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Biomedical subjects

U Gleichmann

Publications and source records attributed to U Gleichmann.

At least 109 records · Page 6Linked to original sources
PubMed1986

[Long term therapy of coronary heart disease with 120 mg slow release isosorbide dinitrate once a day. Study of duration of action and development of tolerance].

Twenty-one patients (3 women, 18 males, mean age 55.7 +/- 6 years) with coronary heart disease proven by coronary angiography entered a double blind randomised study with isosorbide dinitrate slow release 120 mg once a day. 2, 12 and 24 hours after acute medication patients underwent a symptom-limited exercise-ECG. The following parameters were measured: ST-depression, blood pressure, heart rate and working capacity. After one week of therapy the same parameters were measured to look for the development of tolerance. Two and twelve hours after acute medication working capacity increased to 220% and 139% respectively. After 24 hours there was no statistically significant effect. The sum of ST-depression in three leads decreased from 4.85 +/- 3.02 mV to 1.87 +/- 0.96 mV (38.5%; p less than 0.05) 2 hours after medication, and to 2.10 +/- 1.73 mV 12 hours after medication. 24 hours after medication there was still a slight but not significant reduction of ST-depression. There was no statistically significant effect in the placebo group. After one week of therapy there was a slight reduction of action, but no development of tolerance.

Clinical Trials as Topic↗
PubMed1985

[4 different nitrate preparations with regard to the possible development of tolerance in long-term treatment].

Thirty-two hospitalized patients with angiographically-documented coronary artery disease and stable angina pectoris (NYHA class III) were randomly assigned to one of four treatment groups. After a one-week washout period, baseline examinations (systolic time intervals, blood pressure and exercise ECG) were performed. The patients were then treated with either 20 mg isosorbide dinitrate in sustained-release form (sustained-release ISDN), 20 mg isosorbide 5-mononitrate (IS 5-MN), 2.5 mg buccal nitroglycerin in sustained-release form (NTGB) or 6.5 mg oral nitroglycerin in sustained-release form (NTGO) and one hour thereafter, the heart rate, blood pressure and systolic time intervals were determined. Subsequently, the patients were treated with the respective nitrates four times daily for two weeks. On the seventh and 14th days, the heart rate, blood pressure and systolic time intervals were again determined before and after the first dose of the day. Additionally, after the first dose on the 14th day, an exercise ECG was performed. The effect of the nitrates on the venous capacitance system is reflected by the increase in the PEP/LVET ratio where NTGO and NTGB elicited marked actions and those of sustained-release ISDN and IS 5-MN were of a lesser extent. An effect on systolic and diastolic blood pressure at rest and during exercise could be documented only after administration of NTGB. The anti-ischemic effect of the nitrates was based on the reduction of ST-segment depression during exercise; after two weeks of treatment, sustained-release ISDN and IS 5-MN were associated with complete tolerance development while NTGO continued to exert a slight, and NTGB a clear reduction in ST-segment depression. Personal protocols documented that nitrate consumption and rate of anginal attacks during longterm treatment were unaffected by sustained-release ISDN, IS 5-MN and NTGO, but were reduced by 50% while on treatment with NTGB.

Administration, Oral↗
PubMed1984

[Prevention of coronary heart disease--practical viewpoints].

The recently published intervention studies have shown that effective prevention of coronary artery disease can be done by risk factor modification. Identification and care for patients with higher risk is a challenge for the attending physician. He should focus his attention on the three major risk factors: hypertension, hypercholesterinemia and smoking. Normalisation of eating behaviour is the basis in the treatment of hypertension and hypercholesterinemia. For smoking cessation family members should also be advised to stop smoking, too. An effective reduction in the risk profile by life style changes can only be achieved if a good relation between patient and physician can be established.

Cholesterol↗
PubMed1983

Correlation between R-wave amplitude and left ventricular volume at rest and with exercise.

In 52 patients with exercise angiography (12 normals, 31 with coronary heart disease, 9 with congestive cardiomyopathy) exercise ECGs were examined for R-wave changes. An increasing R-wave amplitude was found an insensitive sign of ischemia in patients with coronary heart disease (sensitivity 29%, specificity 81%). Sensitivity and specificity of the observed ST depression in this study were 83% and 71%, respectively, as reported by others. There was no positive correlation between the changes in the R-wave amplitude and left ventricular end-diastolic volume during exercise, thus there was no proof of the existence of the so-called Brody effect in humans.

Cardiac Catheterization↗
PubMed1983

[Current status of ambulatory coronary groups in West Germany. Results of a nation-wide survey].

The aim of the study was to gather detailed information on the structure and function of ambulatory coronary training groups in Germany by means of a nationwide survey. The response rate was 66.7%; the results are therefore representative for the FRG. From the collected data it can be estimated that approximately 500 coronary clubs care for approximately 9 000 patients. Sponsorship, financing, group structure, and club activities, as well as data on morbidity and complications, are presented in detail. Statements by both physicians and patients support the view that the main benefit of coronary clubs is not the improvement of physical fitness, but the improvement in the quality of life of the participants.

Ambulatory Care↗
PubMed1982

The influence of beta-adrenoceptor antagonists with and without intrinsic sympathomimetic activity on local wall motion abnormalities in patients with coronary heart disease.

1 A single-blind randomized study of the effects of a beta-adrenoceptor antagonist with intrinsic sympathomimetic activity (pindolol 0.4 mg i.v., n = 10) and a drug lacking this property (metoprolol 5 mg i.v., n = 11) on local wall motion abnormalities was carried out in 21 patients with coronary heart disease and anterior wall hypokinesia. 2 The drugs produced similar changes in left ventricular end diastolic pressure (LVEDP) and end diastolic volume index (EDVI) but differed in their effects on heart rate and ejection fraction. Pindolol did not exert any marked effect on heart rate or ejection fraction whereas after metoprolol treatment both were significantly decreased. 3 Shortening of the hypokinetic wall segments was improved by both drugs. Shortening of the non-hypokinetic contralateral segments was unchanged after pindolol administration but was decreased after metoprolol. 4 The differing effects of beta-adrenoceptor antagonists on regional wall motion appear to be dependent on the presence or absence of intrinsic sympathomimetic activity.

Adrenergic beta-Antagonists↗
PubMed1982

[Influence of betablocking agents with and without intrinsic sympathicomimetic activity (ISA) on local wall-motion disorders in patients with coronary heart disease].

UNLABELLED: A single blind randomized study on the effect of betablockers with (Pindolol = P, 0.4 mg i.v., n = 10) and without (Metoprolol = M, 5 mg i.v., n = 11) intrinsic sympathicomimetic activity (ISA) on local wall-motion abnormalities was performed in 21 patients with coronary heart disease in anterior wall hypokinesia. Before and 10 minutes after intravenous application of P or M strokes, volume index, cardiac index, heart rate, systolic and enddiastolic left-ventricular pressure were measured. The left-ventricular volumes were calculated biplane with the area-length method of Dodge and Sandler. Analysis of wall-motion disorders were performed by hemichord method measuring 7 hemiaxis and 1 long axis. RESULTS: Similar hemodynamic effects of both beta-blockers were found on LVEDP und LV-EDVI. Different effects were observed on heart rate and ejection fraction. With M heart rate and ejection fraction decreased, with P heart rate and ejection fraction increased significantly due to the intrinsic sympathicomimetic activity (ISA). Shortening of hypokinetic wall segments was improved by both P and M, shortening of non-hypokinetic contralateral segments, however, remained unchanged with P and decreased with M. With P shortening of chords was improved, whereas with M shortening of chords decreased. Our findings suggest that in therapy of patients with coronary heart disease differential use of beta-blocking agents with or without ISA has to be discussed.

Adrenergic beta-Antagonists↗
PubMed1982

[Hemodynamics of the St. Jude Medical aortic prosthesis in comparison to the Björk-Shiley and Lillehei-Kaster prostheses].

Pre- and postoperative hemodynamic data in 10 patients in whom the aortic valve was replaced by a St. Jude Medical (SJM) prosthesis are compared with those in 29 patients who received a Lillehei-Kaster tilting disk (LK) valve prosthesis and 11 patients with a Björk-Shiley tilting disk (BS) valve prosthesis. The SJM aortic prosthesis of the small size (A 21) has advantages over the LK and BS types, and it is therefore particularly suited to use in a small aorta. There are also good hemodynamic results for the larger sizes of the SJM prosthesis. As a result of the 85-degree opening angle and the favorable ratio between the inner and outer diameters of the valve (suture ring), there is only minor impedance of blood flow. The SJM aortic prosthesis thus involves a lesser degree of hemolysis than the BS and the LK. In spite of the promising hemodynamic data, however, long-term findings on the durability of the SJM prosthesis in vivo have not yet been published. It therefore seems to us justifiable, especially where the aorta is large, to continue to use BS prostheses.

Aged↗