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Biomedical subjects

A Zeiher

Publications and source records attributed to A Zeiher.

25 records · Page 2Linked to original sources
PubMed1985

[Dilatation of epicardial coronary vessels by intravenous diltiazem in patients with coronary heart disease].

UNLABELLED: Coronary diameters and central hemodynamics were measured in 22 patients with stable coronary artery disease before and after 20 mg of intravenous diltiazem. Coronary diameters from high quality biplane coronary angiograms were calculated as mean values after caliper measurements of identical segments. Measurements were made in angiographically normal and abnormal proximal, middle and distal vessel segments. Central hemodynamics showed a significant decrease for heart rate, mean aortic pressure and peripheral resistance (p less than 0.001). Coronary diameters increased between 2 and 16% (proximal or distal segments). Diameter increases were statistically significant for all segments (p less than 0.001) except for proximal atherosclerotic segments. These hemodynamic and diameter changes were seen after 5, 10 and 20 minutes. CONCLUSION: Intravenous diltiazem shows an acute coronary dilative effect in patients with stable coronary artery disease. This effect is regarded as one of the essential antianginal actions of the drug.

Benzazepines↗
PubMed1984

Sudden cardiac death recorded during ambulatory electrocardiographic monitoring.

Two case reports of sudden cardiac death are detailed here. Holter monitoring plays an important role in documenting arrhythmias leading to sudden cardiac death. In addition, the importance of the Lown grading concept should not be underestimated. Our two case reports and a subsequent review of the literature demonstrate both points.

Aged↗
PubMed1984

[The effect of various cutaneously administered nitroglycerin preparations on coronary heart disease].

Sublingually administered nitroglycerin provides marked benefit in the treatment of angina pectoris due to occlusive coronary disease. Because of its brief duration of action, its usefulness as a prophylactic agent is limited. One way to prolong the beneficial effects is cutaneous administration of a nitroglycerin ointment, and the effects and duration of action of three different preparations of topical nitroglycerin on exercise performance have therefore been studied in a double-blind randomized manner in 44 patients with well documented coronary artery disease and stable angina pectoris. 30 mg 2% nitroglycerin ointment((Plantorgan Co.) produced significant improvement in maximal exercise capacity one and six hours after application; concomitantly there was a decrease in the sum of exercise induced ST-segment depression especially one hour, but less markedly six hours, later. 10 mg 2% nitroglycerin ointment (Pohl Boskamp Co.) also produced an increase in maximal exercise tolerance and a reduction in the degree of myocardial ischemia estimated by the magnitude of exercise-induced ST-segment depression one hour after application, but no clear effect could be measured four hours later. 25 mg nitroglycerin in the "transdermal therapeutic system" (Ciba Geigy) produced a significant improvement in maximal exercise capacity and a significant decrease in the sum of exercise-induced ST-segment depression one and five hours after cutaneous application. Side effects were not observed during these studies, and the topical compatibility of the different ointments was good.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗
PubMed1984

[Prognostic significance of the QT-interval following myocardial infarction].

The prognostic value of QT prolongation was evaluated in 109 patients with myocardial infarction. Patients who suffered from reinfarction during the first month or developed ventricular fibrillation and sudden death did not have longer QT intervals than patients without these complications. On the other hand, QT prolongation was of prognostic value in the prediction of late reinfarction. The reasons for varying results from different investigators are discussed.

Adult↗
PubMed1983

Flecainide-induced aggravation of ventricular tachycardia.

Flecainide acetate is a new class I antiarrhythmic agent which slows atrial, A-V nodal and ventricular conduction velocity, and prolongs refractoriness of these structures (Borchard et al., 1982; Hodess et al., 1979). Recent studies with oral flecainide therapy suggested its high potential for suppression of ventricular tachycardia in humans (Anderson et al., 1981; Duff et al., 1981; Hodges et al., 1982). Its favorable pharmacokinetics with an average plasma half-time of about 20 hours allows in most patients twice daily dosing (Duff et al., 1981). Usually, the drug seemed to be well tolerated and side-effects, such as blurred vision, could be resolved with smaller but still effective doses (Duff et al., 1981). Actually, the ideal antiarrhythmic agent which represents a high degree of effectiveness, a low level of toxicity, a wide therapeutic range, and a prolonged antiarrhythmic action does not exist (Dreifus and Ogawa, 1977). In this report we describe a patient with flecainide-induced aggravation of ventricular tachycardia necessitating resuscitation because of severe hemodynamic deterioration.

Anti-Arrhythmia Agents↗
PubMedDate not supplied

Combined thallium 201/technetium 99m-labeled pyrophosphate tomography for identification of the "culprit" vessel in acute myocardial infarction.

BACKGROUND: Many previous investigations have used the presence of transient ischemic 201Tl perfusion defect to localize coronary artery stenosis. This study reports the results of 201Tl tomography alone and combined 201Tl/99mTc-labeled pyrophosphate (99mTc PYP) tomography employed to identify the infarct-related vessel in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: All short-axis images were evaluated by dividing each left ventricular slice into eight equal sectors. In addition, for combined 201Tl/99mTc PYP tomography, two sectors were added to evaluate involvement of the right ventricle. In a preevaluation phase of the study, the sectors were assigned to the supplying coronary arteries in 75 patients with single chronic myocardial infarction related to the left anterior descending coronary artery (LAD), left circumflex artery (LCX), or right coronary artery (RCA). In this pilot phase, 201Tl tomograms were reviewed in conjunction with the angiographic data. This assignment was then tested prospectively in 117 patients with AMI. As confirmed by angiography, the AMI was related to the LAC, LCX, and RCA in 54, 17, and 46 patients, respectively. Sensitivity and specificity for 99mTc PYP accumulation on combined 201Tl/99mTc PYP tomography were 98% a nd 100% for the LAD, 88% and 99% for the LCX, and 98% and 96% for the RCA, respectively. For 201Tl tomography, sensitivity and specificity for identification of the culprit vessel were 94% and 89% for the LAD, 82% and 91% for the LCX, and 72% and 96% for the RCA, respectively. CONCLUSION: This prospective study demonstrates that combined 201Tl/99mTc PYP tomography is highly accurate for identification of the infarct-related artery in AMI, even in patients with multivessel disease. Positive contrast visualization of myocardial necrosis in both the left and right ventricle allows for reliable differentiation between AMI related to the LCX or RCA territory. In comparison, for 201Tl tomography the sensitivity to detect the culprit vessel, particularly the LCX and RCA, appears to be lower than for 201Tl 99mTc PYP imaging, particularly in patients with prior infarction or right dominant coronary artery.

Coronary Vessels↗