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  • Articles: DFG German National Licenses  (2)
  • 1990-1994  (2)
  • Diuretic therapy  (1)
  • PDE inhibition  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Volumes and Na+/H+ antiporter activity of lymphocytes in patients with congestive heart failure (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 985-991 
    Details
    ISSN: 1432-1440
    Keywords: Cell volume ; Na+/H+ antiporter activity ; Human mononuclear leukocytes ; Angiotensin-converting enzyme inhibitor ; Diuretic therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Previous studies in patients with congestive heart failure (CHF) treated with diuretics and/or digoxin have shown abnormalities of cellular volume and electrolytes in biopsies of skeletal muscle. These abnormalities seem to play an important role with regard to the dysregulation of peripheral vascular resistance and characteristic clinical features of CHF, for example, muscular weakness. This study assessed the effect of angiotension-converting enzyme (ACE) inhibitor therapy on cell volume and cell volume regulation in patients with CHF. Cell diameters of human mononuclear leukocytes (HML) were determined electronically by a Coulter Counter. Cell diameters for 19 patients with decreased left ventricular ejection fraction (determined via levocardiography) on therapy with ACE inhibitors (group 1) were compared to those of HML from patients on diuretics alone (group 2,n = 16). The activity of the Na+/H+ antiporter was determined by cell swelling in isotonic propionate. The control group consisted of 20 normal, age- and sex-matched volunteers. HML diameters were significantly increased from 7.16 ± 0.07 in normals to 7.24 ± 0.08 μm (group 1;P 〈 0.01) and 7.23 ± 0.11 μm (group 2;P 〈 0.05), indicating an abnormal regulation of cell volume. There were no statistically significant correlations between the individual ejection fraction or digoxin therapy and average cell diameters. In both patient groups ethylisopropylamiloride-sensitive swelling rates were normal compared to the control group indicating a normal activity of the Na+/H+ antiporter. In conclusion, increased cell sizes reflect a structural change in HML rather than a rapidly reversible functional abnormality which was not affected different by ACE inhibition and diuretic therapy. The pathomechanisms underlying abnormal cell sizes in CHF patients remain to be determined but could be similar to those responsible for muscular changes in CHF. Further studies should show whether HML, being easily accessible, are a valid cell model to reflect these muscular abnormalities in CHF, and whether a normal cell size can be achieved therapeutically by normalized neurohumoral activities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00577741
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Short-term effects of oral enoximone on hemodynamics, exercise capacity, anaerobic threshold, and arrhythmias in congestive heart failure (1991)
    Springer
    Journal of molecular medicine 69 (1991), S. 430-435 
    Details
    ISSN: 1432-1440
    Keywords: Congestive heart failure ; PDE inhibition ; Positive inotropic action
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Enoximone, a phosphodiesterase-inhibitor, is a potent inotropic vasodilator agent that causes a marked improvement in hemodynamics in patients with congestive heart failure. The acute effects of oral enoximone on rest and exercise hemodynamics, ejection fraction, aerobic metabolism, exercise capacity, and arrhythmias were studied in 11 patients with moderate to moderately severe dilative cardiomyopathy after 8 days of enoximone (100 mg tid) in addition to baseline therapy (diuretics and digitalis). The cardiac index increased from 2.44±0.45 to 2.72±0.50 l/min/m2 (p〈0.01) at rest and from 4.00±0.96 to 4.75±0.95 l/min/m2 (p〈0.005) during exercise. Pulmonary wedge pressure decreased from 16.8±7.3 to 12.5±6.5 mmHg (p〈0.005) at rest and from 28.2±8.0 to 24.5±10.3 mmHg (p〈 0.05) during exercise. Systemic vascular resistance decreased from 1608±243 to 1495±300 dynes*sec*cm−5 (p〈0.05) at rest and from 1152±155 to 1027±236 dynes*sec*cm−5 (ns) during exercise. The anaerobic threshold, which was recorded simultaneously, increased from 13.2±2.7 to 15.5± 2.5ml/kg/min VO2 (p〈0.02). The radionuclide ventriculography ejection fraction improved from 21.7±5.0 to 28.1±9.1% (p〈0.01) during exercise; the changes at rest were not significant (20.8±6.2 vs 25.8±8.4%). Exercise tolerance showed an increase of 16% (492±133 to 573±135 sec, p〈 0.005). The resting heart rate remained unchanged (81.8±13.4 vs 81.8±11.9). Interestingly, 24-h Holter monitoring revealed more or new repetitive arrhythmias in 9/11 patients. Short-term therapy with oral enoximone enhances ventricular performance by increasing cardiac contractility and lowering vascular resistance, both of which extend exercise tolerance and improve aerobic metabolism. Potential proarrhythmic effects need further evaluation, however.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01666828
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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