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Biomedical subjects

R Hopf

Publications and source records attributed to R Hopf.

At least 73 records · Page 4Linked to original sources
PubMed1986

[The effect of cardiac glycosides on the visual system of man measured with cortical evoked potentials].

The effect of beta-acetyldigoxin (Novodigal) on color vision in normal, healthy subjects was studied using cortical evoked potentials. Initial results indicate a significant latency increase of one component of the visual evoked potential (VEP) and a dose dependency following a change of color from blue to red. The Farnsworth-Munsell-100-Hue test, however, showed no significant changes in color vision. It is postulated that the VEP is an even more sensitive measurement of color vision than subjective tests are.

Acetyldigoxins↗
PubMed1985

Treatment of hypertrophic cardiomyopathy: relation to pathological mechanisms.

In patients with hypertrophic cardiomyopathy, clinical symptoms such as exertional dyspnea, angina and collapse are considered to be rather the consequence of diastolic than of systolic dysfunction of the left ventricle. Beta-blocker therapy is aimed at reducing systolic overcontraction while calcium blockers predominantly therapy is aimed at reducing systolic overcontraction while calcium blockers predominantly improve diastolic filling characteristics. Therefore 61 consecutive patients with well defined hypertrophic cardiomyopathy were treated with calcium channel blockers: 60 patients with verapamil at average dose 530 mg (320 to 720 mg/d) and one patient received 30 mg nifedipine. All patients had clinical, noninvasive and cardiac catheterization evaluation at the time of entry into the study. Therapy was continued for an average of 54 months (10 to 96). Follow-up studies were performed at 6-month intervals. Subjective improvement was achieved in 47 of 55 symptomatic patients (85%). Heart size, judged as heart volume from tele-chest X-ray in supine position, showed a reduction in 36/61, no change in 15/61 and increase in 10/61. On average in all 61 patients, a significant reduction from 947 to 833 ml/1.73 m2 was seen. Twenty-six patients who had been followed for an average of 24 months prior to verapamil therapy on beta blockers or no treatment had heart volume increases averaging 12% in the pre-verapamil period. Electrocardiography (ECG) showed a significant reduction in QRS amplitude and a tendency towards normalization of ST/T segments. Serial echocardiography study showed small but significant reduction in left atrial diameter. Repeat catheterization was performed in 19 patients and a significant reduction in intraventricular pressure gradient, left ventricular muscle mass and coronary artery diameter was demonstrated. Three patients died during the study (256 patient-treatment-years) for an annual mortality rate of 1.3%. This mortality is considerably lower than reported for patients receiving no treatment, beta-blockade, or surgery. Of all 61 patients only one had surgery related to the hypertrophic cardiomyopathy. One patient had the dose of verapamil reduced because of the occurrence of heart block. No patient discontinued the drug because of side-effects. Utilizing serial noninvasive and invasive studies, we conclude that verapamil therapy in hypertrophic cardiomyopathy results in objective and subjective improvement, a low death rate and little need for operation as compared to standard therapy.

Adolescent↗
PubMed1985

[Transluminal coronary angioplasty 1977-1985. Experience with 1000 interventions].

Transluminal coronary angioplasty (TCA) was introduced in 1977 for dilatation of coronary stenoses. From October 1977 to December 1984 1087 procedures have been performed in Frankfurt. The mean success rate was 77% with an increase from 58% to 84% since 1977. Recurrences were seen within the first year in 15% of the patients, which could be treated successfully in a high percentage with a second TCA. Emergency bypass operations were necessary in 5.2%. Four patients (fatality rate 0.37%) died as consequence of the intervention. Within few years TCA has become an established procedure for myocardial revascularisation, with a high success rate. Major progress has been possible in the last few years due to technical developments, which are still going on. They may lead to further improvement of the results and enlargement of the indication for TCA.

Adult↗
PubMed1985

[Coronary perfusion in acute vascular occlusion within the scope of transluminal coronary angioplasty].

The procedure of coronary perfusion during transluminal coronary angioplasty (TCA) is described. By using guide wires of a length of 300 cm it is possible to exchange a balloon catheter for a perfusion catheter in acute vascular occlusion. Arterial blood is withdrawn and correspondingly supplied distal to the occlusion to meet the myocardial need for sufficiently oxygenated blood. Ischemia resolves, resulting in the normalization of left ventricular function and resolution of subjective complaints. This procedure can maintain myocardial oxygen supply until emergency coronary bypass graft surgery or repeat angioplasty. It might help to reduce mortality secondary to transluminal coronary angioplasty.

Angioplasty, Balloon↗
PubMed1985

[Long-term results of transluminal coronary angioplasty of chronic coronary artery occlusions].

In 43 patients an occlusion of the coronary artery, which had occurred a few weeks or months previously, was diagnosed between 1977 and 1983. Angiograms were available prior to the occlusion in 35 patients but not in 8 patients. In 31 patients mechanical revascularization was attempted with acute success in 42 percent of the patients. The primary success rate in a control population without occlusion but high-grade stenoses at similar sites was 83 percent. Reocclusions or high-grade restenoses occurred in 54 percent of the revascularized vessels. Taking into account successful repeated dilatations, 62 percent of the successfully treated patients showed long-term success a year after intervention. With reference to all patients in whom revascularization had been attempted, the long-term success rate was 26 percent. Hence, mechanical revascularization of subacute and chronic artery occlusions by angioplasty shows much less chance of acute success together with a markedly increased restenosis rate compared to angioplasty of chronic stenoses. Regarding the good long-term results in a quarter of patients, the technically unproblematic approach as well as minimal dangers for the patients, a revascularization attempt seems to be justified in corresponding clinical presentations.

Angina Pectoris↗
PubMed1984

[Anti-angina effect of gallopamil in comparison with another calcium antagonist and a placebo].

UNLABELLED: In 12 male patients with angiographically confirmed coronary heart disease and stable angina the antianginal effects of 50 mg Gallopamil have been studied in comparison with 10 mg Nifedipine and placebo. The study has been carried out using a double-blind cross-over protocol with standardized exercise stress tests. Patients underwent 5 exercise step tests, without any medication and 120 minutes after randomized drug administration (placebo, placebo, Gallopamil, Nifedipine). Both Gallopamil and Nifedipine had good antianginal effects. Following 50 mg Gallopamil, ischemic ST-depression was reduced by 45% compared to placebo and by 50% compared to ergometry without any medication. The reduction of ST-depression after 10 mg Nifedipine was 26% compared to placebo and 31% compared to a drug-free exercise test. Due to the negative chronotropic effects, Gallopamil led to a slight but significant reduction of heart rate at rest and during exercise of about 5%. In contrast, after Nifedipine administration, a reflex-mediated increase in heart rate could be seen. In normotensive patients both channel-blocking agents showed a slight reduction of arterial blood pressure. CONCLUSIONS: The results indicate a considerable antianginal effect of a single oral dose of 50 mg Gallopamil. In comparison to 10 mg Nifedipine this effect is more pronounced.

Adult↗
PubMed1983

[Direct recanalization with transluminal angioplasty in acute myocardial infarct].

Treatment of acute cardiac infarction by invasive recanalization permits simultaneous removal of stenosis and occlusion: this is achieved by direct transluminal angioplasty, passage of the occlusion with the folded balloon catheter and dilatation of the stenosis. In a 42-year-old patient with anterior wall infarction and cardiogenic shock a high subtotal occlusion of the interventricular anterior branch with a thrombus beyond the 99% occlusion was seen. Due to the life-threatening state of the patient the narrowing was directly passed and relieved by dilatation. The patient survived the severe cardiogenic shock. In a second patient with posterior wall infarction complete occlusion of the right coronary artery occurred. A balloon catheter was passed without prior manipulation of the guide wire, and the occlusion was passed without difficulty. After dilatation, only moderate narrowing could be observed. Both cases demonstrate that recanalization and simultaneous removal of stenosis is possible when transluminal angioplasty is used from the beginning.

Adult↗
PubMed1982

[Conservative medical treatment of hypertrophic myocardiopathies].

50 patients with hypertrophic cardiomyopathy were treated with 480 mg Verapamil per day over a period of 47 months (11-82 months beginning in 1973). Subjective improvement was seen in 37 of 50, 6 were unchanged, 1 worsened, 6 were symptom-free from the beginning and remained so during treatment. Heart size (heart volume determined from chest x-rays in supine position) showed a reduction in 35 of 50. On average of all 50 patients a significant reduction of 8.6% was seen; in 26 patients treated for more than 2 years the average reduction was 11%. 26 patients on no medication or betablockers were followed over 24 months and revealed an average increase in heart volume of 11.9%. The ECG showed during Verapamil treatment a reduction in QRS amplitude and a tendency towards normalization of ST/T segments . . . On echocardiography a small but significant reduction in septal and free wall thickness as well as in left atrial diameter was seen. Recatheterization was performed in 19 patients while all 50 had right and left heart catheters before entering the study. Recatheterization showed on average of the 19 patients a reduction in left ventricular filling pressure, pressure gradient, left ventricular muscle mass and coronary artery diameter. It is concluded that subjective improvement, noninvasive and invasive parameters as well as the low death rate of 1% per year during a total of 200 treatment years point towards a beneficial influence of Verapamil treatment superior to other types of therapy.

Adolescent↗
PubMed1981

[The effect of diltiazem and nifedipine on exercise-induced ST-segment depression and heart rate in patients with coronary heart disease (author's transl)].

In 10 patients with angina pectoris and angiographically proven coronary heart disease, the effect of 60 mg of orally administered diltiazem (D) and 20 mg of nifedipine (N) on heart rate and exercise-induced ST-segment depression was investigated under randomized double-blind conditions. A significant reduction in mean ST-segment depression could be observed at 90 and 180 minutes for N (-36% and -33%) and D (-28% and -27%). One patient did not improve after D; two patients showed a paradoxic increase in ST-segment depression after N. Mean heart rate at rest, during, and after exercise compared to the drug-free periods was lower for D and higher for N. The difference in mean heart rate between N and D was significant (p less than 0.001). In respect to their ability to reduce ST-segment depression, 20 mg of N appears to be nearly equipotent to 60 mg of D. The different effects of D and N on heart rate and AV condition must be considered in certain clinical settings.

Adult↗
PubMed1979

Treatment of hypertrophic obstructive cardiomyopathy with verapamil.

Twenty-two patients with hypertrophic obstructive cardiomyopathy were treated with the calcium inhibitor, verapamil, which was administered in a mean oral dose of 480 mg per day. After an average of 15 months of treatment (4 to 24 months), the QRS amplitude in the electrocardiogram was significantly reduced from 4.2 to 3.8 mV. Heart volume calculated from chest x-ray films in the supine position decreased significantly from 858 to 766 ml per 1.73 m2. In 10 patients, follow-up heart catheterisation showed a decrease in left ventricular muscle mass in 7 patients and a slight increase in 3 patients. Coronary artery diameter decreased in 7 patients, increased in 1, and was unchanged in 2. The reduction in coronary artery diameter is considered to be a consequence of a reduced heart muscle mass. From all available clinical data it is concluded that verapamil treatment is superior to beta-blocker therapy.

Adult↗