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Biomedical subjects

M Kaltenbach

Publications and source records attributed to M Kaltenbach.

At least 307 records · Page 17Linked to original sources
PubMed1982

[Extent of beta-blocking action of S- and R-penbutolol during exercise testing (author's transl)].

The effect of 40 mg penbutolol (pure S-form = laevo penbutolol) and 40 mg isopenbutolol (pure R-form) on heart rate and blood pressure during exercise testing was investigated under double-blind, randomized, placebo-controlled conditions in 9 probands. 1.5 and 5.5 hours after ingestion of 40 mg penbutolol, resting, standing, exercise, and recovery heart rate as well as systolic pressure during exercise displayed a significant decline. Diastolic blood pressure rose slightly 1.5 hours after penbutolol. Isopenbutolol had no significant effect on resting and standing heart rate. 1.5 hours after ingestion, a slight reduction in exercise and recovery heart rate could be confirmed. The decline, however, was significantly lower than that achieved with penbutolol. In comparison with its dextrorotatory isomer, isopenbutolol, penbutolol has an approximately 100-fold more potent effect on exercise heart rate. This is also reflected in the drug's duration of action.

Adult↗
PubMed1982

[Dose-response relationship and duration of action of acebutolol / investigations on heart rate behaviour and ischemic ST-segment depression].

1. The dose-response relationship and duration of action of 3'-acetyl-4'-(2-hydroxy-3-isopropylaminopropyl)-butyranilide (acebutolol, Prent) were determined under double-blind conditions in 9 volunteers using heart rate at rest and during exercise as a test parameter. 2. The effect of 200 mg of acebutolol on ischemic ST-segment depression, heart rate, and blood pressure was investigated in 10 patients with coronary heart disease. 3. Heart rate at rest and while standing was most markedly reduced in the volunteers 3 h following ingestion of acebutolol 300 mg. 100 and 300 mg lowered heart rate during exercise by 9.9 and 18.9%, respectively. No significant additional effect was achieved by increasing the dosage to 500 mg. 4. 24 h after single oral doses of 300 and 500 mg of acebutolol, nearly 50% of the substance's activity was still evident. 5. In patients with coronary heart disease, maximum heart rate during exercise 3 h after oral intake of 200 mg declined by 13%. The heart rate sum during ergometry fell by 11.2%. Systolic blood pressure at rest and during exercise also was lower. 6. A single oral dose of 100-300 mg of acebutolol consistently reduces heart rate during exercise as well as exercise-induced myocardial ischemia. Since the drug remains active over a 24-h period, administration once daily should provide an adequate therapeutic effect in many patients.

Acebutolol↗
PubMed1982

[Conservative medical treatment of hypertrophic myocardiopathies].

50 patients with hypertrophic cardiomyopathy were treated with 480 mg Verapamil per day over a period of 47 months (11-82 months beginning in 1973). Subjective improvement was seen in 37 of 50, 6 were unchanged, 1 worsened, 6 were symptom-free from the beginning and remained so during treatment. Heart size (heart volume determined from chest x-rays in supine position) showed a reduction in 35 of 50. On average of all 50 patients a significant reduction of 8.6% was seen; in 26 patients treated for more than 2 years the average reduction was 11%. 26 patients on no medication or betablockers were followed over 24 months and revealed an average increase in heart volume of 11.9%. The ECG showed during Verapamil treatment a reduction in QRS amplitude and a tendency towards normalization of ST/T segments . . . On echocardiography a small but significant reduction in septal and free wall thickness as well as in left atrial diameter was seen. Recatheterization was performed in 19 patients while all 50 had right and left heart catheters before entering the study. Recatheterization showed on average of the 19 patients a reduction in left ventricular filling pressure, pressure gradient, left ventricular muscle mass and coronary artery diameter. It is concluded that subjective improvement, noninvasive and invasive parameters as well as the low death rate of 1% per year during a total of 200 treatment years point towards a beneficial influence of Verapamil treatment superior to other types of therapy.

Adolescent↗
PubMed1982

[Coronary circulations in patients with valvular aortic stenoses (author's transl)].

This study was done to substantiate the observation that there is a high coincidence of predominant left coronary circulations in patients with valvular aortic stenoses, Between 1973 and 1980, 506 patients, who underwent coronary angiography and ventriculography, were investigated: patients with mitral stenosis (group I; n = 77), mitral regurgitation and combined mitral valve dysfunction (group II; n = 50), aortic regurgitation with or without mitral valve disease (group III; n = 61), pure aortic stenosis (group IV; n = 49) and the combination of aortic stenosis and insufficiency with mitral valve disease group V; n = 69). Patients with coronary heart disease (group 6; n = 200) served as control. Predominant left circulation was present in a comparable frequency in the valve-patient group 1 (8%), group 2 (10%) and group 3 (8%) and with patients with coronary heart disease (7.5%). A distinctly higher frequency was observed in group 4 (33%; p less than 0.001) and in group 5 (19%; p less than 0.01). We conclude that valvular aortic stenosis and predominant left coronary circulation might have the same genetic or developmental background.

Adult↗
PubMed1982

[Combined first-pass-/equilibrium radionuclide ventriculography for non-invasive evaluation of aortic valve incompetence].

In 15 patients with pure aortic valve incompetence and 5 patients with normal valvular function we determined cardiac output by first-pass-radionuclide ventriculography. In addition, left ventricular stroke volume was evaluated by equilibrium radionuclide ventriculography. The difference between those two volumes in relation to left ventricular stroke volume is the regurgitant fraction. Stroke volume index was calculated as the ratio of enddiastolic-endsystolic count differences of left and right ventricle. Patients with aortic insufficiency demonstrated a regurgitant fraction between 20 and 88%, whilst controls never exceeded 10% (on average-2%). Sensitivity therefore was 100%. In contrast, 2 of 15 patients with aortic valve incompetence showed a stroke volume index within normal range (sensitivity 87%). Regurgitant fraction correlated well with aortographically determined severity of valvular incompetence (r = 0.94). We conclude that combined first-pass-/equilibrium radionuclide ventriculography is a highly sensitive quantitative method for evaluation of aortic insufficiency.

Adult↗
PubMed1981

[Transluminal dilatation of renal artery stenoses for treatment of renovascular hypertension (author's transl)].

Transluminal angioplasty according to Grüntzig was performed for 10 stenoses in 7 patients with renovascular hypertension. Nine out of 10 renal artery stenoses were passable and could be dilated. Definite angiographic improvement could be shown in each case. The degree of stenosis could be decreased from 86% to 38% on average. At the narrowest point the diameter was enlarged by a factor of 3.1. The pressure gradient at the stenosis fell on average from 147 to 26 mm Hg. The maximal arterial blood pressure which was on average 254/124 mm Hg before drug treatment, and 169/97 mm Hg after high dosage antihypertensive treatment, fell to 140/84 mm Hg immediately after dilatation. Before dilatation there was a definite increase in peripheral plasma renin activity in every case which fell from 41 to 12 ng AI/ml . h. In one out of 5 patients restenosis occurred after 3 months which could again be successfully dilated. In the two younger patients blood pressure 3 to 9 months later was normal even without antihypertensives. In the older patients normal blood pressure could be maintained with mild antihypertensive treatment.

Adult↗
PubMed1981

Antianginal effect of nifedipine after intracoronary and intravenous administration judged by reduction of ischemic ST-segment depression in exercise tests.

The purpose of the study was to distinguish between the peripheral and the cardiac mode of action of nifedipine, a drug which inhibits transmembrane calcium transport. To assess the cardiac and peripheral antianginal effect independently, two routes of application were employed: systemic intravenous and intracoronary infusion into the left coronary artery of approximately equipotent doses.

Angina Pectoris↗