[Antiarrhythmic treatment with mexiletine in acute myocardial infarction (author's transl)]. / Trattamento antiaritmico con mexiletina nell'infarto acuto.

The effect of an introduced i.v. bolus of 250 mg of mexiletine was checked in cases of acute myocardial infarction with ventricular premature beats. On the 19 observed subjects 17 are male and 2 female: 18 cases with acute myocardial infarction and 1 with acute coronary failure. The introduction of the bolus was followed by an infusion of 0.75 mg/m for the successive four days. After 60 m' no significant changes in arterial pressure and in the heart rate were recorded. The Extrasistolies decrease from 11 +/- 3 to 3 +/- 2/m' (-71%, p less than 0.01); PQ and QT variations were not significant. After four days of infusion, systolic arterial pressure decrease from 135 +/- 4 to 121 +/- 3 (-10%; p less than 0.01), sinusal rate drops from 90 +/- 4 to 80 +/- 3 (-12%, p less than 0.05). The changes of diastolic arterial pressure, PQ and QT were not significant. Extrasistolies disappears entirely. A comparison between a mexiletine and a xilocaine i.v. bolus showed that mexiletine performs a higher antiarrhythmic activity.

[Value and limits of echocardiography of the acute or previous myocardial infarction. Mono- and bi-dimensional study (author's transl)]. / Valore e limiti dell'ecocardiografia nell'infarto miocardico acuto e pregresso. Studio mono e bidimensionale.

81 subjects with acute or previous myocardial infarction were studied in order to assess the relations between ecg location and diskinetic zones as seen on the echocardiogram; another purposes of the work was to establish if serial echocardiographic measurements would be useful for prognostic purposes. The obtained results were the following: 1) there is a good correlation between ecg location of anterior infarction and diskinetic or ipokinetic zones if on the echocardiographic pattern were simultaneously present the following echocardiographic findings: lessened systolic escursion + lessened systolic thickening + enhanced left ventricular diastolic dimension (LVDD); 2) in the group of posterior and inferior infarctions is observed either an ipokinetic left ventricular posterior wall either an ipokinetic septum; 3) left ventricle diastolic dimension (LVDD) was greater and the motion of the septum was less frequently paradoxical in previous infarction than in acute infarction; 4) there was a good correlation in anterior acute infarction among M-mode echo-patterns which indicate both progressive dilatation of the left ventricle and an abnormal septum movement and the appearance of congestive failure, shock and intrahospital mortality; 5) the aneurysms localized in apical section of the ventricles could be missed by M-mode studies and therefore when this complication is suspected bidimensional investigations are more indicated.

The therapeutic value of clonidine in patients with coronary heart disease.

11 coronary patients, 8 with mild hypertension, were treated with clonidine, at a dose of 75 micrograms b.i.d. per os for a week. The effect of the drug on coronary heart disease was assessed by means of a symptom-limited multistage exercise test on the cycloergometer. Clonidine was effective in reducing the exercise-induced increases in blood pressure (by 15.5 +/- 6.1%), the double product (by 34.8 +/- 20.8%) and the electrocardiographic ischemic changes. In 2/4 patients, effort related ventricular extrasystoles were reduced by greater than 50% after clonidine. The drug worsened the anginal pain in 3 and relieved the pain in 3 patients. However, it reduced the exercise-induced ST-T segment downsloping in 7 patients. The tolerance was good, since only 3/11 patients reported slight dry mouth, sedation and pyrosis. In view of the electrocardiographic effect, further studies with clonidine on myocardial ischemia should be performed.

[Changes in precordial movements in non-ischaemic heart disease patients after i.v. administration of isoproterenol and dopamine. Comparison between normal and cardiopathic subjects (author's transl)]. / Modificazioni dei movimenti precordiali in cardiopatici non ischemici durante l'infusione intravenosa di isoproterenolo e di dopamina. Considerazioni comparative con individui normali e coronaropatici.

18 patients with non-ischemic heart disease have been studied with reference to the kinetocardiographic changes before and after i.v. administration of dopamine (DOP) (Revivan) or Isoproterenol (ISP) (Aleudrin). For this purpose a simultaneous registration of ECG (lead D2), Kinetocardiogram (KCG) in K25 and K45 was performed. Volume curves were considered as a normal features of KCG, curves showing systolic outward movements during the ejection phase were classified as pathologic. The reduction or disappearance of the systolic movements during the drug administration, were considered as kinetic improvement, the increase of their site was judged as kinetic worsening. During the infusion, 17 KCGs maintained a normal morphological pattern; out of 19 pathological KCGs, 4 did not show any change, and 15, 5 reached a complete normalization. It is pointed out the overlap of the precordial kinetics in the ventricular hypertrophies and in the normal subjects (kinetic improvement), and the possibility to differentiate a systolic outward movement due to synergic contraction of hypertrophied ventricle from a systolic outward movement to be reffered to a diskynetic contraction in the myocardial ischemia (kinetic worsening).

[Peripheral lymphatico-venous anastomosis. New surgical technic]. / Anastomosi linfatico-venose periferiche. Nuova tecnica chirurgica.

A new surgical technique for peripheral lymphatic-venous anastomosis is presented. It is designed especially for cases of node block, e.g. lymphoedema after mastectomy. The distal ends of the collectors are sectioned downstream from the block and passed through a patch, which also serves to close a phlebotomy on an adjacent vein. An experimental study and preliminary clinical results are discussed.