Search PubMed⌕ Search

Biomedical subjects

G P Sanna

Publications and source records attributed to G P Sanna.

At least 19 recordsLinked to original sources
PubMed2001

Absence of slowest oscillations in short term heart rate variability of post-myocardial infarction patients. GISSI-3 arrhythmias substudy. GISSI-3 Arrhythmias Substudy Investigators.

Despite the widely demonstrated association of reduced heart rate variability (HRV) to bad prognosis after myocardial infarction (MI), reference values for HRV parameters are still not available. The GISSI-3 Arrhythmias Substudy studied short-term HRV in a relatively unselected population of patients (324) with recent MI (13 +/- 7 days) providing the statistical description of the main time and frequency domain parameters. All HRV indices, except for the RR interval, showed a non-normal distribution generally skewed around the lowest values. Particularly, no LF power was detected in 75 patients (23%) by power spectral analysis. The absence of LF oscillation in RR spectra was associated to the lower standard deviation of normal RR intervals (SD), aging (> 65 years) and blood pressure hypertension. This result seems to indicate a paradoxical effect of sympathetic overactivity in post-MI patients.

Aged↗
PubMed2000

Spectral and bidirectional filters give different results for signal-averaged ECG analysis in patients with postmyocardial infarction. GISSI-3 Arrhythmias Substudy Investigators.

This study aims at assessing the specific effects of bidirectional filters (BF) and spectral filters (SF) on signal-averaged ECG (SAECG) analysis. The GISSI-3 Arrhythmias Substudy collected SAECGs of 598 patients 10 +/- 4 days after myocardial infarction (MI) from 20 Italian coronary care units. BF and SF were applied on 340 and 258 patients, respectively. QRS duration (QRSD), low amplitude signal duration (LAS40), and root mean-square-voltage (RMS40) were measured with filters set at 40 to 250 Hz. For ventricular late potentials (VLP) detection filter-specific criteria were adopted: QRSD > 114 ms, LAS40 > 38 ms, RMS40 < 20 microV for BF and QRSD > 120 ms, LAS40 > 38 ms, RMS40 < 20 microV for SF. VLP were considered present if any 2 of the criteria were met. The QRSD obtained by BF (100.6 +/- 13 ms) was shorter (P < .0001) than that obtained by SF (109.1 +/- 12 ms). Nevertheless, a higher prevalence of VLP for patients with BF than for patients with SF was found (23.8% vs 16.7%; P < .04). Indeed, filter-specific criteria were able to avoid any differences in the prevalence of abnormal QRSD and LAS40, but not of RMS40 (25.6% vs 17.1%, P < .02). Finally, the difference of VLP prevalence was mainly owing to the higher number of abnormal pairs of RMS40 + LAS40 (58% vs 44%) for BF than for SF. This multicentric study suggests that after MI, BF and SF produce discordant results on low-amplitude signals of filtered QRS that are not avoided by adopting filter-specific criteria. On the contrary, specific criteria seem to be suitable for comparison of QRSD between different SAECG devices in post-MI patients.

Action Potentials↗
PubMed1989

Hodgkin's disease presenting in 1 of 4 siblings affected by hereditary spinocerebellar ataxia: clinical, immunological and genetic study.

One of 4 siblings affected by hereditary spinocerebellar ataxia (HSCA) of Marie's type developed Hodgkin's disease (HD): the stage was IV B, the patient was submitted to conventional chemo- and radiotherapy and achieved complete remission. An accurate clinical, genetic and immunological study was carried out on all his family, including a complete HLA typing, a chromosome study, the immunophenotyping of peripheral blood mononuclear cells (PBMC), the PBMC response to polyclonal mitogens, to interleukin 2 (IL-2), to the association of PHA + IL-2 and the evaluation of the IL-2 receptor expression. No association was clearly demonstrable between an HLA haplotype and HSCA, while the patient with HSCA and HD was HLA-B18- and DQw3-positive (the last at homozygous level), two antigens known to be strongly associated with HD, mainly among the Sardinian ethnic group. The mode of inheritance of HD susceptibility is however completely different from that of Marie's HSCA. The chromosome study did not show any characteristic pattern of the karyotype, neither of the HSCA affected nor of the unaffected members. The immunological investigations did not elucidate any characteristic behavior of the family members, apart from the typical findings of HD seen on patients with HSCA and HD. Our study could not demonstrate any genetic and/or immunologic common background shared by the two diseases, HSCA and HD. Their coexistence in our patient, although the statistic probability is very low, seems to be a fortuitous coincidence more than the result of a common genetic and pathogenetic mechanism.

Adult↗
PubMed1986

[Value of Holter's dynamic ECG a as predictor of the effectiveness of anti-arrhythmia therapy].

Holter/exercise approach has been designed to evaluate and predict the efficacy of the antiarrhythmic therapy. Acute drug testing permit to identify drug responders to effective antiarrhythmic agents. So far only one group has reported the long-term outcome of patients managed using this approach. Patients with malignant ventricular arrhythmias in which efficacy was achieved had better chance of surviving during follow-up than did the nonresponder patients (3 year mortality 14% vs 84%). In addition to acute drug testing chronic trials have been undertaken in order to evaluate the efficacy of drugs. Long-term Holter evaluation of antiarrhythmic therapy has to face the problem of the spontaneous changes in VPD frequency mimicking drug efficacy. To overtake these considerable variations a critical suppression is required in 24 hour Holter. One group has reported the long-term results in 124 drug trials performed in arrhythmic patients. Cumulative probability of survival at 12 months was 0.93 for "responders" and 0.64 for "nonresponders" (p less than 0.005). New perspective trials have now been undertaken. Long-term Holter evaluation of antiarrhythmic therapy has to recognize the problem of "proarrhythmic effect" of antiarrhythmic agents which in ambulatory monitoring has been observed cumulatively in 9% of the treated patients.

Administration, Oral↗
PubMed1984

New drugs in the management of ventricular arrhythmias.

New antiarrhythmic drugs are chiefly assigned to Class 1C and 1B: "procainamide analogues" (acecainide, lorcainide, flecainide, encainide) and propafenone for the former, and mexiletine, tocainide and aprindine for the latter. Pharmacokinetics vary widely among the different antiarrhythmic agents. These and other problems which regulate therapeutic interventions, such as patient compliance, drug interactions, efficacy/toxicity ratio, drug combinations, and drug monitoring with plasma concentrations of antiarrhythmic agents are briefly considered.

Acecainide↗
PubMed1982

[Clinical study evaluated by Holter monitoring and by mexiletine serum levels in ventricular arrhythmias].

Three normal individuals and 17 cardiac patients with frequent VPBs were given mexiletine orally for 5 days (400-1000 mg daily in two to five doses). Each patient was evaluated by means of 24-hour Holter monitoring before treatment, on the fifth day and 4 days after the drug was discontinued. In 15 patients mexiletine serum levels were measured before and 2 hours after the first dose given in the morning. Urinary pH was also measured. VPBs were reduced by an average of 67.6%; in 11 patients the VPBs decreased by 92.3%. After treatment was discontinued, VPBs increased by 2.6%. Serum levels of the drug were generally within the therapeutic range (1.05 +/- 0.39 mcg/ml). We conclude that mexiletine is effective in reducing the number of VPBs; Holter monitoring and serum level measurements are both clinically helpful.

Administration, Oral↗