The Experts below are selected from a list of 81 Experts worldwide ranked by ideXlab platform

Erling Karlsson - One of the best experts on this subject based on the ideXlab platform.

  • established beta Adrenergic Receptor Blocking therapy and acute myocardial infarction a clinical study of risks and benefits
    Acta Medica Scandinavica, 2009
    Co-Authors: Ulf Dahlstrom, Ulf Berglund, Erling Karlsson
    Abstract:

    . In order to evaluate the risks and benefits of continuing established therapy with β-Adrenergic Receptor Blocking drugs during acute myocardial infarction (AMI), 183 consecutive patients, 63 with (β-blocker group) and 120 without (control group) this therapy, were studied. Detailed information on previous diseases, present symptoms, established medication, clinical and laboratory findings on admission and during the first 12 hours in the CCU was collected. The incidences of congestive heart failure, hypotension, AV blocks and ventricular arrhythmias were not significantly different in the two groups. The incidence of anterior wall infarction was the same in both groups (38%) but inferior wall infarction was significantly more common in the control group (8 vs. 28%, p<0.01). Thus, continuation of established therapy with β-Adrenergic Receptor Blocking drugs does not seem to increase the risk of complications after hospital admission for AMI. The reason for the low incidence of inferior wall infarction in the β-blocker group is not clear but it cannot be excluded that when patients on β-Adrenergic Receptor Blocking therapy develop an inferior AMI, they may run a greater risk of sudden death.

  • Established Beta-Adrenergic Receptor Blocking Therapy and Acute Myocardial Infarction: A Clinical Study of Risks and Benefits
    Acta Medica Scandinavica, 2009
    Co-Authors: Ulf Dahlstrom, Ulf Berglund, Erling Karlsson
    Abstract:

    . In order to evaluate the risks and benefits of continuing established therapy with β-Adrenergic Receptor Blocking drugs during acute myocardial infarction (AMI), 183 consecutive patients, 63 with (β-blocker group) and 120 without (control group) this therapy, were studied. Detailed information on previous diseases, present symptoms, established medication, clinical and laboratory findings on admission and during the first 12 hours in the CCU was collected. The incidences of congestive heart failure, hypotension, AV blocks and ventricular arrhythmias were not significantly different in the two groups. The incidence of anterior wall infarction was the same in both groups (38%) but inferior wall infarction was significantly more common in the control group (8 vs. 28%, p

M Jan D Lessem - One of the best experts on this subject based on the ideXlab platform.

  • combined therapy with ca antagonists and beta Adrenergic Receptor Blocking agents in chronic stable angina
    Acta Medica Scandinavica, 2009
    Co-Authors: M Jan D Lessem
    Abstract:

    Summary There have been conflicting reports on the safety of combining betaAdrenergic Receptor blockers and Ca++ -antagonists, especially verapamil, in the treatment of cardiovascular diseases. Warnings have been raised against additive negative chronotropic and inotropic effects. This study was designed to compare the efficacy and safety of simultaneous administration of verapamil, 360 mg daily, and atenolol, 100 mg daily, with that of either drug alone. Eighteen patients (mean age 58 years) with chronic stable angina were included in the study. After a two-week run-in period, the patients received either drug alone for six weeks and were then given the combination for another six weeks. Frequent ECG and blood pressure measurements were performed. Radionuclide evaluation of left ventricular ejection fraction was done before and at the end of the combined therapy. Exercise testing using a bicycle ergometer was performed during each treatment period. Only one patient developed sinus bradycardia when on combined therapy (48 bpm). The P-Q time increased with single drug therapy as well as with the combination (p < 0.01). Maximal exercise time increased more with the combination than with single drug therapy. No serious adverse hemodynamic effects were recorded. LVEF increased by 4.6% (p < 0.01) with the combined therapy. A decrease in nitroglycerine consumption occurred, beeing most pronounced with the combined therapy and corresponding to a subjective improvement. It is concluded that an additive negative chronotropism occured but that the combination is safe and offers an effective therapeutic alternative in chronic stable angina.

David L. Hare - One of the best experts on this subject based on the ideXlab platform.

  • A nurse-led up-titration clinic improves chronic heart failure optimization of beta-Adrenergic Receptor Blocking therapy--a randomized controlled trial.
    BMC Research Notes, 2014
    Co-Authors: Andrea Driscoll, Piyush M. Srivastava, Deidre Toia, Jackie Gibcus, David L. Hare
    Abstract:

    Beta-Adrenergic blockade has been shown to improve left ventricular function, reduce hospital admissions and improve survival in chronic heart failure with reduced ejection fraction (HFrEF), with mortality reduction starting early after beta-Adrenergic Receptor blocker initiation and being dose-related. The aim of this pilot study was to determine the effectiveness of a nurse-led titration clinic in improving the time required for patients to reach optimal doses of the beta-Adrenergic Receptor Blocking agents. We conducted a prospective pilot randomized controlled trial. Twenty eight patients with CHF were randomized to optimisation of beta-Adrenergic Receptor blocker therapy over six months by either a nurse-led titration (NLT) clinic, led by a nurse specialist with the support of a cardiologist in a CHF clinic, or by their primary care physician (usual care (UC)). The primary endpoint was time to maximal beta-Adrenergic Receptor blocker dose. The secondary end-point was the proportion of patients reaching the target dose of beta-Adrenergic Receptor blocker by six months. The patients were predominantly men (72%), age 67 ± 16 years; New York Heart Association (NYHA) functional class I (32%), II (44%) and III (20%); baseline left ventricular ejection fraction 33 ± 10%, and a low mean Charlson co-morbidity score of 2.5 ± 1.4. The time to maximum dose was shorter in the NLT group compared to the UC group (90 ± 14 vs 166 ± 8 days, p 

  • a nurse led up titration clinic improves chronic heart failure optimization of beta Adrenergic Receptor Blocking therapy a randomized controlled trial
    BMC Research Notes, 2014
    Co-Authors: Andrea Driscoll, Piyush M. Srivastava, Deidre Toia, Jackie Gibcus, David L. Hare
    Abstract:

    Beta-Adrenergic blockade has been shown to improve left ventricular function, reduce hospital admissions and improve survival in chronic heart failure with reduced ejection fraction (HFrEF), with mortality reduction starting early after beta-Adrenergic Receptor blocker initiation and being dose-related. The aim of this pilot study was to determine the effectiveness of a nurse-led titration clinic in improving the time required for patients to reach optimal doses of the beta-Adrenergic Receptor Blocking agents. We conducted a prospective pilot randomized controlled trial. Twenty eight patients with CHF were randomized to optimisation of beta-Adrenergic Receptor blocker therapy over six months by either a nurse-led titration (NLT) clinic, led by a nurse specialist with the support of a cardiologist in a CHF clinic, or by their primary care physician (usual care (UC)). The primary endpoint was time to maximal beta-Adrenergic Receptor blocker dose. The secondary end-point was the proportion of patients reaching the target dose of beta-Adrenergic Receptor blocker by six months. The patients were predominantly men (72%), age 67 ± 16 years; New York Heart Association (NYHA) functional class I (32%), II (44%) and III (20%); baseline left ventricular ejection fraction 33 ± 10%, and a low mean Charlson co-morbidity score of 2.5 ± 1.4. The time to maximum dose was shorter in the NLT group compared to the UC group (90 ± 14 vs 166 ± 8 days, p < 0.0005). At six months, in the NLT group there were nine patients (82%) on high dose and one patient (9%) on low dose beta-Adrenergic Receptor blocker compared to the UC group with five (42%) patients reaching maximum dose and five (42%) patients on low dose (p = 0.04). The patients allocated to the NLT group also had significantly less worsening of depression between baseline and six months (p = 0.006). A NLT clinic improves optimisation of beta-Adrenergic Receptor blocker therapy through increasing the proportion of patients reaching maximal dose and facilitating rapid up-titration of beta-Adrenergic Receptor blocker agents in patients with chronic HFrEF. Australian Clinical Trials Registry ( ACTRN012606000383561 ).

Guowei He - One of the best experts on this subject based on the ideXlab platform.

  • Inhibition of vasoconstriction by AJ‐2615, a novel calcium antagonist with α1‐Adrenergic Receptor Blocking activity in human conduit arteries used as bypass grafts
    British Journal of Clinical Pharmacology, 2001
    Co-Authors: Storm H Floten, Qin Yang, Guowei He
    Abstract:

    Aims  Graft spasm may develop during coronary artery bypass grafting and reversal of spasm is still challenging. The purpose of this study was to investigate the in vitro vascular relaxant properties of AJ-2615 in human internal mammary artery (IMA). Methods  We studied 264 IMA rings taken from 65 patients undergoing coronary artery bypass grafting surgery with organ bath technique. The interaction between AJ-2615 and various vasoconstrictors was investigated in two ways. Results  AJ-2615 caused complete relaxation in methoxamine-contracted IMA rings (100.0±0.0%; n = 8) and nearly full relaxation in potassium chloride-contracted IMA rings (91.4±5.7%; n = 8) or noradrenaline-contracted IMA rings (89.3±2.8%; n = 8). AJ-2615 also induced remarkable relaxation in IMA rings contracted by other vasoconstrictors. In comparison with the α1-adrenoceptor antagonist prazosin, AJ 2615 showed similar maximal relaxation in IMA rings contracted by methoxamine or norepinephrine. On the other hand, incubation with AJ-2615 (0.1–1 µm) significantly inhibited all the vasoconstrictor-mediated vasoconstriction except endothelin-1 in a concentration-dependent manner. Conclusions  The results suggested that in human IMA, AJ-2615 has an inhibitory effect on vasoconstriction mediated by a variety of vasoconstrictors and the mechanism of relaxation may be related to its calcium antagonism and α1-Adrenergic Receptor Blocking activity. AJ-2615 may have important clinical implications for patients undergoing coronary artery bypass surgery for reversing and preventing graft spasm.

  • inhibition of vasoconstriction by aj 2615 a novel calcium antagonist with α1 Adrenergic Receptor Blocking activity in human conduit arteries used as bypass grafts
    British Journal of Clinical Pharmacology, 2001
    Co-Authors: Storm H Floten, Qin Yang, Guowei He
    Abstract:

    Aims  Graft spasm may develop during coronary artery bypass grafting and reversal of spasm is still challenging. The purpose of this study was to investigate the in vitro vascular relaxant properties of AJ-2615 in human internal mammary artery (IMA). Methods  We studied 264 IMA rings taken from 65 patients undergoing coronary artery bypass grafting surgery with organ bath technique. The interaction between AJ-2615 and various vasoconstrictors was investigated in two ways. Results  AJ-2615 caused complete relaxation in methoxamine-contracted IMA rings (100.0±0.0%; n = 8) and nearly full relaxation in potassium chloride-contracted IMA rings (91.4±5.7%; n = 8) or noradrenaline-contracted IMA rings (89.3±2.8%; n = 8). AJ-2615 also induced remarkable relaxation in IMA rings contracted by other vasoconstrictors. In comparison with the α1-adrenoceptor antagonist prazosin, AJ 2615 showed similar maximal relaxation in IMA rings contracted by methoxamine or norepinephrine. On the other hand, incubation with AJ-2615 (0.1–1 µm) significantly inhibited all the vasoconstrictor-mediated vasoconstriction except endothelin-1 in a concentration-dependent manner. Conclusions  The results suggested that in human IMA, AJ-2615 has an inhibitory effect on vasoconstriction mediated by a variety of vasoconstrictors and the mechanism of relaxation may be related to its calcium antagonism and α1-Adrenergic Receptor Blocking activity. AJ-2615 may have important clinical implications for patients undergoing coronary artery bypass surgery for reversing and preventing graft spasm.

Daniel Schlenk - One of the best experts on this subject based on the ideXlab platform.

  • determination of beta Adrenergic Receptor Blocking pharmaceuticals in united states wastewater effluent
    Environmental Pollution, 2003
    Co-Authors: Duane B Huggett, Christy M Foran, Ikhlas A Khan, Daniel Schlenk
    Abstract:

    Beta Adrenergic Receptor antagonists (β-Blockers) are frequently prescribed medications in the United States and have been identified in European municipal wastewater effluent, however no studies to date have investigated these compounds in United States wastewater effluent. Municipal wastewater effluent was collected from treatment facilities in Mississippi, Texas, and New York to investigate the occurrence of metoprolol, nadolol, and propranolol. Propranolol was identified in all wastewater samples analyzed (n=34) at concentrations ⩽1.9 μg/l. Metoprolol and nadolol were identified in ⩾71% of the samples with concentrations of metoprolol ⩽1.2 μg/l and nadolol ⩽0.36 μg/l. Time course studies at both Mississippi plants and the Texas plant indicate that concentrations of propranolol, metoprolol, and nadolol remain relatively constant at each sampling period. This study indicates that β-Blockers are present in United States wastewater effluent in the ng/l to μg/l range.

  • toxicity of select beta Adrenergic Receptor Blocking pharmaceuticals b blockers on aquatic organisms
    Archives of Environmental Contamination and Toxicology, 2002
    Co-Authors: Duane B Huggett, Bryan W Brooks, Bethany N Peterson, Christy M Foran, Daniel Schlenk
    Abstract:

    One class of pharmaceutical compounds identified in U.S. and European waters are the B-Adrenergic Receptor Blocking compounds (B-blockers). However, little information is available on the potential aquatic toxicity of these compounds. Therefore, Hyalella azteca, Daphnia magna, Ceriodaphnia dubia, and Oryias latipes (Japanese medaka) were exposed to metoprolol, nadolol, and propranolol to determine potential toxicity. Average 48-h LC50 for propranolol to H. azteca was 29.8 mg/L. The no-observed-effects concentration (NOEC) and lowest-observed-effects concentration (LOEC) for propranolol affecting reproduction of H. azteca were 0.001 and 0.1 mg/L, respectively. The average propranolol and metoprolol 48-h LC50s for D. magna were 1.6 and 63.9 mg/L, respectively. C. dubia 48-h LC50s were 0.85 and 8.8 mg/L for propranolol and metoprolol, respectively. The NOEC and LOEC of propranolol affecting reproduction in C. dubia were 0.125 and 0.25 mg/L, respectively. In O. latipes, the propranolol 48-h LC50 was 24.3 mg/L. Medaka growth was decreased at 0.5 mg/L propranolol. A 2-week medaka reproductive study indicated significant changes in plasma steroid levels; however, no changes in the average number of eggs produced or number of viable eggs which hatched was observed. In a 4-week follow-up propranolol exposure, the total number of eggs produced by medaka and the number of viable eggs that hatched were decreased at concentrations as low as 0.5 μg/L. Based on this study and the expected aqueous environmental exposure levels, adverse effects of propranolol to invertebrate populations is unlikely; however, further reproductive studies are need to elucidate the risk to teleosts.