ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16730.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTCardiac transplantation in 10 patients with congestive heart failure resulted in reduction of high plasma concentrations of atrial natriuretic peptide (ANP), preoperatively five‐fold above normal, to a level two‐fold above normal, which was maintained throughout a 12‐week follow‐up period. Cardiac function was normalized in all patients. Transient increases in plasma ANP, in four cardiac recipients 3–10‐fold their basal levels, could neither be related to rejection episodes nor to cardiac dysfunction, but rather to signs of fluid and sodium retention. High plasma ANP levels in cardiac transplant recipients suggest that the capacity to secrete ANP is preserved in the transpl

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16731.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTOne hundred and one representative post‐myocardial infarction (MI) patients were investigated with radionuclide angiocardiography (RNA) and exercise test within 1 month of the MI and after 6 and 12 months. From the RNA were calculated the left ventricular ejection fraction (LVEF) and a quantified phase image, the phase standard deviation (phase‐SD), representing the timing of the left ventricular contraction. The mean phase‐SD was significantly higher among these patients (18°, 19° and 18°, respectively, at the three investigations) compared to phase‐SD in normals (6°), indicating an impaired timing of the left ventricular (LV) contraction. At all three investigations a significant correlation was found between the phase‐SD and the LVEF (r=0.58,r=‐0.74 andr=‐0.75, respectively) and the corrected QT interval (r=0.27,r=0.44 andr=0.39, respectively). Maximal serum ASAT in patients with their first MI correlated significantly to phase‐SD. Low exercise capacity or unfavourable NYHA classification was associated with high phase‐SD. Phase‐SD higher than mean was also associated with significantly increased mortality during the follow‐up year (P=0.0057). In conclusion, phase‐SD, reflecting the timing of the LV contraction wave, is easily accessible and clinically relevant. It merits further investigation as a pr

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16732.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTOne year's experience of an acute revascularization program for unstable angina pectoris is presented. In the total material of 63 patients, significant coronary artery stenosis was found in 61 and normal coronary arteries in two. Coronary artery bypass grafting was performed in 39 patients (62%) and percutaneous transluminal angioplasty in nine (14%). There were two perioperative myocardial infarctions and one hospital death. Thirteen patients were not eligible for revascularization. At follow‐up (14–26 months) 60 patients were still alive (95%). In the revascularization group, one patient had died, but of the remaining 46 patients, 30 (65%) were free of angina pectoris, and in addition six had only minor sympt

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16733.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTTo study the effect of a combination of amiloride, 5 mg, and hydrochlorothiazide, 50 mg (Moduretic®), on plasma and skeletal muscle electrolytes in patients on long‐term diuretic therapy (>1 year) for arterial hypertension and/or congestive heart failure, 58 patients were recruited. Fifty‐five patients completed the study, 27 controls and 28 in the treatment group. The Moduretic® group demonstrated a significant increase in skeletal muscle potassium and magnesium values and a significant decrease in systolic blood pressure after 6 months on therapy. There was no significant change in these parameters in the control group. It is concluded that this combination of amiloride and hydrochlorothiazide is capable of preserving the internal and external balance of potassium and magnesium on a long‐term basis in the patient categories

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16734.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTIn 787 patients with acute myocardial infarction originally participating in the Göteborg Metoprolol Trial, mortality and morbidity during 5 years' follow‐up were assessed and related to whether patients had diabetes mellitus. Diabetes occurred in 78 patients (10%). Patients with diabetes had a different risk factor pattern, including higher age, higher occurrence of angina pectoris and hypertension, whereas smoking habits did not differ. In the early phase (hospitalization), patients with diabetes had a higher mortality (12% versus 8%), required more treatment for heart failure and stayed longer in hospital. Other morbidity aspects, such as severity of pain, occurrence of severe supraventricular and ventricular arrhythmias, high‐degree AV‐block and infarct size did not differ. During 5 years' follow‐up mortality rate in patients with diabetes mellitus was 55% as compared with 30% among patients with no diabetes (P<0.001). Reinfarction rate during 5 years was 42% in daibetics versus 25% in non‐diabetics (P<0.001). In a multivariate analysis, taking into account the differences in risk factor pattern, diabetes turned out to be an independent determinant for long‐term mortality and reinfarction (P<0.001). We conclude that patients with diabetes mellitus, developing acute myocardial infarction, is a group with particularly high risk of death and reinfarction. Interventions aiming at its reduction h

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16735.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTPyelonephritic renal scarring is a common cause of renal failure and hypertension. We studied glomerular filtration rate (GFR), renal plasma flow (RPF), filtration fraction (FF), total renal area (TRA), systolic (SBP) and diastolic (DBP) blood pressure in 22 female patients with verified renal scarring and a history of febrile urinary tract infection (UTI) and in 9 healthy age‐matched women with normal urograms and no history of symptomatic UTI. The patients with renal scarring had significantly lower GFR, smaller TRA and higher SBP than the healthy controls, but not significantly different RPF or FF. A decrease in GFR and RPF was associated with higher SBP and DBP in the patients with renal scarring. RPF/TRA, representing an approximation of the perfusion of renal tissue and GFR/TRA, were similar in patients with renal scarring and healthy controls. A reduction of renal parenchyma was accompanied by a proportional decrease in GFR and RPF, resulting in unchanged FF. These findings do not support the concept of hyperfiltration as a main cause of renal insufficiency in patients with pyelonephritic renal scarring. An increase in FF and a decrease in GFR/TRA and RPF/TRA was associated with higher DBP and a decrease in GFR/TRA and RPF/TRA with an increase in the urinary albumin excretion. We conclude that renal hemodynamics play an important part in the blood pressure control of patients with renal scarring and that in these patients with various degrees of renal failure there was no evidence of hyperfiltration or hyperperfusion by remnant glomerul

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16736.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTPatients with pyelonephritic renal scarring are at risk of developing renal failure and hypertension. We studied glomerular filtration rate (GFR), renal plasma flow (RPF), filtration fraction (FF), systolic (SBP) and diastolic (DBP) blood pressure, fractional sodium, potassium and phosphate excretion, peripheral renin activity (PRA), plasma aldosterone (p‐Aldo), urinary albumin excretion (U‐Alb) and urinary β2‐microglobulin excretion (β2‐M) in hydropenia and during transition to 3% volume expansion with isotonic saline infusion in 22 female patients with renal scarring due to pyelonephritis and 9 healthy controls. The patients had significantly lower GFR, higher SBP and higher PRA in hydropenia, but there was no significant difference in RPF, FF, DBP or p‐Aldo. After volume expansion, SBP, DBP, PRA and p‐Aldo were significantly higher in patients than in controls. Transition to 3% volume expansion was associated with a similar increase in SBP in both patients and controls, whereas DBP increased significantly more in the patients (p<0.01). Volume expansion resulted in a significant suppression of PRA and p‐Aldo in both patients and controls. The patients with renal scarring had the same capacity to excrete sodium and water during transition to volume expansion as the healthy controls. The renin‐aldosterone system seems abnormally activated and is probably more important than hypervolemia in the development of hypertension in this

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16737.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTTwenty‐nine patients undergoing maintenance hemodialysis were examined for dermatologic symptoms. Nineteen patients (66%) complained of pruritus, which was classified as mild (34%), moderate (24%), and severe (8%). Patients with pruritus did not differ from those without pruritus regarding serum concentrations of creatinine, urea, calcium, alkaline phosphatase or aluminum, nor was there any difference in duration of hemodialysis, age or sex. In pruritic patients serum concentrations of parathyroid hormone were significantly higher when determined with a mid‐region radioimmunoassay technique (p<0.01)and higher, although not significantly, when the intact parathyroid hormone molecule was measured. Serum concentrations of phosphate were significantly lower in patients with pruritus (p<0.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16738.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTAtrial natriuretic peptide (ANP), angiotensin II (AII) and aldosterone (Aldo) in plasma were determined at supine rest in 16 normotensive and 9 hypertensive patients with chronic glomerulonephritis and in 18 control subjects (Study 1). In addition, 12 of the normotensive, 7 of the hypertensive patients and 11 of the control subjects were studied with the same parameters after an exercise test (Study 2). Study 1 showed that supine ANP, AII and Aldo did not differ significantly between the groups. In Study 2, ANP increased after exercise in the normotensive patients (8.4 vs. 11.4 pmol/1 (median),p<0.05)and control subjects (7.6 vs. 9.3 pmol/1,p0.10), and after exercise ANP was increased in the normotensive patients compared with the controls (p<0.02). After exercise, an enhanced increase of Aldo was found in the hypertensives but not in the normotensive patients compared with the controls, whereas the increase of AII did not differ significantly between the groups. It is concluded that patients with chronic glomerulonephritis and relatively well preserved renal function do not have major abnormalities of ANP at rest or during exercise. In the normotensive patients, however, ANP increased to a higher level than in the controls, but the difference was small and further studies are needed to define the role of ANP in blood pressure regulation of early stage chronic glomerulonephritis.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb16739.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY