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Biomedical subjects

F Waagstein

Publications and source records attributed to F Waagstein.

At least 127 records · Page 7Linked to original sources
PubMed1983

Effects of iohexol and metrizoate on myocardial blood flow and metabolism.

In 10 patients coronary sinus blood flow (CSBF) was measured during and after injection of iohexol and meglumine-Na-Ca metrizoate in the left coronary artery. Oxygen saturation, lactate concentration and hematocrit were determined in the aorta and coronary sinus before and after a second injection of the two contrast media. The increase in CSBF was significantly more marked and sustained after injection of metrizoate than after iohexol and myocardial arterio-venous oxygen difference was significantly lower. Myocardial oxygen consumption and lactate metabolism were not adversely affected by any of the contrast media. The fall in hematocrit in coronary sinus blood was significantly greater after metrizoate.

Contrast Media↗
PubMed1982

Effects of prenalterol administered orally in patients with congestive heart failure.

A single-blind study of prenalterol 20-200 mg daily in a slow-release tablet preparation and a placebo was performed in 15 patients with moderate to severe congestive heart failure (NYHA II-IV) to evaluate the haemodynamic and clinical effects of oral prenalterol. Non-invasive parameters in the measurement of cardiac output, stroke volume, pre-ejection period index (PEPI), PEP/LVET ratio, ejection fraction and mean Vcf were significantly improved, indicating beneficial effects of prenalterol on cardiac contractility. Systolic blood pressure, heart rate and rate-pressure product were slightly increased at rest but were considerably lower during exercise. Arrhythmogenecity was not seen in the patients studied. Subjective improvement was noted in the majority of patients as evidenced by a decreased frequency of dyspnoea, fatigue and angina. Unwanted effects, such as palpitations and transmitted arm pulsations, were transient and disappeared with dose adjustment, while the inotropic effect of the medication was maintained. The clinical response appeared to be sustained for up to 2 weeks of treatment, indicating non-development of tachyphylaxis.

Administration, Oral↗
PubMed1982

Haemodynamic effects of intravenously administered prenalterol in patients with severe heart failure.

The acute haemodynamic effects of prenalterol 75-225 micrograms/kg i.v. were studied at rest and during exercise in the supine position in 12 patients with chronic congestive heart failure secondary to myocardial infarction (6 pts), chronic valvular disease with valvular replacement (4 pts), ischaemic cardiomyopathy (1 pt) and post myocarditis (1 pt). In 5 of the 6 AMI patients the effect of prenalterol on myocardial oxygen consumption at rest was measured. Pulmonary artery end-diastolic pressure decreased significantly from 17 to 10 mm Hg at rest and from 31 to 21 mm Hg during exercise. Resting heart rate increased from 78 to 90 at rest but was unchanged during exercise. MVO2 in the 5 patients was unchanged or lower in 4 patients and increased in one in whom angina developed after prenalterol. In general, dyspnoea and angina during exercise were less pronounced after prenalterol. The calculated triple product was lower after prenalterol, especially during exercise, indicating lower myocardial oxygen consumption and probably less myocardial ischaemia.

Adrenergic beta-Agonists↗
PubMed1981

Effect on mortality of metoprolol in acute myocardial infarction. A double-blind randomised trial.

The effect of metoprolol on mortality was compared with that of placebo in a double blind randomised trial in patients with definite or suspected acute myocardial infarction. Treatment with metoprolol or placebo started as soon as possible after the patient's arrival in hospital and was continued for 90 days. Metoprolol was given as a 15 mg intravenous dose followed by oral administration of 100 mg twice daily. 1395 patients (697 on placebo and 698 on metoprolol) were included in the trial. Definite acute myocardial infarction developed in 809 and probable infarction in 162. Patients were allocated to various risk groups and within each group patients were randomly assigned to treatment with metoprolol or placebo. There were 62 deaths in the placebo group (8.9%) and 40 deaths in the metoprolol group (5.7%), a reduction of 36% (p less than 0.03). Mortality rates are given according to the treatment group to which the patients were initially randomly allocated.

Adult↗
PubMed1981

Clinical results with prenalterol in patients with heart failure.

The hemodynamic effect of 75 to 225 microgram/kg prenalterol (PNL) intravenously were studied at rest and during exercise in eight patients with chronic congestive heart failure (CHF) after myocardial infraction (three patients), valvular surgery (three patients), and congestive cardiomyopathy (two patients). All head New York Health Association functional class III and IV CHF and were receiving digitalis and diuretics. With PNL at rest, left ventricular filling pressure (LVFP) fell from 17 to 12 mm Hg, cardiac index (CI) rose from 2.1 to 2.9 L/min/m2, heart rate (HR) increased mildly, systemic vascular resistance (SVR) declined moderately, and peripheral arterial pressure was unchanged. During PNL exercise compared with control, LVFP rise was less and CI, HR, and SVR responses were similar; dyspnea and angina were reduced in most patients. The eight patients were than given PNL orally, 30 to 200 mg/day, versus placebo for 6 days with comparative evaluation by echocardiogram, systolic time intervals (STI), exercise test, and continuous ECG. With PNL orally five of eight patients improved symptomatically, ejection fraction increased from 0.44 to 0.53, and STI preejection period shortened by 10 msec, without change in resting HR or systemic arterial blood pressure. The incidence of ventricular premature beats was not increased. PNL orally vs placebo exercise capacity increased 10%. Thus PNL may be of value for long-term CHF treatment in addition to conventional therapy.

Administration, Oral↗
PubMed1980

Beneficial effects of long-term beta-blockade in congestive cardiomyopathy.

Twenty-eight patients with heart failure caused by congestive cardiomyopathy, which had been diagnosed according to the criteria of Goodwin and Oakley, were treated with beta-blocking agents for six to 62 months, except for four patients who died within two months. Repeated non-invasive investigations were performed before and during treatment as well as exercise tests and chest x-rays. The echocardiographic and pulse curve findings indicated an improvement in systolic and diastolic myocardial function. The ejection fraction increased from 0.32 +/- 0.02 to 0.42 +/- 0.04, and the third heart sound amplitude and rapid filling wave were significantly reduced. The functional classification improved in 15 patients while in 12 patients it remained unchanged and in one it deteriorated. During follow-up, 10 patients died, most of them suddenly. The mortality was lower than expected in this severely ill group of patients. The beneficial effect of chronic beta-blockade in patients with congestive cardiomyopathy suggests that catecholamines are involved in the pathogenesis of congestive cardiomyopathy, and that patients with congestive cardiomyopathy may have inappropriate sympathetic cardiac stimulation which can be reduced by chronic beta-blockade. It is suggested that beta-receptor blockade should be added to conventional treatment with digitalis and diuretics in all patients with severe myocardial failure caused by congestive cardiomyopathy.

Adolescent↗
PubMed1980

Adverse effects of beta-blockade withdrawal in patients with congestive cardiomyopathy.

Fifteen patients with congestive cardiomyopathy who had improved conspicuously on chronic administration of a beta-blocker were studied after withdrawal of the drug. In six patients there was a pronounced deterioration of their clinical condition, and in all of the remaining patients there was a significant decrease in ejection fraction, and signs of compromised diastolic function with pathological apex curves and an increase in third heart sound. All these changes were reversed within a few weeks to a few months after readministration of beta-blocking drugs. This study supports the idea that an aetiological factor in congestive cardiomyopathy may be a pathological response to sympathetic stimulation which could be partly controlled by administration of beta-blocking drugs.

Adolescent↗
PubMed1979

Prolongation of survival in congestive cardiomyopathy by beta-receptor blockade.

24 patients with congestive cardiomyopathy (group I) were compared with a group of 13 controls with similar clinical findings and myocardial function who were selected retrospectively (group II) . All patients received digitalis and diuretics, but group I patients received beta-blockers as well. The survival-rate in group I patients (83%, 66%, and 52% after one, two, and three years respectively) differed significantly from that in group II subjects (46%, 19%, and 10%, respectively). This finding is supported by the demonstration that beta-blockade improved myocardial function in group I subjects. It is therefore suggested that beta-blockade prolongs survival in patients with congestive cardiomyopathy.

Adolescent↗
PubMed1979

Haemodynamic effects of a new beta 1-receptor agonist in acute myocardial infarction. A useful antidote to unwanted cardiac effects of beta-blocking agents.

The haemodynamic effects of a new beta 1-receptor agonist, 1-(4 hydroxyphenoxy) 3-isopropylamino-2-propanol, were studied in 25 patients after acute myocardial infarction using non-invasive methods. The drug caused an increase in systolic blood pressure and pulse pressure, without change in diastolic blood pressure, and a slight increase in heart rate and reduction in the pre-ejection period. These changes were greater in patients without a history of left heart failure. It is suggested that this cardioselective drug possesses positive inotropic activity but only slight positive chronotropic activity. The substance has been further investigated as a possible antidote to unwanted cardiac side effects of the cardioselective beta-blocker, metoprolol. The changes in the cardiovascular dynamics caused by metoprolol in patients with acute myocardial infarction were promptly reversed by this new beta 1-agonist. With its positive inotropic properties and its efficacy in reversing the effects of a cardioselective beta-blocker, the drug is a potentially useful pharmacological agent to support an acutely depressed myocardium in patients on beta-blocking agents.

Acute Disease↗
PubMed1978

Hemodynamic effects of the cardioselective beta-blocking agent metoprolol in acute myocardial infarction. A 24-hour catheterization study.

Hemodynamic changes were studied in ten patients with uncomplicated transmural myocardial infection during 24 hours on beta-blockade. The cardioselective beta-adrenergic blocking drug metoprolol was injected (15 mg i.v.) within the first 24 hours after onset of chest pain and was followed by oral therapy (25-50 mg at 6-hour intervals). There was a decrease in heart rate, systolic BP, and cardiac output, which was most marked after the injection. The stroke volume and diastolic BP for the whole group of patients remained unchanged. The pulmonary artery end diastolic pressure did not change significantly after the injection but a continuous fall was obtained in three out of four patients with initially elevated values. The preejection period, measured from the ECG and carotid pressure curve, as initially short and was prolonged in all patients after administration of the beta-blocking drug. It is concluded that the cardioselective beta-blocking drug metoprolol may be used in selected patients in the acute phase of myocardial infarction without danger of hemodynamic deterioration during the first 24 hours of therapy. The selection of patients can be based on clinical criteria. In this study signs of left heart failure, hypotension, poor peripheral circulation, bradycardia, and AV block were regarded as contraindications.

Acute Disease↗
PubMed1978

The use of dobutamine in myocardial infarction for reversal of the cardiodepressive effect of metoprolol.

1 Ten patients with acute myocardial infarction were infused dobutamine in increasing doses up to 15 microgram kg--1 min--1. 2 Metoprolol (total dose 15 mg) was then given intravenously to nine of these patients and the beta-adrenoceptor against effects produced by dobutamine were effectively reversed. 3 Nine patients with acute myocardial infarction pretreated with metoprolol (15 mg) were infused dobutamine 15 microgram kg--1 min--1 for 10 min. This resulted in effective reversal of the beta-adrenoceptor antagonist effects induced by metoprolol, without the occurrence of serious arrhythmias or other unwanted effects. 4 Dobutamine may be valuable in counteracting any undesirable cardiodepressive effects of beta-adrenergic receptor blocking drugs (especially the cardioselective agents) in patients with acute myocardial infarction.

Acute Disease↗
PubMed1978

beta-Adrenoceptor stimulation of the human urinary bladder in vivo.

The effect of beta-adrenorecptor stimulation on the volume of the urinary bladder in 16 neurologically normal humans without symptoms of micturition disturbances was investigated. Terbutaline, a selective beta2-adrenoceptor stimulating agent, was tested in 9 persons and isoprenaline, a general beta-adrenoceptor stimulating agent, was tested in 7 persons. After terbutaline the maximum increase in the bladder volume was 10% and on an average aroung 5%. After isoprenaline the maximum increase in the bladder volume was 15% and on an average around 5%. Terbutaline as well as isoprenaline administration resulted in tachycardia and an increased pulse pressure. The tachycardia was somewhat more marked after isoprenaline. In conclusion, only a small increase in the volume of the urinary bladder was noted after beta-adrenoceptor stimulation in neurologically normal humans without symptoms of micturition disturbances, in contrast to effects achieved in some patients with urgency. Terbutaline seems to have less cardiac effects compared to isoprenaline and is therefore to be preferred when beta-adrenoceptor stimulation is required in patients with urgency.

Adolescent↗
PubMed1978

Effect of beta-adrenoceptor stimulation on the human bladder in vivo.

The effect of beta-adrenoceptor stimulation on the volume of the urinary bladder in 16 neurologically normal humans without symptoms of micturition disturbances was investigated into. Terbutaline, a selective beta2-receptor-stimulating agent, was tested in 9 persons and isoprenaline, a general beta-receptor-stimulating agent, was tested in 7 persons. After terbutaline the maximum increase in the bladder volume was 10% and on an average around 5%. After isoprenaline the maximum increase in the bladder volume was 15% and on an average around 5%.

Adolescent↗