[Angiotensin-converting enzyme inhibition--new methods in the treatment of arterial hypertension and heart failure].
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Biomedical subjects
Publications and source records attributed to G Linss.
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53 patients with coronary heart disease were investigated synchronously by means of impedance and angiocardiography combined with the measurement of the pressure in the aorta and the left ventricle. In these cases relatively close correlations were found between the stroke volumes and systolic time intervals, determined by the two methods, as well as between the ejection fraction on the one hand and the parameter dz/dt max on the other. The pressures, measured invasively, do not correlate significantly with the impedance cardiography parameters. With help of the relations found it is possible to coordinate the changes of the thoracic impedance curve depending on the heart action with the various phases of the left-ventricular volume change.
The aim of the study was to test whether there are typical changes in haemodynamics and humoral regulation in untreated hypertensives compared to normotensives with acute lowering of blood pressure (and venous return) induced by nitroglycerin (NTG). 23 hypertensives were investigated by radiocardiography and microcatheterization of the pulmonary artery as well as by means of humoral analyses in comparison to 10 normotensives. After performing the studies at rest and during exercise, 0.8 mg NTG was given and the investigations were repeated. There were only insignificant differences in cardiac output and left ventricular filling pressure (PAEDP) at rest and during exercise between both groups. The pressure reductions due to NTG were also similar. Plasma renin activity and plasma kallikrein did not differ in hypertensives and normotensives either at rest and during exercise or after NTG. The prostaglandins (PgE, PgF2-alpha, PgI) were extremely variable. In hypertensives, only PgI was decreased, with increase after NTG, at rest. Thus, PgI is the only humoral indicator participating in blood pressure lowering induced by NTG.
89 patients (31 healthy subjects, 31 hypertensives, and 27 patients with coronary heart disease) were examined simultaneously by means of impedance (ICG)-, ultrasonic (UCG)-, radio (RCG)-, and calib. and diff. apex cardiography (cACG). There were found significant correlations between the ICG-, UCG-, and RCG-parameters, all describing the heart function in the auxotonic ejection phase. Whereas there were no significant correlations between the methods mentioned and the cACG. Of all investigated parameters in hypertensives only the quotient A/S of cACG is significantly increased compared with persons with healthy heart and circulation. In patients with coronary heart disease all the parameters of the auxotonic ejection phase are significantly decreased, the isometric contraction time and the quotient A/S are increased.
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Porphyria cutanea tarda-like changes of the skin are described in two male patients undergoing chronic haemodialysis. The protoporphyrin values of the erythrocytes were somewhat higher than normal. Despite the same conditions of dialysis and the same medication in the subsequent two years of control no recidivations could be registered. The etiopathogenesis is not clarified.
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