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Biomedical subjects

F Hagemeijer

Publications and source records attributed to F Hagemeijer.

At least 55 records · Page 3Linked to original sources
PubMed1977

Effectiveness of intraaortic balloon pumping without cardiac surgery for patients with severe heart failure secondary to a recent myocardial infarction.

Twenty-five patients with class III or class IV left ventricular failure (Myocardial Infarction Research Unit criteria) after a recent myocardial infarction were treated with intraaortic balloon pumping between December 1, 1972 and December 1, 1976. Three patients had no improvement and died during pumping. Two patients with improvement died during at attempt at weaning from circulatory assistance. Of 20 patients successfully weaned, 6 died within 3 months, 5 of these within 10 days after the weaning procedure. Of 14 patients who survived for more than 3 months, 13 were alive on February 15, 1977. Twelve of these 13 were in functional class II and 6 had resumed professional activities. Intraaortic balloon pumping proved an effective method for treating severe left ventricular failure after an acute myocardial infarction. Even withour surgery, 14 of 25 patients survived 3 or more months after an acute infarction complicated by serious pump failure.

Adult↗
PubMed1977

Design of a study to evaluate drug therapy of serious ventricular rhythm disturbances after an acute myocardial infarction.

A study was designed to investigate whether long-term use of aprindine can prevent sudden death from primary ventricular fibrillation. Patients with a proven recent myocardial infarction and malignant ventricular arrhythmias occurring late after the acute episode were asked to participate in a 1-yr, double-blind, randomized, placebo-controlled trial to suppress the rhythm disturbances observed on an ambulatory electrocardiogram. Particular care was taken to monitor drug adherence. Arrhythmia detection by ambulatory electrocardiography was used to assess drug efficacy; side-effects establish the maximum tollerated dose for each individual patient. Aprindine was therefore used under optimal circumstances. An interactive computer system served as a data base and provided the investigators and the monitoring committee with all the information required for a proper evaluation of the progress of the study.

Aprindine↗
PubMed1977

Bidimensional real-time echocardiological visualization of a ventricular right-to-left shunt following peripheral vein injection.

Contrast techniques were used in the echocardiological evaluation of a 28-yr-old patient with congenital cyanotic heart disease; catheterization showed an association of an atrial septum defect, a ventricular septum defect, and a patent ductus arteriosus, with equalization of pulmonary artery and systemic pressures. Glucose 5% in water, injected as a 10-ml bolus into an antecubital vein, constituted an adequate echogenic contrast solution. The heart was examined with both a single-crystal transducer (echoes recorded in M mode) and with a 51-elements dynamically focuses multiscan system (echoes recorded on video-tape). Contrast echocardiology showed that right-to-left shunting occurred at the level of the ventricular septum defect and was not significant at the atrial level.

Adult↗
PubMed1976

Cardiovascular effects of an antiarrhythmic aminosteroid ORG 6001 in the anesthetized pig.

The hemodynamic effects of 3alpha-amino-5alpha-androstan-2beta-ol-17-one-hydrochloride (ORG 6001), an aminosteroid possessing antiarrhythmic properties, were studied in 14 anesthetized pigs. ORG 6001 was administered i.v. cumulatively until a toxic level was reached. Doses less than 20mg/kg had, in spite of the negative inotropic properties of ORG 6001, no effect on the pump function of the heart, as the afterload was reduced and the filling pressure was not significantly altered. After administration of 40 mg/kg A-V conduction was depressed and second degree A-V block appeared. This was associated with deterioration of the pump function and for 6 of the 14 animals this was fatal. In the survivors, the alterations were reversible after cessation of drug administration. Since ORG 6001 has been shown to be effective against arrhythmias at doses less than 20 mg/kg, though in a different species (dog), it seems likely that it can be used safely for antiarrythmic treatment.

17-Ketosteroids↗
PubMed1976

Suicide with aprindine and digoxin.

A 48 year old man with severe coronary artery disease died approximately 33 hours after swallowing unknown amounts of aprindine, digoxin, furosemide, acenocoumarol, flurazepam, nitrazepam and lorazepam. Blood analysis carried out 40 min. before death showed no hydric or ionic imbalance; blood gases were normal. Serum digoxin concentration was 3.9 ng/ml; plasma concentration of aprindine was 2.5 mug/ml and plasma concentration of desethylaprindine was 386 ng/ml. Patient was profoundly comatose, hypotensive, and the electrocardiogram showed broad and bizarre QRS complexes; patient ultimately died in irreversible secondary ventricular fibrillation and asystole. Aprindine probably played a decisive role in the fatal outcome of this complex drug intoxication.

Aprindine↗
PubMed1976

Quinidine syncope: torsade de pointes with low quinidine plasma concentrations.

In 2 patients without clinically significant ischemic heart diseases, oral quinidine was used to control supraventricular arrhythmias. In both patients, syncopal attacks occurred, caused by a particular type of ventricular tachyarrhythmia called torsades de pointes. Quinidine plasma concentrations were low (2.6 and 1.2 mg/1, respectively); QRS duration was normal, but the Q-T interval was markedly prolonged.

Aged↗
PubMed1975

Absorption, half-life, and toxicity of oral aprindine in patients with acute myocardial infarction.

Plasma concentrations of aprindine were used to assess its absorption, toxicity and disappearance rate after oral administration to patients within 24 hours of admission to a coronary care unit. Despite high oral doses, absorption was so slow that in half the patients effective plasma levels (exceeding 0.70 mug/ml) were not found during the first 12 hours of treatment. Therefore the oral route should not be used to treat cases of acute myocardial infarction with severe ventricular dysrhythmias. Clinical tolerance was good; there was one episode of delirium tremens in a chronic alcoholic (aprindine plasma concentration: 3 mug/ml); no case of tremor or cerebellar syndrome was observed. Disappearance of aprindine from plasma was slow, by far exceeding the half-lives found in healthy volunteers, and ranging from 20 to over 100 h. The variability of biological half-life in individual patients makes plasma level determiniations necessary whenever aprindine is to be administered for a long period.

Administration, Oral↗
PubMed1975

Titrated energy cardioversion of patients on digitalis.

Elective cardioversion with titrated energy was carried out under diazepam anaesthesia (38 procedures) in 26 patients on digitalis who presented with supraventricular or ventricular arrhythmias. Low energy shocks were given to establish the absence of latent digitalis intoxication, not unmasked by previous carotid sinus massage, and to restore sinus rhythm with the lowest possible energy discharge. In the absence of digitalis overdosage, titrated energy cardioversion restored sinus rhythm, at least temporarily, without dangerous ventricular arrhythmias. In one patient this precaution was neglected: a shock of 200 Ws provoked ventricular tachycardia. We present experimental and clinical evidence for the safety and effectiveness of titrated energy cardioversion in patients on digitalis.

Adolescent↗
PubMed1975

Short-term survival after acute myocardial infarction predicted by hemodynamic parameters.

In the acute phase of myocardial infarction, short-term prediction of the likelihood of survival helps the physician choose the appropriate therapy for individual patients. Of 122 patients admitted to the coronary care unit of the Thoraxcenter, University Hospital, Rotterdam, with an acute myocardial infarction, 16 died from pump failure. In these and the 106 survivors, the predictive value of peripheral systolic (SP) and diastolic (DP) blood pressure, pulmonary capillary wedge pressure (PCW), mixed venous oxygen saturation (MVO2sat) in the pulmonary artery and heart rate (HR), both alone and in combination, was evaluated at the time of admission and 24 hours later. When, at admission, (DP X MVO2sat)/PCW exceeded 250%, 97/99 patients survived, whereas values below 250% were associated with death in 14/23. All other papameters, taken alone or in other combinations, showed less discriminatory power. Thb mean value of this index in survivors (549%) was statistically different (P less than 0.001) from the mean value in nonsurvivors (183%). Twenty-four hours later all survivors with admission values lower than 250% had an improved index. Of the 14 nonsurvivors with admission values lower than 250%, seven had already died, and in seven others the index had decreased still further; Linear discriminant analysis showed that (0.024 SP -- 0.217 PCW + 0.234 MVO2sat) was the most powerful prognostic index at the time of admission; its time course did not provide a more effective prediction of ultimate fatality than (DP XMVO2sat)/PCW. Determination of (DP X MVO2sat)/PCW in patients hospitalized for acute myocardial infarction provides a reliable prognosis for short-term patient survival. Its practical value in guiding patient management, more particularly for initiating mechanical circulatory assistance or for emergency surgery, must be further assessed.

Acute Disease↗
PubMed1975

Cardiac rupture following myocardial infarction.

The 38 months incidence of cardiac rupture in a coronary care unit was found to be 10/460 or 2.1%. The patients at high risk were elderly people with a first transmural infarct, digitalized, experiencing recurring pain without a pericardial friction rub. 7/10 heart ruptures occurred within 36 hours after the first symptoms of infarction. Decreasing left ventricular work may be an effective method for preventing rupture of infarcted myocardium.

Aged↗
PubMed1975

[Bidimensional and direct visualization of the heart by multiple element echocardiography].

Multiple element echography permits a direct visualization of heart sections. In congenital heart diseases, an accurate anatomical diagnosis is often possible. In valvular heart diseases, visualization of the valvular movements and measurement of haemodynamic repercussions over the other cardiac structures makes it possible to assess the severity of the lesion. The overall function of the heart may also be assessed as well on the basis of measurement of the size of the heart, and above all through analysis of valvular movements and the left ventricular wall kinaetics, an information analogous to that obtained by cineangiocardiography. A quantitative study of the left ventricular function by measurement of the systolic and diastolic volumes is still in the experimental stage. A different method of recording and the use of a large single cristal allow a better resolution of the picture of conventional echography, but technical progress might be foreseen in multiple element echography.

Child↗