Roberto Bolognesi
University of Parma
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Featured researches published by Roberto Bolognesi.
American Journal of Cardiology | 1997
Roberto Bolognesi; Dimitri Tsialtas; Paolo Vasini; Massimo Conti; Carlo Manca
In 2 young adult women who experienced acute heterocyclic antidepressant intoxication, we found a quite unusual electrocardiographic pattern characterized by abnormal ST-tract elevation in the right precordial leads associated with a marked QRS widening (right bundle branch block and left anterior fascicular block type). Because serum electrolyte imbalance and acute myocardial ischemic events were excluded, the mechanism by which antidepressant overdose may produce such elevation of the ST tract remains unclear.
Journal of Electrocardiology | 1979
Franciscus N. Effendy; Roberto Bolognesi; Giovanni Bianchi; Odoardo Visioli
A forty-five year old man with longstanding rheumatic heart disease whose surface electrocardiogram (ECG) showed absent P waves and two alternating QRS complex rhythms, one regular and the other irregular, was submitted to electrophysiological studies. For regular QRS complex rhythm these studies revealed (1) presence of total and bilateral atrial standstill and (2) regular ventricular rhythm originating in the A-V junction; while for irregular QRS complex rhythm the studies showed (1) presence of atrial standstill in the area of the upper right atrium, and (2) a +/- 150/min atrial activity rate in the intracavitary and esophageal electrogram and a +/- 300/min rate in the epicardial mapping. The spread of conduction of this atrial activity indicates that it originated within an atrial area near the tricuspid valve. The presence of an alternating partial and total atrial standstill is a unique feature which to data has not been reported in the literature.
The Cardiology | 1979
Carlo Manca; G. Bianchi; F.N. Effendy; Roberto Bolognesi; Francesco Cucchini; Odoardo Visioli
Five different stress testing methods: bicycle ergometer exercise (BE), treadmill exercise (TD), isoproterenol infusion test (IPN), dopamine infusion test (DPM), and atrial pacing (AP), were performed on 90 male patients who underwent coronary arteriography. Ischemic S-T segment depression of 1.0 mm or greater was used as the criterion for a positive test. Within the group of 56 subjects having significant coronary artery disease (CAD) the diagnostic sensitivity of the single tests was as follows: 64.3% for BE, 66.1% for TD, 69.6% for IPN, 41.1% for DPM, 75.0% for AP. For the 34 subjects with no CAD the folowing specificity was found: 88.2% for BE and for TD, 82.3% for IPN, 85.3% for DPM, 63.8% for AP. When the results of the different tests were combined, it was seen that the association of an ergometric test with IPN enhanced the sensitivity of the exercise test (p less than 0.05) without significantly decreasing the specificity.
International Journal of Cardiology | 1987
Roberto Bolognesi; Francesco Cucchini; Carlo Manca; Roberto Ferrari
We have evaluated the effects of nifedipine and verapamil on rate of left ventricular relaxation in 26 patients having coronary arterial disease with normal ejection fraction and normal left ventricular contractility. None of the patients had myocardial infarction. All patients showed normal contractile indices and abnormally high values of T constant, neg, dP/dt and left ventricular protodiastolic pressure, suggesting an impairment of left ventricular relaxation. Nifedipine, injected intravenously (15 micrograms/kg) in 14 patients induced a significant reduction of afterload parameters and an increase of contractility. Nifedipine also improved left ventricular relaxation, as it induced a reduction of the T constant from 42 +/- 2 msec to 33 +/- 2 msec (P less than 0.01). It induced a tendency to a reduction of negative dP/dt and protodiastolic pressure without reaching statistical significance. Verapamil, injected intravenously in the remaining 12 patients (0.1 mg/kg as a bolus followed by chronic infusion of 0.005 mg/kg/min for 3 min) induced a reduction of the T constant from 43 +/- 10 to 37 +/- 6 msec (P less than 0.01). It reduced the negativity of dP/dt from 2302 +/- 273 to 2021 +/- 252 mm Hg/sec (P less than 0.05) and of left ventricular protodiastolic pressure from 3.2 +/- 1.4 to 1.5 +/- 1.1 mm Hg (P less than 0.01). Verapamil, like nifedipine, reduced the afterload parameters although to a lesser extent. It did not substantially affect the left ventricular contractility. These data suggest that abnormalities of left ventricular relaxation may precede changes in systolic function and that nifedipine and verapamil favourably modify the indices of left ventricular diastolic function in patients with coronary arterial disease.
American Journal of Cardiology | 1992
Roberto Bolognesi; Francesco Cucchini; Antonio Javernaro; Roberto Zeppellini; Carlo Manca; Odoardo Visioli
In 10 patients with coronary artery disease, preserved left ventricular (LV) performance and absence of previous myocardial infarction, the effects of an acute intravenous administration of k-strophantidin (0.005 mg/kg over 10 minutes) on selected parameters of both LV systolic and diastolic function, including relaxation, were evaluated. An increase in positive first derivative of LV pressure (dP/dt) and in the ratio between dP/dt and the pressure developed (dP/dt/P) (1,530 +/- 287) 1,600 +/- 329 mm Hg/s [p less than 0.05], and 30 +/- 6 to 34 +/- 8 s-1 [p less than 0.05], respectively) demonstrated the inotropic effect of k-strophantidin, whereas volumetric parameters of systolic function (end-systolic and stroke volume indexes, and ejection fraction) did not show any significant change. However, LV relaxation was impaired by k-strophantidin injection; in fact, mean values of T constant were significantly increased from 50 +/- 12 to 55 +/- 13 ms (p less than 0.01). Lowest LV and end-diastolic pressures increased from 8 +/- 4 to 11 +/- 4 mm Hg (p less than 0.05) and from 17 +/- 6 to 20 +/- 8 mm Hg (p less than 0.05), respectively. The end-diastolic volume and maximal rate of volumetric increase during the early and late filling phases were not modified by k-strophantidin. Mean aortic pressure increased from 110 +/- 10 to 120 +/- 12 mm Hg (p less than 0.001). Therefore, in patients with coronary artery disease and LV preserved performance, an acute intravenous administration of k-strophantidin appears to stimulate contractility and to worsen relaxation, and minimal LV and end-diastolic pressures.
Journal of Diabetes and Its Complications | 2011
Roberto Bolognesi; Dimitri Tsialtas; Maria Giulia Bolognesi; Claudio Giumelli
We report an uncommon case of an insulin-treated diabetic patient, presenting severe hypoglycemia, coma, marked sinus bradycardia and QT prolongation. Intravenous administration of glucose and atropine awaked the patient and increased heart rate but did not affect QT prolongation. Basal and exercise electrocardiogram excluded primary diseases associated with QT prolongation. Pathophysiologic aspects of electrocardiographic and clinical findings occurring in the hypoglycemic patients are briefly discussed.
Cardiovascular Drugs and Therapy | 1991
Roberto Bolognesi
SummaryThe pharmacologic treatment of atrial fibrillation (AF) is aimed at controlling the ventricular response, restoring sinus rhythm, and preventing or delaying relapses. In the control of ventricular response, digitalis maintains a primary role when the arrhythmia is accompanied by heart failure. In ischemic, hypertensive, and degenerative (whose number is increasing at present) cardiopathies without evident ventricular dilatation, treatments with calcium antagonists (such as verapamil, gallopamil, or diltiazem) or beta-blocking agents must be preferred. In order to control the ventricular response in patients with chronic AF during physical activity, the association of digitalis with beta-blocking agents or calcium antagonists seems to provide satisfactory results. The drugs of the IC class, especially flecainide, represent a certain therapeutical progress in the restoration of sinus rhythm in the treatment of paroxysmal atrial fibrillation affecting subjects without evident alterations of ventricular function, particularly in subjects with Wolff-Parkinson-White syndrome, with forms of vagal origin, or with atrial fibrillation alone. A therapeutic combination of digitalis and quinidine may produce resolution of the arrhythmia in the presence of altered ventricular function or when AF is of an uncertain onset. In patients with hypertensive, ischemic, and/or degenerative cardiopathy without evident ventricular or advanced heart failure, the verapamil-quinidine association may also be effective and even quicker. The combination of drugs of the I and III class for restoration of the sinus rhythm in particularly resistant forms of AF without evident structural heart alterations is promising but must be verified in a greater number of patients. In the prevention of relapses amiodarone appears to have the widest spectrum of advantages from an electrophysiologic point of view; however, because of its many side effects, amiodarone represents a late therapeutical choice. The promising results obtained with flecainide are disputed by the results of the CAST, which limit the possibilities of using this drug to a low number of cases (W.P.W. syndrome, AF of vagal origin, atrial fibrillation alone). In the past, quinidine and disopyramide have been the drugs most widely used in the prophylaxis of AF. These drugs have a similar efficacy, and both of them provided some positive results. However, because of untoward side effects (especially for quinidine) during chronic treatment, the use of these drugs has been questioned. Perhaps in the majority of patients, the less dangerous therapeutic choice after the termination of the fibrillation is a combination of drugs slowly down AV node activity (digitalis or calcium antagonists and beta blockers) with class IA antiarrhythmics.
La Ricerca in Clinica E in Laboratorio | 1980
Elio Roti; Patrizia Bandini; Giuseppe Robuschi; Rossella Emanuele; Roberto Bolognesi; Emilio Ciarlini; Paolo Buzzonetti; Angelo Gnudi
SummarySerum concentrations of myoglobin, creatine kinase and lactate dehydrogenase were measured in 33 euthyroid, 21 hyperthyroid and 15 hypothyroid subjects. The results showed that myoglobin, creatine kinase and lactate dehydrogenase were increased and decreased in the hypoand hyperthyroid states, respectively. In addition, the concentrations of myoglobin, creatine kinase and lactate dehydrogenase values were inversely related to both the thyroxine and triiodothyronine concentrations. To study the origin of the increased muscle protein values observed in hypothyroidism, the cardiac isoenzyme fractions were measured; the results obtained support the view that the muscle enzymes are mainly derived from skeletal muscles.
Heart Surgery Forum | 2007
Dimitri Tsialtas; Roberto Bolognesi; Cesare Beghi; Daniela Albertini; Maria Giulia Bolognesi; Carlo Manca; Tiziano Gherli
BACKGROUND Whether the use of stentless aortic bioprostheses improves hemodynamics more than stented bioprostheses in the small aortic root is still a matter of debate. METHODS Early- and mid-term effects were compared between 2 different types of stentless bioprotheses and 1 type of stented bioprosthesis for left ventricular remodelling. The effects of the bioprotheses were studied by echocardiography in 68 patients (age, 74 +/- 7 years) with aortic annulus diameter < or =23 mm who were undergoing prosthesis implantation due to aortic isolated stenosis. Stented bioprostheses (Carpentier-Edwards Perimount [CEP]) were implanted in 36 subjects and stentless bioprostheses (18 Toronto SPV and 14 Shelhigh Super Stentless) were implanted in 32 subjects. RESULTS A progressive and similar decrease in left ventricular mass of 30% was observed in both stented and stentless bioprostheses at 12 months. A progressive increase in transprosthetic effective orifice area and a decrease in transprothetic pressure gradient were observed at 3, 6, and 12 months in the Toronto group, but these variables showed improvement only at 3 months in the CEP and Shelhigh groups. No mortality occurred during surgery or during the 1-year follow-up period. CONCLUSIONS Our results confirmed good feasibility of aortic stented and stentless bioprostheses implantation in the elderly population. A 30% decrease in left ventricular mass occurred in the early- and mid-term (12 months) periods after surgery with all 3 types of bioprostheses. Advantages consisting of a progressive increase in transprosthetic effective orifice area and a decrease of the transprosthetic pressure gradient were observed in the Toronto group in comparison to the CEP and Shelhigh groups. These observations may help surgeons in choosing bioprostheses.
Cardiovascular Drugs and Therapy | 1987
O. Visioli; Roberto Bolognesi; F. Cucchini; Roberto Ferrari
SummaryWe studied the acute effects of intravenous nifedipine on hemodynamics and left ventricular function of CAD patients without previous treatment (group 1) and of 10 CAD patients receiving acebutolol (9 mg/kg daily) and who had been shown to be adequately beta blocked (reduction in heart rate by 25%) (group 2). Intravenous nifedipine (15 μg/kg) significantly reduced systemic peripheral resistances in both groups: this was associated with decreased systolic blood pressure and increased left ventricular cardiac output with a slight nonsignificant increase of ejection fraction. There was a significant increase in heart rate in both groups, the chronotropic response to nifedipine being attenuated in patients receiving acebutolol. Left ventricular end-diastolic pressure did not change in the first group, but it was significantly decreased in the second group, with a concomitant increase of end-diastolic left ventricular volume, suggesting an amelioration of diastolic compliance.The effect of nifedipine on intrinsic myocardial contractility was quite different, depending on the presence of beta adrenergic blockade. When given to patients of group 1, nifedipine significantly increased dP/dtmaxVcemax, and Vmaxd. The same indices, however, were significantly depressed when nifedipine was given to the patients of group 2 receiving acebutolol.This study shows that intravenous nifedipine can be usefully administered to patients with coronary artery disease who have been on adequate beta-blocking doses of acebutolol with relative safety. Under these conditions nifedipine increases cardiac output in association with arterial dilation, despite evidence for a negative inotropic effect. These data also suggest that such an intrinsic negative inotropic effect would normally be masked by compensatory sympathetic activity.