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Biomedical subjects

J V Gimeno

Publications and source records attributed to J V Gimeno.

At least 19 recordsLinked to original sources
PubMed1995

[Prolonged treatment with isosorbide-5-mononitrate in patients with silent ischemia].

UNLABELLED: INTRODUCTION AND PURPOSES: The purpose of this study was to check the beneficial effect of isosorbide-5-mononitrate (IS-5-MN) in patients with myocardial postinfarction silent ischemia, and to evaluate the possible appearance of tolerance after prolonged treatment. METHODS: We have studied 20 patients, all males, with a history of infarction (11 with inferoposterior infarction and 9 with anterior infarction) and having a positive effort test by electrocardiographic criteria (ischemic S-T depression > 1 mm). The study was designed in two parts, first crossover with placebo, double-blind and then open during 100 days; until day 20, 40 mg/12 hours of IS-5-MN were administered and from then on 40 mg/8 hours of the drug. Effort tests were carried on days, 1, 20, 34 and 100, first basal ones and then at 3 and 6 hours after the administration of the medication. RESULTS: The time of S-T segment depression was prolonged in relation to the tests carried out with placebo and to its basal values (Placebo-basal: 235 +/- 97, Placebo-3 hours: 196 +/- 92, Placebo-6 hours: 201 +/- 80, day 1-basal: 197 +/- 84, day 1-3 hours: 420-96, day 1-6 hours: 381 +/- 93, day 20-basal: 221 +/- 81, day 20-3 hours: 384 +/- 121, day 20-6 hours: 389 +/- 112, day 34-basal: 272 +/- 91, day 34-3 hours: 437 +/- 102, day 34-6 hours: 362 +/- 100, day 100-basal: 269 +/- 102, day 100-3 hours: 389 +/- 112, day 100-6 hours 369 +/- 111). The duration of the effort was prolonged in relation to the placebo values (Placebo-basal: 480 +/- 100, Placebo-3 hours: 445 +/- 73, Placebo-6 hours: 430 +/- 79, day 1-basal: 450 +/- 95, day 1-3 hours: 510 +/- 79, day 1-6 hours: 532 +/- 86, day 20-basal: 524 +/- 93, day 20-3 hours: 535 +/- 77, day 20-6 hours: 519 +/- 77, day 34-basal: 517 +/- 85, day 34-3 hours: 567 +/- 87, day 34-6 hours: 558 +/- 94, day 100-basal: 520 +/- 89, day 100-3 hours: 593 +/- 91, day 100-6 hours: 590 +/- 92). This effect lasted throughout the 100 days of the study. CONCLUSIONS: Therefore, in patients with silent ischemia after myocardial infarction, the administration of 40 mg/12 hours as well as of 40 mg/8 hours of IS-5-MN shows an obvious anti-ischemic effect; with long-term treatment, the effect persists without evidence of tolerance phenomenon.

Adult↗
PubMed1993

[Heparinoids versus nitroglycerin in the treatment of superficial phlebitis].

The purpose of this study was to evaluate the beneficial effects of transdermal nitroglycerine (TNG) in the treatment of superficial phlebitis caused by endovenous catheters and to compare them with the effects from the application of heparinoid substances. The study performed was prospective, randomized during a six-day period. One hundred patients (73 male and 27 female), aged 28-89 years (mean 67.3), participated in the study; all presented phlebitis, diagnosed by the presence of pain, erythema, edema, and fibrous cord in the area around the catheter. Among 50 subjects, two cm of NTG gel were administered to the affected zone once a day, and for the other 50 subjects, heparinoid substances were applied three times a day. The value parameters were: time for the disappearance of pain and time for reducing erythema, edema, and fibrous cord in half (all measured in hours). We found significant differences between the two treatments with TNG yielding greater improvement in terms of disappearance of pain (TNG: 50.2 +/- 39.7, heparinoids: 72.0 +/- 39.9), time for reducing erythema in half (TNG: 28.0 +/- 24.2, heparinoids: 54.6 +/- 34.5), and time for reducing fibrous cord in half (TNG: 58.3 +/- 38.4, heparinoids: 84.5 +/- 41.5). Edema was reduce before with TNG; however, this difference was not significant (TNG: 31.2 +/- 20.3, heparinoids: 33.0 +/- 25.7). We conclude that transcutaneous TNG should be applied systematically in patients with superficial phlebitis, given that it is more effective than the usual treatment with heparinoid substances.

Adult↗
PubMed1993

[Clinical evaluation of the changes produced by nitrates in patients with chronic heart insufficiency].

The aim for this study was to evaluate the hemodynamic changes that appear in patients with myocardiopathy at functional stage II (NYHA) subjected to standard treatment (digital+diuretics) plus nitrates. We used isosorbide-5-mononitrate (IS-5-MN). We studied 20 patients for 100 days in different phases. The placebo-controlled, crossover, double-blind stage random distribution was from day 2 to 5. From day 6 to 20 all the patients took 40 mg/12 hours of IS-5-MN, taking 40 mg/8 hours of active ingredient from day 21 to 100. We performed basal cycloergometrics 3 and 6 hours after administration on days 2, 5, 20, 34 and 100 of the treatment, as well as echocardiograms on these same days. We compared the results obtained versus placebo (p < 0.05). There were no significant differences in heart rate at rest or systolic arterial tension at rest or maximum. Maximum heart rate increased significantly in the tests at days 34 (basal: 143 +/- 9; 3 hours: 139 +/- 8; 6 hours: 140 +/- 7) and 100 (basal: 145 +/- 7; 3 hours: 141 +/- 8; 6 hours: 142 +/- 6) versus the tests carried out with placebo (basal: 136 +/- 8; 3 hours: 135 +/- 7; 6 hours: 136 +/- 7). There were no differences in the tests after acute dose or at treatment day 20.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Acute, short- and long-term efficacy of oral bevantolol in patients with coronary artery disease: a placebo-controlled, randomized, double-blind study.

The efficacy and safety of bevantolol (new cardioselective beta-blocking agent without intrinsic sympathetic activity) were evaluated in chronic stable angina pectoris. Acute effects on heart rate (HR) and pulmonary function (forced expiratory volume in the first second, FEV1, and vital capacity, VC) (double-blind placebo, propranolol, 80 mg, and bevantolol, 150 mg) and the antianginal efficacy during early (double-blind placebo period) and chronic bevantolol therapy (long-term follow-up for 52 weeks) were studied. Bevantolol reduces HR in the same way as propranolol (both p less than 0.01). Pulmonary function is modified significantly only by propranolol (decreasing FEV1, p less than 0.05). Bevantolol reduces antianginal attacks and nitroglycerin consumption (p less than 0.01) and improves exercise tolerance (p less than 0.01) during early and chronic therapy.

Administration, Oral↗
PubMed1984

Time constant of isovolumic pressure fall: new numerical approaches and significance.

The effects of left ventricular diastolic pressure changes on the values of the time constant (T) of isovolumic pressure fall are controversial. Normally, T is calculated either by linear regression of 1n left ventricular pressure (LVP) vs. time (TL) or by using an exponential model with asymptote (PB, extrapolated base-line pressure to which LVP would fall if decay continued indefinitely). This study, in intact dogs, has been designed to revise the effects that drugs that alter load (angiotensin and nitroprusside, without and with autonomic blockade) and inotropism (isoproterenol and propranolol) might have on the relaxation rate using different numerical methods. We found that 1) the upward or downward translation of the LVP curve had an important effect on the value of TL calculated by the semilogarithmic method; 2) when a model with asymptote was used, the simultaneous changes of T and PB, were not related to the dose of the drug; 3) the values of TL and the -dP/dt values extrapolated to 15 mmHg from a model with PB, were much more sensitive to beta-agonist or antagonist drugs than to others whose action was through load alteration. We feel that some of the earlier studies on relaxation rate determinants should be revised as possibly some of the conclusions have been based on artifacts introduced by the method chosen for the computation of the relaxation parameters.

Angiotensin II↗
PubMed1981

Effects of high-frequency harmonics on cardiac relaxation indices.

This study was designed to determine the degree to which the systematic distortions in the pressure curve due to recording and filtering systems influence the relaxation indices. The purposes are 1) to analyze the dependency on the high frequencies of the relaxation and contractility parameters, 2) to determine the degree to which the catheter recordings modify those parameters, and 3) to test the monoexponential hypothesis in which the T index is based (Weiss, Frederiksen, and Weisfeldt, J. Clin. Invest. 58: 751-760, 1976). In 17 open-chest dogs, the left ventricular pressure (LVP) was recorded in four different ways: 1) with a large-bored metal cannula, 2) with a catheter-tip manometer, 3) with a Cournand catheter, and 4) with a pigtail catheter. The ECG and LVP were digitized by a computer. A Fourier analysis was performed, and the LVP waves were resynthesized with different numbers of harmonics. We conclude that 1) the catheter recordings are not recommended to calculate relaxation indices, 2) relaxation parameters present more sources of errors than contractility parameters, 3) the monoexponential hypothesis of T is fulfilled if the isovolumic relaxation is considered to end at the time the LVP is 10 mmHg more than left ventricular end-diastolic pressure level, 4) the dependency on higher harmonics of T index and +dP/dtmax is similar, and 5) -dP/dtmax is much more high-frequency dependent than T index.

Animals↗