bluuebunny/crossref_metadata_2025_split huggingface dataset:
Circulatory response to prenalterol in normal subjects and in patients with primary congestive cardiomyopathy
Authors: Guazzi M. D. , Qing Lü Guo , Olivari M. T. , Fiorentini C. , Loaldi A. , Bartorelli A. , Moruzzi P. , Polese A. 
Published: August 2010

ABSTRACTExperimental pharmacology indicates that prenalterol is a selective β1–adrenoceptor activator. In 5 normal individuals, 15 minutes after the drug (infused at a dose of 15 μg/kg over 5 min) the following circulatory changes were seen:a) increase of cardiac index (+31%), heart rate, stroke Index, systolic aortic pressure, left and right ventricular mean rate of ejection and mean rate of the pressure rise in either ventricle during the pre–ejection phase;b) reduction of systemic vascular resistance (–18%), appearance, built–up and disappearance times in the left ventricular dye dilution curves. Pulmonary systolic, diastolic and wedge pressures and vascular resistance did not vary consistently. The circulatory effects persisted almost unchanged 30 minutes after the infusion.In a group of 5 patients with heart failure due to primary congestive cardiomyopathy, refractory to conventional therapy, the haemodynamic response to prenalterol (infused at a dose of 30 μg/kg over 5 min) was qualitatively similar to that of normal subjects in 3 cases. In 2 other patients cardiac performance deteriorated. The reasons for this paradoxical effect were not identified.These preliminary results suggest that prenalterol is a potent selective inotropic agent in man, that may assist in the therapeutic management of refractory heart failure due to congestive cardiomyopathy. However, careful haemodynamic monitoring is advisable for its use in this dysfunction until broader clinical experience can be accumulated.
Dose–dependent haemodynamic response to prenalterol in patients with congestive heart failure
Authors: Leinberger H. , Mäurer W. , Haueisen H. , Schuler G. , Kübler W. 
Published: August 2010

ABSTRACTThe effect of three doses of prenalterol, 12.5, 25 and 50 μg, on cardiac index (CI), pulmonary artery pressure (PAP), heart rate (HR), and stroke volume index (SVI) was investigated in 18 patients with congestive heart failure (CHP). Twelve patients received only prenalterol, while 6 patients received prenalterol 1 hour after an oral dose of hydralazine and isosorbid dinitrate. In 7 out of 12 patients a dose–dependent increase in HR was observed. The response of HR was inversely correlated to resting catecholamine levels; patients with high resting catecholamines – these are patients with severe CHP – did not show any increase2 in HR. CI increased in 8 out of 12 patients (average l.l/min m2) and SVI in 5 out of 12 patients. This inconsistent response was not dependent on left ventricular ejection fraction or plasma catecholamines at rest. Pretreatment with vasodilators did not improve the haemodynamic response to prenalterol. Pour out of 17 patients demonstrated an increase in severity of arrhythmias suggestive of arrhythmogenic properties of prenalterol.
Twelve Years of Coronary Bypass Surgery in Helsinki
Authors: Frick M. H. , Harjola P‐T. , Valle M. , Järvinen A. , Hekali P. 
Published: August 2010

ABSTRACT. During the 12‐year period from 1970 to 1981 662 patients have had an elective coronary bypass operation at our institution with a hospital mortality of 1,9%. Selected randomized subsets of the series have been subjected to detailed postoperative studies to elucidate the effects on morbidity, employment, and mortality, in particular. Other studied variables include graft patency, progression of coronary atherosclerosis, and left ventricular function.Exercise tolerance is markedly improved especially in patients with complete revascularization (+98%, p < 0.001) in contrast to unchanged data in medically managed patients. This improvement persists for at least 2 years and has an impact on employment. Sixty per cent of the surgical patients were at work 2 years after operation in contrast to 26% of the similar medically managed patients (p < 0.05). Annual mortality during a follow‐up of 5 years has been 0.9% in surgical patients compared with 4% in randomized medical patients (p < 0.05).Unsettled topics include the surgical management of patients with unstable angina pectoris and patients with modest or no symptoms but a multivessel coronary artery disease. Further problems are the possible surgical management of high risk patients at discharge after myocardial infarction and the final position of non‐surgical coronary artery manipulations.
THE PROGRESS OF PATIENTS IN THE EUROPEAN WORKING PARTY ON HYPERTENSION IN THE ELDERLY TRIAL
Authors: Amery A. , Beard K. , Birkenhäger W. , Bogaert M. , Brixko P. , Bulpitt C. , Clement D. , de Leeuw P. , De Plaen J.F. , Deruyttere M. , De Schaepdryver A. , Fagard R. , Feltkamp H. , Forette F. , Forte J. , Grauwels R. , Harady R. , Henry J.F. , Koistinen A. , Leonetti G. , Lewis P. , Lund‐Johansen P. , MacFarlane J.P.R. , Meurer K. , Miguel P. , Morris J. , Mutsers A. , Nissinen A. , O'Brien E. , O'Callaghan W. , O'Malley K. , Omvik P. , Petrie J.C. , Puska P. , Terzoli L. , Tuomilehto J. , Varis R. , Webster J. , Williams B. , Willemse P. 
Published: August 2010

ABSTRACT792 hypertensive patients above the age of 60 have entered the double‐blind multicentre trial of the European Working Party on High blood pressure in the Elderly (EWPHE). Half were treated with hydrochlorothiazide and triamterene and half were given placebo and a second capsule was given and if necessary up to 2 g of methyldopa/day. The measurements in a sample of 157 patients suggested 80–86% compliance rate.A significant blood pressure difference of 25/10 mm Hg was obtained between the groups and maintained during five years of follow‐up.The increase in serum creatinine found in the actively treated group was related to the decrease in sitting systolic blood pressure. Changes in serum uric acid correlated with changes in serum creatinine both in the placebo and in the actively treated group. Fasting blood glucose changed significantly in the active treatment group. The balance between this decreased risk on the basis of the blood pressurer eduction and the increase produced by the rise in blood glucose and the other treatment effects remains to be determined. The trial continues and more patients are being admitted.
Effect of Verapamil on Serum Lipoproteins in Patients with Angina Pectoris
Authors: Walldius Göran 
Published: August 2010

SummarySince several β‐blocking agents increase the atherogenic VLDL‐triglycerides and decrease the atheroprotective HDL‐cholesterol we studied if verapamil also affects these lipoproteins or the most atherogenic LDL‐cholesterol. Twelve patients (three females), mean age 56 years, with angina pectoris or hypertension/tachyarrhythmias were treated with verapamil 240–320 mg/day. Serum lipoproteins were measured before and after 6 and 24 weeks of therapy. Initial total serum cholesterol averaged 7.27 mmol/1. After 6 weeks of treatment it decreased by 9%, p<0.02. These results remained significant, p<0.01 after 24 weeks. The decrease was due to a fall in LDL‐cholesterol by 12%, p < 0.01. The reduction in LDL‐cholesterol was correlated to initial LDL‐cholesterol concentration, r=‐ 0.73, p < 0.01. Within LDL there was a parallel decrease in phospholipids, p < 0.05. There were no changes in total or VLDL‐triglycerides or total HDL‐cholesterol. In the HDL fraction HDL2 decreased insignificantly but HDL3 cholesterol increased by 12%, p<0.05.We conclude that verapamil has a beneficial effect on serum lipoproteins in that it lowers the atherogenic LDL‐cholesterol and does not affect the other lipoproteins in an undesirable way.
Serum lipoproteins after treatment with verapamil for 6 months
Authors: Færgeman Ole , Meinertz Hans , Fischer Hansen Jørgen 
Published: August 2010

SummaryFasting levels of serum lipids and lipoproteins were measured in survivors of acute myocardial infarction after 6 months of treatment with placebo (n = 19) or verapamil 360 mg daily (n = 13). There were no significant differences between the groups and values had not changed in the verapamil group 2 weeks after cessation of treatment.
Effects of Verapamil in Hypertensive Patients
Authors: de Leeuw P.W. , Birkenhäger W.H. 
Published: August 2010

SummaryIn fifteen patients with uncomplicated essential hypertension verapamil reduced systolic as well as diastolic blood pressure by virtue of a decrease in total peripheral vascular resistance. Renal vascular resistance also fell, but renal perfusion was well maintained. Although levels of renin and angiotensin II remained unchanged, aldosterone levels fell significantly. Noradrenaline levels rose slightly, but changes were not significant. On the other hand adrenaline was significantly reduced. Renal sodium excretion was markedly enhanced, perhaps secondary to aldosterone suppression. Despite sodium loss, plasma volume increased suggesting that verapamil not only lowers arterial but also venous resistance.
Antihypertensive Effect of Verapamil in Patients with Newly Discovered Mild to Moderate Essential Hypertension
Authors: Hedbäck B. , Hermann L. S. 
Published: August 2010

SummaryThe antihypertensive effect of verapamil (Isoptin®) 120 mg × 3 for four weeks was compared with that of placebo in a randomized, double‐blind, cross‐over investigation. Twenty patients with newly discovered, not previously treated, mild to moderate essential hypertension were included in the study. Verapamil significantly reduced the diastolic and systolic blood pressure in the supine and standing positions, as well as the heart rate. One patient discontinued the treatment because of rash. Otherwise, only constipation was registered as a side effect of Isoptin. No orthostatic reactions were observed and the PQ‐interval was unchanged. Compliance was excellent.
Blood Pressure Changes in Man during Infrasonic Exposure
Authors: DANIELSSON ÅKE , LANDSTRÖM ULF 
Published: August 2010

ABSTRACT.Danielsson Å. LandstrÖm U. (Department of Internal Medicine, University Hospital, and National Board of Occupational Safety and Health, UmeÅ, Sweden.) Blood pressure changes in man during infrasonic exposure.Twenty healthy male volunteers were exposed to infrasound in a pressure chamber especially designed for the experiments. The effects on blood pressure, pulse rate and serum cortisol levels of acute infrasonic stimulation were studied in a series of different experiments. Varying frequencies (6, 12, 16 Hz) and pressure levels (95, 110, 125 dB(lin)) were tested. Significantly increased diastolic and decreased systolic blood pressures were recorded without any rise in pulse rate. The increase in diastolic blood pressure reached a maximal mean of about 8 mmHg after 30 min exposure. The results suggest that acute infrasonic stimulation induces a peripheral vasoconstriction with increased blood pressure, previously shown to occur in conjunction with industrial noise. Chronic long‐term exposure to environmental infrasound may be of importance for the development of essential hypertension in predisposed individuals.
Long‐term β1‐Selective Adrenergic Blockade and Adrenergic Receptors in Human Subcutaneous Adipocytes
Authors: WAHRENBERG HANS , ARNER PETER , ENGFELDT PETER , HAGLUND KJELL , RÖSSNER STEPHAN , ÖSTMAN JAN 
Published: August 2010

ABSTRACT. Wahrenberg H, Arner P, Engfeldt P, Haglund K, RÖssner S, Östman J. (Department of Internal Medicine and Research Centre, Huddinge Hospital, Karolinska Institute, Huddinge, and Department of Internal Medicine, Karolinska Hospital, and King Gustaf V Research Institute, Stockholm, Sweden.) Long‐term β1‐selective adrenergic blockade and adrenergic receptors in human subcutaneous adipocytes.The influence of β‐adrenergic blockade with metoprolol, a β1‐selective agent, on the adrenergic regulation of lipid mobilization was explored in subcutaneous adipocytes removed from 13 patients with essential hypertension. Treatment with metoprolol, which was associated with adequate β‐adrenergic blockade and an antihypertensive effect, resulted in a significant increase (p<0.05) in the binding of the β‐adrenergic antagonist (‐)‐(3H)‐dihydroalprenolol and a 50% increase (p<0.01) in the maximum lipolytic response to the β‐adrenergic agonist isopropylnoradrenaline. In 7 patients with normotriglyceridaemia the total plasma triglyceride level increased significantly (p<0.025) during metoprolol treatment, a change that was due to an increase in the very low density lipoprotein triglycerides. The findings suggest that chronic treatment with the β1‐selective adrenergic blocker metoprolol leads to a significant increase in β‐adrenoceptor density and an increase in the lipolytic response to β‐adrenergic agonists. This latter finding may, in some measure, account for the increased plasma triglyceride level observed.
Morbid Obesity, Gastric Plication and a Severe Neurological Deficit
Authors: SOMER HANNU , BERGSTRÖM LEA , MUSTAJOKI PERTTI , ROVAMO LIISA 
Published: August 2010

ABSTRACT. SomerH, BergstrÖm L, Mustajoki P, Rovamo L. (Department of Neurology, Third Department of Internal Medicine and Children's Hospital, University of Helsinki, Helsinki, Finland.) Morbid obesity, gastric plication and a severe neurological deficit.A 39‐year‐old man had protracted vomiting after gastric plication for morbid obesity. Within three months he lost 53 kg in weight and developed neuromuscular weakness, especially in the lower extremities. Clinical and laboratory studies suggested both radicular and peripheral neuropathy. One year later the condition was only marginally improved: he took only few steps unsupported. The apparent etiology is malnutrition but the primary cause remained unknown.
Left Ventricular Function During Transluminal Angioplasty: A Haemodynamic and Angiographic Study
Authors: Serruys P. W. , Wijns W. , van den Brand M. , Mey S. , Slager C. , Schuurbiers J. C. H. , Hugenholtz P. G. , Brower R. W. 
Published: August 2010

ABSTRACT. The response of left ventricular function, was studied in a series of patients undergoing percutaneous transluminal coronary angioplasty (PTCA). From 4 to 6 balloon inflations procedures per patient were performed with an average duration per occlusion of 51 ± 12 sec (mean ± SD), total occlusion time 252 ± 140 sec. Analysis of left ventricular (LV) haemodynamics showed that the relaxation parameters peak negative rate of change in pressure and the early time constant of relaxation responded earliest to acute coronary occlusion while other parameters such as peak pressure, LV end‐diastolic pressure, and peak positive rate of change of pressure responded more gradually and suggested a progressive depression in myocardial mechanics during the entire procedure. LV angiogram available in 14 patients indicate an early onset of asynchronous relaxation concurrent with the early response in peak ‐dP/dt and the time constant of early relaxation. All haemodynamic parameters fully recovered within minutes after the end of PTCA.The results of this study indicate no permanent dysfunction to global or regional myocardial mechanics, after PTCA with 4 to 6 coronary occlusions each lasting 40 to 60 seconds.
PACEMAKER INFECTIONS
Authors: Bluhm Gösta 
Published: August 2010

ABSTRACTInfection is a major complication of pacemaker treatment. Antibiotic prophylaxis has been used in association with pacemaker surgery with conflicting results, and conclusive prospective trials are lacking. This investigation indicated that systemic antibiotic prophylaxis was of benefit when infections occured frequently. The effect of local antibiotic prophylaxis was comparable with that of systemic prophylaxis at generator replacements. No serious adverse effects of the prophylaxis were noted. However, with modern surgical methods and hygienic principles, antibiotic prophylaxis did not seem to be necessary at implantation of new cardiac pacemakers.Once infection had developed it was difficult to eradicate and serious complications sometimes occured. Most infections commenced in the pacemaker pocket. A few cases were cured by antibiotic treatment alone but, particularly if the infection spread along the electrode, surgery was strongly needed and in the presence of endocarditis and/or septicemia all foreign material should be removed if possible.The most common causal microorganisms of pacemaker infections were Staphylococcus aureus and Staphylococcus epidermidis. Routinely performed pre‐, per‐ and postoperative cultures were of no prognostic value. Persistent use of antibiotics could select for methicillin‐resistant coagulase‐negative staphylococci, therefore bacteriological monitoring of wound infections was considered important.The dosage schedules used for cloxacillin and flucloxacillin gave satisfactory serum concentrations peroperatively. Local treatment with cloxacillin in the pacemaker pocket peroperatively gave adequate concentrations in tissue fluid from the pocket 24 h after the operation, as did systemic administration of flucloxacillin. The pharmacokinetics of flucloxacillin in these elderly patients differed in some respects from that found in healthy volunteers. Plasma elimination half‐life was almost twice as long. Despite the high degree of plasma protein binding, flucloxacillin appeared to pass rapidly and efficiently to extravascular compartments, such as a pacemaker pocket.
VALUE OF THE CLONIDINE SUPPRESSION TEST IN THE DIAGNOSIS OF PHEOCHROMOCYTOMA
Authors: Karlberg Bengt E. , Hedman Lisbeth 
Published: August 2010

ABSTRACT. The clinical value of a clonidine suppression test was assessed in three different groups: I. 14 normotensive, healthy people: II. 34 patients with “neurogenic” hypertension: III. 10 patients with pheochromocytoma confirmed at operation. After clonidine (300 mg by mouth) blood pressure (BP) and circulating plasma catecholamines (CA) were reduced in groups I and II. The maximum fall in mean BP was 25/9 mmHg in group I and 43/24 mmHg in group II; the corresponding fall in patients with pheochromocytoma was 19/0 mmHg. The mean concentrations of ciruculating noradrenaline (NA) were significantly reduced in groups I and II, maximum suppression occurring 2–3 h after giving clonidine. In group I the mean reductions in NA were from 1.3 (SEM 0.2) to 0.6 (0.06) nmol/l (p <0.01), and in group II from 2.6 (0.3) to 0.7 (0.05 nmol/l (p< 0.2); plasma concentrations of A were very low (<0.01 nmol/l) in both groups, and remained unchanged throughout the test.In contrast, in the 10 patients with pheochromocytoma the mean basal plasma CA concentrations exceeded our upper reference limit NA 7.7 (2.2 and A 4.0 (1.7 nmol/l), and remained high or even rose during the test. Four patients in this group with only marginally elevated basal plasma CA showed the same pattern of response during clonidine administration. After successful removal of the catecholamine‐secreting tumour all patients achieved a normal BP. The plasma CA was suppressed into the normal range when the clonidine test was repeated 1–2 weeks postoperatively. No serious adverse effects were observed. We conclude that the clonidine suppression test is a safe and useful procedure in the diagnosis of pheochromocytoma, especially when basal levels of CA are normal or only marginally elevated.Part of this matter was presented at the First International Congress of Endocrine Surgery, Paris, September 1–6, 1985.
THIAZIDES AND LOOP‐DIURETICS THERAPEUTIC ASPECTS
Authors: Beermann Björn 
Published: August 2010

AbstractThiazides and compounds with similar models of action exert their most important renal effects on the cortical‐diluting segment of the nephron, most likely from the peritubular side, In contrast, the most important site of action of loop‐diuretics is the luminal side of the ascending part of the diluting segment. The different sites of action explain the clinically proven efficacious combination of thiazides and loop‐diuretics in severe cardiac failure.Most thiazides and loop‐diuretics are eliminated via renal tubular secretion, which leads to decreased renal clearance in patients with chronic heart failure (CHF) as their renal blood flow is decreased even if glomural filtration rate (GFR) is maintained. A rational approach to enhance the effects of loop‐diuretics is to combine them with drugs that increase renal blood flow, thereby increasing the rate of delivery of the drug to its site of action.Dilutional hyponatremia is an important complication of treatment with diuretics. An efficacious treatment of that condition seems to be a combination of loop‐diuretics and ACE‐inhibitors.Thiazides decrease the urinary excretion of calcium, while loop‐diuretics have the opposite effect. The possibility of loop‐diuretic induced osteopenia cannot be ruled out, which should be considered when choosing between thiazides and loop‐diuretics for the treatment of mild to moderate CHF.
Increased Plasma Levels of Atrial Natriuretic Peptide (ANP) in Patients with Paroxysmal Supraventricular Tachyarrhythmias
Authors: NILSSON GÖRAN , PETTERSSON ANDERS , HEDNER JAN , HEDNER THOMAS 
Published: August 2010

ABSTRACT. Nilsson G, Pettersson A, Hedner J, Hedner T (Department of Internal Medicine, Central Hospital, Halmstad and Department of Clinical Pharmacology, Sahlgrenska University Hospital, Göteborg, Sweden). Increased plasma levels of atrial natriuretic peptide (ANP) in patients with paroxysmal supraventricular tachyarrhythmias. Acta MedScand 1987; 221:15–21.Atrial natriuretic peptide (ANP) is a cardiac hormone originating from atrial cardiocytes. It seems to be involved in the regulatory control of circulating volume and vascular tone. Plasma immunoreactive atrial natriuretic peptide (IrANP) was investigated in 22 patients with paroxysmal supraventricular tachyarrhythmia (16 with atrial fibrillation, 4 with atrial flutter, one with a Wolf‐Parkinson‐White syndrome (WPW) and one with atrial tachycardia). During the aute attack, IrANP was significantly increased (125.3± 11.4 pmol/1) compared to samples obtained during convalescence (55.9±4.7 pmol/1). Heart rate (HR) was 144±4.3 beats/min during the arrhythmia and 75±2.6 during convalescence. The reduction of IrANP in plasma from the acute attack of tachycardia to follow‐up was significantly related to the reduction of HR (p<0.05). Irrespective of type of paroxysmal supraventricular tachyarrhythmia, 50% of the patients experienced polyuria during the attack. This symptom was more frequent in younger patients with a shorter duration of tachycardia. Polyuria patients had a higher HR during the attack of supraventricular tachycardia. Even though polyuria was not alwavs found in the patients with the highest IrANP values, the symptom was associated with significantly higher concentrations of Ir ANP in plasma compared to the non‐polyuria group. We conclude that Ir ANP is increased in plasma during acute attacks of paroxysmal supraventricular tachycardia. Furthermore, the polyuria frequently associated with this condition may partly be due to excess release of ANP from cardiac myocytes.