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Biomedical subjects

H Löllgen

Publications and source records attributed to H Löllgen.

At least 55 records · Page 3Linked to original sources
PubMed1982

Comparison of the antiarrhythmic activity of mexiletine and lorcainide on ventricular arrhythmias.

In a blind cross-over study, 12 patients with ventricular arrhythmias (VPC's; Lown Grades II-IVB) resistant to a daily dose of quinidine 1.2 g, disopyramide 0.8 g, N-propyl-ajmaline 0.1 g were randomly given, each dose for one week, placebo (PL), mexiletine (MEX; 400, 600, 800 mg daily) and lorcainide (LOR; 200, 300, 400 mg daily). On the last day of each treatment period, patients were evaluated by 24-h continuous ambulatory monitoring, 6-channel surface ECG, plasma concentrations and side-effects. During PL I (before) and PL II (after drug treatment), the mean number of VPCs per hour was 670 and 701. VPCs were reduced in 5 of the 12 patients with MEX by 43% (400 mg), 74% (600 mg) and 91% (800 mg). VPCs were reduced in 10 patients with LOR by 60% (200 mg), 78% (300 mg) and 93% (400 mg). Log. lin. plasma conc. effect relationships were constructed for MEX and LOR. Vomiting, nausea, and abdominal pain were seen in 2 patients with MEX; insomnia and feeling heat in 10 patients with LOR. At the end of the LOR-treatment, these side-effects were less in 5 and absent in 5 patients. In this study, LOR seems superior to MEX in refractory ventricular arrhythmias.

Adult↗
PubMed1981

Hemodynamic response to graded water immersion.

Hemodynamic response to graded immersion was studied in healthy male subjects in a thermoneutral bath in the sitting position. Pressures in the right heart and cardiac output were determined by means of a semifloating catheter with a thermistor probe. Pressures in the right atrium, pulmonary artery and in pulmonary wedge position increased with increasing depth of immersion, cardiac output was likewise augmented. Heart rate decreased from rest to hip immersion but remained constant from hip to head out water immersion. Plasma norepinephrine concentration remained constant throughout the experiment. The reported changes depend on the blood shift from capacitance vessels into the thoracic cavity. From this, preload increased and cardiac performance was improved. However, in patients with disturbed left ventricular function, immersion to the neck may be potentially hazardous due to augmented left ventricular filling pressure.

Adult↗
PubMed1981

Short- and long-term effects of hydralazine and combined hydralazine-prenalterol therapy in severe chronic congestive heart failure.

The hemodynamic benefits of combined administration of prenalterol (P) with hydralazine (H) were evaluated in ten patients with severe chronic heart failure. Single administration of 100 mg H increased cardiac index (CI) from 2.3 to 3.0 l/min/m2, whereas pulmonary capillary wedge pressure (PWC) remained unchanged. After 3--4 weeks of treatment with 200 mg H hemodynamic improvementt was maintained (CI: 2.9 l/min/m2). Additional administration of P caused further augmentation of CI (3.3 l/min/m2). After long-term treatment with the combination of H and P sustained augmentation of CI (3.2 l/min/m2), and, furthermore, a slight but significant decrease of PCW were observed (p less than 0.05 vs. chronic single H-therapy). Five patients were able to perform exercise testing; H improved maximal exercise capacity and exercise hemodynamics in three patients. Further improvemen was observed after combined treatment (H + P) in three of five patients. It is concluded, the prenalterol may enhance the effectiveness of hydralazine therapy in congestive heart failure by providing concomitantly the principal actions of the vasodilator and positive inotropic agent used separately. Furthermore, the results indicate that oral long-term administration of hydralazine and prenalterol can produce sustained beneficial improvement.

Adult↗
PubMed1981

[Non-invasive methods of investigation cardiology (author's transl)].

Non-invasive assessment of heart and chamber size employs various techniques which yield different information. Overall size as estimated by biplane chest roentgenogram in the upright or - better - supine position is a valuable quantitative method. Correlation with individual chamber size is, however, only fair. Information on wall thickness can currently be obtained only by ultrasound echocardiography. ECG and vectorcardiography as a means for determining ventricular hypertrophy have remained semi-quantitative techniques, but can probably be developed into more quantitative information by means of computer analysis. A method of predicting left ventricular muscle mass using the Frank orthogonal lead system is described. Regional disorder of contraction and contractility have been difficult to assess non-invasively. Kymographic techniques describe only motion of the lateral wall. Ultrasound techniques, even using a two-dimensional approach, rarely include the ventricular apical region. Systolic time intervals and radionuclide minimal transit times have remained of limited importance. The value of ECG-gated computertomography cannot be assessed as yet. The greatest promise can be expected from radionuclide techniques with gated blood pool scanning and myocardial scintigraphic techniques.

Angiocardiography↗
PubMed1981

The hemodynamic effect of AR-L 115 BS, a new positive-inotropic agent, in patients with left ventricular failure.

The hemodynamic effects of i.v. administered 2-[(2-methoxy-4-methylsulfinyl)phenyl]-1H-imidazo[4,5-b]pyridine (AR-L 115 BS) were studied in 6 patients whose cardiac function was routinely monitored in an intensive care unit. The investigations were performed by Swan-Ganz catheterisation. There was an immediate onset of action with maximum activity at 5--10 min after administration. The duration of action was not longer than 30 min. Cardiac output was significantly increased by 11.5% (p less than 0.05) and the mean pulmonary pressure and pulmonary capillary pressure were reduced by 16% (p less than 0.05) and by 26% (p less than 0.05), respectively. The heart rate was increased by 12% (p less than 0.05) and the mean systemic blood pressure remained nearly unchanged with a slight tendency to fall. No side effects were reported. The results in these patients support the findings in animal studies that AR-L 115 BS has a positive-inotropic and vasodilating action.

Aged↗
PubMed1981

Study of the acute effect of AR-L 115 BS, a new positive-inotropic agent in patients with exercise-induced heart failure.

Invasive cardiac measurements were performed at rest and during exercise after i.v. infection of 0.7 mg/kg 2-[(2-methoxy-4-methylsulfinyl)phenyl]-1H-imidazo[4,5-b]pyridine (AR-L 115 BS) in 10 patients with heart failure in NYHA class II and III of various origins. At rest AR-L 115 BS increased the cardiac index by 0.74 l/min/m2 (p less than 0.01) and the heart rate by 10 beats/min (p less than 0.01). Mean arterial pressure and pressures in the pulmonary artery and in the pulmonary capillary bed were not changed significantly. Stroke work index remained unchanged. At the highest comparable workload AR-L 115 BS reduced the pulmonary capillary wedge pressure by 7 mm Hg (p less than 0.001) and the mean pulmonary arterial pressure by 8 mm Hg (p less than 0.001). The other parameters measured did not change significantly. In most of the patients there was a reduction in the pulmonary capillary pressure in parallel with a slight increase in the stroke work index, indicating an improvement in left ventricular pump function. Four patients reported bright vision immediately after injection which lasted for several hours in 1 patient and for about 5 min in the others. One patient developed muscle tremor which lasted for several hours. The results suggest that AR-L 115 BS exerts a vasodilating action on the capacitance vessels and a positive-inotropic effect on the heart.

Adult↗
PubMed1981

[Plasma catecholamines and hemodynamics in left heart failure (author's transl)].

7 healthy male subjects, 17 patients with left heart failure of degree I and II and 14 patients of degree III and IV (3 patients) based on a coronary heart disease were examined at rest and during ergometric exercise in supine position during a right-heart-catheter examination. Three patients degree IV were not exercised. Compared to healthy subjects, the patients showed, according to disease severity, catecholamine level increases at rest and at the same submaximum exercise intensity. The catecholamine levels show no difference between the patients and healthy subjects during maximum ergometric exercise, although the patients exercise load was 30% (degree I and II) and 60% (degree III) lower. Three patients of the degree IV already have plasma catecholamine levels at rest like those of healthy subjects during maximum ergometric exercise at 155 +/- 33 Watts. Adrenaline and noradrenaline show a direct correlation to pressure dimensions as to the PCPm or the PAPd corresponding to the limitation extent of cardiac function. Estimation of plasma catecholamines in left heart failure during ergometric exercise allows an orientational judgement of the course of hemodynamic dimensions such as PCPm, PAPd and HMV without renewed invasive diagnostic.

Catecholamines↗
PubMed1981

[Hemodynamic actions on alinidine during exercise in patients with coronary artery disease].

The effect of Alinidine (ST 567) on hemodynamics at rest and during exercise was studied in subjects with angiographically documented coronary artery disease and left ventricular dysfunction. Exercise tests were performed before and 30 min after intravenous administration of 20 mg of Alinidine. Significant decreases were observed for heart rate at rest and during exercise, for systolic and diastolic blood pressure. Pressures in the pulmonary artery and in capillary wedge position were significantly reduced after Alinidine by about 12 to 18% (mean PAP) and by about 19 to 28% (PCW). Cardiac output and stroke volume increased during exercise after Alinidine, but the differences were not significant. Depression of ST-segment in the exercise-ECG was significantly lower after Alinidine, angina pectoris occurred in all but one subject during control testing but in none after Alinidine. It is concluded that Alinidine is an effective antianginal drug. Intravenous administration of this agent even in a low dose improves cardiac performance during exercise in patients with impaired left ventricular function. Negative inotropic effects of Alinidine were not observed in this study. Bradycardia and in addition preload reduction are suggested to be the main mechanisms to improve left ventricular function and symptomatic status.

Clonidine↗
PubMed1980

Wall motion characteristic of the right pulmonary artery in the suprasternal echocardiogram.

This study describes the motion pattern of the right pulmonary artery (RPA) as it can be assessed from the suprasternal echocardiogram. The motion characteristic of the RPA is dependent on hemodynamic factors within the lumen of the RPA and those within the left atrium and the aortic arch. During atrial contraction the superior wall of the left atrium separates from the inferior wall of the RPA (IWRPA) and produces an "a" dip in the wall motion of the IWRPA. During isovolumic contraction the RPA is shifted upward (IC point). The incisura in the pulmonary artery pressure curve reflecting pulmonic valve closure can be seen by a sudden decrease in the diameter of the RPA (PC point). In conditions coinciding with pulmonary arterial hypertension, the overall diameter of the RPA increases, and the IC and PC points are flattened or even absent. Thus, changes in hemodynamics caused by pulmonary or cardiac disease may be analyzed noninvasively on the basis of altered wall motion of the RPA.

Adult↗