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Biomedical subjects

P Fitscha

Publications and source records attributed to P Fitscha.

At least 127 records · Page 7Linked to original sources
PubMed1982

Hypertension and beneficial treatment with beta-blocking agents does not change the platelet sensitivity to the antiaggregatory prostaglandins.

Recent publications have described increased vascular prostacyclin synthesis in vascular tissue from both spontaneous and experimental hypertensive animals and hypertensive humans. The only paper dealing with the platelet sensitivity reported that the cells are not abnormally sensitive to PGI2 in spontaneously hypertensive rats. In 22 patients with essential hypertension the platelet sensitivity to the antiaggregatory prostaglandins PGI2, PGE1, and PGD2 was studied on admission and two weeks after successful treatment with a beta-blocking agent. In all the age groups and in both sexes no differences in platelet sensitivity could be detected. These findings suggest that increased vascular PGI-2 synthesis is not counterbalanced by a change in platelet sensitivity in men.

Adult↗
PubMed1982

The effect of intrinsic sympathomimetic activity of beta-adrenoceptor blockers on circadian heart rate.

1 The effect of a beta-adrenoceptor blocker without intrinsic sympathomimetic activity (propranolol) and a beta-adrenoceptor blocker with ISA (pindolol) on circadian heart rate was studied in 10 patients (3 women and 7 men) with an average age of 55 years and the following diagnoses: coronary heart disease (n = 7) and hypertension (n = 3). The therapy was carried out in a randomized, cross-over study, with 3 x 40 mg propranolol and 3 x 5 mg pindolol. 2 Propranolol lowered the averaged circadian heart rate significantly (P less than 0.001) from 78 to 68 beats/min. The rate decreased both during the day and at night and the reduction was greater the higher the control value. The minimal hourly heart rate also decreased significantly (P less than 0.005) from 65 to 69 beats/min. 3 After pindolol the averaged circadian heart rate was not markedly changed. It reached a stable rate of around 70 beats/min. At a heart rate of below 70 beats/min an increase in rate was observed, whereas above 70 beats/min a reduction was found. The mean heart rate during the day remained unchanged. There was a significant relationship between the level of the control heart rate and the decrease in rate (r = 0.85, P less than 0.005). 4 In a bicycle exercise test of 1 Watt/kg body weight over a period of 6 min, both beta-adrenoceptor blockers lowered blood pressure and heart rate to the same extent.

Adrenergic beta-Antagonists↗
PubMed1982

Effects of age and smoking on the pharmacokinetics of pindolol and propranolol.

1 Pharmacokinetic investigations were carried out in a group of 32 ambulant normal male volunteers in order to determine the effect of age and smoking on steady-state plasma levels of pindolol and propranolol. There were four groups of 8: young non-smokers (YNS), young smokers (YS), old non-smokers (ONS) and old smokers (OS). Each subject received, in a randomized cross-over sequence, 5 mg pindolol and 80 mg propranolol three times daily for 2 days with an interval of at least 14 days between the two treatment periods. 2 Neither age nor smoking was shown to have any influence on the time to reach a peak plasma level after pindolol or propranolol. Age, on the other hand, significantly increased the peak plasma levels and the areas under the plasma concentration time curves, and decreased the elimination rate constants, the differences between the age groups being more pronounced for propranolol than for pindolol. No effect of smoking on these parameters was observed. 3 Differences were found between pindolol and propranolol in respect of time to reach a peak plasma level, peak plasma levels and area under the plasma concentration time curves in the groups ONS and YS when related to the YNS control group. Changes observed (with the exception of the time to reach a peak level) tended to be less for pindolol and were considered to be of little clinical relevance.

Adult↗
PubMed1982

Influence of smoking and age on pharmacokinetics of beta-receptor blockers.

The influence of age and smoking on pharmacokinetics of pindolol and propranolol was investigated. Although there was a statistically significant difference in certain pharmacokinetic parameters (maximum plasma concentration, area under the curve, elimination constant and elimination half-life) between elderly patients (more that 60 years) and young persons (20-30 years) no significant differences were found as far as smoking and nonsmoking is concerned. This is in contrast with some reports in the literature. The higher plasma concentrations of both investigated drugs may be the result of a decreased metabolism of propranolol in older persons, in a decreased hepatic blood flow and a decreased renal elimination. Because of the lower sensitivity of beta-receptors in old persons, the higher plasma concentrations of beta-receptor blockers in this group of patients should not result in a diminished dose of the investigated beta-receptor blockers in the elderly.

Adrenergic beta-Antagonists↗
PubMed1982

[Comparison of 24-hour long-term electrocardiogram and exercise testing in the detection of ventricular arrhythmias (author's transl)].

The incidence of ventricular arrhythmias was investigated in 100 patients with a mean age of 53 years with symptom-limited maximal bicycle exercise testing and 24-hour long-term electrocardiogram. 47% of the patients developed ventricular ectopic beats under exercise and 78% in the long-term electrocardiogram. Repetitive forms such as couplets and ventricular tachycardias were found to be three times as frequent with monitoring than with exercise. Therefore it may be concluded that 24-hour monitoring was superior to exercise testing in the detection of incidence and severity of ventricular ectopies. In contrast, there was no significant difference between the two method when comparing exercise testing with the first hour of monitoring. Therefore it may be concluded that exercise testing exposes the grades of ectopic activity occurring during the first hour of the monitoring session. Two-thirds of patients without arrhythmias under exercise had no or insignificant ventricular arrhythmias under monitoring, whereas two-thirds of patients with exercise-induced arrhythmias had advanced grade ventricular ectopic activity with monitoring.

Adult↗
PubMed1982

[Value of the detection of arteriosclerotic lesions with labeled autologous thrombocytes].

In 44 patients with clinical signs of carotid artery stenosis a positive Doppler-ultrasound was obtained. In all patients the lesions were confirmed by angiography. In the patients labelling of autologous platelets with 111Indium-oxine-sulphate was done in order to calculate the platelet half-life. In addition we tried to visualize the verified atherosclerotic lesions under a gamma-camera. In all patients the platelet half-life was significantly shortened in comparison to the controls. In none of the patients studied a visualization of the angiographically verified atherosclerotic lesions could be obtained. These findings point out, that only in recently developed and very severe atherosclerotic lesions the number of platelets deposed on the vascular surface is enough to allow gamma-camera imaging.

Aged↗
PubMed1981

[Optimized sequential pacing of atrium and ventricle (author's transl].

A new stimulation system for pacemaker is described, which was implanted in a 49 years old patient. The new pacemaker stimulates the atrium when needed, the ventricle when needed and both when needed and can be inhibited completely. At a faster atrial activity and disturbed atrio-ventricular conduction the pacemaker synchronizes the ventricle at the appropriate rate. Thus the optimized stimulation comes very near to the physiologic rhythm of the heart.

Echocardiography↗
PubMed1981

[Influence of the venous wall--platelet interaction by dihydroergotamine (author's transl)].

The incubation of rabbit venous rings (vena cava) is followed by the synthesis and release of prostacyclin (prostaglandin I2, PGI2), as measured by the inhibition of ADP-induced platelet aggregation. The incubation of the venous rings in dihydroergotamine leads to a stimulation of PGI2 synthesis and/or release. This effect of dihydroergotamine, apart from the vasoactive properties of this compound, might prove advantageous as a prophylactic measure in venous thrombosis.

Adenosine Diphosphate↗
PubMed1981

[Contribution of long-term ECG monitoring in analysing cardiac arrhythmias (author's transl)].

Long-term analysis is one of the greatest advances in clinical cardiology within the last 15 years. With the introduction of computers exact quantification and qualification of arrhythmias, over long periods has become possible. Major indications for long-term ECG monitoring are detection of occult arrhythmias, evaluation of subjective symptoms such as palpitations, dizziness or syncope, recognition of pacemaker dysfunction, identification of high-risk patients with coronary heart disease and evaluation, as well as monitoring of drug therapy.

Aortic Stenosis, Subvalvular↗
PubMed1981

[Influence of physical training on resting and exercise haemodynamics in patients after acute myocardial infarction (author's transl)].

Resting and exercise haemodynamics were investigated in 17 patients with acute myocardial infarction after hospital treatment at the end of the third week. After 8 weeks of physical training measurements were repeated. The data were analyzed for the whole group and also with respect to enddiastolic pulmonary pressure (PAEDP) during exercise (50 Watts). Group I: (PAEDP less than 20 mm Hg) was regarded as normal. Group II: (PAEDP greater than 20 mm Hg) as pathological. Systolic and diastolic blood pressure during rest and exercise were not influenced by the training programme in the total group nor on subdivision into groups I and II. Resting heart frequency was reduced by 5 beats per minute in the total group after rehabilitation, but there was an increase of 10 beats per minute (p less than 0.05) on exercise in group I. Resting double product remained unchanged in all groups, but during exercise an increase from 15.8 +/- 3.4 to 18.1 +/- 4.1 (p less than 0.05) was noticed in group I. The reduction in double product during exercise in group II was insignificant. Under resting conditions PAEDP remained unchanged, but during exercise the mean PAEDP in the total group increased from 21.2 +/- 6.0 mm Hg to 24.3 +/- 6.0 mm Hg after rehabilitation. 15 out of 17 patients showed pathological values after rehabilitation. Increase in heart frequency and PAEDP may be interpreted as signs of heart failure during exercise. Therefore, an intensive exercise programme three weeks after acute myocardial infarction may be premature.

Adult↗
PubMed1981

[Electrocardiographic changes during long-term monitoring in a case of cardiac rupture after myocardial infarction (author's transl)].

Electrocardiographic changes in long-term electrocardiogram are described in a patient with inferior myocardial infarction and cardiac rupture. In a monitoring period of more than seven hours, malignant arrhythmias could be diagnosed, which are not specific for cardiac rupture. During the last minutes, sinus bradycardia, slow nodal rhythm, and idioventricular escape rhythm could be diagnosed.

Aged↗
PubMed1979

[Beta-blockader, pindolol, in the therapy of angina pectoris; a report on a multicentric controlled study].

68 patients with angina pectoris were treated 14 days with placebo and four weeks with 15 mg/die pindolol (Visken) in a double blind multicenter study. The patients were divided into two groups at random: group I received pindolol/placebo, group II pacebo/pindolol. Pindolol reduced in both groups significantly the number and intensity of angina pectoris attacks and the consumption of nitroglycerin capsules. There was no evidence for a rebound phenomenon after abrupt cessation of pindolol treatment. In the wash out period still a relevant antianginous effect of the beta-blocker could be observed. The oxygen demand of the myocardium was reduced by reduction of systolic blood pressure and heart rate whereas diastolic blood pressure remained unchanged. The tolerance of the preparation was good.

Angina Pectoris↗
PubMed1979

[Echocardiographic diagnosis of subpulmonic obstruction in hypertrophic cardiomyopathy (a case report) (author's transl)].

The echocardiogram of a patient presenting with a systolic ejection murmur and ECG evidence of left ventricular hypertrophy revealed asymmetric septal hypertrophy but no abnormal systolic anterior motion of the mitral valve as in IHSS. Her pulmonary echo disclosed small A waves, partial valve closure in early systole and coarse systolic fluttering. This motion pattern--which is similar to that of patients with infundibular pulmonary stenosis and which resembles the aortic valve motion pattern in discrete subaortic stenosis--led us to the diagnosis of hypertrophic cardiomyopathy with subpulmonic obstruction, which was later confirmed by cardiac catheterization.

Aortic Valve↗
PubMed1977

[Pindolol as an antihypertensive agent].

26 hypertensive patients groupded according to the severity-index and the WHO-index were treated with pindolol (monotherapy, 15 mg daily). The response of blood pressure depression was statistically significant, although not always sufficient when judged by clinical parameters. Plasma renin activity responded variably to the treatment in different patients and different groups. In 18 patients a statistically significant increase of serum potassium could be observed. No major side effects of therapy were encountered.

Adult↗
PubMedDate not supplied

Beneficial effect of PGI2 on circulating endothelial cells.

Endothelial damage is an early event in atherogenesis. Recent data present evidence that the counting of circulating endothelial cells in human peripheral blood may provide reliable information about endothelial integrity. We therefore assessed the influence of PGI2 on the number of circulating endothelial cells in patients suffering from peripheral vascular disease. As cigarette smokers and patients with hyperlipoproteinemia show an increased number of circulating endothelial cells, they were excluded from this investigation. PGI2 causes a certain drop in circulating endothelial cells. In parallel, a prolongation in platelet half-life can be noted. This is most pronounced at a daily duration of infusion between 4 an 12 h. A shorter duration of PGI2 therapy is less effective in reducing circulating endothelial cells. All of the three different doses used, however, were equally effective. Placebo controls were ineffective. These findings indicate that PGI2 might exert a rather long-lasting beneficial action on endothelial integrity and the hemostatic balance.

Adult↗