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Biomedical subjects

E Schleussner

Publications and source records attributed to E Schleussner.

At least 19 recordsLinked to original sources
PubMed2001

The application of fetal magnetocardiography (FMCG) to investigate fetal arrhythmias and congenital heart defects (CHD).

OBJECTIVES: Fetal magnetocardiography (FMCG), a new non-invasive diagnostic tool in the analysis of the electrophysiological changes of the heart, was selectively applied in cases of fetal arrhythmias and congenital heart defect (CHD) to demonstrate its value for diagnosis and prenatal management. METHODS: The FMCG was analysed and compared to the postnatal ECG in four cases of fetal arrhythmia [supraventricular tachycardia (two cases), complex tachy-/bradycardia (one case), ventricular extrasystoles (one case)] and a case of right heart hypoplasia diagnosed by established methods prior to investigation. RESULTS: A Wolf-Parkinson-White (WPW) syndrome was diagnosed by its characteristic features and the appropriate transplacental therapy chosen. The types of arrhythmia could be characterised in accordance with postnatal ECG findings and irregular conduction was demonstrated in association with a CHD. CONCLUSIONS: The use of the FMCG provides additional information to the common diagnostic tools that influence therapeutic decisions and thus contributes to optimal pre- and postnatal management.

Adult↗
PubMed1999

[In Process Citation]

OBJECTIVE: We examined the placental transfer of the calcium antagonists Flunarizine and Verapamil and their effects on the placental metabolism using the dual in vitro perfusion of the human placental lobulus. MATERIAL AND METHODS: Eight placental lobuli were perfused with either 10 micrograms/ml Flunarizine or Verapamil over 6 hours. Two perfusions without any substrate were used as control. RESULTS: The transfer of the control substances antipyrin and kreatinin was not affected by the perfusion with the calcium antagonists. Flunarizine and Verapamil crossed quickly the placental wall, but most of them were accumulated in the perfused placental tissue. Verapamil had a greater placental transfer than Flunarizine. The placental glucose consumption as well as the lactate production were not changed by both of the calcium antagonists. Flunarizine and Verapamil stimulated the placental beta HCG synthesis into the maternal circulation.

Journal Article↗
PubMed1987

Influence of the medial preoptic dopaminergic activity on the efficiency of the negative estrogen feedback in prepubertal and cyclic female rats.

Immature and adult female rats were bilaterally implanted in the medial preoptic area (MPOA) or hypothalamic ventromedial-arcuate region (VMAR) with the dopamine (DA) antagonist, pimozide, or the DA agonist, apomorphine, and the sensitivity to the LH-inhibiting effect of a subcutaneous injection of estradiol benzoate (EB), the onset of puberty and ovarian cyclicity were investigated. Diminution of the inhibitory effect of EB on LH secretion was recorded in ovariectomized immature and adult females implanted in the MPOA with pimozide. This response was not obtained in rats implanted in the VMAR. In contrast, medial preoptic, but not intrahypothalamic, implantation of agar pellets containing apomorphine resulted in enhanced sensitivity to estrogen both prepubertally and during the ovarian cycle. The sensitizing effect of apomorphine was completely prevented in prepubertal rats by pretreatment with EB for 6 days. Bilateral implantation of pimozide-agar pellets in the MPOA of 28-day-old intact females induced significant advancement of the onset of puberty, whereas sexual maturation was not affected by daily subcutaneous injections of the DA antagonist from day 28 till the day of vaginal opening. In adult 4-day-cyclic rats fitted with guide cannulae, the forthcoming ovulation was delayed for about 7 days as compared to the controls implanted with agar if apomorphine was placed in the MPOA from the morning of metestrus to the morning of diestrus. Similar implants located in the VMAR were ineffective in this regard. The results suggest that: (1) low DA activity in the MPOA reduces and high activity enhances the sensitivity of the negative estrogen feedback in immature and adult female rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

[Hemodynamics and changes in compliance of the extra-thoracic capacity system following administration of prostacyclin (PGI2)].

Hemodynamic effects of prostacyclin (PGI2) given as an intravenous infusion at a rate of 8 ng/kg/min were assessed in 50 patients with coronary artery disease at the time of aortocoronary bypass surgery. 1. During steady-state neuroleptic anesthesia, after sternotomy and pericardiotomy, before cannulation of the aorta and vena cava PGI2 led to the following changes: decreases in mean arterial pressure (-24%), total peripheral resistance (-46%), left ventricular pressure (-12%) and left ventricular end-diastolic pressure (-48%), increases in heart rate (+9%), cardiac output (+41%), stroke volume (+30%) and dp/dtmax (+26%) as well as nonsignificant decreases in right ventricular filling pressure (-13%) and mean pulmonary arterial pressure (-9%) together with an unaltered rate-pressure product. 2. In a randomized double-blind study PGI2 was infused throughout the period from two minutes prior to, until termination of extracorporeal circulation. The effects on compliance of the extrathoracic venous system were analyzed on the basis of changes in venous pressure and oxygenator volume. As compared with controls, patients receiving PGI2 were found to have a significant increase in compliance (.157 ml/mm Hg X kg). Thus, in this setting, PGI2 can affect marked vasodilatation with reductions in peripheral resistance and mean arterial pressure together with increases in cardiac output and heart rate.

Clinical Trials as Topic↗
PubMed1983

Prostacyclin in aortocoronary bypass surgery: a double-blind, placebo-controlled study.

In a double-blind, placebo-controlled trial of 40 patients requiring aortocoronary vene transplant surgery, prostacyclin (PGI2) was infused in a dose of 8 ng/kg/min throughout cardiopulmonary bypass. When compared with the placebo-group, the patients treated with PGI2 were found to have significantly higher platelet counts 60(2) and 90 minutes after onset of extra-corporeal circulation (EC). Although this platelet preservation by PGI2 was accompanied by less degranulation of alpha-granula, total antithrombin III (AT III) as well as active AT III and factor Xa inhibitory activity did show comparable results in both treatment groups. In the early phase of EC coagulation factors (fibrinogen, prothrombin and factor VII) exhibited a trend in favour of higher plasma levels in the PGI2-treated group. The same results were found for plasminogen. F VIII-related antigen and complement factors (C3, C4, C3 activator) did not show any difference between the two treatment groups. Bleeding times, blood loss and renal function also did not exhibit any significant differences between the two groups of patients. Except for one control (60 minutes after onset of EC) hemodynamic parameters were not significantly different between the two patient groups. Whether the trend in favour of a lower mortality in PGI2-treated patients can be confirmed, will be up to further studies with greater numbers of patients.

Antithrombin III↗
PubMed1982

[Haemodynamic effects of fentanyl in man during cardiac surgery (author's transl)].

In 93 cardiac patients the effects of low, mean and high fentanyl dosage--0.003 mg/kg, 0.015 mg/kg and 0.03 mg/kg--on haemodynamics, inotropic state and myocardial oxygen consumption were investigated during surgical procedures under basic neuroleptanalgesia. There was an increase in heart rate with the low fentanyl dosage, whereas mean and high doses lowered heart rate. Decreases in arterial pressure, left ventricular pressure, and perfusion pressure during extracorporal circulation as well are interpreted as peripheral vasodilatory effects. Most of the measured and calculated hemodynamic parameters such as PAP, dp/dtmax, CI, TSR decreased. There was, however, no decrease in myocardial contractility, when considering changes in heart rate, pre- and after-load and dp/dtmax. The decrease in heart work and myocardial oxygen consumption may be of advantage especially in patients with coronary heart disease.

Animals↗
PubMed1982

[The utilization of parenterally administered amino acids in the postoperative phase. II. Calculation of an amino acid solution by pharmacokinetic criteria with 1st clinical trial].

The composition of an amino acid (AA) solution suitable for the postoperative period was calculated on the basis of previously reported pharmacokinetic data, special attention being paid to the use of these data in pathological conditions. In preliminary clinical trials, 10 patients were infused with this solution during the first 3 postoperative days. AA blood levels were measured during continuous infusion of 1 g AA/kg body weight (BW)/day. Most AA blood levels normalized during infusion. 5 additional patients received increasing dosages (0.5, 1.0, 1.5, 2.0 and 5.0 g AA/kg BW/day) infused over 4 h. Nearly all blood levels lay within the normal range with dosages ranging from 0.75 to 1.5 g AA/kg BW/day.

Abdomen↗
PubMed1981

[Haemodynamic effects and characteristics of midazolam during induction of anesthesia (author's transl)].

Our investigations have shown the following: 1. 8-Chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a] [1,4]benzodiazepine (midazolam, Ro 21-3981, Dormicum) produces no adverse haemodynamic changes in healthy subjects. 2. The reduction in peripheral resistance becomes apparent mainly in the case of raised baseline values, as, for example, in hypertensive subjects, but it can also be of significance prior to anaesthesia, when there may be raised systemic vascular resistance due to stress. 3. Venous pooling, which leads to a decrease in pre-load and subsequent lowering of the cardiac index, can have a compensatory effect in cardiac insufficiency. Under certain conditions, as for example, in the case of imminent volume deficit, a marked fall in pressure is to be expected. 4. The haemodynamic effects of midazolam are thus limited to vascular reactions. Under certain circumstances volume therapy may be necessary before the drug is used.

Adult↗
PubMed1981

[Cardiac and vascular effects of midazolam during induction of anesthesia prior to and during extracorporeal circulation in coronary-surgical patients (author's transl)].

8-Chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a] [1,4]benzodiazepine (midazolam, Ro 21-3981, Dormicum) is a new benzodiazepine which, when compared with its predecessors diazepam (Valium) and flunitrazepam (Rohypnol), has several outstanding advantages: We conducted hemodynamic investigations with 0.15 mg/kg b.w. midazolam in a total of 28 coronary patients divided into 3 groups. The new water-soluble benzodiazepine is at the dose given useful in the induction of and as an adjuvant to anesthesia because of its hemodynamic effect.

Anesthetics↗
PubMed1981

[Comparative clinical investigations on the cardiovascular effects of piritramide (dipidolor) and fentanyl (author's transl)].

In 36 patients with acquired heart disease effects of 0.15 mg/kg piritramide on hemodynamics, inotropic state and myocardial oxygen consumption were investigated during and after cardiac surgery (basic neuroleptanalgesia). It could be demonstrated, that piritramide is not inducing any negative inotropic effects compared to a control group (n = 36) and a fentanyl group (0.003 mg/kg, n = 31). There were only small changes in HR, SV, PRA and PLA. A slight decrease in Part, PLV, and arterial perfusion pressure during extracorporeal circulation is interpreted as a peripheral vasodilatation. The resulting decrease in heart work caused a significant decrease in myocardial oxygen consumption (-18%), which is of special advantage in patients with coronary heart disease.

Anesthesia, General↗
PubMed1981

[Haemodynamic effects of morphine in man (author's transl)].

In 52 patients with acquired heart disease haemodynamic effects of 0,2 mg/kg and 1,0 mg/kg morphine were investigated during surgical procedures under neuroleptanalgesia. The following parameters were measured or calculated: heart rate (HR), arterial pressure (Part, Psyst, Pdiast), pulmonary artery pressure (PAP), right (PRA) and left atrial pressure (PLA), left ventricular pressure (PLV), left ventricular end-diastolic pressure (PLVED), left ventricular peak dp/dt (dp/dtmax), cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke index (SI), total systemic resistance (TSR), total pulmonary resistance (TPR), work index of the right (RVWI) and left ventricle (LVWI). Myocardial oxygen consumption (EG) was calculated according to the method of Bretschneider. There was almost no change in cardiac index and stroke index. In comparison to a control group (n=36) morphine caused a dose-dependent decrease in arterial pressure and in arterial perfusion pressure during extracorporeal circulation. This, however, was mainly attributable to vasodilatation and not to a negative inotropic effect. In accordance with the changes in haemodynamics there was a remarkable decrease in myocardial oxygen consumption (EG: -21.1%; 1,0 mg/kg morphine).

Adult↗
PubMed1980

[The effects of dihydroergotamine on volume content and compliance of the extrathoracic capacitance vessels of man under anesthesia during extracorporeal circulation in hypothermia (author's transl)].

The influence of dihydroergotamine on volume content and compliance of the extrathoracic capacitance vessels during extracorporeal circulation was investigated. Compared with an untreated control group the compliance decreased (0.44 ml/mm Hg/kg b. wt.) and 490 ml of blood was mobilized and shifted from the circulation into the blood reservoir of the machine. Therefore DHE counteracts the effects of venous pooling.

Anesthesia, General↗
PubMed1980

[The effects of dihydroergotamine on the circulatory system of man during neurolept analgesia (author's transl)].

The effect of 0.015 mg/kg KHE i.v. on the circulatory system was investigated in 10 patients after closure of an atrial septal defect under neuroleptanalgesia. The arterial pressure increased due to an increase of total systemic resistance. The filling pressures of the right and the left ventricle increased while the stroke index remained unchanged. The maximal rate of rise of left ventricular pressure did not change despite the marked changes of pre- and afterload. The data support the drug mechanism of a volume shift from the peripheral to the central circulation. The possible reasons for the missing stroke index increase are discussed.

Adult↗