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H Dürr

Publications and source records attributed to H Dürr.

36 records · Page 2Linked to original sources
PubMed1990

Hypertension and sports activities: institutional experience.

Findings of 185 patients and 271 control subjects are presented for the assessment of work capacity in hypertensive individuals (primary hypertension); an attempt at classification by hypertensive stage is seen as an essential presupposition. The subdivision into three stages recommended by the Experts' Commission of the WHO places the effects of hypertension on the organism, especially on the heart, in the focal point. This appears justified from a prognostic, pathophysiological, and therapeutic point of view. Hemodynamics in the examined patients undergo increasing impairment in relation to the stage of hypertension with a decrease in maximum cardiac index and work capacity and an increase in myocardial oxygen requirement. Initially, only the diastolic cardiac function is impaired; however, in advanced stages, the systolic function of the heart is impaired as well. Evaluation of work capacity is usually possible from a cardiac point of view by means of noninvasive echocardiographic and spiroergometric methods. The mass/volume ratio of the left cardiac ventricle and the relationship between left ventricular muscle mass (or volume) and work capacity are especially important. Both experience characteristic changes depending on the stage of hypertension and thus permit precise determination of work capacity, progress controls, and delineation from physiological cardiac hypertrophy (athletic heart).

Cardiomegaly↗
PubMed1989

[Regression of hypertension-induced left heart enlargement in an endurance athlete treated with verapamil RR].

In October 1987, Stage II arterial hypertension, probably of primary genesis, was diagnosed in a 52-year-old male patient. There was marked left-ventricular hypertrophy (left-ventricular muscle mass 224g, corresponding to 2.99 g/kg: mass-volume ratio of the left ventricle 1.9 g/ml; end-diastolic septum thickness 15 mm, posterior wall thickness 13 mm). The patient is engaged in endurance sports for 5-12h each week and participates regularly in competitions. He was not advised to terminate athletic activities. The patient's submaximum performance (supine ergometry) is 3.3 watts per kg body weight. Under therapy with 2 x 240 g Verapamil per day, blood pressure decreased in the course of a year by 30/30 mm Hg at rest and 30/20 mm Hg at a specified exercise level. The left ventricular muscle mass decreased by about 70g, the mass-volume ratio normalized to 1.3 g/ml.

Blood Pressure↗
PubMed1989

Plasma catecholamine and cardiovascular responses to nifedipine in hypertensives WHO-stage II.

77 patients with arterial hypertension were consecutively examined. An evaluable echocardiogram could be recorded for 75 patients. 54 (72%) had non-pathological cardiac findings, 15 (20%) showed concentric left ventricular hypertrophy of the heart (mean left ventricular muscle mass (LVM) 2.5 g/kg or 113 g/m2; mean LVM/EDV 1.6 g/ml). 6 patients had an excentric hypertrophy of the left ventricle (8%). The influence of 10 mg nifedipine (Adalat) sublingual on the heart, blood pressure and sympathetic activity was examined in 15 patients with left ventricular hypertrophy of the heart. 5-10 min after administration, a significant decrease in systolic and diastolic pressures (p less than 0.05) and an increase in plasma noradrenaline (p less than 0.05) and heart rate (p less than 0.01) could be registered. The thickness of the posterior wall and septum decreased in 8 to 10 of the 15 patients, EDV, shortening fraction and ejection fraction increased in 8 of the 15 patients. A reduction in peripheral resistance, sympathetic counterregulation accompanied by an increase in heart rate, shortening and ejection fractions with increased enddiastolic volume and decrease in wall thickness can be observed as the gross effect in the majority of the 15 patients with left ventricular concentric hypertrophy. The decrease in wall thickness as a relaxation effect should not be confused with a regression of hypertrophy, whereby the mass-volume ratio shifts toward the normal range under nifedipine.

Administration, Sublingual↗
PubMed1988

[Behavior of heart rate, blood pressure, lactate, glucose, noradrenaline and adrenaline level in coronary heart disease patients in the course of light swimming stress].

In previous investigations, we have been able to demonstrate that healthy individuals and CHD patients with normal exercise capacity experience changes in cardiovascular parameters, metabolism and sympathetic activity during light swimming exercise, changes which are not observed in seated bicycle ergometry at an exercise level of less than 2 W/kg-1. We have now examined 12 post-infarction patients (54.3 +/- 6 years) with limited exercise capacity (1.2 +/- 0.3 W/kg-1), who have been participating in physical therapy for 29 months (median time) under continuous medication. The examination comprised incremental seated bicycle ergometry and, approximately 60 min later, light swimming (2 to 3 x 2 min; speed v = 0.33 +/- 0.02 m.s-1; T = 28 degrees C). The changes in heart rate, blood pressure, lactate, glucose, adrenaline and noradrenaline levels during the swimming exercise were equivalent in mean value to ergometry at the 100 W level. Three patients had to discontinue swimming before the scheduled time, due to considerable arrhythmias. Three other patients stopped swimming because of subjective overexertion. The exercise reaction was less favorable among those unaccustomed to swimming than among regular swimmers.

Adult↗
PubMed1988

[Differential diagnosis: physiologic-pathologic hypertrophy of the heart. A case report].

We report on a 52-year-old asymptomatic patient, whom we have examined regularly since 1981. The principal finding is a marked terminal negativity of the T-wave in the extremities and left precordial chest leads in the electrocardiogram with regression at high exercise levels. The patient engages intensively in sports (running, cross-country skiing, gymnastics). His performance capacity is above normal at 4.5 (1981) and 3.8 watts/kg body weight (1988). The echographically determined left ventricular muscle mass (LVM) increased from 2.1-2.3 g/kg body weight to 2.9 g/kg, the end-diastolic thickness of the septum from 9 to 13, and the posterior wall from 8 to 12 mm. In physiological cardiac hypertrophy (athlete's heart), a LVM of 2.9 g/kg is not unusual, whereby the end-diastolic wall thickness does not, exceed 10 to 11 mm and the mass-volume ratio (LVM/end-diastolic ventricular volume) remains constant (about 1.2 g/ml) in contrast to the 1.75 g/ml in our patient. Thermodilution catheter examination of the heart showed a pathological increase in mean pulmonary capillary pressure (26 mm Hg) under exercise as an indication of impaired left-ventricular function. Normal myocardial scintigraphy (resting and exercise) and a lack of symptoms permit the exclusion of relevant coronary heart disease. We diagnosed non-obstructive hypertrophic cardiomyopathy. The problems of differentiating between physiological and pathological cardiac hypertrophies are discussed.

Cardiac Volume↗
PubMed1976

[The influence of saralasine on blood pressure and renal function in Bartter's syndrome and decompensated hepatic cirrhosis (author's transl)].

Infusion of the angiotensin-II-antagonist saralasine led in one patient with Bartter's syndrome and one patient with decompensated hepatic cirrhosis, both of whom had a markedly raised plasma renin activity, to a fall in systolic and diastolic blood pressure. The results indicate that in normotensive patients a raised angiotensin II concentration in blood is haemodynamically important for the level of blood pressure if plasma renin activity is raised. In normotensives with normal plasma renin activity saralasine in the usual dosage (4.2 mug/kg-min) does not influence the blood pressure.

Adult↗
PubMedDate not supplied

Physical performance and cardiovascular and metabolic adaptation of elite female wheelchair basketball players in wheelchair ergometry and in competition.

Spinal cord injury leads to a pronounced reduction of cardiovascular, pulmonary, and metabolic ability. Physical activity, up to and including high-performance sports, has obtained importance in the course of rehabilitation and the postclinical phase. Thirteen elite female wheelchair basketball players from the German National Basketball Team and 10 female sedentary spinal cord-injured persons were examined in the study. Heart volume was measured by an echocardiography. All subjects underwent a graded exercise test on a wheelchair ergometer. Additionally, heart rate, lactate, and player points were measured during a competitive basketball game in wheelchair basketball players. Cardiac dimensions were larger for spinal cord-injured wheelchair basketball players (620.3 ml; 9.6 ml x kg(-1)) in comparison with spinal cord-injured persons (477.4 ml; 8.2 ml x kg(-1)) but did not exceed the heart volume of untrained nonhandicapped persons. In contrast, athletes with amputations or those having had poliomyelitis reached training-induced cardiac hypertrophy in relation to body mass (713.7 ml; 13.2 ml x kg(-1)), as observed in nonhandicapped athletes. During graded wheelchair ergometry, wheelchair basketball players showed a higher maximal work rate (59.9 v 45.5 W), maximal oxygen consumption (33.7 v 18.3 ml x min(-1) x kg(-1)), and maximal lactate (9.1 v 5.47 mmol x l(-1)) without a difference in maximal heart rate and workload at AT4 than did spinal cord-injured persons. The average heart rate during the wheelchair basketball game was 151 x min(-1), and the lactate concentration was 1.92 mmol x l(-1). Female athletes with a less severe handicap and higher maximal oxygen consumption during the graded exercise test reached a higher game level in the evaluation. During the competitive basketball game, high cardiovascular stress was observed, indicating a fast aerobic metabolism; the anaerobic lactic acid capacity played a subordinate role. Wheelchair basketball is an effective and suitable sport to enhance physical performance and to induce positive physiological adaptations.

Adult↗
PubMedDate not supplied

Semiautomated T-bag peptide synthesis using 9-fluorenyl-methoxycarbonyl strategy and benzotriazol-1-yl-tetramethyl-uronium tetrafluoroborate activation.

Multiple peptide synthesis using the T-bag method is considerably facilitated using 9-fluorenyl-methoxycarbonyl strategy and benzotriazol-1-yl-tetramethyl-uronium tetrafluoroborate activation. Convenient protocols were achieved when semiautomation was applied. Successful syntheses of analogues of neuropeptide Y demonstrate the advantages of these improvements. Various peptides consisting of up to eighteen residues were built up with unusual amino acid residues. Useful hints are given for semiautomated multiple peptide synthesis for up to 120 different peptides.

Amino Acid Sequence↗