Search PubMed⌕ Search

Biomedical subjects

B Sigurd

Publications and source records attributed to B Sigurd.

At least 37 records · Page 2Linked to original sources

Verapamil and beta-adrenoceptor blockade in the treatment of stable angina pectoris.

1. In a double blind cross-over study the effect of verapamil (Isoptin) 360 mg/d and propranolol 180 mg/d was evaluated in patients with stable angina pectoris. The results of verapamil and propranolol treatment are compared to a single blind placebo period of 2 weeks. 2. Both verapamil and propranolol caused a significant reduction in glyceryl trinitrate tablet consumption, days with angina pectoris and in severe angina attacks compared to placebo. A 50% reduction in angina pectoris attacks and/or glyceryl trinitrate consumption compared to placebo was demonstrated in thirteen of eighteen patients during verapamil treatment (P less than 0.01) and in seven of seventeen patients during propranolol treatment (P greater than 0.05). Of sixteen patients accomplishing both treatment periods, ten improved both on verapamil and propranolol, three on verapamil only, one on propranolol only, one was unchanged and one deteriorated on verapamil and propranolol. During exercise, maximum exercise capacity was increased during verapamil compared to placebo (P less than 0.01) and propranolol (P less than 0.02). Maximum exercise capacity was not increased after propranolol compared to placebo. 3. These findings are in accordance with other reported series, and verapamil is at least as effective as propranolol in the treatment of angina pectoris.

Adrenergic beta-Antagonists↗

Comparative natriuretic and diuretic efficacy of theophylline ethylenediamine and of bendroflumethiazide during long-term treatment with the potent diuretic bumetanide. Permutation trial tests in patients with congestive heart failure.

The additive natriuretic and diuretic effects of theophylline ethylenediamine and of bendroflumethiazide have been compared in permutation trial tests in patients with advanced congestive heart failure receiving long-term treatment with the highly potent diuretic, bumetanide. Statistical analysis of renal water and electrolyte excretion revealed that theophylline ethylenediamine, 400 mg orally, and bendroflumethiazide, 5 mg orally, had very similar effects, both quantitatively and qualitatively. The mechanism of action of the supplementary diuretics is discussed. It is concluded that theophylline ethylenediamine represents a useful alternative to thiazide diuretics when supplementary natriuretic treatment is considered in patients with congestive heart failure during long-term treatment with potent diuretics. The significance of maintaining the potassium balance during such a combined regimen is stressed.

Bendroflumethiazide↗

Haemodynamic effects of intravenous disopyramide in heart failure.

The haemodynamic effects of disopyramide have been studied in 11 patients with manifest or imminent heart failure. Disopyramide, 2 mg per kg body weight, was given intravenously during right and left heart catheterisation. The cardiac index decreased by an average of 28% (p less than 0.01); mean maximal left and right ventricular end-diastolic pressures were increased by 5.0+/-0.9 mm Hg (p less than 0.01) and 5.0+/-0.6 mm Hg (p less than 0.05), respectively; and left ventricular systolic pressure fell slightly but significantly (p less than 0.05). No significant change in right ventricular systolic pressure was seen. Pulmonary wedge pressure rose on average by 2.7 mm Hg (p less than 0.05). No significant change in heart rate was observed in 5 patients with sinus rhythm. In 6 patients with atrial fibrillation, there was a significant (p less than 0.01) increase in heart rate; the average increase in heart rate for the entire group was 19.6 beats per minute. The maximum effect on all the parameters occurred 7-11 minutes after the injection, and it gradually subsided during the following 10 minutes. It was concluded that disopyramide had a potentially serious myocardial depressant effect.

Adult↗

The supra-additive natriuretic effect addition of bendroflumethiazide and bumetanide in congestive heart failure. Permutation trial tests in patients in long-term treatment with bumetanide.

The additive natriuretic effect of a single dose of bendroflumethiazide, 5 mg., has been studied in patients with advanced congestive heart failure in long-term treatment with bumetanide, 4 mg., daily. Three permutation trial tests were performed including six patients each. In the first trial, the response to supplementary bendroflumethiazide, 5 mg., was definitely superior to that of additional bumetanide, 4 mg., in terms of renal output of sodium, chloride, potassium, water, and osmolar clearance. In the second trial, a similar pattern was found in patients receiving a combination of bumetanide, 4 mg., and spironolactone, 100 mg., daily. The third trial compared the effects of bendroflumethiazide, 5 mg., plus bumetanide, 4 mg.; of bendroflumethiazide, 5 mg.; and of bumetanide, 4 mg. In terms of natriuresis and chloruresis, the response to the combination of two drugs was significantly larger than the sum of the effects of other treatments. It is concluded that the combined effects of the drugs represent a supra-additive effect addition for sodium and chloride. A tentative explanation of the mechanism of interaction in terms of inhibition of renal tubular supplementary spironolactone, involve a tendency to development of hypokalemia, hypochloremia, and alkalosis, it is recommended that supplementary use of bendroflumethiazide in this setting is combined with the administration of potassium chloride or potassium-saving diuretics.

Adult↗

Adams-Stokes seizures due to ventricular tachydysrhythmias in patients with heart block: prevalence and problems of management.

One hundred and twelve patients with heart block and chronic tendency to syncope were ECG-monitored during syncope. Ventricular tachycardia and/or fibrillation (VT-VF) was observed as the cause of syncope in 11 patients: in 6 of 20 patients with chronic third degree A-V block, in 3 of 65 with paroxysmal A-V block and in 2 of 27 with S-A block. The R-R interval preceding the escape beat which initiated VT-VF varied between 1.2 and 2.2 seconds. The cerebral attacks were amenable to long-term pacemaker treatment. However, relapses of VT-VF were observed during pacing with a low rate of 55 per minute and during short interruptions in pacing, as produced by intermittent pacemaker failure or threshold determination. In one patient, supplementary treatment with a beta-blocking agent had to be given to suppress exercise-induced attacks of VT-VF after pacemaker implantation.

Adams-Stokes Syndrome↗