F. Covelluzzi

Società Italiana di Cardiologia

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F. Rengo

Istituti Clinici Scientifici Maugeri

Domenico Acanfora

Istituti Clinici Scientifici Maugeri

L. De Caprio

Università Cattolica del Sacro Cuore

Marco Papa

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda

Lucio Santangelo

Ospedale Monaldi

Giuseppe Furgi

Istituti Clinici Scientifici Maugeri

M. Cicatiello

University of Naples Federico II

Dario Leosco

University of Naples Federico II

F. Gallucci

University of Naples Federico II

C. Borgnino

Novartis (Italy)

Cooperative Institutions

University of Naples Federico II

Federico II University Hospital

Società Italiana di Cardiologia

Istituti di Ricovero e Cura a Carattere Scientifico

Fondazione Salvatore Maugeri

University of Campania "Luigi Vanvitelli"

Istituti Clinici Scientifici Maugeri

University of Bari Aldo Moro

Centro Clinico Nemo

Casa di Cura San Michele

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[Evaluation of heart rate changes in the aged. An ambulatory electrocardiography study. Arrhythmias in the aged].

PubMed (1989)

P Predotti Marianna Gabriella Rispoli R Ascoli F. Covelluzzi Lucio Santangelo

The Holter examinations of 111 subjects aged more than 65 who then underwent dynamic ecg were investigated in order to assess the clinical significance of cardiac arrhythmias in geriatric age. Group A was formed of 53 patients with no clinical signs of cardiovascular diseases. Thirty-two patients with clinical evidence of ischaemic cardiopathy made up Group B and 26 with arterial hypertension formed Group C. The Holter examinations were evaluated in accordance with current guidelines, considering the basic rhythm, heart rate, pulse formation and conduction disturbances and supraventricular and ventricular hyperkinetic arrhythmias. Sinus base rhythm was present in most cases whereas atrial fibrillation was noted in a similar percentage in the three groups, whether or not cardiovascular disease was present. Supraventricular and ventricular hyperkinetic arrhythmias were extremely common in the elderly and made no discrimination between patients with ischaemic cardiopathy or hypertension and the clinically healthy; for example, ventricular tachycardia was observed in 10.6% of Group A subjects, in 7.1% of Group B and 8.6% of Group C. To conclude, the clinical significance of heart rhythm changes in the elderly remains obscure because in most subjects they are not related to the presence of cardiovascular disease.

Supraventricular arrhythmia

Supraventricular Tachycardia

Sinus tachycardia

Hypertensive heart disease

Premature atrial contraction

Clinical Significance

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Role of metabolic therapy in cardiovascular disease

The Clinical Investigator (1993)

F. Rengo Pasquale Abete Pietro Landino Dario Leosco F. Covelluzzi

Coenzyme Q10

Contractility

Carvedilol

10.1007/bf00226852

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Acute Effects of Nisoldipine, Propranolol, and Their Combination in Patients with Chronic Stable Angina

Journal of Cardiovascular Pharmacology (1990)

L. De Caprio Marco Papa Domenico Acanfora Pasquale Abete Fernando Gallucci

We studied the short-term effects of oral administration of nisoldipine (10 mg) and propranolol (80 mg) alone and in combination in 14 patients with chronic exertional angina pectoris in a double-blind, randomized, cross-over study. The 14 patients (13 men and 1 woman, mean age 56 ± 7 years) performed symptoms-limited bicycle exercise stress test 3 h after placebo or active substance administration. Maximal work load, exercise duration, and time to 1-mm ST segment depression were significantly increased and ST depression at peak exercise was significantly decreased by drugs alone and in combination. Propranolol and nisoldipine alone improved exercise duration similarly and as well as the combination; however, a different response to the three pharmacologic interventions was found in patients treated with single drugs. The improvement in exercise tolerance was associated with rate-pressure product values at peak exercise, unchanged after nisoldipine and significantly reduced after both propranolol alone and in combination. After placebo, all patients had exercise-induced angina, in 9, 8, and 4 patients after nisoldipine, propranolol, and the combination of the two drugs, respectively. Nisoldipine is effective in the treatment of effort angina and its combination with propranolol may be useful and superior in patients who show poor response to monotherapy.

Nisoldipine

Stable angina

10.1097/00005344-199008000-00020

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Acute effects of nisoldipine in patients with chronic stable angina

The Cardiology (1988)

L. De Caprio Domenico Acanfora Marco Papa F. Gallucci Dario Leosco

Nisoldipine

Stable angina

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[Comparative evaluation using an ergometric test of the efficacy of the 3 major calcium antagonists on exertion stable angina].

PubMed (1987)

Marco Papa Domenico Acanfora D Artiaco Lucio Santangelo F. Covelluzzi

Nifedipine, diltiazem and verapamil are three effective calcium-antagonists in the treatment of angina pectoris. We compared their effects on effort angina to evaluate whether one of them is more efficacious. The data were collected from 42 patients (37 males, 5 females; mean age 51 +/- 4) entering one of 3 different trials; the beginning of all trials comprised a two-week, single blind, placebo run-in phase. An exercise stress test was performed at the end of this period and it was considered as basal test for the statistical analysis. Then the 42 patients were divided in 3 groups of 14 and entered a double-blind, randomized phase of drug treatment. The 3 groups started 3 parallel trials: 1) placebo/nifedipine 60 mg/day; 2) placebo/verapamil 360 mg/day; 3) placebo/diltiazem 240 mg/day. The duration of each trial was of 6 weeks (3 weeks of treatment with placebo and 3 weeks with active substance). Exercise stress tests were performed at the end of each phase of the trials, and the resulting data were compared with the data of the test performed at the end of run-in period. Parameters evaluated were: heart rate, blood pressure and rate pressure product at basal conditions, at submaximal and peak exercise; moreover we considered workload, maximal ST segment depression, total exercise duration and frequency of exercise-induced angina. Verapamil reduced rate pressure product at basal condition; all three drugs reduced rate pressure product at submaximal exercise, but a significant statistical difference was found only for verapamil and diltiazem.(ABSTRACT TRUNCATED AT 250 WORDS)

Rate pressure product

Basal (medicine)

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EFFICACIA DEL VERAPAMIL IN PAZIENTI ANZIANI CON ANGINA STABILE DA SFORZO

Giornale di gerontologia (1990)

Domenico Acanfora L. De Caprio F. Covelluzzi Lucio Santangelo P. Cacc ese

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The efficacy of diltiazem in elderly patients with stable effort angina

Giornale di gerontologia (1988)

Domenico Acanfora Francesco Fıcı S Cuomo Lucio Romano Marco Papa

Stable angina

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[Acute effects of nisoldipine in patients with stable effort angina].

PubMed (1988)

De Caprio L Domenico Acanfora Maria Letizia Papa F. Gallucci Dario Leosco

Nisoldipine

Stable angina

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Relationship between QT/QS2 ratio and angiographic severity of coronary heart disease.

PubMed (1988)

S Cuomo Domenico Acanfora Marco Papa F. Covelluzzi C. Tedeschi

The relationship between QT/QS2 ratio and angiographic severity of coronary heart disease (CHD) was determined in 99 patients who underwent coronary arteriography because of chest pain. Sixteen control patients with normal coronary arteriograms and normal left ventricular function and 83 patients with angiographic evidence of CHD were studied. QT/QS2 ratio and systolic time intervals were calculated from poligraphic recordings taken at rest. In control subjects QT/QS2 ratio was significantly shorter (0.91 +/- 0.04) than in patients with double (0.95 +/- 0.07; p less than 0.05 versus control subjects) and triple vessel coronary artery disease (0.95 +/- 0.05; p less than 0.05 versus control subjects). QT/QS2 ratio was significantly higher (p less than 0.01) in patients with 3 areas or more of left ventricular abnormal wall motion (LV AWM) (0.98 +/- 0.05) than in patients with none (0.92 +/- 0.06) or just 1-2 areas (0.93 +/- 0.06) of LV AWM. Multiple regression analysis revealed no relation between the number of coronary stenoses and QT/QS2 (t = 0.86; p = NS), while a relation was identified between the number of asynergic segments and QT/QS2 (t = 1.99; p less than 0.05). A significant correlation was found between QT/QS2 and PEP/LVET (r = 0.39; p less than 0.001). Setting the upper normal limit at 2 standard deviations from the mean of control subjects (QT/QS2 = 0.99), QT/QS2 criterion yielded a 30% sensitivity, a 94% specificity and a 96% predictive accuracy in diagnosing CHD. We conclude that in CHD patients QT/QS2 ratio is influenced by the extension of LV AWM. Although a low sensitivity may limit its use, a QT/QS2 value higher than 0.99 in a patient with chest pain strongly suggests CHD and thus this criterion may be diagnostically useful.

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