[Transesophageal echocardiographic evaluation of tricuspid endocarditis from implanted pacemaker: description of two cases]. / Valutazione con ecocardiografia transesofagea dell'endocardite tricuspidale da impianto di pacemaker: descrizione di due casi.

Two cases of tricuspid valve endocarditis due to staphylococcus epidermidis have been examined in patients with permanent transvenous pacemaker. While transthoracic echocardiography was unable to detect any tricuspidal abnormalities, large vegetations located on the tricuspidal leaflets and the electrocatheter were detected by transesophageal echocardiography. Both cases required surgical removal of the electrostimulation system and valve toilet.

Haemodynamic effects of coffee and purified caffeine in normal volunteers: a placebo-controlled clinical study.

In order to evaluate the effects of 'espresso' Italian coffee on resting flow, blood pressure, and peripheral resistance, 15 non-coffee drinking healthy volunteers received 2 cups of regular coffee, 200 mg purified caffeine or placebo in a latin square double-blind crossover protocol. Before and 30, 60, 90 and 120 min after ingestion, segmental resting flow and BP were measured and peripheral resistance was calculated. An echocardiogram was also performed before and 60 and 120 min after caffeine intake. Both regular coffee and caffeine produced a significant decrease in resting flow and a significant increase in resistance; both systolic and diastolic BP also increased, although not significantly. No variation was observed in heart rate and in cardiac contractility. Placebo (highly decaffeinated coffee for regular coffee and china bitter extract for caffeine) did not produce any haemodynamic effect. In five other healthy volunteers used to drinking more than 5 cups of coffee a day, coffee administration had no effect. These data demonstrate that the caffeine contained in espresso Italian coffee is a vasoconstrictor agent whose effects however are completely blunted in usual coffee drinkers as a consequence of adaptation.

Haemodynamic effects of coffee and caffeine in normal volunteers: a placebo-controlled clinical study.

The acute haemodynamic effects of Italian coffee and 200 mg purified caffeine were investigated in 15 healthy non-coffee-drinkers compared to individuals who consumed placebo (highly decaffeinated coffee for regular coffee, and china bitter extract for caffeine). Before coffee and caffeine consumption and 30, 60, 90 and 120 min afterwards, rest flow and blood pressure were measured, and peripheral resistance in the arm was calculated; an echocardiogram was also performed before and 60 and 120 min after caffeine consumption. Both coffee and caffeine significantly decreased rest flow, and increased peripheral resistance. Systolic blood pressure increased by 10% and diastolic pressure increased by 5% for at least 2 h. No variation in heart rate or cardiac contractility was found. No effects were observed after placebo treatment. It is concluded that Italian coffee and caffeine increase blood pressure via vasoconstriction.

[Hemodynamic effects of "expresso" Italian coffee and pure caffeine on healthy volunteers]. / Effetti emodinamici del caffè espresso all'italiana e della caffeina pura in volontari sani.

In 15 healthy non-coffee-drinker subjects and in 5 usual coffee-drinkers, the effects were studied of 2 cups of "espresso" italian coffee and of 200 mg purified caffeine on blood pressure, heart rate, forearm rest flow and peripheral resistance. In the 15 non-coffee-drinkers, left ventricular ejection fraction, fractional shortening, cardiac output and end-systolic stress were also evaluated by a 2D-guided M-mode echocardiogram before and 60 and 120 min after oral administration of 200 mg purified caffeine. In the non-coffee-drinker volunteers, diastolic and systolic blood pressure and peripheral resistance increased both after "espresso" coffee and after caffeine. In the usual drinkers no hemodynamic effect was seen. No variation of cardiac contractility was observed. We conclude that caffeine contained in the "espresso" coffee obtained with the high-pressure italian procedure is a strong vasoconstrictor agent, while it has no action on cardiac contractility.