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Biomedical subjects

A Marmor

Publications and source records attributed to A Marmor.

At least 55 records · Page 3Linked to original sources
PubMed1988

Comparative effects of captopril and nifedipine on diastolic and systolic cardiac function in elderly hypertensive patients.

Both nifedipine and captopril are effective in the treatment of systemic hypertension in the elderly, but their effects on cardiac function in this age group have not been evaluated. We studied the effects of acute oral administration of 20 mg nifedipine and 12.5 mg captopril on systolic and diastolic cardiac function, as evaluated by a radionuclide method, in 14 elderly hypertensives, mean age 73.4 +/- 3.9 years. The radionuclide studies were performed 1 h after ingestion of nifedipine and 1.5 h after captopril, on separate days. Nifedipine accelerated the heart rate whereas captopril slowed it. Nifedipine increased the ejection fraction by 2.6 +/- 14.6% but captopril increased it by 13 +/- 15.3%. Nifedipine reduced the left ventricular peak ejection rate by 4.8 +/- 21.7% whereas captopril increased it by 18 +/- 24.3%. Nifedipine increased the peak filling rate by 14.3 +/- 41.6% and captopril increased it by 27.6 +/- 32.6%. Nifedipine reduced the time to peak filling rate by 24.9 +/- 27.0%, but captopril reduced it by 68.8 +/- 59.6%. All these differences were statistically significant. Therefore, captopril improves some diastolic and systolic parameters of cardiac function more than nifedipine does. Other parameters are impaired by nifedipine but improved by captopril.

Aged↗
PubMed1988

Flosequinan induces hemodynamic improvement in heart failure complicating acute myocardial infarction.

The hemodynamic effects of a single dose of flosequinan, a new balanced vasodilator, were studied in twelve patients with severe acute onset heart failure complicating acute myocardial infarction. Flosequinan was added to conventional therapy within 3.8 +/- 0.5 days of the infarction, in the form of a single oral dose of 100 mg in ten of the patients. In the remaining two, reinfarction developed on the sixth day and they received flosequinan immediately thereafter. Hemodynamic monitoring was performed for four hours after the administration, without any other drug being given. Flosequinan produced hemodynamic improvement in all patients. The effect peaked at one to two hours and remained at this level at four hours. Pulmonary capillary wedge pressure decreased from 27.4 +/- 5.0 to 16.5 +/- 2.9 mm Hg and cardiac output increased from 3.5 +/- 0.3 to 4.1 +/- 0.4 l/min (p less than 0.001 for both). Pulmonary arterial and right atrial pressures and systemic and pulmonary vascular resistances were also significantly reduced. Heart rate was not significantly altered (from 84.0 +/- 4.5 to 87.4 +/- 4.6). Mean systemic arterial pressure was slightly reduced. Administration of flosequinan was not associated with any adverse effects and the hemodynamic effect was not related to the pre-treatment serum sodium concentration. We concluded that flosequinan can produce acute hemodynamic improvement in patients with heart failure, complicating acute myocardial infarction. The drug is well tolerated.

Adult↗
PubMed1984

Scintigraphic assessment of atrial function in patients with longstanding hypertension.

Right and left atrial function were assessed using Fourier analysis of gated radionuclide images in 14 normal subjects and 50 patients with long-standing essential hypertension. Slopes representing filling and early diastolic emptying were similar for both atria; however, early diastolic emptying of the left atrium was slowed markedly in the hypertensive group (42.6 +/- 18.6 counts/sec., vs. 79 +/- 16 in normal persons; p less than 0.001), implying a reduction in left ventricular compliance. The right ventricular ejection fraction was depressed in hypertensive patients compared with normal subjects (37.1 +/- 6% vs. 43.4 +/- 8.1%; p less than 0.01). These findings may be helpful in understanding the effect of hypertension on the left and right heart and could have prognostic and therapeutic implications as well.

Adult↗
PubMed1983

The efficacy of Ajmaline in ventricular arrhythmias after failure of lidocaine therapy in the acute phase of myocardial infarction.

Forty-three patients in the acute phase of myocardial infarction who were resistant to conventional doses of lidocaine received Ajmaline intravenously (50 mg bolus followed by constant infusion rate of 1-1.5 mg/min). Dangerous ventricular arrhythmias were abolished in 72% of this group of patients (group A). In the remaining patients (28%), Ajmaline was found to be ineffective (group B). There was no reduction of systolic or diastolic blood pressure and there was an insignificant increase in heart rate. Atrio-ventricular or intraventricular conduction defects appeared in 46% of the patients described. There was a statistically significant increase in occurrence of heart blocks in group B patients and among these complete left bundle branch block (CLBBB) was the most prevalent. Atrio-ventricular or intraventricular conduction defects were transient, appearing between 8-36 h (mean 23 h), and were not accompanied by reduction of ventricular rate. Conduction defects disappeared within several hours (up to 24 hours) after Ajmaline was discontinued. It is concluded that Ajmaline administered by this regimen is an effective alternative agent for patients with ventricular arrhythmia not controlled by lidocaine in the acute phase of myocardial infarction.

Ajmaline↗
PubMed1981

Factors presaging early recurrent myocardial infarction ("extension").

A prospective study of 200 consecutive patients with acute myocardial infarction was undertaken to characterize the frequency and severity of early recurrent infarction (extension), manifested by secondary plasma MB creatine kinase (CK) and myoglobin peaks, and to identify patients at particularly high risk. Serial MB CK and myoglobin determinations and continuous electrocardiographic recordings were obtained in all patients for 14 days, and serial radioventriculograms were obtained in selected patients. Chest pain and S-T segment changes occurred often, in 57 and 43 percent, respectively, of the entire group of patients. However, a secondary rise in plasma MB CK levels indicative of recurrent infarction, occurring an average of 10 +/- 4 days after the initial infarct, was evident in only 17 percent of patients. Forty-three percent (25 of 58) of patients with initial subendocardial infarction exhibited recurrent infarction compared with only 8 percent of those with initial transmural infarction. The mortality rate was 7 percent in patients with subendocardial infarction without early recurrence compared with 16 percent among those with recurrent. Logistic regression analysis indicated that obese women with initial subendocardial infarction and repeated episodes of prolonged chest pain had a high probability rate (60 percent) of recurrence in contrast to the low probability (2 percent) in patients without these features. Thus, early recurrent infarction is frequent after subendocardial infarction and is associated with a marked increase in mortality. These results suggest that patients with subendocardial infarction are at particularly high risk for recurrent infarction and that patients with this type of infarction require vigorous monitoring and prolonged surveillance.

Aged↗
PubMed1981

A new scintigraphic technique for assessment of right atrial function.

Gated radionuclide imaging with 99mTc-labeled red blood cells was employed to assess changes in right atrial (RA) volume in 17 subjects. Studies were repeated within two hours in five of 12 normal subjects and at two and ten days after infarction in five patients. Time-activity curves were generated for the RA and right ventricle (RV) from variable regions of interest defined by automatic edge detection. The RA time-activity curve exhibited four phases: filling, early emptying, equilibration, and late emptying. Repeated measurements of RA early emptying rates correlated closely in normals (r = 0.93). Early RA emptying and RV filling rates corresponded closely (r = 0.89). In four patients with infarction, the RA emptying rate was slowed on the first study but had normalized by 10 days. In a patient with inferior infarction and suspected RV infarction, the RA emptying rate was depressed and remained so for 10 days. Thus, relative changes in right atrial volume can be assessed reproducibly by a radionuclide technique, which is relatively independent of geometric assumptions. This technique offers great promise as a method to assess atrial function in health and disease.

Adult↗
PubMed1981

Gorham's disease of the clavicle with bilateral pleural effusions.

A patient with Gorham's disease (massive osteolysis, disappearing bone disease) of the right clavicle had bilateral sanguinous pleural effusions. Complete cure was achieved by removal of the bony remnants with the hemangiomatous mass which caused bone destruction, and by obliteration of the pleural spaces using repeated talcum insertion. In six out of seven previously described cases of Gorham's disease with pleural effusions, the patients died, while the only survivor had a unilateral chylous effusion.

Adult↗
PubMed1980

Prenylamine-induced ventricular tachycardia and syncope controlled by ventricular pacing.

We describe eight patients treated for angina with prenylamine who developed life-threatening ventricular arrhythmias after QT interval prolongation. When prenylamine administration was stopped QT interval shortened to within normal values, while the ventricular arrhythmias were controlled by a temporary ventricular pacemaker and disappeared after several days. We stress the importance of surveillance of the QT interval and ventricular arrhythmias in patients receiving long-term treatment with prenylamine.

Aged↗
PubMed1980

Regional distribution of the MB isoenzyme of creatine kinase in the human heart.

Human myocardial tissue obtained at autopsy from ten patients was examined for content of the MB isoenzyme of creatine kinase (CK-MB). We wished to determine whether this isoenzyme is distributed homogeneously throughout the heart. In eight cases, there was no history or pathological evidence of heart disease. Two had a history of previous myocardial infarction; in these, tissue was obtained from sites distant from the scar. Difference was found between the CK-MB content of the right atrium and the left atrium, and between the right ventricle and left ventricle. In all cases, the CK-MB content of the right side of the heart significantly exceeded that of the left side of the heart. Statistically significant differences were also found between the CK-MB content of the anterior interventricular septum and that of the posterior septum. These topographical variations in CK-MB content may be related to differences in the density of contractile elements in various parts of the heart and, moreover, are not taken into account in the enzymatic estimation of infarct size.

Creatine Kinase↗