[Comparative analysis of the metabolic parameters of myocardial ischemia in humans].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to G Specchia.
Explore the source record for details and available documents.
Left ventricular contractile function was evaluated in twenty patients with coronary artery disease before and during handgrip by use of Vpm, VCEIO and Vmax (obtained with a simplified calculation) from high-fidelity pressure measurements. In eight patients the response to handgrip was characterized by an increase of the contractile indices accompanied by small changes of left ventricular end-diastolic pressure (not exceeding + 4 mm Hg) and was considered normal. Twelve patients who showed abnormal or pathologic reaction to isometric exercise repeated handgrip after administration of 0.4 mg of spray nitroglycerin. Thus eight patients normalized their response to exercise, while in four we observed again a pathologic reaction to handgrip. It is concluded that is a useful and simple manoeuvre for a better evaluation of left centricular function in patients with coronary artery disease; the repetition of the test after administration of nitroglycerin can be useful in identifying those patients with greatest contractile reserve.
In fifteen patients with coronary artery disease who underwent hemodynamic studies, pressure measurements and left ventricular angiography were performed prior and 5' after the administration of 0.4 mg of spray nitroglycerin (TNG). Two different expressions of left ventricular diastolic compliance (dV/dP - V at end-diastole, delta V/delta P normalized by end-systolic volume-VTS) were assessed in basal conditions and after TNG. Nitroglycerin decreased left ventricular end-diastolic pressure (control 22.7 +/- 7.6 mmHg; TNG 11.4 +/- 6.1 mmHg, p less than 0.001) left ventricular end-diastolic volume (control 138 +/- 54 ml/m2, TNG 122 +/- 54 ml/m2, p less than 0.001) and improved compliance indexes (dV/dP - VED control 1.3 +/- 0.5 10(-2)/mmHg; TNG 4.6 +/- 4.3 10(-2)/MMHg; p less than 0.01; delta V/delta P - VTS control 0.071 +/- 0.04 mmHg-1; TNG 0.170 +/- 0.14 mmHg-1, p less than 0.01). TNG decreased the average value of modulus of chamber stiffness K (control 0.031 +/- 0.009; TNG 0.028 +/- 0.008, p less than 0.02) shifting the pressure-volume curve in some patients rightward and downward. Thus the increase of end-diastolic compliance (dV/dP - VED) is due to preload reduction and in patients who presented a marked decrease in K, also to the shift of the pressure-volume relation. These effects of TNG have important implications because they permit patients with coronary artery disease to engage in a given effort at a significantly lower end-diastolic pressure, avoiding pulmonary congestion.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Fifty patients who suffered from an acute myocardial infarction at age 40 or below and underwent coronary arteriography, were studied from 8 to 184 months after the infarction (mean follow-up 56 months). Hyperlipidaemia (60%) and cigarette-smoking (82%) were the most common risk factors, while hypertension and diabetes mellitus were found in 10% of all patients. Thirty-seven patients had two or more risk factors. Preinfarction angina was present in 7 subjects. Death rate was 14% within five years and was related to the severity of symptoms. Out of the patients with normal coronary arteriogram (6 patients) or with a single vessel disease 21 were free of angina and 30 did not suffer a reinfarction. Out of 17 patients with two or more coronary vessel disease, angina was present in 14 and reinfarction was seen in 5.
Explore the source record for details and available documents.
In 6 patients affected by spontaneous angina with S-T elevation and coronariographic findings of obstruction, intravenous administration of ergonovine maleate determined the same clinical and ECG patterns of spontaneous episodes. The coronary arteriography during pain showed a marked spasm with occlusion of a large coronary vessel in four patients. In 2 patients with atypical chest pain and normal coronariogram, E.M. did not induce pain, ECG abnormality or coronariographic alterations. The role of spasm in spontaneous angina is discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Three cases of peripartum cardiomyopathy (CMP PP) are presented. In our opinion this term is more correct than post-partum cardiomyopathy. The study was performed both clinically and hemodynamically; patients were followed up for a long period (in one case up to 14 years). Although there were consistent differences in the rise and development of the disease, the clinical and laboratory results could be put together clearly. In the light of this clinical experience, a wide revision of the literature on the topic was carried out, using the hypotrophic-hypokinetic forms of cardiomyopathy (congestive) as a comparison with peripartum cardiomyopathy, which seem to be clinically correlated.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Five cases with angiocardiographically diagnosed posterior mitral valve prolapse and without ausculatotory findings of midsystolic click or late systolic murmur were studied with phonocardiographic technique employing pharmacological tests and postural changes. A midsystolic click was thus obtained. Isoprenaline was the must helpful drug to achieve it. The accompanying electrocardiographic and coronarographic features of this syndrome are described and discussed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.