PubMed Health⌕ Search

Biomedical subjects

K Chatterjee

Publications and source records attributed to K Chatterjee.

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

Hydralazine in heart failure.

Hydralazine is a smooth muscle relaxant and a potent arteriolar dilator. The major hemodynamic effect of hydralazine in patients with heart failure are increased cardiac output and stroke volume, and decreased vascular resistance without any significant change in pulmonary and systemic venous pressure. Hydralazine also produces beneficial hemodynamic effects in patients with mitral and aortic regurgitation and in some patients with large ventricular septal effect with reduced systemic output. However, the role of long-term hydralazine therapy in these patients remains uncertain. In many patients with chronic heart failure with low cardiac output, hydralazine produces sustained beneficial hemodynamic and clinical effects. The long-term prognosis of patients with chronic heart failure, however, remains unchanged, although certain subsets of patients appear to have better prognoses than others during long-term hydralazine therapy.

Animals↗
PubMed1983

Analysis for Fusarium toxins in various samples implicated in biological warfare in Southeast Asia.

Samples of leaves, water, cereal grains, soil, and yellow powder as well as blood, urine, and body tissues from chemical warfare victims were analyzed for Fusarium toxins by using gas chromatography and mass spectrometry. The leaves, water, and yellow powder samples contained various combinations of T-2 toxin, diacetoxyscirpenol, deoxynivalenol, nivalenol, and zearalenone in concentrations ranging from trace (1.0 ppb) amounts to 143 ppm. These trichothecenes do not occur naturally on the substrates described and were correlated with the so-called "yellow rain" chemical attacks against Hmong people in Southeast Asia. Analysis of leaves, soil, water, and cereals collected in areas adjacent to but apart from the area where chemical attacks had been staged did not contain any Fusarium toxins. Moreover, T-2 and HT-2 toxins were found in human blood, urine, and body tissues (heart, esophagus, kidney, lung, and large intestine) of alleged victims. In addition, diacetoxyscirpenol was found in the kidney of one person who had died.

Adult↗
PubMed1982

Captopril in congestive heart failure: improved left ventricular function with decreased metabolic cost.

The oral angiotensin-converting enzyme inhibitor captopril (CPT) produces beneficial hemodynamic and clinical responses in patients with chronic congestive heart failure (CHF). Cardiac output and stroke volume increase, along with a decrease in pulmonary capillary wedge pressure, indicating improved left ventricular function. During maintenance CPT therapy, the beneficial hemodynamic and clinical effects appear to be sustained. Improved left ventricular pump function with CPT is associated with decreased metabolic cost, as myocardial oxygen consumption consistently decreases in proportion to the decrease in myocardial oxygen demand. Myocardial ischemia occurs infrequently, as is evident from the abnormal myocardial lactate metabolism. Hypotension appears to be the major adverse effect, particularly after the first dose. However, with dose titration and the use of a smaller initial dose, a marked precipitous fall in blood pressure can be avoided in the majority of patients. Thus, CPT may prove to be a useful agent in the vasodilator therapy of chronic CHF.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1982

Minoxidil therapy in chronic congestive heart failure: acute plus long-term hemodynamic and clinical study.

The hemodynamic response to minoxidil, an orally active, potent vasodilator, was evaluated in 11 patients with severe chronic congestive heart failure (CHF). The hemodynamic response was determined following single doses of 10, 15, 20, 25, and 30 mg of minoxidil. The hemodynamic response was characterized by marked increases in cardiac index (+63%) and stroke volume index (+52%) and by decrease in systemic vascular resistance (-38%). There was also a slight decrease in pulmonary capillary wedge pressure from an average of 24 +/- 8 to 21 +/- 7 mm Hg. Although the average mean arterial pressure remained unchanged, one patient developed significant hypotension. Chronic minoxidil therapy (eight patients) was associated with fluid retention and weight gain. In four patients in whom fluid retention could be minimized with larger doses of diuretics, a sustained clinical and hemodynamic improvement was observed. These findings suggest that minoxidil has the potential to improve cardiac function and may be useful in chronic vasodilator therapy of CHF, provided fluid retention can be controlled.

Adult↗
PubMed1982

Vasodilators in heart failure secondary to coronary artery disease.

Although vasodilators produce acute beneficial hemodynamic effects in patients with chronic congestive heart failure, their effects on the long-term management of such patients are unclear. In 56 patients followed up for an average of 13 months, there was a 37% mortality at 1 year. Because of the potential adverse effects of vasodilators in patients with coronary artery disease, we evaluated the effects of prazosin, hydralazine, and isosorbide dinitrate on hemodynamics, coronary sinus flow, and myocardial oxygen consumption (MVO2). Isosorbide dinitrate reduced ventricular filling pressure with no change in heart rate or mean arterial pressure; coronary sinus flow and MVO2 fell significantly. With prazosin there was a reduction in ventricular filling pressures and rate-pressure product but no change in coronary sinus flow or MVO2. With hydralazine there were parallel changes in the rate-pressure product and MVO2. Results emphasize the differing effects of vasodilators on oxygen supply and demand, which may influence the long-term course of patients with coronary artery disease.

Cardiac Output↗
PubMed1982

The significance of nitroglycerin-induced changes in ventricular function after acute myocardial infarction.

The potential of nitroglycerin for improving global and regional ventricular function after acute myocardial infarction and predicting serial change in ventricular function at the time of hospital discharge was investigated. Equilibrium multiple gated blood pool scintigrams were performed at rest before and after sublingual administration of nitroglycerin in 18 patients an average of 36 hours after infarction and again at discharge. Global right and left ventricular function and regional left ventricular function of infarct and noninfarct zones were determined scintigraphically. In the early study nitroglycerin increased both mean (+/- standard deviation) left ventricular ejection fraction (0.51 +/- 0.15 to 0.55 +/- 0.15 ; p less than 0.02) and mean right ventricular ejection fraction (0.42 +/- 0.14 to 0.47 +/- 0.13; p less than 0.05). Left ventricular ejection fraction significantly increased in 5 of the 18 patients. It increased late in five of the six patient who exhibited an increase early after nitroglycerin but in only 2 of the 12 patients who did not exhibit an early increase (p less than 0.06). Regional ejection fraction in the infarct zone increased late in 7 of the 12 patients who exhibited an early increase after nitroglycerin and in none of the 6 who did not exhibit an early increase (p less than 0.05). Both right and left ventricular global ejection fraction and regional ejection fraction showed little late responsiveness to nitroglycerin. Early after infarction, sublingual nitroglycerin improved left, right and regional ejection fraction at the infarct site in some patients. These nitroglycerin-induced changes predicted those patients whose global ventricular function and regional left ventricular function at the infarct site improved late.

Administration, Oral↗
PubMed1982

Haemodynamic and myocardial metabolic effects of captopril in chronic heart failure.

In 15 patients with chronic left ventricular failure caused by ischaemic heart disease, cardiac output and right heart pressures were measured before and after the oral angiotensin-converting enzyme inhibitor, captopril, which was administered in increasing doses. In 12 of 15 patients, coronary blood flow, and in 11 patients myocardial oxygen extraction and consumption and lactate extraction were also determined before and after captopril therapy. Cardiac index and stroke volume index increased by an average of 25% and 27%, respectively. Pulmonary capillary wedge pressure also decreased in all patients (average 27%), suggesting improved left ventricular function. The rate-pressure product, coronary blood flow, and myocardial oxygen consumption decreased significantly; in one of 11 patients there was myocardial lactate production, despite decreased myocardial oxygen demand and consumption. These findings suggest that in patients with chronic heart failure, improved left ventricular function with captopril is generally associated with decreased metabolic cost and that deterioration of metabolic function occurs infrequently.

Aged↗
PubMed1982

The role of right ventricular systolic dysfunction and elevated intrapericardial pressure in the genesis of low output in experimental right ventricular infarction.

To elucidate the pathophysiology of severe right ventricular infarction (RVI), isolated RVI was produced in 15 dogs with the pericardium intact or open. After RVI in dogs with the pericardium intact, RV systolic pressure decreased by 27%, aortic pressure by 29% and cardiac output by 34%. RV transmural pressure, RV end-diastolic size and intrapericardial pressure increased, left ventricular transmural pressure and end-diastolic size decreased and the diastolic pressures equalized. Pericardiotomy after RVI resulted in increased ventricular transmural pressures and diastolic size, improved cardiac output and resolution of equalized diastolic pressures. RVI in dogs with the pericardium open resulted in similar changes, but of lesser magnitude and without equalization of diastolic pressures. These results indicate that reduced left ventricular preload due to impaired RV systolic function contributes to low cardiac output in RVI. Elevated intra-pericardial pressure further reduced left ventricular preload and produces equal diastolic pressures.

Animals↗
PubMed1982

The late prognostic value of acute scintigraphic measurement of myocardial infarction size.

Infarct, perfusion and blood pool scintigraphy were performed in 62 patients during hospitalization for acute myocardial infarction. The largest measured infarct or perfusion image defect and left ventricular ejection fraction were related to the late prognosis determined a mean of 16 months after the event. Breakpoint values for all scintigraphic variables could separate those who were asymptomatic on follow-up from those who died. The best indicators for selection of survivors and nonsurvivors were a scintigraphic infarct size greater than or equal to 25 cm2 and a perfusion abnormality greater than or equal to 35% of the projected left ventricular area. Among patients with perfusion abnormalities above this limit, 61% died; 93% of those with small perfusion abnormalities survived. Scintigraphic measurements of relative myocardial perfusion and function best separated patients asymptomatic on follow-up from those who developed heart failure and also best identified those with an unfavorable evolution, who developed heart failure or died. Early scintigraphic parameters appeared more accurate than other clinical laboratory indicators for determining late prognosis and could be important in planning treatment after acute infarction.

Aged↗
PubMed1982

Hemodynamic benefit of atrial pacing in right ventricular myocardial infarction.

Right ventricular and inferior-posterior myocardial infarctions in four patients were complicated by low-output syndrome unresponsive to increasing intravascular volume. Ventricular pacing was started because of bradyarrhythmias, but failed to increase cardiac output; atrial pacing at identical rates resulted in dramatic increases in cardiac output. The importance of atrial contribution to ventricular function, as well as the role of the pericardium in this clinical setting, are discussed. In treating right ventricular myocardial infarction, atrial or atrioventricular sequential cardiac pacing may be preferable to ventricular pacing.

Aged↗
PubMed1982

Effects of high dose application of lindane to rats and influence of L-ascorbic acid supplementation.

Oral application of lindane at a dose of 2 mg/100 g body weight of rat/day for 15 days produced alterations in the activities of several enzymes viz, glutamate oxaloacetate transaminase, alkaline phosphatase, acetylcholinesterase and inorganic pyrophosphatase in different organs and serum. Histological changes in liver and kidney tissues and changes in whole liver and liver plasma membrane lipids were also noted by chronic administration of lindane. Partial alleviation of the toxic symptoms with respect to some of these parameters were noted by high dose administration of L-ascorbic acid.

Acetylcholinesterase↗
PubMed1981

Hemodynamic effects of prazosin in chronic heart failure.

Three series of investigations were carried out with prazosin (PZN) hydrochloride. In the first, hemodynamic effects of PZN were compared with those of hydralazine (HDZ) in 11 patients with chronic congestive heart failure (CHF). In doses up to 5 mg, PZN increased cardiac output (CO) 20% accompanied by a 20% decrease in pulmonary capillary wedge pressure (LVFP). HDZ increased CO by 50% with little or no effect on LVFP. An additional 12 patients were given multiple 5 mg doses of PZN at 6-hour intervals with measurements of hemodynamic and plasma blood levels. Results suggested an attenuation of the effects of PZN on increasing CO but not on decreasing LVFP. This attenuation of CO was not due to inadequate plasma levels. Acute exercise studies (supine bicycle) were performed in 10 patients with severe CHF before and after the administration of several doses of PZN. There appeared to be a greater effect of PZN during exercise than at rest, with a beneficial increase in CO and reduction in LVFP. These data suggest that, despite hemodynamic attenuation of its effects on CO at rest, PZN may still be beneficial to active patients with CHF. In vitro studies with various vasodilators were performed to evaluate potential intropic effects. Isometric force (cat papillary muscle) increased 2% with 10-4M and 31% with 10-3M HDZ. PZN increased force 4% at 10-6M and 18% at 10-4M. Captopril did not increase force development at any dose level. The doses of HDZ and PZN that increased force development were higher than usual clinical doses.

Adult↗
PubMed1981

Dobutamine in chronic ischemic heart failure: alterations in left ventricular function and coronary hemodynamics.

Changes in cardiac performance and coronary hemodynamics were evaluated during dobutamine infusion in patients with chronic heart failure associated with ischemic heart disease. At the maximal administered dose (10 micrograms/kg per min) cardiac index increased by 54 percent and stroke work index by 65 percent, indicating improved left ventricular function. Coronary sinus flow and myocardial oxygen consumption increased concomitantly, but myocardial lactate production occurred in only one of eight patients. These findings suggest that improved left ventricular function with dobutamine is associated with increased myocardial oxygen consumption; however, overt myocardial ischemia occurs infrequently.

Aged↗
PubMed1981

Influence of oral prazosin therapy on exercise hemodynamics in patients with severe chronic heart failure.

In 10 patients with severe chronic congestive heart failure, changes in hemodynamic and cardiac performance at rest and during exercise were evaluated following short-term oral prazosin therapy. The median total dose of prazosin was 43 mg (range 23 to 95 mg) and the median duration of therapy was 47 hours (range 18 to 92 hours). Prazosin increased cardiac output and stroke volume significantly during exercise (both p less than 0.05) but not at rest (both p greater than 0.10). The magnitude of the increase in pulmonary capillary wedge pressure during exercise with the addition of prazosin was also significantly less than that during conventional therapy, suggesting improved cardiac performance during exercise. Peak oxygen consumption, peak lactate concentration and rate of disappearance of the increased concentration of lactate induced by exercise, however, remained unchanged following prazosin therapy. These findings suggest that short-term prazosin therapy, as other vasodilators, improves cardiac performance during exercise but may not necessarily influence oxygen consumption.

Administration, Oral↗