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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 67 (1989), S. 1132-1137 
    ISSN: 1432-1440
    Keywords: Carotid sinus syndrome ; Vasodepressor component ; Orthostasis ; Pacemaker therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 45 patients with carotid sinus syndrome, the heart rate-independent vasodepressor component under ventricular and av-sequential pacing of the heart was investigated both in supine and in standing patients. Under both forms of pacing, the carotid pressure determination has led to a marked lowering of systolic and diastolic arterial blood pressure which is significantly more pronounced under orthostasis. The blood pressure values reached both in supine and in standing patients are significantly higher under av-sequential pacing than under ventricular pacing. Accordingly, the proportion of symptomatic patients is less under av-sequential pacing in the supine position (17% versus 29%) and in standing (65% versus 83%). The heart rate-independent vasodepressor reaction is maximal on average between 11 s and 16 s after the beginning of the carotid pressure test and persists for 3 s to 7 s. The blood pressure reaches initial values again after 14 s to 20 s. To summarize, these data document that a clinically relevant heart rate-independent vasodepressor reaction is to be reckoned with in the majority of patients with carotid sinus syndrome. This shows a different time course than the vagally determined effect of the carotid sinus reflex on heart rate. Orthostasis intensifies the vasodepressor reaction so that the hemodynamically more favorable avsequential pacing which is actually more favorable in hemodynamic terms cannot guarantee freedom from symptoms in the majority of patients in the upright standing position.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 67 (1989), S. 1126-1131 
    ISSN: 1432-1440
    Keywords: Acromegaly ; Cardiac function ; Echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 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. Double M-mode echocardiography was performed in all patients and the results compared with data obtained from a control group of 24 healthy volunteers (N: 22 men, 2 women; mean age: 23 yrs). The mean left ventricular diameter at end-diastole was greater in the acromegalics than in the controls (A: 55±6 mm, N: 50±4 mm;p〈0.005, $$\bar x \pm SD$$ ). After correction for age and body surface area, it, however, was outside the 95% confidence interval in 5 patients. Left ventricular hypertrophy was present in 3 patients, one of whom had coexistent arterial hypertension. A total of 3 patients were hypertensive. Significantly higher values for the maximal velocity of systolic wall thickening (A: 6.1±0.6 cm/s, N: 4.2±0.6 cm/s,p〈0.001) and diameter change (A: 12.4±2.0 cm/s, N: 10.6±1.0 cm/s,p〈0.005) indicate increased contractility with concurrently increased relaxation; fractional shortening did not differ significantly (A: 38±5%, N: 37±5%, ns). The isovolumetric relaxation period at diastole was slightly longer in the acromegalics (A: 70±17 ms, N:61±13 ms,p〈0.05). Whereas the values for maximal diastolic velocity of wall thinning (A: 14.1±4.9 cm/s, N: 11.0±3.4 cm/s,p〈0.02) and diameter increase (A: 21.6±4.7 cm/s, N: 17.8±4.1 cm/s,p〈0.02) were significantly higher, those for the rapid filling period did not differ significantly (A: 115±24 ms, N: 102±30 ms, ns). We concluded that systolic and diastolic left ventricular function did not deviate from the norm in our patients, only a relatively small percentage of whom had coexistent arterial hypertension and left ventricular hypertrophy.
    Type of Medium: Electronic Resource
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