Biomedical subjects

W Rutishauser

Publications and source records attributed to W Rutishauser.

At least 91 records · Page 5Linked to original sources

PubMed1987

Percutaneous transluminal coronary angioplasty for chronic total coronary arterial occlusion.

Experience is reported with 100 consecutive patients in whom percutaneous transluminal coronary angioplasty (PTCA) was attempted on chronically occluded coronary arteries that had no visible anterograde flow. Ninety-eight patients had angina and all had collateral vessels to the occluded artery on angiography. A movable guidewire/dilatation system was used in all cases. Overall initial PTCA success rate was 56% and was related to duration of occlusion (69% success rate for occlusions of 1 month or less, 50% for 1 to 6 months and 11% after 6 months). Complications were minor; no patient died or required emergency bypass operation. Of the 44 patients in whom PTCA failed, 20 underwent elective bypass surgery for relief of angina and 24 were treated medically. Follow-up at a mean of 8 months (range 1 to 48) was available for 49 of the 56 patients in whom PTCA was successful: 40 had subjective improvement, 6 no change and 3 felt worse. Control angiography was carried out in 40 of the 56 patients with primary success and showed long-term success in 18 and reocclusion or significant stenosis in 22. Of these 22, 11 were successfully treated by a second PTCA, 2 underwent operation and 9 were treated medically. Recanalization of totally occluded coronary arteries with no forward flow has a lower initial success rate (56%) than PTCA for stenoses and the recurrence rate is higher (55%), but effective relief of angina is achieved in successful cases. The risk of serious complications appears to be low.

Adult↗

PubMed1987

Percutaneous transluminal coronary angioplasty by high-volume and low-volume operators.

We retrospectively compared the results of percutaneous transluminal coronary angioplasty (PTCA) of three low-volume operators (1.3 PTCAs/month) to those of a relatively high-volume operator (14.9 PTCAs/month) in 396 consecutive procedures (358 patients). PTCA for multiple vessels, total occlusions, or evolving acute myocardial infarction had been excluded. For low-volume operators experienced assistance was considered present when the high-volume operator participated as second operator. The three low-volume operators performed 42, 38, and 24 PTCAs, respectively. Success rates per procedure for these operators were 88%, 84%, and 83%, and the complications rates 5%, 3%, and 13%, respectively. The success rates for assisted vs. nonassisted procedures were 89% vs. 88%, 100% vs. 78%, and 90% vs. 71%, and the complications rates were 6% vs. 4%, and 0% vs. 21%, respectively. The high-volume operator performed 292 PTCAs, with a success rate of 93%, and a complication rate of 5%. The cumulated success rate of the three low-volume operators of 85% was significantly (p less than 0.05) lower than the 93% success rate of the high-volume operator, while the complication rates of 6% and 5%, respectively, were not significantly different. Low-volume operators in an experienced center can perform PTCA safely even without assistance by a high-volume operator. However, their success rate is lower.

Angioplasty, Balloon↗

PubMed1987

Free fatty acid metabolism in "stunned" myocardium.

To assess whether myocardial lipid metabolism is altered in the "stunned" myocardium we have studied the metabolism of (1-14C)-palmitate during reperfusion in a modified rat heart preparation. Hearts were perfused retrogradely at a physiological flow rate (2 ml/min) in a non-recirculating system with erythrocyte-enhanced Krebs-Henseleit buffer containing albumin 0.4 mM, glucose 11 mM, palmitate 0.4 mM and trace amounts of (1-14C)-palmitate. Left ventricular pressure was measured by a latex balloon in the left ventricular cavity. Control hearts were perfused at constant flow for 120 min. To achieve reversible ischaemic damage, myocardial perfusion was reduced by 95% for 40 min, followed by reperfusion at the control flow rate for 60 min (reperfusion group). For comparison, irreversible damage was produced by calcium free perfusion (calcium paradox group). In the reperfusion group, the developed pressure was severely depressed 5 min after reperfusion to 23% of the value in the control group (p less than 0.05) but recovered to 84% (NS) at 60 min. In the calcium paradox group, mechanical activity ceased completely without recovery. Myocardial uptake of (1-14C)-palmitate in the reperfusion group was similar to the control experiments for the entire reperfusion period, whereas a marked depression was observed in the calcium paradox group. 14CO2 production was severely depressed at the onset of reperfusion in both the reperfusion and calcium paradox group to 42% (p less than 0.05) and 29% (p less than 0.05) respectively. In contrast to the calcium paradox group, 14CO2 production in the reperfusion group recovered progressively to 70% (NS) of the control value during the 60 min of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1987

Coronary angioplasty: results with expanded indications.

We reviewed 600 consecutive percutaneous transluminal coronary angioplasty procedures in 530 patients. There were 475 men (89%) and 55 women (11%) with a mean age of 55 +/- 9 years. Primary success per patient was 87%. Major acute complications occurred in 58 patients (10%): 2 deaths, vessel or side branch occlusion in 44 patients and ventricular fibrillation in 12 patients. Clinical follow-up was available in 344 of the first 348 patients (99%) at 12 +/- 6 months. Of these, 242 patients (70%) underwent control angiography at 12 +/- 6 months. Including repeat angioplasty, 82% of patients (281/344) with primary success were improved by at least one New York Heart Association functional class. Coronary events among the patients with no improvement were one sudden death, one myocardial infarction, and 16 bypass operations. Four subgroups of special interest were analysed: multivessel angioplasty (100 patients), angioplasty for chronic total occlusion (100 patients), angioplasty for evolving myocardial infarction (50 patients), and repeat coronary angioplasty (70 patients). Primary success rates were 87, 56, 84 and 90%, complication rates 9, 0, 9, and 3%, and recurrence rates 41, 48, 23, and 48%, respectively. At follow-up, improvement by at least one New York Heart Association class was observed in 77, 85, 88, and 80% of patients, respectively. Successful coronary angioplasty including repeat procedures achieved a long-term clinical success in about 80% of patients.

Angioplasty, Balloon↗

PubMed1987

Coronary wedge pressure: a predictor of restenosis after coronary balloon angioplasty.

Coronary wedge pressure is the pressure recorded distal to a stenosis while the inflated balloon occludes the coronary artery during angioplasty. This pressure has been shown to reflect actual (visible) and potential (recruitable) collateral flow to the stenosed artery, distal to the angioplasty site. In 100 consecutive vessels (91 patients) for which coronary wedge pressure had been measured at the time of angioplasty, the long-term (7 +/- 3 months) angiographic results was evaluated. The overall angiographic restenosis rate was 37%. It was 52% (25 of 48) in arteries with a coronary wedge pressure greater than or equal to 30 mm Hg and 23% (12 of 52) in arteries with a coronary wedge pressure less than 30 mm Hg (p less than 0.01). The mean coronary wedge pressure was 30 +/- 10 mm Hg for vessels with restenosis and 26 +/- 9 mm Hg for those without restenosis (p less than 0.01). The prevalence of angiographically visible collateral flow was 42% and 29%, respectively (p = NS). Neither age, sex, presence of unstable angina, left ventricular function, number of diseased vessels nor initial and final transstenotic pressure gradient and degree of stenosis were significantly associated with the long-term outcome after angioplasty. Restenosis rate is significantly increased when coronary wedge pressure measured at the time of angioplasty is high (greater than or equal to 30 mm Hg). This suggests a negative influence of competitive collateral flow on long-term results of angioplasty.

Angiography↗

PubMed1987

Improvement of left ventricular contraction and relaxation synchronism after recanalization of chronic total coronary occlusion by angioplasty.

Twenty patients with a chronic total coronary artery occlusion were studied before and 1 to 48 months (mean 9) after successful recanalization by angioplasty and compared with a group of 20 normal subjects. Before angioplasty, 19 of these 20 patients had angina. Collateral vessels to the distal part of the occluded vessel were visible in all 20 patients. A previous myocardial infarction was documented in 14 patients (9 with a Q wave and 5 with a non-Q wave infarction). At the time of follow-up, three patients were symptomatic: one had unstable angina and two had a positive stress test. The follow-up angiogram showed a significant restenosis in six patients and reocclusion in two. The mean ejection fraction had improved slightly from 59 +/- 11% to 63 +/- 9% (p less than 0.05). Left ventricular wall motion synchronism was studied using two variables for 128 shortening segments: the "time of peak contraction" and the "time of peak relaxation," as obtained from biharmonic Fourier transformation for each segment. Their respective standard deviations reflect the synchronism of contraction and relaxation. The mean standard deviations of the two variables expressed in degrees of one cardiac cycle (360 degrees) were respectively: 5.5 +/- 0.4 degrees for the time of peak contraction and 6.0 +/- 0.5 degrees for the time of peak relaxation in the 20 normal subjects, 11.7 +/- 1.7 degrees and 23.0 +/- 3.0 degrees before recanalization and 9.6 +/- 1.8 degrees and 12.5 +/- 2.2 degrees at follow-up in the group of 20 patients. These values were significantly higher (p less than 0.05) in the patients than in the normal group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1987

Digital videodensitometric measurement of aortic regurgitation.

A videodensitometric method for quantification of aortic regurgitation which requires neither measurement of cardiac output nor determination of enddiastolic and endsystolic left ventricular volumes has been developed. The injection of 20 ml of contrast medium into the left ventricle is digitally recorded at 25 images s-1 during 20 s using an equipment for digital subtraction angiography (Digitron 2, Siemens). The Digitron computes 2 'time dilution curves' (TDC) from the unsubtracted image sequence, for 2 regions of interest drawn around the angiographic enddiastolic and endsystolic left ventricular silhouettes. Enddiastolic and endsystolic points of the TDC are then entered into a VAX-750 computer, which calculates the ejection fraction (EF), the forward ejection fraction (FEF) and the regurgitant fraction (RGF). This is performed by a complex fitting algorithm based on a physical model of the washout process of contrast medium, which reconstructs the two best enddiastolic and endsystolic baselines in the washout parts of the two TDC. The EF, FEF and RGF obtained in 9 regurgitant and 11 nonregurgitant patients have been compared with the corresponding values EFv, FEFv and RGFv obtained by a conventional technique (Cardiogreen and biplane LV area-length volumetry). Regression analysis yielded: EF = 0.88 X EFv (regression line forced through the origin), r = 0.77, FEF = 0.76 X FEFv + 3, r = 0.96, RGF = 0.94 X RGFv + 5, r = 0.98 (v stands for volumetry).

Absorptiometry, Photon↗

PubMed1987

Thermodilution determination of right ventricular volume and ejection fraction: a comparison with biplane angiography.

In 13 patients without tricuspid incompetence, we compared the values of right ventricular ejection fraction (RVEF) and right ventricular end-diastolic volume (RVEDV) obtained with biplane angiography and thermodilution at end-inspiration. A modification of Simpson's rule was used to measure angiographic volumes, and a new pulmonary artery catheter equipped with a rapid response thermistor was used to measure the ejection fraction by the Holt plateau method. The correlation between the two methods was acceptable (r = 0.83 for RVEF, r = 0.71 for RVEDV) despite the limitations of both angiography and thermodilution. Thermodilution underestimated RVEF and overestimated RVEDV when compared to angiography. The variation coefficient with thermodilution for five measurements of the RVEF per patient was 12 +/- 5%. In addition to pressure and cardiac output measurements, monitoring of RVEF and RVEDV in the ICU should be possible with such a catheter. Further work is needed to assess the clinical relevance of these added data and their use for optimizing the therapy of right ventricular failure in acutely ill patients.

Adult↗

PubMed1987

Follow up results of treatment of unstable angina by coronary angioplasty.

Eighty nine of 327 consecutive patients undergoing coronary angioplasty at a centre had unstable angina--defined as either a worsening of the frequency or the severity of chest pain or severe episodes of chest pain at rest with no evidence of acute myocardial infarction. Multivessel disease was present in 31 of these patients. Two or more vessels were dilated in the same procedure in one fifth of the patients. Primary success was obtained in 80 (90%) patients. Acute myocardial infarction was a complication in four (5%) patients, including two of four patients who needed emergency coronary bypass grafting. Follow up coronary angiography at a mean (SD) of 10 (6) months in 57 patients showed restenosis in 21 (37%): of these, 13 patients had repeat coronary angioplasty and three had elective coronary bypass grafting. All patients in whom angioplasty was initially successful were followed up for 10 (6) months after the last angioplasty procedure. There were no deaths. One patient had sustained a myocardial infarction unrelated to the dilated vessel. Clinically, 74 patients improved by at least one New York Heart Association class and 40 (50%) were symptom free and with no signs or symptoms of myocardial ischaemia on a stress test. Coronary angioplasty offers long term symptomatic improvement at an acceptable risk in the majority of patients with unstable angina.

Adult↗

PubMed1987

Coronary wedge pressure in relation to spontaneously visible and recruitable collaterals.

Coronary angiography demonstrates only collateral arteries that are already in use (spontaneously visible collaterals). Percutaneous transluminal coronary angioplasty (PTCA) provides an opportunity to uncover collaterals ready to become functional in case of occlusion of the recipient artery (recruitable collaterals). The incidence of recruitable collaterals and their relation to the distal pressure in the occluded artery (coronary wedge pressure) during a 30 sec or longer balloon occlusion was assessed in 57 coronary arteries of 49 patients undergoing PTCA for a proximal coronary stenosis or occlusion. Collateral to 75% of the arteries were present. Spontaneously visible collaterals were four times as frequent as recruitable collaterals. Coronary wedge pressure was significantly higher in arteries with spontaneously visible and recruitable collaterals (41 +/- 12 and 36 +/- 12 mm Hg, respectively) than in arteries without collaterals (18 +/- 4 mm Hg). A coronary wedge pressure of 30 mm Hg or higher was found exclusively in the presence of collaterals. Electrocardiographic changes during balloon occlusion were found more frequently with arteries without collaterals than with arteries with spontaneously visible or recruitable collaterals. Chest pain was more frequent in patients without collaterals or with recruitable collaterals than in those with spontaneously visible collaterals. Major in-hospital events occurred in three patients with collaterals, with a salutary influence of the collaterals in two. The coronary wedge pressure allows prediction of recruitable collaterals. Their clinical impact remains to be investigated in long-term studies on large patient populations.

Angioplasty, Balloon↗

PubMed1987

[Chronic total coronary occlusion dis-obstruction by balloon angioplasty].

Ninety-three consecutive patients with chronic total coronary occlusion underwent an attempted mechanical des-obliteration by percutaneous coronary angioplasty with a balloon catheter. The global results were 55 p. 100 initial successes (residual stenosis less than 50 p. 100). The good prognostic factors were: 1) left coronary artery, especially left circumflex artery occlusion p less than 0.50, and 2) the proximity to the date of occlusion as assessed from the clinical history or by the occurrence of occlusion between the time of diagnostic coronary angiography and angioplasty. In cases of recent occlusion dating less than one month, the success rate was high: 69 p. 100. On the other hand, there were no successes in occlusions of over 6 months standing. The presence of myocardial infarction did not influence the results. There were few complications (7 p. 100) and these did not include any deaths or cases requiring emergency surgery. Exercise stress tests were carried out after the procedure and were negative in 28 out of 32 patients (88 p. 100). Forty-three patients successfully revascularised were followed up for 1 to 48 months (average 9 months) after angioplasty. Thirty-one patients were asymptomatic. Of the 12 symptomatic patients, 7 underwent exercise stress tests (6 positive) and all had control angiography which showed restenosis in 10 cases with 5 occlusions. Percutaneous coronary angioplasty of recent total coronary occlusions gives good initial results without major complications, and the medium term clinical results are satisfactory.

Adult↗

PubMed1987

Recurrence of stenosis after first and repeat coronary angioplasty. Clinical and angiographic follow-up.

The incidence of restenosis after initially successful first coronary angioplasty and the long-term effectiveness of repeat angioplasty for recurrence were examined on the basis of data on 282 consecutive patients with successful angioplasty. Primary success of first coronary angioplasty was obtained in 86% of patients and major complications (death, acute myocardial infarction and emergency coronary bypass surgery) occurred in 5% of patients. Control coronary angiography 10 +/- 6 months after successful angioplasty in 195 patients documented recurrence of stenosis in 33%. Repeat angioplasty was attempted in 52 patients with a primary success of 92%. One patient sustained an acute infarction as a complication of the procedure (2%). Control coronary angiography 7 +/- 4 months after a successful second procedure in 28 patients documented a second recurrence of stenosis in 39%. Recurrence rates after first and second coronary angioplasty were comparable (33 vs 39%, ns) but, for lesions of the left anterior descending coronary artery, recurrence was observed more frequently after second than after first angioplasty (47 vs 31%, p less than 0.05). Restenosis after second angioplasty, but not after first, was more frequent in women than in men. Patients with second recurrence were older than those with continuing angiographic success (59 +/- 8 vs 50 +/- 12 years, p less than 0.05). Recurrence was treated by a third coronary angioplasty in 5 patients, with success in all. Clinical follow-up 8 +/- 6 months after the last successful procedure was available for all 43 patients with repeat angioplasty who did not cross over to coronary surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1987

Percutaneous transluminal coronary angioplasty in patients with silent myocardial ischemia during exercise testing.

Silent myocardial ischemia was present in 50 of 507 patients undergoing PTCA. Of these patients, five had type 1 (asymptomatic with no previous myocardial infarction), 27 had type 2 (asymptomatic after myocardial infarction) and 18 had type 3 silent myocardial ischemia (angina present in addition to silent episodes). Ischemia was documented in all patients in the exercise ECG, in 18 patients with thallium scintigraphy and in four with radionuclide ventriculography. The indication for PTCA was considered established in patients with type 1 silent ischemia based on ECG changes in the presence of high grade stenosis of the left anterior descending artery under the assumption of improved prognosis. The fact that patients with myocardial infarction have a poorer prognosis in the presence of ST-segment depression served as the basis for the indication for PTCA in type 2 patients. In type 3 patients, PTCA was carried out to ameliorate the symptomatic as well as asymptomatic episodes of ischemia. The follow-up period averaged 12 +/- 6 months. The primary rate of success was 92% with no differences between the groups. There were no complications in type 1 and type 2 patients; in two patients with type 3 silent ischemia, immediate bypass surgery was carried out due to acute occlusion of the dilated vessel. One patient in the latter group had myocardial infarction in the region perfused by the dilated vessel four months after the procedure. The angiographically-documented rate of restenosis was 33% in type 1 patients, 26% in type 2 and 40% in type 3 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon↗

PubMed1987

[Echocardiographic discoveries in 102 patients with vascular cerebral accidents].

The causes of vascular ischaemic accidents are numerous, and when the brain is involved management is limited to the prevention of similar events. Since cardiac sources of embolism potentially curable, we have prospectively analyzed the results of cardiovascular examinations (including ECG and radiography of the chest) and of echocardiography in 102 patients with cerebral or peripheral vascular ischaemic event in order to determine the impact of echocardiography and the influence of different diagnoses on the need for anticoagulant therapy. Intracardiac thrombi, mitral stenosis, dilated cardiomyopathy, severe left ventricular dysfunction with or without aneurysm and cardiac valve vegetations were regarded as diseases carrying a high risk of embolism, the low risk diseases being mitral valve prolapse, mitral annulus calcification and isolated left atrial dilatation. Atrial fibrillation was treated separately, as it may be associated with several of the diseases listed above. We found 14 diseases with a high risk of embolism (14 p. 100) and 35 diseases with a low risk of embolism (34 p. 100). 10/91 patients with cerebral vascular accident (11 p. 100) and 4/11 patients with peripheral vascular accident presented with a heart disease carrying a high risk of embolism. The most common heart disease with a high risk of embolism (10/14, 71 p. 100) was severe left ventricular dysfunction secondary to a coronary disease or a dilated cardiomyopathy. We did not find more cases of mitral valve prolapse or mitral annulus calcification than in the normal population. 20/29 patients with normal cardiac examination had a normal echocardiogram. The anticoagulant treatment was modified after echocardiography in only one case.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

[Pathophysiologic aspects and modern treatment of congestive heart failure].

Congestive heart failure is a clinical syndrome with inadequate cardiac output and increased venous pressure, characterized by hyperfunction of the sympatho-neuro-endocrine system, favoring maximal vasoconstriction in non-essential organs and retention of salt and water. Identification of the cause of heart failure and its correction is the best treatment. The suppression of precipitant factors is also essential. Traditionally the treatment of congestive heart failure is based on diuretics, restriction of salt intake, and digitalis. The conventional vasodilators are effective in the short term, but they have a marked tendency to tachyphylaxis. The inhibitors of angiotensin-converting enzyme are, through their specific action on neuro-endocrine dysregulation, the most important advance in recent years. Of the non-glycosidic inotropic agents used in severe heart failure, the new inhibitors of phosphodiesterase need further testing. In certain cases, permanent synchronous pacing has to be considered.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed1986

Clinical evaluation of soft-tipped catheters for coronary angiography.

New soft-tipped Judkins catheters for coronary angiography were compared with conventional femoral catheters for coronary angiography in a randomized, controlled fashion with cross-over exchange of catheters when problems occurred. The problems encountered with a first generation of soft-tipped catheters (n = 113) versus conventional catheters (n = 103) were as follows: difficult introduction 27% versus 1% (p less than 0.01), difficult placement 13% versus 8% (not significant), difficult aspiration 4% versus 0% (p less than 0.05), wedging 5% versus 0% (p less than 0.05), spasm 3% versus 0% (not significant), overselectivity 7% versus 2% (not significant), cross-over necessary and successful 18% versus 1% (p less than 0.01). Problems with a second generation of soft-tipped catheters (n = 200), modified according to the experience gathered from the first generation, versus conventional catheters (n = 194) were as follows: difficult placement 10% versus 7%, difficult aspiration 2% versus 0.5%, wedging 2% versus 1%, spasm 1% versus 0%, overselectivity 3% versus 2%, ventricular fibrillation 1.5% versus 0%, cross-over necessary and successful 3% versus 2%. None of the differences attained statistical significance. The performance of soft-tipped catheters for coronary angiography was inferior for the first generation but comparable for the second generation to that of conventional catheters. In terms of safety, soft-tipped catheters were not superior on the basis of our criteria.

Angiography↗

PubMed1986

Tandem balloon catheter for coronary angioplasty.

The Tandem balloon catheter is a triple lumen steerable catheter for coronary angioplasty with two separately inflatable balloons of different diameters. Indications and results of 26 consecutive patients treated with a Tandem balloon catheter are reviewed. Adequate distal pressure measurements were obtained in 71% of the cases. In ten patients, the Tandem balloon catheter was selected for two stenoses in different segments of the same coronary artery. Angioplasty was successful for all lesions in five and for at least the strategic lesions in five patients (in one only after changing to a single-balloon catheter). In the seven patients with stenoses in two different coronary arteries of various calibers, angioplasty was successful for both vessels in three and for one vessel in four patients. In the six patients with a very tight stenosis, where the Tandem balloon catheter was selected to predilate with the small balloon, the procedure was technically successful in all, but there was a myocardial infarction in one patient. In the three patients with a chronic total occlusion, where the stiffness of the Tandem balloon was the reason for selection, one recanalization was successful. The Tandem balloon catheter provides a handy tool for complex coronary angioplasty. It offers comparable ease in manipulation and pressure transmission and may save time, money, and radiation exposure by avoiding catheter exchanges.

Aged↗

PubMed1986

Effects of bopindolol on left ventricular function during exercise in patients with coronary artery disease.

Bopindolol is a new beta blocker with a long duration of action. We examined the haemodynamic effects of multiple oral doses of 2 mg in 12 male patients, with coronary artery disease. Placebo was given for 7 days followed by bopindolol 2 mg daily for 14 days. Scintigraphic ventriculography combined with an exercise test was carried out at baseline before treatment with bopindolol, and repeated after 7 and 14 days treatment. On day 7 the measurements were made 2 h after therapy (i.e., when plasma levels were maximal) and on day 14 when plasma levels were lowest (24 h after the last dose). The results showed that bopindolol had little effect on blood pressure or heart rate at rest in these normotensive patients but that both parameters measured after exercise were statistically significantly reduced (p less than 0.001). There was little difference between the effect seen 2 h after therapy and the effect seen 24 h after therapy, thus, demonstrating the long duration of action. The mean ejection fraction was not changed by bopindolol either at rest or after exercise but individual patients who responded to exercise with a fall in ejection fraction before treatment did not do so following treatment. These were mainly patients with 2 and 3 artery disease and the failure of the mean ejection fraction to show this protective effect was probably due to the predominance in our patients of those with mild single vessel disease who did not react adversely to exercise. We conclude that bopindolol protects the myocardium against ischaemia and that the effect lasts for at least 24 h when therapy is given once daily.

Adrenergic beta-Antagonists↗