[Action of clonidine on cardiac hemodynamics in hypertensive patients].
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Biomedical subjects
Publications and source records attributed to O Pleşea.
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The action of atropine on heart rate, prevention of arrhythmias, electrical activity and heart contractility was studied in 35 patients with acute myocardial infarction. Atropine had a favourable effect in 24 out of 27 patients with sinus bradycardia, and hypotension present in some cases was improved. Ventricular extrasystoles observed in 12 patients were suppressed within one hour after atropine administration. A--V block was well influenced in 9 of 16 cases. Nine patients with A--V block, of whom 8 with pump failure, presented arrhythmias after atropine. In 12 patients atropine determined a transient enhancing of the ST segment elevation, caused a persistent increase of the Q wave and altered the systolic time intervals by reducing contractility, with subsequent partial return to initial values. The data obtained justify the use of atropine for the improvement of sinus bradycardia, of arterial hypotension and of A--V block. During the effect of the drug there occurred electrical and contractility changes and, in some patients with pump failure, arrhythmias appeared. These observations demonstrate the necessity of monitoring the patients under atropine treatment and of using small doses, repeated if necessary.
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Serial measurements of left ventricular systolic time intervals (STI) were carried out in 44 patients with acute myocardial infarction (AMI) in the first 5 days after onset, by indirect methods. The patients with heart failure showed significant decreases of ejection time (ET) (p less than 0.001) and of the ejection time index (p less than 0.005) and increases of Wiessler's ratio (PEP/ET) (p less than 0.001). The pre-ejection period (PEP), the isovolumetric contraction time and the total electromechanical systole were unsignificantly changed. Ejection time was shorter than 250 msec in the patients with acute pulmonary edema or congestive heart failure, in most of the patients with flutter or atrial fibrillation and in 16 of the 17 patients who died. Ejection time may have a prognostic significance and may be useful in the early detection of heart failure in AMI. The changes of STI after administration of lanatosid C show the positive inotropic effect of this drug in patients with AMI.