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Biomedical subjects

W Merx

Publications and source records attributed to W Merx.

At least 19 recordsLinked to original sources
PubMed1990

Hypertension and hyperlipidaemia: garlic helps in mild cases.

Forty-seven non-hospitalised patients with mild hypertension took part in a randomised, placebo-controlled, double-blind trial conducted by 11 general practitioners. The patients who were admitted had diastolic blood pressures between 95 and 104 mmHg after a two-week acclimatization phase. The patients then took either a preparation of garlic powder (Kwai) or a placebo of identical appearance for 12 weeks. Blood pressure and plasma lipids were monitored during treatment after four, eight and 12 weeks. Significant differences between the placebo and the drug group were found during the course of therapy. For example, the supine diastolic blood pressure in the group having garlic treatment fell from 102 to 91 mmHg after eight weeks (p less than 0.05) and to 89 mmHg after 12 weeks (p less than 0.01). The serum cholesterol and triglycerides were also significantly reduced after eight and 12 weeks of treatment. In the placebo group, on the other hand, no significant changes occurred.

Aged↗
PubMed1985

[Asystolic pauses in atrial fibrillation. Incidence, dependence on the underlying disease and significance for pacemaker therapy].

The frequency and duration of asystolic pauses in atrial fibrillation was investigated in 100 consecutive patients using 24-hour ECG's obtained by Holter monitoring. Patients were subdivided, according to the length of the maximal RR-interval, into group A (no asystolic pauses over 2 seconds duration), group B (pauses between 2 and 4 seconds) and group C (asystoles over 4 seconds duration). Pauses longer than 2 seconds occurred in 57% of patients, but longer than 4 seconds only in 6 cases. A statistically higher frequency was seen in patients with permanent (78.3%) than in those with paroxysmal (24.5%) atrial fibrillation, and in patients with rheumatic valve disease (82.4%) in comparison with the rest (54.3%). In contrast, pauses over 2 seconds occurred in only 22.2% of general medical ward patients. Up to 50% of all asystoles in groups A and B were registered during the night, whereas a day-night variation for group C was not apparent. No correlation could be demonstrated between dizziness and bradycardic conduction in group A and B, but all patients in group C made such complaints during the monitoring period. Asystoles of up to 4 seconds duration in atrial fibrillation can be regarded as "normal"; longer asystoles must be anticipated particularly in patients with rheumatic valvular disease. It is only here that permanent pacemaker therapy appears to be indicated.

Adult↗
PubMed1985

[Intracoronary streptokinase in acute myocardial infarct. Experience with 461 patients].

Between March 1980 and July 1984, coronary angiography was performed on 461 consecutive patients (no age limit) with acute myocardial infarction, and the partially or completely obstructing thrombus lysed by selective intracoronary infusion of streptokinase. At the time of first coronary angiography 96 patients (21%) had a high degree of stenosis but no total occlusion of the infarct vessel (group A). In 365 patients (79%) there was complete occlusion which in 315 patients (86%) was removed successfully after an occlusion period of 213 +/- 87 minutes (group B). In 50 patients (14%) (group C) attempts at reperfusion failed. In 129 of 163 patients (79.1%) with one-vessel disease, PTCA (percutaneous transluminal coronary angioplasty) was successful. Patients with multiple-vessel disease and an occlusion time of less than four hours, on the other hand, were treated surgically within the first ten days (78 patients). In the remaining 254 patients conservative treatment was practised. Within the first 30 days there were seven deaths (14%) in group C, while among group A and B patients, under conservative treatment, 16 died (7.8%). After successful PTCA four patients (3.1%) died. The lowest mortality was among patients with a short occlusion time and early bypass operation (2.6%). The most frequent cause of death was cardiogenic shock (20 of 29 patients), more rarely ventricular fibrillation (3) or other causes (4). Ventricular rupture occurred in three patients, one of whom was saved by pericardial tap. One year later the mortality among the conservative group was 21.2%, after successful PTCA or bypass operation 9.3% and 6.4%, respectively.

Aged↗
PubMed1985

Sequential intervention procedures after intracoronary thrombolysis; balloon dilatation, bypass surgery, and medical treatment.

After successful intracoronary thrombolysis of an acute myocardial infarction in 145 patients subsequent intervention procedures were evaluated. In 48 of 62 patients (43%), percutaneous transluminal coronary angioplasty was performed successfully (success rate 77%), 41 patients (28%) were operated on and 56 patients (39%) were treated only medically. During the hospital phase in the angioplasty group, 4 reinfarctions were noted and 3 repeat angioplasties were required, while 41 of the 48 successfully treated patients (85.4%) remained clinically stable. In the surgical group, one cardiac failure occurred, while 40 patients (97.6%) were without cardiac event. In the medical group, 5 patients died (8.9%), 8 patients (14.3%) had a reinfarction, and 76.8% were clinically stable. During the follow-up period in the surgical group of 6 months 37 patients (90.2%) were clinically stable, all in functional classes I and II. In the angioplasty group 33 patients were stable (68.8%), and in the medical group 26 patients were stable (46.6%). In the whole group of 145 patients the hospital mortality together with that in the 6 months follow-up period was 9.7% with a reinfarction rate of 22.8%.

Adrenergic beta-Antagonists↗
PubMed1979

[Ventricular arrhythmias in mitral valve prolapse syndrome (author's transl)].

Long-term ECG monitoring over 22 hours and exercise ECGs were performed in 72 patients with mitral valve prolapse syndrome. 70% of the patients had ventricular arrhythmias. In 28% severe arrhythmias in the form of multifocal atopic beats and ventricular runs were demonstrated. Long-term ECG monitoring was a suitable method for detection of these arrhythmias and superior to exercise ECG. Clinical, electrocardiographic and echocardiographic findings could not be correlated to the severity of ventricular arrhythmias.

Adolescent↗
PubMed1979

[A new method of pericardiocentesis and quantification of pericardial effusions by echocardiography (author's transl)].

With a new method for safe and complete evacuation of pericardial effusions it was possible to check the quantification of pericardial fluid is was possible to check the quantification of pericardial fluid by echocardiography. Using a formula based on the assumption that in systole the pericardial fluid is distributed equally around the contracting heart (like a coat enveloping a sphere), it was demonstrated that pericardial effusions ranging from 250 to 600 ml could be fairly accurately measured. Smaller effusions were not so readily determined. Effusions over 600 ml could be only roughly measured, usually being underestimated.

Echocardiography↗
PubMed1979

Spontaneous course of ST-segment elevation in acute anterior myocardial infarction.

The spontaneous course of ST-segment elevation (sigmaST) in 24 patients with acute anterior myocardial infarction (AMI) was studied by precordial ST-segment mapping, which was recorded at 2-hour intervals during the first 48 hours after admission. Change of sigmaST between two registrations was expressed as mV/hr, and was compared with clinical and hemodynamic parameters, course of MB-CK curve, calculated infarct mass and arrhythmias. After an initial rapid increase, there was a decrease of sigmaST, which reaches a plateau-like curve approximately 12 hours after the onset of chest pain. A second new increase of sigmaST exceeding a value of 0.6 mV/hr correlates well with extension of necrosis, verified by re-elevation of MB-CK. During the first 2 days, extension of necrosis could be detected in 50% of our patients. As new ischemic episodes and extension of necrosis in AMI occur frequently and are promptly indicated by an increase of sigmaST, the physician should, while monitoring therapeutic interventions, concentrate on such a second increase rather than on a decrease of sigmaST (which may occur spontaneously), as has been suggested in most previous reports.

Adult↗
PubMed1979

Circus movement in canine right ventricle.

The present study reports on the epicardial spread of excitation during premature beats and during the initial stages of ventricular fibrillation, both of which were induced by single-test stimuli during regional ischemia or local hypothermia. Simultaneous recording of the activity at 48 epicardial sites on the right ventricle of dog hearts enabled us in some instances to demonstrate a circus movement.

Animals↗
PubMed1979

Efficacy of propranolol versus placebo in long-term treatment in patients with mitral valve prolapse.

In 60 patients with mitral valve prolapse syndrome a randomized controlled interindividual double-blind study of propranolol (p) was performed. Patients received p 80 mg (A), 160 mg (B) and placebo (C) orally for 4 weeks. Prior to and after treatment, heart rate (HR) and blood pressure (RR) as well as systolic time intervals (STI) were measured and corrected for heart rate--electromechanical systole (QS2I), left ventricular ejection time (LVETI), and preejection period (PEPI). The ratio PEP/LVET was calculated. Plasma levels were measured by an optimized fluorimetric method. 1. STI lay in the upper part of the normal range, indicating that some patients had a hyperkinetic cardiac function. 2. P had no influence on QS2I and LVETI in A and B. PEPI was prolonged (A: +13.2 ms, B: +14.2 ms) and PEP/LVET was increased (A: +0.040, B: +0.050). 3. As indicated by the changes in HR, RR, PEPI, and PEP/LVET p showed in B compared to A only minor additional effects. 4. Plasma levels of p were in B three times higher than in A (A: 89.2 +/- 10.0 nmol/l B: 246.7 +/- 30.5 nmol/l). With a dose of 80 mg propranolol a point close to the plateau of maximum efficacy was reached, where a higher dose resulted only in small additional negative inotropic effects.

Clinical Trials as Topic↗
PubMed1978

[Incidence of spontaneous rhythm after pacemaker implantation for total A-V block (author's transl)].

Follow-up investigation over 12--84 months (mean 30 months) of 86 patients with the primary diagnosis of permanent total atrioventricular block revealed that spontaneous rhythm could be demonstrated in all but 17 patients. A-V conduction was re-established in 13, but in most of them it was on the basis of ventricular ectopic beats. These findings prove that in the described type of patient spontaneous rhythm after pacemaker implantation is common. Therefore, fixed-rate pacemakers are not indicated in these patients.

Atrioventricular Node↗