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[Drug lowering of the HDL concentration in the serum of cardiologically treated patients].

The connection between decreased concentration of HDL-cholesterol in the serum and increased risk of arteriosclerosis has attracted the attention to such sizes of influence which are able to decrease the HDL-cholesterol-concentration. In these cases the question is asked, whether the analytic reliability of the techniques which are at the disposal for the estimation of HDL-cholesterol is sufficient for the recognition of the changes of the concentration to be expected. To the sizes of influence belong medicaments which cannot be fancied away in the therapy of cardiovascular diseases; thus the beta-receptor blockers talinolol and propranolol. The examination of 118 cardiologically treated patients yields the result that there is no particular risk of the patients treated by means of these medicaments, since an essential decrease of the HDL-cholesterol-concentration could not be proved.

Adrenergic beta-Antagonists↗

[Prolonged hemodynamic effects of pentaerythrityl tetranitrate combined with piridoxylate].

Long acting nitrate derivatives have varying hemodynamic effects of a piridoxilate-pentaerithrityle tetranitrate administration. The purpose of this study was to assess the hemodynamic effects of a piridoxilate-pentaerithrityle tetranitrate compound and measure their duration of action. The study was carried out in 11 patients with left ventricular incompetence. All other medications, except for anticoagulants, had been discontinued 5 days earlier and patients fasted during the investigations. Each patient was given the active product (100 mg pentaerithrityle tetranitrate) and the placebo orally, under double blind conditions. Pulmonary vascular pressure, peripheral arterial pressure, heart rate and cardiac output were measured over 8 hours for 2 consecutive days. The results show a decrease in the left ventricular preload from the 30th minute to the eighth hour, which is statistically significant from the first to the fourth hour. No changes were recorded in the postload or in any of the other parameters measured or derived. These findings suggest that the compound has an anti-anginal action by diminishing the pressure in the ventricular wall and reverses pulmonary edema in left ventricular failure. The long duration of action (at least 8 hours) allows prolonged dosage intervals.

Double-Blind Method↗

[Effects of the PETN-piridoxylate combination in the long-term treatment of cardiac failure in the aged patient].

Vasodilator treatment with long-activity nitrate derivatives intensifies the effects of treatment with digitalis and diuretics in left ventricular insufficiency. The object of this study was to evaluate, in an open comparative trial, the clinical effects of a prolonged adjunctive treatment with Mycoril, which is composed of a sustained-release nitrate derivative (pentaerythrityl tetranitrate: PETN) and an antianoxic agent (piridoxilate). The study was conducted in 90 patients with cardiac insufficiency who were treated and followed-up for at least one year. Study patients were divided into two groups matched for age, sex and etiology. The control group (42 patients) received digitalis and diuretics; the treatment group (48 patients) was given digitalis, diuretics and Mycoril in a daily dose of 4 to 6 capsules. The results show a significant improvement of symptoms in patients with ischemic cardiac insufficiency treated with Mycoril (83%) compared with the control group (52%) (p less than 0,03). Diuretics were needed in lower doses or withdrawn in a significantly higher number of patients in the Mycoril group (67%) than in the control group (38%) (p less than 0,01). This study provides clinical confirmation of the value of adjunctive treatment with a product such as Mycoril in patients under digitalis and diuretic therapy.

Aged↗

[Efficacy of using vasodilating preparations in latent heart failure in patients with chronic ischemic heart disease].

The tolerance to exercise and parameters of the central hemodynamics were studied in 111 patients with coronary heart disease and latent cardiac failure. It has been ascertained that they have a considerably increased peripheral resistance. The treatment with erinit and nitrong improves the propulsive function of the heart and diminishes significantly the peripheral resistance which results in an increased tolerance to physical load. The latter depends on the degree of the peripheral resistance decrease due to erinit and nitrong. Vasodilating agents may be useful in preventing the progression of heart failure in patients with coronary heart disease.

Blood Pressure↗