Biomedical subjects

E A Rodrigues

Publications and source records attributed to E A Rodrigues.

27 records · Page 2Linked to original sources

PubMed1987

Improvement in left ventricular diastolic function in patients with stable angina after chronic treatment with verapamil and nicardipine.

A placebo-controlled double-blind randomized crossover study was carried out to assess the effects of chronic therapy with two calcium antagonists on left ventricular diastolic function in patients with stable angina. Ventricular function was assessed using equilibrium radionuclide angiography and the data was analysed using an automated algorithm. The mean +/- SD ejection fraction on placebo was 59 +/- 10% and this remained unchanged on both verapamil (59 +/- 9%; P = NS) and nicardipine (58 +/- 7%; P = NS). Verapamil increased the peak filling rate index (P less than 0.001) and first one-third filling fraction (P less than 0.005). Nicardipine increased the peak filling rate index (P less than 0.005), but did not alter the other diastolic indices. Early filling rate index was not altered by either drug. Comparison of the effects of nicardipine and verapamil revealed no significant differences in ejection fraction, peak filling rate index or early filling rate index. However, verapamil showed a greater improvement in time to peak filling rate and first one-third filling fraction (P less than 0.01, P less than 0.01, respectively) compared with nicardipine. Heart rate (P less than 0.002) and systolic blood pressure (P less than 0.01) were also lower on verapamil than on nicardipine. These data suggest that left ventricular 'relaxation' abnormalities may be detected in patients with chronic angina pectoris before systolic dysfunction becomes apparent and that these abnormalities may be partially corrected by calcium antagonists.

Adult↗

PubMed1986

Antianginal efficacy of carvedilol, a beta-blocking drug with vasodilating activity.

The efficacy of carvedilol, a new vasodilating beta-blocking drug, was evaluated in 20 patients with chronic angina using a single-blind, placebo-controlled protocol. A 2-week placebo phase was followed by therapy with carvedilol, 25 mg twice daily for 2 weeks, after which the dose was doubled. There was then a second placebo phase lasting 2 weeks. Treadmill exercise testing, 24-hour ambulatory electrocardiographic monitoring and drug blood level assays were performed at the end of each phase. Exercise time (mean +/- standard error of mean) increased from 7.4 +/- 0.5 minutes during placebo to 9.0 +/- 0.5 minutes carvedilol, 25 mg twice daily (p less than 0.001), and to 9.2 +/- 0.4 minutes with 50 mg twice daily (p less than 0.001). Mean time to 1 mm of ST depression in both bipolar leads CM5 and CC5 increased significantly, but peak ST depression did not change. Heart rate at rest was reduced at both dose levels, from 86 +/- 4 beats/min during placebo to 70 +/- 2 beats/min with 25 mg twice daily (p less than 0.001) and to 67 +/- 3 beats/min with 50 mg twice daily (p less than 0.001). Systolic blood pressure at rest was significantly reduced at both doses (p less than 0.05; p less than 0.01), but blood pressure during exercise was decreased only with the larger dose (p less than 0.001). The exercise rate-pressure product was 182 +/- 9 with placebo and decreased to 153 +/- 5 with 25 mg twice daily (p less than 0.001) and to 138 +/- 6 with 50 mg twice daily (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗

PubMed1986

Acute and sustained effects of isosorbide 5-mononitrate in stable angina pectoris.

Isosorbide 5-mononitrate (IS 5-MN) is an active metabolite of isosorbide dinitrate and is widely used as an antianginal agent. The acute and subacute (2 weeks) effects of IS 5-MN, 40 mg twice daily, were evaluated in 18 patients with stable angina pectoris using computerized exercise testing and a placebo-controlled, double-blind, randomized trial protocol. There were 2 phases of 2 weeks each in which patients received placebo or active IS 5-MN. Acute testing (8 patients) was performed 2 hours after the first dose and subacute testing 2 hours after the morning dose on day 14. Acute testing showed an increase in exercise time from a mean (+/- standard error of mean) of 8.2 +/- 0.6 minutes to 11.1 +/- 0.5 minutes (p less than 0.001) after a single dose of IS 5-MN. Time to 1 mm of ST depression increased significantly and peak exercise ST-segment depression decreased significantly. Rest and peak exercise heart rate increased significantly during acute testing with IS 5-MN; blood pressure did not change significantly. After 2 weeks of therapy, exercise time had not changed (9.9 +/- 0.6 with placebo to 9.7 +/- 0.6 minutes). The beneficial effects on ST-segment variables were sustained at 2 weeks. The data suggest that there is an attenuation of effect with respect to exercise time and sustained beneficial effect on the ST-segment variables. This may be a result of development of partial tolerance to IS 5-MN after 2 weeks of therapy.

Adult↗

PubMed1986

Diagnosis and prognosis of right ventricular infarction.

The values of several non-invasive methods for the diagnosis of right ventricular necrosis in inferior myocardial infarction were compared in 51 consecutive patients who underwent serial radionuclide ventriculography, pyrophosphate scintigraphy, and cross sectional echocardiography. In addition a unipolar electrocardiographic lead V4R was recorded on admission, daily, and during episodes of further pain. Profound right ventricular dysfunction was evident in 50% of patients studied by radionuclide methods after inferior myocardial infarction but recognition on clinical groups alone was poor. Functionally important right ventricular infarction was best detected and followed serially by radionuclide ventriculography. Echocardiographic methods for evaluating right ventricular ejection fraction correlated poorly with radionuclide methods. Increased uptake of radioactivity by the right ventricle on pyrophosphate scintigraphy usually indicated poor right ventricular function, but a scan that was negative in the right ventricular territory did not exclude dysfunction. ST segment elevation in V4R was not specific for right ventricular infarction and its routine use may lead to overdiagnosis of this condition. Serial measurements suggest that profound right ventricular dysfunction persists after acute inferior infarction and is associated with considerable morbidity and mortality. Of 25 patients with severe right ventricular dysfunction, six died in the late hospital period. In the remaining 19 patients mean right ventricular ejection fraction over a two month period did not improve; six patients had persistent right ventricular dyskinesia and features of chronic right ventricular failure developed in three survivors.

Adult↗

PubMed1986

Aortic stenosis presenting with predominant right heart failure.

Two cases of severe aortic stenosis presenting with pure right heart failure and unimpressive cardiac murmurs are reported. Both responded well to aortic valve replacement. The mechanism of right heart failure is discussed as is the need for urgent surgery.

Aortic Valve Stenosis↗

PubMed1983