Biomedical subjects

K Sühler

Publications and source records attributed to K Sühler.

5 recordsLinked to original sources

PubMed1993

[Lipid metabolism--effect of cardiac agents and ACE inhibitors. Effects of anti-arrhythmia agents, ACE inhibitors, positive inotropic substance and anti-angina agents].

AIM: Cardio-active substances and ACE-Inhibitors are often employed in patients with metabolic disturbances. The question as to whether they have any effect on the lipid levels therefore needs to be answered. MAJOR POINTS STUDIED: The effects of antiarrhythmics, ACE-inhibitors, positively inotropic substances and antianginal substances on lipid metabolism are discussed on the basis of a search through the literature. The wealth of data permit the conclusion that many of the drugs in these substance groups are neutral in terms of metabolism. There are, however, also individual substances that lead to an elevation of lipid levels. Via an improvement in glucose tolerance, ACE-inhibitors can contribute to a lowering of triglyceride concentrations and an increase in the HDL cholesterol levels. For a number of substance groups, the data available still do not suffice to permit a definitive conclusion to be drawn. CONCLUSION: In the case of treatment with the above-mentioned substance groups, effects on lipid metabolism should be checked wherever this is in doubt. This applies, of course, in particular to patients already suffering from hyperlipoproteinemia.

Angina Pectoris↗

PubMed1993

Increased endothelin plasma concentrations in patients with coronary artery disease or hyperlipoproteinemia without coronary events.

Endothelins are made by endothelial cells, macrophages, and vascular smooth muscle cells, among others, and are the most potent endogenous vasoconstrictors yet discovered, with additional growth-promoting properties. A locally increased endothelin production in coronary artery disease or other atherosclerotic diseases may increase circulating endothelin plasma concentrations before symptoms of disease are manifest. We determined endothelin plasma concentrations (1) in 43 patients suffering from coronary artery disease (CAD); (2) in 43 patients with hyperlipoproteinemia without coronary artery disease (HLP); (3) in 29 healthy control subjects (C), by means of a novel extraction procedure and radioimmunoassay followed by chromatographic separation. Plasma concentrations in HLP and C overlapped, but were still significantly different (29 +/- 10 vs 21 +/- 8 fmol/ml, ANOVA and Duncan's test). Significantly increased plasma concentrations were also found in patients with CAD, with the highest levels in a subgroup of 8 patients presenting with unstable angina (43 +/- 12 vs 53 +/- 15 fmol/ml). There were no statistically significant differences between CAD groups with (n = 28) or without hyperlipoproteinemia (n = 15) (42 +/- 14 vs 41 +/- 16 fmol/ml; n.s.). Likewise there was no relationship between endothelin plasma concentration in any of the patients studied and lipid fractions in serum. Increased endothelin plasma concentrations in HLP patients without evidence of coronary artery disease are thus not related to the hyperlipidemic state per se, but may rather indicate presence of an increased vasoconstrictor tonus, pre-clinical or silent atherosclerotic disease.

Chromatography, Gel↗

PubMed1993

Three-year treatment of familial heterozygous hypercholesterolemia by extracorporeal low-density lipoprotein immunoadsorption with polyclonal apolipoprotein B antibodies.

Familial hypercholesterolemia is a disorder of lipid metabolism associated with a highly increased risk for cardiovascular disease. Since in such patients even combined drug therapy often fails to decrease low-density lipoprotein (LDL) cholesterol levels sufficiently, extracorporeal LDL elimination has been developed. We treated eight adult patients with LDL immunoadsorption using antibodies against apolipoprotein B without additional lipid-lowering drug therapy for 3 years; this procedure was performed at weekly intervals. By one treatment session, LDL cholesterol and lipoprotein(a) levels were decreased by 55%. Under regular treatment, mean LDL cholesterol levels of 165 mg/dL between two consecutive treatment sessions could be reached, compared with 522 +/- 24 mg/dL before any treatment. As high-density lipoprotein (HDL) cholesterol levels increased under regular treatment, the LDL/HDL cholesterol ratio decreased from 13.4 to 3.4. Positive influences on plasma and whole-blood viscosity as well as on erythrocyte aggregation also seem to be beneficial with regard to retarding atherosclerosis. Very-low-density lipoprotein (VLDL) levels were reduced by approximately 50% after treatment, accompanied by a marked increase of lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL) activity. The effects of LDL apheresis on hemostasis, complement activation transport proteins, and hematological parameters were found to be small. In addition, no side effects amounting to any major clinical relevance occurred in any of the patients. After 3 years of LDL apheresis, a decrease in the frequency of anginal chest pain and ST segment depression on exercise testing and a marked reduction of tendon xanthoma size were observed.

Adult↗

PubMed1990

Short- and long-term effects of LDL-apheresis on lipoprotein (a) serum levels.

The effect of two extracorporeal elimination procedures for LDL on lipoprotein (a) concentrations in serum was studied in patients with heterozygous familial hypercholesterolemia. During a single apheresis serum lipoprotein (a) levels fell by 45% and 58%. Over a long-term period with weekly elimination lipoprotein (a) concentrations were lowered significantly by 43% (after 10-50 treatments) and 30% (after 51-99 treatments) compared to pre-treatment values. The rise during the week following apheresis was comparable to the corresponding reincrease of LDL-cholesterol and apolipoprotein B. We conclude that both apheresis techniques are very effective in reducing lipoprotein (a) serum levels.

Adult↗

PubMed1990

[Diabetic radiculopathy].

Four patients (two men and two women, aged between 54 and 75 years), known to have type II diabetes since two to twenty years, had for several months been suffering from segmental pain of thoracoabdominal or lumbosacral distribution. Diabetic radiculopathy was confirmed by paravertebral electromyography. Analgesics having brought insufficient relief, treatment with an insulin infusion pump was commenced. The pains disappeared within 2-14 days. Even when the infusion treatment was no longer used, pains did not recur under an euglycaemic regimen. These results suggest that the transitory use of insulin infusion by pump can be a worthwhile therapeutic alternative in diabetic radiculopathy.

Aged↗