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Biomedical subjects

W Enenkel

Publications and source records attributed to W Enenkel.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Moducrin--a new combined preparation in the treatment of hypertension (author's transl)].

A product combining 25 mg hydrochlorothiazide, 2.5 mg amiloride hydrochloride and 10.0 mg timolol maleate (Moducrin) was tested in 20 previously untreated hypertensive persons. The systolic blood pressure before treatment was 199.1 +/- 24.8 mmg Hg and after treatment 149.1 +/- 19.1 mm Hg. Diastolic blood pressure showed a drop from 120.9 +/- 11.9 mm Hg to 92.2 +/- 13.3 mm Hg. Both decreases were highly significant (p less than 0.01). The heart rate, moreover, was reduced during treatment from 81.5 +/- 11.1 beats per minute to 66.8 +/- 9.25 beats (p less than 0.01). Haemoglobin, haematocrit and serum uric acid showed significant changes, but did not reach pathological ranges. Treatment had to be stopped in only one case in this study because of incipient asthmatic bronchitis. We conclude that this combination drug has a very good antihypertensive effect and is well tolerated.

Adult↗
PubMed1980

[Influence of isosorbiddinitrate on hemodynamics at rest and during exercise (author's transl)].

23 patients with acute transmural myocardial infarction were exercised (4 min. 30 Watt) at the end of the hospital period (14-26 days after administration) (probatory exercise). This test was repeated identically after 5 mg of ISDN; again hemodynamic measurements were done (heart rate, arterial pressure, pulmonary artery pressure, cardiac output). 60% of the investigated patients had elevated (above 20 mm Hg) wedge pressures (pulmonary diastolic pressure) during exercise. The elevated PA-pressure was lowered significantly by administration of ISDN. In Group II (with exercise PADP above 20 mm Hg) this reduction of preload improved ventricular performance significantly. In Group I (PADP ex below 20 mm Hg) reduction of the preload worsened ventricular performance (not significant). Heart rate rose at rest and was reduced during exercise after ISDN. Arterial pressure was lower after ISDN as well as during exercise. ISDN proved to be a valuable drug in the postinfarction period even in patients free of angina pectoris since it may help to normalize disturbed hemodynamics (which can only be detected by exercise testing in many cases).

Adult↗
PubMed1980

[Importance of risk factors in myocardial infarction (author's transl)].

Importance of risk factors as hypertension, hyperlipidaemia, diabetes mellitus and cigarette smoking because of hemodynamic and complication during acute myocardial infarction and influence of live quality during the first year after myocardial infarct was pointed out in this study. No risk factor was found in 12.1% out of 248 patients. 25.8% had one, 33.5% two, 12.9% three and 3.2% four risk factors. If only one risk factor for coronary heart disease was documented, 35.9% showed cigarette smoking. If there were two risk factors, most of the people had diabetes mellitus and hypertension, and the combination diabetes mellitus, hyperlipidaemia and cigarette smoking was favourite if there were three risk factors present. The mean age of all patients was 65.9 +/- 10.8 years. Patients who smoked or had hyperlipidaemia were statistically significantly younger (p < 0.001). There was no correlation between number of risk factors or kind of it and pulse frequence, cardiac index, pulmonary artery pressure and third heart sound during phase of acute myocardial infarction. Also no correlation was found between the risk factors hypertension, diabetes mellitus and cigarette smoking and rhythm disturbance of reinfarction. Patients with normal lipids had significant more bradycard or tachycard rhythm disturbances as patients with hyperlipidaemia (p < 0.05). Patients without diabetes mellitus or hypertension had better bicycle tests than patients with this risk factors (p < 0.01). 92% of hypertensive patients had regular drug medication; 14.1% of smoking patients continued smoking cigarettes after acute myocardial infarction. Only 62.1% of diabetic patients, 54.1% of hyperlipidaemic patients and 40% of overweight patients kept diet. Because of this bad quality of patient compliance there was no exact information possible in predicting value of secondary preventive measurements after acute myocardial infarction.

Adolescent↗
PubMed1979

[The efficacy of the intra-aortic balloon pump for patients with heart failure complicating acute myocardial infarction (author's transl)].

Assisted circulation was carried out with the help of an intra-aortic balloon pump in 22 patients with acute transmural myocardial infarction and heart failure (despite medication). Two patients died in hospital. The combination of the balloon pump and nitrates proved to be particularly effective. The follow-up examination of the survivors showed a distinct pulmonary arterial pressure during ergometry. All of the examined patients revealed extensive akinetic and diskinetic areas, significant stenosis being detectable either in the proximal area of the Ramus descendens anterior or in two or three blood vessels.

Adult↗
PubMed1979

[The value of different investigation procedures in arterial hypertension (author's transl)].

221 patients with arterial hypertension were investigated as outpatients. 198 patients were found to have primary and 23 patients to have secondary hypertension. The results of urinary analysis were pathological in 25% of patients and renal function tests were abnormal in 20% of cases. Significant bacteriuria was recorded in 19% of urinary cultures. Intravenous pyelography showed true pathological findings in 12% of cases, false positive findings in 7% and false negative findings in 5%. Isotopic nephrograms showed true positive findings in 52%, false negative in 3% and 45% showed normal results. In 53% of patients angiography of the kidneys showed normal results, whilst this investigation proved pathological in 44% of cases and gave false negative results in 3% of patients. An additional search for coronary heart disease risk factors revealed that 73% of these hypertensive patients were overweight, 47% had hyperlipidaemia, 33% suffered from diabetes mellitus and nicotine abuse was present in 21% of cases. A relevant yet inexpensive screening programme for the investigation of hypertension is formulated on the basis of the results of this investigation.

Adult↗
PubMed1979

A double-blind comparison of a novel indanone diuretic (MK-196) with hydrochlorothiazide in the treatment of essential hypertension.

1 The antihypertensive effect and tolerability of MK-196 (10 mg and 15 mg daily) was compared to hydrochlorothiazide (HCT; 50 mg daily) in a 4-week multiclinic, double-blind study involving 42 patients with mild to moderate, essential hypertension. 2 Both doses of MK-196 were as effective and sometimes more effective than HCT in lowering standing and supine systolic and diastolic blood pressures. 3 HCT consistently brought about significant increases in serum uric acid and significant decreases in serum potassium; both doses of MK-196 produced similar but less frequent and smaller changes in both of these parameters. 4 Both doses of MK-196 brought about significant decreases in body weight at Weeks 3 and 4 of drug treatment. 5 Patients taking MK-196 reported fewer adverse clinical reactions (10 mg = 15%; 15 mg = 13% than those taking HCT (21%). 6 MK-196 may offer a therapeutic advantage over HCT as an antihypertensive agent for use in the treatment of mild to moderate, essential hypertension.

Adult↗
PubMed1979

[Ventricular rupture during acute myocardial infarction (author's transl)].

In a series of 523 consecutive patients with acute myocardial infarction (AMI) 112 died; among these were 18 with rupture of the free wall of the left ventricle (HR) (group RU); two other cohorts were formed: one sample of all patients with acute (transmural) myocardial infarction (group KO) and another cohort of death of AMI in 1976 (EX). 1. patients with HR are significantly older than the KO group; there is no difference in age compared to the patients who died of AMI other than HR (group EX). 2. Women with AMI have a higher chance to die of HR than men. 3. The RU group has significantly more often clinical signs of congestive heart failure than the control group. 4. Cardiogenic shock is significantly more frequent in the RU-group than in the control group. 5. All deaths (EX + RU) have worse hemodynamic data than the control group (KO). 6. Elevated blood pressure (before and after AMI) could not be identified as a risk factor for HR in our patients. 7. In the course of AMI, death in pump failure occurs significantly later than heart rupture.

Acute Disease↗
PubMed1977

[Arrhythmias during catheterization of patients with acute myocardial infarction (author's transl)].

Arrhythmias in forty consecutive patients with acute myocardial infarction during ventricle passage of floating catheters were compared with those in forty patients with chronic heart disease. Lidocaine (1 mg/kg body weight i. v.) as a bolus proved to be effective in reducing the incidence of these arrhythmias, because the number of single ventricular premature beats (VPBs), and the number of VPBs in salves was significantly reduced. Haemodynamic changes due to this bolus are small and short-lasting, so that they are acceptable, especially when continuous monitoring of the patients is attempted. Furthermore dangerous arrhythmias are reported in 1600 cases treated with floating catheters.

Acute Disease↗
PubMed1977

[Continuous monitoring of the pulmonary artery pressure in acute myocardial infarction (author's transl)].

The method of continuous pulmonary artery pressure (PAP) monitoring and its use in 66 patients with acute myocardial infarction is described. Measurement of PAP should be the first diagnostic step in hemodynamic monitoring and early recognition of left ventricular failure. In cases of elevated PAP and critical general state of the patient, monitoring should be extended by measuring pulmonary wedge pressure and cardiac output. Hemodynamic monitoring should be continued for 3 to 5 days, since some cases of acute myocardial infarction with increasing PAP up to the 4th day after the onset were recorded. With the safety precautions mentioned, neither threatening, arrhythmia, nor thromboembolic or septic complications were observed.

Acute Disease↗
PubMed1977

[Behavior of pulmonary artery pressure in the egometric exercise test in chronic coronary disease].

Bicycle exercise stress tests of 39 patients with coronary heart disease are compared to those of 33 healthy persons. The difference in enddiastolic pulmonary artery pressure (PAEDP) of the patients compared to the healthy is low at rest (PAEDPhec healthy = 8.49 +/- 2.80, PAEDPCHD = 10.51 +/- 5.09, p = 0.05). Stress testing (50 Watts) brings significant differences of the average enddiastolic pressures (PAEDP healthy = 12.76 +/- 3.61, PAEDPCHD = 19.38 +/- 7.96, p = 0.001). More important than this (already well known difference) is the wide divergence of results within the group of patients with CHD. For this reason this type of investigation seems to be a good "screening method" regarding selection for coronary arteriography. The reason for the pathological rise of PAEDP can be found in a decrease of compliance due to ischaemia ("coronary factor"), or in exercise induced temporary heart failure ("myocardial factor"), or both.

Adult↗
PubMed1977

[Agranulocytosis after antiarrhythmic therapy with ajmalin (author's transl)].

A case of agranulocytosis (min. leucocyte count 980/mm3) after 4 weeks of treatment with an ajmalin derivate is reported. Recovery could be achieved by taking away the antiarrhythmic drug. It appears that these agranulocytoses only happen after a dosage of more than 300 mg/die, and that they have an intermediate position between allergic and toxic agranulocytosis (phenothiazine type).

Aged↗
PubMed1976

[Advances in the treatment of cardiogenic shock (author's transl)].

Advances in the conservative treatment of cardiogenic shock have been achieved by a combination of the use of drugs (dopamine, furosemide, prednisolone), artificial ventilation and parenteral nutrition (to avoid a negative energy situation). Basic requisites for such therapy are the continuous monitoring of haemodynamic parameters (pulmonary wedge pressure, cardiac index) and of laboratory results (blood gas analysis, pO2, pCO2, osmolarity, blood glucose level). Assisted circulation (IABP) should be started immediately if it becomes apparent that little or no effect has been achieved by medical treatment. Protection is provided by the IABP for further investigation of the patient by selective coronary angiography and surgical intervention whenever possible.

Assisted Circulation↗
PubMed1976

[Pulmonary artery end-diastolic pressure recordings after myocardial infarction (author's transl)].

29 patients with acute myocardial infarction were subdivided into 3 groups using the information gained by continuous measurement of the pulmonary artery end-diastolic pressure (PAEDP) during a stay of 3 to 5 days in the coronary care unit of this hospital. Group I comprised patients with a PAEDP of below 12 mm Hg (without treatment), group II those with a PAEDP of between 12 and 20 mm Hg and group III those patients with a PAEDP of above 20 mm Hg. 3 to 6 months after rehabilitation and ambulant ""coronary training'' a follow-up control PAEDP measurement was performed at rest and during ergometric stress with the bicycle exercise test. 2 out of the 15 patients in group I had a pathological PAEDP at rest, whilst exercise of 50 watts raised the PAEDP to pathological values in 40% of this group of patients. Group II: 58% of the patients with an initially-raised PAEDP showed a normal value at follow-up examination 3 months subsequently. Exercise of 50 watts raised the PAEDP to pathological values in 66% of the patients in this group. Group III. The pathologically high PAEDP recordings at rest made it impossible to subject these patients to stress with the bicycle ergometer. The prognostic value of the classification of patients with myocardial infarction into pressure groups and the importance of PAEDP follow-up measurements on patients after myocardial infarction at rest and after ergometric stress are discussed.

Acute Disease↗