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Biomedical subjects

H Just

Publications and source records attributed to H Just.

At least 361 records · Page 20Linked to original sources
PubMed1981

Hemodynamic response to graded water immersion.

Hemodynamic response to graded immersion was studied in healthy male subjects in a thermoneutral bath in the sitting position. Pressures in the right heart and cardiac output were determined by means of a semifloating catheter with a thermistor probe. Pressures in the right atrium, pulmonary artery and in pulmonary wedge position increased with increasing depth of immersion, cardiac output was likewise augmented. Heart rate decreased from rest to hip immersion but remained constant from hip to head out water immersion. Plasma norepinephrine concentration remained constant throughout the experiment. The reported changes depend on the blood shift from capacitance vessels into the thoracic cavity. From this, preload increased and cardiac performance was improved. However, in patients with disturbed left ventricular function, immersion to the neck may be potentially hazardous due to augmented left ventricular filling pressure.

Adult↗
PubMed1981

[Pattern quantification of coronary artery stenosis by computerized analysis of multiple ECG parameters (author's transl)].

Coronary angiograms of 200 patients with coronary artery disease were studied. The distribution of stenoses was analyzed and classified utilizing a special score, taking into account coronary supply pattern (according to Baroldi et al.), localization and severity of stenosis, as well as collateralization. Frank-lead vectorcardiograms were obtained and analyzed by computer. 140 scalar and spatial vector parameters were evaluated. A statistical comparison was made in 36 patients with highgrade stenoses of the left anterior descending branch of the left coronary artery with 37 patients without such vascular narrowing. Utilizing 4 ECG-parameters a mathematical formula can be derived which separates the two groups. Another equation based on 5 parameters allows the calculation of a score from conventional electrocardiograms. By discriminance analysis a specificity of 78.4% and a sensibility of 77.8 in prediction results for the group with stenosis. For the control group a specificity of 75.7% and a sensibility of 77.8% were computed. Correlation between the score obtained by calculation on the one hand, and the score derived from direct analysis of the arteriogram was highly significant with an r = 0.796.

Angina Pectoris↗
PubMed1981

[Treatment of severe congestive heart failure with the beta-agonist fenoterol (author's transl)].

The acute hemodynamic effects of the semiselective beta 2-stimulating compound Fenoterol were studied in 7 patients with severe congestive heart failure (IV NYHA) as a result of a low-output-syndrome of varying aetiology (coronary heart disease/cardiomyopathy). The continuous infusion of Fenoterol (2.5 micrograms/min for 60 min) induced the following changes in parameters of pump function: a slight but not yet significant fall of PCPm which we considered as a reference value of LVEDP from 24 +/- 9 to 20 +/- 6 mm Hg (13%); a highly significant increase in CI from 1.96 +/- 04 to 2.71 +/- 0.53 l/min . m2 (39%; p less than 0.001) and in SVI from 18.7 +/- 4.9 to 24.8 +/- 8.1 ml/m2 (32%; p less than 0.01); a clear reduction of TPR from 1374 +/- 427 to 977 +/- 282 dyn . s . cm-5 (28%; p less than 0.001). PVR was reduced from 245 +/- 158 to 192 +/- 85 dyn . s . cm-5 (n.s.). There were no significant changes in right ventricular filling pressure (15 +/- 8 to 15 +/- 9 mm Hg), mean arterial pressure (76 +/- 17 to 75 +/- 16 mm Hg) and heart rate (107 +/- 13 to 117 +/- 23 beats/min). The study indicates that the "selective" beta 2-agonist Fenoterol in severe congestive heart failure produces a significant improvement in pump function. We assume the increase in SV to be due to a positive inotropic effect -- caused by beta 1-stimulation -- and a reduction of impedance to left ventricular ejection by decrease in TPR -- caused by beta 2-stimulation. Thus Fenoterol seems to be useful in treatment of severe congestive heart failure with elevated TPR.

Adrenergic beta-Agonists↗
PubMed1981

Short- and long-term effects of hydralazine and combined hydralazine-prenalterol therapy in severe chronic congestive heart failure.

The hemodynamic benefits of combined administration of prenalterol (P) with hydralazine (H) were evaluated in ten patients with severe chronic heart failure. Single administration of 100 mg H increased cardiac index (CI) from 2.3 to 3.0 l/min/m2, whereas pulmonary capillary wedge pressure (PWC) remained unchanged. After 3--4 weeks of treatment with 200 mg H hemodynamic improvementt was maintained (CI: 2.9 l/min/m2). Additional administration of P caused further augmentation of CI (3.3 l/min/m2). After long-term treatment with the combination of H and P sustained augmentation of CI (3.2 l/min/m2), and, furthermore, a slight but significant decrease of PCW were observed (p less than 0.05 vs. chronic single H-therapy). Five patients were able to perform exercise testing; H improved maximal exercise capacity and exercise hemodynamics in three patients. Further improvemen was observed after combined treatment (H + P) in three of five patients. It is concluded, the prenalterol may enhance the effectiveness of hydralazine therapy in congestive heart failure by providing concomitantly the principal actions of the vasodilator and positive inotropic agent used separately. Furthermore, the results indicate that oral long-term administration of hydralazine and prenalterol can produce sustained beneficial improvement.

Adult↗
PubMed1981

[Non-invasive methods of investigation cardiology (author's transl)].

Non-invasive assessment of heart and chamber size employs various techniques which yield different information. Overall size as estimated by biplane chest roentgenogram in the upright or - better - supine position is a valuable quantitative method. Correlation with individual chamber size is, however, only fair. Information on wall thickness can currently be obtained only by ultrasound echocardiography. ECG and vectorcardiography as a means for determining ventricular hypertrophy have remained semi-quantitative techniques, but can probably be developed into more quantitative information by means of computer analysis. A method of predicting left ventricular muscle mass using the Frank orthogonal lead system is described. Regional disorder of contraction and contractility have been difficult to assess non-invasively. Kymographic techniques describe only motion of the lateral wall. Ultrasound techniques, even using a two-dimensional approach, rarely include the ventricular apical region. Systolic time intervals and radionuclide minimal transit times have remained of limited importance. The value of ECG-gated computertomography cannot be assessed as yet. The greatest promise can be expected from radionuclide techniques with gated blood pool scanning and myocardial scintigraphic techniques.

Angiocardiography↗
PubMed1981

The hemodynamic effect of AR-L 115 BS, a new positive-inotropic agent, in patients with left ventricular failure.

The hemodynamic effects of i.v. administered 2-[(2-methoxy-4-methylsulfinyl)phenyl]-1H-imidazo[4,5-b]pyridine (AR-L 115 BS) were studied in 6 patients whose cardiac function was routinely monitored in an intensive care unit. The investigations were performed by Swan-Ganz catheterisation. There was an immediate onset of action with maximum activity at 5--10 min after administration. The duration of action was not longer than 30 min. Cardiac output was significantly increased by 11.5% (p less than 0.05) and the mean pulmonary pressure and pulmonary capillary pressure were reduced by 16% (p less than 0.05) and by 26% (p less than 0.05), respectively. The heart rate was increased by 12% (p less than 0.05) and the mean systemic blood pressure remained nearly unchanged with a slight tendency to fall. No side effects were reported. The results in these patients support the findings in animal studies that AR-L 115 BS has a positive-inotropic and vasodilating action.

Aged↗
PubMed1981

Study of the acute effect of AR-L 115 BS, a new positive-inotropic agent in patients with exercise-induced heart failure.

Invasive cardiac measurements were performed at rest and during exercise after i.v. infection of 0.7 mg/kg 2-[(2-methoxy-4-methylsulfinyl)phenyl]-1H-imidazo[4,5-b]pyridine (AR-L 115 BS) in 10 patients with heart failure in NYHA class II and III of various origins. At rest AR-L 115 BS increased the cardiac index by 0.74 l/min/m2 (p less than 0.01) and the heart rate by 10 beats/min (p less than 0.01). Mean arterial pressure and pressures in the pulmonary artery and in the pulmonary capillary bed were not changed significantly. Stroke work index remained unchanged. At the highest comparable workload AR-L 115 BS reduced the pulmonary capillary wedge pressure by 7 mm Hg (p less than 0.001) and the mean pulmonary arterial pressure by 8 mm Hg (p less than 0.001). The other parameters measured did not change significantly. In most of the patients there was a reduction in the pulmonary capillary pressure in parallel with a slight increase in the stroke work index, indicating an improvement in left ventricular pump function. Four patients reported bright vision immediately after injection which lasted for several hours in 1 patient and for about 5 min in the others. One patient developed muscle tremor which lasted for several hours. The results suggest that AR-L 115 BS exerts a vasodilating action on the capacitance vessels and a positive-inotropic effect on the heart.

Adult↗
PubMed1981

[Plasma catecholamines and hemodynamics in left heart failure (author's transl)].

7 healthy male subjects, 17 patients with left heart failure of degree I and II and 14 patients of degree III and IV (3 patients) based on a coronary heart disease were examined at rest and during ergometric exercise in supine position during a right-heart-catheter examination. Three patients degree IV were not exercised. Compared to healthy subjects, the patients showed, according to disease severity, catecholamine level increases at rest and at the same submaximum exercise intensity. The catecholamine levels show no difference between the patients and healthy subjects during maximum ergometric exercise, although the patients exercise load was 30% (degree I and II) and 60% (degree III) lower. Three patients of the degree IV already have plasma catecholamine levels at rest like those of healthy subjects during maximum ergometric exercise at 155 +/- 33 Watts. Adrenaline and noradrenaline show a direct correlation to pressure dimensions as to the PCPm or the PAPd corresponding to the limitation extent of cardiac function. Estimation of plasma catecholamines in left heart failure during ergometric exercise allows an orientational judgement of the course of hemodynamic dimensions such as PCPm, PAPd and HMV without renewed invasive diagnostic.

Catecholamines↗
PubMed1981

Posterior aortic wall motion and left atrial volume changes.

The motion characteristic of the posterior aortic wall has been used in precordial M-mode echocardiography as a parameter of cardiac function. However, the determinants of this characteristic motion pattern of the aorta are still unknown. In this study the posterior aortic wall motion was studied angiographically as it is related to left atrial volume changes. 21 patients with various heart diseases served as the study group. 18 patients were in sinus rhythm, 3 patients in atrial fibrillation. We found an excellent agreement between left atrial volume changes and the movement of the posterior aortic wall. The correlation coefficient between both parameters ranged from .73 to .95 irrespective of the underlying heart disease and heart rhythm. From this study one can conclude that left atrial volume changes are reflected by the motion of the posterior aortic wall.

Adult↗
PubMed1981

[Hemodynamic actions on alinidine during exercise in patients with coronary artery disease].

The effect of Alinidine (ST 567) on hemodynamics at rest and during exercise was studied in subjects with angiographically documented coronary artery disease and left ventricular dysfunction. Exercise tests were performed before and 30 min after intravenous administration of 20 mg of Alinidine. Significant decreases were observed for heart rate at rest and during exercise, for systolic and diastolic blood pressure. Pressures in the pulmonary artery and in capillary wedge position were significantly reduced after Alinidine by about 12 to 18% (mean PAP) and by about 19 to 28% (PCW). Cardiac output and stroke volume increased during exercise after Alinidine, but the differences were not significant. Depression of ST-segment in the exercise-ECG was significantly lower after Alinidine, angina pectoris occurred in all but one subject during control testing but in none after Alinidine. It is concluded that Alinidine is an effective antianginal drug. Intravenous administration of this agent even in a low dose improves cardiac performance during exercise in patients with impaired left ventricular function. Negative inotropic effects of Alinidine were not observed in this study. Bradycardia and in addition preload reduction are suggested to be the main mechanisms to improve left ventricular function and symptomatic status.

Clonidine↗
PubMed1981

[Posterior aortic wall motion in mitral valve disease (author's transl)].

The posterior aortic wall motion was studied in 60 patients, 39 patients with mitral valve disease and 21 normals. The motion of the posterior aortic wall was measured by using the amplitude of the posterior aortic wall motion from the beginning of left ventricular contraction to aortic valve closure and an atrial filling and emptying index. The latter two indices were used, because left atrial volume changes were reflected by the motion of the posterior aortic wall. It could be demonstrated that normals differed in their motion pattern of the posterior aortic wall to those with mitral valve disease. Furthermore, patients with mitral stenosis, mitral insufficiency and mixed mitral valve disease could be differentiated from each other in terms of these indices and an atrial filling-emptying ratio. Thus careful inspection of the posterior aortic wall motion by precordial echocardiography can be used as a parameter of mitral valve function.

Adult↗