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At least 955 records · Page 53Linked to original sources
PubMed1989

[Dose-response relation of gallopamil in comparison with nifedipine, diltiazem and tiapamil in patients with coronary heart disease].

For effective treatment of coronary heart disease with calcium antagonists, knowledge of both the dose-response relationship of a remedy and equipotent dosage for comparison of different drugs is necessary. We performed controlled studies to evaluate the influence of single oral doses of calcium antagonists on ischemic ST-depression (calculated as the mean of all exercise and recovery minutes = mean ST-depression) in exercise ECGs of patients with proven CHD and stable angina pectoris. Ergometries were carried out under constant conditions, particularly with individually constant work load and duration. All calcium antagonists reduced ischemic ST-depression during ergometry dose-dependent when compared to placebo. Diltiazem: 90 mg: 6% (n.s.), 120 mg: 19% (n.s.) und 180 mg: 26% (p less than 0.025); gallopamil: 25 mg: 19% (n.s.), 50 mg: 34% (p less than 0.01) und 100 mg: 57% (p less than 0.0025); nifedipine-Cps.: 5 mg: 17%, 10 mg: 33% und 20 mg: 42%; nifedipine-Tbl.: 20 mg: 8% (p less than 0.05), 40 mg: 23% (p less than 0.057 und 60 mg: 31% (p less than 0.05); tiapamil: 300 mg: 30% (p less than 0.05) und 600 mg: 60% (p less than 0.01). As the result of our findings, comparable antiischemic effects can be expected with 120 mg diltiazem, 50 mg gallopamil, 20 mg nifedipin as capsule or 60 mg nifedipin as tablet and 600 mg tiapamil.

Adult↗
PubMed1989

[Multifactorial analysis of changes in heart rate during exercise in patients with ischemic heart disease as a method of evaluating myocardial reserve].

An attempt has been made to elucidate causes of heart rate change during exercise in anginal patients, using multifactorial mathematical analysis. Seventy-one patients underwent bicycle ergometry and the intravenous ergometrin test. Heart rate variation was found to be unrelated to the type of stress (bicycle ergometry or Master's test), or the presence or absence of ischemic ECG changes during an attack of pain. During exercise, heart rate shifts preceding an anginal attack are similar to those in patients with painless response to stress. At the onset of pain, an abrupt rise in heart rate is seen, its magnitude being particularly great in postmyocardial infarction patients with low physical stress tolerance and high sensitivity to ergometrin. Myocardial insufficiency may be the cause of excessive tachycardia in this category of patients. In patients with high stress tolerance in the absence of ergometrin sensitivity, increased sensitivity to endogenic catecholamines may be a cause of tachycardia during an anginal attack.

Adult↗
PubMed1989

[The peroral dipyridamole test in the diagnosis of coronary insufficiency].

Sixty-six subjects selected at random during the routine work of a medical outpatient department, without typical cardiac complaints, aged 58.4 +/- 8.2 years, and 29 patients in the third week after a new myocardial infarction aged 55.8 +/- 6.9 years drank on fasting a suspension of 450 mg dipyridamole. The ECG tracing was made on fasting, 45 and 60 minutes after ingestion of the suspension, on development of angina pectoris immediately and then aminophylline was administered by the i.v. route. In the first group there were 4.5%, in the second group 24.1% positive tests of coronary insufficiency. The oral test replaces the intravenous dipyridamole test. It is suitable as a supplementary test for the assessment of coronary insufficiency in combination with ergometry and as an alternative examination where ergometry cannot be performed.

Administration, Oral↗
PubMed1989

Hypokalaemia in hypertensive patients treated with diuretics: no increase in cardiac arrhythmias.

Hypokalaemia is a risk factor for the development of cardiac arrhythmias, at least in patients with a cardiac disease, but it is not known whether this applies to subjects with normal hearts. In the present study, 8 young patients with essential hypertension were treated with chlorthalidone for 12 wk followed by a combination of chlorthalidone (50 mg/day) and triamterene (100 mg/day) for 6 wk. This protocol was chosen in order to create different phases in the intra- and extracellular potassium concentrations. At the end of each 6-wk period, blood analyses were performed together with whole body counting for 40K, 24-h electrocardiogram registration, and ergometry. Although plasma potassium concentration and total body potassium decreased significantly in the chlorthalidone period and increased significantly in the period when triamterene was administered together with chlorthalidone, no changes in ectopic activity were seen during either 24-h registration or ergometry. It is concluded that, although hypokalaemia may be dangerous in patients with diseased hearts, a similar risk could not be established in subjects with a normal heart and uncomplicated essential hypertension. Whether the conclusion applies to the average patient with essential hypertension is still a subject of study.

Adult↗
PubMed1986

[Functional state of the heart in patients with hypertension and varying degrees of atherosclerosis of the coronary vessels].

Twenty-five patients with stable arterial hypertension associated with the painful syndrome in the heart region were examined. In addition to the general clinical examination, all the patients were subjected to echocardiography, bicycle ergometry, and coronaroangiography. According to the character of alterations in the coronary arteries the patients were distributed into 3 groups. The first group comprised the patients with angiographically intact coronary arteries, the second the patients with initial atherosclerosis of the coronary arteries. The third group included the patients with disseminated atherosclerosis of the coronary arteries. In accordance with the bicycle ergometry data, the coronary insufficiency associated with essential hypertension was primarily related to the disseminated atherosclerosis of the coronary arteries. However, in cases of marked hypertrophy of the left ventricle the patients could develop relative coronary insufficiency. The pump and total contractile function of the myocardium remained satisfactory in all the examinees. In the third group patients, however, there were alterations in the local contractility as shown by the ventriculography findings. The diastolic function of the myocardium of the left ventricle was disordered in all the patients examined, while alterations in that function correlated with an increase in the mass of the left ventricle myocardium whatever the degree of changes in the coronary vessels.

Adult↗
PubMed1978

[Spiroergometry in assessing the late results of the aortocoronary shunting operation].

The remote results of aorticocoronary shunting were studied in 105 patients (follow-up periods of 1 to 5 years and more). The values of bicycle ergometry and spiroergometry (rehabilitation coefficient, oxygen expenditure per 1 kgm of work, maximum oxygen consumption per 1 kg body mass during muscular exertion, effectiveness of work) were studied before and after operation. The data obtained were compared with the results of spiroergometry in 175 patients with various lesions of the coronary arteries identified by coronarography and in 50 healthy individuals. Spiroergometry is an effective method for diagnosing coronary atherosclerosis before performing coronarography. Patients with good postoperative results showed values which were close to normal; in poor results of surgery and in thrombosis of the coronary shunts initial values characteristic of atherosclertoic involvement of the coronary arteries are encountered. Increase of the effectiveness of work to normal, decrease in oxygen expediture per 1 kgm of work, diminution of maximum oxygen consumption per 1 kg body mass during muscular exertion in the remote postoperative period make it possible to presume, before performing coronarography, that the shunts are functioning. The study conducted allow bicycle ergometry and spiroergometry to be considered demonstrative functional methods for appraising the remote results of operation.

Coronary Angiography↗
PubMed1988

[Anti-anginal and hemodynamic effects of single doses of propranolol, verapamil and nitroglycerin-depot in patients with stenocardia].

The results of single separate administration of nitroglycerin depot (sustak forte), propranolol, verapamil and low-dose sustak-propranolol combinations were assessed by means of bicycle ergometry, echocardiography and rheography in 123 anginal patients. Bicycle ergometry is shown to have an advantage over other techniques in the assessment of the efficiency of antianginal drugs.

Adult↗
PubMed1988

[Comparative assessment of stress electrocardiographic and echocardiographic tests in the diagnosis of insufficiency of the coronary circulation].

Altogether 29 patients (14 with a characteristic clinical picture of CHD, 6 with probable angina and 9 with nonischemic cardialgia) were investigated by methods of two-dimensional echocardiography (echoCG) at rest and in combination with isometric exercise and left atrial transesophageal pacing test (LATPT) as well as by electrocardiographic exercise tests (bicycle ergometry testing and LATPT). EchCG exercise tests were conducted in most of the examinees (96.6%) whereas bicycle ergometry results were obtained in 75.9% of the patients (p less than 0.05). A significantly higher frequency of positive results of echoCG exercise tests in patients with typical CHD as compared to electrocardiographic exercise tests, and significantly high correlation of the results of the combination of echoCG with isometric exercise and echoCG with a degree of the pain syndrome in the heart area were revealed. The results obtained made it possible to recommend echoCG exercise tests for the diagnosis of coronary insufficiency.

Adult↗
PubMed1988

Exercise testing in patients with musculoskeletal handicaps.

To determine safe and effective exercise testing techniques for musculoskeletally handicapped individuals, 20 patients (mean age, 61 years) were studied. Types of handicaps included various degrees of paralysis of arms and legs, and leg amputations. Seventeen of the 20 patients had concurrent cardiovascular problems. All were currently hospitalized, engaged in various physical therapy exercises, and referred for exercise testing to increase rehabilitation therapy or for cardiovascular evaluation. Of 20 tests, arm ergometry was used in 15, leg or combination arm-leg ergometry in four, and treadmill in one. All patients completed testing with mean increases in heart rate (82 to 106 bpm arm, 88 to 125 other) and systolic blood pressure (114 to 127 mmHg arm, 118 to 146 other). Low-grade atrial and ventricular ectopy occurred in eight patients, decrease or plateauing of systolic blood pressure in three, increased diastolic blood pressure in two, and significant (greater than or equal to 1mm) ECG S-T segment displacement in one. With the use of appropriate equipment for each patient, exercise testing can be done safely and effectively in musculoskeletally handicapped individuals.

Adult↗
PubMed1988

[Effective use of study procedures using instruments in infarct patients before discharge from the clinic].

81 males and 23 females after myocardial infarction at the age of 61 +/- 12 and 69 +/- years, respectively, were examined at the end of the stay in the clinic and after one year by means of ergometry and echocardiography. While at the discharge from the clinic the females reached maximally only 50 Watt, 34.7% of the males transgressed this achievement. Also in the watt pulse and in the product of the pressure frequency these patients reached high values, less frequently showed pathological ST segments under exercise and echocardiographical revealed a smaller left ventricle, a greater shortening fraction as well as more insignificant disturbances of the kinetics. This group-typical behaviour remained up to the first year. In patients with pathological diastolic pressure of the pulmonary artery at rest in 8% the latent left heart insufficiency could clinical not be recognized and in those patients with pathological pressure under exercise 54% finished the ergometry without any other recognizable reasons of discontinuation. Finally, the patients who died up to the first year belonged to the group with complications in the intensive care unit, with high resting pulse rate, pathological diastolic pressure of the pulmonary artery, large left ventricle as well as left atrium and low shortening fraction at rest and low watt-number, when discharged from hospital.

Aged↗
PubMed1988

Assessment of a physical training program in patients with myocardial infarction in a tropical country.

Twenty-five myocardial infarction patients, included in a comprehensive cardiac rehabilitation programme, were studied in order to assess the physical training effects upon several physiological parameters in a country with a tropical climate. Training consisted of three-times weekly supervised sessions with running, under telemetric control, accomplished continuously, during thirty minutes at 120 m/min as mean speed. Symptom-limited exercise stress testing was initially performed and repeated after three months of training. 88% of patients showed an increase in physical working capacity, 84% in exercise time duration and 80% in the myocardial efficiency index at subsequent ergometries. A decrease of double product and submaximal heart rate was observed. Angina, ECG ischaemic alterations and arrhythmias during exercise in the first test disappeared or occurred with higher workload in the second ergometry. Mean resting acid concentration, 1.28 +/- 0.36 mmol/l, increased immediately after exercise to 2.03 +/- 0.58 mmol/l. The prescribed physical training programme showed satisfactory results and increased the patients' quality of life, even in a humid and moderately hot climate.

Cuba↗
PubMed1988

[Functional status of the myocardium in thyrotoxicosis].

Twenty-two patients with thyrotoxicosis, showing no clinical signs of heart failure were examined electro- and echocardiographically. Bicycle ergometry was also used in 13 of those. Central and intracardiac hemodynamics were assessed at rest, as was cardiovascular response to exercise. The results were compared to similar parameters in 18 normal subjects. Echocardiography demonstrated hyperkinetic circulation and normal myocardial contractility in the resting patients. Bicycle ergometry showed considerably limited working capacity in those patients. Limited chronotropic and inotropic reserve of the heart in the presence of increased left-ventricular operation at rest may be pathogenetically involved in reduced stress tolerance, seen in patients with thyrotoxicosis.

Adult↗
PubMed1987

[Relation between fixed and dynamic coronary obstruction in the pathogenesis of various clinical forms of ischemic heart disease].

Ninety-five coronary patients were studied, including 44 patients with stable angina and 51 with unstable angina. All patients underwent bicycle ergometry and the intravenous ergometrin test. An anginal attack developed in response to bicycle ergometry in 63.5% of patients with stable angina and in 74.4% of patients with progressive coronary insufficiency. The threshold capacity achieved was directly related to the functional class of stable angina, and dependent on the clinical variety of unstable angina. The ergometrin test was positive in 70.4% of patients with stable angina and 82.4% of patients with unstable angina. An ergometrin-induced anginal attack developed where the double product was significantly smaller than that of threshold stress. The differences were the highest in patients with progressive angina and attacks of acute coronary insufficiency.

Adult↗
PubMed1987

[Assessment of the working capacity of patients with chronic cortico-adrenal insufficiency].

A study was made of CVS function in 48 patients with Addison's disease by submaximum bicycle ergometry to specify and improve the existing criteria of assessment of a degree of gravity of disease and the working capacity of patients before and after hormonal substitution therapy. According to the results of bicycle ergometry, the working capacity of these patients was lowered, the total volume of work done, loading power, and maximum oxygen consumption were also lowered. The data obtained can be used for assessment of therapeutic efficacy and in medical labor examination to determine the working capacity of patients with hypocorticism.

Addison Disease↗
PubMed1987

The pressor response to exercise and stress in uncomplicated insulin-dependent diabetes.

We investigated whether or not an increased pressor response to exercise or stress is a feature of the diabetic state per se or a feature of its complications was investigated. Twelve insulin-dependent diabetic patients without clinical evidence of complications and with normal albumin excretion rates (less than 20 micrograms/min) were studied together with 12 matched control subjects. Each underwent a study protocol of isometric handgrip exercise at 30% of maximum capacity for four minutes, a cold pressor test with immersion of one hand in ice-cold water for two minutes, and bicycle ergometry at a resistance of 105 watts per minute for six minutes. The tests were undertaken in the same order in all subjects. There was, in both groups, a similar and significant rise in systolic blood pressure and pulse rate in response to each stimulus. Diastolic pressure also rose significantly in response to handgrip exercise and to cold pressor stimulation, but fell slightly during bicycle ergometry in both groups. Mean plasma noradrenaline concentration rose in response to each stimulus but the changes reached conventional significance in both groups only in response to handgrip exercise. Pressor responses to exercise and stress, as tested here, are concluded to be normal in insulin-dependent diabetic patients without complications due to their disease.

Adolescent↗
PubMed1987

Ergometer modification for combined arm-leg use by lower extremity amputees in cardiovascular testing and training.

A commercial arm-leg ergometer was adapted so that combined bilateral arm-single leg work could be performed by unilateral lower extremity amputees from their own wheelchairs. Three middle-aged to elderly unilateral amputees performed progressive discontinuous bilateral arm crank and combined bilateral arm-single leg cycle exercise tests on the same air-braked ergometer adapted for either form of ergometry. Select amputees may achieve greater peak oxygen uptakes (VO2), power outputs (PO), and heart rates (HR) during combined bilateral arm-single leg cycle testing versus bilateral arm crank testing. Following 14 weeks of combined arm-leg training on the modified ergometer, a 73-year-old above-knee amputee demonstrated peak VO2 and PO increases of 25% (+3.8 mL X kg-1 X min-1) and 33% (+25W) respectively. Combined arm-leg ergometry as described herein may activate the largest available muscle mass and elicit the greatest oxygen uptake during exercise testing. In addition this exercise modality may simultaneously condition the arms and leg, providing functional gains in both wheelchair propulsion and prosthetic ambulation.

Amputees↗
PubMed1987

[Effect of peripheral vasodilators on pulmonary respiratory function and the indices of bicycle spiroergometry in heart failure patients].

The effect of corinfar and isosorbide on respiratory function of the lungs and indices of spirobicycle ergometry was studied in 40 patients with heart failure resulting from various heart diseases. The results have shown that despite difference in the mechanism of action, the use of these drugs at the given doses combined with digoxin is accompanied by a distinct and comparable positive influence on external respiratory function and indices of spirobicycle ergometry in patients with heart failure.

Adolescent↗
PubMed1987

[Validity of the dynamic exertion test for the diagnosis of arterial hypertension. The exertion test in hypertension].

To assess the role of dynamic stress test in hypertension three normotensive and ten borderline or mild hypertensive subjects were studied by means of the intraarterial Oxford technique. In all of the subjects the intraarterial monitoring lasted for 12 hours; during the recording a graded maximal bicycle exercise test was performed. Five patients considered hypertensive on the basis of their office blood pressure readings showed normal average 12-hour intraarterial recordings. Systolic blood pressure increase during ergometry ranged from 22 to 57 mmHg; exertional pressure readings were strictly related to average 12 hours intraarterial blood pressure (r = 0.92; p less than 0.001). No correlation was found between resting blood pressure and the exertional pressure taken with the auscultatory method. These data indicate that the level that blood pressure attains during ergometry primarily depends on the resting blood pressure values, and therefore do not justified the separation between normo and hyperreactive subjects as some authors have done. In conclusion, dynamic exercise may be a useful diagnostic test for hypertension but has no predictive value for either the development of high blood pressure or the progression from borderline to more severe forms of hypertension.

Adolescent↗