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Biomedical subjects

M Aschermann

Publications and source records attributed to M Aschermann.

At least 91 records · Page 5Linked to original sources
PubMed1990

Randomized double-blind comparison of isosorbide dinitrate and nifedipine in variant angina pectoris.

The antianginal and anti-ischemic effect of isosorbide dinitrate (ISDN), 120 mg once daily, and nifedipine, 20 mg twice daily, both in slow-release formulations, were compared in 17 patients with variant angina pectoris in a randomized, double-blind trial. The design included a placebo run-in period and two 6-week crossover periods of active treatment. Mean frequency of angina decreased significantly from 43 attacks per week during the placebo period to 4 per week with ISDN and 8 with nifedipine (p less than 0.001). Sublingual nitroglycerin consumption decreased significantly from 37 tablets per week with placebo to 3 tablets per week with ISDN and 7 with nifedipine (p less than 0.001). Both drugs reduced the silent and symptomatic ST-segment deviations on ambulatory electrocardiographic recording and increased maximal exercise tolerance. Episodes of coronary spasm could be provoked, by hyperventilation, in all patients during the placebo phase but in no patient during therapy with either active drug. Thus, both ISDN and nifedipine, in their slow-release formulations, are effective in the treatment of variant angina pectoris.

Adult↗
PubMed1990

[Restenosis after percutaneous transluminal coronary angioplasty].

Restenosis after percutaneous transluminal coronary angioplasty is a critical factor limiting the usefulness of this procedure. It has been reported to occur in 25% to 50% of patients averaging 33%. In the majority of patients it appears within 6 months after procedure. Some clinical, angiographic and procedural factors can predict higher incidence of restenosis--they are discussed in the article. Main mechanisms which result in restenosis are intimal hyperplasia and smooth muscle cellular proliferation. Exercise thallium-201 scintigraphy and coronary angiography are the best methods in diagnosis of restenosis. The prevention and the therapy of restenosis appear as a difficult problems. Successful pharmacological approach doesn't exist until now. In about 50% of patients with restenosis coronary angioplasty is repeated with the same success and restenosis rate as in the first angioplasty.

Angioplasty, Balloon, Coronary↗
PubMed1990

[Thrombolytic therapy in acute myocardial infarct].

The purpose of this review is the evaluation of the available data related to thrombolytic therapy. The pharmacological and clinical characteristics of thrombolytic agents of the first, second and third generations are discussed. The results of the cooperative studies dealing with thrombolysis using streptokinase, tissue plasminogen activator, urokinase and prourokinase are reviewed. Short-term mortality has decreased about 50% in patients with acute myocardial infarction with thrombolytic treatment. The main factors which influence outcome are: the time interval between onset of symptoms and beginning of the treatment, the extent of restoration of myocardial function, the degree of residual stenosis and concomittant medication. During the follow-up after thrombolysis the benefit of aspirin was shown, the question of immediate coronary angioplasty is unresolved. The important risk of thrombolytic treatment is intracerebral bleeding, which appears up to 2% of patients treated with streptokinose and tissue plasminogen activator.

Humans↗
PubMed1989

[Comparison of isosorbide dinitrate and nifedipine in the treatment of variant angina pectoris. Randomized study].

The effects of isosorbide dinitrate single dose 120 mg daily and nifedipine 20 mg twice daily were studied in 17 patients with variant angina pectoris due to coronary artery spasm. After a placebo phase the patients were randomized to treatment with either isosorbide dinitrate or nifedipine. After six weeks the patients were crossovered for another six weeks period of treatment. There was significant decrease of number of angina attacks during both treatment regimens. Using 24 hours Holter monitoring we also proved significant decrease of number of ST segment elevation or depression, either symptomatic or asymptomatic. There was increase of performed work during exercise tests after both treatment periods. The efficacy of Isoket 120 mg and Adalat Retard 2 x 20 mg daily in the treatment of patients with active variant angina pectoris was comparable in our study. 3 patients suffered untolerable headache during isosorbide dinitrate phase and had to terminate treatment after first day only.

Adult↗
PubMed1989

[Percutaneous transluminal coronary angioplasty. Initial clinical experience].

Percutaneous transluminal coronary angioplasty was performed in 20 patients with angina pectoris (16 patients with stable AP, class II-III., 4 patients with unstable AP) in the period of 1 year. There was single-vessel disease in all patients. Left ventricular function was normal as well in all patients. PTCA was successful in 16 patients (80%), in the remaining 4 patients coronary artery stenosis was not reached with balloon catheter. There were no death, Q-wave myocardial infarction or emergency bypass surgery. Transient ischemic changes on ECG has been found in 2 patients (10%). All patients with successful PTCA were symptomatically improved in period of 1-12 months, in one half of them this improvement was confirmed with stress ECG. Control coronary angiography was made in 2 patients until now, restenosis was not found.

Adult↗
PubMed1989

[Long-term prognosis of patients with chronic post-infarct aneurysms. II. Comparison of patients treated conservatively and surgically].

UNLABELLED: Survival rates were determined for a group of 136 patients in whom left ventricular aneurysm was determined by angiography. They were treated medically (99 patients) or surgically (37 patients). Congestive heart failure was predominant in all patients. The two groups did not differ in regard to clinical and haemodynamic data except for a more extensive coronary artery disease in the surgical group. Survival rates at the 5, 7 and 9 years were 62.5%, 52.5% and 37.5% in the medicaly treated group and 50%, 40% and 32.5% in the surgical group. Functional improvement at least one Functional Class NYHA was present in 75% patients postoperatively, and in 27% of patients treated medically. CONCLUSION: In patients with left ventricular aneurysm with predominant congestive heart failure surgical treatment improved quality of life but did not increase long-term survival.

Chronic Disease↗
PubMed1989

[Long-term prognosis in patients with chronic postinfarct aneurysms. I. Conservative treatment of patients].

Natural history of 99 patients with angiographically defined left ventricular aneurysm (LVA) has been studied. Congestive heart failure (CHF) was predominant in 52.5% patients. Mean follow-up was 94 months. The cumulative survival at 1, 5, 7, 10 years were 92, 65, 60 and 28% respectively. Left ventricular end-diastolic pressure averaged 2.8 kPa (LVEDP), ejection fraction (EF) 31%, contractile segment ejection fraction (CSEF) 45%, stroke work 6.7 mj. g-1, diastolic compliance 0.36 kPa-1 and passive elastic modulus 64.1 kPa. High risk groups of patients were those with LVEDP more than 3.3 kPa, CSEF less then 40%, EF less then 20% and with extent of LVA more then 40% of the diastolic area of the left ventricle. The Cox analysis of survival indicated following variables predicted outcome: functional impairment due to CHF, LVEDP, LVEDVI and number of vessels diseased.

Heart Aneurysm↗
PubMed1986

Comparison of M-mode echocardiography and angiography in the evaluation of left ventricular hypertrophy.

The authors analysed in a group of 82 patients with a symmetric left ventricle and a homogeneous ventricular wall thickness the reliability of M-mode echocardiography in recognizing left ventricular hypertrophy. In concentric hypertrophies, a sufficient diagnostic criterion is ventricular wall thickness. Measurement of the interventricular septum offers a better correlation with angiographic values (r = 0.609, p less than 0.001) than measurement of the posterior wall (r = 0.358, p less than 0.01); a correct diagnosis can be determined in 84%. In excentric hypertrophies, the hypertrophy must be assessed on the basis of calculating the left ventricular mass. The most accurate of echocardiographic methods proved to be the calculation according to the authors' own formula (r = 0.760, p less than 0.001), which recognizes left ventricular hypertrophy correctly in 85%. The diagnostic correctness of Teichholz' formula is 80% and of the cubic formula 74%. Fortuin's equations proved to be of no value for documenting ventricular hypertrophy. In a group of 13 patients with hypertrophic cardiomyopathy, the correlation between angiographic and echocardiographic values of the left ventricular mass was very low (r = 0.534, p = 0.05).

Angiography↗
PubMed1986

Changes in the left ventricular function after application of contrast media.

The authors studied at repeated ventriculographic examinations the changes in the left ventricular function after application of routinely used ionic contrast medium and of newer nonionic medium. They demonstrated that ionic medium does not significantly change the left ventricular volume and ejection fraction, but influences the left ventricular diastolic function. Nonionic contrast material does not significantly change the left ventricular function. The mechanism of side-effects of contrast agents and possible indications for the application of nonionic contrast media are discussed.

Contrast Media↗