The total peroxyl radical trapping potential in serum - an assay to define the stage of atherosclerosis.

Lipid peroxides were identified among the factors that contribute to the atherosclerotic plaque formation in the arterial wall. We hypothesised that a correlation may exist between the content of antioxidant constituents in the serum and the gravity of atherosclerosis. To this purpose, we have determined the serum total peroxyl radical- trapping potential (TRAP), which is the combined capacity of all antioxidants to neutralize free radicals in serum and followed its variation in hyperlipemic animals in correlation with the stage of atherosclerosis. In addition, we compared TRAP values in the sera of coronary heart disease (CHD) patients, with or without type II diabetes mellitus. Results showed that after 18 weeks of hyperlipemic diet, the mean TRAP values measured in sera isolated from hyperlipemic hamsters exhibited an about 44% decrease, in good agreement with the increase of serum cholesterol and triglycerides. In the 3 groups of CHD patients, TRAP values decreased with about 10% in sera of stable angina patients, 20% in unstable patients, as compared with normal subjects. The lowest TRAP values were detected in the sera of patients with acute myocardial infarction. The results obtained for different experimental animals and for CHD patients sera indicate that the TRAP method, as adapted in our laboratory, is a reliable and reproducible assay, fit to be used in clinical studies as an ex vivo measurable parameter that correlates with the stage of the atherosclerosis.

Results of Sotalol (Darob) therapy in ventricular arrhythmias.

UNLABELLED: The aim of this prospective study was to evaluate the benefit of Sotalol (Darob) use in the therapy of potential malignant ventricular arrhythmias and in the prophylaxis of potential malignant and malignant arrhythmias; the influence on mortality has also been considered. Eighty four patients (pts) diagnosed with ventricular extrasystoles (68 pts., namely 80.95%), ventricular tachycardia (9 pts., namely 10.71%) and ventricular fibrillation (7 pts., namely 8.34%) were included in this study. They have been monitored clinically, electrocardiographically and echocardiographically at 1,3,6 and 12 months (1 year). The drug was given orally in doses 80-320 mg/day in patients with ventricular extrasystoles and in mean doses of 160 mg/day, for 1 year, to prevent recurrencies of ventricular arrhythmias. CONCLUSIONS: 1. In malignant and potential malignant ventricular arrhythmias Darob has been efficient on long term (1 year) in 77.67% cases, while in curative treatment of non-malignant ventricular arrhythmias Darob has been efficient in 68.31% cases. 2. Only minor proarrhythmogenic effects have been noticed for the doses of Darob used in this study. 3. long-term administration of Darob seems to reduce the incidence of cardiovascular deaths (35.30% cardiac deaths and 64.70% non-cardiac deaths have been recorded; p < 0.05). 4. Darob constitutes a drug of choice in postinfarction ventricular arrhythmias therapy, due to the beta-blocking effect, favourable during the ischemic episodes which may trigger arrhythmias.

The effect of early perindopril administration on mortality and morbidity in patients with high risk of acute myocardial infarction.

The angiotensin-converting enzyme inhibitors (ACEI) therapy reduces mortality and morbidity after acute myocardial infarction (AMI). Though, there are a few questions to face, in what concerns the ACEI therapy: patients selection, starting time and duration of treatment, pharmacological profile of the various ACEI and their therapeutic efficiency. We aimed to determine if early Perindopril administration in AMI, for three months, may decrease mortality and morbidity in selected patients (high risk and streptokinase thrombolysis).

Results of sotalol (Darob) therapy in supraventricular tachyarrhythmias.

UNLABELLED: The benefit of sotalol therapy in atrial flutter and in atrial fibrillation was considered, aiming as well the suppression of paroxysmal episodes and the prevention of their recurrencies and the control of the ventricular rhythm in chronic cases. The prospective study comprises 60 patients institutionalized in the Cardiology Clinic in which the supraventricular tachyarrhythmia range included: atrial flutter (20 cases) and atrial fibrillation (40 cases), from which atrial fibrillation of recent onset (20 cases) and chronic atrial fibrillation with fast ventricular response (20 cases). Sotalol was administered orally in doses of 80 to 320 mg daily, b.i.d. The conversion to sinus rhythm was obtained in 45% of cases of atrial fibrillation of recent onset and in 30% of cases of atrial flutter. The prophylactic administration of sotalol on long term (6 months), in medium dose of 160 mg daily, may protect against the recurrence of the supraventricular arrhythmias (63.85%). As adverse effect, a case of "torsade des pointes" was recorded. IN CONCLUSION: 1) a greater benefit was noticed by using sotalol prophylactically for the recurrence of the supraventricular arrhythmias (63.85%) compared to the positive results in the therapy of acute cases (37.5%); 2) the maximal efficiency in the prevention of arrhythmia recurrencies can be observed in patients that present underlying compensated ischemic cardiopathy; 3) a decrease of 30% of the ventricular rhythm in patients with atrial fibrillation was obtained.

Acute myocardial infarction and acute "stress ulcer".

Six patients (males, mean age 45 years) who developed gastroduodenal "stress" ulcerations following an acute myocardial infarction (AMI) were studied. In these subjects no previous digestive disease symptoms had been mentioned. The clinical pattern of the "stress ulcer" is often atypical. Stomach seems to be the preferred site of "stress ulcer", which generally appears under the form of multiple lesions. Acute "stress ulcer" prognosis is very severe, due to the high rate of mortality (five out of the six cases in this report).

Lung and heart impairment in patients with chronic cor pulmonale associated or not with acute myocardial infarction. Anatomoclinical and morphometric study.

This study comprises the comparative analysis of the pathological and morphometric findings in the lung and heart of two groups of patients who died with chronic cor pulmonale (CCP), associated or not with acute myocardial infarction (AMI). The histological pulmonary changes were fairly similar in subjects from both groups. In the heart, the right ventricle (RV) is more evidently impaired than the left ventricle (LV) in individuals with CCP without AMI, while in patients with CCP associated with AMI there was a fairly homogeneous damage of both ventricles. These data emphasize the involvement of LV in both groups of patients and support the view that CCP can be considered as an overall myocardiopathy and vasculopathy.