Cardioprotection by aldosterone receptor antagonism in heart failure. Part I. The role of aldosterone in heart failure.

In recent years understanding of the role of aldosterone has expanded beyond the known classic effects of promoting renal sodium retention and potassium and magnesium loss. It is now well documented that aldosterone causes myocardial and perivascular fibrosis, blocks the myocardial uptake of norepinephrine, and increases plasminogen activator inhibitor levels. In conjunction with angiotensin II, aldosterone causes vascular damage, endothelial dysfunction, and decreased vascular compliance.

Severe Serratia liquefaciens sepsis following vitamin C infusion treatment by a naturopathic practitioner.

A 66-year-old female patient developed severe Serratia liquefaciens sepsis following vitamin C infusion treatment by a naturopathic practitioner. The clinical course of the infection was characterized by several complications, and the direct costs of the hospital stay amounted to about 40000 Euro. Genotypically identical S.

Advanced pacemaker diagnostic features in the characterization of atrial fibrillation: impact on preventive pacing algorithms.

Pacing algorithms to prevent PAF are mainly based on the suppression of premature atrial complexes (PACs), which play an important role in its initiation. In contrast to 24-hour ambulatory electrocardiograms, advanced pacemaker (PM) diagnostic features are capable of recording AF episodes during long follow-up periods and of characterizing AF in a detailed fashion. For the specific use of these algorithms, a detailed characterization of AF was performed in 91 dual chamber PM recipients with histories of AF.

The effects of orthostasis on the ventricular-evoked response.

Aims: The effects of orthostasis on the morphology of the ventricular-evoked response were investigated.

Methods And Results: Seven patients (five females; 74.9 +/- 4.

Fatal arrhythmia in a juvenile athlete due to myocardial hypertrophy and infarction.

This report is a case history of a 16-year-old highly trained athlete who suffered from ventricular fibrillation during exhaustive physical activity. After resuscitation and admission into hospital ECG revealed posterior wall infarction. Thrombolytic therapy was advised and ST-segment elevation reversed.

Surgery in patients with coronary artery disease--silent ischaemia during transurethral resection of tumors of prostate or bladder.

Background: Asymptomatic episodes of myocardial ischemia in clinically stable patients seem to occur frequently and may hint at a worse prognosis.

Hypothesis: This study was undertaken to determine whether surgical patients with coronary artery disease (CAD) have a higher risk of cardiac ischemia during the perioperative period compared with the late postoperative period and compared with patients without CAD.

Methods: In all, 14 patients with and 14 patients without CAD were examined by Holter monitoring during the perioperative and three days later during the postoperative periods for the presence of ST-segment depression as a marker of silent myocardial ischemia.

[Hypercalcemia in florid pulmonary and cervical lymph node tuberculosis].

A 57-year-old man with a history of tuberculosis (TB of the knee-joint 44 years ago and open pulmonary TB six months ago with poor patient drug compliance) had lost 10 kg in weight during the preceding six months. In addition, firm lymph-node swellings with redness of the overlying skin and a skin fistula developed on the right side of the neck. There was mild hypercalcaemia (albumin-corrected serum calcium concentration 2.

[Silent myocardial ischemia in long-term ECG with various mani festations of coronary heart disease].

Silent myocardial ischaemia seems to be of prognostic value in coronary artery disease. We examined 47 patients with coronary artery disease: 1. 20 patients with a history of myocardial infarction (MI), 2.

[The hemodynamic profile of amrinone and enoximone in patients with severe heart failure].

Hemodynamic measurements were done in 42 patients with congestive heart failure of NYHA classes III and IV after administration of the phosphodiesterase inhibitors amrinone und enoximone. Amrinone decreases mean arterial pressure (-4%), right atrial pressure (-39%), and systemic vascular resistance (-23%), while cardiac index and stroke volume index increase to 27% and 26%, respectively; heart rate is nearly unchanged. Enoximone administration in a dose of 1 mg/kg bw produces an increase in cardiac index of 13%, an increase in heart rate of 12%, and a decrease of systemic vascular resistance of 13%, whereas stroke volume index is unchanged.

[Central hemodynamics of a new positive inotropic substance, adibendan. Data from a dose-finding study].

Central Hemodynamics from the New Positive-inotrope Substance Adibendan/An open dose-finding study We investigated the influence of Adibendan which is a new phophodiesterase inhibitor on central hemodynamics in an open dose-finding study. 10 patients with chronic heart failure NYHA II-IV (mean age 67 +/- 5 years) got Adibendan i.v.

Cardiac function in endocrine diseases: I. Acromegaly.

The aim of our echocardiographic study was to characterize cardiac function and anatomy of 14 acromegalics (A: 9 women, 5 men; mean age: 42.4 yrs) more closely. The duration of acromegaly in 4 of these patients was between 3 and 12 years; the disease was diagnosed for the first time in the other patients.

[Effect of pimobendan on peripheral hemodynamics].

Peripheral hemodynamics and some metabolic parameters were studied in 20 patients with coronary artery disease (x = 59 +/- 9 y) and in 20 healthy volunteers (x = 25 +/- 3 y) at rest and after isometric handgrip exercise both before and after administration of pimobendan or placebo using a randomized, double-blind study. Forearm blood flow was measured using venous occlusion plethysmography. In pimobendan treated patients and volunteers an increase in forearm blood flow between 9% and 38% could be noticed.

Acute effects of enoximone in chronic heart failure.

In 19 patients with chronic heart failure in NYHA stages III and IV, hemodynamic measurements were made using a Swan-Ganz catheter before and 15 and 30 min after intravenous administration of enoximone. Group A (n = 10) received 1.0 mg of enoximone/kg of body weight and group B (n = 9) received 1.

[Aggressive mediastinal fibrosis, a rare cause of superior vena cava obstruction--case report and review of the literature].

An aggressive mediastinal fibrosis was found to be a cause of superior vena caval obstruction in 1 to 2% of patients. Symptoms can be discrete for a long time, but the progressing disease can cause many symptoms. A 56-year-old man who, for half a year, suffered from thoracic pain during deep inspiration, and then rapidly developed superior vena caval obstruction caused by aggressive mediastinal fibrosis is discussed.

[Peripheral hemodynamics and metabolic parameters influenced by amrinone at rest and following handgrip stress].

Peripheral hemodynamics and metabolic parameters were studied in 12 healthy volunteers (mean = 24.6 years) and in 12 patients with coronary artery disease (mean = 51.1 years) at rest and after isometric handgrip exercise both before and after application of amrinone (1.

Investigations on staphylococcal infection of transvenous endocardial pacemaker electrodes.

Infections of pacemaker electrodes and/or aggregate pockets are usually caused by staphylococci, primarily Staphylococcus epidermidis. From in vitro experiments it can be demonstrated that staphylococci are able to adhere to the plastic electrode sheath, to multiply there, and to form microcolonies. Furthermore, the staphylococci produce a slimy amorphous substance with which they are completely covered after a 24-hour incubation.

Effect of haemodynamic changes during rapid atrial pacing on determination of sinus node recovery time.

Arterial blood pressure was continuously monitored during rapid atrial pacing in 31 patients with different types of heart disease to determine sinus node recovery time and corrected sinus node recovery time. Pacing was initiated at 70 beats/min and increased stepwise to 160 beats/min. One to one atrioventricular conduction was maintained throughout the one minute stimulation period.

[Hemodynamic studies at rest and under stress in patients with coronary heart disease after administration of carteolol].

In 17 patients with coronary heart disease the influence of the beta-blocking agent 5-(3-tert-butylamino-2-hydroxy-propoxy)-3, 4-dihydro-2(1H)-quinolinone-hydrochloride) (carteolol hydrochloride, Endak, Endak mite) (0.4 mg i.v.