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Biomedical subjects

F Rovelli

Publications and source records attributed to F Rovelli.

At least 109 records · Page 6Linked to original sources
PubMed1978

[Natural history of angina pectoris: follow-up on 519 unoperated patients (author's transl)].

519 patients with angina pectoris studied by selective coronary arteriography and left ventriculogram, were followed for a period ranging from 18 months to 7 years. The mean follow-up was 42.2 months. The patients showed a survival probability of 81% at the 7th year. After 5 years the survival probability was 83.2% for patients with typical stable angina, 70.3% for patients with unstable angina, 96.7% for patients with atypical angina. The survival probability was 78.8% for the male sex and 94.6% for the female (at the 5th year). Age, a long-lasting angina, the presence of: previous infarction, myocardial failure, cigarette smoking, hyperlipidemia, cardiomegaly and an ischemic resting EKG were factors with poor prognostic value. The prognostic value of significant coronary stenosis was confirmed. The survival probability at the 5th year of the patients without critical stenosis was 96.6%, of patients with stenosis of 1, 2 and 3 main coronary arteries was respectively: 87.6%, 79% 54.7%. Significative prognostic differences were observed in patients with normal left ventricle kinesia (survival probability at the 5th year: 90%), compared with patients with severe VS ipokinesia (62.7%) and with VS diskinesia (69%). In the follow-up period an incidence of 9% of myocardial infarctions was observed. The degree of each stenosis and the number of vessels involved, the type of angina, the presence of risk factors or previous myocardial infarction did not affect the clinical evolution of angina.

Adult↗
PubMed1978

[Permanent endocardial pacing. Experience on 1678 patients. (De Gasperis Cardiology Center--Ente Ospedaliero Niguarda--Milano) (author's transl)].

The Authors report on eleven years and six months experience with permanent endocardial pacing in the treatment of various conduction disturbances. This experience relates to 1678 patients, 3617 pacers were used. The age of the patients ranges from 60 to 80 (70%), 30% referring to the remaining decades, minimum 14--maximum 94. Fixed rate pacers were used in 31% of cases, QRS synchronous or QRS inhibited pacers were used in 69%. Average life of the pacers varies from 25 to 29 months; the average life of fixed rate pacer is higher. Complications and causes of failures, among which electrode dislodgement is the most relevant and frequent, as well as the relative therapeutical treatments, are described. Early mortality is about 1% and late mortality 20%; the survival rate calculated altogether after 11 years and 6 months treatment with implantable pervenous pacing is about 16%.

Aged↗
PubMed1977

[Effectiveness of nifedipine on exercise tolerance in patients with angina pectoris. Comparison with a nitroderivative and a beta-blocking agent].

The effect of nifedipine on effort angina was investigated by means of exercise tests with bycicle ergometer and compared, in the same patients, with the effects of a nitroderivative and a betablocking agent. Five patients with stable effort angina entered the study, after an hemodynamic and contrasto-graphic control. According to the protocol of a latin square 5 X 5, all the patients received in a random sequence the following treatments: placebo, 1 c. orally; isosorbide dinitrate, 5 mg sublingually; propranolol, 40 mg orally; nifedipine, 10 mg sublingually; nifedipine, 10 mg orally. No significant change of any of the considered parameters was observed after the placebo. Isosorbide dinitrate and nifedipine produced significant increases of the duration of work before appearance of pain and EKG positivity, and of total work performed before anginal pain. Only the duration of work before EKG positivity was improved by propranolol. The comparisons between treatments showed no significant difference of the effects of the administered doses of isosorbide dinitrate and nifedipine. The improvements observed after propranolol were significantly lower than that observed after isosorbide dinitrate and oral nifedipine. On the basis of the observed changes of cardiac rate, maximal arterial pressure, ejection time index and triple product, the authors evaluate the possible mechanism of action of nifedipine.

Adolescent↗
PubMed1976

[The mitral prolapse syndrome. Observation of 100 cases (author's transl)].

100 patients with mitral prolapse syndrome (MPS) were studied with electrocardiogram, phonocardiogram, thorax radiography and echocardiogram. In 44 of the patients, the effort test and dynamic electrocardiogram were performed; 25 underwent hemodynamic examination, and 10 underwent selective coronarography. The most frequent symptomatologies were palpitations and vertigo; the most-registered electrocardiographic alterations were ventricular extrasystoles and altered electrical repolarization in the inferior seat. The symptomatic patients with rhythm disturbances showed reduced work capacity (RWC) with aggravation of the effort arrhythmias. The phonocardiogram showed variability of the phonoauscultatory reports, not only from patient to patient, but also in the same patient. The apicocardiogram presented a characteristic systolic re-entry which coincided with the non-ejective click. In all cases, the echocardiogram demonstrated a systolic movement backwards from the mitralic strips with different aspects. The endocavitary pressures in the studied cases were normal or only slightly altered. The left ventriculography frequently demonstrated assynergic areas, and constantly, eversion of the posterior mitralic strips in the left atrium. In most of the cases, the selective coronarography showed the absence of the ventricular atrial tract of the circumflex. The sustained role of the mixomatous degeneration in the pathogenetic mechanism of the MPS must be emphasized. The beta-blockers were the most effective drugs against arrhythmias, which in some cases showed themselves impervious to any medicinal treatment. MPS is considered a very diffuse disease which can run its course without detection or which can be accompanied by serious rhythm disturbances that can threaten the patient's life. The importance of echocardiography in the diagnosis of MPS is emphasized. The SPM patient showed undergo a series of wave tests which reveal malignant potentialities, so that the best therapeutic principles, both for the treatment and prevention of the arrhythmias, can be applied.

Adolescent↗
PubMed1976

[Permanent endocardiac electric stimulation. Observations on 1125 patients (1 January 1966-31 August 1974)].

The authors report on nine years' experience with permanent endocardial pacing in the treatment of various conduction disturbances. Their experiences relate to 1125 patients; 2208 pacers were used. The age of the patients ranges from 60 to 80 (85%), 15% referring to the left decades, minimum 17 - maximum 94. Fixed rate pacers were used in 41% of cases, QRS synchronous or QRS inhibited pacers were used in 59%. Average life of pacers varies from 8.5 to 28.3 months; the average life of fixed rate pacers is higher. Complications and causes of failures, among which electrode dislodgement is the most relevant and frequent, as well as the relative therapeutical treatments, are described. Early mortality is about 1% and late mortality 8-9%: the survival rate calculated altogether after 9 years' treatment with implantable pervenous pacing is about 24%.

Adolescent↗
PubMed1976

[The effects of verapamil on angina threshold during exercise (author's transl)].

The efficacy and duration of the effects of verapamil on angina threshold during exercise were examined in five patients with proved angina pectoris, with the experimental model of a latin square 5 X 5. The effects of verapamil (0,1 mg/kg i.v.) were compared with those of a placebo (20 ml saline i.v.), of isosorbide dinitrate (5 mg, sublingual), of propranolol (0,1 mg/kg i.v.), and of dipyridamol (20 mg i.v.). All the treatments were studied within 20 minutes after administration; the efficacy of the "drugs" was checked against placebo. Verapamil and isosorbide dinitrate significantly prolonged the duration of exercise and total amount of work done before angina and EKG alteration appearance. Similar changes were observed after propranolol, but not significantly different from the effects of placebo. Dipyridamol reduced thw work performance, without significant difference from placebo. The effects of verapamil, though less marked than its peak effects, were still present 70 minutes after administration. The possible mechanism of work performance improvements induced by verapamil in angina pectoris is briefly discussed on the basis of the Triple Product changes observed during exercise.

Adult↗
PubMed1976

[Giacomo Binda].

Explore the source record for details and available documents.

Cardiology↗
PubMed1976

[Use of atrial pacing in diagnosis of coronary insufficiency. Comparison between coronarography and exercise test (author's transl)].

--123 atrial pacings (AP) performed as diagnostic investigations in patients with chest pains were re-examined. By using floating catheter without fluoroscopic control, this technique is very simple to perform and free from relevant risks. The diagnostic sensibility and specificity of AP were examined in 93 patients in which a coronary arteriography was performed; these figures were compared with the corresponding values observed in 65 patients in which an adequate diagnostic exercise test (ET) was also available. The diagnostic sensibility of AP examined in 63 patients with significant coronary artery disease was 90%; the corresponding value of ET was 79%. In particular, in patients with single vessel disease, the sensibility of AP (90%) was much higher than that observed in ET (40%). The specificity of AP examined in 30 patients free from significant stenosis of the coronary arterial tree was 43%. This value was largely lower than that observed in ET (82%) in the same patients, and appears to be inadequate for validation AP as a diagnostic tool in coronary heart disease. Therefore, AP must be limited to functional, and not diagnostic, evaluation of patients in which the diagnosis of coronary heart disease can be made by other means.

Cardiac Catheterization↗
PubMed1975

[Unstable angina: observtions on 187 patients of whom 84 were operated on for aorto-coronary bypass (author's transl)].

Clinical data, EKG and coronary angiography of 187 patients with unstable angina are given. The patients are divided into 4 groups: spontancous angina, spontaneous angina Prinzmetal's variant, "in crescendo" agina, intermediate syndrome. 103 patients were treated with pharmacological therapy only and 84 underwent aortocoronary bypass; 2 of them were operated on for acute myocardial infarction. The clinical and pathologic peculiarities of two groups are not similar and therefore the results are not comparable. There was a mortality rate of 10.3% of patients with pharmacological treatment and the incidence of non fatal myocardial infarction was 10.4%. The mortality during operation was 14.2% and the incidence of non fatal myocardial infarction was 13.1%. The spontaneous angina and Prinzmetal's variant often had normal rest EKG and a very similar coronary angiographic pattern, with obstructive lesions often localized in the proximal part of a single vessel. In 9% of cases coronary arteries were normal. The incidence of serious arrhythmias was higher in Prinzmetal's variant than in other types of unstable angina. The mortality in patients with Prinzmetal's angina was particularly high during the first period of experience (1970-1973) when the operation was performed after a few days of unsatisfactory results with pharmacological treatment; it decreased after patients underwent operation in an attenuate phase of the disease. The rest EKG of "in crescendo" angina was almost always pathologic; these cases presented obstructive lesions of 2 or 3 coronary arteries, functional impairment of left ventricle, collateral circulation. The mortality in patients treated with pharmacological therapy was higher than in other types of unstable angina. The mortality during operation, fairly high in the first period of experience, decreased in this group of patients as well, during the second period of experience.

Adult↗