Rehabilitation results are reported concerning the behavior of blood pressure and heart rate, peripheral and central hemodynamics, after resting and during exercise and physical conditioning by running as training and sauna, respectively, in hypertensive patients with IHD after aortocoronary venous bypass (ACVB) surgery. Bicycle ergometric examinations an xenon wash-out (for the determination of the mean functional vessel cross section A) were performed in 43 male untrained patients before and after physical therapy. The left ventricular ejection fraction (EF) at rest was also determined in these patients. Significant increases in the ejection fraction at rest (on average by 7-8%) could be demonstrated in both therapy groups. The group average value for peripheral microcirculation improved only in the sauna group. Blood pressure after resting and on exercise was not influenced. Results are discussed on the basis of the literature and practical conclusions drawn.

Adult↗

PubMed1988

[Effect of active rehabilitation measures on the blood pressure, heart rate, ejection fraction and peripheral microcirculation in patients with ischemic heart disease and hypertension following coronary bypass surgery].

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Adult↗

PubMed1987

[New aspects in the diagnosis of ischemic heart disease in females].

To investigate still uncertain aspects of the diagnosis of ischemic heart disease (IHD) in women, between 1969 and 1984, repeated exercise studies were performed in 706 asymptomatic women (between the ages of 17 and 63 years). On observation of pathologic ST-segment depression of more than 0.1 mV, the exercise study was repeated after administration of 0.8 mg nitroglycerin. Pathologic ST-segment depression was seen in 310 women (44%). In 217 patients (31%), nitroglycerin had no effect (NTG negative); in 93 women (13%), there was normalization of the ST-segment changes (NTG positive). Additionally, in selected subgroups of patients, pulmonary artery pressure was measured at rest and during exercise and ECG mapping performed (n = 114); radionuclide ventriculograms (n = 64) and 201-thallium scintigrams (n = 99) were obtained and coronary angiography (n = 85) was performed. In the NTG-negative women, ejection fraction, myocardial perfusion and coronary arteries were normal. NTG-positive women had lower mean ejection fractions but still within normal limits and indications of impaired myocardial perfusion. High-grade coronary stenoses were found in 25%. No patient with pathologic ST-segment depression had mitral valve prolapse. NTG-positive women had significantly more risk factors than NTG-negative women. In the former group, pulmonary artery pressure measurements showed pathologic exercise hemodynamics, only in 25% of whom IHD with significant stenosis was found to be the cause. For this condition, differential diagnostic considerations include cardiomyopathy or small vessel disease.

Adolescent↗

PubMed1987

[Kidney function in spontaneously hypertensive rats under minoxidil treatment].

In 25 spontaneously hypertensive rats the blood pressure was lowered from 192 +/- 11.6 to 130 +/- 11.7 mm Hg and in 26 normotensive Wistar rats from 129 +/- 9.1 to 107 +/- 6.7 mm Hg by applying 1 mg/kg body weight minoxidil twice a day orally. 19 spontaneously hypertensive and 21 normotensive rats served as untreated control groups. During the treatment the glomerular filtration rate, determined by the slope clearance of Tc-99m-DTPA, remained unchanged. Under maximal water diuresis the excretion fraction of sodium was diminished compared with the control data. The Na+ and water reabsorption was increased in the proximal tubules (not an aldosterone effect) only in the treated spontaneously hypertensive rats. The potassium clearance was increased in this group, but decreased in the treated normotensive group. The different reactions of the renal tubular function to the treatment with minoxidil in spontaneously hypertensive compared with normotensive rats were discussed in connection with changes of membrane transport in essential hypertension.

Animals↗

PubMed1986

Haemodynamic and humoral reaction in arterial hypertension during acute blood pressure lowering induced by nitroglycerin.

The aim of the study was to test whether there are typical changes in haemodynamics and humoral regulation in untreated hypertensives compared to normotensives with acute lowering of blood pressure (and venous return) induced by nitroglycerin (NTG). 23 hypertensives were investigated by radiocardiography and microcatheterization of the pulmonary artery as well as by means of humoral analyses in comparison to 10 normotensives. After performing the studies at rest and during exercise, 0.8 mg NTG was given and the investigations were repeated. There were only insignificant differences in cardiac output and left ventricular filling pressure (PAEDP) at rest and during exercise between both groups. The pressure reductions due to NTG were also similar. Plasma renin activity and plasma kallikrein did not differ in hypertensives and normotensives either at rest and during exercise or after NTG. The prostaglandins (PgE, PgF2-alpha, PgI) were extremely variable. In hypertensives, only PgI was decreased, with increase after NTG, at rest. Thus, PgI is the only humoral indicator participating in blood pressure lowering induced by NTG.

Adult↗

PubMed1986

[Modern studies of kidney function].

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Adolescent↗

PubMed1986

[Differing acute effects of propranolol on the hypertensive heart during exercise].

Exercise investigations were performed in 39 male hypertensives (WHO stage I-III) to assess haemodynamics and cardiac function after intravenous application of 5 mg propranolol for the detection of latent heart failure. Radiocardiography was used to determine volumetric parameters such as LV end-diastolic volume and ejection fraction, and microcatheterization was employed to obtain the LV filling pressure via pressure measurement in the pulmonary artery (PA). The negative inotropic and chronotropic effects of propranolol on pump function and myocardial mechanics at rest were found to be minimal. During 50 watt exercise however, an increase of the diastolic PA pressure has been observed simultaneously with a diminution of cardiac output (stroke volume being constant). Thus, under acutely administered beta blockade, a general disturbance in the flow-pressure relation could be induced, being comparable to heart failure. Only in a few cases was the reduced contractility compensated by the Frank-Starling mechanism, but only if the mechanism did not participate in the regulation of pump function during the previous control investigation. In other cases a remarkable reduction of cardiac output and even stroke volume occurred, results which may be explained as a consequence of a reduced venous return (or pooling) connected with acutely induced vascular effects (beta-2 blockade).

Adult↗

PubMed1985

[Bacteriologic, histologic and functional studies of the kidney in 5 days' therapy of experimental E. coli pyelonephritis with gentamycin. Comparison with 9 days' therapy].

Short-term antibiotic treatment is recommended in infections of the lower urinary tract but its effectiveness is questioned in the upper urinary tract infections. We compared a 5 and a 9 day treatment of experimental E. coli 022 pyelonephritis after unilateral nephrectomy in 127 mal Wistar rats. We used 9 mg gentamycin per kg b.w. twice daily. I131 hippurat excretion was not decreased during the 5 day treatment but was only temporarily diminished during the 9 day treatment. Histologically the severe acute pyelonephritis was decreased after the 9 day treatment but not after 5 days of treatment. Bacteriologically almost all the kidneys were sterile after the 9 day treatment but the majority of the kidneys showed the injected strain of E. coli after the 5 day treatment. The results indicated that the shortened treatment was much less effective in our acute experimental pyelonephritis.

Animals↗

PubMed1985

[Kidney function and bacteriological and histological research in the therapy of experimental E. coli pyelonephritis using trimethoprim-sulfamethoxazole (TMP-SMO)].

40 uninephrectomized male Wistar rats with an experimental E.-coli-022-pyelonephritis (PN) were treated twice daily for 9 days with 30 mg trimethoprim and 150 mg sulfamethoxazole (TMP-SMO) i.p. Bacteriologically most of the kidneys became sterile. Histologically a significant reduction of the frequency of severe PN was found in the treated group. The biologic half-life of 131I-hippuran indicated a decrease of excretory function which was reversible. Urine osmolality and osmotic clearance were increased after oral water loading in 10 untreated control animals with PN but not in the treated group. The 9 day treatment had a favourable effect bacteriologically, histologically and also on renal function.

Animals↗

PubMed1984

[Behavior of blood pressure and peripheral hemodynamics in interval therapy in untreated and propranolol-treated patients with arterial circulatory disorders of the lower extremities].

Searching for a possibility of an effective therapy of disturbances of peripheral arterial blood supply (stage I and II), the authors examined a medicamentously untreated group of patients as well as a comparable group of patients which was pretreated with propranolol. The two groups of patients performed twice a week an interval run exercise. Under the three-month training therapy in the two groups significant systolic and diastolic blood pressure reductions as well as statistically ascertained shortenings of the xenon-133-half-value time under working conditions and enlargements of the average functional vascular cross section A appeared. The distance of the intermittent claudication and the standardized moving up and down test prolonged. An influence on the microcirculation caused by propranolol could not be proved. The results are discussed on the basis of literature.

Adult↗

PubMed1984

[Studies and results of the use of nuclear medicine methods in kidney function tests].

It is sought for alternative methods for the endogenous creatinine clearance as parameters for the GFR. For this purpose served investigations with Tc-99m-Sn-DTPA. It was found a good reproducibility for the slope clearance with 3 blood takings between 60 and 120 minutes. When combined with the camera function scintigraphy a side-separated quantitative statement of the clearance equivalent is possible. The inulin clearance serves as reference method. The investigations at the gamma-camera with Tc-99m-Sn-DTPA also allow the determination of the perfusion which is particularly of interest in patients with hypertension. According to the comparison at the gamma camera a diagnostic schema is recommended.

Adult↗

PubMed1983

[Effect of sauna and walking series on blood pressure, peripheral microcirculation and performance behavior in essential hypertension].

On the basis of two groups with hypertension (stage I and II) pre-treated with propranolol the authors report on possibilities of the assessment of therapeutic effects in physical therapy series. The systolic and diastolic behaviour of blood pressure at rest and under load as well as the peripheral blood supply before and after the therapeutic effect of sauna bath and running series lasting several weeks were investigated according to the principle of staying power. The xenon-133 muscle clearance served as method for the recognition of the peripheral microcirculation. In the series of sauna bath hyperthermia as well as in the running treatment significant reductions of blood pressure at rest and statistically provable improvements of the peripheral haemodynamics were the result. In higher degrees of load the hypertensive position of regulation is not influenced by the therapeutic method described.

Adult↗

PubMed1983

[Swim therapy in elderly patients with essential hypertension treated with beta receptor blockers].

It is reported on the behaviour of blood pressure and heart rate at rest as well as on the peripheral microcirculation of the working musculature after physical conditioning in older patients with essential arterial hypertension (stage I and II). The patients with hypertension conditioned in 4 groups (twice a week swimming or once a week swimming and run each with and without propranolol) showed systolic and diastolic decrease of blood pressure with the exception of some patients. The heart rate at rest was significantly reduced only in the groups with swimming twice a week with and without beta-blockers. By means of the xenon-133-half-life period with the exception of the run-swimming group in all groups could be proved significant improvements of the peripheral microcirculation after the therapy, in contrast to the time before therapy. Value and limits of the training treatment described for the influence on the factor of risk arterial hypertension at old age are discussed.

Aged↗

PubMed1983

[Experiences with the application of physiotherapy in peripheral arterial circulatory disorders of the lower extremities (stage I and IIa) under ambulatory conditions].

In a comparative study the authors report on results of series of physical therapy in disturbances of the peripheral arterial blood supply. Examined were the behaviour of blood pressure, the painless walking distance and the peripheral microcirculation with the xenon-133-muscle clearance method before and after treatments lasting 10 to 12 weeks with combined exercises consisting of gymnastics and walking according to the interval principle (twice a week), with sauna visits twice a week as well as before and after diadynamic series of the current. In all therapy groups an improvement of the peripheral haemodynamics could be statistically ascertained. The distance of the intermittent claudication prolonged particularly in the group with interval walking. In the walking group and in the sauna group the values of the systolic blood pressure were significantly reduced. Side-effects were not observed. Therapy effects of the series of physical therapy described are best to be proved by the xenon-133 muscle clearance.

Adult↗