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  • Congestive heart failure  (2)
  • Acute myocardial infarction  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Evaluation of long-term oral levodopa therapy in chronic congestive heart failure (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 1087-1094 
    Details
    ISSN: 1432-1440
    Keywords: Levodopa ; Inotropic drugs ; Congestive heart failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate the long-term effects of orally administered levodopa, 11 patients with chronic congestive heart failure (NYHA III–IV) were studied during maintenance therapy (30±1 days) and after withdrawal from levodopa. The daily levodopa dose was 4 g in six patients; because of side effects the levodopa dose was reduced to 2–3 g in the remaining patients. After withdrawal of levodopa, mean pulmonary capillary wedge pressure and mean right atrial pressure increased significantly (from 19±2 to 24±3 and from 7±2 to 9±2 mmHg, respectively). Effective renal plasma flow was 329±57 during levodopa therapy and decreased significantly to 252±27 ml/min after withdrawal of levodopa. The number of ventricular premature contractions and couplets increased during levodopa therapy and decreased again significantly after withdrawal of levodopa. No significant differences between on and off levodopa were observed in resting heart rate, arterial blood pressure, cardiac index, stroke work index, systemic vascular resistance, sodium and water excretion, or creatinine clearance. Seven patients improved on levodopa therapy by one NYHA class; four of these seven patients deteriorated again by one NYHA class after withdrawal of levodopa. Regarding both clinical and hemodynamic changes after withdrawal of levodopa, three patients were classified as responders to long-term levodopa therapy. All three responders received 4 g levodopa per day. Average dopamine plasma level was 5.3±0.8 ng/ml in the responder group and 2.0±0.5 ng/ml in the nonresponder group. Long-term administration of oral levodopa is associated with beneficial clinical and hemodynamic response in only a minority of patients with chronic congestive heart failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01736115
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Kalziumantagonisten bei Herzinsuffizienz? (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 993-1002 
    Details
    ISSN: 1432-1440
    Keywords: Congestive heart failure ; Calcium antagonists ; Hemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although beneficial acute hemodynamic effects of calcium antagonists in heart failure have been reported, their use in this setting is still controversial because of the negative inotropic effects produced by these agents. The direct actions of calcium antagonists, that is direct depression of myocardial contractility and coronary and peripheral vasodilatation, are modulated by systemic hypotension-induced baroreceptor activation of autonomic reflexes. Thus, at clinically relevant dosages, the baroreceptor-mediated cardiac stimulatory effects may counterbalance or override the direct negative-inotropic effects, as usually observed with nifedipine or diltiazem. By contrast, with verapamil significant depression of contractility may occur. Newer calcium antagonists with higher vasoselectivity such as nisoldipine or felodipine may be particularly interesting in the setting of congestive heart failure because of pronounced arterial vasodilatation and their additional effects on coronary blood flow, LV-regional wall motion and diastolic function and peripheral blood flow distribution with negligible myocardial effects. Due to their marked vasodilatating properties, newer derivatives may be advantageous in the treatment of heart failure due to coronary artery disease and hypertension. Although limited data concerning long-term efficacy are available, preliminary studies suggest long-term benefit in selected patients. It appears that verapamil should not be used for vasodilator therapy of severe heart failure, since deterioration of LV function may occur.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01757206
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Left ventricular function after acute myocardial infarction (1976)
    Springer
    Intensive care medicine 2 (1976), S. 7-11 
    Details
    ISSN: 1432-1238
    Keywords: Left ventricular function ; Wall stiffness and contractility ; Acute myocardial infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract 10 patients with their first AMI were studied within the first 48 hours and again after 3 weeks. Central and peripheral haemodynamics (CI, SV, SW, TPR) were examined, including indices of contractility (dp/dlmax) and wall stiffness (ΔP/ΔV, relation ΔP/ΔV to P) of the left ventricle. In the early phase CI and SW, as well as LV dp/dtmax were depressed in accordance with symptoms of LV failure. ΔP/ΔV was increased. Elevation of LVEDP correlated well with ventricular gallop rhythm, but less consistently with LV functional disturbance. During convalescence CI increased uniformly, both in digitalized and non-digitalized individuals. In contrast heart rate, aortic pressure, LVEDP and dp/dtmax remained unchanged. The increase of CI, SV and SW was accompanied by a fall of TPR and ΔP/ΔV. LV wall stiffness was still elevated above normal after 3 weeks. The improvement of cardiac pumping during infarct convalescence may have been effected through a fall of TPR and LV wall stiffness. Recovery of depressed contractile performance was generally not observed, and does therefore not seem to contribute to recuperation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00571890
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    Paper (German National Licenses)
    Fulltext
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