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Biomedical subjects

S Fazio

Publications and source records attributed to S Fazio.

At least 127 records · Page 7Linked to original sources
PubMed1990

[HR/QT ratio during ergometric test: influence of ischemia and beta blocking therapy].

The aim of this study was to analyze the HR/QT relation during exercise in a group of patients with effort angina (Group B) in comparison with the same relation obtained in a group of normal subjects (Group A) comparable for age and sex. The regression analysis was carried out separately during effort in upright position and during rest in clinostatic position to avoid influences on QT by the patient's posture. During effort in patients of the Group B the regression shows a lower value of the slope and of the intercept (p less than 0.001) than those obtained in the subjects of the Group A. A similar behaviour is shown also from the regressions obtained during rest in the same groups. Thus at the highest HRs we observed a longer QT in the Group B. Moreover QT of ischemic patients in the presence of ECG signs of ischemia (ST less than or equal to 1 mm) resulted significantly longer (p less than 0.01) either during effort and at rest, respect to that obtained in Group A at comparable HRs. The analysis of the regression HR/QT after administration of atenolol 100 mg per os in a subgroup of patients of Group B clearly shows a less prolonged QT at the highest HRs where ECG ischemia frequently appears. This fact is demonstrated by the presence of a higher slope (p less than 0.05) respect to that obtained in the same group without therapy. In conclusion, myocardial transient ischemia provokes a longer QT in patients with ischemic heart disease in comparison with normal subjects. Acute therapy with atenolol per os is able to condition the regression HR/QT showing a relative shortening of QT at the highest HRs respect to that carried out in the same patients in absence of therapy.

Adrenergic beta-Antagonists↗
PubMed1990

[Heart function (angioscintigraphic evaluation) and sympathetic tone in insulin-dependent diabetes mellitus].

Cardiac failure is a frequent feature in diabetic patients and it often causes their death. But how and when cardiac disease begins in this kind of patient is still debatable. For example, cardiac failure can be present even in the absence of atherosclerotic involvement of coronary arteries in young diabetics. The aims of our study were to evaluate the cardiac function and sympathetic tone of 16 young type 1 diabetic patients (8 M and 8 F, mean age: 27 years, SD +/- 5) in comparison with 10 normal subjects (4 M and 6 F, mean age: 30 years, SD +/- 7). Diabetic patients were choose from a large population because of the following features young age, absence of clinical and instrumental evidence of micro- or macroangiopathy, clinical evidence of diabetic autonomic neuropathy, proteinuria or arterial hypertension. They were in good metabolic control on daily insulin therapy of two or three administrations. Cardiac function was evaluated at rest and during submaximal exercise on a cycloergometer in supine position using radionuclide ventriculography with technetium 99m. Sympathetic tone was checked using the five clinical tests according to Ewing and the plasmatic level of catecholamines at rest was evaluated using high pressure chromatography. The ejection fraction, cardiac output, stroke volume of diabetics were comparable with those of normal subjects even in the presence of comparable systemic vascular resistance. The increase in ejection fraction during effort was normal. Only in one diabetic patient (incidentally the oldest one) did ejection fraction decrease (7%) during effort. The peak ejection and filling rates were significantly higher (p less than 0.001) in diabetic patients compared to those of normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

A prospective randomized trial of doxorubicin versus idarubicin in the treatment of advanced breast cancer.

Seventy-six patients with advanced breast cancer were entered into the current study. They were randomized to receive either idarubicin (IDA) 45 mg/m2 orally or doxorubicin (DX) 75 mg/m2 intravenously (IV), both drugs being administered every 3 weeks. Among 37 evaluable patients who received DX treatment the overall response rate was 46%, whereas it was 21% in 34 evaluable patients treated with IDA. This difference was statistically significant. In previously untreated patients the response rate with DX was 60% compared to 29% with IDA. Patients with prior chemotherapy had 29% response rate to DX in contrast to 12% with IDA. The median time to response, the median response duration, and the median time to progression were similar in both groups. The median survival of all patients was 20 months in DX arm and 14 months in IDA arm (95% confidence limits 16.69-23.31 and 10.77-17.23, respectively; P = 0.09). Both treatments produced equivalent incidence and severity of myelotoxicity. Gastrointestinal toxicity and alopecia were significantly lower in patients receiving IDA. As for cardiotoxicity, four cases of congestive heart failure were recorded among patients treated with DX whereas no cases occurred in the IDA group. The results of this study indicate that, although DX remains the best single agent available in the treatment of breast cancer, IDA may have a role in selected patients with this disease.

Adult↗
PubMed1989

[Hemodynamic adaptation in severe obesity with or without arterial hypertension].

Hypertension and obesity are 2 common pathological conditions that have been directly related. The incidence of hypertension in an obese population is far greater than in otherwise normal people. Nevertheless, a causal relationship between the 2 disorders has not been established. But their coincidence in the same patient carries increased risk of cardiovascular morbidity and mortality. In the present study we have studied a group of normotensive obese patients (21 patients, Group A), a group of hypertensive obese patients (19 patients, Group B) and a group of normal subjects (11 patients, Group C) by radionuclide ventriculography with Tc 99m to visualize the different hemodynamic adaptation to these different conditions. Overweight causes an increased preload while hypertension causes an increased afterload. In response to the increase in preload the heart of obese patient undergoes eccentric hypertrophy; when an increase in afterload is present at the same time, the left ventricle develops concentric hypertrophy. We found an increased preload in both the obese groups (A and B) testified by increased blood volume and end diastolic volume. Heart rate was higher in the 2 populations of obese patients. As a result, cardiac output was significantly increased in Group A and B. But the stroke index is decreased in Group A and B with respect to Group C. The ejection fraction is reduced in Group A with respect to Group B and C. The contractility index (systolic blood pressure/end systolic volume) is higher in Group B in comparison with Group A. Thus, hypertensive obese patients seem to have a better cardiac performance respect to the normotensive obese patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Exercise electrocardiogram in the evaluation of coronary atherosclerosis: correlations between electrocardiographic signs of ischemia and a coronarographic study].

We divided 51 patients (Group C) with stable effort angina into 2 groups: Group A of 30 patients without previous myocardial infarction, Group B of 21 patients with previous myocardial infarction. The aim of this study was to test the relation between some ECG signs of ischemia and coronary artery disease (CAD) severity and to propose a new simple angiographic score of CAD. The patients, after a pharmacological wash-out period, were submitted to a treadmill effort test and to a coronarography. Stenoses were quantified using a score system recently proposed in the literature and a new simple score obtained summing the coronary stenosis in percent. Significant correlations between the time to the onset of ischemia (TSI) and the recovery time (TR) with the CAD severity in Groups A, B, and C using both scores were observed. The total stress time and the new index obtained summing the total effort time and the time to the onset of ischemia were related to the severity of CAD in Groups A and C using both scores. The multivariate discriminant analysis suggested that the TSI is the most sensitive variable to predict CAD severity in our patients. A good correlation between the 2 scores was also observed.

Angiography↗
PubMed1987

Bisoprolol in the treatment of angina pectoris: a double blind comparison with verapamil.

In order to verify the anti-ischaemic effect of a new beta-blocking agent, bisoprolol, a double blind parallel groups trial was carried out in comparison with verapamil. 26 patients with a history of spontaneous and/or effort angina were studied. After a two-week treatment with placebo, they were randomized in two groups. One group was treated for 4 weeks with bisoprolol 10 mg o.d. and for the following 4 weeks with bisoprolol 20 mg o.d. The other group received verapamil 80 mg t.i.d. for the first 4 weeks and 120 mg t.i.d. for the remaining 4 weeks. Throughout the study isosorbide dinitrate 20 mg b.i.d. was administered and sublingual nitroglycerin was allowed when necessary. 21 patients completed the study. Both bisoprolol and verapamil significantly reduced the number of angina episodes and nitroglycerin tablets consumption, as well as ischaemic episodes recorded on Holter ECG. The total number and severity of ectopic ventricular beats were reduced too. On multistage treadmill exercise test, both drugs increased effort time and time to ST depression = 1 mm, and reduced ST depression and double-product. The effect of bisoprolol on double product was greater than that of verapamil because of the better control of heart rate. The relationship ST/double product suggested that beta-blockers act essentially through the reduction of myocardial oxygen consumption and verapamil possibly with an additive effect on coronary circulation. Radionuclide ventriculography showed no deterioration of rest ventricular function with both drugs. In conclusion, bisoprolol and verapamil showed a satisfactory anti-ischaemic effect, with good tolerability.

Adult↗
PubMed1987

Lack of association between arterial blood pressure and erythrocyte fatty acid composition in an Italian population sample.

The relation between arterial blood pressure and erythrocyte fatty acid composition was investigated in a large urban female population aged 20-69 years. No significant differences in the relative amounts of saturated, monounsaturated and polyunsaturated (n-6 and n-3 series) fatty acids and in the mean polyunsaturated/saturated and linoleic/oleic ratios were observed in the different quartiles of both systolic and diastolic blood pressure. Moreover, there was no significant correlation between individual erythrocyte fatty acids and their ratios and either blood pressure or other risk factors for atherosclerosis (age, body mass index, total serum cholesterol and triglycerides). In the multivariate analysis no independent correlations between systolic and diastolic blood pressure and the individual erythrocyte fatty acids were observed; age and body mass index were strongly related to blood pressure. Our results do not confirm for erythrocyte fatty acids the reported associations between plasma fatty acids and blood pressure.

Adult↗
PubMed1985

Muzolimine and nitrendipine in the treatment of arterial hypertension.

Thirty patients with moderate to severe hypertension (diastolic blood pressure greater than or equal to 115 mmHg), after a run-in wash out period of 15 days, were treated with muzolimine at a dosage of 20 mg once daily, given at 1 p.m., for three weeks. At the end of this period of treatment the patients with diastolic blood pressure greater than or equal to 100 mmHg started a double blind randomized study of comparison of nitrendipine, a vasodilator calcium antagonist agent, and captopril, an inhibitor of converting enzyme. The dosage was 10 mg twice daily for nitrendipine and 25 mg twice daily for captopril, the duration of each treatment being four weeks. At the end of 28 days of double blind treatment, the patients with diastolic blood pressure greater than or equal to 100 mmHg were treated with a triple combination: muzolimine plus nitrendipine plus captopril at the same dosage for a further four weeks. At the end of run-in and of each period of treatment blood pressure and heart rate were recorded in supine and erect positions and after a treadmill exercise test. At these times laboratory tests, including PRA and aldosterone, were performed. After the run-in period supine blood pressure was 189.6 +/- 13.9/123.1 +/- 7.7 mmHg. At the end of muzolimine treatment, supine blood pressure was 176.5 +/- 10.8/117.8 +/- 5.6 mmHg (p less than 0.001); at this time 4 patients had their diastolic blood pressure normalized and left the study. Thus 26 patients were randomized for comparative study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Nitrendipine and atenolol: comparison and combination in the treatment of arterial hypertension.

The effectiveness and tolerability of nitrendipine (Bay e 5009) and atenolol in the treatment of mild or moderate arterial hypertension in monotherapy and in association were evaluated in a randomized double-blind study. The drugs were administered once daily at the dose of 20 mg for nitrendipine and 100 mg for atenolol. The trial consisted in two phases of monotherapy and of a combined regimen phase, whose sequence was randomly established; tablets were administered according to a double-dummy design. The results were evaluated according to the criteria of the Hypertension Detection and Follow-up Program Cooperative Group. 5/20 patients were considered "responders" after atenolol treatment, 4/20 after nitrendipine alone, and 14/20 after combined therapy. Side effects resulted mild in severity, and their incidence was lower during the association phase. The combination of atenolol and nitrendipine appears to improve the effectiveness and acceptability of both drugs.

Adult↗