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  • 1
    Electronic Resource
    Electronic Resource
    Efficacy and Safety of Thrombolysis with Intravenous Streptokinase Initiated Prior to Ambulance Transport from Community Hospital to Tertiary Health Care Center (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of interventional cardiology 2 (1989), S. 0 
    Details
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied the safety and efficacy of thrombolytic therapy for acute myocardial infarction initiated prior to ambulance transport. Two treatment regimens were compared in a prospective design: 40 patients (group A) received intravenous streptokinase 5 ± 105 IU (SK-IV) prior to and during ambulance transport and were compared with 36 patients (group B) in whom the same dosage of streptokinase was given after arrival in our hospital. In all patients immediate coronary angiography was performed, followed by intracoronary streptokinase administration. Infarct size was assessed by cumulative release of α-hydroxybutyrate dehydrogenase. Apart from three episodes of ventricular fibrillation no procedure-related complications occurred during transport. Median time to SK-IV was 70 minutes in group A versus 125 minutes in group B (P 〈 0.001). At first visualization the infarct-related vessel was patent in 23 patients (58%) in group A and in 6 patients (17%) in group B (P 〈 0.001). Anterior wall infarction median infarct size in group A was 32% smaller than that in group B (P 〈 0.05). We conclude that SK-IV started before ambulance transport is safe, accelerates early reperfusion rate, and consequently leads to a further limitation of infarct size in patients with anterior wall infarction. (J Interven Cardiol 1989:2:3)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8183.1989.tb00771.x
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  • 2
    Electronic Resource
    Electronic Resource
    The role of scintigraphic techniques in the evaluation of functional results of coronary bypass grafting and percutaneous transluminal coronary angioplasty (1993)
    Springer
    The international journal of cardiovascular imaging 9 (1993), S. 49-58 
    Details
    ISSN: 1573-0743
    Keywords: nuclear cardiology ; viable myocardium ; thallium-201 ; technetium-99m
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Scintigraphic techniques can be used first, to guide appropriate referral for interventional procedures, and second to predict the effect of revascularization on regional perfusion and functionprior to the intervention, thereby being able to assess efficacy of revascularization and to assess whether ischemia is the origin of recurrence of symptoms. Of increasing importance is the ability of nuclear techniques to identify those myocardial regions with abnormal function which might benefit from revascularization by showing improvement in regional wall motion. Positron emission tomography is considered to be the gold standard to assess regional myocardial perfusion and metabolism. The introduction of the reinjection technique makes201Tl-scintigraphy the method of choice to detect jeopardized myocardium and to guide appropriate referral for revascularization procedures in those institutes where PET is not available. Even when the costly PET-instrumentation is available, cost-benefit analysis is indicated to assess the additional value of PET compared with201Tl reinjection imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01143146
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  • 3
    Electronic Resource
    Electronic Resource
    Quantitative thallium-201 scintigraphy after dipyridamole infusion combined with low level exercise in healthy volunteers (1989)
    Springer
    European journal of nuclear medicine 15 (1989), S. 239-243 
    Details
    ISSN: 1619-7089
    Keywords: Dipyridamole infusion ; 201Tl scintigraphy ; Volunteers
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To establish test specific normal limits for quantitative analysis of uptake and washout of 201Tl after dipyridamole infusion combined with low level exercise, 20 healthy volunteers were studied with low likelihood of coronary artery disease (CAD) assessed by a stepwise probability analysis based on age, sex, symptoms, resting electrocardiogram, and exercise electrocardiography. Likelihood of CAD in these volunteers was calculated as ≦1%. After dipyridamole infusion combined with low level exercise, one volunteer complained of headache; no other side effects were observed. There were no chest pain complaints. Maximal hemodynamic changes were achieved during the 6th and 7th min of the test. No ST segment depression was recorded. Visual analysis of the 201Tl scintigrams was normal in all volunteers. Mean regional washout at 4 h was 44.37%±2.11%. The regional washout in the 70° LAO view (46.65%±1.10%) was significantly higher than in the anterior and 30° LAO views (43.44%±1.50% and 43.02%±1.45%, respectively). Profiles of uptake and washout of 201Tl were different after dipyridamole infusion combined with low level exercise as compared to maximal exercise. Thus, in quantitative analysis of 201Tl scintigraphy after dipyridamole infusion in conjunction with low level exercise as applied in the present study, it is mandatory to use normal limits of uptake and washout of 201Tl derived from healthy volunteers who underwent the same combined protocol.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00257540
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  • 4
    Electronic Resource
    Electronic Resource
    Abnormal septal motion after aortic valve replacement for chronic aortic regurgitation: no evidence for myocardial ischaemia by exercise radionuclide angiography (1990)
    Springer
    European journal of nuclear medicine 17 (1990), S. 252-256 
    Details
    ISSN: 1619-7089
    Keywords: Radionuclide angiography ; Exercise ; Aortic valve replacement ; Aortic valve insufficiency ; Septal wall motion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate interventricular septal motion and left ventricular function after aortic valve replacement for chronic aortic regurgitation, we studied 12 patients at rest and during exercise by radionuclide angiography after a mean of 19 (range 12–36) months after operation (group I). Twenty patients with chronic aortic regurgitation without aortic valve replacement served as controls (group II). None of the patients had coronary artery disease as documented by arteriography. Abnormal interventricular septal motion at rest was seen in 11 patients of group I, of whom 8 showed hypokinesis and 3 akinesis. During exercise, the interventricular septal wall motion improved in 4 patients, worsened in 3 patients and did not change in 5 patients. All patients of group II had normal interventricular septal motion at rest. During exercise, 5 patients showed septal wall hypokinesia together with apical and posterolateral wall motion abnormalities. The left ventricular ejection fraction at rest was 62% ± 20% in group I and 66% ± 8% in group II (not significant). During exercise, the left ventricular ejection fraction was 59% ± 24% in group I and 68% ±13% in group II (not significant). We conclude that abnormal interventricular septal motion at rest is commonly found in patients with aortic valve replacement for chronic aortic regurgitation. During exercise, septal wall motion in the patients with aortic valve replacement shows a variable response from complete normalization to akinesia. These findings are mostly associated with a normal global left ventricular function both at rest and during exercise, which precludes myocardial ischaemia as a primary cause for abnormal septal wall motion after aortic valve replacement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00812366
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  • 5
    Electronic Resource
    Electronic Resource
    Intravenous instrumentation alters the autonomic state in humans (1996)
    Springer
    European journal of applied physiology 73 (1996), S. 113-116 
    Details
    ISSN: 1439-6327
    Keywords: Heart rate ; Autonomic nervous system ; Intravenous injections ; Metoprolol ; Atropine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intravascular instrumentation may induce syncope or presyncope. It is not known whether asymptomatic subjects also have autonomic reactions, albeit concealed. We addressed this issue by studying 44 healthy young male subjects of various levels of fitness, ranging from inactivity to athletic [mean maximal oxygen uptake was 49.1 (SD 10.7) ml·kg−1·min−1, range 28.7–71.9 ml·kg−1·min−1]. The autonomic response to venous cannulation was quantified by measuring heart rate before cannulation (HR1), after cannulation (HR2), and after complete pharmacological autonomic blockade (HR0 = the intrinsic heart rate). The sympathovagal balance before and after cannulation was computed as HR1/HR0 and HR2/HR0, respectively. The group means of heart rate and sympathovagal balance decreased significantly (paired Student's t-test P 〈0.01) from 62.5 to 59.9 beats·min−, and from 0.71 to 0.68, respectively. The maximal decrease in heart rate was 8.8 beats·min−1, and in the sympathovagal balance was 0.11. Our study demonstrated that the asymptomatic subjects responded to intravenous instrumentation with a concealed autonomic reaction. Thus, from our findings it would seem that intravenous instrumentation interferes with measurements relating to autonomic nervous system activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00262818
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  • 6
    Electronic Resource
    Electronic Resource
    Acute effects of intravenous nisoldipine on left ventricular function after acute myocardial infarction (1994)
    Springer
    Cardiovascular drugs and therapy 8 (1994), S. 345-351 
    Details
    ISSN: 1573-7241
    Keywords: nisoldipine ; acute myocardial infarction ; myocardial stunning ; left ventricular function ; radionuclide angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nisoldipine is a calcium antagonist with potent coronary vasodilating effects in patients with chronic stable angina pectoris. In an initial study we showed that intravenous nisoldipine, given 24–72 hours after uncomplicated myocardial infarction, was a safe and feasible intervention that had beneficial effects on global and regional myocardial function. We subsequently studied the acute effects of nisoldipine in six patients within 24 hours (mean 14±4 hours) after the onset of myocardial infarction. Nisoldipine was administered as a 4.5 µg/kg intravenous bolus over 3 minutes, followed by intravenous infusion of 0.2 µg/kg over 60 minutes. Radionuclide angiography, cardiac output, and intraarterial blood pressure measurements were performed before and during nisoldipine. Left ventricular ejection fraction increased from 48.3±10.3% to 55.3±11.8% (p=0.034) during nisoldipine infusion. Regional wall motion score changed during nisoldipine infusion from 3.3±2.5 to 1.8±2.6 (p=0.027). Cardiac output increased from 5.5±1.0 to 7.3±1.3 1/min (p=0.0001). I eart rate increased from 78±12 to 88±11 min−1 (p=0.004). Mean arterial blood pressure decreased from 92±20 to 79±13 mmI g (p=0.038). The rate-pressure product did not change significantly during nisoldipine infusion. It is concluded that nisoldipine improves global and regional left ventricular function in patients with acute myocardial infarction within the first 24 hours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00877319
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  • 7
    Electronic Resource
    Electronic Resource
    The acute effects of intravenous nisoldipine on left ventricular function 24 to 72 hours after uncomplicated acute myocardial infarction (1988)
    Springer
    Cardiovascular drugs and therapy 2 (1988), S. 673-678 
    Details
    ISSN: 1573-7241
    Keywords: nisoldipine ; acute myocardial infarction ; left ventricular function ; radionuclide angiography ; echocar-diography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The acute effects on left ventricular function of nisoldipine were studied in six patients 56±12 hours (range 44 to 72 hours) after the onset of uncomplicated acute myocardial infarction. Nisoldipine was administered as a 4.5 μg/kg intravenous bolus over 3 minutes followed by an infusion of 0.2 μg/kg during 60 minutes. Radionuclide angiography and two-dimensional echocardiography were performed before and during infusien with nisoldipine. The left ventricular ejection fraction increased significantly from 38%±10% to 49%±10% (P=0.028) during nisoldipine infusion. Regional wall motion index was determined both by radionuclide and by two-dimensional echocardiography and showed a significant change during nisoldipine infusion from 1.9±0.3 to 1.5±0.3 (p=0.028, radionuclide angiography) and from 0.7±0.2 to 0.3±0.2 (p=0.043, two dimensional echocardiography). Heart rate increased significantly from 78±12 min-1 to 92±13 min-1 (p=0.028), but mean double product did not change significantly during nisoldipine infusion. It is concluded that nisoldipine significantly improves global and regional left ventricular function in patients shortly after acute myocardial infarction. This beneficial effect may, however, be partially offset by an increase in heart rate. Since mean double product did not change, it is suggested that nisoldipine may improve coronary blood flow in patients with acute myocardial infarction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00054208
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  • 8
    Electronic Resource
    Electronic Resource
    Improved detection of acute myocardial infarction by magnetic resonance imaging using Gadolinium-DTPA (1989)
    Springer
    The international journal of cardiovascular imaging 5 (1989), S. 1-8 
    Details
    ISSN: 1573-0743
    Keywords: Magnetic Resonance Imaging ; acute myocardial infarction ; Gadolinium-DPTA ; contrast agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To assess the value of the paramagnetic contrast agent Gadolinium (Gd)-DTPA in Magnetic Resonance Imaging (MRI) of acute myocardial infarction (AMI), we studied 20 patients with a first AMI by ECG-gated MRI before and after intravenous administration of 0.15mmol/kg Gd-DTPA. The MRI studies were performed after a mean of 98 hours (range 15–241) after the acute onset of AMI. Spin-echo measurements (TE 30 msec) were made using a Philips Gyroscan (0.5 Tesla). After performing the baseline MRI scans, the MRI procedure was repeated every 10 minutes for up to 40 minutes following injection of Gd-DTPA. In 18 (90%) patients contrast enhancement in the infarcted myocardial areas was observed after Gd-DTPA. In these patients intensity versus region curves, derived from 9 to 11 adjacent myocardial regions of interest, showed increased signal intensities in the infarcted areas after administration of Gd-DTPA. The precontrast signal intensity ratio between infarcted and normal myocardium was 1.14±0.15 (mean±SD); the postcontrast ratios at 10 minutes were 1.41±0.21 (P 〈0.05), at 20 minutes 1.61±0.19 (P 〈0.01), at 30 minutes 1.43±0.20 (P 〈 0.05), and at 40 minutes 1.33±0.20 (P=NS). It is concluded that MRI using the contrast agent Gd-DTPA significantly improves the visualization and detection of infarcted myocardial areas in patients with AMI and that optimal contrast enhancement is obtained 20 minutes after administration of Gd-DTPA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01745226
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