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Biomedical subjects

R Gianrossi

Publications and source records attributed to R Gianrossi.

At least 37 records · Page 2Linked to original sources
PubMed1989

Exercise-induced ST segment depression in the diagnosis of multivessel coronary disease: a meta analysis.

To evaluate the variability in the reported accuracy of the exercise electrocardiogram (ECG) for predicting severe coronary disease, meta analysis was applied to 60 consecutively published reports comparing exercise-induced ST depression with coronary angiographic findings. The 60 reports included 62 distinct study groups comprising 12,030 patients who underwent both tests. Both technical and methodologic factors were analyzed. Wide variability in sensitivity and specificity was found (mean sensitivity 81% [range 40% to 100%, SD 12%]; mean specificity 66% [range 17% to 100%, SD 16%]). All three variables found to be significantly and independently related to sensitivity were methodologic (the exclusion of patients with right bundle branch block, the comparison with another exercise test thought to be superior in accuracy and the exclusion of patients taking digitalis). Exclusion of patients with right bundle branch block and comparison with a "better" exercise test were both significantly associated with sensitivity for the prediction of triple vessel or left main coronary artery disease. Adjustment of exercise-induced ECG changes for changes in heart rate was strongly associated with the specificity for critical disease (partial R2 = 0.436, p = 0.0001).

Coronary Angiography↗
PubMed1989

Exercise-induced ST depression in the diagnosis of coronary artery disease. A meta-analysis.

To evaluate the variability in the reported diagnostic accuracy of the exercise electrocardiogram, we applied meta-analysis to 147 consecutively published reports comparing exercise-induced ST depression with coronary angiography. These reports involved 24,074 patients who underwent both tests. Population characteristics and technical and methodologic factors, including publication year, number of electrocardiographic leads, exercise protocol, use of hyperventilation, definition of an abnormal ST response, exclusion of certain subgroups, and blinding of test interpretation were analyzed. Wide variability in sensitivity and specificity was found (mean sensitivity, 68%; range, 23-100%; SD, 16%; and mean specificity, 77%; range, 17-100%; SD, 17%). The four study characteristics found to be significantly and independently related to sensitivity were the treatment of equivocal test results, comparison with a "better" test such as thallium scintigraphy, exclusion of patients on digitalis, and publication year. The four variables found to be significantly and independently related to specificity were the treatment of upsloping ST depressions, the exclusion of subjects with prior infarction or left bundle branch block, and the use of preexercise hyperventilation. Stepwise linear regression explained less than 35% of the variance in sensitivities and specificities reported in the 147 publications. There is wide variability in the reported accuracy of the exercise electrocardiogram. This variability is not explained by information reported in the medical literature.

Coronary Disease↗
PubMed1986

Inhibition of prolactin and aldosterone secretion by the dopamine derivative ibopamine.

In 7 patients with congestive heart failure acute oral administration of ibopamine, a new dopamine derivative, induced a significant decrease in serum prolactin and aldosterone without affecting serum growth hormone or cortisol. The Metoclopramide-induced secretion of prolactin and aldosterone was blunted in 6 patients pretreated with 200 mg ibopamine. The data are consistent with a dopaminergic effect of ibopamine due to a peripheral action, probably on D-2 receptors.

Adult↗
PubMed1985

Humoral immunity and lymphocyte subpopulations in patients with dilated cardiomyopathy.

The incidence of serum organ and non-organ specific autoantibodies, the peripheral blood lymphocyte blastogenic response to phytohaemagglutinin, concanavalin A and pokeweek mitogen, and the surface markers of peripheral T and B lymphocytes were studied in 15 patients affected by coronary artery disease and in 21 patients with dilated cardiomyopathy. In the latter group there was a significantly impaired blastogenic response to concanavalin A with respect to both the normal control group and patients with coronary artery disease (P less than 0.01). The percentage of peripheral blood lymphocytes with cytotoxic/suppressor activity was also reduced in patients with dilated cardiomyopathy in comparison to normal subjects and patients with coronary artery disease (P less than 0.01 and P less than 0.05, respectively). These data may reflect an in vivo defect in suppressor cell function in patients with dilated cardiomyopathy.

Adolescent↗
PubMed1985

Left ventricular thrombus and myocardial infarction.

The aim of our study was to determine whether a relationship existed between echocardiographic evidence of left ventricular thrombus (LVT) and clinical course of myocardial infarction. We followed 143 patients who had had typical myocardial transmural infarction (82 with "anterior") and 61 with "inferior" myocardial infarction) over a three month period. Incidence of LVT, detected by Two-Dimensional Echocardiography (TDE) was significantly greater in subjects affected by "anterior" myocardial infarction (p less than 0.05). Furthermore, the occurrence of LVT was more frequent in the presence of left ventricular a-, dys-kinesis detected by TDE (p less than 0.01). No significant relationship was demonstrated either with the occurrence of severe ventricular arrhythmias (Lown 3-4-5) or with an abnormal stressing test performance. Thus certain clinical and laboratory features such as anterior site of infarction, higher serum level of CPK and CPK-MB and severe alterations of left ventricular kinesis proved to be useful in identifying a subset of patients most likely to have LVT who may benefit from early anticoagulant therapy.

Angina Pectoris↗
PubMed1984

Depression of lymphocyte reactivity by serum from patients with dilated cardiomyopathy.

We have investigated the presence of serum factors (serum inhibitory factor and rosette inhibitory factor) which inhibit the blastogenic response to phytohemagglutinin and E-rosette function of normal lymphocytes in patients affected with dilated cardiomyopathy. We found them to be present in significantly higher levels with respect to a "control disease" group (P less than 0.05) and normal subjects (P less than 0.02). Furthermore, serum inhibitory factors were significantly correlated to the functional class of cardiac failure as evaluated according to the New York Heart Association functional classification (P less than 0.05). There was no correlation between serum factors and other immunological parameters investigated (serum IgG, IgA, IgM, C3 and C4 concentrations, alpha-2-macroglobulin levels). Serum inhibitory factors may affect lymphocyte subpopulations, accounting for a T-suppressor functional defect correlated with greater severity of the disease.

Adolescent↗
PubMed1982

[Evaluation of various cardiovascular parameters during the intravenous administration of ranitidine].

In this paper we evaluated whether a block of cardiac H2 histamine receptors by ranetidine could modify some non-invasive indices of cardiac function: PEP/LVET, heart rate, blood pressure. Five healthy volunteers underwent studies in baseline conditions and 5, 10, 15, 30, 45 minutes following i.v. injections of 1, 5 m/g Kg of ranitidine. None of the studied parameters showed any significant variation at the various time intervals. Ranetidine does not appear to alter the cardiovascular function at the dose we used.

Adult↗
PubMed1982

[Comparative evaluation of the effects of intravenous administration of cimetidine and ranitidine on several cardiovascular parameters].

We have compared the effects of intravenous administration of cimetidine and ranetidine on some cardiovascular parameters. Five healthy volunteers received both cimetidine (3, 5 mg/Kg) and ranetidine (1, 5 mg/Kg). Heart rate, blood pressure and PEP/LVET were recorded at baseline and 5, 10, 30, 45 minutes after administration of both drugs. Intravenous administration of cimetidine and ranetidine did not induce any significant alterations in cardiovascular variables.

Adult↗
PubMed1978

Unchanged thyrotropin and prolactin responses to thyrotropin releasing hormone after indomethacin treatment.

Experimental effects of prostaglandin synthetase inhibitors have been considered in the literature as a clue to the possible interactions of prostaglandins with the hypothalamic releasing hormones at the pituitary level. Some results of the administration to man of these drugs are apparently in contrast with the in vivo and in vitro animal data. The present investigation deals with the comparison between the thyrotropin releasing hormone (TRH) effect on prolactin and thyrotropin when the hormone was administered intravenously at doses of 50, 100 and 200 microgram respectively to three groups of six men (aged 22 to 30 years), before and on the sixth day of indomethacin administration (50 mg orally at 6-hour intervals). No significant change in the releasing hormone effect was observed either in the case of prolactin, where TRH caused a consistently similar release of the hormone at every dose employed, or in the case of thyrotropin, where a dose-dependent releasing effect was obtained before and after indomethacin treatment.

Adult↗