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Biomedical subjects

R Luccioni

Publications and source records attributed to R Luccioni.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Evaluation of the dose-effect relationship of perindopril in the treatment of arterial hypertension].

To evaluate the dose-effect relationship of antihypertensive drugs is essential to a rational determination of their effective dosage. Two double-blind and strictly controlled trials have demonstrated the effectiveness of perindopril 4 mg orally in the treatment of mild to moderate arterial hypertension (100 less than DAP less than 120 mmHg). The drug remained effective 24 hours after the last dose. The 2 mg dose proved insufficient to obtain a significant reduction of blood pressure. In case where the 4 mg dose was not sufficiently active, a better antihypertensive effect could be achieved with an 8 mg dose without major untoward reactions. The antihypertensive activity of perindopril was parallel to the percentage of angiotensin-converting enzyme inhibition induced by the compound. This study also illustrates clearly the value of semi-automatic blood pressure recording with the Dinamap system in the determination of dose-effect relationship, compared with the conventional sphygmomanometric method.

Administration, Oral↗
PubMed1989

Evaluation of the dose-effect relationship of perindopril in the treatment of hypertension.

The evaluation of the dose-antihypertensive effect relationship of a drug is essential for the rational determination of the effective dose. The efficacy and safety of the dose of 4 mg of perindopril in the treatment of mild-to-moderate hypertension were demonstrated by means of two double-blind studies conducted according to a rigorous methodology. This efficacy was still present 24 hours after the last dose of perindopril. The dose of 2 mg appeared to be insufficient to exert a significant antihypertensive effect. In the case of inadequate efficacy of the dose of 4 mg of perindopril, the dose of 8 mg is able to exert a greater antihypertensive effect without any major harmful effects. The antihypertensive efficacy is parallel to the percentage of converting enzyme inhibition induced by perindopril. The contribution of the automated method of blood pressure recording using the Dinamap method to establish a dose-effect relationship with reference to the classical sphygmomanometric method is clearly illustrated.

Adolescent↗
PubMed1988

Evaluation of the dose-effect relationship of a new ace inhibitor (perindopril) by an automatic blood pressure recorder.

Repeated blood pressure recordings by non-invasive devices are of better predictive value than single measurements in the evaluation of antihypertensive treatment. Such a method has been used to establish the dose-effect relationship of perindopril. After a two-week placebo run-in period, 40 patients with essential hypertension (age 56.6 +/- 1.5 years, 31 males, nine females) were treated with placebo or 2, 4 or 8 mg of perindopril once daily for one month following a randomized double-blind design. They were included if at least 75% of diastolic blood pressure recordings, made over an 8 h diurnal period using an automatic blood pressure recorder, were greater than 95 mmHg on placebo. Values (mean +/- SEM) before and after treatment were assessed using analysis of variance. These data showed a significantly greater reduction of blood pressure with 4 mg and 8 mg daily doses compared to placebo and the 2 mg daily dose. Such results were not obtained with blood pressure levels recorded by a mercury sphygmomanometer, confirming the value of an automatic blood pressure recorder as a tool in therapeutic trials.

Adult↗
PubMed1987

Comparative trial of lisinopril and nifedipine in mild to severe essential hypertension.

A total of 136 patients with mild to severe uncomplicated essential hypertension were evaluated in a multicenter, randomized, double-blind, double-placebo, parallel study to compare the effect of lisinopril, a new angiotensin-converting enzyme inhibitor, with that of nifedipine. Following a 2-week placebo control period the patients were treated with either 20-80 mg/day of lisinopril (n = 89) or with 40-80 mg/day of nifedipine (n = 47). Blood pressure was significantly reduced in both groups after 4, 8, and 12 weeks of treatment. There was no difference in the effect of lisinopril compared to nifedipine. No serious clinical or laboratory adverse experiences were observed during the study. The incidence of clinical side effects was significantly lower in the lisinopril group than in the nifedipine group (21.3 vs. 48.9%, p less than or equal to 0.01). There were no significant changes in laboratory data in either group. The results indicate that lisinopril is as effective as nifedipine in the treatment of uncomplicated essential hypertension and that lisinopril is well tolerated and has an acceptable safety profile.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1987

[Analysis of 1,400 blood pressure profiles].

Hypertension may be defined by 3 criteria obtained by indirect, non invasive, automatic measurement of blood pressure using the DINAMAP device analyses the profile obtained over a 12 hour period (one recording every fifteen minutes): percentage of abnormal values (BP greater than 160/95 mm Hg), average values of systolic, diastolic and mean BP, variability (standard deviation of means), The analysis was based on 1,400 profiles recorded from 174 normotensive and 1,226 hypertensive patients. The following observations were made: the largest group was that of patients with predominantly diastolic hypertension under 60 years of age (81.3 p. 100 vs. 18.9 p. 100 systolic hypertension) and predominantly systolic hypertension over 60 years of age (68.9 p. 100 vs. 31.1 p. 100 diastolic hypertension), borderline hypertension (between 1 and 20 p. 100 of pathological values) is observed in 34.5 p. 100 of hypertensive patients under 60 years of age, and 21.8 p. 100 of patients over 60 years of age. This form of hypertension may be managed without drug therapy but requires a control blood pressure profile at least once a year, the other groups of patients were much smaller: pure diastolic hypertension (4.8 p. 100 in the under 60's, 0.6 p. 100 in the over 60's); pure systolic hypertension (1/1,226 cases of hypertension), permanent hypertension (5.7 p. 100 in the under 60's and 4.4 p. 100 in the over 60's), paroxysmal hypertension (2.1 p. 100 in the under 60's and 5.6 p. 100 in the over 60's).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Pharmacokinetics of isosorbide dinitrate and its mononitrate metabolites after intravenous infusion.

Plasma concentrations of isosorbide dinitrate (ISDN) and its two active metabolites 2-isosorbide mononitrate (2-ISMN) and 5-isosorbide mononitrate (5-ISMN) have been measured during and for 6 hr after intravenous infusion at a rate of 2.5 mg/hr during 1.75 hr in six cardiac patients, by a capillary gas chromatographic method. Data were analyzed by simultaneous modeling of the observed kinetics of the three compounds. Two or three phases were detected on the postinfusion ISDN concentration-time curves. ISDN concentrations declined with a mean terminal half-life of 2.81 hr +/- 0.7 SD. The mean systemic clearance of ISDN (2.9 L/min +/- 0.7 SD) and its mean total volume of distribution (259 L +/- 48 SD) were relatively high. Plasma 5-ISMN concentrations were 5- to 6-fold greater than those of 2-ISMN during the whole observation period. Maximum levels of 2-ISMN (6.7 ng/ml +/- 0.9 SD) and of 5-ISMN (27 ng/ml +/- 6 SD) occurred within a few minutes after the end of infusion. The mean half-lives of 2-ISMN (1.59 hr +/- 0.19 SD) and of 5-ISMN (3.78 hr +/- 0.79 SD) estimated by the model were smaller than those calculated by a model-independent method (2.95 hr +/- 0.41 SD and 5.98 hr +/- 2.22, respectively), but were in good agreement with those reported in the literature following separate administration of both metabolites to man. This study shows how such modeling can distinguish between metabolite formation and elimination processes and allow the determination of metabolite half-lives after administration of the precursor drug.

Adult↗
PubMed1986

Long-term follow-up of mitral valve prolapse and latent tetany. Preliminary data.

The association between idiopathic mitral valve prolapse (MVP) and latent tetany (LT) is common, as shown in our previous studies on adults and children. On the basis of our experience with the effects of magnesium salts and/or beta-blockers on the symptoms of such patients, we tried to determine whether this therapy could also modify the left ventricular hyperkinesia (LVH) constantly associated with MVP. After showing the failure of short-term therapy (1-3 months), we found 12 cases treated for more than 1 year, having MVP, LVH and LT. The mean duration of this continuous therapy was 36.5 months (range 12-72 months). 5 men and 7 women (mean age 49; range 28-70) received magnesium salts (pyrrolidone carboxylate 4.5 g/day, lactate 3 g/day) either alone (2 cases) or associated with a beta-blocker (atenolol 100 mg/day, acebutolol 200-400 mg/day, propranolol, 40-160 mg/day; 10 cases). The erythrocyte magnesium was measured before, during and after therapy. All these 12 patients had repeat echocardiography at the end of the treatment. MVP was still present, as was LVH, in 50% of them. Mean erythrocyte magnesium was below the normal range before therapy (43 +/- 6.3 mg/l) and in the normal range after therapy (50.8 +/- 7 mg/l). But no relationship was found between the increase in erythrocyte magnesium and the disappearance or persistence of MVP and LVH. Therefore, the improvement of the patients' clinical status was not always followed by a significant change in erythrocyte magnesium values and in echocardiographic findings, even after long-term therapy.

Adrenergic beta-Antagonists↗
PubMed1985

[Long-term prevention of the recurrence of auricular fibrillation using cibenzoline. Multicenter study apropos of 89 case reports].

The aim of this study was to evaluate the long-term efficacy of cibenzoline in preventing recurrence of atrial fibrillation compared to a reference drug: quinidine arabo-galactane sulfate (QAGS). The two products were administered orally in a double blind multicentre trial to two different groups of patients (96 patients in all) in whom atrial fibrillation had been previously converted to sinus rhythm after having been present for at least 15 days and less than 18 months. The patients were either given four 65 mg gelules of cibenzoline (group I) or four 206 mg gelules of Longacor (group II) and were reviewed systematically after 3 days of treatment, in order to retain only those who had not relapsed during the first 72 hours (89 patients: 42 in group I; 47 in group II). As Holter monitoring was not available in all centres, follow-up was assessed by conventional ECG during clinical examination after 2 weeks, 6 weeks, 3 months and 6 months. The results seem to indicate that cibenzoline was more effective at the 6th month (20% recurrence rate in group I compared to 43.2% in group II). This difference was significant especially at the end of the 2nd week of treatment (p less than 0.04); the number of recurrences did not differ significantly between the two groups thereafter. In general the clinical tolerance was good. Biochemical tests showed a greater increase in serum transaminases (SGOT) in the cibenzoline than in the QAGS group but this difference did not attain statistical significance. We conclude that at 6 months cibenzoline is more effective than QAGS in preventing recurrent atrial fibrillation.

Adult↗
PubMed1983

[Arterial hypertension induced by a nasal decongestant. Value of the use of an automatic and programmable recording technic].

The case of a twenty-three-year-old woman with spasmodic coryza in whom the overuse of a nasal decongestant resulted in arterial hypertension is reported. The relationship between the treatment and the occurrence of hypertension is firmly established. The original feature of this case is the use of the technique for monitoring the blood pressure and heart rate, before and after the treatment had been discontinued, which ascertained the hypertension, making it appear as an experimental model.

Adult↗
PubMed1979

[Mitral valve prolapse and spasmophilia in the adult].

75 cases of mitral valve prolapse (MVP) for which no cause was found underwent electromyography (EMG). In 64 cases (85.3%) EMG showed changes suggestive of spasmophilia. The symptoms observed were those already described in this condition. The specific clinical signs of spasmophilia were often elicited with a positive Chvostek sign in 20 out of 30 cases (73.3%). Radiological, echocardiographical and haemodynamic studies underlined the hyperkinetic state of the left ventricle. Biochemical investigations showed a high incidence of low erythrocytic magnesium levels. Chest pain suggestive of angina pectoris, mitral valve prolapse and spasmophilia are frequently associated. The role of the low erythrocyte magnesium on left ventricular hyperkinesis and the production of MVP is discussed.

Adult↗
PubMed1977

[Abnormalities of insulin secretion in coronary patients. Apropos of 67 cases].

The curve of blood insulin levels recorded during the oral provoked hypoglycaemia test (OPHG) was studied in 67 proven coronary patients. None of the curves obtained was normal. The abnormalities found in this way are of two types: either a hypoinsulinaemic response, with a high non-retarded peak (type 1) or a high retarded peak (type 2), or else a hypoinsulinaemic response, with a flat curve (type 3) or a very small late peak (type 4). The possible role of these abnormalities of insulin secretion in the pathogenesis of atheroma is discussed. The correlations between age, sex, obesity, hypertriglyceridaemia, and the OPHG curve are investigated. The preliminary results of a test in which insulin levels are monitored after intravenous provoked hypoglycaemia, followed by tolbutamide, are reported.

Adult↗
PubMed1976

[Treatment of rhythm disorders by fenoxedil hydrochloride].

Fenoxedil chlorhydrate (FC), which is used as a treatment for cerebral circulatory failure and peripheral vascular disease, has been given to 100 patients with a cardiac arrhythmia: atrial fibrillation (78 cases), atrial flutter (4 cases), atrial tachysystole (2 cases), ventricular extrasystoles (12 cases), and supraventricular extrasystoles (4 cases). FC has been prescribed alone, or as a complement to current anticoagulant or digitalis treatment; combination with prenylamine, amiodarone, dysopyramide or a drug of the quinidine group must always be avoided, and the potassium level checked and corrected if necessary before treatment. In 78 cases of atrial fibrillation, the authors found that sinus rhythm was restored in 58 (74.4%); four cases of flutter were restored, and one case out of two of atrial tachycardia. In case of supraventricular and ventricular extrasystoles the results are less clear, and merit a further study with a larger number of cases. The electrocardiographic disorders encountered in this series have been evaluated: lenghthening of the QT interval, disorders of atrioventricular conduction, sinus inhibition. They were either produced by or aggravated by the FC. No cases of axis deviation were encountered. The authors make mention of the complications observed by other authors, but draw a distinction between the prescription of FC in cases of cerebral vascular insufficiency, without previous knowledge of the exact cardiac status of the patient (otherwise there is a risk of severe accidents), and the use of FC in cases of arrhythmia which have undergone full assessment before the drug is used. According to this study, FC appears to be a very effective anti-arrhythmic agent, but its use demands very rigorous clinical and electrocardiographic supervision.

Anti-Arrhythmia Agents↗
PubMed1976

[Atrioventricular "sequential" stimulation by implantable "bifocal" stimulator].

The "bifocal pacemaker achieves a sequential" stimulation which reproduces the physiological atrio-ventricular sequence. This type of stimulation has the advantages of atrial stimulation without the disadvantages of being inefficient when an atrio-ventricular block exists or supervenes. The pacemaker was used by the endocavity route in 12 patients. The indications included a disease of the sinus node (8 cases), supra-ventricular arrhythmias associated to conduction disorders (3 cases) and a cardiomyopathy with conduction disorders (1 case). The preliminary results were appraised after two to twenty four months. One displacement of the ventricular electrode was noted. On the other hand no displacement of the atrial electrode was reported. One battery was worn out after 19 months. The "bifocal" pacemaker was efficient in the treatment of symptoms which justified its implantation. Or particular interest were the results obtained in patients with no supraventricular arrhythmias. This pacemaker may be of use: 1) in the disease of the sinus node, in particular in the tachycardia-bradycardia syndrome; 2) in supraventricular arrhythmias associated to paroxystic conduction disorders; 3)in patients with an alteration of the myocardial function and for whom the atrial contribution to cardiac output is essential.

Aged↗