211 results on '"Neuzner J"'
Search Results
202. [Non-pharmacological methods of the treatment of arrhythmia].
- Author
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Musiał W, Pitschner HF, and Neuzner J
- Subjects
- Catheter Ablation instrumentation, Electrodes, Implanted, Equipment Design, Humans, Arrhythmias, Cardiac surgery, Catheter Ablation methods, Heart Conduction System surgery
- Published
- 1992
203. Antiischemic and hemodynamic effects of an oral single dose of 150 mg of the phosphodiesterase inhibitor enoximone in patients with coronary artery disease--relation to plasma concentration.
- Author
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Mitrovic V, Petrovic O, Bahavar H, Neuzner J, Dieterich HA, and Schlepper M
- Subjects
- Administration, Oral, Aged, Cardiotonic Agents therapeutic use, Electrocardiography drug effects, Enoximone, Female, Humans, Imidazoles blood, Imidazoles therapeutic use, Male, Middle Aged, Phosphodiesterase Inhibitors therapeutic use, Cardiotonic Agents administration & dosage, Coronary Disease drug therapy, Hemodynamics drug effects, Imidazoles administration & dosage, Phosphodiesterase Inhibitors administration & dosage
- Abstract
The hemodynamic and antiischemic effects of a 150-mg single oral dose of the PDE inhibitor enoximone were correlated with the plasma levels of enoximone and its sulfoxide metabolite. Twenty-one patients with angiographically documented coronary artery disease were investigated by exercise testing 1 and 2 hours after drug administration. The control group consisted of 15 patients with proven coronary artery disease and stable reproducible angina pectoris on exercise. The enoximone group included 14 responders with therapeutic plasma concentrations 2 hours after drug intake and significantly reduced mean pulmonary artery pressures on exercise (from 42.4 +/- 8.6 to 30.9 +/- 11.2 mmHg, p less than 0.05). Compared to basal exercise values, responders showed a reduced ST-segment depression by 1 hour after drug intake (2.1 +/- 1.2 vs. 1.3 +/- 3 mm, p less than 0.05) and minimal values after 2 hours (0.9 +/- 1.0 mm, p less than 0.01) at comparable workloads. There were no significant changes in heart rate, blood pressure, cardiac output, and systemic vascular resistance. No significant improvement in the hemodynamic parameters and ST-segment depression was found in nonresponders with plasma concentrations below 100 ng/ml and 500 mg/ml for enoximone and its metabolite, respectively. In summary, oral administration of enoximone in patients with coronary artery disease led to favorable acute hemodynamic and antiischemic effects at sufficiently high plasma levels of enoximone and its sulfoxide metabolite.
- Published
- 1991
- Full Text
- View/download PDF
204. [Continuous enoximone infusion in patients with severe heart failure in dilated cardiomyopathy, hemodynamic, neurohumoral, chemical laboratory and clinical results].
- Author
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Neuzner J, Mitrovic V, Pitschner HF, Lissmann H, and Schlepper M
- Subjects
- Aldosterone blood, Atrial Natriuretic Factor blood, Cardiomyopathy, Dilated blood, Cardiotonic Agents pharmacokinetics, Enoximone, Epinephrine blood, Heart Failure blood, Hemodynamics physiology, Humans, Imidazoles pharmacokinetics, Infusions, Intravenous, Norepinephrine blood, Renin blood, Cardiomyopathy, Dilated drug therapy, Cardiotonic Agents administration & dosage, Heart Failure drug therapy, Hemodynamics drug effects, Imidazoles administration & dosage, Neurotransmitter Agents blood
- Abstract
Unlabelled: The hemodynamic, clinical, and neurohumeral effects of a prolonged (6-days) intravenous enoximone-infusion therapy were evaluated in 12 patients suffering from severe cardiac failure due to dilated cardiomyopathy. The loading dose of enoximone was 1.5 mg/kg. The maintenance dose during the two phases of constant intravenous infusion were 4 and 8 mcg/kg/min, respectively. The enoximone infusion therapy produced sustained salutary effects on cardiac hemodynamics and on clinical status in every patient. The enoximone infusion therapy caused a decrease in mean pulmonary artery pressure by 38%, an increase in cardiac index by 60%, the pulmonary and systemic vascular resistance decreased by 61% and 37%, respectively. Side effects and therapy-related cardiac arrhythmias were not observed., Conclusion: Enoximone infusion therapy provides sustained salutary hemodynamic and clinical effects in patients with severe cardiac failure.
- Published
- 1991
205. [Dipyridamole thallium-201 myocardial scintigraphy in coronary diagnosis; a comparison of methods with thallium-201 myocardial scintigraphy after ergometer stress].
- Author
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Neuzner J, Kornecki P, Kremer P, Grebe S, and Schlepper M
- Subjects
- Coronary Vessels diagnostic imaging, Female, Humans, Male, Middle Aged, Radionuclide Imaging, Risk Factors, Coronary Disease diagnostic imaging, Dipyridamole, Exercise Test, Thallium Radioisotopes
- Abstract
Two scintigraphic methods, resting dipyridamole and exercise thallium-201 myocardial perfusion imaging, to detect and localize coronary artery stenosis were compared in 32 patients suffering from coronary artery disease. The sensitivity of detecting a greater than 50% coronary stenosis was 94% for exercise thallium-201 perfusion imaging and 88% for dipyridamole thallium-201 perfusion imaging. The overall sensitivity and specificity of localizing a greater than 50% coronary stenosis by the two methods were also not significantly different. The results of the two scintigraphic methods were independent of the severity of coronary artery disease. Dipyridamole thallium-201 myocardial perfusion imaging provides a useful and safe alternative test for detecting and localizing coronary artery stenosis in patients unable to perform maximal exercise.
- Published
- 1987
206. [Hemodynamic, anti-ischemic, metabolic and neurohumoral effects of enoximone (MDL 17,043) in patients with coronary disease].
- Author
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Mitrovic V, Schlepper M, Neuzner J, Bahavar H, Volz M, and Dieterich HA
- Subjects
- Aged, Coronary Circulation drug effects, Electrocardiography, Energy Metabolism drug effects, Enoximone, Epinephrine blood, Exercise Test, Female, Hemodynamics drug effects, Humans, Male, Middle Aged, Norepinephrine blood, Cardiotonic Agents therapeutic use, Coronary Disease drug therapy, Imidazoles therapeutic use
- Abstract
The hemodynamic, anti-ischemic, metabolic, and neurohumoral effects of the phosphodiesterase inhibitor enoximone were investigated in 17 patients (mean age 58 +/- 2 years) with coronary heart disease as established by coronary angiography and positive exercise tests after i.v. application of 0.75 mg/kg body weight. Whereas administration of enoximone resulted in a significant increase in heart rate from 75 +/- 17 to 83 +/- 14 per minute (p less than 0.01), exercise heart rate, blood pressure and myocardial oxygen consumption did not change significantly (p greater than 0.05). At rest, enoximone led to a significant decrease of mean right atrial pressure from 5.7 +/- 2.3 to 3.8 +/- 1.2 mm Hg (p less than 0.01). During exercise there was a significant fall in pulmonary pressure (PAm from 40 +/- 7 to 24 +/- 7 mm Hg, p less than 0.001; PCm from 24 +/- 7 to 14 +/- 6 mm Hg, p less than 0.001) caused by preload reduction and concomitant inotropic increase; there was also a significant rise in cardiac output from 12.7 +/- 5 to 13.8 +/- 5 mm Hg (p less than 0.01) and a decrease of ST-segment depression from 1.97 +/- 0.76 to 0.53 +/- 0.51 mm (p less than 0.001). With improved peripheral and probably coronary blood flow, a concomitant decrease of the metabolic ischemic markers was detected during exercise (potassium 4.44 +/- 0.29 vs. 4.31 +/- 0.30 mval, p less than 0.05; lactate 19 +/- 9 vs. 18 +/- 7 mg/dl; pH 7.28 +/- 0.27 vs. 7.36 +/- 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1988
207. IgG therapy in autoimmune haemolytic anaemia of warm type.
- Author
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Salama A, Mahn I, Neuzner J, Graubner M, and Mueller-Eckhardt C
- Subjects
- Adolescent, Adult, Blood Transfusion, Erythrocytes immunology, Female, Humans, Male, Middle Aged, Mononuclear Phagocyte System immunology, Anemia, Hemolytic, Autoimmune therapy, Immunoglobulin G therapeutic use
- Abstract
Three patients with autoimmune haemolytic anaemia of warm type were treated with high doses of intravenous immunoglobulin (Sandoglobulin). The therapy was ineffective in all three cases. The possible reasons for this therapeutic failure are discussed.
- Published
- 1984
- Full Text
- View/download PDF
208. Hemodynamic, antiischemic, and neurohumoral effects of enoximone in patients with coronary artery disease.
- Author
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Mitrovic V, Thormann J, Neuzner J, Bahawar H, Volz M, Dieterich HA, and Schlepper M
- Subjects
- Atrial Natriuretic Factor blood, Catecholamines blood, Coronary Circulation drug effects, Coronary Disease blood, Enoximone, Humans, Imidazoles adverse effects, Imidazoles blood, Lactates blood, Lactic Acid, Middle Aged, Phosphodiesterase Inhibitors adverse effects, Phosphodiesterase Inhibitors blood, Prostaglandins blood, Coronary Disease physiopathology, Hemodynamics drug effects, Imidazoles pharmacology, Neurotransmitter Agents blood, Phosphodiesterase Inhibitors pharmacology
- Abstract
To evaluate the risk of ischemia in 17 patients with significant coronary artery disease, the influence of enoximone was analyzed under the following conditions: (1) at rest (RC) and during exercise (ExC) under control conditions and (2) at rest (RE) and during exercise (ExE) after administration of enoximone (0.75 mg/kg, intravenously). During ExC all patients had ischemia (angina, and ST segment alterations); metabolic markers of ischemia (MMI) increased, as did the mean pulmonary artery pressure, from 19 to 41 mm Hg. However, during ExE ischemia was abolished (no angina, decrease in mean pulmonary artery pressure to 24 mm Hg, and improvement in MMI) and there was some improvement in left ventricular pump function, whereas pre- and afterload decreased (pulmonary artery pressure by 40%, systemic vascular resistance by 10%), and heart rate, arterial pressure, and myocardial oxygen consumption (MVO2) were all unchanged (p greater than 0.05). Comparative hemodynamics at RE vs RC showed a decrease in pulmonary artery pressure (by 25%) and pulmonary vascular resistance (by 19%) and an increase in heart rate (by 11%), whereas arterial pressure and MVO2 were unchanged (p greater than 0.05). Enoximone did not induce changes in plasma catecholamine, prostaglandin, or thromboxane levels (p greater than 0.05), whereas the atrial natriuretic factor decreased (by 15%), probably because of unloading of the atria during exercise. We concluded that enoximone induces beneficial hemodynamic effects in coronary artery disease without causing ischemia, probably by enhancing myocardial contractility, vasodilation, and improved diastolic properties.
- Published
- 1989
- Full Text
- View/download PDF
209. Continuous subcutaneous insulin infusion therapy (CSII) influences cardiovascular responses to graded exercise in patients with autonomic diabetic neuropathy of the cardiovascular system (ADNCS).
- Author
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Sachse G, Neuzner J, Mäser E, and Federlin K
- Subjects
- Autonomic Nervous System Diseases physiopathology, Cardiovascular Diseases physiopathology, Cardiovascular System innervation, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 1 physiopathology, Diabetic Neuropathies physiopathology, Exercise Test, Heart Rate, Humans, Autonomic Nervous System Diseases complications, Cardiovascular Diseases complications, Diabetic Neuropathies drug therapy, Insulin Infusion Systems
- Abstract
We have demonstrated previously the effect of CSII on diabetics with ADNCS. In this study 16 Type-1-diabetics with ADNCS, 20 diabetics without ADNCS and 20 non diabetic controls were examined. Mean age and mean diabetes duration were similar in all groups. Graded exercise was performed in all patients using an ergometer cycle. In patients with ADNCS resting heart rate was significantly higher. The increase in heart rate during exercise was significantly lower, maximal tolerated work load was significantly reduced, and blood pressure-heart-rate multiplication as indirect measurement of oxygen uptake was significantly reduced too. The 16 diabetics with ADNCS were divided into 2 groups: 6 patients got CSII (12 months), 10 patients continued conventional s.c. therapy. After 6 and after 12 months graded exercise was performed again. The patients on s.c. therapy showed no improvement. 3 of the 6 CSII treated patients showed a significant improvement of the above mentioned parameters. Thus, in diabetics with ADNCS, CSII might not only influence the cardiovascular reflex tests, but might also have an effect on cardiovascular responses to graded exercise.
- Published
- 1985
210. Lack of efficacy of high-dose intravenous immunoglobulin in autoimmune haemolytic anaemia: a clue to its mechanism.
- Author
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Mueller-Eckhardt C, Salama A, Mahn I, Kiefel V, Neuzner J, and Graubner M
- Subjects
- ABO Blood-Group System, Adolescent, Adult, Aged, Anemia, Hemolytic immunology, Erythrocytes immunology, Female, Hemolysis, Humans, Immune Sera, Immunoglobulins analysis, Immunotherapy, Male, Middle Aged, Anemia, Hemolytic therapy, Autoimmune Diseases therapy, Immunoglobulin G administration & dosage
- Abstract
5 patients with autoimmune haemolytic anaemia (AIHA) of warm type (4 idiopathic, 1 associated with systemic lupus erythematosus and thrombocytopenia) were treated with high doses of i.v. immunoglobulin (IgG; Sandoglobulin; 2.0 g/kg body weight). IgG therapy was ineffective in all 5 cases as indicated by a lack of clinical improvement, continuous signs of accelerated red blood cell (RBC) destruction, and an unchanged survival rate of 51Cr-labelled autologous RBC in 4 patients studied. IgG infused at equivalent doses into 5 healthy volunteers led to an increase of IgG coating of autologous RBC (irrespective of the ABO blood groups) without concomitant changes of haemoglobin, haematocrit or reticulocytes, increase of serum IgM in 3/5, a decrease of serum C4 in 5/5, and a decrease of serum haptoglobin in 2/5 individuals. We conclude that IgG at a dose of 2.0 g/kg body weight is ineffective in AIHA. This may be caused by an increased, though clinically inapparent, interaction of IgG-coated autologous RBC with the mononuclear phagocyte system.
- Published
- 1985
- Full Text
- View/download PDF
211. The influence of various degrees of cardiac failure, chronic medical treatment, and acute additional enoximone application on the parameters of the vasopressor system.
- Author
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Mitrovic V, Neuzner J, Husseini H, Volz M, and Schlepper M
- Subjects
- Adult, Body Weight drug effects, Cardiomyopathy, Dilated drug therapy, Cardiomyopathy, Dilated physiopathology, Cardiotonic Agents administration & dosage, Cardiotonic Agents blood, Chromatography, High Pressure Liquid, Enoximone, Heart Failure drug therapy, Hormones blood, Humans, Imidazoles administration & dosage, Imidazoles blood, Injections, Intravenous, Middle Aged, Radioimmunoassay, Cardiotonic Agents therapeutic use, Heart Failure physiopathology, Imidazoles therapeutic use
- Abstract
The characteristics of norepinephrine and epinephrine as well as plasma renin activity, angiotensin II, aldosterone, vasopressin, and atrial natriuretic factor (ANF) were examined in 64 patients (mean age of 52 +/- 16 years) with dilated cardiomyopathy. The findings were grouped according to the NYHA classification and compared with a normal cohort of 38 patients (mean age of 42 +/- 10 years). Furthermore, the influence of different cardioactive substances used in the treatment of cardiac failure was analyzed in more detail. Patients in NYHA class II already demonstrated an increased activity of the sympathicoadrenal, renin-angiotensin-aldosterone system (RAAS), vasopressin, and ANF system. The highest values were found in patients of NYHA class IV. In these patients, norepinephrine was enhanced by a factor of 7, epinephrine by a factor of 2, plasma renin activity by a factor of 7, angiotensin II by a factor of 2.5, aldosterone by a factor of 5, vasopressin by a factor of 1.5, and ANF by a factor of 4 compared with those in normal subjects. The highest correlation coefficient was found for norepinephrine (r = 0.84). The acute application of 1-2 mg/kg of body weight of enoximone in patients with dilated cardiomyopathy (n = 15) resulted only in a significant lowering of the atrial natriuretic factor as an indicator for drug-induced unloading effects (venous pooling). All the parameters showed only a tendency; in none could statistical significance be established. Application of 0.75 mg/kg of body weight of enoximone i.v. in patients with coronary artery disease (n = 17) has no direct influence either on the sympathoadrenal, the ANF, or the prostaglandin systems. It could be demonstrated that the mode of medical treatment influences the parameters of vasoconstrictor systems in different ways.
- Published
- 1989
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