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Biomedical subjects

M Waynberger

Publications and source records attributed to M Waynberger.

At least 19 recordsLinked to original sources
PubMed1990

Acute pulmonary oedema: preliminary results of a randomized trial of the intravenous phosphodiesterase inhibitor, enoximone, vs conventional therapy.

The purpose of this open study was to compare the effects of enoximone and conventional therapy in 44 patients with acute pulmonary oedema. In this preliminary report, 22 patients were randomly assigned to the enoximone group (1 mg/kg bolus, every 8 hours for 48 hours) and 22 patients to conventional therapy (frusemide, nitrates, dopamine-dobutamine). Patients were assessed clinically at 0, 1, 2, 24 and 48 hours by the change in their Killip-Kimball score, dyspnoea, pulmonary rales, blood pressure, diuresis, requirement for additional therapy and/or death. Patient characteristics were similar except for distribution of the sexes. Improvements of each clinical parameter seemed more marked in the enoximone group, except during the first hour (due to the diuretics). The general course of the disease was more favourable in the enoximone group (17 cases vs 11 in the conventional therapy group), in which enoximone used alone was sufficient to normalize the haemodynamic variables. On the other hand, in the conventional therapy group, it was necessary to institute enoximone therapy in 9 cases. With the dosage used, enoximone appeared to be at least as effective as conventional therapy in acute pulmonary oedema. Moreover, no side-effects or tachyphylaxis appeared during the hospital assessment.

Adult↗
PubMed1990

[Intravenous enoximone versus conventional treatment in acute lung edema. Preliminary results of a randomized study].

The aim of this open study was to compare the efficacy of Enoximone and conventional treatment in 44 patients with acute pulmonary edema. At the time of this interim analysis, 22 patients had received Enoximone (1 mg/kg by rapid intravenous injection every 8 hours for 48 hours) and 22 were given conventional treatment (furosemide, nitrates, dopamine-dobutamine). The treatment schedules were randomised. Clinical data was obtained at 0, 1, 2, 24 and 48 hours and evaluated using the Killip-Kimball score, dyspnoea, pulmonary rales, the need for additional therapy and patient mortality. The patients in the two groups were comparable in all clinical features except the sex ratio. The improvement of all clinical criteria of evaluation seemed to be greater in the Enoximone group, except during the first hour of treatment (due to the action of diuretics). The overall outcome was better in the Enoximone group (17 favourable responses compared to 11 in the group receiving conventional treatment). Normalisation of haemodynamic parameters was observed only with Enoximone. In addition, it became necessary to administer Enoximone to 9 patients in the conventional treatment group. At these doses, Enoximone was at least as effective as conventional treatment of acute pulmonary edema. What is more, no secondary effects or tachyphylaxis were observed during the period of hospital treatment.

Acute Disease↗
PubMed1989

Myocardial infarction: is bepridil, a new calcium antagonist, able to improve the course of the acute phase?

Several calcium antagonists are useful in the treatment of ischemic heart disease. This open randomized study was designed to determine the effects of bepridil, a new long-acting calcium antagonist with antiarrhythmic properties, on the course of acute myocardial infarction (AMI). Two hundred patients with AMI of less than 48 hours duration (average 10.9 hours) were randomly assigned to two treatment groups: The first one was treated with bepridil (BEP, n = 100), and the second one was considered as a control group, using isosorbide dinitrate at a low dosage (ISDN, n = 100). BEP was administered intravenously for 48 hours at a dosage of 4 mg/kg/day; at the same time, an oral dose of 200 mg t.i.d. was started and continued for 21 days. In the control group, ISDN was given orally at the low dosage of 5 mg every 4 hours for 21 days. An uneventful course was seen in 28 BEP patients versus 15 in the control group (p less than 0.05). Mortality and recurrence of angina were lower in the BEP group than in the control group, but the difference is not significant. On the other hand, moderate and severe hemodynamic complications did not occur in 80 BEP patients versus 65 in the control group (p less than 0.05). Ventricular arrhythmias occurred in 36 BEP patients versus 50 in the control group (p less than 0.05). Antiarrhythmic therapy was required in 14 BEP patients versus 61 in the control group (p less than 0.001). These results show that bepridil seems capable of improving the hemodynamics and arrhythmologic course of AMI.

Acute Disease↗
PubMed1989

[Acute thrombosis of mitral Starr prosthesis. Value of color coded two-dimensional doppler echocardiography].

In a case of acute thrombosis on mitral Starr valve two-dimensional doppler-echocardiography rapidly showed that parts of the transprosthetic jets had disappeared, while conventional continuous wave doppler ultrasound confirmed the presence of a severe haemodynamic obstacle. With colour-coded doppler ultrasound, there only remained a jet that was parallel to the posterior wall of the left ventricle. This jet was of unusual pattern, with the presence of turbulence and high velocities in aliasing colour. The effectiveness of a thrombolytic treatment was demonstrated by the reappearance of the missing diastolic jets with return to normal velocities. Comparison between a post-thrombolysis colour-coded doppler examination and a reference examination confirmed that the valve was now functioning normally. Thus, while conventional doppler recordings accurately quantify prosthetic dysfunctions leading to stenosis, two-dimensional doppler recordings rapidly provide an anatomical information. By showing changes in the transprosthetic jets they indicate the precise location and extent of valve obstruction.

Echocardiography, Doppler↗
PubMed1989

[Post-infarction anterior septal rupture. Aspects of the IVC flux on bidimensional Doppler with color coding].

In a case of anterior septal rupture complicating a transeptal myocardial infarction, the diagnosis of IVC is immediately confirmed by bidimensional Doppler with color coding. The abnormal flow and its three components are studied in multiple section planes. Incidences permitting the best visualization of the shunt are the longitudinal sections: left parasternal and apical-long axis. The parasternal short axis section only visualizes an abnormal intraventricular flow. Sweeping of the septum by caudal tilting of the probe, from an apical section of the 4 cavities, successively studies the three portions: left intraventricular, trans-septal, and right intraventricular of the abnormal flow. The size of the defect seems underestimated on bidimensional ultrasonograms as well as color Doppler. Speed, sensitivity and reliability of the color coded bidimensional Doppler, places it as the reference diagnostic test in this type of pathology. Catheterization still has a place in evaluating the severity of the shunt.

Aged↗
PubMed1983

Electrophysiological profile of bepridil, a new anti-anginal drug with calcium blocking properties.

The electrophysiological effects of intravenously administered bepridil, a new anti-anginal drug with slow calcium current blocking properties, were studied in 20 patients undergoing an endocavitary cardiac exploration for various reasons. Classical techniques of programmed electrical stimulation were used. Bepridil markedly increased the refractory period of the atrium, atrioventricular node and the AH-interval. The effects on HR and ventricular refractory period were minimal, and sinus rate decreased slightly. A pronounced reduction in the heart rate at which the Wenckebach phenomenon was obtained in the anterograde direction (16%) and particularly in the retrograde direction (26%) was observed. During this study the drug appeared beneficial in suppressing atrial flutter, atrial extrasystoles, and ventricular extrasystoles. In two patients with intranodal reciprocal rhythm, the injection of bepridil terminated the tachycardia which could not be reinitiated later. No side-effects occurred and it appears that bundle branch block and prolonged HV interval are not contraindications to the use of bepridil.

Adult↗
PubMed1976

[Isolated ventricular tachycardia without patent cardiopathy].

The authors have made a further study of the case notes of 49 patients who were followed up for several years with isolated ventricular tachycardia occurring in a heart which was otherwise healthy; such tachycardias are also called essential or idiopathic. First they define the criteria necessary for the diagnosis of essential ventricular tachycardia: -- an arbitrary age criterion (less than 45 years in men and 50 years in women) which seeks to exclude the so-called "arterial" ventricular tachycardias; -- a follow-up period of supervision of more than two years, which excludes certain primary cardiomyopathies whose presenting feature is a series of attacks of ventricular tachycardia. They then attempt to classify the ventricular tchycardias into four types, according to their clinical features and the electrocardiographic tracings at rest and on exercise, and to predict the prognosis. The most frequently encountered and benign type was the classical ventricular tachycardia of Bouveret.

Adolescent↗