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[Enalapril improves hemodynamics and exercise tolerance in pulmonary heart disease caused by obstructive lung disease].

Chronic enalapril therapy was assessed in 11 patients with cor pulmonale due to chronic obstructive pulmonary disease. Enalapril was added to the maintenance dose of diuretics and digitalis and when clinical stabilisation was achieved haemodynamics, spirometry, blood gases and maximal treadmill exercise test accompanied by +pulse oximetry were performed before and after 30 days, 10-20 mg a day, enalapril therapy. Haemodynamic study showed moderate but significant decrease in mean pulmonary artery pressure, from 24 +/- 3 to 21 +/- 5 mmHg (p = 0.05). There were no substantial differences in cardiac output as well as in blood gases and spirometry after enalapril therapy. Slight decrease in oxygen delivery, on an average from 9157 +/- 3808 to 8074 +/- 3574 (p = NS), was accompanied by a concomitant fall in haemoglobin. We noted significant improvement of maximal exercise test results after enalapril therapy. Maximal workload achieved and the time of exercise increased. It was accompanied by subjective improvement as assessed by Borg scale. We observed no adverse effects of enalapril during one month therapy in patients with cor pulmonale and COPD.

Aged↗

[Chronic pulmonary heart disease and its risk factors among a worker population in Teheran].

Because of the high frequency of chronic cor pulmonale in workers admitted to the cardiology department of the Khazaneh Hospital in Teheran, we studied the clinical aspect and the risk factors of this disease in 66 male patients. The average age of patients was 56.1 years and they often had a long history of bronchitis isolated or associated with emphysema. The ECG analysis showed that most abnormalities were localized on the QRST wave. Tobacco and a polluted working environment were the factors most frequently met in our patients. The opium habit probably acted as a risk factor for chronic bronchopneumopathy, but further studies are necessary to ascertain the fact.

Adult↗

[Problem-specific grading in disease course assessment and calculation of the likelihood of transition of chronic cardiovascular diseases].

For the course rating of cardiovascular caused drop in efficiency a problem-specific grading is introduced, the characterization of which is composed of simple, non-invasive parameters. The grading is specified for 4 clinical diagnostic classes (hypertension, coronary heart diseases, pulmonary heart, "other heart and vessel diseases") and takes into consideration the frequent coincidence or connection of several diagnoses of heart and vessel diseases with each other. The choice of parameter and connection have to fulfil the demand, which is essential for the course rating of heart and vessel diseases, like practicability proportionate with the frequency of heart and vessel diseases, adequate registration of changes in severe degrees, statement about the patient and not about several parameters. Furthermore it has to make it possible to calculate provisional probabilities under variable conditions as well as to make possible a valuation of prognosis. For that purpose the construction of suitable matrixes is shown and an integral projection is represented, which is used for the interpretation of courses dependent on severe degrees. The conception of grading has the function to modify necessary parameters for inclusion in the hierarchy according to medical starting position (for instance primary mode of registration). The model which is applicable to level of population makes possible an electronic data - processing - based evaluation including algorithmic classification.

Cardiovascular Diseases↗