[Doppler echocardiography evaluation of left ventricular function in intra-aortic balloon counterpulsation].

Doppler-echocardiographic measurement of transaortic and mitral flow allows an assessment of systolic and diastolic left ventricular performance. To evaluate the hemodynamic effects of intra-aortic balloon counterpulsation (IABP) 10 patients were examined during IABP after myocardial infarction or cardiothoracic surgery. Doppler echocardiographic transaortic (VAo), early (VE) and late (VA) transmitral flow velocities, transaortic velocity time integral (VTIAo), acceleration and deceleration intervals and rates were obtained.

[Spontaneous coronary artery dissection: a rare cause of myocardial infarct].

The case of a 52-year-old female is presented who suffered from myocardial infarction with a prolonged course of symptoms. The angiographic examination revealed a spontaneous dissection of the right coronary artery without evidence for atherosclerotic coronary artery disease. Under medical treatment no further complications occurred.

Influence of long-term treatment with ketanserin on blood pressure, pulmonary artery pressure, and cardiac output in patients with heart failure.

Ketanserin is a selective serotonin2-receptor blocker and by this mechanism decreases peripheral resistance and blood pressure in hypertensives. We examined the hemodynamic effects of ketanserin during long-term treatment in patients with heart failure. Five male patients with coronary artery disease and heart failure (NYHA classes II-III) were treated with ketanserin (80 mg daily) for 12 months.

Serotonin antagonism in the treatment of cardiac insufficiency.

One approach in the therapy of cardiac insufficiency is the administration of vasodilator substances for afterload reduction. Ketanserin selectively blocks the serotonin-2 receptors and thus inhibits the vasoconstrictor effect of serotonin. A hypotensive action of ketanserin has been documented in several studies.

Prevention of an early re-occlusion after thrombolytic therapy of acute myocardial infarction by ketanserin.

A problem after successful thrombolytic therapy of acute myocardial infarction is the early occurrence of re-occlusions. An incidence between 10 and 30% is reported. All efforts made so far to reduce the re-occlusion rate using a variety of agents have been disappointing.

Arguments supporting the use of calcium antagonists in idiopathic dilated cardiomyopathy: theoretical considerations and clinical results.

There is increasing evidence that sarcolemmal disorders in idiopathic dilated cardiomyopathy (IDC), due either to viral infection, catecholamine excess, ethanol intoxication, microcirculatory disorders, or autoimmune responses, induce enhanced Ca2+ inflow. This may lead to mitochondrial Ca2+ accumulation and activation of phospholipase and proteases, resulting in left ventricular dysfunction. The acute beneficial hemodynamic response to diltiazem in IDC patients, in comparison to other calcium blockers, enabled us to perform an open trial investigating the effects of chronic diltiazem (60-90 mg t.

Effect of serotonergic antagonism on local responses to an acute and selective endothelial trauma in vivo.

Serotonin is liberated during platelet release reaction. It is concluded from in vitro experiments that serotonin influences both platelet activation and thrombus-induced vasoconstriction. The subject of the present study was to assess the impact of the serotonin2 antagonist naftidrofuryl on both thrombogenesis and thrombus-induced vasoconstriction in vivo.

Structure and function of contractile proteins in human dilated cardiomyopathy.

The pathogenesis of reduced systolic left ventricular function in dilated cardiomyopathy is yet unclear. To analyze a possible involvement of contractile protein, function and structure of left ventricular myofibrils were examined in hearts of patients with advanced cardiomyopathy undergoing heart transplantation and in normal control hearts (from renal transplant donors). Myosin and actin content of the left ventricular myocardium was slightly reduced in cardiomyopathic hearts.

Contrary effects of acetylcholine on coronary arteries and aortocoronary venous grafts in man.

The endothelium-dependent vasomotor responses differ in arteries and veins, and the transfer of veins into the arterial circulation by venous grafting may change their endothelial function. The purpose of this study was to examine the responses to acetylcholine in aortocoronary venous grafts of coronary arteries in man which may indicate differences in the endothelial function of these vessels. Five patients with venous grafts (12 to 72 months after implantation) and five patients without any angiographic evidence for coronary artery disease (controls) were examined.

[Acute myocardial infarct caused by nicotine-induced erythrocytosis].

A 29-year-old heavy smoker presented with an acute myocardial infarction and hematocrit of 70%. At immediate coronary angiography a complete occlusion of the right coronary artery was found. After intracoronary urokinase the coronary arteries were found to be completely normal.

Combined treatment with vitamins E and C in experimental myocardial infarction in pigs.

The effect of two different combined treatments with vitamin E acetate and vitamin C on infarct size and recovery of regional myocardial function was investigated in ischemic, reperfused porcine hearts. The left anterior descending coronary artery was distally ligated in 30 thoracotomized pigs for 45 minutes followed by 3 days of reperfusion. Infarct size was determined as the ratio of infarcted (tetrazolium stain) to ischemic (dye technique) myocardium.

Will emergency coronary bypass grafting after failed elective percutaneous transluminal coronary angioplasty prevent myocardial infarction?

An emergency aorto-coronary bypass grafting operation was performed within 12 hours after the development of acute myocardial ischemia due to partial or complete vascular occlusion in 34 of 950 (3.6%) patients who had received elective percutaneous transluminal coronary angioplasty (PTCA). Of the 34 patients, three (= 8.

[Excimer laser angioplasty in arterial obstructive disease. Clinical experience with guidewire-controlled catheter systems].

Percutaneous transluminal laser angioplasties (PTLA) were performed in nine patients (7 males, 2 females, aged 52-81 years) with peripheral vascular disease, stages IIB-IV (Fontaine's classification), with 75% stenosis (5 patients) or occlusion (4 patients) in the area of the superficial femoral artery. Two catheter systems were used. One was a monofiber catheter (600 microns) with eccentric guidewire, the other a multifiber catheter with 12 concentrically arranged fibres (200 microns each) and a central guidewire.

A randomized prospective study on anxiety reduction by preparatory disclosure with and without video film show about a planned heart catheterization.

Unfortunately, giving preparatory information to the patient is generally regarded as legally mandatory for obtaining his written consent to an invasive procedure. Disclosure, however, could be used to reduce his anxiety as well; we hypothesized that showing a preparatory video film might be helpful in this respect. Patients who were admitted for elective coronary angiography were eligible for the study.

Effect of alpha-tocopherol (vitamin E) in a porcine model of stunned myocardium.

Oxygen free radicals have been suggested to cause the myocardial damage resulting in the prolonged contractile depression following brief periods of regional ischemia. In pigs, we infused the natural antioxidant alpha-tocopherol as its water-soluble acetate [0.3 g/kg intravenously (i.

Treatment of reperfusion injury with intracoronary calcium channel antagonists and reduced coronary free calcium concentration in regionally ischemic, reperfused porcine hearts.

The effect of intracoronary diltiazem, EGTA (ethylene-bis-(beta-aminomethylether)-N,N'-tetraacetic acid), nifedipine, verapamil and isotonic saline solution as placebo on reperfusion injury was investigated in regionally ischemic, reperfused porcine hearts. The left anterior descending coronary artery was distally occluded for 45 min and was reperfused for 3 days. Intracoronary infusion was started immediately before reperfusion and continued during 45 min of reperfusion.

Beneficial effects of long-term diltiazem treatment in dilated cardiomyopathy.

There is increasing evidence that chronic enhanced exogenous or endogenous catecholamine stimulation in patients with dilated cardiomyopathy may worsen hemodynamic status and prognosis. The cause of this deterioration may lie in myocellular calcium accumulation and microcirculatory disorders. In a prospective study, the calcium channel antagonist diltiazem was given to 22 patients with dilated cardiomyopathy (60 to 90 mg three times daily) in addition to conventional therapy of digitalis, diuretics and vasodilators.

Pros and cons of surgery of the left ventricular aneurysm--a review.

The prognosis for the patient with a left-ventricular aneurysm depends on the size of the aneurysm and the function of the remaining ventricle. Data in the literature suggest a 5-year-survival rate of 70-75% and a hospital mortality rate of 10% for aneurysmectomy with and without any additional aortocoronary bypass surgery. Medical treatment on the other hand is only credited with a markedly lower 5-year-survival rate of 45%.

Effect of intracoronary superoxide dismutase on regional function in stunned myocardium.

This study investigates the ischemic-time dependency of dysfunction in reversibly ischemic myocardium and the effect of postischemic oxygen free radical scavenging thereupon. In open chest pigs, occlusion of the distal left anterior descending coronary artery (LAD) for 4 (n = 5), 8 (n = 5), or 12 min (n = 5) resulted in paradoxical systolic and diastolic regional function, measured by ultrasonic crystals. With onset of reperfusion, systolic shortening (SS) and diastolic lengthening (DL) normalized completely in the 4- and 8-min groups, followed by a significant decrease to 50% control in the 8-min group.

The effect of intracoronary diltiazem on regional myocardial function and development of infarcts in porcine hearts.

The effect of intracoronary (i.c.) pretreatment with diltiazem on regional myocardial function and the development of infarcts was investigated in regionally ischemic, reperfused porcine hearts.

[Beneficial long-term effects of diltiazem on the course of dilated cardiomyopathy].

There is increasing evidence that chronic enhanced exogenic or endogenic catecholamine stimulation in patients with dilated cardiomyopathy may worsen hemodynamics and prognosis. The cause of this may lie in myocellular calcium accumulation and microcirculatory disorders. In a prospective study the calcium antagonist diltiazem was given to 22 patients with dilated cardiomyopathy (60-90 mg t.

Comparative study on the enhancement of ischemic tolerance by intracoronary pretreatment with three calcium antagonists in pig hearts.

The effect of intracoronary (IC) pretreatment with different calcium antagonists (diltiazem, nifedipine, verapamil) on the development of infarcts was investigated in two experimental series including 35 open-chest pigs. The left anterior descending coronary artery (LAD) was distally ligated for 75 minutes (series A) or for 45 minutes (series B) and was reperfused for 24 hours. Infarct size was determined as the ratio of infarcted myocardium (tetrazolium stain) to the risk region (dye technique).

Coronary arterial embolism due to valvular debris after percutaneous valvuloplasty of calcific mitral stenosis.

A 74-year-old woman with refractory congestive heart failure due to long-standing calcific mitral stenosis who refused surgical intervention was treated with percutaneous balloon valvuloplasty. After an uneventful procedure, hemodynamic results were satisfactory with an increase in the mitral valve area from 0.4 to 1.