RESUMEN

The authors report about a long-term study (three months) on blood pressure and heart rate at rest and during exercise (50 W) in hypertensive patients (WHO stadium I and I, n = 24) running twice a week. The control group were 15 healthy people who were running as well. In addition, the peripheral microcirculation (musculus tibialis anterior) was recorded by the Xenon-133 muscle clearance method and the cardiac output by means of radiocardiography (Indium 113m) as parameter of central hemodynamics. A positive influence of running on hypertension and hemodynamics, resulting in a significant decrease of systolic and diastolic blood pressure and a significant improvement of the peripheral microcirculation was registered. The measured values of blood pressure, heart rate and cardiac output show that there was no cardial risk caused by running at a velocity of 2 to 2.5 m/s.

Asunto(s)

RESUMEN

Effective treatment of hypertension includes decrease of blood pressure at rest, dynamic and isometric exercise. Therefore, we investigated the hemodynamic changes by radiocardiography (central hemodynamic) and Xenon-133-muscle clearance (peripheral hemodynamic) before and after a sauna treatment during a period of 3 months. 46 hypertensive men (WHO I-II, aged 41 +/- 11 years) participated in the study. Systolic and diastolic blood pressure at rest and during dynamic exercise were decreased significantly (p < or = 0.01) by sauna therapy. Change of blood pressure at isometric exercise was not significant (from 157.5 +/- 16.5 mmHg to 155.0 +/- 15.4 mmHg). The changes of cardiac output and total peripheral resistance were also not significant. Half-time of muscle clearance decreased significantly (from 4.4 +/- 1.9 min to 3.2 +/- 1.2 min, p < or = 0.01) and functional cross-section A increased significantly (from 3.8 +/- 0.9 mm2.c to 4.4 +/- 0.9 mm2.c, p < or = 0.01) after the sauna therapy at dynamic exercise, but not at isometric exercise. These results show the changes between isometric and dynamic exercise, which can only be explained well by a study of peripheral hemodynamic. Contrary to dynamic exercise, sauna therapy did not significantly decrease blood pressure at isometric exercise.

Asunto(s)

RESUMEN

The authors report on the influence of a single sauna-stay of patients following heart transplantation (HTX) during the rehabilitation phase III. Investigations of blood pressure, heart rate, changer in hemodynamics in the small and large vessels in 8 male patients following HTX (medium age: 42 years) showed that sauna-hyperthermia is well tolerated. We watched significant decreases of blood pressure (systolic and diastolic values), an improvement of the microcirculation in the small vessels, an increase of the left ventricular ejection fraction (LVEF) and a decrease of the total peripheric vascular resistance (TPVR). Possibilities and limitations of sauna-therapy for the therapy of risk factors following HTX especially under immunosuppression are discussed. First results are demonstrated.

Asunto(s)

RESUMEN

This is a report on the application and importance of nuclear-medical procedures in physical therapy and rehabilitation. In particular, attention is focused on the parameters of peripheric haemodynamics (T1/2 and -A) and of the left ventricular ejection fraction. The authors aim at demonstrating their own results gained during the last 10 years in different groups of patients suffering from cardiovascular diseases at rest and under load. The results are critically estimated, including the relevant literature, and conclusions are drawn for clinical practice.

Asunto(s)

RESUMEN

It is reported about the influence of the sauna therapy on blood pressure, heart frequency, peripheric hemodynamics (Xenon-133-muscle-clearance) and the reaction of the cardiac output or left ventricular ejection fraction with hypertonia patients, patients with coronary heart disease (CHD) and hypertension and after aneurysm resection after heart infarction. It was shown that sauna therapy has a positive effect on hypertonic regulations troubles. One of the reasons of lowering blood pressure is the significant improvement of the peripheral hemodynamics. Sauna therapy does not result in any improvement of the left ventricles pumping function after operation. All described groups of patients showed a good tolerance and compliance with sauna therapy.

Asunto(s)

RESUMEN

The authors report on the influence of autogenous training on blood pressure at rest and under stress conditions in patients with coronary heart disease following coronary bypass operation. We investigated the influence of autogenous training on the microcirculation and the left ventricular ejection fraction (LVEF) as well. The results showed a significant decrease in blood pressure at rest and also an increase of muscle circulation F and of LVEF.

Asunto(s)

RESUMEN

Physical endurance training as practised at spas in the active treatment of hypertension will usually result in an increase in oxygen supply reserves and will also improve haemodynamics, so that it could help in objectively identifying the success of cardiovascular treatment. For this reason we conducted a bicycle ergometer load test in recumbent position in a group of 23 male hypertensives in stages I and II (age between 25 and 58 years) before and after a treatment course at a spa of 4 to 5 weeks' duration. The measurement parameters were ECG, blood pressure, cardiac output and the ventilatory parameters tidal volume, oxygen uptake, respiratory equivalent and respiratory quotient. Significant blood pressure reductions were seen if the load did not exceed 75 watts. The treatment course had a definite influence on cardiac output at rest and under stress. The treatment course achieves reduction and largely also normalisation of the tidal volume which is otherwise higher than in healthy persons. No influence is exercised on the respiratory equivalent. Reduction of the tidal volume and of the oxygen uptake, as well as reduction of the respiratory quotient after the treatment course can be interpreted as an improvement in the economy of the cardiovascular system. The ventilatory parameters are only conditionally suitable for arriving at an objective assessment of the curative effect of the treatment course.

Asunto(s)

RESUMEN

The authors report about the long-term response (one and three years) of blood pressure and heart frequency under rest and load (50 W) in patients with hypertension, coronary heart disease, essential hypertension and after aortocoronary venous-bypass operation (ACVB) (n = 65) under regular visits (twice a week) to the Finnish sauna. In comparison, 68 hypertensive patients who took a regular kinesiotherapy (running and swimming) were studied. Besides the parameters of heart circulation mentioned above, peripheric microcirculation (M. tibialis anterior) by means of xenon-133 muscle clearance and central hemodynamics by means of LVEF (single probe with In 113) were studied in CHD-patients. Cardiac output at rest and under 50 W load was recorded in hypertensive patients. It was shown that regular balneotherapy had a positive effect on regulation of blood pressure and hemodynamics in patients with hypertension or CHD with hypertension, as had kinesiotherapy in hypertensive patients.

Asunto(s)

RESUMEN

It is being reported about the influence of a CO2-bathing series with 12 patients after heart-transplantation in connection with a light-motion therapy on blood pressure and haemodynamics. The comparative group was a group of 12 heart-transplantation patients of the same age without cure during the comparative time. It was shown that the balneotherapy after HTPL has positive effect on the development of the systolic blood pressure under rest and exercise. The peripheric microcirculation (musculus tibialis anterior) improved significantly. The left ventricular ejections fraction (LVEF) kept without change. Generally, the balneotherapy is well tolerated by heart-transplantation patients. There is no danger of a cardiac overcharge of the left ventricle.

Asunto(s)

RESUMEN

The aim of the study was to demonstrate the possibility of transfemoral balloon occlusion of the coronary sinus and to detect changes of the left ventricular function during this occlusion in patients with angina pectoris. In 9 of 18 patients a stable occlusion over 15 seconds was performed. There were found only short term negative effects on the left ventricular contraction and relaxation. The coronary sinus pressure increased to 53 +/- 11 mm Hg. Numerous venous anastomoses made it difficult to occlude completely the sinus. The retrograde perfusion of the myocardium reached 20-30% of the antegrade one.

Asunto(s)

RESUMEN

In the frame of the attendance to patients with specific myocardial diseases differences are found in contrast to groups of patients, in particular of older age. The complex diagnostic clarification, including myocardial biopsy, is recommended. Convalescent treatment is of priority. Because of the bad prognosis of patients with impaired left-ventricular function, in particular patients with normal or slightly impaired left-ventricular ejection fraction should be mobilised using complex rehabilitative measures (psychologist, welfare worker) only after some longer convalescent treatment. Decisions as to sanatorium treatment or on further special therapeutic principles have to be made individually.

Asunto(s)

RESUMEN

Unilateral nephrectomy was performed in 109 male Wistar rats, 35 animals served as controls. Determinations of glomerular filtration rate (GFR) using slope clearance of 99mTc-DTPA and of tubular function using an orally water-loading test were made. The tests were performed 2 and 5 days as well as 2, 4, 5 and 6 weeks after nephrectomy. In all examinations the GFR was more than 50% of the level of two-kidney control animals. Fractional maximum diuresis was increased in the first 2 examinations after nephrectomy from 8.9 +/- 2.1 to 15.4 +/- 4.2% of the GFR and fractional clearance of osmotically free water from 6.8 +/- 1.9 to 10.9 +/- 3.5%. In the fourth and sixth week the proximal tubular reabsorption was increased and the glomerulo-tubular balance had been recovered. However, the minimal urine osmolarity was increased to 107.8 +/- 17.7 mmol/l and the osmotic load of the nephrons remained elevated. Possible clinical implications of the results are discussed.

Asunto(s)

RESUMEN

Report on mild and single whole body-irradiations with near infrared (IRA). The central body temperature went up to 38.5 degrees C in 9 healthy subjects and 9 patients known as having essential arterial hypertension of the stages I or II. In case of hypertensive patients a single exposure decreased significantly both arterial and venous blood pressure as well as the resulting mean arterial blood pressure. This beneficial effect lasted for at least 24 hours. Besides that, improvement of peripheral hemodynamics and plasma viscosity also was proven. Obviously, improved peripheral hemodynamics is linked to that blood pressure lowering effect which happens due to dilatation of peripheral blood vessels.

Asunto(s)

RESUMEN

Hyperthermia therapy in hypertensive patients is been discussed as an effective treatment. The aim of this study was to control the behaviour of circulation in conditions of hyperthermia. A group of 6 males, 32-53 years old, suffering from essential hypertension stage I-II underwent a single whole body-irradiation with near infrared (IRA), lasting over one hour. The body temperature rises up to maximal 38.5 degrees C. Before, during and after treatment the blood pressure (BP), the heart rate (HR), the stroke volume (SV), the cardiac output (CO) and the ejection fraction - measured by radionuclide ventriculography - where estimated and the peripheral arterial mean pressure (Pm), the ejection resistance (AW) and the Total peripheral resistance (TpW) were calculated. During irradiations there was a significant decrease of BP, AW and TpW. HR, SV, CO and EF increased significantly. Due to IRA irradiations there was a change in microcirculation with the consequence of lowering the blood pressure. The concomitant stimulation of the heart was well compensated as shown by CO, SV and EF.

Asunto(s)

RESUMEN

The acute effects of 1.6 mg glycerol trinitrate (2 x 0.8 mg) on the hemodynamic function were compared in 11 healthy subjects and 25 hypertensive patients (WHO stages I and II), at rest and during exercise. The nitrate testing was performed before the beginning of antihypertensive treatment, during nonmedical therapy, as well as under additional oral therapy with diisopropylamin. Right-heart-catheterization, echocardiography, radionuclide-ventriculography and venous occlusion plethysmography were performed. Nitroglycerin consistently led to a reduction of blood pressure in the systemic and pulmonary circulation both at rest and during exercise. There was a small decrease of peripheral arterial resistance (TPR) at rest and a more pronounced decrease of pulmonary arteriolar resistance (PAR) at rest and during exercise. The documented effects may be important with regard to combined antihypertensive treatment. In addition, the application of nitrates in hypertensive crises may be useful.

Asunto(s)

RESUMEN

Peripheral perfusion abnormalities are considered a possible reason for myocardial ischemia in the absence of visible coronary artery stenoses. In 85 women (age: 41-58 years, mean age: 46 +/- 8) with pathological exercise ECG (precordial mapping: 50 leads), hemodynamic studies were performed without medication, after sublingual nitroglycerin (NTG, 0.8 mg), sublingual Nifedipin (N, 30 mg), and intravenous Dipyridamol (D, 0.5 mg/kg). Eighteen women showed normal coronary arteries and a normal myocardial perfusion (group I), 21 an impaired perfusion due to coronary stenoses (Group II), and 46 women a reduced perfusion without visible changes (Group III). Reference methods were measurement of pulmonary artery pressure, 201-TI-scintigraphy, and coronary angiography. In group II, enddiastolic and endsystolic left ventricular volume (EDV, ESV) as well as enddiastolic pulmonary artery pressure (pAd) were increased, the ejection fraction (EF) was reduced, and cardiac output (CO) was normal. In group III, ESV, EDV, EF, and CO were significantly reduced, while pAd increased. In group II, N led to a normalization of ESV, EDV, EF, and pAd. In group III, NTG led to a reduction of pAd and EDV, and concomitantly to a further reduction of the already low CO. In both groups the reduction of ST-segment depressions after NTG was significant. N led to a moderate reduction of pAd and ST-segment depression, but to an increase of CO in both groups. D exhibited a comparable effect in group III. In group II an increase of ST-segment changes and of pAd with unchanged CO was observed. With regard to longterm treatment of women in group III, N and D seemed to be more efficacious than nitrates due to a beneficial effect on cardiac output.

Asunto(s)

RESUMEN

The influence of injections of Amidotrizoate and Iopromide into the left coronary artery on global myocardial perfusion and function (pressures in the left ventricle, heart rate) as well as excitation formation and transmission was studied in 16 patients with ischaemic heart disease. No statistically significant differences in myocardial perfusion measured were found with xenon-133 in this small group between rest and dipyridamole load for ionic and non-ionic contrast media.

Asunto(s)

RESUMEN

31 healthy volunteers at the age of 19 to 29 years underwent whole-body irradiations by either ultraviolet radiation (NARVA UVS 65-2; continuous sunshine-like emission, predominantly UVA plus 8% UVB; cumulative doses after 4 and 20 irradiations 8.8 J/cm2 and 51.0 J/cm2, respectively), or visible light (emission of a 3,500 Watt lamp HGMI 3500 DL, Tungsram CSSR, filtered through 6 mm window glass; cumulative dose 267.0 J/cm2 after 4 irradiations) or infrared radiation (250 Watt infrared lamps NARVA "Biotherm", emitting more than 70% infrared radiation; cumulative dose 159.0 J/cm2 after 4 irradiations). Before, during and after the irradiation series the following investigations were made: Arterial and venous oxygen pressure, oxygen utilization index; flow properties of peripheral blood (plasma viscosity, erythrocyte aggregation kinetics, apparent blood viscosity); hemodynamics (veineal plethysmography, 133Xenon clearance, functional diameter of small blood vessels, peripheral blood pressure), phagocytotic capacity of polymorphonuclear white blood cells; hematological parameters (blood sedimentation rate, polymorphonuclear and eosinophilic blood cells, red blood cells, hemoglobin, hematocrit), serum proteins (IgG, IgA, IgM, complement C3, alpha-1-glycoprotein, alpha-1-antitrypsin, haptoglobin, transferrin); calcium and phosphate in serum. As far as irradiance, dose and treatment frequencies are concerned, the experimental conditions were very similar to those in phototherapeutical practice. Under these circumstances there were no hints for unwanted early effects after application of all the three kinds of optical radiation used in that study. Considerable systemic responses exclusively were found by use of ultraviolet radiation. Under these experimental conditions according to dermatological phototherapy it has been proven the following biopositive systemic responses are due to happen: increase of serum calcium and phosphate, improvement of blood oxygen utilization, improvement of blood flow properties, and enhanced phagocytic capacity of polymorphonuclear white blood cells. Regarding the parameters taken in that study, no early unwanted side effects are to expect after therapeutical application of rather large doses of visible light or infrared radiation.

Asunto(s)

Asunto(s)

RESUMEN

Rehabilitation results are reported concerning the behavior of blood pressure and heart rate, peripheral and central hemodynamics, after resting and during exercise and physical conditioning by running as training and sauna, respectively, in hypertensive patients with IHD after aortocoronary venous bypass (ACVB) surgery. Bicycle ergometric examinations an xenon wash-out (for the determination of the mean functional vessel cross section A) were performed in 43 male untrained patients before and after physical therapy. The left ventricular ejection fraction (EF) at rest was also determined in these patients. Significant increases in the ejection fraction at rest (on average by 7-8%) could be demonstrated in both therapy groups. The group average value for peripheral microcirculation improved only in the sauna group. Blood pressure after resting and on exercise was not influenced. Results are discussed on the basis of the literature and practical conclusions drawn.

Asunto(s)