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Biomedical subjects

R J Vecht

Publications and source records attributed to R J Vecht.

8 recordsLinked to original sources
PubMed1989

Comparison of intravenous nicardipine and nitroglycerin to control systemic hypertension after coronary artery bypass grafting.

The efficacy of intravenous (i.v.) nicardipine hydrochloride (a calcium antagonist) compared with nitroglycerin, the drug generally used for treatment of hypertension after coronary artery bypass grafting, was tested in 20 postoperative patients. The patients were randomly divided in a nonblinded manner into 2 groups. Baseline characteristics were similar in the 2 groups. Patients in both groups received various oral calcium antagonists. In addition, 1 group was treated with i.v. nitroglycerin. Both drugs were infused at a maximal rate of 30 mg/hour, as needed to maintain systolic blood pressure below 110 mm Hg. If blood pressure increased to more than 120 mm Hg, nitroprusside was administered. Intravenous nicardipine was superior to nitroglycerin in control of hypertension after coronary artery bypass grafting. In patients treated with nicardipine, blood pressure was decreased sooner (mean infusion time 7.7 hours vs 11.9 hours for nitroglycerin), mean systolic blood pressure was reduced (94 vs 108 mm Hg for the nitroglycerin group; p less than 0.05), and no patient required nitroprusside treatment (compared with 3 patients who required this treatment in the nitroglycerin group). There were no differences in heart rate, diastolic pressure, cardiac index and urine flow between the 2 treatment groups. No adverse effects were observed in patients treated with nicardipine.

Coronary Artery Bypass↗
PubMed1979

Uhl's anomaly.

Uhl's anomaly of the heart is a rare condition. Another well-documented case is presented with a review of the published reports outlining the main clinical features and the bad overall prognosis. Right atriotomy should be avoided if closure of the atrial septal defect is attempted.

Adult↗
PubMed1978

Plasma noradrenaline concentrations during isometric exercise.

Blood was collected simultaneously from the left ventricle and pulmonary artery in 12 patients undergoing routine cardiac catheterisation and was analysed for noradrenaline concentrations at rest, during, and after isometric stress (hand grip). Moderate isometric exercise resulted in a significant rise in plasma noradrenaline with a return to basal values 10 minutes after discontinuing the grip test. There were no significant differences in noradrenaline levels between the left ventricular and pulmonary arterial samples either at rest or during exercise. Three patients with evident left ventricular dysfunction had the highest plasma noradrenaline concentrations, in contrast to the much lower levels in 2 patients on beta-blockers and in 1 patient with a normal heart. As moderate isometric effort results in an important increase in noradrenaline level, this form of exercise could be dangerous in subjects suffering from ischaemic heart disease or in those with impaired left ventricular function since these patients are particularly susceptible to arrhythmias.

Adult↗
PubMed1977

Left ventricular apical thin point.

The wall thickness of the apex of the left ventricle has been measured at its thinnest point in 60 adult hearts at necropsy. This measured 2 mm or less in 97% of them and 1 mm or less in 67%.

Adult↗
PubMed1976

Fatal outcome arising from use of a sutureless "corkscrew" epicardial pacing electrode inserted into apex of left ventricle.

A 59-year-old man is described in whom the insertion of an epicardial sutureless "corkscrew" electrode resulted in fatal ventricular perforation. Fatal myocardial perforation can occur with this electrode and the apex of the left ventricle should never be used as the site of insertion. Necropsy also showed that the transvenous right ventricular electrode, inserted one year previously, had penetrated a tricuspid leaflet. This could have accounted for the ensuing pacing failure.

Electrodes, Implanted↗
PubMed1976

The grip test: a simple method for the assessment of left ventricular performance.

37 patients with mixed cardiac pathologies were subjected to isometric exercise (hand grip) during routine cardiac catheterization. On the basis of a simple and safe grip test it was possible to distinguish three groups of patients according to the left ventricular pressure at rest and its response to this test. Group 1 consisted of 14 patients with left ventricular end diastolic pressures remaining below 12 mm Hg both at rest and on exercise. These patients were considered to have normal left ventricular function some, even in the presence of organic heart disease. No deaths occurred in this group during the follow-up period which averaged 33.8 months. At the other extreme (Group 3) there were 12 obviously disabled patients with resting left ventricular filling pressures above 12 mm Hg rising further under isometric stress. Six of these patients (50%) died during the period of the study. (Average follow-up 21.4 months). By the application of the hand grip test, an intermediate population (Group 2) of 11 patients was discernible. These patients were able to maintain a normal cardiac reserve at rest (LVEDP less than 12 mm Hg) but not during isometric effort (LVEDP greater than 12 mm Hg). Two of these patients (18%) died during the follow up period (average 22.1 months). Assuming a pathological progression with time from groups 1-3 and in view of the different prognoses observed in the course of the long-term follow-up it would appear that the Group 2 patients should be considered more critically and offered more active management.

Adolescent↗