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Biomedical subjects

H Kulbertus

Publications and source records attributed to H Kulbertus.

At least 37 records · Page 2Linked to original sources
PubMed1988

Cardiovascular risk factors in a sample of a rural Belgian population: the Bellux MONICA Study.

A sample of 1949 subjects of the population of the Belgian province of Luxembourg was screened for levels of cardiovascular risk factors. Cigarette smoking was more prevalent among males (51%) than among females (17%). The relationship between smoking and socio-economic status was inverse in males (M) and direct in females (F). Blood pressure (BP) measurements showed definite high BP in 10% of this sample, and 60% of those with definite high BP were not taking any hypertensive drugs. The average total cholesterol value was 6.49 mmol/L in M and 6.45 mmol/L in F. F had lower values than M at a younger age, but higher values than M at an older age. The high-density lipoprotein cholesterol was higher in F (1.57 mmol/L) than in M (1.27 mmol/L). Diabetes was present in 4.2% of this sample. In nearly half of these participants, the disease had been discovered during the screening. Obesity was especially frequently among F in all three age groups. In conclusion, the main cardiovascular risk factors were found to be at a fairly high level in this population sample.

Adult↗
PubMed1988

Left main coronary dissection after mild chest trauma. Favorable evolution with fibrinolytic and surgical therapies.

A 32-year-old woman had acute anterior myocardial infarction after a mild chest trauma (automobile accident). Unstable angina recurred shortly after admission, and extensive dissection of the left coronary artery was demonstrated. Medical therapy including systemic fibrinolysis was started but clinical stabilization and good long-term result was achieved only by aortocoronary bypass grafting.

Accidents, Traffic↗
PubMed1987

Intravenous anisoylated plasminogen streptokinase activator complex versus intravenous streptokinase in evolving myocardial infarction. Preliminary data from a randomised multicentre study.

The efficacy of a single intravenous bolus of anisoylated plasminogen streptokinase activator complex (APSAC 30U in 4 to 5 minutes) versus an intravenous infusion of streptokinase (1.5 X 10(6) U in 60 minutes) was assessed in 86 patients with evolving myocardial infarction of less than 6 hours duration in a cooperative randomised study. The patency of the infarct-related artery was assessed by coronary angiography at, on average, 90 minutes after therapy (mean time: APSAC 95 minutes, streptokinase 105 minutes). The treatment groups were similar with respect to sex, age, location of myocardial infarction and the delay from onset of pain to treatment. The 90-minute patency rate (grade 2 to 3) was 71.8% in the APSAC group and 55.8% in the streptokinase group; the difference was not statistically significant. There was no difference between the drop in fibrinogen concentrations in the 2 groups at 3 or 24 hours. The minimal concentration obtained at the first assessment was +/- 0.2 g/L in the streptokinase group and 0.5 g/L in the APSAC group. One patient in the APSAC group, who had a previous meningeal bleeding, had a non-fatal cerebrovascular accident. In a subgroup of 38 patients who had 3 control coronary angiograms at 90 minutes, 24 hours and 3 weeks, the patency rate was 63, 82 and 93%, respectively, in the APSAC group and 48, 88 and 92%, respectively, in the streptokinase group (the difference was not statistically significant). None of the patients in the APSAC group presented with reocclusion, whilst 3 patients in the streptokinase group had reocclusions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Myocardial blood flow and glucose uptake after myocardial infarction.

Position emission tomography can picture the distribution of flow tracers as well as of metabolic substrates or analogs. Studies of the distribution of these tracers allow to infer information about regional myocardial clearance (flow X extraction) and substrate utilization. In a study of 32 patients after myocardial infarction, we have contrasted flow and substrate utilization to demonstrate ischemic but viable myocardium in the arterial territory of the infarct in a number of patients also specially after fibrinolytic reperfusion. Restoration of blood flow to the ischemic but viable myocardium through coronary bypass or dilatation improves flow from 56.3% to 84.2% of control and restores substrate utilization. In another group of 32 patients studied with the Strontium-82/Rubidium-82 generator, we have demonstrated perfusion changes both in the myocardial infarct area and at a distance. These changes predominate in patients with multiple vessel disease. Combined PET studies of flow and substrate utilization are new tools to study early intervention after myocardial infarction and to document the benefits of revascularization.

Aged↗
PubMed1986

[Treatment of refractory tachycardias using an implantable cardiac stimulator].

Treatment of tachycardia by permanent cardiac stimulation involves the application of techniques developed in laboratories of clinical cardiac electrophysiology. Clinicians using such treatment must possess detailed knowledge of the physiopathology of arrhythmias and of pacemaker technology, which is essential in the correct selection of patients. We report therapeutic (and not prophylactic) stimulation techniques for treatment of tachycardia, and discuss the possibilities of existing pacemakers and their clinical performance in the light of our own experience and literature data. The results are very promising and suggest that this is a treatment of the future for certain refractory supraventricular tachycardias, and particularly for rapid ventricular tachyarrhythmias. The efficacy and long-term value of this costly treatment in such cases must be evaluated by further studies.

Electric Countershock↗
PubMed1985

Programmable extrastimulus pacing for long-term management of supraventricular and ventricular tachycardias: clinical experience in 16 patients.

Sixteen patients with recurrent, drug-resistant supraventricular (13 patients) or ventricular (3 patients) tachycardia were treated chronically by programmable extrastimulus pacing; either a fully automatic device (Telectronics PASAR 4151: eight patients with supraventricular tachycardia) or a patient--activated device (Medtronic Interactive Tachy System) was used. During a follow-up period of 5 to 30 months, five of the subjects treated with the fully automatic device showed successful results, one had recurrent tachycardia, and two had their units explanted for system-related problems. The patients treated with the externally activated device were, on the whole, very well controlled. This mode of treatment, if applied in well-selected cases, is promising; it seems safe and considerably reduces the number of hospital admissions.

Adult↗
PubMed1985

Evaluation of the effects of molsidomine by cardiac equilibrium blood pool scintigraphy.

We have used equilibrium gated blood pool scintigraphy to evaluate the hemodynamic effects and duration of action of molsidomine, a new peripheral vasodilator antianginal drug, after sublingual administration (4 mg) in five patients with heart failure. The following parameters were studied at rest and 10, 60, and 240 minutes after drug administration: left and right ventricular ejection fractions, end-diastolic and end-systolic volumes, stroke volume, heart rate, and cardiac index. Systolic and diastolic blood pressures were determined by cuff measurement. Statistically significant (p less than 0.05) changes were observed after 10 minutes for left ventricular ejection fraction (+26.2%), left and right end-diastolic volume (-12.4% and -15.2%), left ventricular end-systolic volume (-15%), and cardiac index (+7.9%); after 60 minutes for left ventricular ejection fraction (+49%), left ventricular systolic volume (+30.5%), cardiac index (+29.7%), systolic blood pressure (-7.9%), and right ventricular end-diastolic volume (-14.3%); and after 240 minutes for cardiac index (+23.9%), systolic blood pressure (-6.3%), and right ventricular ejection fraction (+23.1%). No changes in heart rate were observed. No patient experienced any side effect. We conclude that the hemodynamic improvement observed with molsidomine can be prolonged and results both from preload and afterload reduction.

Adult↗
PubMed1985

Prevention by acebutolol of rhythm disorders following coronary bypass surgery.

Seventy-one patients submitted routinely to coronary artery bypass surgery were randomized into 2 groups. Group A (32 patients) received 24 hr after initiation of surgery an intravenous perfusion of 100 mg of acebutolol given over 24 hr (22 cases) or 600 mg administered orally (10 cases). On subsequent days, they received 1200 mg of acebutolol/day orally. Group B (39 patients) was used as control. The groups were comparable in terms of age, sex, severity of coronary disease, preoperative therapy, duration of extracorporeal circulation, aortic clamping time, and immediate postoperative haemodynamic findings. No patient received digitalis. During hospital stay (10 days), 1 group A patient (3%) and 13 group B patients (33%; P less than 0.001) developed a sustained episode of atrial arrhythmia (fibrillation, flutter or atrial ectopic tachycardia). The majority of these rhythm disorders developed between days 2 and 4. On Holter monitoring on days 7-10, malignant ventricular extrasystoles (grades IV and V of Lown's classification) were more frequent in group B (65.2%) than in group A (19.3%; P less than 0.001). Haemodynamic measurements taken at rest performed in 27 patients on days 7-10 (16 patients of group A; 11 of group B). No difference was observed between the two groups. Acebutolol is a safe and efficacious drug for the prevention of arrhythmias following coronary surgery.

Acebutolol↗
PubMed1985

Electrophysiologic effects, antiarrhythmic activity and pharmacokinetics of cibenzoline studied with programmed stimulation of the heart in patients with supraventricular reentrant tachycardias.

Cibenzoline, an imidazoline derivative is a new antiarrhythmic agent. Its electrophysiological effects and antiarrhythmic properties were studied with programmed electrical stimulation of the heart in 12 patients with recurrent episodes of reentrant supraventricular tachycardia; atrionodal (5 cases), circus movement tachycardia involving an accessory pathway (6 cases), intraatrial reentry (one case). Cibenzoline was infused intravenously at a dose of 1 mg kg-1 to 1.75 mg kg-1 during sustained episodes of tachycardia and over 9 to 15 min. Cibenzoline shortened the sinus cycle length, moderately increased the transnodal conduction time and markedly lengthened the HV interval. The refractory periods of the atrioventricular (A-V) node, the atrium and the ventricle did not change. The effects of cibenzoline on accessory pathways used in the anterograde direction were measurable in 4 cases. Complete blockade of the bypass was seen in every case. In the retrograde direction the refractory period of the bypass could be evaluated; in 5 patients it lengthened systematically. Infused intravenously during epidoses of tachycardia, the drug terminated the rhythm disorder in 9 out of 12 cases. Tachycardia could still be initiated in 8 patients after i.v. cibenzoline (2 out of 5 A-V nodal tachycardias, 6 out of 6 circus movement tachycardias). The distribution of the drug followed a bicompartment pharmacokinetic model. The plasma levels at the end of infusion ranged from 1.34 to 3.19 microgram ml-1. Cibenzoline, primarily has class I antiarrhythmic properties and its well-understood pharmacokinetics should be of help in tailoring the treatment to the individual needs of the patient.

Adolescent↗