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Biomedical subjects

R Kala

Publications and source records attributed to R Kala.

At least 37 records · Page 2Linked to original sources

Ambulatory ECG recording in patients referred because of syncope or dizziness.

Data are presented on patients referred for ambulatory ECG recording because of syncope or dizziness during a 2-year period. Of the 272 consecutive patients subjected to the recording, 107 (39.3%) had syncope or dizziness as the main indication for referral. Sixteen of these patients (14.9%) experienced the presenting symptom during the recording, and in 8 (50%) of these the simultaneous ECG finding was interpreted as causative. In patients who were symptom-free during the recording, sinus arrests exceeding 2.5 seconds seemed to be a valuable finding to support the cardiac aetiology of the syncopal symptoms, whereas the diagnostic value of second degree AV block with either Wenckebach or Mobitz II like patterns, as such, and of ventricular tachycardia remained mostly unsettled.

Ambulatory Care↗

Ambulatory electrocardiographic recording in endurance athletes.

Data from ambulatory electrocardiographic recording in 35 highly trained endurance athletes and in 35 non-athletic controls of similar ages are given. The minimal, mean hourly, and maximal heart rates were significantly lower in the athletes. Thirteen athletes (37 . 1%) but only two controls (5 . 7%) had sinus pauses exceeding 2 . 0 seconds. First degree atrioventricular block was observed in 13 athletes (37 . 1%) and five controls (14 . 3%), second degree Wenckebach type block in eight athletes (22 . 9%) and two controls (5 . 7%), and second degree block with Mobitz II-like pattern in three athletes (8 . 6%) and no control. All athletes with Mobitz II-type pattern also had first degree and Wenckebach-type second degree atrioventricular block. The behavior of sinus rate on development of atrioventricular block varied, not only interindividually but also intraindividually, from absence of change to an increase or decrease in most subjects in both study groups. A decrease in sinus rate on appearance of atrioventricular block was found constantly in only two athletes and one control. Atrioventricular dissociation with junctional rhythm occurred in seven athletes (20%) and with ventricular rhythm in one athlete. Neither of these phenomena was seen in the group of controls. The athletes had slightly fewer ventricular extrasystoles than controls, and no athlete had ventricular tachycardia, whereas two controls had ventricular tachycardia.

Adolescent↗

Chest pain and rate-dependent left bundle branch block in patients with normal coronary arteriograms.

A triad of exertional chest discomfort, transient rate-dependent left bundle branch block (LBBB), and normal coronary arteries is presented in seven consecutive patients. Although the clinical symptoms resembled effort angina, qualities atypical of classic angina pectoris were commonly noted: 1) the onset was always abrupt; and 2) the pain was local, never radiating; 3) palpitation; and 4) "walk through" phenomenon were often present. The abrupt pain took place simultaneously with the appearance of LBBB induced by physical exercise in all seven patients. Atrial pacing or spontaneous resting heart rate changes produced similar sensations and LBBB in four of the five patients examined in this way. Similarly, in the same four patients kinetocardiographic recordings disclosed a sudden occurrence of paradoxic cardiac movement at the moment LBBB and chest pain appeared. The paradoxic systolic motion disappeared at reversion to normal conduction.

Adult↗

Atrioventricular block, including Mobitz type II-like pattern, during ambulatory ECG recording in young athletes aged 14 to 16 years.

Twenty young male athletes, aged 14 to 16 years, and 20 nonathletic male controls of the same ages were studied with regard to atrioventricular block using ambulatory ECG recording. Among the athletic youngsters, the mean hourly heart rates were significantly (p less than 0.01) lower during most of the night hours and during school hours when activities in both groups were uniform. First degree block was found in the athletes in 3 cases, second degree Wenckebach-type block in 3 cases and second degree block with Mobitz type II-like pattern in 2 cases. Among the nonathletes, first degree block was found in one case and second degree Wenckebach-type block in another. The results indicate that after approximately 3 years of physical training, on average 5 times a week, various forms of atrioventricular block, apparently vagally mediated, are observable in young athletes more often than in nonathlete controls.

Adolescent↗

Antiarrhythmic significance of dosing intervals in beta receptor blocking therapy of hypertension with acebutolol.

Six hypertensive patients with daily ventricular arrhythmias underwent a double-blind crossover study to examine whether a once daily regimen of beta receptor blockade was equipotent in antihypertensive and antiarrhythmic activity to a twice daily regimen. Acebutolol, a relatively cardioselective beta blocking compound with intrinsic sympathomimetic properties, was given in two regimens: 200 mg twice daily or 400 mg once daily. Ventricular ectopic beats were analyzed both during physical exercise and with multiple 24 hour ambulatory electrocardiographic (Holter) recordings. Serum concentrations of acebutolol and its acetyl metabolite were determined using high pressure liquid chromatography. The two regimens of acebutolol were equally potent in reducing the blood pressure and heart rate at rest and during physical exertion. The hourly heart rates during 24 hours were reduced to the same extent by both regimens. The single daily 400 mg dose did not significantly reduce the incidence of arrhythmias, whereas 200 mg twice daily evoked a significant reduction during 24 hours. Serum concentrations of acebutolol were twice as great with the twice daily regimen as with the single dose. Both treatments significantly shortened the Q-Tc interval. The data suggest that, despite apparent beta receptor blockade and good blood pressure control, beta blocking agents with a relatively short plasma half-life lose their antiarrhythmic potency when administered on a once daily basis. This property seems to be more related to the plasma concentration of the compound than to the degree of clinically assessed beta receptor blockade.

Acebutolol↗

Ventricular arrhythmias during exercise testing, jogging, and sedentary life: a comparative study of healthy physically active men, healthy sedentary men, and men with previous myocardial infarction.

The occurrence of ventricular arrhythmias during exercise testing, jogging, and sedentary life with and without preceding exercise was studied with the aid of ambulatory electrocardiographic monitoring in healthy physically active men, healthy sedentary men, and men with previous myocardial infarction (15 men in each group). Ventricular premature beats of the same grade were found during exercise testing and jogging in ten of the 15 healthy physically active men, in ten of the 15 healthy sedentary men, and in eight of the 15 men with previous myocardial infarction. When unifocal ventricular premature beats were omitted, the corresponding figures were 14/15, 11/15, and 15/15, respectively. Healthy physically active men had less ventricular arrhythmias in all of the tested situations. The greatest number and also the highest grades of ventricular arrhythmias during the exercises were found in healthy sedentary men, whereas the men with previous myocardial infarction had ventricular arrhythmias more during sedentary life.

Adult↗

Solitary renal cyst, hypertension and renin.

Solitary renal cysts may cause renin hypersecretion with associated hypertension by compressing surrounding tissue and by distortion of renal vessels. Selective measurements of plasma renin activity in the renal veins can predict the antihypertensive effect of decompression. An illustrative case is presented and its significance is discussed.

Adult↗

Binding of iodinated angiotensin congeners to angiotensin II antibodies.

Antibodies against angiotensin II (A II) were generated in rabbits by immunization with val5-angiotensin II coupled to albumin. All antisera bound significant amounts of 125I-labelled A II hepta (2-8) and hexapeptide (3-8), but angiotensin I (A I) was not bound. High specificity for A II was found in 3 sera out of 10. The other sera showed above 50% cross-reaction with hepta- or hexapeptide, or both. No sera were found to cross-react with A I. The amino acids in position 1 and 2 may become additional immunological determinants, providing the basis for the generation of antibodies highly specific for A II. Labelling with 125I using the chloramine method may alter the immunoreactivity of angiotensin congeners. Selected antisera against A II may be used for radioimmunoassays of the biologically active angiotensin "III" (2-8 heptapeptide) and the 3-8 hexapeptide fragment of A II.

Angiotensin II↗