ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15787.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTA cross‐sectional analysis of characteristics possibly associated with congestive heart failure (CHF) was performed among 644 men, all 67 years of age and randomly selected from the general population. A total of 13% had symptoms and signs of overt CHF. Another 10% had early or “latent” CHF. Among overt CHF cases, 46% had hypertension, 55% coronary heart disease and 79% any one of these conditions. Among “latent” CHF cases, the corresponding proportions were 52%, 25 % and 65 %. Simple indices of left ventricular diastolic function and filling pressure as well as of pulmonary artery pressure were closer related to the CHF stage, than were measures of systolic left ventricular function. Smoking habits, hypertension, blood lipids, weight and other measures of body fat, blood glucose, and serum insulin were all correlated to CHF stage. In a multivariate analysis, smoking habits, hypertension, body weight, and serum insulin were independently and significantly correlated to

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15788.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTDisturbances of calcium or vitamin D metabolism have been suggested to be of pathogenetic importance both for hypertension and impaired glucose tolerance, two disorders that are commonly associated. In the present study 65 men, aged 61–65 years, with impaired glucose tolerance were enrolled in a prospective, double‐blind, placebo‐controlled study over 12 weeks evaluating the effects of 0.75 μg alphacalcidol, a synthetic analog to the active metabolite of vitamin D. In the 26 patients with blood pressure ≥ 150/90 mmHg before treatment a significant reduction (p<0.01) of both the systolic (SBP) and diastolic (DBP) blood pressure was found after therapy (from 171/95 to 150/88 mmHg). The effect was additive to concomitant antihypertensive treatment and was correlated (p= 0.03) to a reduction of serum levels of parathyroid hormone. Also in the whole group of patients given alphacalcidol blood pressure was moderately lowered from a mean of 152/87 ± 22/10 (SD) to 143/84 ± 17/8 mmHg. There were no relationships between the changes in body weight, blood glucose or insulin parameters and the changes in blood pressure during the trial. The findings are compatible with the concept that calcium metabolism influences blood pressure regulation and suggest that supplementation with a physiologic dose of active vitamin D could be beneficial for patients with high bloo

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15789.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTThe anti‐anginal effect of a controlled‐release (Durules®) formulation of isosorbide‐5‐mononitrate (5‐ISMN) 60 mg, Imdur®, once daily was evaluated in a randomised double‐blind, placebo‐controlled, crossover study with a placebo run‐in period. Each period lasted for 2 weeks. A total of 70 patients (58 men and 12 women) with stable exertional angina pectoris on β‐blockade, mean age 59 years (range 39–71), were included. Exercise testing was performed on a bicycle ergometer 3 hours after the dose at the end of each period. Anginal attacks and intake of sublingual nitroglycerin tablets were noted. Imdurr̀ in combination with a β‐blocker significantly increased the total exercise capacity, the time and total work until the onset of chest pain and at 1 mm ST‐depression compared with β‐blockade alone. The attack rate and the nitroglycerin consumption were significantly decreased. Headache was the only significant side‐effect. In conclusion, the addition of Imdur® once daily to β‐blockade significan

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15790.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTThis study reports the mortality over a 5‐year‐period determined a double‐blind trial, which evaluated the effect of early intervention with metoprolol in suspected acute myocardial infarction. In all, there were 1 395 randomized patients, 698 and 697 of whom were allocated to metoprolol 200 mg daily and placebo treatments, respectively, for the first 3 months. Thereafter, the two groups were treated in a similar fashion implyingβ‐blockade to a majority. Within the first 3 months, mortality in the metoprolol group was 5.7% versus 8.9% of the placebo group (p= 0.02). This difference persisted after 2 years (metoprolol 13.2%; placebo 17.2%;p= 0.04). Over a 5‐year‐period, 24.2% of the patients who originally were allocated to metoprolol had died as compared to 25.7% of those originally allocated to placebo (p>0.2). Among patients in whom treatment started early (≤ 8 hours after onset of pain = the median delay time), enzyme activities in the metoprolol group was lower (p= 0.03) than in the placebo group. Mortality during the first 2 years among these patients treated early was lower in the metoprolol (11.8%) than in the placebo group (17.3%;p= 0.04). Corresponding figures after 5 years were 22.0% and 25.3%, respectively (p>0.2). Among patients in whom treatment started later than 8 hours onset of pain, there was neither any difference in enzyme activity nor in mortality after 2 and 5 years. It can be concluded that early treatment with metoprolol in suspected acute myocardial infarction reduced mortality during the first 3 months compared with placebo. The difference persisted after 2 years. However, 5 years after randomization, no significant difference in mortality was observed between the two tr

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15791.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTThe relationship between non‐esterified fatty acids (NEFA) in serum and heart muscle was examined in 15 patients who died of myocardial infarction (MI) and seven people who died suddenly in accidents. There was no correlation between NEFA levels of serum and non‐infarcted cardiac muscle in patients with fatal MI. No significant difference was encountered in cardiac NEFA content between patients with fatal MI and people who died in accidents. The phospholipid (PL) content was significantly lower in patients with fatal MI than observed in people who died in accidents. The arachidonic acid (20: 4 (n‐6)) concentration of serum NEFA was significantly lower in patients with fatal MI compared to normal subjects. The cardiac NEFA and PL in patients with fatal MI contained significantly lower percentage levels of arachidonic acid compared to people who died in accidents. The results indicate that the death of the MI patients was not accompanied by elevated cardiac NEFA l

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15792.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTWorking capacity, left ventricular ejection fraction (EF), stroke volume and the phase of the left ventricular contraction were tested before and after 3 weeks of atenolol treatment in 14 patients with angina pectoris and coronary insufficiency diagnosed by thallium tomography. Eight patients (group A) increased their EF during exercise and six patients (group B) showed a decrease in EF when tested with placebo. When treated with atenolol the changes in EF during exercise were reversed in the two groups. Group B increased and group A decreased their EF. Atenolol caused an increase in working capacity in group B, but not in group A. In both groups atenolol caused an increased stroke volume and a decreased phase deviation at rest, while no significant volume changes or phase changes occurred during exercise. These results indicate that atenolol treatment had the most marked effect in patients with the most pronounced disease.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15793.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTA clinical series of acute aortic dissections is presented. Twenty cases were of type A and 10 of type B. Acute severe chest pain was common, in type A also blood pressure difference between the arms and aortic regurgitation. The diagnosis was established by echocardiography, computerized tomography and/or aortography. Antihypertensive therapy was instituted immediately after diagnosis and was in type A cases followed by acute surgery unless definite contraindications existed. Of 14 surgically treated type A patients 13 survived the operation. On follow‐up 1.5–3.5 years later, 12 patients were still alive and doing well, but the false channel remained open in all cases where it had not been resected totally. Only one of six conservatively treated type A patients survived. Type B dissections were operated on only if conservative therapy failed. Four of five conservatively and two of five surgically treated type B patients survi

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15794.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTIn eight of 10 consecutive cases of IgM monoclonal gammopathy of undetermined significance (MGUS), the M‐protein had specificity towards various tissues as estimated by direct and indirect immunofluorescence studies of skin and/or sural nerve biopsies. Five of the cases had neuropathy. In three of them, including two siblings with a demyelinating peripheral neuropathy, the IgM was bound to the myelin‐associated glycoprotein (MAG) of peripheral nerves. One had axonal neuropathy with IgM activity against the peri‐ and endoneurium, while another case with post‐infectious neuritis had IgM activity against structures in the endoneurium but no IgM autoimmunity in the direct fluorescence test. The latter improved clinically in parallel with a decrease in the M‐protein indicating a pathogenetic role of the autoantibody. In three other cases, the IgM was bound to connective tissue structures, two of them also had plasma antibodies against the peri‐ and endoneurium in the indirect fluorescence test. Finally, two cases showed no reaction of the M‐protein against any tissue structures. Since an autoimmune pathogenesis is suspected, the HLA types of seven patients

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15795.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

ABSTRACTWe studied the influence of plasmapheresis on the plasma concentrations of proteins (IgG, IgA, β2‐microglobulin) used for estimation of tumour cell mass in patients with multiple myeloma. Simultaneously, the effects of plasmapheresis on plasma concentrations of proteins (CRP, α1‐antitrypsin, haptoglobin) used for the assessment of inflammatory processes were studied. Also, changes in the plasma concentration of protein HC, a recently described protein occurring both as a free protein and as an IgA complex, were studied. The influence of plasmapheresis varied for the different proteins. The plasma levels of IgG, IgA, CRP, α1‐antitrypsin, and haptoglobin decreased during plasmapheresis. The simultaneous reduction of the level of protein HC was smaller than that of IgG, IgA and haptoglobin. The plasma concentration of β2‐microglobulin did not decrease during plasmapheresis. The recovery rates of the proteins were found to be approximately inversely related to their molecu

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1988.tb15796.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY