Cor et Vasa

As the prevalence of congestive heart failure is steadily increasing correct treatment becomes more and more important. In pathophysiology, clinical signs once believed to express the effort of the body to "compensate" for the failure (hypervolaemia, tachycardia, sympathetic stimulation) have been recognized as sort of a physiological error: to a primary signal which still remains not fully understood, the body responds in a similar way as to dehydration. As late as the mid-sixties, "function curves" represented a framework for our conceptual thinking and digitalis the essential treatment...

A randomized clinical study was conducted to compare the effect of "conventional" antiaggregation therapy (ASA plus dipyridamole) versus indobufen in patients after aortocoronary bypass (ACB) surgery. The patency of venous ACB using coronary DSA one week and one year after surgery was evaluated in 52 patients divided into two groups. The study included only ACB's with intraoperative blood flow rates < or = 40 ml/min as it is just these ACB's which are at the highest risk of early and late occlusions. While, in the ASA plus dipyridamole-treated group, occlusions were found in 11 of the 39 reconstructions (28...

The transjugular intrahepatic portosystemic shunt (TIPS) is a relatively new method of creating a portosystemic shunt using a needle, angioplasty balloon catheters and expandable metallic stents. During a 6-month period, the authors have performed TIPS, using the spiral Z-stent--another modification of the Gianturco-Rósch stent--in 13 patients with portal hypertension. The procedure was technically successful in all patients. Portal pressure decreased by 6 mmHg in one group of patients with 9-10 mm stents, and by 12 mmHg in another group using 12 mm stents...

Though the benefits of DDD pacing in patients with high-degree atrioventricular (AV) block are undisputable, it is desirable to identify--because of economic aspects--the subgroups of patients with maximum benefit from DDD pacing. An attempt has been made in the presented study to identify the subgroups of patients with a high increase in maximum working capacity during DDD pacing. The predictability of artificial pacemaker block based on atrial rate behaviour during exercise in heart block and VVI pacing has also been determined...

In a group of endomyocardial biopsies (EMB), performed in 45 patients with the clinical diagnosis of suspect myocarditis or dilated cardiomyopathy, positive findings (including histologically suspect lesions) were made in 53.3% of first EMB. Myocarditis, particularly its focal or multifocal forms, is bound to pose a major challenge not only in clinical diagnosis but, often, also in histological diagnosis. Of paramount importance in this situation are 1) early specimen removal after the onset of clinical manifestations and before initiation of the appropriate therapy, 2) removal of a major number of specimens in a single EMB because of the potential of focal lesions...

Quinidine-like immunoreactivity (Abbott TDx Quinidine fluorescence polarization immunoassay) was measured in control, sham-operated, abdominal aorta stenotic and hyperthyroid (thyroxine feeding 0.1 mg/rat/day rats. The mean quinidine levels (mumol quinidine/1 serum) were 0.07, 0.14, 0.13 and 0.25, respectively. The elevation in experimental hyperthyroidism was statistically (analysis of variance, Duncan's test) significant. The possibility of the existence of an endogenous antiarrhythmic, immunologically cross-reacting in quinidine immunoassay, is discussed...

Programmed electrical stimulation (PES) of the ventricle plays an important role in diagnosis and in testing the effect of pharmacological and non-pharmacological therapy of ventricular tachyarrhythmias. A stimulation protocol should reliably reproduce clinical ventricular tachyarrhythmia. The authors compared the results of the standard one-site protocol to those of a new test delivering extrastimuli alternately into the right and left ventricle. In group I (control group, n = 37), clinically without ventricular tachycardia, tachycardia could not be induced in any of the patients...

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Hyperinsulinaemia and insulin resistance are associated with essential hypertension irrespective of obesity and non-insulin-dependent diabetes mellitus. One of the mechanisms whereby hyperinsulinaemia may play a role in the increase in blood pressure, is an increased activity of the sympathetic nervous system. The authors studied the incidence of hyperinsulinaemia, and the possibility of modulating it by 12-week administration of the ACE inhibitor (ACEI) lisinopril (Prinivil by MSD) at a dose of 20-40 mg/day...