Effect of Atenolol on Left Ventricular Function in Hypertensive Patients

1. Atenolol (100 mg/day) was given to 12 hypertensive patients for 8 weeks, and its effects on mean arterial pressure, cardiac index and ejection phase indices of myocardial performance were examined by echocardiography. 2. Echocardiographic studies were made before treatment after 4 weeks on placebo and repeated after 4 and 8 weeks of atenolol therapy. Mean arterial pressure fell by 14 and 21% after 4 and 8 weeks respectively. Cardiac index fell by 22 and 20%, and stroke index fell by 11 and 7%. Calculated peripheral resistance did not change significantly. 3. Ejection phase indices, namely fractional shortening, ejection fraction and normalized mean rate of circumferential fibre shortening, did not change. End-diastolic volume index did not change and there was no relationship between changes in heart rate and end-diastolic volume index. 4. The study shows that atenolol in the resting state has no effect on certain echocardiographic indices of left ventricular function when given orally to hypertensive patients with normal left ventricular size and function. The reduction in cardiac and stroke indices were presumably secondary to a decrease in cardiac venous filling.

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Ketanserin Alone and in Combination with Enalapril in the Treatment of Essential Hypertension: Assessment of the Haemodynamic Effects

Journal of International Medical Research ◽

10.1177/030006059302100301 ◽

1993 ◽

Vol 21 (3) ◽

pp. 113-125

Author(s):

O de Divitiis ◽

M Galderisi ◽

A Celentano ◽

P Tammaro ◽

M Garofalo ◽

...

Keyword(s):

Left Ventricular Function ◽

Ventricular Function ◽

Left Ventricular ◽

Haemodynamic Effects ◽

Once Daily ◽

Hypertensive Patients ◽

Systolic Volume ◽

End Diastolic Volume ◽

End Systolic Volume ◽

Blood Pressures

The antihypertensive and haemodynamic efficacies of ketanserin and ketanserin plus enalapril were compared. The monotherapy phase of the study involved the oral administration of 40 mg ketanserin twice daily or 20 mg enalapril once daily for 12 weeks to 25 hypertensive patients. Systolic and diastolic blood pressures were significantly reduced by both drugs. Left ventricular function both at rest and during effort improved significantly with either drug. This was due to a reduction of end-systolic volume; end-diastolic volume decreased only with the use of enalapril. Combination therapy, involving 16 patients and both drugs given at the original dosage schedule for 12 weeks, resulted in further reductions in systolic and diastolic blood pressures, and an improvement in left ventricular function; indices of diastolic function were not modified. In conclusion, ketanserin and enalapril showed comparable antihypertensive and haemodynamic activities. A combination of ketanserin and enalapril increased the favourable characteristics of both drugs.

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Individually Optimized Hemodynamic Therapy Reduces Complications and Length of Stay in the Intensive Care Unit

Anesthesiology ◽

10.1097/aln.0b013e31829bd770 ◽

2013 ◽

Vol 119 (4) ◽

pp. 824-836 ◽

Cited By ~ 115

Author(s):

Matthias S. Goepfert ◽

Hans Peter Richter ◽

Christine zu Eulenburg ◽

Janna Gruetzmacher ◽

Erik Rafflenbeul ◽

...

Keyword(s):

Mean Arterial Pressure ◽

Cardiac Index ◽

Arterial Pressure ◽

Stroke Volume ◽

Stroke Volume Variation ◽

Volume Index ◽

Volume Variation ◽

Hemodynamic Therapy ◽

End Diastolic Volume ◽

Icu Discharge

Abstract Background: The authors hypothesized that goal-directed hemodynamic therapy, based on the combination of functional and volumetric hemodynamic parameters, improves outcome in patients with cardiac surgery. Therefore, a therapy guided by stroke volume variation, individually optimized global end-diastolic volume index, cardiac index, and mean arterial pressure was compared with an algorithm based on mean arterial pressure and central venous pressure. Methods: This prospective, controlled, parallel-arm, open-label trial randomized 100 coronary artery bypass grafting and/or aortic valve replacement patients to a study group (SG; n = 50) or a control group (CG; n = 50). In the SG, hemodynamic therapy was guided by stroke volume variation, optimized global end-diastolic volume index, mean arterial pressure, and cardiac index. Optimized global end-diastolic volume index was defined before and after weaning from cardiopulmonary bypass and at intensive care unit (ICU) admission. Mean arterial pressure and central venous pressure served as hemodynamic goals in the CG. Therapy was started immediately after induction of anesthesia and continued until ICU discharge criteria, serving as primary outcome parameter, were fulfilled. Results: Intraoperative need for norepinephrine was decreased in the SG with a mean (±SD) of 9.0 ± 7.6 versus 14.9 ± 11.1 µg/kg (P = 0.002). Postoperative complications (SG, 40 vs. CG, 63; P = 0.004), time to reach ICU discharge criteria (SG, 15 ± 6 h; CG, 24 ± 29 h; P < 0.001), and length of ICU stay (SG, 42 ± 19 h; CG, 62 ± 58 h; P = 0.018) were reduced in the SG. Conclusion: Early goal-directed hemodynamic therapy based on cardiac index, stroke volume variation, and optimized global end-diastolic volume index reduces complications and length of ICU stay after cardiac surgery.

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Impact of Papillary Muscle Infarction on Ischemic Mitral Regurgitation Assessed by Magnetic Resonance Imaging

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren ◽

10.1055/s-0043-115121 ◽

2017 ◽

Vol 190 (01) ◽

pp. 42-50 ◽

Cited By ~ 1

Author(s):

Christiane Bretschneider ◽

Hannah-Klara Heinrich ◽

Achim Seeger ◽

Christof Burgstahler ◽

Stephan Miller ◽

...

Keyword(s):

Myocardial Infarction ◽

Mitral Regurgitation ◽

Left Ventricular Function ◽

Ventricular Function ◽

Papillary Muscle ◽

Left Ventricular ◽

Ischemic Mitral Regurgitation ◽

Chronic Myocardial Infarction ◽

End Diastolic Volume ◽

Significant Difference

Objective Ischemic mitral regurgitation is a predictor of heart failure resulting in increased mortality in patients with chronic myocardial infarction. It is uncertain whether the presence of papillary muscle (PM) infarction contributes to the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function. Methods and Materials 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included. The location and extent of MI depicted by MRI were correlated with left ventricular function assessed by MRI and mitral regurgitation assessed by echocardiography. The presence, location and extent of PM infarction depicted by late gadolinium enhancement (LGE-) MRI were correlated with functional parameters and compared with patients with chronic MI but no PM involvement. Results PM infarction was found in 11 of 48 patients (23 %) using LGE-MRI. 8/11 patients (73 %) with PM infarction and 22/37 patients (59 %) without PM involvement in MI had ischemic mitral regurgitation. There was no significant difference between location, extent of MI and presence of mitral regurgitation between patients with and without PM involvement in myocardial infarction. In 4/4 patients with complete and in 4/7 patients with partial PM infarction, mitral regurgitation was present. The normalized mean left ventricular end-diastolic volume was increased in patients with ischemic mitral regurgitation. Conclusion The presence of PM infarction does not correlate with ischemic mitral regurgitation. In patients with complete PM infarction and consequent discontinuity of viable tissue in the PM-chorda-mitral valve complex, the probability of developing ischemic mitral regurgitation seems to be increased. However, the severity of mitral regurgitation is not increased compared to patients with partial or no PM infarction. Key points Citation Format

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