[The antianginal effects of a new delayed-release formulation of diltiazem in patients with stable angina pectoris: its evaluation by the ergometry test and dynamic electrocardiogram]. / Effetti antianginosi di una nuova formulazione ritardo di diltiazem nei pazienti con angina pectoris stabile: valutazione mediante test ergometrico ed elettrocardiogramma dinamico.

The antianginal efficacy and duration of action of slow-release (SR) diltiazem were evaluated in 12 patients with stable angina. Patients underwent maximal symptom limited bicycle exercise testing and 24-hour Holter monitoring at the end of 1-week placebo run-in phase and after 1-month therapy with either placebo or SR-diltiazem (120 mgs bid) using a placebo controlled, double-blind, randomized cross-over trial. No concomitant antianginal therapy, except sublingual nitroglycerin, was allowed during the trial. Exercise testing was performed 3 and 12 hours after drug administration. Blood samples were obtained for the determination of diltiazem plasma concentrations. After diltiazem administration, peak exercise duration increased significantly in comparison both with placebo and the run-in phase: from 292 +/- 48 to 378 +/- 113 s at 3 hours and from 286 +/- 59 to 366 +/- 109 s 12 hours after drug administration. Similarly, ST depression time increased from 240 +/- 59 to 374 +/- 123 s at 3 hours and from 231 +/- 57 to 332 +/- 123 s 12 hours after diltiazem. No significant changes of heart rate, blood pressure and double product were detected. Diltiazem plasma concentrations averaged, respectively, 175 +/- 86 pg/ml and 109 +/- 43 pg/ml 3 and 12 hours after its administration. No correlation was found between plasma concentrations and antianginal effects of diltiazem. At 24 hours Holter monitoring, SR-diltiazem induced a significant decrease of mean heart rate with a reduction in the number and duration of ischemic episodes.(ABSTRACT TRUNCATED AT 250 WORDS)

[Lower myocardial infarct with depression of the ST segment in anterior precordial leads. Correlation of the electrocardiogram, coronarography and ventriculography performed in the acute phase]. / Infarto inferiore con sottoslivellamento del tratto ST nelle derivazioni precordiali anteriori. Correlazione fra elettrocardiogramma, coronarografia e ventricolografia eseguiti in fase acuta.

We report on 11 pts affected by acute inferior myocardial infarction (group A: 4 pts without precordial ST-segment depression; group B: 7 pts with ST precordial ST-segment depression). These pts underwent left and right coronarography and left ventriculography in the course of intracoronary thrombolysis. We did not observe, in the group B pts, an involvement of the LAD branch of the left coronary, neither contractility abnormalities of the left ventricular anterior wall. ST depression in the precordial leads was associated with severe and extensive abnormalities of left ventricular inferior wall contractility.

Pre-operative sinus node function in adult patients with atrial septal defect (ostium secundum type).

The authors studied, pre-operatively, the sinus node function in adult patients with secundum atrial septal defect and large left-right shunts, using Holter ECG and electrophysiological tests. Sinus node electrophysiological tests were found abnormal in 17 out of 26 patients; on the contrary, Holter monitoring was always within normal limits. The authors believe that concealed sinus node dysfunction existing before surgical correction may be a cause of early, acute, and reversible, post-operative sick sinus syndrome.

Iopamidol: a new contrast medium in coronary angiography. Comparison, on electrophysiological changes in man, with a commonly used contrast medium.

In 30 patients undergoing coronary angiography the effects of Iopamidol on sinus node activity, atrioventricular and intraventricular conduction were evaluated using His Bundle recordings, and compared to the effects produced by Diatrizoate. Diatrizoate resulted in an increase in sinus cycle length and prolonged AV nodal conduction, resulting in second degree AV block in two patients. Iopamidol had significantly less effect on sinus cycle (P less than 0.01) and AV nodal conduction (P less than 0.01). Neither contrast media affected intraventricular conduction. No difference was noted in the imaging power of the two contrast media. It is suggested that non-ionic, low osmotic contrast media such as Iopamidol will result in increased patient safety during coronary angiography without loss of imaging power.