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Biomedical subjects

G I Gomes

Publications and source records attributed to G I Gomes.

8 recordsLinked to original sources
PubMed1983

Electrophysiologic properties of furosemide in man.

Furosemide has been extensively used in the treatment of heart failure and its effect on cardiovascular dynamics are well established. Clinical relief of the symptoms of pulmonary congestion frequently precedes any demonstrable diuretic effect, suggesting that extra renal factors may also be involved. More recent studies on the extra-renal action of furosemide showed an increase of venous capacitance as an early hemodynamic effect of the drug. In spite of furosemides wide use in the treatment of heart failure and hypertension, there is no information on the electrophysiologic properties of the drug in man. The present study involving 8 human subjects was undertaken to determine what effect intravenously administered furosemide has on the human conduction system.

Aged↗
PubMed1982

Paradoxical response to the vasodilators.

A 52-year-old male was admitted to the hospital in congestive heart failure. Mitral stenosis as well as an aortic valve prosthesis were the underlying cardiac abnormalities. A Swan-Ganz catheter was inserted and various vasodilators were administered. Phentolamine, nitrates, nitroprusside, and hydralazine all produced an unexpected and at times an alarming increase in the pulmonary artery pressure. The explanation of this paradoxical hemodynamic response is unknown but demonstrates the importance of hemodynamic monitoring with vasodilator therapy

Blood Pressure↗
PubMed1982

Effect of nebulized isoproterenol on cardiac conduction in man.

The effects of Isuprel administered by means of a mistometer were studied in 8 patients with heart disease. Recordings were made at varied heart rates using atrial pacing. In addition, the functional and effective refractory periods were measured with the use of the extra stimulus technique. Four inhalations of the mistometer were administered to each patient (0.5 mg). The AH interval was 100 +/- 13 msec before and 93 +/- 23 msec 5 minutes after the Isuprel administration (p less than 0.05). Isuprel significantly reduced the AH interval with atrial pacing. The AH interval at an atrial pacing rate of 100/minute was 148 +/- 70 msec before and 131 +/- 51 msec after Isuprel (p less than 0.05). Isuprel had no significant effect on the HV interval. The effective and functional refractory period of the atrioventricular node was not significantly changed after Isuprel. The heart rate and blood pressure showed no significant change after Isuprel. No cardiac arrhythmias were seen. (The systemic absorption of the drug was probably minimal.) Isuprel administered by means of the mistometer can improve conduction through the atrioventricular node. Nevertheless, the potent bronchodilating effects of Isuprel and the absence of tachycardia and cardiac arrhythmias does attest to the safety of this agent.

Administration, Oral↗
PubMed1981

Pacemaker failure following external defibrillation.

An 81-year-old female with the sick sinus syndrome had a permanent pacemaker implanted. She subsequently developed ventricular fibrillation and was successfully defibrillated. However, the defibrillation paddle was placed on the pulse generator which led to a complete loss of function of the pulse generator. External defibrillation can produce varying degrees of damage to the implanted pulse generator. The resultant abnormalities are discussed and recommended defibrillation procedures are also outlined in this report.

Aged↗
PubMed1981

Noninvasive assessment of load reduction in chronic congestive heart failure patients.

Therapy with phentolamine can improve the condition of patients with congestive heart failure due to the inotropic effect of this drug as well as its vasodilating action. Therefore, 8 patients with volume-overloaded left ventricles due to aortic insufficiency and mitral insufficiency received 50 mg of phentolamine 4 times a day for 2 weeks. Peak and end systolic wall stress were estimated using a noninvasive echocardiographic technique. The peak systolic wall stress in this group was 133 X 10(3) dynes/sq cm, which is similar to the reported normal value. However, the end systolic wall stress was 89 X 19(3) dynes/sq cm, which is much higher than the reported normal values. After PO administration of phentolamine, the end systolic stress was normalized while the peak systolic stress was reduced below normal. As a result of therapy with phentolamine, the ejection fraction, the percentage of change in the minor axis, and the velocity of circumferential fiber shortening significantly increased. Thus, PO administration of phentolamine can improve left ventricular function in patients with mitral insufficiency and aortic insufficiency.

Adult↗