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Biomedical subjects

B Kemkes

Publications and source records attributed to B Kemkes.

At least 37 records · Page 2Linked to original sources
PubMed1987

Baseline and stimulated ANF plasma levels: is an impaired stimulus-response coupling diagnostically meaningful?

Plasma levels of ANF were determined and chromatographically analysed in normotensive controls, cirrhotic patients with and without ascites, hypertensive patients, patients with congestive heart failure and heart transplant recipients. A comparison of baseline plasma levels allowed for the conclusion that cirrhotic patients do not differ in this regard from control subjects (9.0 +/- 1.3, n = 41 vs. 9.6 +/- 1,0 fmol/ml, n = 51). Cirrhotic patients with ascites do not have lower plasma levels than cirrhotic patients without ascites (8.8 +/- 1.4, n = 8 vs 8.6 +/- 1.5 fmol/ml, n = 10). Stimulation of the ANF-system by head-out water immersion, however, revealed an impaired increase in ANF release in cirrhotic patients with ascites (146 +/- 18% vs 204 +/- 16%). Patients with cardiovascular disease display tonically-elevated ANF plasma levels. Heart failure patients displayed the highest plasma concentration (81.5 +/- 32.7 fmol/ml, n = 17), whereas plasma levels in hypertensive patients ranged from normal to greatly elevated (61.7 +/- 13.2 fmol/ml, n = 36). Heart transplant recipients also had significantly elevated plasma levels as compared to control subjects (31.2 +/- 7.9 fmol/ml, n = 14) but levels were lower than in hypertensive patients in spite of a comparable arterial pressure. Short term ventricular pacing (f = 150/min for 5 min) revealed an impaired phasic activity of the ANF system in heart failure patients and heart transplant recipients.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial Natriuretic Factor↗
PubMed1985

[Age-dependent regulation of cardiac glycoside receptors].

Specific binding of cardiac glycosides to their receptors precedes their actions on the myocardium. Thus changes in the number and affinity of these membrane bound receptors will vary the response to cardiac glycoside therapy and the incidence of side-effects. Several studies have reported an age-dependent decrease in the number of cardiac glycoside receptors in animals as well as in human erythrocytes. These results may explain the increase in cardiac glycoside sensitivity with age which is not accounted for by the reduction in kidney function. Furthermore, changes in both binding affinity and capacity are known to occur in several diseases which are more common in older patients. Therefore, we have measured the number and affinity of cardiac glycoside receptors in atrial samples from 209 patients and in papillary muscle samples from 59 patients taken during coronary bypass graft surgery or mitral valve replacement. Further, the maximal increase in force of contraction was measured using papillary muscle strips from some of these patients. Our results show no significant age-dependent alteration in the characteristics of the cardiac glycoside receptors but a reduced myocardial receptor density in males (3.47 +/- 0.14 X 10(14)/g protein) compared with females (4.44 +/- 0.21 X 10(14)/g protein) (p less than 0.001) which is more pronounced in older patients. About 30% fewer cardiac receptors either per g protein or per g wet weight are present in patients with coronary heart disease or dilative cardiomyopathy. The maximal inotropic effect of ouabain in human papillary muscle strips is correlated with the number of cardiac glycoside receptors present.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Progression of coronary and valvular heart disease in patients on dialysis.

Coronary heart disease and end-stage renal disease: Coronary heart disease is frequent in patients with end-stage renal disease. Without invasive procedures coronary heart disease is often not diagnosed in patients with end-stage renal disease. We have no evidence for accelerated progression of coronary heart disease under conditions of dialysis. Valvular heart disease and end-stage renal disease: Valvular heart disease shows an increasing frequency depending on the period of dialysis. Valvular heart disease is often unnoticed and constantly underestimated without invasive investigation. Valvular heart disease often indicates a bad prognosis in our patients with end-stage renal disease.

Adult↗
PubMed1983

[Advantages in the therapy of bradycardiac rhythm disorders by physiologic pacemaker systems].

A review of the recent development in cardiac pacing is given, based on the experience of the Department for Cardiac Surgery of the University of Munich. Meanwhile the frequency of physiological pacemaker systems has increased to more than 30 percent of all implantations. Basical informations about physiological stimulation, indications, techniques of implantation--particularly via the subclavian vein and patient's follow-up--are discussed.

Bradycardia↗
PubMed1983

[Heart transplantation--2 years' experience in the Grosshadern Clinic of the University of Munich].

Between August 1981 and August 1983 11 heart transplantations were carried out at the Klinikum Grosshadern of the University of Munich. The recipients were 10 men and 1 women. The age of the patients at the time of the operation ranged from 20 to 45 years. The diagnosis was: congestive cardiomyopathy (4 cases), coronary heart disease (5 cases), Uhl's disease (1 case), valvular heart disease (1 case). Cyclosporin A was used as the main immunosuppressive agent in all cases. 3 patients died (1., 10. and 73. postop. day). 8 patients survived now since 2 to 25 months. The survival time exceeds 0.5 years in 5 cases and 1 year in 3 cases.

Adult↗
PubMed1982

[Effect of the intravenous administration of lormetazepam on hemodynamics and arterial blood gases in patients with coronary heart disease].

In 11 conscious patients suffering from coronary artery disease undergoing aorto-coronary bypass operations the hemodynamic and respiratory effects of Lormetazepam were investigated preoperatively. Lormetazepam was administered i.v. in a dosis of 2 mg (average weight 70.4 +/- 5.7 kg) into the right atrium. The maximum of hemodynamic changes was found about 10 min after injection. At that time the mean arterial pressure was diminished about 14%. At the same time total peripheral resistance fell about 15% below the control level. The cardiac index remained unchanged. The hemodynamic effect therefore consisted in a peripheral vasodilation. This was emphasized by the reduction of right atrial pressure and pulmonary capillary wedge pressure. The heart rate was unchanged. The arterial pO2 was reduced to 18% below the control level. The arterial pCO2 was increased about 24%. This finding is possibly due to an additional effect of Morphine and Phenobarbital used for premedication.

Anti-Anxiety Agents↗
PubMed1981

Treatment of acute left heart failure using dobutamine and intraaortic counterpulsation. Animal experiments and first clinical experiences.

Ten anesthetized mongrel dogs had a left anterolateral thoracotomy; the left anterior descending coronary artery was then ligated. After 60 min five animals each were treated either with dobutamine (4 microgram/min/kg; for 10 min), or with dobutamine and intraaortic counterpulsation. Combined treatment of cardiogenic shock proved superior. Those five dogs had significantly lower heart rates and dp/dt/p-values. Due to IABP the non-ischemic parts of the left ventricle were better perfused; there was no difference in treatment with regard to ischemic parts. The combined treatment was successfully inaugurated in two patients with cardiogenic shock.

Adult↗
PubMed1978

[Assisted circulation with the heart-lung machine after cardiosurgical interventions: one year's experience with intra-aortal counter-pulsation with the heart-lung machine after cardiosurgical operations is reported (author's transl)].

In the period from September 1976 to 1977, aortic or mitral valve replacement was performed in 84 and 34 patients respectively. Cardiogenic shock occurred during or immediately after the operation in 3 and 2 patients respectively (= 8.8% and 2.4%). In spite of the use of intra-aortal counter-pulsation, none of the patients survived the acute event. During the same period, 8 (= 5%) out of 113 patients who had undergone coronary surgery needed intra-aortal counter-pulsation. 4 of them survived the acute left heart failure and at the present time are clinically healthy (N.Y. Heart Association Class II).

Acute Disease↗