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Biomedical subjects

S Scardi

Publications and source records attributed to S Scardi.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Clinical and hemodynamic implications of anterior ST segment depression in inferior myocardial infarct].

The finding of ST segment depression (reduced ST) in the anterior leads during acute inferior myocardial infarction is a common clinical sign. Nevertheless, its significance is not yet well established. To evaluate the significance of this finding, 58 patients with acute inferior myocardial infarction, who has an electrocardiogram within 8 hours from the onset of the disease, were divided into 2 groups: group A (14 patients with anterior reduced ST less than 1 mV) and group B (44 patients with reduced ST greater than or equal to 1 mV in one or more anterior leads). All patients subsequently underwent coronary angiography and left ventriculography, mean 50 days after acute myocardial infarction. reduced ST was not predictive of left anterior descending coronary artery disease. On the contrary, a significantly higher rate of 2-3 vessel disease (p less than 0.05) and of critical stenosis or occlusion of the right or circumflex coronary artery (p less than 0.05) was found in group B. Peak CK level was significantly higher (p less than 0.01) in this group as well. No significant difference was found in ejection fraction and anterior wall motion abnormalities, whereas a higher number of patients in group B showed a depressed function of the postero-basal segment (p less than 0.05). During 6 months follow-up, 2 patients in group A and 24 in group B experienced cardiac events (angina, reinfarction, heart failure, coronary artery by-pass grafting, cardiac death) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

May early exercise testing after myocardial infarction predict the extent of coronary artery disease?

To determine whether exercise testing performed soon after myocardial infarction may predict the degree of coronary artery disease, 78 patients performed stress testing and coronary angiography 15 +/- 5 and 64 +/- 35 days, respectively, after myocardial infarction. Out of 34 patients with a positive test, 22 (65%) demonstrated a multivessel disease, and 37 (84%) out of 44 patients with a negative test had normal coronary angiograms or single vessel disease (p = .0006). In addition to stress testing, no clinical parameter considered (infarct location, heart failure and cardiomegaly) was predictive of the extent of coronary artery disease.

Coronary Angiography↗
PubMed1985

[Supraventricular tachyarrhythmia of a variable degree of atrial synchronization caused by drinking cold water].

We report upon a patient with mitral valve prolapse of mild degree who complained of paroxysmal tachyarrhythmias after drinking ice-cold beverages. It was demonstrated that iced water ingestion was followed, in this patient, by transient episodes of supraventricular tachyarrhythmias. The reproducible induction of acute, transient rhythm disturbance can possibly be explained by the temperature changes of either the pericardium or the left atrial wall, which have been experimentally shown to follow iced water swallowing. Whether this is a direct cause-to-effect phenomenon or one involving a neural mechanism cannot be currently inferred.

Adult↗
PubMed1984

Compliance with cardiac rehabilitation in the elderly.

To evaluate the compliance of the elderly with cardiac rehabilitation (CR) after myocardial infarction, 370 consecutive patients greater than or equal to 65 years of age, admitted to our Coronary Care Unit over a period of 2 years, were examined: 48 died in the hospital, 34 were transferred to other wards and 29 were unable to perform a submaximal exercise test before discharge. Out of the remaining 259 patients, 43 began the CR and 32 completed it with a good outcome. Eleven patients interrupted the CR because of associated diseases. A social investigation was carried out on 83 of the 259 patients discharged from our ward. In addition to associated diseases and an extremely low exercise tolerance (41% of cases), the lack of participation was due to socioeconomic problems (9.5%), to lack of motivation (52.3%) and to inadequate information (38.1%). Nevertheless, 76% of patients indicated that they attained their previous way of life in a relatively short period of time. It is concluded that: CR is useful in patients who complete it; low compliance is due mainly to medical problems and lack of motivation; better information might slightly increase the compliance in our Center; most patients can, in any case, reach their previous way of life. It is debatable whether CR is advisable in old age, or should be directed towards selected groups of patients.

Aged↗
PubMed1984

[Level of knowledge on cardiovascular health in schools].

In order to determine the status of cardiovascular health knowledge, a standardized questionnaire was administered to 325 students (currently) in their last year, in 18 high schools of Trieste. The schools were divided into 3 groups according to their teaching programmes: technical schools (Group A), teacher-training colleges (Group B) and junior high schools (Group C). The adopted questionnaire was that developed by the cardiovascular centre of the University of Iowa, slightly modified by the authors, but keeping the "multiple choice" pattern. The questions were focused on the three major areas of anatomy, physiology and pathology. All the students answered the questionnaire although none with 100% accuracy. The highest performance (95% of correct answers) was given in the field of the physiology of the heart of effort, the lowest one concerned the position of the heart in the chest (20%). Fifty-seven per cent of the students refrained from answering the question on myocardial ischaemia. The total score (based on the number of correct answers, incorrect ones and the number of blanks) revealed a significantly different level of cardiovascular health knowledge between the various school groups: group C (64.13 +/- 7.55) performed better than group A (67.15 +/- 9.45, P less than 0.001), which in turn was more successful than group B (71.6 +/- 10.0, P less than 0.001). In comparison to the group of 325 students, the score obtained by a sample group of hospital nursing students, showed a significantly higher level of health knowledge (46.1 +/- 1.56, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

[Health education in the prevention of ischemic heart disease in school children: feasibility study].

A feasibility study of health education was undertaken among the pupils of a primary school in order to: 1) investigate the level of participation of children and teachers to the program; 2) test the efficacy of the program itself; 3) determine whether the children can modify family's behavioral patterns of the family components. Seventy-two children, belonging to different socio-economic classes, were studied. Children were given a questionnaire at the beginning and the end of the programme course, which was held by previously trained teachers. The participation of children and teachers to the program was very satisfactory. On the contrary very low involvement of the parents was achieved. This experience emphasizes the difficulties that arise when interventions to modify adult people's life style are attempted. On the contrary, a standardized education program, to last a whole school year, could be a feasible useful and costless type of intervention not only for the primary prevention of coronary artery disease, but for any program of extensive health care.

Adolescent↗
PubMed1983

[Early exercise test after myocardial infarct: prognostic stratification].

Exercise testing in myocardial infarction before discharge has been used for treatment and exercise prescription in the post-hospital phase. Aim of this study was to investigate the prognostic significance, within one year after the infarction, of submaximal exercise testing before discharge. 428 patients performed the test 14.5 days after the acute episode and were followed for 12 months. The following variables were examined: heart rate, blood pressure, rate-pressure product at maximum exercise, total work and reasons for stopping the test (fatigue, submaximal HR, BP greater than or equal to 200/110, hypotension, ischemic or arrhythmic response). Two events were considered: 1) non fatal reinfarction; 2) cardiac death. Two methods of multivariate analysis (Cox's model regression analysis and discriminant analysis) were used. None of the considered variables was found to be predictive of non fatal reinfarction. According to Cox's model total performed work and hypertensive response were found to be predictive of cardiac death, while using discriminant analysis only total work had a predictive value (discriminant function: L = 0.00094 X total work performed + 1.48643; p less than 0.01). In detail, the higher the total work, the better the probabilities of survival, while in patients who stopped the test because of hypertension, the probabilities of cardiac death were lower. Exercise testing performed in uncomplicated myocardial infarction before hospital discharge provides, the basis for a more rational management of patients in the post-infarction phase, and contributes to identify a subset of high-risk patients.

Aged↗
PubMed1983

[Status of the "cure" of non-complicated myocardial infarct in Italy].

To analyze the state of health care for patients with myocardial infarction, questionnaires were sent to 191 Italian general hospital and university cardiological departments equipped with an intensive coronary care unit (ICCU). A total of 139 returned the questionnaire (72.7%), of which 138 were usefully completed. The mean number of beds per ICCU is 5.7 and still today 14% of the ICCU's transfer their patients to a medical department. The mean time to admission is 7 hours. In the acute phase, rehabilitation is begun in 49% of the ICCU; mobilization and hospitalization times are shorter than in 1978. The most widely employed pharmacological treatment in the acute phase is the glucose-potassium-insulin infusion (74%). Prior to discharge, 16% of the institutions obtain an exercise test, 74% an echocardiogram and 42% a dynamic ECG. Health education programs, on the other hand, are very poor: only a few Centers provide educational material. In the case of recurrent chest pain, 81% of the institutions advise the patients to take nitroglycerin, and 67% with the patients to report to the hospital. Eighty-nine percent of the Centers carry out follow-up tests on all their patients 1 month after discharge. Calcium antagonists and nitrates are prescribed on discharge by one half of the departments. In the post-infarction period an effort test is performed in 54% of Centers; coronary angiography is carried out on the youngest patients in 9% of Centers; in 30% of Centers, coronary angiography is only performed in patients with severe symptoms. Sixty-five institutions administer their own rehabilitation programs, while 35 send their patients to other institutions.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Care Units↗
PubMed1983

[Prevention of ischemic heart disease: a feasibility study of health education in the primary school].

To verify the level of participation of children and teachers in an educational program, the reliability of the program itself and to determine whether children can modify family's behavioral patterns, a feasibility study was undertaken among the pupils of a primary school. Seventy-two children, belonging to different socio-economic classes, were studied. Children were given a questionnaire before and after the course, which was held by previously trained teachers. Very good participation of children and teachers in the program was observed. On the contrary very low involvement of the parents was achieved. This experience emphasizes the difficulties arising when actions to modify adult's life styles are attempted. On the contrary, a standardized education program, lasting for a whole school year, could be a feasible, useful and not too costly program not only for the primary prevention of coronary artery disease, but for any program of extensive health care.

Adolescent↗
PubMed1982

Afterload reduction with nifedipine in aortic insufficiency.

The acute hemodynamic effects of nifedipine were assessed in 12 patients with severe aortic insufficiency during control conditions and 30 minutes after administration of nifedipine (20 mg sublingually). Left ventricular end-diastolic pressure decreased from 19 +/- 8 (mean +/- standard deviation) to 9 +/- 5 mm Hg (probability [p] less than 0.0001), mean aortic pressure from 98 +/- 12 to 80 +/- 9 mm Hg (p less than 0.00001), systemic vascular resistance from 1,135 +/- 280 to 794 +/- 176 dynes . s. cm-5 (p less than 0.0002) and rate-pressure product from 11,732 +/- 1,727 to 10,022 +/- 1,103 mm Hg beats/min (p less than 0.01). Forward cardiac index increased by 24 percent, from 3.8 +/- 1.1 to 4.4 to 0.8 liters/min per m2 (p less than 0.04). Left ventricular end-diastolic volume, ejection fraction and total stroke work index did not change significantly. Regurgitant fraction, measured in five patients, changed parallel with systemic vascular resistance. Left ventricular function was maintained while both preload and afterload were decreased. Regurgitant flow was moderated and myocardial oxygen demand decreased. This hemodynamically favorable condition, due to nifedipine, is clinically important and suggests the need for further therapeutic trials.

Adult↗
PubMed1982

[Comparison of dynamic electrography and stress test in the diagnosis of ventricular arrhythmias in the early phase of myocardial infarction].

UNLABELLED: Ventricular premature beats are probably important in the prognostic evaluation after acute myocardial infarction and may allow a better management of these patients. The purpose of this study was to compare the sensitivity of two methods exercise testing - ET - and ambulatory electrocardiographic monitoring - AM - detecting potentially dangerous ventricular arrhythmias and to evaluate their prognostic value. Sixty-four patients have been studied (53 males and 11 females); their mean age was 61 years. They underwent ET and AM before discharge (mean 13.9 days) and were followed for a period of 12 months. CONCLUSIONS: -- ET and AM are useful to detect ventricular arrhythmias; -- AM is the most sensitive method; -- there are no significant differences between the two methods in the diagnosis of major arrhythmias; -- the combined use of the two methods has a greater sensitivity; -- late mortality is not higher in the patients who have suffered from major arrhythmias in the acute phase of the disease.

Aged↗
PubMed1981

[Situation in Italy regarding institutions for cardiovascular function testing].

In order to evaluate the number and the capacity of the exercise testing laboratories, a questionnaire has been sent to 294 institutions throughout Italy. Responses available for analysis were returned from 148 Centres. The number of laboratories performing exercise testing (2,6 every 1.000.000 inhabitants) is not sufficient; regional volume and capacity of testing is much higher in the north of Italy than in the south. The number of exercise stress tests performed is very low and facilities of some laboratories insufficient for population requirements. Laboratory equipment is good. The protocols used during the test and the criteria for the evaluation of results are different within the country. It is only by potentiating the capacity and the quality of the exercise testing laboratories that it will be possible to increase the small number of centres doing cardiac rehabilitation in Italy.

Cardiac Rehabilitation↗
PubMed1979

[Early exercise testing after myocardial infarction (author's transl)].

203 patients suffering from acute myocardial infarction performed a cycloergometric submaximal exercise test before leaving hospital. The causes for stopping the test were fatigue or submaximal heart rate (24,1%), angina (14,2%), ischaemic S-T changes (28,08%), arrhythmias (4,9%) and changes of blood pressure (17,2%). No important complications were observed. The test proved useful for the definition of more objective criteria in order to prescribe an individualized rehabilitation programme. Above all it was possible to prescribe treatment which would not have otherwise been prescribed at the time of discharge. The short term prognostic value is not, however quite clear as yet.

Angina Pectoris↗