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Biomedical subjects

K H Günther

Publications and source records attributed to K H Günther.

At least 19 recordsLinked to original sources
PubMed1991

Isoenzyme (lactate dehydrogenase, aspartate aminotransferase) and dipeptidyl peptidase IV activity changes in blood plasma likely indicative of organ involvement due to arterial hypertension.

The plasma activities of LDH and ASAT isoenzymes as well as of DP IV were studied in patients with essential hypertension and related to blood pressure, haemodynamic indicators of latent heart failure and to ischaemic heart risk indicators. Patients with elevated systolic or diastolic blood pressure showed significantly increased activities of ASAT m. In hypertensives with elevated pulmonary artery pressure markedly increased activities of ASAT, ASAT m, LDH M and DP IV could be observed. Distinctly increased activities of ASAT, ASAT m, LDH M and DP IV were also found in patients with elevated plasma cholesterol. The results obtained suggest that changes of LDH and ASAT isoenzymes as well as of DP IV indirectly reflecting alterations in organ metabolism might provide useful additional information with respect to uncovering hypertension-linked complications.

Adult↗
PubMed1990

[Semi-invasive measurement of pulmonary pressure as a method of evaluating cardiac function in hypertension and ischemic heart disease. Experience at Charité Hospital for more than 20 years].

Since 1969, microcatheterization (floating catheterization) of the pulmonary artery has systematically been used at the Hospital Charité in Berlin for measuring (indirectly) the left ventricular filling pressure. That seemed especially be justified in patients in whom conventional catheterization was not needed. Noninvasive techniques had not been available. Since then, our interest was focused on the hypertensive heart, earlier under the aspect of early discovering and influencing heart insufficiency, later concerning a developing myocardial ischemia, in relationship to left ventricular hypertrophy. At the Charité more than 1,000 microcatheterizations in more than 400 hypertensive cases have been performed, mostly in combination with nuclear-cardiological measurements. The rate of complications was found minimal. Thus, cardiac function could be characterized hemodynamically, at rest and even under ergometric load. Special programmes served the acute application of drugs for diagnostic or therapeutic reasons. In the meantime a longterm study could also be finished by using hemodynamic measurements, starting with hygienic means and followed by a antihypertensive basis therapy, in newly detected hypertensives. That included repeated catheterizations of the pulmonary artery.

Catheterization, Peripheral↗
PubMed1989

[Use of nitrates in hypertension. Cardiac and peripheral effects before and during antihypertensive therapy at rest and during stress].

The acute effects of 1.6 mg glycerol trinitrate (2 x 0.8 mg) on the hemodynamic function were compared in 11 healthy subjects and 25 hypertensive patients (WHO stages I and II), at rest and during exercise. The nitrate testing was performed before the beginning of antihypertensive treatment, during nonmedical therapy, as well as under additional oral therapy with diisopropylamin. Right-heart-catheterization, echocardiography, radionuclide-ventriculography and venous occlusion plethysmography were performed. Nitroglycerin consistently led to a reduction of blood pressure in the systemic and pulmonary circulation both at rest and during exercise. There was a small decrease of peripheral arterial resistance (TPR) at rest and a more pronounced decrease of pulmonary arteriolar resistance (PAR) at rest and during exercise. The documented effects may be important with regard to combined antihypertensive treatment. In addition, the application of nitrates in hypertensive crises may be useful.

Administration, Sublingual↗
PubMed1989

[Differential therapy of myocardial ischemia in females].

Peripheral perfusion abnormalities are considered a possible reason for myocardial ischemia in the absence of visible coronary artery stenoses. In 85 women (age: 41-58 years, mean age: 46 +/- 8) with pathological exercise ECG (precordial mapping: 50 leads), hemodynamic studies were performed without medication, after sublingual nitroglycerin (NTG, 0.8 mg), sublingual Nifedipin (N, 30 mg), and intravenous Dipyridamol (D, 0.5 mg/kg). Eighteen women showed normal coronary arteries and a normal myocardial perfusion (group I), 21 an impaired perfusion due to coronary stenoses (Group II), and 46 women a reduced perfusion without visible changes (Group III). Reference methods were measurement of pulmonary artery pressure, 201-TI-scintigraphy, and coronary angiography. In group II, enddiastolic and endsystolic left ventricular volume (EDV, ESV) as well as enddiastolic pulmonary artery pressure (pAd) were increased, the ejection fraction (EF) was reduced, and cardiac output (CO) was normal. In group III, ESV, EDV, EF, and CO were significantly reduced, while pAd increased. In group II, N led to a normalization of ESV, EDV, EF, and pAd. In group III, NTG led to a reduction of pAd and EDV, and concomitantly to a further reduction of the already low CO. In both groups the reduction of ST-segment depressions after NTG was significant. N led to a moderate reduction of pAd and ST-segment depression, but to an increase of CO in both groups. D exhibited a comparable effect in group III. In group II an increase of ST-segment changes and of pAd with unchanged CO was observed. With regard to longterm treatment of women in group III, N and D seemed to be more efficacious than nitrates due to a beneficial effect on cardiac output.

Administration, Sublingual↗
PubMed1989

[General, non-medicamentous treatment of arterial hypertension].

This review focuses on the following aspects of nonpharmacological management concerning elevation of blood pressure: historical development, highlights and theses, possibilities of intervention, as well as favorable observations, advantages (in early diagnosis), disadvantages, fields of application, and integration of this form of treatment into a comprehensive strategy of hypertension control at a population level. A selection of detailed results is elaborated including: possible failure in primary classification of elevated blood pressure and its consequences, the reducibility of the hypertension problem if nonpharmacological measures are generally used, risk factor prevalences in medical and non-medical university cadres, blood pressure reduction in a spa, and hemodynamic changes induced by nonpharmacological or combined antihypertensive treatment simultaneously with drugs. Finally, reference is made to international results, as well as to the importance of the relation between diagnosing and treating blood pressure elevation concomitantly with a simultaneous management of other main risk factors that must be influenced in order to reduce the cardiac risk in hypertensives.

Adult↗
PubMed1988

Diagnosis of silent myocardial ischemia in women.

The diagnosis of silent ischaemic heart disease may be important in men as well as in women. However, diagnosing women by exercise ECG is limited due to the higher rate of false positive results. For improving diagnostic validity the following investigations were done. In 310 women, aged 41-63 years (mean age 47 years', revealing 'pathological' exercise ECG, further testing was performed using nitroglycerin (NTG 0.8 mg). As a reference method, pulmonary artery (PA) pressure measurement was used. As a result of NTG testing, two groups could be separated: (a) those in whom ST segment depression remained constant (N = 217, NTG negatives = 70%). Since the end-diastolic PA pressure was found normal, these results were interpreted to be false-positive. (b) NTG effected a reduction or normalization of exercise induced ST segment changes (N = 93, NTG positives = 30%). There was a correspondence with exercise inducible end-diastolic PA pressure decrease. Consequently, true positives were assumed. Analysis of angina pectoris history indicated typical chest pain in 2% of NTG negatives only, but in 16% of NTG positives. In agreement with this during exercise, angina was reported by NTG negatives in 3% of cases and by NTG positive in 17%. The rest of this group (83%) is considered having exercise induceable silent myocardial ischaemia. When checking-up after five years, exercised-induced angina could be found in 4% of NTG negatives again, but in 36% of NTG positives. It was concluded that exercise testing by additionally using nitroglycerin is a rather important approach for diagnosing myocardial ischaemia in women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Haemodynamic and humoral reaction in arterial hypertension during acute blood pressure lowering induced by nitroglycerin.

The aim of the study was to test whether there are typical changes in haemodynamics and humoral regulation in untreated hypertensives compared to normotensives with acute lowering of blood pressure (and venous return) induced by nitroglycerin (NTG). 23 hypertensives were investigated by radiocardiography and microcatheterization of the pulmonary artery as well as by means of humoral analyses in comparison to 10 normotensives. After performing the studies at rest and during exercise, 0.8 mg NTG was given and the investigations were repeated. There were only insignificant differences in cardiac output and left ventricular filling pressure (PAEDP) at rest and during exercise between both groups. The pressure reductions due to NTG were also similar. Plasma renin activity and plasma kallikrein did not differ in hypertensives and normotensives either at rest and during exercise or after NTG. The prostaglandins (PgE, PgF2-alpha, PgI) were extremely variable. In hypertensives, only PgI was decreased, with increase after NTG, at rest. Thus, PgI is the only humoral indicator participating in blood pressure lowering induced by NTG.

Adult↗
PubMed1979

[A-wave in calibrated apex cardiogram in hypertension. Studies during rest and after exertion].

Apexcardiographic examinations were carried out of 86 hypertensive patients without clinically manifest heart failure. The amplitude of the wave a (or the per cent fraction of the wave a of the total amplitude) and the maximal rate of wave rise, df/dta were statistically significantly higher in the hypertensive patients than in normal subjects. The findings are interpreted as a manifestation of an increased left ventricular rigidity and of an increased atrial contractility in hypertensive patients. No correlation was found between the apexcardiographic indicators checked and the indicators of the cardiac pump function. In 46 hypertensive patients, in addition, a dynamic exercise test was performed (50 W for 6 min); 1 minute after cessation of exercise an apexcardiogram was recorded. An increase in the a/T quotient (greater than or equal to 5%) was found in 20; a decrease (=5%), in 10; and no change (less than +/- 5%), in 16 hypertensive patients. The postexercise apexcardiographic changes had no correlations with haemodynamic changes occurring during exercise.

Adolescent↗
PubMed1978

[Reproducibility of the answers of various groups of cardiovascular patients in a standardized questionnaire, differentiated by age and gender].

For the purpose of the valuation of a questionnaire developed by us for the anamnestic recognition of angiocardiopathies, which consists of 63 questions, a repeated interrogation was performed with 220 patients of different age and sex during 14 days. The average reproducibility of the yes/no-decisions was good and varied only slightly in the 8 groups of diseases (86.3--99.4%). The average degree of reproducibility referred to the sexes is nearly the same (94.7% and 95.5%, respectively). Referred to the age groups the highest reproducibility was established in the patients older than 60 years (95.7%) and the lowest in patients between 50 and 60 years (93.3%).

Aged↗
PubMed1977

[Heart function studies under stress in hypertonic patients with and without ischemic heart disease].

Recently in patients with hypertension in one third of the cases by haemodynamic investigations in rest a latent heart insufficiency could be proved. It was the aim of the at present performed examinations to test, whether or in which degree the proportion of latent heart insufficiency increases in patients with hypertension affected. In 30 patients with essential hypertension a complex haemodynamic examination program consisting of catheterisation of the right heart, radiocardiography and ergometry was carried out. It could be demonstrated that complex examinations of such a kind are possible also under physical stress and may be used in the judgment of the cardiac function in patients with hypertension.

Coronary Disease↗
PubMed1975

[Qualification of anamnestic data for cardiovascular screening].

The projecting of an anamnestic questionnaire concerning angiocardiopathies for purposes of screening for the 8 most important groups of angiocardiopathies was performed in two simultaneous stages--model experiments and population experiment. In the model stage, which is the topic of this paper, apart from investigations of reproducibility and controls of voluntary falsifications of answers above all an examination concerning the significance of the data was carried out. The methods used for this--analysis of the complaints of typical groups of patients (analysis of discriminancy) and analysis of experiences of recognized experts of angiocardiopathies (scale graduation of symptoms)--were discussed and first results described.

Cardiovascular Diseases↗
PubMed1975

[Anamnesis as a screening method for cardiovascular diseases].

In general the anamnesis meets all requirements which are put to a screening method; however, special problems arise when the anamnesis is made by means of a questionnaire. The team which gives the report had projected a questionnaire for 8 cardiovascular groups of diagnosis (ischaemic heart disease, hypertension, functional, inflammatory and pulmonary heart disease, disturbances of the peripheral arterial blood supply, cerebrovascular insufficiency and venous diseases). This questionnaire was reduced and qualified and tested on test persons of a Berlin enterprise. A final judgment concerning the use of the anamnesis as screening method cannot be given at present. However, it limns oneself already that it is possible with its help to establish many endangered persons and patients and to subject them to the primary and secondary prevention.

Cardiovascular Diseases↗