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Biomedical subjects

O Uhlír

Publications and source records attributed to O Uhlír.

At least 19 recordsLinked to original sources
PubMed1997

[A Czech and Slovak interventional study of spirapril (the CASSIS study). A randomized, double-blind, multicenter, placebo-controlled study in chronic heart failure].

Spirapril, an ACE-inhibitor without the SH group was tested in a randomized double-blind multicentric study in patients with chronic symptomatic heart failure (NYHA II-IV). After a 1-4-week initial stage with placebo the patients were randomized into five groups: the first was given placebo, the second one spirapril 1.5 mg, the third one spirapril 3 mg, the fourth one spirapril 6 mg and the fifth one 5 and later 10 mg for a period of 12 weeks. The number of patients in different groups was in the following order: 48, 48, 53, 51 and 48. The condition for admission into the study was chronic heart failure not responding adequately to treatment with digoxin and diuretics, IHD or dilatation cardiomyopathy with the left ventricular ejection fraction (% tolerating a basic ergometric load for two minutes. The primary criterium was an increment during the period of the load, secondary criteria comprised objective and subjective cardiac symptoms, changes in the left ventricular ejection fraction, cardiothoracic index/heart size and quality of life. The load tolerance increased in all groups, however, no significant differences between groups were found. The authors also found regression of signs of pulmonary congestion during active spirapril treatment and diminution of the cardiac shadow. Moreover the authors proved a significant reduction of the mortality in the actively treated patients as compared with those receiving placebo, a lower frequency of hospital admissions and reduction of serious undesirable cardiovascular symptoms during active treatment. In patients with medium severe and severe cardiac failure with IHD, combination with short acting calcium channel blockers had an unfavourable effect on the load tolerance and clinical parameters. Sprirapril, combined with diuretics and digoxin is a suitable drug also in chronic cardiac failure. Questionable remains the importance of loading tests when verifying the effectiveness of ACE-inhibitors. Treatment with short-time acting calcium antagonists cannot be recommended in symptomatic chronic cardiac failure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1997

[Therapy of heart failure with spirapril--the open phase of the CASSIS study. Analysis of the 2nd year extension of the CASSIS study].

The CASSIS study was a double-blind multicentric controlled Czech and Slovak study focused on treatment of chronic heart failure with the ACE inhibitor spirapril; it was conducted for 12 weeks. The present work analyzes the second year of the extended open part of the study when all patients (n = 168) were treated with 3 mg or 6 mg spirapril. A small proportion of the patients was treated with 12 mg spirapril. The objective of the study was to test the long-term effectiveness and tolerance of spirapril. The general mortality was analyzed throughout the whole two-year period. The results revealed an unchanging total mortality, analyzed after three-month intervals, during the whole two-year period. Also the functional improvement of the patients according to NYHA which occurred after the first three months of treatment was preserved during the second year. Spirapril proved to be a well tolerated ACE-inhibitor. The authors did not observe angioneurotic oedema in any of the patients. Hypotension and cough were recorded in 0.6% of the patients. The incidence of undesirable laboratory effects was also low and the majority was due to the basic disease. Creatinine did not rise significantly and a rise of urea was observed only in a small number of patients. Liver functions and haemogram did not change during treatment. The results of the second year of erxtension indicate that spirapril is a very effective and safe ACE-inhibitor which will extend in a significant way therapeutic means in patients with chronic heart failure.

Aged↗
PubMed1996

[Corotenol, its effectiveness and tolerance in light of new studies].

The effectiveness and tolerance of Corotenol of Mepha Co. was investigated in two studies under conditions of common ambulatory practice of specialists in internal medicine and general practitioners in patients suffering from mild to moderate hypertension and/or ischaemic heart disease. A surprising finding was a high percentage of patients with an inadequately controlled blood pressure before enlistment into the study. During regular check-up examinations already after two weeks a marked reduction or normalization of the blood pressure, was recorded, in the majority of patients. The author assumes that in addition to the effectiveness of the administered drug the marked improvement of the patients is due to better collaboration of the patients and adherence to the prescribed dosage and lifestyle.

Antihypertensive Agents↗
PubMed1995

Czech and Slovak spirapril intervention study (CASSIS). A randomized, placebo and active-controlled, double-blind multicentre trial in patients with congestive heart failure.

A randomized, double-blind, placebo- and active-controlled multicentre study with spirapril, a new angiotensin-converting enzyme inhibitor (ACEI), has been conducted in patients with chronic congestive heart failure (CHF) of NYHA classes II-IV. After a placebo run-in period of 1-4 weeks, patients were randomly assigned to one of five treatment groups: placebo (n = 48), spirapril 1.5 mg (n = 48), spirapril 3 mg (n = 53), spirapril 6 mg (n = 51) or enalapril 5/10 mg (n = 48). The primary objective was to assess changes in exercise tolerance, and the secondary objective was an assessment of cardiovascular signs and symptoms, quality of life, ejection fraction and chest X-ray findings. Exercise tolerance increased in all groups; however, no statistically significant differences were found between any of the groups. There was a statistically significant reduction of mortality in the pooled spirapril groups compared with placebo, and a trend for reduction of serious cardiovascular adverse events as well as duration of hospitalization. These effects and improvements in lung congestion appeared to be dose dependent. In patients with moderate to severe heart failure, the combination with first-generation calcium channel blockers had an unfavourable effect on exercise capacity and clinical parameters. Spirapril might be an effective alternative to enalapril in the treatment of patients with CHF. The role of the exercise tolerance test in establishing efficacy of ACEIs in CHF and the widespread use of nifedipine in CHF is questioned.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1995

[24-hour effectiveness and tolerance of perindopril (Prestarium), an ACE inhibitor, in the treatment of mild to moderate hypertension. A 1-year Czech and Slovak study].

This one-year open study conducted in two centres investigated the 24-hour effectiveness of the ACE inhibitor perindopril in the treatment of 31 patients with mild or moderate hypertension. The investigation evaluated the so-called "through" effect, i.e. the effect of the drug at the end of the 24-hour dosage period. Monotherapy with perindopril (4 mg or 8 mg administered once a day) led to normalization of the diastolic pressure to values lower than 90 mmHg in 48% of the patients, and a combination of perindopril with hydrochlorothiazide produced this effect in another 38% of patients. Treatment thus was able to normalize the diastolic blood pressure in 86% of patients. The mean decline of systolic pressure in a recumbent position was 17.6 mmHg and 13 mmHg for diastolic pressure assessed in a recumbent position 24 hours after ingestion of the drug. The reduction of blood pressure achieved after three months treatment persisted for the whole year. In 93% of the patients the diastolic pressure was at the end of one year lower than 95 mmHg. The drug was very well tolerated and in none of the patients the treatment had to be discontinued because of undesirable side-effects. Perindopril is a significant contribution to the spectrum of drugs used in the treatment of hypertension because of its 24-hour effectiveness and very good tolerance.

Adolescent↗
PubMed1992

[24-hour effect and tolerance for perindopril (Prestarium) in mild and moderate essential hypertension].

A multicentre investigation of antihypertensive treatment by perindopril was conducted in three centres of Czechoslovakia. The investigation comprised 51 patients with mild to moderate essential hypertension (diastolic pressure 95-115 mmHg) who were taking perindopril for a period of three months, the initial dose being 4 mg (1 tablet per day). If the blood pressure did not drop to normal levels (dBP < 90 mmHg), the dose was increased to 8 mg after 1 month and if after 2 months of treatment the blood pressure did not reach normal levels, a thiazide diuretic was added. The antihypertensive effectiveness was assessed 24 hours after ingestion of the drug. The blood pressure declined significantly already after the first month of monotherapy with perindopril. It declined then significantly up to the end of the 3rd month of treatment. The systolic blood pressure declined by 9.4 mmHg after the first month of monotherapy with perindopril and by 15.9 mmHg after 3 months of treatment. The diastolic blood pressure declined by 8.1 mmHg after one month of monotherapy and by 12.4 mmHg at the end of three-month treatment. The clinical and biological tolerance was excellent and only one patient discontinued treatment for reasons not related to the administered drug. Twenty-four hour monitoring of the blood pressure also proved the favourable effect of perindopril.

Adolescent↗
PubMed1989

[Clinical evaluation and comparison of the effects of Dobuject and Dobutrex after open heart surgery].

The paper list the results of a comparative study on the clinical and haemodynamic effects of 2 medicaments, registered in the Czechoslovak Socialist Republic, i. e. dobutamine hydrochloride, Dobutrex the Federal Republic of Germany) and Dobuject (Loiras, Finland). The medicaments were applied to high-risk patients (NYHA III-IV) after open heart surgery with the low cardiac output syndrome. Dobutrex was applied in 14 patients and Dobuject in 16 patients. Both preparations improved the cardiac output shown in an increased cardiac index and left ventricular stroke work index and the pressure decrease in pulmonary capillaries measured with a wedged-in catheter. Both these preparations (Dobutrex, Dobuject) appear to have comparable parameters as regards favourable positive inotropic effects.

Cardiac Output, Low↗
PubMed1989

Bopindolol in the treatment of hypertension: a double blind study comparing bopindolol and metoprolol.

The article presents the experience gained with a new betablocker- bopindolol-in the treatment of hypertension. Using a three-month double blind study conducted in 2 centres, the antihypertensive effect of bopindolol and metoprolol was compared in a total of 86 patients. The incidence of undesirable effects was determined, and biochemical parameters before and after therapy were followed up. Both drugs were equally effective in controlling blood pressure. In 70% of patients with mild and moderate hypertension, diastolic pressure values less than 95 mmHg were obtained in monotherapy with a betablocker. The incidence of undesirable effects was low, the drug was tolerated well. Biochemical parameters did not change within the three months of study.

Adrenergic beta-Antagonists↗