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Biomedical subjects

K I Saunamäki

Publications and source records attributed to K I Saunamäki.

At least 19 recordsLinked to original sources
PubMed1996

[Angiopeptin versus placebo for reductin of restenosis after PTCA treatment. A randomized, double-blind study].

Angiopeptin, a somatostatin analogue, inhibits intimal hyperplasia after (percutaneous transluminal coronary angioplasty) (PTCA) in several animal models. This pilot study sought to determine the effect of subcutaneous infusion of angiopeptin on clinical events and restenosis in patients undergoing successful PTCA. One hundred and twelve patients were randomized to receive continuous subcutaneous angiopeptin (750 micrograms/day) or placebo infusion from the day before PTCA and for the following four days in a double-blind study. Eighty patients had a successful PTCA, and 75 of these patients with 94 lesions underwent angiography 6 +/- 2 months after PTCA. All 112 patients underwent clinical follow-up at 12 months. The 12-month event rate (death, myocardial infarction, coronary artery bypass grafting and re-PTCA) was reduced from 34% to 25% (p = 0.30) by angiopeptin by intention to treat analysis. Restenosis (> or = 50% diameter stenosis) was significantly reduced in lesions treated with angiopeptin (12% vs 40%; p = 0.003). Late lumen loss was also significantly reduced after angiopeptin treatment (0.12 +/- 0.46 mm vs 0.52 +/- 0.64 mm; p = 0.003). In conclusion, continuous subcutaneous angiopeptin infusion for five days tended to decrease clinical events and restenosis after PTCA.

Adolescent↗
PubMed1994

[The effect of thrombolytic therapy on the outcome of early exercise test in patients with acute myocardial infarction].

UNLABELLED: Exercise test variables, such as an impaired heart rate response, are known to be related to left ventricular function and patient prognosis following acute myocardial infarction. The present study was performed to compare exercise test variables in acute myocardial infarct patients following either intravenous thrombolysis or placebo. Symptom-limited bicycle ergometer tests, carried out one to two weeks from the infarction, were performed in 85 patients randomized to intravenous streptokinase (n = 41) or placebo (n = 44) given within 12 hours from onset of symptoms. Resting heart rate, systolic blood pressure and rate-pressure product were similar in the two groups. At maximum workload the streptokinase treated patients had a significantly higher median maximal heart rate than controls (136 vs. 126 min-1; p < 0.01) but only a trend towards higher systolic blood pressure was seen (175 vs. 163 mmHg; p = 0.09). Rate-pressure product at maximal exercise was 23.620 vs. 20.100 mmHg x min-1; p < 0.01). A significantly smaller number of patients in the streptokinase group had exercise capacity below 50 W (0% vs. 15.9%; p < 0.01). IN CONCLUSION: patients treated with intravenous streptokinase for acute myocardial infarction reach both higher heart rates and rate-pressure products at maximum workload than their controls thus indicating that the beneficial effects of thrombolysis after acute myocardial infarction are reflected in an improved heart rate response during exercise.

Aspirin↗
PubMed1994

Myocardial blood flow rate and capillary permeability for 99mTc-DTPA in patients with angiographically normal coronary arteries. Evaluation of the single-injection, residue detection method with intracoronary indicator bolus injection and the use of a mobile gamma camera.

The aims of the present study were to quantitate myocardial perfusion and capillary permeability in the human heart by means of the single-injection, residue detection method using a mobile gamma camera. With this method, the intravascular mean transit time and the capillary extraction fraction (E) can be determined in one experiment and in the same myocardial region. Eighteen patients with a history of chest pain episodes and angiographically normal coronary arteries were studied after intracoronary bolus injections of 99mTc-DTPA during elective coronary angiography. Two measurements were performed at a 15-min interval during resting conditions, and a third measurement was made during atrial pacing. Regions of interest were drawn in the left anterior descending (LAD) and the circumflex (CX) coronary artery perfusion beds. Sources of variation in plasma flow rate (fpl), E, and the calculated capillary permeability area product (PS) were determined. Spontaneous 15 min variations (mean of two values) for the LAD and the CX territory, respectively, gave a mean fpl(LAD) of 74.2 (measurement 1) and 77.8 ml.(100 g.min)-1 (measurement 2) (SD of the difference 7.5 ml.(100 g.min)-1) and fpl(CX) of 82.7 and 92.1 ml. (100 g.min)-1, respectively (SD of the difference 16.1 ml.(100 g.min)-1), and E(LAD) was 51.0 and 55.7%, respectively (SD of the difference 8.4%), and E(CX) was 52.9 and 50.4%, respectively (SD of the difference 5.9%). During atrial pacing, the rate-pressure product increased by 97%, and in the LAD area fpl increased by 46% (p < 0.05), E decreased by 6% (NS), and PS increased by 39% (NS), whereas in the CX region flow increased by only 9% (p < 0.01), E decreased by 15% (p < 0.05), and PS decreased by 15% (NS) compared with baseline values. Both the spontaneous variation and the observer variation are low. The reduced vasodilator response in the CX region in combination with the decrease in E, which reduce the supply of nutrients, may play a role in the symptoms of these patients.

Adult↗
PubMed1992

Effect of thrombolytic therapy on exercise response during early recovery from acute myocardial infarction: a placebo controlled study.

Several studies have shown that infarct size is reduced following thrombolytic treatment in patients with acute myocardial infarction. Exercise test variables, such as an impaired heart rate response during exercise, are known to be related to left ventricular function and patient prognosis following acute myocardial infarction. The present study was performed to compare exercise test variables in acute myocardial infarction patients following either intravenous thrombolysis or placebo. Symptom-limited bicycle ergometer tests, carried out 1-2 weeks from the infarction, were performed in 85 patients randomized to intravenous streptokinase (N = 41) or placebo (N = 44) given within 12 h from onset of symptoms. At rest heart rate, systolic blood pressure and rate-pressure product were similar in the two groups. At maximum workload the streptokinase treated patients had a higher median maximal heart rate than controls (136 vs. 126 b.min-1, P less than 0.01) but only a trend towards higher systolic blood pressure was seen (175 vs. 163 mmHg, P = 0.09). Rate-pressure product at maximal exercise was 23,620 vs. 20,100 mmHg.b.min-1 respectively, (P less than 0.01). Total exercise time, ST-segment deviation, occurrence of angina pectoris and left ventricular ejection fraction were similar in the two groups. The trend towards an increased heart rate at maximum workload in streptokinase-treated patients was seen at all levels of left ventricular ejection fraction, and at all levels of exercise capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1988

Early post-myocardial infarction exercise testing. Exercise response and clinical value.

Based on 7 previously published original papers the present review evaluates the response to an exercise test during early recovery from acute myocardial infarction. Selected exercise variables are related to the long-term survival of the patients. The conclusions can be summarized as the following: The exercise test can be carried out with sufficient safety. The exercise physiological response of the patients is dependent on their age, sex and reason to discontinue exercise. ST-segment depression is not significantly predictive of subsequent mortality. Other categories of the ST-segment response are of limited value as prognostic predictors. An exercise index of left ventricular function and exercise associated ventricular arrhythmias are independent, significant predictors of the long-term survival of the patients, regardless their age. These variables can identify a substantial number of patients with a very low subsequent death rate, irrespective of a clinical risk stratification. Different degrees of increased risk of dying can be determined by combining exercise and clinical variables. The prognostic significance of exercise induced ventricular arrhythmias is related to their frequency and the occurrence of repetitive ventricular premature beats.

Adult↗
PubMed1985

Post-myocardial infarction exercise testing: clinical significance of a left ventricular function index and ventricular arrhythmias. A prospective study.

A predischarge exercise test was performed in a prospective series of 187 patients, less than 70 years old, with acute myocardial infarction. A survival analysis confirmed previous retrospective findings of a significantly increased long-term mortality in patients with a low increase in the pressure-rate-product (PRP) and/or with major exercise-induced arrhythmias. ST segment depression was without prognostic significance. By a graduated, quantitative re-evaluation of the significance of exercise-induced ventricular arrhythmias, an appropriate, significantly discriminating cutoff point for the frequency of solitary ventricular premature beats (VPBs) was found at two or more VPBs/min. Repetitive VPBs had an equal significance. The probability of 4.5-year survival in patients with these arrhythmias and a low increase in PRP was 0.49 vs. 0.85 in patients with less frequent arrhythmias and with a high increase in PRP (p less than 10(-6)).

Aged↗
PubMed1985

Purulent pericarditis in children. Review and case report.

Acute purulent pericarditis is infrequent in children. Only around 200 cases have been reported in the western literature in the past 25 years (1-10). From the Scandinavian countries only two cases have been described (6, 7). Purulent pericarditis is usually a complication of upper respiratory tract infection. Mortality is very high in unrecognized or inadequately treated cases. Early diagnosis and appropriate treatment with adequate surgical drainage and antimicrobial therapy are vitally important for the outcome.

Child, Preschool↗
PubMed1984

Early post-myocardial infarction exercise testing in subjects 70 years or more of age. Functional and prognostic evaluation.

A subjective maximal exercise test was performed in 62 patients, 70 years of age or more, in the third week after an acute myocardial infarction. Forty-two percent of the surviving AMI population in this age group could be tested. The estimated aerobic work capacity of the patients was on the average about 3 mets. Their maximal heart rate was about 70-80% below the normal age predicted maximum. A low increase of the pressure-rate product from rest to maximal exercise and occurrence of major exercise associated ventricular arrhythmias identified a high-risk group of 32 patients with probability of 4.5 year survival of 0.250 vs 0.767 in the remaining patients (P less than 10(-5)).

Aged↗
PubMed1983

Prognostic significance of the ST-segment response during exercise test shortly after acute myocardial infarction. Comparison with other exercise variables.

An exercise test was made in 317 patients in the third week after acute myocardial infarction. The following types of exercise associated ST-segment responses were registered in patients less than 70-years-old. I: no ST-deviation (33.6%), II: ST-depression (42.9%), III: ST-elevation (13.4%) and IV: inconclusive ST-response (10.1%). The 5-year mortality was significantly lower in group III than in groups II and IV. Group IV had a significantly higher 5-year mortality than all the other groups. Patients with ST-depression had an increased late mortality compared to that of the patients without ST-deviation, but the total mortality did not differ between these two groups. A highly increased risk of dying was found in groups I, II and IV in patients with exercise associated major ventricular arrhythmias and/or with a small increase of the pressure-rate-product (PRP) during exercise. Patients without arrhythmias and with a high increase of the PRP had a low mortality rate irrespective of their ST-response. In the older patients (70-years-old or more) the ST-response was of no prognostic value at all. The ST-segment response was thus generally of limited value in the prognostic management of the present patients. Their survival was mainly determined by the other exercise variables-the magnitude of an exercise index of left ventricular function and the occurrence of ventricular arrhythmias.

Adult↗
PubMed1983

The role of exercise testing soon after acute myocardial infarction.

Exercise testing is a readily available form of evaluation following acute myocardial infarction, especially in the early stages of recovery. Care is necessary to exclude bad-risk patients, but 70% of patients can be included. Either a treadmill or bicycle ergometer can be used. The important prognostic variables are left ventricular function indexes, and ventricular arrhythmias.

Arrhythmias, Cardiac↗
PubMed1982

Early exercise test vs. clinical parameters in the long-term prognostic management after myocardial infarction.

An early exercise test was performed in 317 patients with acute myocardial infarction (AMI). The long-term prognosis was assessed after an average follow-up of 5.7 years. The patients with a small increase in the pressure rate product from rest to maximal exercise and/or wih major ventricular arrhythmias constituted a general prognostic high-risk group. The survival was analyzed further applying the above mentioned exercise parameters in the following clinical subgroups: I) patients with clinical heart failure during hospitalization and/or previous myocardial infarction, II) patients with anterior AMI, III) patients with inferior or indefinite AMI. Within each clinical group there was a highly significant difference in survival between the exercise-determined high-risk and low-risk patients. The exercise parameters were more sensitive and more specific prognostic determinators than the clinical variables. The most striking difference was found in patients with clinical heart failure and/or previous infarction. In this group the exercise-determined high-risk patients had a probability of 5-year survival of 0.238 vs. 0.909 in the corresponding low-risk patients (p less than 0.0005).

Age Factors↗
PubMed1981

Early exercise test in the assessment of long-term prognosis after acute myocardial infarction.

Subjective maximal exercise test was performed in 317 patients in the third week after an acute myocardial infarction (AMI); 78% of the total AMI population could be tested. The long-term survival was assessed on the basis of data from the exercise test. The average follow-up time was 5.7 years. Mortality increased significantly among patients with major ventricular arrhythmias and among those with a small increase in the pressure rate product (dPRP) from rest to maximal exercise. Patients with arrhythmias and those with a low dPRP constituted a high-risk group of 165 patients (52%). The probability of 5-year survival was 0.551 in this group vs. 0.783 in the others (p less than 0.001). The death rate was higher in the high-risk group than in the other patients throughout the whole observation period.

Aged↗