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Biomedical subjects

K Wink

Publications and source records attributed to K Wink.

At least 37 records · Page 2Linked to original sources
PubMed1980

[Long term comparison between atenolol and a depot form of propranolol hydrochloride on the heart rate and blood pressure at rest and during physical work in normal subjects].

Atenolol 100 mg and propranolol retard 160 mg were compared by a cross-over trial in 20 male volunteers with respect to their long action on heart rate and blood pressure at rest as well as during ergometric load tests. Both beta-receptor blocking agents showed the following effects 24 h after treatment: 1. The maximal capacity for ergometric load was significantly reduced by atenolol as well as by propranolol retard in comparison to the control. 2. The heart rate was also significantly reduced by both beta-blocking agents after 24 h. 3. The systolic blood pressure during ergometric load as well as the diastolic blood pressure at rest showed significantly lower values 24 h after treatment with both agents.

Adult↗
PubMed1979

[Clinical and hemodynamic studies before and after mitral valve replacement (author's transl)].

Clinical and hemodynamic studies were carried out before and after replacement of stenotic mitral valves in 17 patients, 10 of whom received Björk-Shiley (low profile mechanical) prostheses and 7 who received (porcine heterograft) bioprostheses. Mitral valve replacement led to amelioration of symptoms, improvement of phonocardiographic findings and, partially, to a lowering of pressure in the pulmonary circulation, augmentation of cardiac output, lessening of the pulmonary arteriolar and mitral valvular resistances as well as incrementation of mitral valve orifice area. Preexistent ECG changes, radiologic heart size, right ventricular filling pressure and stroke volume remained unaltered. In consideration of variables such as prosthetic size, severity of the disease and post-operative follow-up periods, the results obtained with both types of prostheses were comparable. The prostheses, however, inherently are responsible for a moderate degree of mitral stenosis which compromises exercise capacity and generally does not lead to normalization of pressure in the pulmonary circulation. Irreversible myocardial damage appears responsible for the fact that electrocardiographic abnormalities, the heart size, the right ventricular filling pressure and stroke volume remain unaltered postoperatively. Thus, patients who have undergone mitral valve replacement continue to require limitation of physical activities, a tailored medical regimen and close cardiologic follow-up.

Adult↗
PubMed1978

[Myocardial infarction "with angiographically normal coronary arteries (author's transl)].

Within a cohort of 121 patients with clinical picture and electrocardiographic pattern of myocardial infarction four cases (3%) had normal coronary arteried demonstrated by selective coronary angiography. Two patients revealed no risk factors, two patients were heavy cigarette smokers. Mean age of patients was 34 years. Exact analysis of clinical, hemodynamic and angiographis data confirmed assumption of regional myoaggressive myocarditis as the underlying disease in one patient and suggested regional myocarditis with high probability in another case. The two other patients however could not be classified as having coronary or primary myocardial disease. The investigation suggests that some cases with the clinical and electrocardiographic pattern of "myocardial infarction" with normal coronary arteries may be due to regional myoagressive myocarditis.

Adult↗
PubMed1977

[Heart size and left ventricular function in coronary artery disease: I. Heart size, exercise tolerance, cardiac output and filling pressures (author's transl)].

The possible relationship between the cardiac volume, as determined radiologically in the supine position in 119 patients with angiographically proven coronary artery disease, and the results of ergometry and balloon catheterization was investigated. There was no relationship between the heart size on the one side and the maximum exercise tolerance and the maximum cardiac output on the other, except for the fact, that these parameters tended to decrease with increasing heart size. This was especially true in patients with angina. The maximum cardiac output of patients with angina was always below the value of patients without angina but comparable heart size. Reduced cardiac output under exercise (exertional cardiac insufficiency) was present in 50% of patients with enlarged hearts but already in 22% of patients with heart volumes in the lower range of normal. The diastolic pulmonary artery pressure, determined under exercise, was the only parameter with a significant relationship to the heart size: The larger the heart size, the higher the diastolic pulmonary artery pressure. On the other hand: the diastolic pulmonary artery pressure at rest was abnormal with significant frequency only, when the heart was enlarged. Our data suggest, that the hemodynamics are determined by 2 factors: Myocardial scarring secondary to infarction and coronary insufficiency (ischemia). Of these two factors only the former influences cardiac size. Therefore, determination of the heart volume helps evaluating the respective role of these two factors in individual cases.

Adult↗
PubMed1977

[Heart size and left ventricular function in coronary artery disease. II. Heart volume, coronary morphology and laevocardiogram (author's transl)].

We have investigated the possible relationship between the radiogically determined cardiac volume and the coronary angiogram and laevocardiogram. There was no relationship between cardiac size and coronary angiogram. Independently from the number of coronary vessels involved, we found normal sized hearts in patients without ECG-evidence of myocardial infarction, and enlarged hearts in patients with ECG-evidence of myocardial infarction. There was a significant, though loose relationship between the cardiac volume and the endsystolic and enddiastolic volumes (r=0.73 and 0.55 respectively) and the ejection fraction (r=0.69) as determined by laevocardiography. The critical value of the cardiac size, about which one encounters an increased number of abnormal volume parameters, was the upper boundary of 1-SD. Using this value we found a specifity of 81% and a sensitivity of 74% for the heart volume as a predictor of a pathological ejection fraction. On the other hand, using the upper boundary of 2-SD as a critical value, there was a sensitivity of only 58%, but a specificity of 92%. Only 11% of the patients with a cardiac size in the lower range of normal or below had an ejection fraction below 50%. Therefore the radiologically determined heart size is a simple, in daily practive acceptable method to assess and follow up left ventricular function in coronary patients.

Adult↗
PubMed1977

[The importance of heterologous implants in cardiovascular surgery (author's transl)].

The importance of heterologous transplants in the substitution of heart valves in cardiac surgery and the substitution or bypassing of displaced arteries of the thigh in vascular surgery is discussed with reference to some results and developmental considerations. In addition to the alloplastic valve material, heterologous bioprosthesis from glutaraldehyde-fixed pig's valves has proved useful to an increasing extent for the substitution of diseased and functionally impaired heart valves. The results of followup examinations show equally favorable results in comparison with the alloplastic prosthesis. In vascular surgery, the calf collagen prosthesis has proved a real alternative to the alloplastic Dacron prosthesis at the level of the thigh.

Animals↗
PubMed1976

[Substitution of the aortic value in florid bacterial endocarditis and severe aortic valvular insufficiency (author's transl)].

Urgent operation for replacement of the aortic valve for the correction of a severe, increasing hemodynamic impairment of the output of the heart and for the removal of the septic focus in florid bacterial aortic endocarditis must be carefully thought over. 3 of our own 7 patients died. The indication is to be made largely on hemodynamic grounds when the clinical symptoms are quite clear without preoperative catheter diagnosis. Preliminary specific treatment with antibiotics and intensive follow-up treatment is necessary. Preoperative identification of bacteria in the blood, just like identification of bacteria on the excised valve, is only possible in some of the cases.

Acute Disease↗
PubMed1976

[Clinical and hemodynamic aspects of myocardial diseases (author's transl)].

Definition, arrangement into primary and secondary forms and classification of myocardial diseases are used irregularly in the literature. The great variety of clinical and hemodynamic parameters are shown with reference to our own patients and an attempt is made to arrange them in individual types. Followup examinations show that signs of congestive failure, heart size and other clinical and hemodynamic parameters may be considerably altered. For this reason it is proposed to describe myocardial diseases accoridng to clinical and hemodynamic parameters in order to obtain a closer insight into the pathomechanism of these diseases.

Cardiomegaly↗