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Biomedical subjects

G Licata

Publications and source records attributed to G Licata.

At least 73 records · Page 4Linked to original sources

Clinical-anamnestic and instrumental data in outpatients suffering from venous disease.

The authors studied 200 consecutive outpatients with symptoms due to venous disease of the lower limbs. All the patients underwent anamnestic, clinical and instrumental evaluation (c.w. Doppler velocimetry and strain-gauge plethysmography). The results of this study showed that some anamnestic and clinical data are significantly related to venous disease detected by instrumental techniques. The superficial and deep vein hypertension were, instead, correlated to oral contraceptive use.

Adolescent↗

Effect of captopril on lymphocytic beta-adrenergic receptors in normal and hypoxic conditions.

BACKGROUND: During heart failure, due to increased level of circulating norepinephrine, the number of beta-adrenergic receptors (beta-AR), both at the cardiac and the lymphocytic level, is reduced (down-regulation). Captopril, an ACE-inhibitor containing an SH group appears capable of resetting beta-AR when used in patients with heart failure. Our study was aimed at checking whether captopril exerts a direct effect upon the beta-AR, possibly through its SH group by disulphur binding with cysteine residues located at the binding sites for catecholamines. METHODS: The study was carried out in vitro on human lymphocytes obtained from healthy volunteers: 10 males (mean age, 34 years; range, 25-45) and 10 females (mean age, 34 years; range 26-48). Lymphocytes were randomly divided in two groups of equal size. Group I were controls; in Group II cells were incubated with three different doses of captopril: 1, 10, and 100 microM. Control lymphocytes and those treated with 10 microM of captopril were exposed to 1 microM isoproterenol. The number of total and surface beta-AR, and the sequestration of beta-AR from isoproterenol under normoxic conditions and after 20 h of hypoxia were checked. Furthermore, the content of cAMP was assayed both in basal conditions and after stimulation with 10 microM and 100 microM isoproterenol and forskolin, respectively. RESULTS: Total beta-AR: 1082 +/- 133 (controls) vs. 1174 +/- 94 (treatment with 1 microM captopril), vs. 1237 +/- 88 (10 microM captopril), vs. 1092 +/- 105 (100 microM captopril). Surface beta-AR: 84 +/- 4.41% (controls) vs. 90.5 +/- 2.1% (10 microM captopril). Basal cAMP: 1.21 +/- 0.4 (controls) vs. 1.23 +/- 0.5 pmol/10 cells (1 microM captopril), 1.05 +/- 0.6 pmol/10 cells (10 microM captopril), 1.15 +/- 0.4 pmol/10 cells (100 microM captopril). After 10 microM isoproterenol: controls 4.10 +/- 0.8 vs. 4.30 +/- 0.9 pmol/10 cells (1 microM captopril), 4.15 +/- 0.7 pmol/10 cells (10 microM captopril), 3.50 +/- 1.0 pmol/10 cells (100 microM captopril). After 100 microM forskolin: controls 13.2 +/- 3.1 vs. 11.2 +/- 3.1 pmol/10 cells (1 microM captopril), 13.1 +/- 4.2 pmol/10 cells (10 microM captopril), 12.6 +/- 2.9 pmol/10 cells (100 microM captopril). Neither of these differences were significant. Lymphocytic beta-AR exposed to hypoxia did not show any significant difference. Exposure to captopril did not cause any further alteration on beta-AR sequestration. CONCLUSIONS: Captopril does not seem to exert any direct action upon lymphocyte beta-AR from healthy volunteers. Moreover, captopril does not modify cAMP storage either in basal conditions or after stimulation with isoproterenol or forskolin. Therefore our data suggest that action of captopril on beta-AR is probably due to the inhibition of both systemic and tissue ACE-system.

Adult↗

Central obesity and hypertension. Relationship between fasting serum insulin, plasma renin activity, and diastolic blood pressure in young obese subjects.

This study was designed to evaluate the role of fasting serum insulin and plasma renin activity in obesity-induced hypertension. In view of this, plasma catecholamines, fasting serum insulin (IRI), urinary sodium excretion (NaU), plasma renin activity (PRA), and plasma aldosterone (PA) levels were assessed in young (age less than 40 years) normotensive (n = 27) and hypertensive (n = 14) subjects with central obesity and in lean normotensives (n = 20). Central obesity was evaluated by waist-to-hip ratio (WHR) according to the indication of the Italian Consensus Conference of Obesity. PRA, PA, IRI, and plasma norepinephrine levels were significantly (P < .05) higher in both obese groups than in lean normotensives. PRA was significantly (P < .05) higher and NaU was significantly (P < .05) lower in obese hypertensives than in obese normotensives. Diastolic blood pressure correlated directly with WHR and PRA in normotensive and hypertensive obese subjects and with IRI but only in normotensive obese subjects. Multiple regression analysis indicated that diastolic blood pressure values increased with WHR (P < .05), IRI (P < .005), and PRA (P < .002), but not with body mass index, NaU, and norepinephrine levels. Our results indicated that increased PRA could play an important role in the development of hypertension in subjects with central obesity.

Adult↗

Lymphocyte beta-adrenergic receptors in young subjects with peripheral or central obesity: relationship with central haemodynamics and left ventricular function.

This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptor (BAR) density and their relationship with central haemodynamics and left ventricular function in young subjects with central or peripheral obesity. A total of 31 obese subjects (BMI > or = 30.5 kg.m-2 for males and > or = 27.3 kg.m-2 for females) aged less than 40 years and without other risk factors for cardiovascular diseases (smoking, hypertension, diabetes and lipid abnormalities) were studied. Nine had peripheral obesity and 22 central obesity according to WHR values; there were 20 lean controls (BMI < 25 kg.m-2 for males and < 24.7 kg.m-2 for females). Casual (c) and 24 h ambulatory mean blood pressures (MBP-24 h) were determined. BAR density was evaluated according to Böyum and De Blasi methods. Plasma catecholamines by high perfusion liquid chromatography and fasting immunoreactive plasma insulin (IRI) were also measured by RIA. Radionuclide angiocardiography was used to determine central haemodynamics and both systolic and diastolic left ventricular function. Total peripheral resistances (TPR) and intravascular volumes were also determined. Echocardiographic study was used to measure LVM, LVM.h-1, LVDD and IVS. Left ventricular ejection fraction (LVEF), peak filling rate (PFR), BARt and BARs were significantly lower (P < 0.05) and cardiac output, cardiac volumes, LVM, LVM. h-1 and time to PFR significantly higher (P < 0.05) in both obese groups than in lean controls. Plasma IRI was significantly (P < 0.05) higher in both obese groups whereas plasma norepinephrine was higher only in central obese.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Salt-regulating hormones in young normotensive obese subjects. Effects of saline load.

To investigate whether the response of salt-regulating hormones to volume expansion is impaired in obese subjects, we assessed the effects of saline load (0.25 mL/kg.min.120 min) in 9 young, healthy, normotensive obese subjects (body mass index, > 30 kg/m2) and in 10 lean control subjects (body mass index, < 25 kg/m2) matched for age, gender, height, and mean blood pressure. Hematocrit, plasma renin activity (PRA), plasma aldosterone (PA), atrial natriuretic factor (ANF), and urinary sodium excretion (UNaV) were evaluated. Saline load increased ANF levels significantly (P < .001) in lean subjects at both 60 and 120 minutes, whereas they decreased in obese subjects. Such decreases became significant (P < .01) at 120 minutes. Suppression of PRA and PA by saline load were more marked in lean than obese subjects. Hematocrit decreased in both groups, and UNaV increased more in lean than obese subjects during saline load. Comparisons of percent changes in ANF, PRA, and PA after saline load showed that the responses of lean and obese subjects were significantly different (P < .001 for ANF at both 60 and 120 minutes; P < .05 for PRA and PA at both 60 and 120 minutes). In conclusion, the lack of ANF response and the reduced suppression of PRA and PA to saline load indicate a dysfunction of these systems in obese subjects. This alteration may be involved in the higher susceptibility of obese subjects to developing hypertension.

Adult↗

[Epidemiology of arterial hypertension and organ damage].

In this review prevalence of hypertension and target organ damage related to hypertension were analyzed. The prognostic role of blood pressure variability in hypertensive patients was also discussed. Prevalence of hypertension has been related to several factors that could influence it. They included environmental and racial factors, sodium and alcohol intake, age, gender and concomitant diseases. Moreover the importance of left ventricular hypertrophy and structural vascular abnormalities in the developing of cardiovascular disease induced by hypertension were evaluated. On the other hand the role of microalbuminuria as marker of renal impairment in hypertensive patients has been reported. At last cerebral and retinal involvement in hypertensives was discussed.

Adolescent↗

Association between reduced lymphocyte beta-adrenergic receptors and left ventricular dysfunction in young obese subjects.

This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptors (BAR) density and their relationships with left ventricular function in young obese subjects. BAR density, plasma insulin, catecholamines and left ventricular function were evaluated in 27 young obese subjects (BMI > 30.5 kg/m2 for males and > 27.3 kg/m2 for females) without other risk factors for cardiovascular diseases (smoking, hypertension, diabetes and lipid abnormalities) and in 20 lean controls (BMI < 25 kg/m2 for males and < 24.7 kg/m2 for females). Both groups were matched for gender, age and body height. BAR density was evaluated according to Böyum and De Blasi methods. Plasma catecholamines by high perfusion liquid chromatography and fasting immunoreactive plasma insulin (IRI) levels by RIA were also measured. Casual (c) and 24 h ambulatory mean blood pressure (MBP/24h) were determined. Radionuclide angiocardiography was used to measure left ventricular ejection fraction (LVEF), peak filling rate (PFR), time to PFR (tPFR), cardiac output (CO) and stroke volume (SV). Total left ventricular mass (LVM), indexed for height (LVM/H), left ventricular diastolic dimension (LVDD) and interventricular septal (IVS) thickness by echocardio-graphic study were calculated. LVEF, PFR, BARt, BARs were significantly lower (P < 0.0001) and plasma IRI, CO, SV (P < 0.0001), LVM (P < 0.003), LVM/H (P < 0.004), LVDD (P < 0.02) and tPFR (P < 0.02) were significantly higher in obese subjects than in lean controls. BARt and BARs correlated inversely with BMI, SV and LVDD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[The effects of terazosin hydrochloride and buflomedil in patients with hemicrania without aura].

Considering the pharmacologic properties of terazosine and buflomedil, the authors postulated a prophylactic activity of these drugs for paroxysmal headache in migraine patients without aura. Therefore, in an open trial, 46 such patients were subdivided into three groups, the first of which (10 patients) was treated with terazosine, the second (29 patients) with buflomedil, and the third (7 patients) with both drugs according to a previously elaborated protocol with periodical assessment of the M.I.C. (Migraine Index Corrected). At the end of the treatment period, statistically evaluated M.I.C. variations appeared to indicate that buflomedil had better therapeutic activity than terazosine and the terazosine-buflomedicl combination. Finally, the authors discuss some hypotheses in the attempt to account for the mechanism of action since the lesser therapeutic effect of the combination compared to buflomedil alone cannot be reasonably explained.

Adolescent↗

Effects of captopril on myocardial protection during cardioplegia.

UNLABELLED: The study aimed at checking effects exerted by captopril (C) on human myocardial ACE system as well as the role played by tissue ACE inhibition in reducing reperfusion damage. A human experimental model was used during cardioplegia due to aorto-coronary-by-pass (CABG). Fifty-four patients with coronary artery disease affecting 3 vessels having suffered from acute myocardial infarction anterior (AMI-ant), homogeneous as far as ejection fraction (35-55%), number of grafts (3), clamping time, age and sex, were randomised in a double blind experiment, and were given captopril or placebo (P). A total of 4 mg/l Captopril was mixed into the cardioplegic solution with blood according to the method of Buckberg (Buckberg GD. J Thorac Cardiovasc Surg 1987; 93: 127-139). Eight samples (blood/perfusate) were obtained from each patients and norepinephrine (NE), epinephrine (E) were assayed using an HPLC technique. Angiotensin I was assayed by RIA. CK was also assayed (units/ml). Blood/perfusate samples were taken during CABG: (1) pre-pump; (2) pump sample; (3) pump preclamping; (4) coronary sinus; (5) coronary sinus sample during reperfusion; (6) coronary sinus during warm reperfusion; (7) after clamping sample; (8) after decanulation; RESULTS: Captopril group (29 patients): angiotensin I: (1) 8.15; (2) 7.0; (3) 7.31; (4) 8.45; (5) 8.93; (6) 8.73; (7) 9.07; (8) 9.40; versus placebo: (1) 7.09, (2) 7.43; (3) 7.80; (4) 9.31; (5) 9.01; (6) 8.35; (7) 8.85; (8) 8.07 ng/ml, probability, not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin I↗

Effects of amlodipine on renal haemodynamics in mild to moderate hypertensive patients. A randomized controlled study versus placebo.

In this study the efficacy and safety of short-term amlodipine administration on renal haemodynamics were evaluated in mild to moderate hypertensive subjects. Our final goal was to evaluate whether the reduced blood pressure induced by treatment was associated with maintenance of renal function. After a run-in period with placebo, 30 hypertensive patients without cardiac or renal diseases were randomly allocated to a double-blind 4 weeks controlled study with amlodipine 10 mg once a day (15 patients) or placebo (15 patients). Renal haemodynamic measurements included effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) by radionuclide study using 131I-hippuran and 99mTc, with methods described by Schlegel and Gates, respectively. In addition, effective renal blood flow [ERBF = ERPF/(1-Ht)], filtration fraction (FF = GFR/ERPF) and renal vascular resistance (RVR = MBP x 80/ERBF) were calculated. Plasma renin activity (PRA), serum aldosterone (ALD) and urinary excretion of sodium (NaU) were evaluated. At the end of amlodipine administration a significant decrease (P < 0.001) in SBP, DBP and MBP from baseline values was observed. A significant decrease (P < 0.01) in RVR and significant increases (P < 0.05) in ERPF, ERBF and in NaU were also found, without relevant changes in GFR, FF, PRA and ALD. No significant variation in clinical and renal measurements was observed in the placebo group. No relevant side effects were observed in either group. In conclusion, amlodipine was effective in lowering blood pressure in mild to moderate hypertension and exerted favourable effects on renal haemodynamics and function.

Adult↗

Left ventricular diastolic filling alterations in subjects with mitral valve prolapse: a Doppler echocardiographic study.

To assess left ventricular diastolic filling in mitral valve prolapse (MVP), we studied 22 patients with idiopathic MVP and 22 healthy controls matched for sex, age, body surface area and heart rate. A two-dimensional, M-mode and Doppler echocardiographic examination was performed to exclude any cardiac abnormalities. The two groups had similar diastolic and systolic left ventricular volumes, left ventricle mass and ejection fraction. Doppler measurements of mitral inflow were: E and A areas (the components of the total flow velocity-time integral in the early passive period of ventricular filling, E; and the late active period of atrial emptying, A), the peak E and A velocities (cm.s-1), acceleration and deceleration half-times (ms) of early diastolic rapid inflow, acceleration time of early diastolic flow (AT), total diastolic filling time (DFT) (ms), and the deceleration of early diastolic flow (cm.s-2). From these measurements were calculate: peak A/E ratio (A/E), E area/A area, the early filling fraction, the atrial filling fraction, AT/DFT ratio. All the Doppler measurements reported are the average of three cardiac cycles selected at end expiration. The mean peak A velocity, A/E velocity ratio, deceleration half time and atrial filling fraction were each significantly higher for subjects presenting a MVP (60 +/- 12 cm.s-1 vs 49 +/- 14, P < 0.008; 98 +/- 13% vs 64 +/- 12%, P < 0.0001; 120 +/- 36 ms vs 92 +/- 11, P < 0.002; 0.45 +/- 0.14 vs 0.36 +/- 0.08, P < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Obesity, hypertension and atherosclerosis.

Hypertension and obesity are associated with an increased risk of clinical cardiovascular complications due to atherosclerosis. Moreover has been reported that hypertension may predispose to atheroma development. In the present review some common aspects to hypertension and atherosclerosis including smooth muscle cell proliferation, endothelial damage and intervention of growth factors have been analyzed. Additional data have to be provided to explain if the connections between hypertension and atherosclerosis could be considered two effects with one unknown cause. In addition some aspects related to obesity and atherosclerosis have been dissected. In particular we have reported our results indicating that young obese subjects without risk factors for cardiovascular disease have already several markers of cardiovascular damage i.e. atherogenetic lipid pattern, pro-thrombotic and hypofibrinolitic pattern without sign of coagulation and/or platelet in vivo activation, increased plasma endothelin and catecholamine values, rised fasting and after OGTT insulin levels. In view of this more extensively data have to be necessary to support the opinion that obesity and atherosclerosis could be two associated conditions evolving during the time to develop cardiovascular disease or events.

Adult↗

Diabetes, hypertension and atherosclerosis: pathophysiological role of intracellular ions.

The clinical coincidence of hypertension, obesity and non insulin diabetes mellitus (NIDDM) has long been recognized. Increasing interest has also been recently focused on the possible role of insulin and insulin resistance in mediating this association. There is also evidence that hyperglycemia per se may have a role in the pathogenesis of hypertension and atherosclerosis in NIDDM patients. Glucose is a determinant to cellular ion homeostasis, promoting an increase of intracellular calcium and suppressing intracellular free magnesium and pH. Moreover, hyperglycemia promotes glycosilation of proteins and the consequent accumulation of advanced glycosilation end products in tissues. It has recently been suggested that iter is a cellular ionic basis for the clinical and epidemiological linkage of hypertension, left ventricular hypertrophy (LVH), obesity and non insulin dependent diabetes mellitus (NIDDM). These clinical conditions may be different expressions of a common underlying defect in ion handling, displayed by elevated cytosolic free calcium and suppressed free magnesium levels. Therapeutically, reversal of this excess free calcium accumulation and/or free magnesium deficit with ion specific agents, such as calcium channel blocker drugs, may thus ameliorate not only the elevated blood pressure of hypertension but also the concurrent cardiac, vascular and metabolic aspects of the hypertensive states.

Arteriosclerosis↗

[Captopril administration before thrombolysis in patients with an acute myocardial infarct: a pilot study of the short- and long-term effects].

Several experimental studies, carried out on animals and on isolated heart, showed that captopril can reduce the post-ischemic reperfusion injury. Our study was aimed at checking the effects of captopril before thrombolysis in acute myocardial infarction (AMI) and included 204 patients, hospitalized within 4 hours from the onset of symptoms. Patients were randomly subdivided into 2 groups: the first group (105 patients, Group A: pretreatment) received 6.25 mg captopril orally about 15 min before iv administration of urokinase (2 million), the second group (99 patients, Group B: late-treatment) received captopril about 3 days after thrombolytic treatment. Captopril doses were later increased in both groups according to blood pressure. All patients were subdivided according to the localization of infarction. One hundred and thirty-seven patients showed anterior AMI (70 from Group A and 67 from Group B); 67 patients showed inferior AMI (35 from Group A and 32 from Group B). Ventricular hyperkinetic arrhythmias (VHA) due to reperfusion were evaluated during the first 2 hours. Ventricular hyperkinetic arrhythmias occurred in 11.4% of patients with anterior AMI in Group A versus 38.8% in Group B (p < 0.001). CK peak normalization time in the group with anterior AMI was achieved after 58 +/- 2 hours in Group A versus 72 +/- 2 hours in Group B (p < 0.01). Late arrhythmias, > Lown's class 2 was found to occur in 15.7% of patients with anterior AMI of Group A versus 32.8% in Group B (p < 0.05), at predischarge Holter test. One hundred and nineteen patients underwent a hemodynamic test about 3 weeks after AMI.(ABSTRACT TRUNCATED AT 250 WORDS)

Captopril↗

Double-blind controlled study of rilmenidine versus hydrochlorothiazide in mild hypertension: clinical and renal haemodynamic evaluation.

Clinical and renal haemodynamic parameters were evaluated in 20 mild hypertensive patients after rilmenidine (RIL) administration during a one month double-blind randomised study compared with hydrochlorothiazide (HCT). At the beginning and at the end of the study, BP, heart rate and renal haemodynamic parameters were evaluated. Renal haemodynamic parameters included effective renal plasma flow (ERPF) evaluated by radionuclide study utilising 131I-Hippuran according to Schlegel's method, effective renal blood flow (ERBF = ERPF/(1-Ht)), glomerular filtration rate (GFR) by creatinine clearance, filtration fraction (FF = GFR/ERPF) and renal vascular resistances (RVR = DBP x 80/ERBF). RIL and HCT significantly (P < 0.01) reduced systolic, diastolic and mean blood pressure without relevant change in ERPF, ERBF, GFR and FF. RVR was significantly reduced both in the RIL group (P < 0.002 vs. baseline) and in the HCT group (P < 0.001 vs. baseline). No relevant side-effects were observed in either group. In conclusion, rilmenidine was effective in reducing BP in mild hypertensive patients and produced favourable effects on renal function.

Adult↗