[Spectral analysis and color-coded Doppler study of the changes in aortic regurgitation induced by vasodilators in asymptomatic patients with severe aortic insufficiency]. / Studio Doppler ad analisi spettrale e a codice di colori delle modificazioni del rigurgito aortico indotte da vasodilatatori in pazienti asintomatici affetti da insufficienza aortica grave.

The acute effects of 20 mg of sublingual nifedipine in 12 patients with chronic severe aortic regurgitation were evaluated with M-mode echocardiography, continuous wave and colour Doppler. After nifedipine, heart rate increased from 68 +/- 8 to 82 +/- 11 beats/m' (p less than 0.001); arterial systolic and diastolic pressures decreased from 143 +/- 16 to 129 +/- 9 mmHg (p less than 0.01) and from 61 +/- 11 to 53 +/- 17 mmHg (p less than 0.01) respectively. Left ventricular systolic and diastolic diameters also decreased from 50 +/- 4 to 46 +/- 4 mm (p less than 0.01) and 76 +/- 6 to 72 +/- 6 mm (p less than 0.01) respectively; the slightly increase in fractional shortening which occurred was not significant. The aortic systolic and diastolic velocity integrals decreased from 38 +/- 9 to 34.7 +/- 8 cm (p less than 0.01) and from 203 +/- 41 to 163 +/- 29 cm (p less than 0.001); the diastolic slope of the velocity curve increased a little but significantly: from 334 +/- 70 to 394 +/- 70 cm/sec2 (p less than 0.01). With colour Doppler, protodiastolic jet areas decreased by 19% in the long parasternal view (p less than 0.01), by 28% in the apical view (p less than 0.001), by 26% in the short-axis view (p less than 0.01); the length of the jets in the long parasternal view decreased by 14% (p less than 0.001), but the height did not change significantly. Positive changes from acute nifedipine administration are present in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

[Holter evaluation in elderly subjects without cardiovascular disease]. / Valutazione Holter nei soggetti anziani senza malattia cardiovascolare.

In 2001, 22% of the Italian population will be over 60 and the morbidity/mortality rate due to cardiovascular disease is extremely high in this age group. However reports in the literature disagree on the incidence of arrhythmias. The present study assesses the incidence of hyper and hypokinetic arrhythmias in a group of "over-sixties" with no clinical signs of cardiovascular and/or systemic disease. Twenty-four hour Holter monitoring was performed on 103 patients (49 male, 54 female) after clinical examination anamnesis, ECG and chest X-rays had shown a normal picture. There was a wide variation in total heart beats and maximum-minimum cardiac frequency but none of these variables appeared related to age. Total heart beat and minimum cardiac frequency figures were significantly higher among the bedridden (p less than 0.01 and p less than 0.05 respectively). There were no supraventricular arrhythmias in 63% of the patients and only simple forms were encountered in the 38 patients presenting such arrhythmias. Ventricular arrhythmias were absent in 60% of the group, while among the 41 patients presenting these phenomena, as many as 32 presented simple forms, while only 5 were in Lown's class IV and 2 of these due to a single pairing, 1 a single triplet. No significant difference was found in the incidence of supraventricular and ventricular arrhythmias among the 60-69 and 70-79 age groups. There were 3 cases of transitory nocturnal grade I atrioventricular block, but no advanced hypokinetic arrhythmias. The ST-T interval revealed no alterations definitely indicative of ischaemia, despite the presence of alterations in the basal morphology. To sum up, the study revealed a low incidence of supraventricular and ventricular arrhythmias in the elderly population examined and most importantly, the vast majority of those encountered were simple forms.