TG), high density and low density lipoprotein cholesterol (HDL-CH and LDH-CH) measured enzymatically, apoproteins A1, B, C2, C3, E measured radial immunodiffusion technique (RID) and Lp(a), measured as apoprotein(a) with immunoradiometric assay (RIA). Our data confirm pravastatin efficacy in decreasing CH (from 305.6 +/- 43.4 mg/dl to 266.2 +/- 47.7 mg/dl, p < 0.01) LDL-CH (from 223.9 +/- 56.4 mg/dl to 187.2 +/- 59.8 mg/dl, p < 0.01) and Apo B (from 170.4 +/- 27.5 to 152.4 +/- 25.2, p < 0.02); non influence was observed on HDL-CH and apoproteins A1, C2, E and Lp(a). Pravastatin determined a significant increase only on Apo C3 (from 8.35 +/- 2.7 to 10.3 +/- 3.1, p < 0.04). The above data confirm the beneficial effect of pravastatin in greatly decreasing CH and LDL-CH considered as major risk factors for coronary artery disease, but also point to a role of pravastatin in regulating the apoproteins equilibrium, an aspect that surely merits further studies.

Adult↗
PubMed1993

Dilation of venous vessels at the splenic hilum in normal sized spleens as an indication of pathologic splenic involvement: preliminary results.

Twelve hundred patients without liver or heart disease, having a normal sized spleen without focal lesions, were examined by ultrasonography to measure the inner diameter of the splenic vein in relation to possible current or recent recovery from pathologic processes. SVD was measured at the hilum of the spleen with the patients supine. Ten of the patients in whom dilation of the SVD was found, together with a group of healthy controls (25), were subsequently studied with a duplex Doppler analysis to measure the venous outflow from the spleen. The results showed 1,175 spleens (98%) with SVD at the hilum of < 8 mm and 25 spleens (2%) with SVD of > 8 mm. Twenty-three of 25 patients (92%) with enlarged SVD had recent histories of hematopoietic or infectious diseases. Ten of 23 patients with enlarged SVD were studied further with a Doppler analysis. They demonstrated a rapid splenic blood flow with maximum flow velocities ranging from 14 to 27 cm/sec and high outflow volumes (from 430 to 1,227 ml/min, averaging 786 ml/min +/- 266), both significantly increased in comparison with controls (outflow volume from 200 to 355 ml/min, averaging 274 +/- 40; P < 0.0001). We conclude that dilation of the SVD accompanied by an increased intrasplenic blood flow volume without splenic enlargement would indicate a state of increased perfusion of splenic tissue associated with an immune response, reflecting reaction of the spleen to disease.

Adolescent↗
PubMed1993

[The effects of treatment with atenolol and benazapril on 24-hour pressure variability].

One of the functions of the sympathetic nervous system is to produce a short-term increase in blood pressure. It might be thought, therefore, that antihypertensive drugs which interfere with the functioning of the sympathetic nervous system (e.g. betablockers) would reduce blood pressure variability over 24 h whereas those that act independently of it (e.g. ACE inhibitors) would not. Two groups of 10 hypertensives underwent noninvasive 24-h blood pressure monitoring before and after antihypertensive treatment with a betablocker (atenolol) and an ACE inhibitor (benazepril) respectively. Blood pressure variability was measured by the variability coefficient (standard deviation/mean). Atenolol induced a non-statistically significant decrease in blood pressure variability, whereas benazepril caused a statistically significant increase in systolic blood pressure variability. Therefore, we conclude that the evaluation of ACE-inhibitor therapeutic effect on blood pressure by the "casual" measurement can be misleading in judging the efficacy of such drugs.

Adult↗
PubMed1993

[The ultrasonic characterization of myocardial hypertrophy: new prospects].

The extensive use of ultrasound imaging in cardiology has greatly contributed to expand both its diagnostic possibilities and its utility in the interpretation of physiopathologic mechanisms. Conventional echocardiography is the more specific technique for the diagnosis of myocardial hypertrophy which, in turn, is one of the most important cardiovascular risk factors. The improvement of ultrasound technology may expand the possibility of noninvasive characterization of left ventricular hypertrophy by adding to the already known information about left ventricular mass and function, and that relative to the degree of hypertrophy-related fibrosis. In the present paper the authors reviewed the knowledge about biological and hemodynamic factors which contribute to the development and regression of myocardial hypertrophy. The possible role of new ultrasonic technology in the tissue characterization of myocardial hypertrophy is also discussed.

Cardiomegaly↗
PubMed1993

[Cardiovascular effects of amitriptyline in therapeutic dosages. Echocardiographic study].

The authors studied the cardiovascular effects of amitriptyline at therapeutic plasma concentrations in 15 depressed patients (6 M. 9 F.) without cardiovascular disease both before treatment and after six months of therapy. The cardiovascular effects were evaluated by means of electrocardiographic and 2D-echocardiographic examinations in basal conditions and after hand-grip stress test. The effects of isometric hand-grip exercise (IHG) on left ventricular size and performance were studied non invasively in all patients at rest and after 3 min. of IHG at 30% of maximum contraction. Left ventricular internal diameter was measured at end-diastole and end-systole on LV echograms, and blood pressure was measured by sphygmomanometer. Our data confirmed the depressant effect of amitriptyline even on healthy myocardium, an effect that becomes manifest only at handgrip stress with a significant reduction of ejection fraction (form 70.6 to 66.4%; p < 0.001), while ECG and arterial blood pressure did not change throughout the study. This goes to show that treatment with tricyclic antidepressants always has a latent depressant effect on myocardial contractility that becomes clinically evident under stress, as well as in subjects with heart disease and in the elderly. Hence the need to monitor left ventricular function, as well as ECG and blood pressure, and to exercise great caution in prescribing tricyclic antidepressants to subjects with a history of myocardial failure.

Aged↗
PubMed1993

[The effect of physical exercise on the response to exertion in the elderly].

BACKGROUND: A decrease in adaptation to exertion has been observed as age progresses. Although this decline may also be affected by factors such as health conditions and age, physical inactivity related to sedentary behaviour plays a dominant role. METHODS: In order to evaluate the influence of physical activity on cardiovascular response to exertion in the elderly, 4 groups of 22 subjects each were submitted to maximal electrocardiographic exercise test on a cycloergometer (multistage program with 30 Watts x 3 min. steps). All subjects were male. The composition of the groups was as follows: 1) veteran long distance runners (mean age: 71 +/- 5.4); 2) sedentary veterans (mean age: 69.8 +/- 3.9); 3) young long distance runners (mean age: 25.4 +/- 4.3); 4) sedentary young adults (mean age: 25.8 +/- 3.9). The endurance athletes, well fitted to competition, had been practicing sport activity for at least 3 years. RESULTS: Heart rate, arterial systolic and diastolic blood pressure were recorded; mean blood pressure and double product were calculated at baseline and at the climax of the stress test; furthermore, total and maximal watts were recorded. For each of the parameters, Student's t test for non-paired observations were used to evaluate statistical differences amongst the four groups. The most interesting result arises in the comparison between veteran long distance runners and sedentary young adults: between the two groups no statistically significant differences in workload, expressed as total watts (1649.55 +/- 296.32 vs 1650.00 +/- 446.32; p = NS) and maximal watts (175.91 +/- 19.19 vs 173.18 +/- 24.38; p = N.S.), were observed. On the contrary, highly significant differences in both total (p < 0.01) and maximal (p < 0.01) watts were noticed by comparing long distance runners and sedentary subjects of the same age. CONCLUSIONS: These data support the hypothesis that the progressive reduction in physical activity, which is usually observed in aging, is the major determinant of exercise deconditioning in the elderly.

Adolescent↗
PubMed1984

[Correlation between electrocardiographic and echocardiographic findings in chronic aortic insufficiency].

Echocardiographic indices of left ventricular volume and mass and electrocardiographic indices of left ventricular hypertrophy have evaluated in 25 patients with chronic aortic regurgitation and in 10 normal subjects. When the patients with aortic regurgitation were subdivided in three groups with increasing evidence of left ventricular hypertrophy, the echocardiographic measures of left ventricular dimension and mass were also found to be increased, with statistically significant differences between patients and controls and among the three groups of patients as well. A specially constructed cumulative electrocardiographic index of left ventricular hypertrophy (Sokolow and Lyon's index plus Lewis' index plus strain pattern) is correlated with the left ventricular end-diastolic diameter (r = 0.65; P less than 0.001), cross-sectional area (r = 0.65; p less than 0.001) and mass (r = 0.75; p less than 0.001) better than the isolated electrocardiographic indexes.

Adult↗
PubMed1984

[Analysis of variations in cardiac performance induced by tilt and hand-grip in athletes and in untrained subjects].

The aim of the present study is to analyze variations of external cardiac work and of indices of myocardial oxygen consumption induced by upright tilting and hand-grip in volley-ball athletes (group A) in comparison with a group of normal subjects (group N). For this purpose we have used impedance cardiography, a simple, reproducible and non invasive technique, which is very reliable in evaluating both systolic time intervals and hemodynamic parameters such as stroke volume and cardiac output. No significant differences, of external cardiac work, double and triple product were observed between group A and N upon upright tilting. Hand-grip test, on the other hand, can differentiate the myocardial behaviour of trained people from that of the control group. The double product was significantly reduced in group A in comparison with group N (P less than 0.001 and the end of the test, P less than 0.05 after 30", P less than 0.001 after 1' and 3"). The triple product was significantly reduced in group A in comparison with group N at the end of the test (P less than 0.005). External cardiac work was always higher in group A in comparison with group N (P less than 0.02, at the stop P less than 0.05 after 30", P less than 0.01 after 1', P less than 0.0001 after 3'). Therefore in volleyball athletes the myocardium exhibits better mechanical performance than in normal subjects.

Blood Pressure↗