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Biomedical subjects

T J Pellinen

Publications and source records attributed to T J Pellinen.

18 recordsLinked to original sources
PubMed1992

Efficacy of conventional and sustained-release verapamil in stable angina pectoris.

The efficacy of sustained-release (s.r.) verapamil and conventional verapamil were compared in a double blind, crossover study in 20 patients (age 53 +/- SD6 years) who had stable effort angina and had used betablockers and long acting nitrates for at least two weeks. All patients received s.r. verapamil 200 mg b.i.d. and conventional verapamil 120 mg t.i.d. in a randomised order for two weeks. A symptom limited bicycle exercise test was performed at the end of the patients' previous medication period with betablocker plus long acting nitrate and at the end of both verapamil treatments in the morning before drug administration and three hours thereafter. All the patients improved subjectively during both verapamil regimens according to NYHA classification and they had fewer anginal attacks. The time to onset of ST-segment depression during exercise remained shorter during beta-blockade and long acting nitrates than during both verapamil regimens (P less than 0.05). During the peak action three hours after drug administration conventional verapamil was most effective at comparable workloads (P less than 0.05), whereas the exercise time was slightly prolonged with s.r. verapamil before drug administration.

Adrenergic beta-Antagonists↗
PubMed1991

Coronary collateral circulation.

The occurrence and influence of coronary collateral circulation and obstruction of the supplying coronary arteries on left ventricular contractility, prevalence of myocardial infarction, and bicycle exercise ergometer test were studied in a random sample of 286 patients with angiographically documented coronary artery disease. Collaterals appeared increasingly in all three main coronary arteries with grade of obstruction. The highest prevalence of collaterals occurred in stenosis of the right coronary artery (60%), followed by the left descending artery (45%); they occurred least in the left circumflex artery (21%) (p less than 0.001). The frequency of intra-arterial collateral circulation was 42%, 11%, and 12%, respectively (p less than 0.001). With total occlusion of the left anterior descending coronary artery, 22% of the patients had normokinetic anterior and apical left ventricular wall when collaterals were present. More often, the inferior wall showed normal contraction with total occlusion of the right coronary artery and collaterals [52%, p less than 0.001 compared with left anterior descending artery (LAD)]. The prevalence of inferior myocardial infarction was 39%, with collateral circulation to the totally occluded right coronary artery. The respective prevalence of anterior infarction and total occlusion in the left coronary artery was 58% (p less than 0.02). The presence or absence of collaterals had no obvious influence on ST-segment response during bicycle ergometer test. In triple-vessel disease, peak work capacity was better when collaterals to LAD were not jeopardized (427 kpm) than when jeopardized (321 kpm) (p less than 0.02).

Analysis of Variance↗
PubMed1990

Hemodynamic effects of pindolol and atenolol at rest and during isometric exercise: a noninvasive study with healthy volunteers.

Hemodynamic effects of intravenous and oral pindolol and atenolol were assessed in ten healthy volunteers by left ventricular echocardiography and systolic time intervals. Measurements were made at rest and during hand-grip-induced isometric exercise. Drug doses were pindolol 0.015 mg/kg intravenously and 10 mg/day orally, atenolol 0.1 mg/kg intravenously, and 50 mg/day orally. Heart rate at rest was reduced by both drugs. The reduction caused by atenolol during oral treatment was significantly greater (p less than 0.01). Intravenously only pindolol reduced mean arterial pressure. During oral treatment atenolol reduced the mean arterial pressure nonsignificantly. Both drugs lowered heart rate during isometric exercise, atenolol being significantly more effective. During oral treatment atenolol blunted the heart-rate reaction to exercise. Mean arterial pressure during isometric exercise rose slightly with both drugs after intravenous administration. During oral treatment only atenolol reduced the mean arterial pressure significantly. Intravenous atenolol reduced cardiac contractility at rest, indicated by significant decreases in fractional shortening, ejection fraction, and the mean velocity of circumferential fiber shortening. In contrast, intravenous pindolol and oral therapy with either drug did not change contractility. Intravenous atenolol raised total peripheral resistance. The preejection period/left ventricular ejection time ratio decreased with intravenous pindolol, while atenolol increased it. In conclusion, atenolol had more negative inotropic and chronotropic effects, especially after acute intravenous administration. Only atenolol reduced cardiac output and increased peripheral resistance. After repeated oral administration, these effects were less apparent.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1990

Haemodynamic effects of bopindolol and atenolol in coronary artery disease. A noninvasive study.

Bopindolol, a new non-selective betablocker, and atenolol, a conventional betablocker, were studied in parallel groups of eight normotensive patients with NYHA II-III angina pectoris. Non-invasive haemodynamic measurements were made using echocardiography and systolic time intervals. Drug doses were 1 mg bopindolol and 100 mg atenolol once daily; measurements were made immediately and at one and six weeks intervals. Both drugs reduced heart rate, atenolol from 62 to 47 beats/minute (24%, P less than 0.01) and bopindolol from 64 to 56 beats/minute (13%, P less than 0.05) at 24 hours. Only atenolol reduced mean blood pressure. Rate pressure product was persistently reduced by atenolol (30% at 24 hours), while with bopindolol this effect lessened with time. Opposite trends in left ventricular enddiastolic and endsystolic diameters were observed; with atenolol tending to increase and bopindolol to lower them. Atenolol had no influence on cardiac contractility, while bopindolol increased it, which was shown by enhancements in the fractional shortening, ejection fraction and maximum velocity of fibre shortening. Neither drug changed peripheral vascular resistance or systolic time intervals. Two patients on bopindolol left the study because of worsening symptoms of coronary artery disease, and two on atenolol owing to side effects, bradycardia and syncope in one and diarrhea in the other. In conclusion, bopindolol showed less beta-blocking effect than atenolol and it had a positive inotropic effect. Its benefit in treating coronary artery disease remains to be proved.

Atenolol↗
PubMed1988

Acute renal failure following nontraumatic rhabdomyolysis.

The etiology and clinical course of acute nontraumatic rhabdomyolysis and ensuing renal failure was surveyed in a series of 40 consecutive patients. In 28 cases the muscle damage occurred after excessive consumption of ethyl alcohol and/or other intoxications. Prolonged lying immobilized was the reason or contributing factor for rhabdomyolysis in 22 cases. The other evident etiologies were convulsions, vigorous physical exercise, arterial occlusion and hypothermia. Typical local signs of rhabdomyolysis--pain, swelling and weakness of the affected muscles--were absent in one fourth of the patients. In these cases the diagnosis was based on transient elevation of serum creatine kinase enzyme activity. Dialyses were required to manage acute renal failure in 24 subjects. All 36 survivors recovered normal renal function. Neurological defects in the extremities still persisted in 16 patients at three months' follow-up.

Acute Kidney Injury↗
PubMed1988

Haemodynamic effects of atenolol and bopindolol at rest and during isometric exercise. A non-invasive study in healthy volunteers.

Circulatory effects of bopindolol, a new nonselective beta blocking agent with intrinsic sympathomimetic activity and atenolol were compared. After baseline and first dose measurements atenolol 25 mg twice daily and bopindolol 1 mg daily were given to 10 healthy young subjects. Haemodynamic measurements were made noninvasively using echocardiography and systolic time intervals. Clinical and circulatory indices were measured at baseline, after initial dose and after one week of regular treatment at rest and at isometric handgrip exercise (IE) (HG). Atenol reduced the heart rate from 62 bpm to 49 and blunted totally the HR increase during IE (p less than 0.01). Bopindolol caused a 10% fall in heart rate (NS) at rest and a 15% fall (p less than 0.05) during IE. BP fell by 6% after atenol administration and 4% after bopindolol (NS) at rest and similarly during IE. In contrast to bopindolol, atenolol caused small increases initially in left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD). A 10% increase in FS was seen at rest after bopindolol administration (NS). With the fall in heart rate the estimated cardiac output (CO) also fell from 3.66 to 3.151/min (P less than 0.05) after atenolol but rose from 3.87 to 3.93 after bopindolol (NS) during chronic treatment. Consecutively the total peripheral resistance (TPR) was increased to some extent by atenolol, whereas bopindolol reduced it at rest and during IE. A similar response was also found in systolic time intervals PEP/LVET which were reduced during bopindolol administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1987

Increase of cardiac output by afterload reduction in patients with severe congestive heart failure using nitroglycerin discs. A double-blind placebo-controlled haemodynamic study.

In a double-blind crossover study, the haemodynamic effects of nitroglycerin discs were compared with placebo in 9 patients with severe chronic congestive heart failure. Hourly measurements were made throughout 24 hours for the placebo and the active treatment; the first 6 hours were used as a dose titration phase to achieve at least a 5 mmHg decrease in pulmonary arterial diastolic pressure. Active treatment, requiring 30 mg of nitroglycerin in most patients, produced a significant improvement in the cardiac index compared with placebo, as assessed from the end of the dose titration period to the 24th hour. Values determined as baseline, as the average from hour 7 to 24, and at the 24th hour for active discs were 2.3, 2.5 and 2.6 litres/min/m2, whereas for the placebo they were 2.3, 2.2. and 2.2 l/min/m2, respectively. Heart rate remained unchanged during the study, though mean systemic arterial blood pressure and vascular resistance were lower during active treatment. Right atrial and pulmonary arterial pressures did not change. In conclusion, nitroglycerin discs decrease afterload and improve cardiac performance over 24 hours in patients with heart failure.

Administration, Topical↗
PubMed1987

Electrocardiographic and clinical features of tricyclic antidepressant intoxication. A survey of 88 cases and outlines of therapy.

The data of 88 consecutive patients with intoxication due to tricyclic antidepressant drugs were retrospectively surveyed. Apart from sinus tachycardia, temporary electrocardiographic changes developed in 48 patients (55%). These included, in order of their frequency, QTc prolongation (85%), T-wave abnormality (82%), PQ prolongation (19%), widening of QRS with or without bundle branch block pattern (19%), and supraventricular or indefinable tachycardia with wide QRS complexes (8%). The clinical course was more severe in patients with electrocardiographic changes. They were more frequently unconscious and more often required assisted ventilation than those without electrocardiographic changes (p less than 0.001). Hypotension developed in 6 patients within the first hours of poisoning; all had repolarization abnormalities and 3 developed paroxysmal supraventricular tachycardia with aberrant ventricular conduction. All 88 subjects made a good recovery and no haemodynamic problems occurred after the first 12 hours of intoxication. Second and third degree atrio-ventricular block, bradyarrthythmias and asystole were not seen in any of the patients. A prophylactic cardiac pacemaker was inserted in 13 patients with wide QRS complexes and/or prolonged PQ interval, but was never needed for bradyarrhythmias or overdrive pacing.

Adolescent↗
PubMed1986

Studies on ergometer exercise testing. I. Significance of the type of ST-segment response, sex, and chest pain.

Ergometer exercise electrocardiographic (EECG) data were surveyed in a series of 328 patients (277 men and 51 women) subjected to coronary arteriography. The sensitivity and specificity of EECG for coronary artery disease (CAD) were 84% and 54%, respectively. The predictive accuracy of a positive test for CAD was 95% in men and 81% in women. The predictive accuracy of a negative test was 25% in men and 62% in women. When slowly ascending ST depression was considered insignificant, the sensitivity of EECG declined to 71%, with an increase in specificity to 64%. CAD was present in 89% of the patients with slowly ascending ST depression and 65% of them had a multivessel disease. Seventy-two subjects had postexercise ST-segment elevation. The predictive value of this sign for CAD was 94%. Exercise-induced chest pain had quite a similar diagnostic significance as EECG. The prevalence of CAD in patients with a history of typical angina was 94% in both sexes. Atypical chest pain was associated with normal coronary arteriography in 59% of males and 100% of females.

Adult↗
PubMed1986

Studies on ergometer exercise testing. II. Effect of previous myocardial infarction, digoxin, and beta-blockade on exercise electrocardiography.

The results of exercise electrocardiography were studied in a random sample of 317 subjects with clinical suspicion of coronary artery disease. In 278 patients with coronary artery disease the rate of false negative tests was 18% with and 12% without previous myocardial infarction. If ST elevation was considered a negative response, the corresponding values were 25% and 13%, respectively, p less than 0.01. The greatest prevalence of negative tests was seen after anterior myocardial infarction: 27% or 42% when ST elevation was not included into positive responses. The sensitivity of exercise-induced ST depression for the presence of multivessel disease was lower after anterior infarction (67%) than in other patients with previous infarction (86%), p less than 0.01. The corresponding specificities were 71% and 22%, respectively, p less than 0.005. If ST elevation was included into positive responses these differences were abolished. In subjects without myocardial infarction the sensitivity was 89% and specificity 43%. Digitalized patients had somewhat higher sensitivity in the exercise electrocardiogram than those without digoxin, 90% vs. 81% (p less than 0.05), but the difference was not seen with exclusion of ST elevation. The specificity was not influenced by digitalis. beta-blockade had no effect on the sensitivity or specificity, but the prevalence of postexercise ST evolution was lower with (11%) than without (30%) beta-blockade. The prevalence of slowly ascending ST depression was reduced by three factors: the presence of digitalis in patients without previous myocardial infarction, infarction itself, and the extent of coronary artery disease. We conclude that exercise electrocardiography has only a limited value in prediction of multivessel disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1983

The microbial colonization due to medical devices in intensive care patients with special emphasis on Candida albicans.

Incidence of microbial colonization related to medical devices was prospectively studied in 101 consecutive patients treated in intensive care unit ICU. Following endotracheal intubation 50% of patients had positive bacterial culture in the trachea within 24 hours irrespective of the use of antibiotics. Positive urine cultures occurred in 33% of patients with indwelling urinary catheters. Colonization of the trachea and the urinary tract with Candida albicans usually followed a few days after the bacterial colonization. However, septic Candida albicans infections seem to be rare in intensive care patients in spite of abundant colonization in the mucous membranes. Simultaneous growth of Candida albicans in the trachea and the urinary tract was associated with poor prognosis.

Candida albicans↗
PubMed1981

Hemoperfusion in quinidine intoxication.

A case report on quinidine intoxication is presented. After having ingested 8.1 g quinidine the patient had clinical and ECG signs of a severe intoxication and a serum quinidine level of 8.5 mg 1. She was treated for six hours with charcoal hemoperfusion. Serum quinidine was on an average 36% lower after than before the cartridge. The mean quinidine clearance of hemoperfusion was 24 ml/min. All clinical and ECG signs of quinidine intoxication were normalized during hemoperfusion. The data justify that hemoperfusion is probably the best way to treat severe quinidine intoxication.

Adult↗