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F Pelliccia

Publications and source records attributed to F Pelliccia.

At least 55 records · Page 3Linked to original sources

Determinants of end-stage idiopathic dilated cardiomyopathy: a multivariate analysis of 104 patients.

Our purpose in this study was to investigate the correlation of clinical, electrocardiographic, hemodynamic, and histopathologic features at diagnosis with the long-term prognosis in 104 patients with idiopathic dilated cardiomyopathy to determine which factors are the independent determinants of the end-stage disease. During a mean follow-up of 3.8 +/- 3.5 years, 35 patients (33%) died, 14 (13%) suddenly and 21 (20%) from congestive heart failure. Univariate analysis of survival curves disclosed that clinical and electrocardiographic variables at diagnosis were similar in survivors and non-survivors. On the contrary, patients who subsequently died had higher mean right atrial pressure (p = 0.0001), right ventricular end-diastolic pressure (p = 0.0061), mean pulmonary artery pressure (p = 0.0001), and left ventricular systolic (p = 0.0049) and end-diastolic (p = 0.0021) pressure than survivors. They also exhibited larger left ventricular end-diastolic (p = 0.0046) and end-systolic (p = 0.0027) volumes, lower ejection fraction (p = 0.0001), and a greater proportion had severe mitral regurgitation (p = 0.0095). Univariate analysis of histologic findings collected in a subgroup of patients referred since 1984 revealed a mild degree of myocellular hypertrophy to be associated with a poor prognosis (p = 0.0217). Multivariate analysis selected only mean right atrial pressure (p = 0.0022), ejection fraction (p = 0.0089), and end-systolic volume (p = 0.0265) as independent determinants of cardiac death. Our results suggest that cardiac catheterization is mandatory for risk stratification of patients with idiopathic dilated cardiomyopathy, since it allows the assessment of hemodynamic, angiographic, and histopathologic features helpful in identifying patients with a poor prognosis.

Adult↗

[Effects of slow-release isosorbide-5-mononitrate on ergometric parameters and cardiac output in stable effort angina pectoris: a double-blind randomized placebo study].

The effects of a single oral dose of 60 mg of sustained release (R) isosorbide-5-mononitrate (ISM) administered in 9 male patients (mean age: 53 +/- 7 years) with stable exercise-induced angina pectoris were studied in a randomized, double blind, cross-over study. The effectiveness of the drug was evaluated by concomitant ergometer exercise stress test and cardiac output determination (bioimpedance method, Bomed Med-Ltd) performed 1 hour before and 1, 4, 10 and 24 hours after acute administration of placebo (P) and ISM-R. After P, all patients showed a positive exercise test, whereas 3 patients during ISM-R treatment had a negative exercise stress test 1 and 4 hours after ISM-R administration. Compared with P, ISM-R produced a statistically significant improvement of exercise stress test parameters at peak exercise (maximum work load, heart rate, systolic and diastolic blood pressures and double product) up to 10 hours after drug administration. On the other hand, cardiac output did not significantly differ at any time after ISM-R compared with both control conditions and P treatment. Moreover, no side effect was detected in any patient during the study. In conclusion, a single oral dose of 60 mg of sustained-release ISM-R seems to be an effective drug in the treatment of effort angina, its effectiveness lasting more than 10 hours without side effects.

Adult↗

[Idiopathic dilated cardiomyopathy: clinical and prognostic significance of the morpho-functional involvement of the right heart].

Aim of this study was to evaluate whether different severity of clinical and functional impairment of right heart in patients with idiopathic dilated cardiomyopathy (IDC) might condition distinct clinical features and prognosis. From 104 consecutive patients with hemodynamically assessed diagnosis of IDC studied between 1977 and 1987 in our Institute, 39 patients (28 males and 11 females, mean age 41 +/- 14 years) were selected on the basis of ejection fraction ranging from 35 to 50%, left ventricular end-diastolic pressure ranging from 13 to 20 mmHg and left ventricular end diastolic volume less than or equal to 150 ml/m2. A significant involvement of right heart (diagnosed according to a mean right atrial pressure greater than or equal to 9 mmHg, a right ventricular end-diastolic pressure greater than or equal to 9 mmHg and a right ventricular end-diastolic diameter greater than or equal to 30 mm) was assessed in 16 patients (41%), 11 males and 5 females, aged 40 +/- 15 years (Group A). On the contrary the remaining 23 patients (59%), 17 males and 6 females, aged 42 +/- 12 years, had a normal right heart (Group B). At entry into the study, clinical features appeared similar in the 2 groups of patients whereas patients of Group A had significantly higher incidence of atrial fibrillation (25% vs 4%, p less than 0.01) and complex ventricular arrhythmia (greater than or equal to 4 Lown class) (25% vs 4%, p less than 0.01) compared with patients of Group B. With respect to conduction defects no difference was found between Group A and Group B.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Predictive value of myocellular hypertrophy in idiopathic dilated cardiomyopathy].

The role of endomyocardial biopsy (EMB) in assessing of idiopathic dilated cardiomyopathy (IDCM) is a well-recognised one. On the contrary, the value of correlating histological features, such as myocellular hypertrophy, with functional evaluation and outcome is still controversial. It was the purpose of the present study to appraise the correlation with hemodynamic data and the predictive role of histological features in 32 consecutive patients affected by IDCM who underwent left ventricular EMB between January 1984 and December 1986. Light microscopy findings were graded by means of a semiquantitative score system. In comparison with the 19 patients with mild myocellular hypertrophy, the 13 patients with marked hypertrophy showed significantly lower right ventricular end-diastolic pressure (10.4 +/- 5.8 vs 6.6 +/- 3.6 mmHg, p less than 0.05) and left ventricular end-diastolic pressure (26.9 +/- 9.0 vs 16.5 +/- 8.8 mmHg, p less than 0.01). On the contrary, different degrees of interstitial fibrosis, as well as of the other morphologic findings, could not identify patients with distinct hemodynamic patterns. However, there was a direct correlation between the amount of myocellular hypertrophy and interstitial fibrosis (p less than 0.01). During a mean follow-up period of 32 +/- 11 months (range: 12-48 months), 6 patients died and 3 further patients underwent heart transplantation. Univariate analysis of histological features (log-rank test) showed a mild degree of hypertrophy alone to be significantly related to a poor outcome (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Synergistic effect of DAPI and thymidylate stress conditions on the induction of common fragile sites.

When supplied to human leukocytes grown in complete medium (RPMI 1640), DAPI, a nonintercalating compound specific for the AT bases of DNA, induces the appearance of three common fragile sites (CFRA) mapped at 1q42, 2q31, and 7p22. The same treatment with DAPI in a medium deficient in folic acid and thymidine (199 M) considerably increases the expression of these sites and induces the appearance of a further 16 CFRA sites at 1q24, 2p25, 4p16, 4q25, 5p15.3, 6p21.3, 6p25, 6q13, 9p24, 16p13.3, 16q23, 17q21, 18q23, 20q13.1, 21q21, and Xq28. The results point to the existence of a synergism between DAPI and thymidylate-stress culture conditions in inducing site-specific chromosome damage. The results also agree with the hypothesis that DAPI-induced CFRA sites are DNA late-replicating chromosomal areas rich in AT bases.

Cells, Cultured↗

DAPI-inducible common fragile sites.

DAPI, a compound specific for the AT bases of DNA, causes gaps and breaks in three human chromosome sites, at the 1q41-1q42 interface, 2q31, and 7p22. It also induces undercondensation of a chromosome site at the 13q21-13q22 interface. The first three sites have the characteristics of "common fragile sites" and are present as gaps and breaks on the chromosomes of seven individuals.

Base Sequence↗