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Biomedical subjects

M Dallocchio

Publications and source records attributed to M Dallocchio.

At least 127 records · Page 7Linked to original sources

[Electrophysiological properties of acute intravenous sotalol in man].

The electrophysiological properties of of 0,6 mg/Kg SOTALOL administered intravenously were studied in 15 subjects aged between 32 and 81 years. The following parameters were recorded: sinus rate (SR), corrected sinus node recovery time (SNRT), sinoatrial conduction time (SACT), PA interval, right atrial effective refractory period (ERP), right atrial functional refractory period (FRP), AH interval at rest, at 100 bpm, Luciani-Wenckebach point (LWP), AV node ERP and FRP, HV interval, His-Purkinje ERP, right ventricular ERP, corrected QT interval. At this dosage, intravenous SOTALOL displays two types of behaviour: --That common to the betablocker drugs: slowing SR by 16%, increasing the AV nodal conduction, increasing the AH interval at rest (5%), at 100 bpm (23%), increasing AV nodal ERP (26%) and FRP (20%), decreasing the LWP (18%). --Other properties: increasing intraatrial PA interval (3%), increasing right atrial ERP (II%), FRP (I7%), increasing right ventricular ERP (8%), increasing His-Purkinje ERP (when measurable) (about 6%), no change in corrected QT interval. At this dosage, SOTALOL exhibits electrophysiological behaviour similar to drugs in Class III (Touboul): those with a "wide electrophysiological spectrum".

Adult↗

[Two dimensional echocardiography. Its main clinical applications (author's transl)].

The authors, who have experience of more than 1500 bidimensional echocardiographic recordings, underline the rapidity, safety and value of the method in cardiovascular disorders. The two-dimension echo provides better evaluation of the mitral area, right cavities and tricuspid valves. It is very sensitive in detecting mitral valve prolapse, pericardial effusion, intracavitary tumours and dissecting aneurysms and permits a detailed study of abnormal segmental contractions in ischaemic heart disease. Spatial and dynamic visualization coupled, if required, with contrast echocardiography is also of considerable help for the diagnosis of congenital cardiopathies.

Aortic Dissection↗

[Changes in left ventricular filling in obstructive cardiomyopathies during long term beta blockade].

Left ventricular filling was studied by echocardiography and cineangiography in 37 patients with hypertrophic cardiomyopathy with obstruction before and during long-term oral beta blockade (166 +/- 61 mg propranolol for 15.6 +/- 21 months on average) in order to determine the mechanism of symptomatic improvement in these patients. This study confirmed that clinical improvement is related to a great degree to the improvement in the parameters of left ventricular filling. In addition, two groups of patients may be identified: the "reactors", that is to say the patients who remained or became asymptomatic, characterised by a significant improvement in the indices of left ventricular filling (maximum filling velocity p < 0.01, duration of rapid filling p < 0.05, left ventricular compliance--volumic kGaasch p < 0.001, parietal ks Mirsky p < 0.01). The "non-reactors" were characterised by very poor indices of left ventricular filling. These abnormalities are principally related to severe and irreversible changes in left ventricular and mitral valve morphology.

Adrenergic beta-Antagonists↗

[Atrial myxoma. Changes in clinical and paraclinical data. Apropos of 17 cases].

The clinical data and presenting signs of 17 cases of atrial myxoma (14 left atrial, 3 right atrial myxomas) were analysed. The aim of the study was to assess changes in the presenting features since the introduction of non-invasive methods of cardiovascular investigation. Two groups of patients were identified according to whether the tumour has been diagnosed before (Group A) or after (Group B) the advent of echocardiography. The diagnosis of cardiac tumour, especially myxoma, has become easier with echocardiography and radio-isotope techniques. The presentation of myxoma, recognised earlier, has changed; the features of advanced valvular disease with resistant heart failure are no longer seen. Variable, atypical clinical signs are now encountered (syncope, pyrexia of uknknown origin, transient ischaemic attacks). The average delay between the first sign and diagnosis was 30 +/- 32 months in Group A, compared to 4,6 +/- 6,5 months in Group B (p < 0, 005). Of the 7 patients in Group B, three had normal cardiac auscultation, and normal ECG, and four had normal ESRs. The diagnosis of myxoma should be considered at the least doubt and an echocardiographic examination, preferably with 2-dimensional echo should be requested. It not only allows positive diagnosis but also orientates the patient to surgery without further investigation.

Adolescent↗

[Comparison of mono and bidimensional echocardiography in the diagnosis of atrial myxoma].

The diagnosis of atrial myxoma, the most common cardiac tumour, has been greatly facilitated by the introduction of echocardiography. The principal echocardiographic features and the diagnostic pitfalls encountered in a personal series of 7 atrial myxomas (5 left and 2 right) studied by M mode and 2-dimensional echocardiography are reported. In M mode, left atrial myxoma is a relatively easy diagnosis when the tumour prolapses into the mitral orifice. On standard mitro-aortic scanning, it is recorded behind the anterior mitral leaflet as a mass of abnormal echos appearing shortly after mitral valve opening. The diagnosis is much more difficult or even impossible in nonprolapsing tumours. Right atrial myxomas, prolapsing into the tricuspid orifice, do not usually pose any diagnotic problems. 2-dimensional echocardiography shows its superiority in the early diagnosis of small, localised, relatively immobile and non-prolapsing tumours. The parasternal (long axis and transverse views), the apical (4 and 2 chamber views) and subxiphoid positions were the most useful incidences and the tumour was visualised as a more or less circumscribed mass of echos. In all cases, 2-dimensional echo provided information on the size, mobility, insertion and the length of the pedicle of the tumour. Atrial myxoma is being recognised more easily and more often nowadays by echocardiography, the diagnostic method of choice, and 2-dimensional studies should be preferred.

Adult↗

[Severe ventricular arrhythmia following parenteral administration of vincamine. Predisposing factors in 6 cases].

Six patients developed ventricular arrhythmias with parenteral administration of vincamine. Direct intravenous injection was the mode of administration in 2 cases, intravenous infusion in 3 cases (one at very high dosage) and intramuscular injection in 1 case. The same signs of toxicity were observed in al patients:--5 patients had recorded attacks of "torsades de pointe", which recurred in 1 of them when the drug was restarted.--1 patient had syncope and, although an ECG was not recorded at the time, an ECG shortly afterwards showed a long QT interval and R/T ventricular extrasystoles. Symptoms were generally neurological in nature with syncope, cyanosis, and convulsions. Spontaneous regression was observed in 3 cases but in the others the drug had to be stopped and cardiopulmonary resuscitation instituted. None of our patients died of their arrhythmia. In some patients a predisposing factor was found:--metabolic: hypokalaemia (1 case), moderate reduction of potassium pool (1 case), severe reduction of calcium pool (1 case);--pharmacological: previous treatment with fenoxidil (1 case), thioridazine (1 case);--cardiac: congenital long QT interval (Romano-Ward) (1 case), revealed by vincamine administration. Chronic obstructive airways disease with right ventricular strain and atrial fibrillation (1 case) which might have predisposed the patient to "torsades de pointes". Three patients had no predisposing factors apart from their age. "Torsades de pointes" occurred in a pacemaker patient, but pacemaker function was normal. These six cases may be grouped with the other ten or so cases of vincamine toxicity already reported; they carry and additional warning on the use of intramuscular vincamine. Vincamine toxicity is probably a direct effect on the myocardial cells. This fact merits verification by further electrophysiological studies.

Aged↗

[Recurrent acute pericarditis. 20 cases].

62 of 100 cases of acute pericarditis observed over 15 years were so-called acute benign pericarditis. 20 of these patients (30%) had multiple relapses. Relapse could not be predicted. The interval between the initial affection and first relapse was usually more than one month (18/20). Each relapse was accompanied by pain, fever, ST-T changes, slight cardiomegaly and acceleration of the ESR. Corticotherapy appeared to be responsible for relapse in 13 cases. In 6 cases the eradication of a deep septic focus prevented further relapses. In two cases the duration of anti-inflammatory therapy was thought to have been insufficient. Antibiotic therapy did not seem to be a provocative factor. Relapses may be numerous (10 to 12) and prolonged (24-36 months) especially in the corticodependant forms in which steroids should be tailed off gradually according to a strict protocol.

Acute Disease↗