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  • 1
    Electronic Resource
    Electronic Resource
    Acute hemodynamic effects of a new inotropic agent, OPC-8212, on severe congestive heart failure (1986)
    Springer
    Heart and vessels 2 (1986), S. 23-28 
    Details
    ISSN: 1615-2573
    Keywords: OPC-8212 ; Heart failure ; Positive inotropic agent ; ventricular function curve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The hemodynamic and clinical effects of OPC-8212, a newly synthesized, orally effective inotropic agent, were assessed for the first time in ten patients with severe congestive heart failure by means of right heart catheterization with a Swan-Ganz catheter. Cardiac output was determined by the thermodilution technique. Patients received a single oral dose of 6 mg/kg. To determine the magnitude and time-course of the effects of OPC-8212, measurements were made during an observation period before and 2, 4, 8, and 12 h after administration. Blood was also taken at these times for measurement of the concentration of plasma OPC-8212. No large meals were allowed during the first 4 h. After the single oral dose of OPC-8212, plasma concentrations increased rapidly, reaching an effective level after 8 h and peaking at 12 h. Hemodynamic performance improved as the mean OPC-8212 plasma level increased, with the maximum effect being observed between 8 and 12 h after acute administration of the drug. At 8 h, the cardiac index was increased from the baseline value of 2.4±0.2 (SEM) to 2.8±0.3 l/min/m2 (P〈0.01). The stroke work index rose from 26.2±5.1 to 31.7±60 g · m/m2. The excessive pulmonary artery diastolic pressure fell from 22±2 to 17±3 mmHg at 8 h (P〈0.001) and to 16±2 mmHg (P〈0.001) at 12 h. The incidence of ventricular premature beats was not increased and no other side effects were observed. These changes were not associated with significant changes in heart rate or systolic blood pressure. Thus, this drug appears to be very promising for the long-term treatment of congestive heart failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02060240
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  • 2
    Electronic Resource
    Electronic Resource
    Kinetics of ajmaline disposition and pharrnacologic response in beagle dogs (1987)
    Springer
    Journal of pharmacokinetics and pharmacodynamics 15 (1987), S. 39-55 
    Details
    ISSN: 1573-8744
    Keywords: Ajmaline ; antiarrhythmic drug ; pharmacokinetics ; pharmacodynamics ; plasma protein binding ; combined pharmacokinetic-pharmacodynamic model ; ECG
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Pharmacokinetics and pharmacodynamics of ajmaline were studied in four healthy dogs after intravenous administration of the drug at the infusion rate of 1.0 mg/min for 45 min. Ajmaline exhibited a saturable binding to plasma protein. One kind of binding site was found in the range of observed drug concentrations and its binding capacity showed nearly threefold interindividual difference. The time course of ajmaline concentration in whole blood Cbcould be described by the two-compartment open model and the unbound concentration of ajmaline in plasma Pf wasestimated from Cbby using the hematocrit value and the parameters of plasma protein binding and erythrocyte partitioning. The pharmacologic responses to ajmaline were assessed by recording ECG, and the changes in PQ and QRS interval were studied in relation to ajmaline disposition. When ECG changes were related to the ajmaline concentration, a significant degree of hysteresis was observed. The relationship between the unbound drug concentration and the pharmacologic effect was analyzed by a combined pharmacokinetic-pharmacodynamic model, where the hypothetical effect compartment is connected to the Pfin the central compartment by a first-order process. This model allows estimation of the changes in PQ and QRS intervals after intravenous administration of ajmaline. By comparing the drug effect on PQ and QRS intervals, it was suggested that ajmaline distributes to the atrial and the ventricular tissue in a similar degree and causes a reduction in the conduction rate in both sites with similar activity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01062938
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  • 3
    Electronic Resource
    Electronic Resource
    An ECG storage and retrieval system embedded in client server HIS utilizing object-oriented DB (1996)
    Springer
    Journal of medical systems 20 (1996), S. 35-43 
    Details
    ISSN: 1573-689X
    Keywords: ECG ; HIS ; system ; object-oriented database
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In the University of Tokyo Hospital, the improved client server HIS has been applied to clinical practice and physicians can order prescription, laboratory examination, ECG examination and radiographic examination, etc. directly by themselves and read results of these examinations, except medical signal waves, schema and image, on UNIX workstations. Recently, we designed and developed an ECG storage and retrieval system embedded in the client server HIS utilizing object-oriented database to take the first step in dealing with digitized signal, schema and image data and show waves, graphics, and images directly to physicians by the client server HIS. The system was developed based on object-oriented analysis and design, and implemented with object-oriented database management system (OODMS) and C++ programming language. In this paper, we describe the ECG data model, functions of the storage and retrieval system, features of user interface and the result of its implementation in the HIS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02260872
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  • 4
    Electronic Resource
    Electronic Resource
    A multicenter study of a new inotropic agent, piperanometozine (opc-8212) in congestive heart failure: Clinical improvement during short-term treatment (1987)
    Springer
    Cardiovascular drugs and therapy 1 (1987), S. 169-175 
    Details
    ISSN: 1573-7241
    Keywords: piperanometozine ; OPC-8212 ; positive inotropic agent ; congestive heart failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Piperanometozine (OPC-8212) is a new, orally effective inotropic agent. To evaluate the efficacy of this agent on systemic hemodynamics and clinical symptoms in patients with congestive heart failure, a multicenter study was performed. Thirty four patients with New York Heart Association (NYHA) functional classes II to IV and initially treated with digitalis were enrolled from ten centers. After a washout period of one or two weeks (placebo period), digitalis was replaced by piperanometozine (30 or 60 mg/day) for four weeks, while other drugs were continued. Clinical symptoms, routine physical findings, electrocardiogram, chest roentgenogram, echocardiogram, exercise tolerance time, and routine laboratory data were obtained in 34 patients. Four patients were withdrawn from the study before completion. After the withdrawal of digitalis, heart rate was increased and ejection fraction was decreased. Exercise tolerance time was increased while other parameters were unchanged. At the end of the treatment period with piperanometozine, ejection fraction significantly (p〈0.05) increased with a decrease in LV end-systolic volume (p〈0.05), whereas heart rate and blood pressure remained unchanged. Systolic blood pressure/LV end-systolic volume (P/V index) tended to decrease after the withdrawal of digitalis and increase during piperanometozine therapy. Exercise tolerance time was further increased (p〈0.01) and NYHA functional class was improved in 11 patients, whereas it worsened in only one patient. No major adverse effects were observed. These results indicate that a short-term therapy of oral piperanometozine restored the depressed cardiac performance of the heart and improved clinical symptoms in patients with congestive heart failure. Thus, this promising agent deserves further clinical study in long-term trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02125470
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  • 5
    Electronic Resource
    Electronic Resource
    Intravenous dopexamine in the treatment of acute congestive heart failure: Results of a multicenter, double-blind, placebo-controlled withdrawal study (1995)
    Springer
    Cardiovascular drugs and therapy 9 (1995), S. 791-797 
    Details
    ISSN: 1573-7241
    Keywords: dopexamine ; double-blind withdrawal study ; acute heart failure ; balanced vasodilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Acute hemodynamic effects of intravenous infusion of dopexamine were evaluated by a placebo-controlled withdrawal study in patients with acute congestive heart failure. Twenty patients were enrolled at 10 centers in Japan. All patients had a pulmonary capillary or diastolic pressure of 15 mmHg or greater and a cardiac index of 2.5 l/min/m2 or less.Phase I: Intravenous dopexamine was introduced in a single-blind, uncontrolled fashion at the rate of 0.5 µg/kg/min and was titrated up to achieve a 30% or more increase in the cardiac index. Two patients withdrew from the study due to sinus tachycardia and ventricular ectopy or exacerbation of heart failure.Phase II: The remaining 18 responders who were free of limiting side effects were randomized in double-blind fashion to continue dopexamine or to switch to placebo for an additional 60 minutes. At the end of phase II, the hemodynamic improvement obtained in phase I of the study disappeared completely after substitution of placebo but was maintained in dopexamine-treated patients. Our findings suggest that dopexamine, when given in appropriate doses to selected patients, shows balanced vasodilator action suitable for the treatment of acute congestive heart failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00879873
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