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Biomedical subjects

W D Bussmann

Publications and source records attributed to W D Bussmann.

At least 181 records · Page 10Linked to original sources
PubMed1976

[Nitroglycerin in the therapy of coronary insufficiency and heart failure].

In the treatment of angina pectoris nitroglycerin is still the most important drug. Its mechanism of action is described in reference to the lowering of preload and afterload as well as to the question of redistribution of regional myocardial blood flow. It is shown that after oral administration of issosorbide dinitrate effects on myocardial ischemia and left ventricular filling pressure can be seen lasting over more than four hours. In the treatment of acute myocardial infarction and left ventricular failure nitroglycerin can be used with favourable results and without undesired side effects if the hemodynamic is carefully observed. Under these conditions the intravenous infusion seems the most appropriate way of administration.

Administration, Oral↗
PubMed1976

Sublingual nitroglycerin in the treatment of left ventricular failure and pulmonary edema.

In 15 patients with left heart failure due to coronary heart disease (10 acute and 5 old infarcts) the enddiastolic pressures in the pulmonary artery (left ventricular filling pressure) were elevated to 25 +/- 8 mm Hg and signs of pulmonary congestion were present. After nitroglycerin sublingually (0.8-1.6 mg) the left ventricular filling pressure fell to 17 +/- 8 mm Hg and caridac output tended to increase. Mean arterial pressure did not change significantly. In 6 patients with pulmonary edema, clinically an impressive improvement was observed within 5-15 min after administration of the drug. In 1 case the left ventricular filling pressure decreased from 50 to 27 mm Hg within 5 min. In left heart failure, especially in the presence of pulmonary edema, sublingual nitroglycerin is a potent drug with a favorable influence on hemodynamic and clinical parameters.

Blood Pressure↗
PubMed1976

[Angiography of left ventricle following volume load and physical work in coronary disease].

In order to recognize and quantitate abnormalities in wall segment motion in 22 patients simultaneous measurements of isovolumic and ejection phase parameters were performed with the Millar-angiographic catheter at rest, after leg raising and during bicycle exercise. 6 patients had slight coronary heart disease (CHD) (group I), 16 patients had severe CHD (group II). During volume load in all patients of gr. II a decrease of peak measured velocity (Vpm) and the velocity of circumferential fiber shortening (Vcf from 1.4 to 1.1 circ/s, p less than 0.025) occurred. In gr. I Vcf increased (p less than 0.05). During exercise there was a high increase in Vpm and Vcf in gr. I (from 1.2 to 1.9 circ/s) whereas in gr. II no increase was observed. LVEDP rose to 29 mm Hg and ESV from 58 to 70 ml/1.73 m2. By increasing LVEDP during volume load underperfused areas became ischaemic and akinetic. During physical work the segmental abnormality can be less pronounced possibly due to the higher prestenotic pressure.

Angiocardiography↗
PubMed1975

[New aspects of the treatment of left ventricular failure: Nitroglycerin (author's transl)].

The effectiveness of Nitroglycerin and its derivates in angina pectoris is well-known. One of the main effects is the reduction of left ventricular filling pressure. Therefore in patients with left ventricular failure after acute myocardial infarction or with chronic coronary heart disease the indication for Nitroglycerin has to be proved. In 51 patients with 76 measurements Nitroglycerin sublingual, intravenous Nitroglycerin, Isosorbide-Dinitrate and Myocardon were investigated. All substances decreased pulmonary artery pressure especially left ventricular filling pressure. Cardiac output increased or decreased in dependence to the height of left ventricular enddiastolic pressure. In the patients with myocardial infarction and left ventricular failure with filling pressures over 20 mm Hg a significant increase in cardiac output was observed. On the contrary in patients without left ventricular failure cardiac output decreased slightly. Nitroglycerin sublingual is especially useful in the most severe form of left ventricular failure: in pulmonary oedema. 0.8 mg of Nitroglycerin 3 to 4 times in 5 to 10 minutes distance is necessary dependent on the severity of the pulmonary oedema and the height of the blood pressure. The permanent intravenous infusion of Nitroglycerin (3 to 6 mg per hour) is very efficient in the treatment of congestive failure in acute myocardial infarction. The left ventricular filling pressure decreased from 28 to 16 mm Hg with an increase in cardiac output from 3.5 to 4.01/min. The mean arterial pressure dropped about 10 mm Hg. Also with oral derivates of Nitroglycerin (Isosorbide-Dinitrate and Myocardon) an extensive decrease in left ventricular filling pressure and an increase in cardiac output has been observed in patients with left heart failure.

Acute Disease↗
PubMed1975

[Effect of nitroglycerin in acute myocardial infarction. III. Isosorbide dinitrate in patients with or without left-heart failure (author's transl)].

The oral effectiveness of isosorbide dinitrate (Isoket) was tested in 21 pateints with acute myocardial infarction. Patients were divided into two groups according to thier initial left-ventricular filling pressure (more or less than 20 mm Hg). In both groups there was a highly significant decrease in pulmonary artery pressure. In group I (less than 20 mm Hg) the left-ventricular filling pressure fell from 13.6 +/- 4.0 to 7.1 +/- 2.6 mm Hg, while in group II it fell from 26.9 +/- 4.6 to 19.0 +/- 3.6 mm Hg (P less than 0.001). The cardiac output fell in group I from 5.1 +/- 1.0 to 4.5 +/- 0.9 l/min, while in group II there was a significant rise from a low value (3.5 +/- 0.8 l/min) to 4.1 +/- 0.9 l/min (P less than 0.001). In both groups there was a slight but not significant fall in arterial blood pressure, while heart rate remained constant.

Acute Disease↗
PubMed1975

[Effect of nitroglycerine in acute myocardial infarction: I: Sublingual nitroglycerine in the treatment of left-heart failure and pulmonary oedema (author's transl)].

In 15 patients with left ventricular failure, ten with recent myocardial infarction and five with old infarct a highly significant fall in pulmonary-artery pressure occurred within 3-5 minutes of sublingual administration of nitroglycerine, 0.8 and 1.6 mg. End-diastolic pulmonary-artery pressure, as an expression of left ventricular filling pressure, fell from 25 plus or minus 8 to 17 plus or minus 8 mm Hg (P smaller than 0.001). In some patients cardiac output rose markedly, while arterial blood pressure fell only slightly (not statistically significant). In six patients with pulmonary oedema there was a decrease in dyspnoea within a few minutes. Left-ventricular filling pressure fell markedly in all cases, in one patient from 50 to 27 mm Hg. This study indicates that nitroglycerine can be effective in the treatment of left-ventricular failure of various causes.

Acute Disease↗
PubMed1975

E1A calculating unit for the determination of the peak measured contraction velocity of the contractile elements.

An analog calculating unit is described, which is able to differentiate the left ventricular pressure and divide dP/dt by P, where P is the absolute pressure value. The parameter dP/dt/P is called the peak measured velocity (Vpm) with the dimension s(-1). The unit has an appropriate accuracy for division, three ranges and easy to handle calibration steps. The time constants for the various ranges are 40, 8 and 4 ms.

Computers, Analog↗