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Biomedical subjects

F Kaindl

Publications and source records attributed to F Kaindl.

At least 19 recordsLinked to original sources
PubMed1992

A decrease in plasminogen activator inhibitor-1 activity after successful percutaneous transluminal coronary angioplasty is associated with a significantly reduced risk for coronary restenosis.

To determine a possible relation of changes in plasma levels of plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (t-PA) to the development of coronary restenosis after successful coronary angioplasty (PTCA), we followed 104 patients with a low grade residual stenosis after PTCA (less than 30%) for a period of 12 months. PAI-1 plasma levels (functional activity) and t-PA antigen were determined 1 day before PTCA and 3 days, 3 months and 6 months thereafter. Thirty-four patients (32.69%) developed angiographically proven coronary restenosis (group A) within a time range of 4-48 weeks (median 12.5 weeks) after PTCA while the remaining patients (group B) had neither clinical signs nor angiographic evidence of restenosis after 6 months. No significant differences could be demonstrated in t-PA antigen or PAI-1 activity (plasma levels between the two groups of patients the day before PTCA). During the whole observation period t-PA plasma levels were not significantly different between the two groups; however, PAI-1 plasma levels were significantly higher at 3 months and 6 months after PTCA in patients of group A (p less than 0.005). When the pattern of PAI-1 plasma levels over time (increase or decrease between two consecutive time points of blood collection) was used to discriminate between the two study groups only 3.5-18% of patients with a decrease in PAI-1 developed coronary restenosis within the following observation period in contrast to 25-58% of patients with an increase in PAI-1 plasma levels (p less than 0.05 to p less than 0.0005).

Aged↗
PubMed1992

Parathyroid hormone and calcium behavior in advanced congestive heart failure.

Parathyroid hormone (PTH) regulates the content of calcium and thus exerts an effect on myocardial function. Abnormal secretion of PTH has been sporadically reported to be associated with depressed mechanical performance of the heart muscle. In the present study, we first measured PTH levels at baseline in 27 consecutive patients with advanced congestive heart failure (LVEF: 17 +/- 9%): five patients (18.5%) revealed elevated PTH levels, one case of hypoparathyroidism was discovered. Furthermore, nine unselected patients underwent symptom-limited exercise stress test leading to an increase in mean pulmonary artery pressure from 25.6 +/- 15 at baseline to 41.2 +/- 18 mm Hg at peak exercise. In contrast to observations in healthy subjects, in heart failure patients both mean PTH and blood calcium concentrations did not change significantly during peak exercise or recovery. Moreover, patients with the lowest left-ventricular ejection fraction showed a decrease in PTH during maximal stress. We conclude that abnormal baseline PTH secretion is common in patients with advanced congestive heart failure. More importantly, these studies show that PTH release is depressed under stress conditions, possibly indicating a dysfunction of the parathyroid gland in severe heart failure.

Adult↗
PubMed1990

Plasminogen activator inhibitor-1 levels in patients with chronic angina pectoris with or without angiographic evidence of coronary sclerosis.

Increased plasma levels of plasminogen activator inhibitor-1 (PAI-1) have been shown to exist in 40 to 60% of patients with stable coronary artery disease and have been suggested to be responsible for the development of coronary thrombotic complications. However, it is also discussed whether PAI-1 elevation might mainly be due to variables like increased age or to reactive mechanisms caused e.g. by the chest pain itself. To exclude age dependent or pain related influences, age-matched patients with stable angina pectoris (NHYA II) and angiographically proven coronary artery disease (CAD, n = 16) or without evidence for coronary sclerosis (variant angina, n = 10; angina-like syndrome with normal coronary angiogram, n = 5; non-CAD, n = 15) have been investigated for their plasma PAI-1 activity and t-PA antigen levels. The mean PAI activity in CAD patients (17.5 U/ml) was significantly higher than in non-CAD patients (9.6 U/ml) (p less than 0.0001). In the CAD patients no significant variation in plasma PAI-1 values could be demonstrated when related to the extent of the disease or to a history of previous myocardial infarction. t-PA antigen was also elevated in CAD patients as compared to the non-CAD group (p less than 0.02). The results suggest therefore a strong correlation between coronary artery disease itself and elevated levels of components of the plasma fibrinolytic system.

Angina Pectoris↗
PubMed1990

[Heart transplantation: indication, selection criteria and patient management].

Evaluation of potential candidates for cardiac transplantation is a difficult and wearisome process for both physician and patients. As long as we are confronted with the present situation of an increasing chronic donor unavailability, the importance of standardized, rational criteria for evaluation of heart transplantation candidates has to be emphasized, since the success of any organ transplantation depends on adequate selection of potential candidates.

Biopsy, Needle↗
PubMed1989

Heparin induced increase of t-PA antigen plasma levels in patients with unstable angina: no evidence for clinical benefit of heparinization during the initial phase of treatment.

Patients with unstable coronary artery disease were randomly treated either with a combination therapy consisting of nitrates and calcium-channel blockers without or with addition of clinical grade heparin administered subcutaneously; in order to evaluate the effect of heparin treatment on the fibrinolytic system, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) plasma levels were related to the clinical course of the disease. In heparinized patients thrombin time was prolonged more than 3-fold the normal range indicating effective heparin treatment. Heparinization led to a significant increase in t-PA antigen plasma levels (p less than 0.0001) within approximately four hours while PAI-1 activities remained unaltered. However, the measurable increase of the anticoagulant and pro-fibrinolytic activities of heparin did not result in a short-term benefit for the heparinized patients because the number of further ischemic attacks per patient during the observation period of three days was not different between the two study groups.

Aged↗
PubMed1988

Ketanserin combined with a beta-blocker or diuretic in essential hypertension. A multicentre study.

The antihypertensive effect of ketanserin 40 mg b.d. in combination with a beta-adrenergic blocking agent or a diuretic was assessed in an open study in 35 patients with essential hypertension, who had not responded to treatment with beta-blockers, diuretics or their combination. The ketanserin/beta-blocker combination decreased mean sitting systolic/diastolic blood pressure (SBP/DBP) from 169/107 mmHg to 156/91 mmHg at the end of the 12-week active treatment period. The decrease in systolic blood pressure was significant only at Week 8, while the decrease in diastolic blood pressure was highly significant at all times. A significant reduction in heart rate by 10 beats.min-1 was observed with the ketanserin + beta-blocker combination. The ketanserin/diuretic combination led to a significant reduction in mean SBP/DBP from 164/106 mmHg to 146/92 mmHg after 12 weeks, with no significant change in heart rate. Body weight slightly increased in both groups. There were significantly fewer adverse reactions with the ketanserin/diuretic combination than with the ketanserin/beta-blocker combination. The results indicate a potentially useful therapeutic role for ketanserin in combination with beta-blockers or diuretics.

Adrenergic beta-Antagonists↗
PubMed1979

[Myocardial revascularization in threatening extension of myocardial infarction (author's transl)].

Myocardial revascularization was performed in 13 patients between two and 14 days following initial infarction because of impending re-infarction. The diagnosis of impending re-infarction was made on the basis of the following criteria: myocardial infarction; repeated stenocardia despite medical treatment; renewed ST-T changes in the ECG. The intra-aortic balloon pump was installed in 7 patients for haemodynamic reasons (shock, massively raised pressure in the pulmonary artery). 12 patients survived the surgical intervention and were eventually discharged free of stenocardia. The presented findings suggest that surgical intervention in impending re-infarction appears of value in those cases which have not been satisfactorily controlled by conventional medical treatment.

Adult↗
PubMed1979

[A study of a swimming training programme in the rehabilitation of patients following myocardial infarction (author's transl)].

A special swimming programme was initiated during the course of rehabilitation of patients after myocardial infarction with additional disturbances of the musculoskeletal system. Allowance was made for aspects of individual training requirements. Patients were divided in two groups according initial values of physical working capacity: One group contained patients with less than 80% of the normal work capacity, the other those with borderline normal values. The first group showed an average increase of 35% in the initial values during a one-year period of swimming training once a week. The other group with practically normal initial values showed only a slight or negligible increase. Serum lipid levels were unchanged in both groups. No serious side effects were encountered in more than 3000 patients hours. However, no prediction of the risks of this type of training as compared to other forms of physical exercise in patients recovering from myocardial infarction can be made from this study.

Adult↗
PubMed1979

Radionuclide assessment of cardiac performance and myocardial perfusion in congestive cardiomyopathies.

To determine the reliability of radionuclide techniques in the diagnosis of congestive cardiomyopathy (COCM), the function of the right ventricle (RV) and left ventricle (LV) was evaluated in 32 patients with COCM and 21 normal subjects using radionuclide angiography (first pass and gated blood pool scan) combined with quantitative 201 thallium (Tl) myocardial perfusion imaging. In COCM parameters of RV and LV performance were significantly reduced (p less than 0.01); regional wall motion analysis revealed a reduced radial shortening ability (p less than 0.05). 201 Tl distribution within the myocardium was not different between COCM and N; however, segmental 201Tl-uptake was significantly reduced (p less than 0.01). RV free wall was visualized on 201Tl scan in 80% of patients with COCM. There was no correlation between RV free wall visualization and RV hemodynamics. Thus these scintigraphic aspects provide an atraumatic and sensitive technique for the evaluation of patients with COCM.

Adult↗
PubMed1979

Assessment of left ventricular performance and myocardial viability using quantitative radioisotope techniques.

The diagnostic value of a combined radionuclide technique was compared with conventional angiocardiographic techniques in 60 patients with coronary artery disease. Quantitative 201Tl myocardial imaging combined with radionuclide angiocardiography using 99mTc-HSA provided a safe and accurate method for the assessment of left ventricular performance. The defects on the 201Tl images correlated with the severity of asynergy seen on the contrast ventriculogram. Static imaging alone distinguished hypokinetic from akinetic or dyskinetic areas. However, using both tracer techniques, akinesis could bedistinguished from dyskinesis. In patients with disturbed left ventricular function, cardiac transit times correlated with haemodynamic changes, and left ventricular ejection fraction was the most sensitive index. Thus, this combined radionuclide approach provides data for the evaluation of overall and regional wall function. A major advantage of this non-invasive auantitative technique is its applicability to the critically ill patient at the bedside.

Adult↗
PubMed1978

Assessment of regional wall motion in coronary artery disease using radionuclide methods.

72 patients with CAD, 10 patients with congestive cardiomyopathies and 10 normal subjects were evaluated by radionuclide angiography. Comparison with contrast angiography showed good results for LVEF (r = 0.83). Regional asynergies observed in the radionuclide angiography correlated well with defects in thallium scintigrams. Extent of abnormal wall motion was measured and compared with normals, appreciating the deviation from the normal mean radial shortening. Good correlation could be demonstrated with radionuclide ventriculography. In 80% of congestive cardiomyopathies the right ventricle wall became visible in the thallium scintigram.

Cardiomyopathies↗
PubMed1977

Pre-excitation of the ventricle associated with total intra His bundle block.

A case with total intra-His bundle block and intermittent pre-excitation syndrome is presented. During A-V conduction there was a P-delta interval of 130 msec. with a P-A interval of 20 msec., an A-H interval of 60 msec. and an H-V interval of 50 msec. During rapid atrial pacing the P-delta interval increased primarily due to an A-H1 prolongation and a Mobitz type 2 block and total A-V block occured at increasing rates showing H1 following every A spike. The escape beats showed a normal width of the QRS complexes with preceding H2 spikes. After administration of Ajmaline the bypass tract was blocked and constant total A-V block occurred. It was concluded that there was a constant total intra-His bundle block and a nodoventricular or fasciculoventricular bypass tract with prolonged conduction to the ventricle. This bypass tract blocked sometimes spontaneously and could also be blocked by rapid atrial pacing and administration of drugs. The close anatomic proximity of the His bundle and Mahaim fibers is responsible for the simultaneous block resulting in total atrioventricular block.

Aged↗