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Biomedical subjects

Z Schlesinger

Publications and source records attributed to Z Schlesinger.

At least 73 records · Page 4Linked to original sources
PubMed1983

Effects of oxprenolol versus propranolol on myocardial performance and myocardial O2 consumption in hypertensive patients.

The purpose of the study was to compare the effects of oxprenolol, a beta-adrenergic blocking agent with intrinsic sympathomimetic activity, to propranolol, a beta-blocker without intrinsic sympathomimetic activity, on myocardial performance and myocardial O2 consumption (MVO2). Myocardial performance was reflected by the systolic time intervals (STI) and MVO2 by the triple product of heart rate X left ventricular ejection time X systolic blood pressure (HR X LVET X SBP). The trial, a double-blind cross-over study, included 32 hypertensive patients, 17 males and 15 females, with a mean age of 50.9 years. The patients were divided into two groups: group A - 16 patients who were treated with effective antihypertensive doses of oxprenolol and diuretics (Esidrex K) for the first 8 weeks (period I) and with similar doses of propranolol and diuretics for the following 8 weeks (period II); Group B - the same number of patients who received the same drugs in the reverse order. All patients were examined during both periods at 2- and 3-week intervals, blood pressure and heart rate were recorded, and patients were provided with the appropriate study medication. At the end of periods I and II, myocardial function was assessed on the basis of STI, and MVO2 was evaluated on the basis of the triple product of HR X LVET X SBP. Four measurements of STI and MVO2 were carried out for each patient at the end of periods I and II: prior to intake of medication and 1 1/2, 3 and 4 1/2 h after intake of medication.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed1982

Carotid sinus hypersensitivity: diagnosis of vasodepressor type in the presence of cardioinhibitory type.

The diagnosis of carotid sinus syncope may sometimes be difficult because its symptoms are not specific, especially in the older age group where carotid sinus hypersensitivity and syncope are not uncommon events. Of major diagnostic importance is the screening of the vasodepressor type of carotid sinus syncope in the presence of the cardioinhibitory type, as this diagnosis has important therapeutic applications. This work is based on the electrophysiological studies performed on seven men with a mean age of 61.9 years who had syncope of unknown cause and hypersensitive carotid sinus reflex. The studies revealed no evidence of sinus node dysfunction or high degree atrioventricular block that would explain the neurological symptoms. The studies also included carotid sinus stimulation with simultaneous interarterial pressure recordings with and without atrial or A-V sequential pacing. The pacing assured the maintenance of normal heart rate during carotid sinus stimulation. The results of these studies revealed that five patients suffered from cardioinhibitory type and two from a combined form of cardioinhibitory and vasodepressor type (mixed form) of carotid sinus syncope. A permanent cardiac pacemaker was implanted in the five patients with the isolated cardioinhibitory type and in one patient with the mixed type of carotid sinus syncope.

Aged↗
PubMed1982

Correlation of T-wave changes occurring during exercise ECG with the hemodynamic changes that govern myocardial O2 balance.

Over 200 healthy males 16 to 60 yr of age were examined with the submaximal exercise test (SMET). ECG, heart rate and blood pressure were measured during rest, immediately after exercise and after 5 min of recovery. Relationships were examined between the percentage change of T-wave amplitude (delta T%) on transition from one phase of the test to the other and the percentage changes of five hemodynamic indices which are known to determine myocardial O2 balance. These indices were heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), myocardial tension index (MTI) and cardiovascular effort index (CVEI). Two new indices of myocardial O2 balance, namely, coronary perfusion index (Formula: see text) and demand supply index (Formula: see text) are also presented. All of these correlations were examined in the group as a whole and in various subgroups, according to age an physical fitness. In the highly fit group, there was a negative correlation between delta T% and delta HR% (P less than 0.001), delta MTI% (P less than 0.007) and delta DSI% (P less than 0.003), and a positive correlation between delta T% and delta CPI% (P less than 0.004). In the young, highly fit subgroup, there was a negative correlation between delta T% and delta HR% (P less than 0.001), delta MTI% (P less than 0.01), delta CVEI% (P less than 0.05) and delta DSI% (P less than 0.004), and a positive correlation between delta T% and delta CPI% (P less than 0.01). These correlations were mainly found during the transition from rest to effort. The results indicate that during the SMET, T-wave depression might be a manifestation of negative O2 balance in the subendocardial layer, even in subjects who most probably do not suffer from organic coronary disease.

Adolescent↗
PubMed1980

Exit block in myxedema, treated effectively by thyroid hormone therapy.

A case of a 71-year-old female who developed exit block one year after implantation of a pervenous pacemaker is reported. The pacemaker had been implanted for sick sinus syndrome; the exit block was probably due to the development of severe myxedema which caused high pacing threshold. Normal pacing threshold was obtained on the seventh day of adequate thyroid hormone therapy and a follow-up one year later revealed effective control of the myxedema and no abnormalities in the function of the pacemaker system.

Aged↗
PubMed1980

Effect of oxprenolol on blood pressure, pulmonary ventilatory function and myocardial contractility in hypertensive patients.

The effects of oxprenolol on blood pressure levels, pulmonary ventilatory function, myocardial contractility and myocardial oxygen consumption are described in 66 patients with essential hypertension and no clinical evidence of obstructive lung disease of heart failure. Two groups of patients were treated with medication for a total of 16 weeks. Group 1 received oxprenolol and diuretics for the first eight weeks and a placebo plus diuretics for the second eight weeks. Group 2 received the same drugs in reverse order. The results of the study indicate that oxprenolol is an effective antihypertensive drug that does not hamper lung volume capacity or myocardial contractility and markedly reduces myocardial oxygen consumption, although it may cause a mild increase in airway resistance.

Adult↗
PubMed1979

An unusual form of mitral insufficiency accompanying atrial septal defect.

An unusual case of atrial septal defect secundum type, associated with intermittent severe mitral insufficiency due to billowing anterior mitral leaflet, in a 56-year old female is described. The degree of mitral insufficiency ranged from severe to none. This phenomenon manifested itself by an intermittent systolic apical thrill and intermittent mitral regurgitation on angiocardiography. Pulling the anterior mitral leaflet at operation through the atrial septal defect demonstrated that this leaflet could be caught in the left atrium, thus causing intermittent mitral insufficiency. Closure of the atrial septal defect and replacement of the mitral valve was performed.

Female↗
PubMed1979

Acute intoxication with ajmaline.

A 57-year-old man ingested 1,000 mg of ajmaline with suicidal intent. He was unconscious, hypotensive and showed serious disturbances in cardiac conduction on admission. High serum and urine levels of ajmaline were found. Although only 4% of the ingested dose was excreted following forced diuresis, all evidence of toxicity disappeared within 21 h.

Acute Disease↗