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Biomedical subjects

S Gentili

Publications and source records attributed to S Gentili.

At least 37 records · Page 2Linked to original sources

Reversal of left ventricular hypertrophy after one-year treatment with clonidine: relationship between echocardiographic findings, blood pressure, and urinary catecholamines.

Previous studies have shown that some antihypertensive drugs, beside controlling arterial pressure (AP), reverse left ventricular hypertrophy (LVH) by reducing adrenosympathetic activity. The aim of our study was to evaluate the relationship between AP levels, echocardiographic LVH and 24-h urinary excretion of epinephrine (UE) and norepinephrine (UNE) in 23 previously untreated stable hypertensive individuals with LVH and in 18 healthy normotensive control subjects before and after 1-year treatment with oral clonidine. Intraventricular septal (IVS) and posterior wall (PW) thickness and left ventricular mass index (LVMI) were related to systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP), as well as to UE and UNE by multivariate regression analysis. Before clonidine treatment increased values for IVS and PW thickness correlated with DAP (r = 0.54; p less than 0.05), and MAP (r = 0.50; p less than 0.05), a positive relation between IVS thickness and LVMI and UNE was found. After clonidine treatment, in addition to a statistically significant reduction in SAP, DAP, MAP, and in NE and UNE (all p less than 0.01), a decrease in IVS (12.5 to 9.5 mm; p less than 0.01) and in PW (11.2 to 9.3 mm; p less than 0.01) thickness as well as in LVMI (152.3 to 108.6 g/m2; p less than 0.01) was observed in hypertensive patients. LVMI weakly correlated with UNE change (r = 0.50; p less than 0.05). These data support a possible influence of catecholamines in modulating the development of LVH. They also confirm the parallel action of clonidine in controlling AP, in reducing UE and UNE, and in reversing LVH in hypertensive patients.

Adult↗

Blood pressure changes over 20 years in nuns in a secluded order.

Blood pressure was recorded for 20 years in 138 nuns in a secluded order and in 126 lay women taken as controls. During the study period none of the nuns or control women smoked, took oral contraceptives or changed residence. Diet was unrestricted and comparable in the two groups. Subjects of both groups were consecutively enrolled without any selection parameters. During the 20 years of observation, systolic and diastolic blood pressure rose with age in the control women but remained almost unchanged in the nuns. The mean of the regression slope of systolic and diastolic blood pressure versus age, which was calculated for each subject, was 0.089 and 0.054 respectively in the nuns, as opposed to 2.171 and 0.742 in the lay women (both P < 0.001). Secluded nuns, who spend almost all their time in silence and prayer in the virtual absence of company apart from when attending religious celebrations, thus showed almost no change in blood pressure with age over a 20-year period. The results support the hypothesis that, at least in women, everyday stress may be a determinant of the progressive increase in blood pressure with ageing.

Adult↗

Oxprenolol on the sympathetic drive during working stress.

Epinephrine and norepinephrine urinary excretion was evaluated in 35 healthy confectioner workers on piece-wage (PW) and in 35 metal workers on the assembly-line (AL) before and after oral administration of oral oxprenolol (and identical placebo on double blind conditions) in order to evaluate the effect of beta-blockade on the adrenosympathetic overactivity due to psychological working stress. When the workers performed their job without any drug and when they were on placebo conditions, urinary levels of epinephrine and norepinephrine rose significantly; whereas when they were given oxprenolol the values of two catecholamines were normal. It could be argued that this study might lead to beta-blocking drugs introduced in circumstances of high scores of psychological stress due to some modern types of work.

Adrenal Glands↗

Free adrenaline and noradrenaline excretion related to occupational stress.

Urinary levels of free adrenaline and noradrenaline were measured in two groups of healthy male industrial workers exposed to alternate four-day periods of working conditions with and without time stress, to test the hypothesis that the sympathetic nervous system is overactivated by occupational stress. Thirty confectionary workers alternated piece-work (payment by results) and work with a fixed daily wage while 30 metal workers alternated work on an assembly line with work off it. Under time stress urinary free adrenaline was 450 per cent and noradrenaline 230 per cent of the levels for similar work without time stress but involving equal oxygen consumption. These differences were statistically highly significant and they persisted on retesting after six months of alternating work regimens. They support the concept that occupational stress in industrial workers influences the adrenosympathetic system and they indicate a possible method for assessing the effects of high levels of sympathetic activity on the aetiology of ischaemic heart disease.

Adult↗

[Efficacy of prazosin in severe cardiac insufficiency].

A new oral vasodilator, prazosin, was evaluated in twenty patients with refractory congestive heart in a double blind non cross-over trial. Patients were divided into two groups. The first (group A) was treated by prazosin (40-50 microgram/Kg/pro die) for 20 days, the second was given placebo for the same period. Ventricular performance was assessed by measurement of the systolic time intervals, the peak time of the first derivative of the apexcardiogram (delta ACG), pressure-rate product and clinical evaluation. After ten days of prazosin left ventricular ejection time (LVET) increased (P < 0.01), pre-ejection period (PEP) and relation PEP/LVET were reduced (respectively: P < 0.05 and P < 0.01). Similarly the peak of delta ACG and pressure-rate product decreased significantly (respectively: P < 0.05 and P < 0.01). Symptomatology improved in NYHA functional class (3.7 to 2.4, P < 0.001). After twenty days of prazosin there was no further significant improvement in myocardial performance. No significant changes of clinical course and of the same parameters were observed in patients of group B. It is concluded that prazosin is effective in improving cardiac performance in refractory heart failure for its balanced dilator action on the arteriolar and venous vessels.

Adult↗

[Urinary excretion of adrenaline, noradrenaline and 11-hydroxycorticoids under job stress (author's transl)].

The role of the sympathoadrenomedullary and adrenocortical systems has been assessed by measuring serially the urinary excretion of free adrenaline, noradrenaline and 11-hydroxycorticosteroids in 32 healthy men under two conditions of job stress: piece-work and assembly line. The urinary levels of two catecholamines and 11-hydroxycorticosteroids rose significantly in piece work and assembly line workers, compared with the values observed respectively during salaried and "ordinary" work. Identical results were obtained in the same workers after six months of stressor exposure to piece-work and assembly line conditions. The results support the assumption that long-term exposure of conditions of work stress significant effects on the function under study, this being in the same direction and of the same order of magnitude as that described during short-term exposure in other types of every-day stress and distress. The methodological and clinical implication of these results are discussed.

11-Hydroxycorticosteroids↗

Adrenosympathetic overactivity under conditions of work stress.

Serial measurements of urinary adrenaline, noradrenaline, and 11-hydroxycorticosteroid excretion were performed on 32 healthy men under two conditions of work stress; piecework and work on assembly line. A statistically significant increase in adrenaline, noradrenaline, and 11-hydroxycorticosteroids was observed for piecework and assembly line workers compared with salaried and 'ordinary' workers. The results support the assumption that psychosocial factors of an everyday type have significant effects on the sympathoadrenomedullary and adrenocortical function.

11-Hydroxycorticosteroids↗