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Biomedical subjects

O Parodi

Publications and source records attributed to O Parodi.

At least 109 records · Page 6Linked to original sources
PubMed1983

Improved diagnostic yield of radionuclide angiography by quantitative phase analysis during resting angina and following isosorbide dinitrate.

The reliability of quantitative phase analysis of radionuclide angiography in the detection of wall motion abnormalities has been investigated in 15 patients with angina at rest. All patients have been studied in the basal state, during spontaneous or ergonovine-induced ischemia and following isosorbide dinitrate acute i.v. administration in the resolution phase. Quantitative phase analysis provided a more sensitive index of impaired wall motion as compared to global ejection fraction changes. Isosorbide dinitrate rapidly and completely solved ischemic dyssynergies caused by coronary vasospasm.

Adult↗
PubMed1982

Long-term effectiveness of verapamil in stable and unstable angina pectoris. One-year follow-up of patients treated in placebo-controlled double-blind randomized clinical trials.

The clinical responses to 12 months' treatment with verapamil were evaluated in 63 patients with stable and unstable angina pectoris in whom the effectiveness of verapamil had been established in short-term double-blind placebo-controlled randomized clinical trials. In 41 patients with effort-related angina, long-term responses were sustained for periods exceeding 1 year. Twenty patients were evaluated by clinical history and showed a sustained reduction in frequency of anginal attacks and consumption of nitroglycerin with verapamil compared with the initial placebo control periods; the magnitude of this benefit was similar to that observed during double-blind treatment with the drug. Twenty-one patients were evaluated by serial treadmill exercise testing and showed a sustained improvement in exercise duration after 4, 8, 16, 24, and 52 weeks of verapamil treatment; withdrawal of the drug resulted in a deterioration of exercise performance to levels similar to those seen before initiation of therapy. In 22 patients with unstable angina at rest, verapamil produced an amelioration of anginal symptoms that was sustained in most patients for longer than 1 year. However, these patients continued to have a high incidence of death and myocardial infarction in a frequency similar to that previously reported in large clinical studies using either combinations of verapamil and nitrates, nifedipine and propranolol, or propranolol and nitrates. Calcium-channel antagonists may decrease the number of patients requiring coronary artery bypass surgery for relief of refractory angina, but they do not appear to alter the natural history of the disease.

Adult↗
PubMed1982

[The role of spasm in angina pectoris, myocardial infarction and sudden death. Indications for future research and treatment].

Recent concepts on the role of coronary artery spasm and other forms of vasoconstriction in coronary artery disease are studied with particular reference to episodes of transient ischemia and their therapeutic implications. The possible contribution of spasm and other obstructive mechanisms such as platelet agregation, to the different forms of angina, myocardial infarction and sudden death, is analysed in the light of clinical observations, some of which have not previously been reported. Based on these concepts and clinical considerations, new orientations for future research and treatment are suggested. In our series, long term treatment of coronary artery disease with the association of nitrate derivatives are suggested. In our series, long term treatment of coronary artery disease with the association of nitrate derivatives and calcium antagonists has led to a reduction in mortality and in the incidence of myocardial infarction over periods ranging from 2 to 4 years.

Angina Pectoris↗
PubMed1982

[Myocardial imaging with 99mTC albumin microspheres for the simultaneous assessment of contraction and perfusion in man].

Radiolabeled human albumin microspheres (HAM) have been used in the past, in order to visualize coronary flow distribution in man. In order to obtain information both on myocardial perfusion and contractility, we applied R-wave synchronized reconstruction of the cardiac cycle in cine mode to HAM imaging. In 20 patients with angina pectoris and coronary stenosis of variable severity and in 1 patient with congestive cardiomyopathy we injected 4 millions of HAM (mean diameter 15 microns) labeled with 15-20 mCi of 99mTc, into the left ventricle during routine cardiac catheterization. Data were collected by a gamma camera, and by the use of a high resolution collimator and were electronically restricted to the cardiac area (64 X 64 matrix). The reconstruction of the cardiac cycle was made according to the technique developed in our laboratory for gated blood pool imaging. From the displayed images we evaluated myocardial flow distribution at the time of injection and regional wall motion (by cine mode) at any subsequent time, with a temporal resolution of 2 to 4 mins. The patterns of contractility of myocardial walls with normal or reduced perfusion were in agreement with those observed by means of contrast ventriculography. Advantages of the technique are: a) simultaneous information on flow and contractility; b) prolonged time for wall motion observation (4 to 6 hours); c) high quality pictures, since the signal to background ratio is much more favourable than with other isotope techniques. The technique appears to be promising from the results obtained in the number of patients included in this study.

Adult↗
PubMed1981

Increased fibrinopeptide A formation and thromboxane A2 production in patients with ischemic heart disease: relationships to coronary pathoanatomy, risk factors, and clinical manifestations.

In 98 patients with ischemic heart disease (IHD), independent of their clinical status (previous myocardial infarction, spontaneous angina or effort angina), a hypercoagulable state (indicated by significant elevation of fibrinopeptide A plasma level) and an increased platelet biologic activity were observed. Moreover, plasma fibrinopeptide A concentration and platelet aggregation were remarkably higher in patients with frequently occurring spontaneous clinical manifestations (active disease) than in IHD patients with relatively quiescent symptoms. Abnormalities of blood clotting and platelet changes were not significantly altered by the presence of severity of coronary angiographic fixed obstruction in IHD. Multiple regression analysis indicated that hypercoagulability and increased platelet biologic activity were not a consequence of differences in risk factor patterns in IHD patients compared to control subjects.

Blood Coagulation↗
PubMed1981

[Comparison between M-mode echocardiography and 201thallium myocardial scintigraphy for diagnosis of transient myocardial ischemia (author's transl)].

Purpose of this study was to evaluate the capability of M-mode echocardiography (M-mode) and of 201Thallium myocardial scintigraphy (201T1) to detect transient myocardial ischemia at rest in man. Fourteen male patients (pts) were studied by the two techniques under basal conditions and during episodes of angina at rest. Data were obtained in 2 pts in rapid succession during the same episode, in the remaining 12 pts in different episodes with electrocardiographic changes similar in site, type, entity and duration. Echocardiographic criteria of transient ischemia (reversible asynergies and transient reduction of systolic thickening) were present in 9/11 pts during episodes of ST segment elevation; the scintigraphic ones (reversible perfusion defects) in 10/11 pts. In 3 pts during episodes of ST segment depression M-mode was positive in 2, 201T1 in all three. The poor acoustic window in 2 pts and the involvement in one of left ventricular lateral wall not seen by M-mode on parasternal approach, may account for the 3 false negatives of M-mode. The single false negative of 201T1 can be related to the short duration (1') of the episode. A complete correspondence of site of ischemia, detected by ECG, M-mode and T1, was observed. In conclusion, M-mode appears a reliable technique for detecting transient ischemic episodes, being the main limits the acoustic window and the incapacity in exploring all ventricular walls and the main advantage the high temporal resolution, which permits to study continuously the full sequence of the ischemic event. On the other hand 201T1 does not allow detection of episodes of short duration. This two techniques, when combined in anginal patients, provide complementary information on perfusion and contraction respectively. The reliability of these techniques in the assessment of transient myocardial ischemia is the basis for their possible diagnostic use in pts with transient specific ECG changes or with typical anginal pain without ECG evidence of ischemia.

Adult↗
PubMed1980

Thallium-201 scintigraphy for diagnosis of old myocardial infarction: comparison with electrocardiographic, ventriculographic, and coronary arteriographic findings.

Myocardial scintigraphy with 201Tl was performed at rest in a selected group of 36 patients with unequivocal clinical and electrocardiographic evidence of old myocardial infarction. The scintigraphic findings were correlated with electrocardiographic pattern, and with regional left ventricular wall motion and the severity of coronary artery disease defined by contrast angiography. Detection was dependent on the extent of the infarct but was independent of QRS morphology and of the severity of coronary disease. When positive, 201Tl scintigraphy was often a more precise method than the electrocardiogram for localising and delineating the extent of the infarct. Furthermore, the perfusion defect corresponded in location and extent to abnormalities of left ventricular wall motion. The site or severity of coronary artery disease could not be determined from the 201Tl scintigram.

Adult↗
PubMed1980

[Hemodynamic effects of dobutamine in patients with severe low-output heart failure (author's transl)].

We studied the hemodynamic effects of dobutamine in 10 patients with severe chronic heart failure due to congestive cardiomyopathy in 5, to ischemic heart disease in 4 and to hypertensive cardiomyopathy in 1. Dobutamine was injected during three periods of 30 min each alternated with equal periods of placebo at doses of 2,5-5 and 7,5 mcg/Kg/min respectively. The most favorable hemodynamic effects, obtained at an infusion rate of 5 mcg/Kg/min, was characterized by a significant inn 4 and to hypertensive cardiomyopathy in 1. Dobutamine was injected during three periods of 30 min each alternated with equal periods of placebo at doses of 2,5-5 and 7,5 mcg/Kg/min respectively. The most favorable hemodynamic effects, obtained at an infusion rate of 5 mcg/Kg/min, was characterized by a significant increase of the cardiac index and of the left ventricle stroke work index, accompanied by a significant decrease of the left ventricular filling pressure and of the systemic and pulmonary vascular resistance. The hemodynamic monitoring showed that the pharmacological effects of the drug subsided about 5-10 min after the interruption of infusion. At the infusion rate of 7,5 mcg/Kg/min we observed a significant increase of premature ventricular beats in 3 patients. We conclude that dobutamine at the dose of 5 mcg/Kg/min shows a powerfull positive inotropic action not accompanied by apparent side effects.

Adult↗
PubMed1979

Management of unstable angina at rest by verapamil. A double-blind cross-over study in coronary care unit.

A therapeutic trial with verapamil, a calcium-antagonist drug, was performed in 12 patients admitted to our coronary care unit because of frequent daily attacks of angina at rest attributed to coronary vasospasm. After a 48-hour run-in period, oral verapamil 480 mg/day and placebo were administered alternately during 4 randomised 48-hour periods. Transient ischaemic attacks with ST segment elevation or depression, with or without pain, were documented by continuous electrocardiographic monitoring. The number of attacks during the run-in and 2 placebo periods were 128, 123, and 130, respectively, and 31 and 23 during the 2 treatment periods (P less than 0.006 and P less than 0.003). This drug therefore appears to be effective in the management of patients with frequent attacks of angina at rest.

Adult↗