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Biomedical subjects

H Smulyan

Publications and source records attributed to H Smulyan.

At least 73 records · Page 4Linked to original sources
PubMed1977

Hemodynamic and plasma renin effects of propranolol in essential hypertension.

Hemodynamics and plasma renin activity were measured in 20 ambulatory hospital inpatients with untreated mild to moderate essential hypertension. The control measurements were made after a period of four to seven days just on a diet containing 10 mEq sodium per day. The measurements were repeated following a week of oral propranolol hydrochloride therapy plus the low salt diet. Heart rate (P less than .001), mean arterial pressure (P less than .001), cardiac output (P less than .05), and plasma renin activity (P less than .05) were reduced in the majority of these patients following propranolol therapy but stroke volume increased (P less than .05). Corrected ejection time and total peripheral resistance did not show significant change. The antihypertensive effect of propranolol could not be related to its hyporeninemic effect or to the fall in cardiac output. Under the experimental conditions of this study, no single parameter, either hemodynamic or plasma renin activity, was predictive of a definite antihypertensive response to propranolol therapy.

Adult↗
PubMed1976

Cine angiographic diagnosis of patent foramen ovale in paradoxical embolism,.

A case of paradoxical embolism is presented in which the antemortem diagnosis was facilitated by a new simple angiographic technique that demonstrated a patent foramen ovale. An additional 14 patients were studied by this technique, and one had a patent foramen ovale. The mechanism of reversal of the normal intraatrial pressure gradient and subsequent right to left shunt through a patent foramen ovale is discussed. This angiographic technique may be readily applied in any diagnostic catheterization laboratory and complements existing methods for detecting patency of the foramen ovale in patients with suspected paradoxidal embolism.

Adult↗
PubMed1976

Effect of digitalis on skeletal muscle in man.

Although an inotropic effect of digitalis on skeletal muscle has been demonstrated in animals, it has not been shown in man. Digitalis, in previous studies, has failed to improve voluntary exercise performance. In this investigation the strength of nerve-stimulated involuntary thumb adduction was measured before, during and after infusion of ouabain into the brachial artery. With this experimental design, the many uncontrolled factors that govern ordinary exercise tolerance were avoided. Large doses of ouabain (0.5 mg) produced significant augmentation of peak strength of thumb adduction whereas smaller doses (75 mug) more likely to reach the thumb during systemic digitalization produced only suggestive increases in peak contraction strength. In patients previously digitalized for heart failure, the large doses of ouabain did not significantly change contractility. The findings suggest that skeletal muscle is less sensitive than cardiac muscle to ouabain, and that systemic digitalization has a minor effect on skeletal muscle. When the differences between skeletal and cardiac muscle in excitation-contraction coupling are considered, the reduced effect of ouabain on skeletal muscle contraction is compatible with cell membrane locus of action in both tissues.

Clinical Trials as Topic↗
PubMed1976

Follow-up catheterization of patients with myocardial infarction during coronary artery bypass surgery.

Of 197 consecutive patients having aortocoronary bypass grafts over a 30 month period, 38 (19 per cent) had ECG evidence of myocardial infarction. The infarctions occurred more commonly in patients receiving multiple grafts. The infarctions were usually in areas supplied by grafted vessels. The infarctions occurred most often in the inferior wall, even when multiple vessels were grafted. Eleven patients with intraoperative infarction have had repeat postoperative coronary arteriograms. Seven had all grafts patent; three of these patients had hypokinesis of the infarcted wall. Four of the 11 patients had one or more occluded grafts; three of these patients had an area of hypokinesis. We conclude that intraoperative myocardial infarction is a common problem in aortocoronary bypass surgery and is not necessarily caused by graft occlusion.

Angiocardiography↗
PubMed1976

Prophylactic digitalization for coronary artery bypass surgery.

One hundred and twenty patients undergoing aortocoronary bypass procedures were randomly placed into control and digitalized groups. All were initially in normal sinus rhythm and without evidence of congestive heart failure. Supraventricular arrhythmias occurred in 17 of 66 controls and in only three of 54 digitalized patients (P less than 0.01). There was no evidence of digitals toxicity. Based on this evidence we recommend prophylactic digitalization for patients having aortocoronary bypass operations.

Arrhythmias, Cardiac↗