[Acute and long-term effects of pimobendan (UD-CG 115) in NYHA II and III heart failure. Results of a randomized multicenter double-blind study]. / Akut- und Langzeiteffekte von Pimobendan (UD-CG 115) bei Herzinsuffizienz NYHA II und III. Ergebnisse einer randomisierten multizentrischen Doppelblindstudie.

The effects of pimobendan (UD-CG 115) on hemodynamics and exercise capacity after acute (single dose) and chronic (6 month) oral treatment, as well as acute treatment after 6 months were investigated in 67 patients with chronic heart failure of NYHA classes II or III, which had persisted in spite of treatment with diuretics and digitalis. They were treated with pimobendan (2.5 mg bid or 5 mg) or placebo in a randomized, double-blind multicenter trial. With a single administration before and after 6 months' treatment there was-compared to placebo-a significant fall in pulmonary capillary pressure (PCP) at rest (R) and during exercise (E) of 7% to 24%. Right atrial pressure (R) and pulmonary arterial pressure (PAP) (R, E) decreased after pimobendan on day 1; cardiac index (E) increased significantly. All other parameters were not influenced. After chronic therapy, PCP (E), PAP (E), LV stroke work index (E), and pulmonary resistance (R and E) values were significantly lowered by pimobendan when compared to day 1. Exercise duration was prolonged after 6 months by 83 s and 47 s after 5 and 10 mg/day, resp., compared to the placebo group (group difference not significant). Subjective wellbeing was improved in all three groups (no group difference). Clinical symptoms were not altered; six patients (two in each group) died suddenly. Another nine patients discontinued the trial prematurely because of poor efficacy or adverse events (no group difference). Overall, pimobendan was well-tolerated and had favorable effects on both acute and chronic hemodynamics and on exercise capacity. There was no evidence of any tolerance development.

[Hemodynamic and clinical studies with Bonnecor--a new anti-arrhythmia drug]. / Hämodynamische und klinische Untersuchungen mit Bonnecor--einem neuen Antiarrhythmikum.

It is reported on clinical and haemodynamic results with Bonnecor, a new antiarrhythmic drug with class I and IV properties, on 68 test persons in parenteral and oral administration. The haemodynamic acute investigations (dosage 2 x 0.1 to 1 x 0.3 mg/kg body weight) which were performed on 10 test persons with compensated heart diseases did not show any negative haemodynamic effects of Bonnecor at rest and on exercition. The chronic effect on ventricular extrasystoles of the degrees of severity mostly II-IV were investigated in the open experiment on 17 patients as well as on 3 patients with supraventricular dysrhythmias and on 30 patients with ventricular extrasystoles Lown III-IV in the single blind cross-over experiments to verapamil retard. A clinically relevant result with regard to the reduction of the ventricular extrasystole about 75% was found in 23% of the patients (open study) and 33.3% of the patients (cross-over), respectively. The reduction of the ventricular extrasystole was significant compared with the empty value. Under the influence of verapamil a significant reduction of the ventricular extrasystole could not be verified, the differences between Verapamil and Bonnecor were, however, not to be ascertained statistically. The effect of Bonnecor on couplets and volleys was clinically relevant in 52 and 46%, respectively, of the patients (reduction greater than or equal to 93%) and approximately corresponds to the results with other antiarrhythmic drugs. The tolerability is to be estimated as relatively good.(ABSTRACT TRUNCATED AT 250 WORDS)

Distribution of alexithymic characteristics within an adult outpatient population.

Utilizing the MMPI Alexithymia Scale (MMPI-AS), a retrospective study was undertaken to determine the distribution of alexithymia within an outpatient population. Approximately 7.64% of the outpatient population displayed the alexithymic trait. Analysis of alexithymia by sex revealed that 10.61% of males and 5.13% of females evidenced alexithymia. This does not correspond with other studies on the distribution of alexithymia within other nonpsychosomatic populations. Issues regarding the measurement instrument, distribution of alexithymia, as well as areas for further investigation are addressed.

[Clinical and paraclinical findings on status following prosthetic heart valve replacement with special reference to the behavior of pulmonary pressure]. / Klinische und paraklinische Befunde bei Zustand nach prothetischem Herzklappenersatz unter besonderer Berücksichtigung des pulmonalen Druckverhaltens.

Retrospectively were evaluated clinical findings of 151 patients with condition after replacement of artificial cardiac valves (Björk-Shiley), who were treated in our department of cardiology in 1986. The patients with mitral valve replacement (MVR) and mitral valve and aortic valve replacement showed the highest rate of individualisation in comparison to aortic valve replacement. 18 patients showed complications and acute deteriorations, respectively, two of which had a fatal course. In 53 patients the bicycle-ergometric exercises were performed with measurement of the pulmonary pressure. Of these patients the majority indeed subjectively improved in their behaviour, however, the objective exercise tolerance was altogether low and the rate of invalidisation increased in comparison to the preoperative rate. The pulmonary pressure at rest in the majority of the patients was reduced mostly in dependence on the initial values. Increases appeared only sporadically. Under exercise, however, particularly the patients with mitral valve replacement showed pathological increases of pressure. Altogether the best results showed patients with aortic valve replacement also with regard to the shrinking of the radiologically established size of the heart.