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Biomedical subjects

J Godtfredsen

Publications and source records attributed to J Godtfredsen.

At least 73 records · Page 4Linked to original sources
PubMed1986

Prospective, randomised, double-blind study of radionuclide determination of left-ventricular ejection fraction in acute myocardial infarction.

In a controlled, randomised, double-blind study to see whether knowledge of left-ventricular ejection fraction (LVEF) could reduce the frequency of left-sided heart failure after acute myocardial infarction, LVEF was determined a few days before hospital discharge in a consecutive series of 60 patients. Subsequently, the patients were randomly assigned to two groups. The cardiologist responsible for their treatment was aware of the LVEF result in group I but not in group II. A month after hospital discharge there was no significant difference in the LVEF between the groups. 2 months after discharge there were no significant differences between the groups in clinical and radiological signs of left-ventricular heart failure or the use of drugs. The cardiologist's clinical estimate of the LVEF and the result of the radionuclide determination were significantly correlated. Thus, the use of LVEF did not change the clinical outcome. The need for randomised controlled studies in the evaluation of diagnostic methods is emphasised.

Adult↗
PubMed1986

Cardiac function and plasma catecholamines during upright exercise in healthy young subjects.

Radionuclide left ventricular ejection fraction, left ventricular volume changes and plasma catecholamines were recorded in six healthy untrained male subjects at rest and during upright exercise at increasing work loads. During mild submaximal exercise mean left ventricular ejection fraction increased 10% because of end-diastolic dilation, while a further 4% increase of left ventricular ejection fraction was recorded at heavy submaximal exercise mainly due to increased end-systolic contraction. Great individual changes were recorded during maximal exercise. Alterations in plasma catecholamines were most pronounced at the high exercise levels indicating that changes in cardiac contractility are not linearly correlated with changes in sympathetic nervous activity. Repeat studies showed only minor variations of mean left ventricular ejection fraction and plasma catecholamines indicating an acceptable reproducibility of the measurements. Variations of both left ventricular ejection fraction and catecholamines were smaller during exercise than at rest.

Adult↗
PubMed1986

Effect of captopril on the cerebral circulation in chronic heart failure.

Cerebral blood flow (CBF) was investigated in 8 patients with chronic heart failure (CHF) (functional class III) and in twelve controls before and after administration of 6.25 mg and 25 mg captopril, respectively. In four controls, CBF was measured by the intracarotid xenon-133 (133Xe) injection technique using stationary external detectors, while inhalation of 133Xe and single photon emission computer tomography was used in the remaining cases. In the control group, the cerebral metabolic rate for oxygen was calculated from measurements of the arterio-venous oxygen difference as well. Mean CBF was significantly (P less than 0.01) lower in the patients with CHF as compared to our controls. Following captopril administration the mean arterial blood pressure decreased in the CHF patients, ranging from 5 to 40%. Three patients showed decreases of blood pressure to values of 56, 65, and 76 mm Hg, but no symptoms of cerebral hypoperfusion were elicited. CBF was unchanged after captopril administration, even in the patients showing a marked reduction in blood pressure. In the control group, the blood pressure, CBF and the cerebral metabolic rate for oxygen remained essentially constant following captopril administration. It is concluded that the cerebral circulation is well preserved during captopril treatment of chronic heart failure. This might be explained by a shift of the lower limit of CBF autoregulation towards lower blood pressure levels.

Adult↗
PubMed1985

[Cardiomyopathy].

Explore the source record for details and available documents.

Heart Diseases↗
PubMed1985

Acute effects of alcohol on left ventricular function in healthy subjects at rest and during upright exercise.

Six healthy men, aged 23 to 30 years, were studied by radionuclide angiocardiography at rest and at 2 submaximal exercise levels in the upright position during increasing alcohol intoxication. At light intoxication (serum ethanol 23 mmol/liter), the median value of left ventricular (LV) ejection fraction (EF) at rest decreased by 5%. At heavy intoxication (serum ethanol 45 mmol/liter), the median LVEF decreased at rest by 11% and during 75% submaximal exercise by 6%, heart rate at rest increased (median 81 vs 62 beats/min), and systolic blood pressure decreased during 50% submaximal exercise (median 145 vs 163 mm Hg). No significant changes of plasma epinephrine concentrations were recorded, whereas plasma norepinephrine concentrations were increased by 24% at rest during light intoxication and by 30 to 38% during heavy intoxication. No changes of LVEF and plasma catecholamine levels were recorded after ingestion of isovolumic, isocaloric drinks as compared with values obtained before intake. Thus, influences of ingestion per se and repeated investigations of LV function were excluded. These findings suggest that in healthy subjects alcohol intoxication causes a dose-dependent impairment of cardiac contractility. Compensatory mechanisms may account for a reduced influence during exercise.

Adult↗
PubMed1985

Pericardiocentesis in patients with and without incipient cardiac tamponade due to pericardial effusion. An easy and safe bedside approach.

Fourteen patients with pericardial effusion of various origins underwent pericardiocentesis on 16 occasions. Incipient cardiac tamponade was present on 19 occasions in 12 patients. Pericardiocentesis was carried out bedside under sterile conditions by a trained cardiologist. In case of impaired central circulation, drainage was sufficient to stabilize the clinical condition haemodynamically, and no adverse events occurred during pericardiocentesis. Fenestration of the parietal pericardium was necessary in 5 patients because of rapid regeneration of the fluid and in one patient due to pyopericardium with cardiac constriction. Pericardiocentesis is recommended in incipient cardiac tamponade. In the hands of experienced cardiologists the drainage procedure can be carried out safely without sophisticated equipment.

Adult↗
PubMed1985

Cardiac disease in patients with reversible cerebral ischemic events.

The establishment of a possible association between ischemic cerebral attacks and prolapsing mitral valve has been studied in 45 consecutive patients aged 60 years or less with transient cerebral ischemic attacks and reversible ischemic neurological deficits. The study comprised cardiac history, auscultation, electrocardiography and echocardiography. We found only one patient (2%) with mitral valve prolapse but 19 patients (42%) with cardiac abnormalities. Two of the patients with cardiac abnormalities had a flail posterior mitral leaflet, one had ventricular septal defect and one had sclerotic aortic valves. We conclude that all patients with transient cerebral ischemic attacks should be subjected to heart examination, if possible including echocardiography.

Adult↗
PubMed1985

Converting enzyme inhibition resets cerebral autoregulation at lower blood pressure.

The cerebrovascular effect of converting enzyme inhibition was investigated in normal volunteers, in hypertensive patients and in patients with severe chronic heart failure. Cerebral blood flow (CBF) was measured by single photon emission tomography of the uptake and wash-out of inhaled xenon-133. In some of the patients, CBF was also monitored by repeated determinations of the cerebral arterio-venous oxygen difference. In the normal volunteers and the hypertensive patients captopril (50 mg) caused a downward shift of the lower limit of CBF autoregulation of 10-15 mmHg. In some of the patients with chronic heart failure, captopril (6.25 mg) induced a marked decrease of the arterial blood pressure. Regional and average CBF, however, remained constant. These findings indicate that captopril treatment may protect the brain against ischaemia during sudden decreases of the blood pressure by a shift of the lower limit of CBF autoregulation.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1984

Cardiac performance in patients with asymptomatic alcoholic cirrhosis of the liver.

Twenty patients with biopsy-proved alcoholic cirrhosis of the liver and no cardiac symptoms entered a noninvasive investigation program in which cardiac performance was evaluated. One patient was excluded from the study because of a significant ethanol content in the serum at the time of investigation and 4 patients were excluded because of significant electrocardiographic ST-segment changes during exercise testing. Fifteen patients (12 men, 3 women, median age 47 years) who had abstained from alcohol drinking for at least 2 months were studied by exercise testing, echocardiography, measurement of systolic time intervals and left ventricular (LV) radionuclide ejection fraction (EF) at rest and during submaximal exercise. Twelve healthy persons of the same age served as control subjects. Heart rate at rest was significantly elevated in the patient group, median 90 beats/min (range 62 to 128) vs 73 beats/min (range 61 to 89) (p less than 0.02). No significant differences were found in physical work capacity and systolic time intervals, and echocardiographic parameters did not differ with the exception of left atrial dimension (median 36 mm [range 22 to 47] in the patient group and 31 mm [range 17 to 38] in the control subjects, p less than 0.05). No significant difference was found in LVEF at rest. During exercise, however, the median LVEF increased only 6% in the patients versus 14% in the control subjects (p less than 0.05). The results of this study suggest that patients with alcoholic liver cirrhosis, although free of cardiac symptoms, may have a latent or preclinical cardiomyopathy that is manifest during physical stress.

Adult↗
PubMed1984

Cerebral blood flow in patients with congestive heart failure treated with captopril.

The effect of captopril on cerebral blood flow was studied in five patients with severe congestive heart failure and in five control subjects. Cerebral blood flow was measured by inhalation of 133xenon and registration of its uptake and washout from the brain by single photon emission computer tomography. In addition, cerebral (internal jugular) venous oxygen tension was determined in the controls. The measurements were made before and 15, 60, and 180 minutes after a single oral dose of captopril (6.25 mg in patients with congestive heart failure and 25 mg in controls). Despite a marked decrease in blood pressure, cerebral blood flow increased slightly in the patients with severe congestive heart failure. When a correction was applied to take account of a change in arterial carbon dioxide tension, however, cerebral blood flow was unchanged after captopril administration even in patients with the greatest decrease in blood pressure, in whom a decrease in cerebral blood flow might have been expected. In the controls, blood pressure was little affected by captopril, whereas a slight, but not statistically significant, decrease in cerebral blood flow was observed. The cerebral venous oxygen tension decreased concomitantly.

Adult↗
PubMed1984

Right and left ventricular ejection fraction and left ventricular volume changes at rest and during exercise in normal subjects.

The effect of exercise upon right and left ventricular ejection fractions (RVEF and LVEF) as well as the changes upon left ventricular end-diastolic and end-systolic volume indices (LVEDVI and LVESVI) were investigated. Twenty-two normal subjects were studied at rest and during upright submaximal exercise. RVEF was determined using a first-pass method. LVEF was measured using multiple gated blood pool imaging. During the exercise test ECGs remained normal. HR and BP increased significantly (P less than 0.01). RVEF increased from 44% +/- 4 (mean +/- SD) to 60% +/- 6 (P less than 0.001). LVEF increased from 62% +/- 6 to 76 +/- 5 (P less than 0.001). A wider scatter was observed in delta RVEF than in delta LVEF. There was a 14% increase in LVEDV-index and a 14% decrease in LVESV-index (P less than 0.001). A multiple regression analysis with delta RVEF as the dependent variable and delta HR, delta systolic BP, delta LVEF, delta LVEDV-index and LVESV-index as independent variables showed a significant correlation between delta RVEF and delta LVEF and delta systolic BP (P less than 0.05). Our data provide insight into the mechanisms by which the pump performance is increased in normal subjects. The central mechanisms observed are the Starling effect and an increase in contractility of the myocardium. This is connected in the general circulation to an increase in afterload, indicating a redistribution of blood from the vascular beds to the muscles and to the heart.

Adult↗
PubMed1984

Atrial fibrillation--a review of course and prognosis.

Four recent major studies concerning the prognosis in atrial fibrillation (AF) are reviewed. The one-year mortality ranged from 16.0 to 0.2%, highest in elderly, hospitalized patients with chronic AF and lowest in young individuals with paroxysmal AF without other heart disease. The recognized clinical impression that the prognosis in AF is determined by age, type of AF and clinical status is thus confirmed. In three studies, however, the prognosis in lone atrial fibrillation seemed to be poorer than previously thought. The overall rate of thromboembolic complications in AF was about 25% in several studies. The effectiveness of coumarin drugs in the prophylaxis of these complications is not proved, and the time has come to subject them to more careful clinical investigation.

Age Factors↗