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Biomedical subjects

L Steingo

Publications and source records attributed to L Steingo.

7 recordsLinked to original sources
PubMed1985

Persistent ST-segment elevation in patients with anterior myocardial infarctions. Evaluation by exercise electrocardiography, echocardiography and Holter monitoring.

One hundred and seventy patients who suffered an acute myocardial infarction (MI) were followed up at 3-monthly intervals by a full clinical evaluation, exercise electrocardiography and ambulatory Holter monitoring. Fifty-eight patients (34%) had anterior MIs, and of these 23 (40%) had persistent ST-segment elevation over the infarct zone, reflected by leads presenting with Q-S configuration. Fifteen (65,2%) of the latter demonstrated further ST-segment elevation during exercise. They were further investigated by cross-sectional echocardiography. Left ventricular (LV) dysfunction was diagnosed in 87% of patients with persistent ST-segment elevation, and in 93% of the patients with additional exercise-induced ST-segment elevation. Organized thrombi occurred in 2 patients (8,7%) and 1 experienced a transient ischaemic attack. Ventricular arrhythmias occurred frequently (ventricular ectopy--91,3%, ventricular tachycardia--17,4%, and couplets--47,8%). Death occurred in 3 patients (13,1%) and 1 patient (4,3%) had a second MI over a mean follow-up period of 83,6 months. This study suggests that persistent ST-segment elevation on the resting ECG of patients with anterior MIs is a reliable indicator of LV wall motion abnormalities, and that this correlation further increases if it is associated with exercise-induced ST-segment elevation. Furthermore, the role of echocardiography as a diagnostic tool in evaluating LV function is stressed. The prognosis of patients with post-infarction LV dysfunction is notably poor and may be the result of frequent complex ventricular arrhythmias.

Arrhythmias, Cardiac↗
PubMed1983

Further experience with long-term captopril therapy in severe refractory congestive heart failure.

Fifty patients in severe congestive heart failure (CHF) were treated with captopril (Capoten; Squibb), an oral angiotensin-converting enzyme inhibitor, over a 2-year period (range 3-24 months, mean 8,6 +/- 7,7 months). At entry, all patients were in New York Heart Association (NYHA) functional class IV despite high-dose diuretic and conventional vasodilator therapy. The overall cumulative survival at 6 and 12 months was 64% and 53% respectively. There were 22 deaths (18 during captopril therapy) including 8 sudden deaths. At 2-year follow-up (mean 14,6 +/- 6,9 months), there were 25 survivors on captopril; 18 in NYHA class I or IIS and 7 in class IIM or III. Diuretic requirements were decreased considerably in all. Side-effects were common but transient and in no case did captopril have to be withdrawn. We confirm our earlier conclusion that captopril has long-term beneficial effects and is a highly effective drug in the treatment of patients with CHF refractory to currently accepted therapy. Sudden death despite satisfactory clinical improvement continues to cause concern. Precautions which may reduce or avoid these are briefly discussed.

Adolescent↗
PubMed1982

Long-term captopril therapy in severe refractory congestive heart failure.

1 The favourable haemodynamic effects of captopril in patients with congestive heart failure have been reported. 2 We have treated 25 patients with severe chronic congestive heart failure with captopril in doses of 75-450 mg daily. Before entering the study all patients remained in New York Heart Association functional class IV despite high-dose diuretic and vasodilator therapy. 3 Mean cardiothoracic ratio was 60%, and all patients had a shortening fraction of 18% or less on echocardiography (normal 25 to 40%). 4 Five patients died within one month of captopril and five between four and seven months, three of whom had improved to class IIM and one to IIS before death. 5 Of the 15 survivors one was referred for a heart transplant when he had improved to class IIM. The remaining 14 patients were followed for 8-16 months. Ten improved to New York Heart Association class I or IIS and four to class IIM or III. Diuretic requirements were decreased considerably in all 14. Side effects were common but captopril did not have to be withdrawn. Captopril is a highly effective drug in the treatment of patients with congestive heart failure refractory to currently accepted therapy.

Adolescent↗