Francesco Aguglia

Early hepatitis during intravenous amiodarone administration

Two patients with acute changes suggesting acute hepatitis after parenteral amiodarone administration are described. No other explanation for liver damage was found in these patients. Normalization of liver function in spite of continuation of drug infusion was observed.

Changes of the intralymphocytic sodium concentration after acute and chronic captopril administration

The effect of captopril on intralymphocytic sodium concentration in hypertensive subjects was studied. After acute and chronic treatment the intralymphocytic sodium content decreased. The possibility is discussed that a similar decrease might also occur in smooth muscle cells, thus enhancing the hypotensive effect of captopril.

Enhanced release of atrial natriuretic factor during exercise-induced myocardial ischaemia in patients after acute myocardial infarction

To determine whether acute myocardial ischaemia induced by dynamic exercise can lead to changes in plasma levels of atrial natriuretic factor, we performed symptom-limited bicycle electrocardiographic tests in 20 males with recent acute myocardial infarction and in 8 control males. Ten patients developed exercise-induced myocardial ischaemia and 10 patients did not. There were no significant differences between the two groups with regard to age, site of myocardial infarction, urinary sodium, atrial sizes, radionuclide left ventricular ejection fraction, workload, baseline and peak-exercise heart rate, baseline and peak-exercise rate-pressure product, duration of exercise. Also baseline atrial natriuretic factor concentrations were similar in both groups (ischaemic patients: 34.51 +/- 15.73 pg/ml; nonischaemic patients: 27.17 +/- 8.74 pg/ml, NS), while peak-exercise atrial natriuretic factor concentrations were higher in patients with exercise-induced myocardial ischaemia (112.31 +/- 35.5 pg/ml) than in the others (80.46 +/- 23.43 pg/ml) (P less than 0.05). After 15 minutes of recovery, plasma atrial natriuretic factor levels were still raised only in the ischaemic patients (63.3 +/- 15.44 pg/ml, P less than 0.01), returning to baseline after 30 minutes in both groups. In control subjects, the behaviour of atrial natriuretic factor resembled that of the patients without exercise-induced ischaemia, with a significant increase at peak-exercise (from baseline levels of 23.1 +/- 10.5 pg/ml to peak-exercise levels of 91.3 +/- 14.5 pg/ml, P less than 0.0005) and a rapid return to baseline levels after 15 minutes of recovery (28.5 +/- 10.6 pg/ml, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Lidocaine, mexiletine and propafenone in the treatment of arrhythmias complicating myocardial infarction. A case report

We describe a case of acute myocardial infarction complicated by atrial and ventricular arrhythmias in which it was possible to verify the effectiveness of lidocaine, mexiletine and propafenone. Intravenous administration of mexiletine was ineffective both on atrial and ventricular rhythm disturbances. The lidocaine therapy reduced ventricular ectopic frequency, but did not prevent the appearance of several paroxysms of atrial fibrillation. Intravenous infusion of propafenone, 11 micrograms/kg per min, after a 1 mg/kg i.v. bolus, immediately and completely suppressed atrial arrhythmias. The increase in infusion rate up to 22 micrograms/kg per min also suppressed ventricular ectopy. This dosage of propafenone did not provoke serious adverse effects in our patient.