Wiek H van Gilst - Academia.edu (original) (raw)

Papers by Wiek H van Gilst

Agents and actions. Supplements, 1992

Restoration of coronary blood flow in the ischemic myocardium is absolutely needed to prevent irr... more Restoration of coronary blood flow in the ischemic myocardium is absolutely needed to prevent irreversible cellular damage but on the other hand may have potentially hazardous consequences. Since thrombolysis during myocardial infarction is designed to salvage a maximal number of myocardial cells threatened by ischemia, a concommitant intervention which reduces cellular damage due to reperfusion will improve the net result of such procedure. The adjunctive use of ACE-inhibitors with thrombolytic therapy early during acute myocardial infarction offers theoretic advantages. This article summarizes the results indicating that ACE-inhibitors do play an important role in cardioprotection in the acute phase of myocardial ischemia followed by reperfusion. Probably, their effect on bradykinin breakdown is at least partly responsible for this effect.

Cardiac Glycoside Receptors and Positive Inotropy, 1984

The inotropic action of ouabain on isolated perfused hearts of rat, guinea-pig, and cat was studi... more The inotropic action of ouabain on isolated perfused hearts of rat, guinea-pig, and cat was studied over a wide concentration range (10(-12)-5 X 10(-3) M). In all three species used, the positive inotropic effect (PIE) of ouabain appeared to be biphasic in character. However, there was a remarkable difference in the course of the logdose-response curves of ouabain on guinea-pig and cat heart as compared with than on rat heart. The first two species showed, at very low concentrations of ouabain (guinea-pig heart: 10(-9) M and cat heart: 10(-10) M), a typical bell-shaped increase in cardiac contractile activity, while at higher concentrations (10(-8)-10(-6) M and 10(-9)-10(-7) M, respectively) the normally observed S-shaped increase in contractile activity occurred. On the contrary, rat hearts showed a flat S-curve between 10(-8) and 10(-6) M and a steep one between 10(-6) and 10(-4) M of ouabain. In order to explain the biphasic action of ouabain a hypothetical model for the mechanism(s) of action of ouabain is discussed. Mathematical description of this model is based on the existence of two different receptor-types for ouabain. It is suggested that sarcolemma-bound calcium may play an important role in both mechanisms of inotropic action of ouabain.

European Heart Journal, 1993

Reversible leukopenia was documented in an 81-year-old woman treated with adjunctive ibopamine 10... more Reversible leukopenia was documented in an 81-year-old woman treated with adjunctive ibopamine 100 mg t.i.d. for chronic congestive heart failure. Her antecedent medical history included stable, mild renal function impairment, mitral regurgitation, atrial fibrillation, recurrent transient ischaemic attacks and cholelithiasis. The drugs concomitantly used were digoxin, isosorbide dinitrate, frusemide, urapidil and chlorthalidone in conjunction with oral potassium substitution. Upon withdrawal of ibopamine but continuation of all other drugs, the patient recovered from the blood dyscrasia within 5 days and showed resolution of symptoms. Measurements of protected isolation and selective intestinal decontamination were taken. No complications resulting from secondary infection occurred. After withdrawal of ibopamine and under continuation of all other concomitant medications her body weight continued to decrease during the following few days, her symptoms were alleviated and she was discharge to a nursing home.

European Heart Journal, 1988

Transient hypokalaemia may occur in acutely ill patients and is associated with an increased inci... more Transient hypokalaemia may occur in acutely ill patients and is associated with an increased incidence of life-threatening arrhythmias. Therefore, we performed a retrospective analysis of the serum potassium values of 538 patients with unstable angina included in the Holland Interuniversity Nifedipine/metoprolol Trial in relation to the use of diuretics. On admission, 113 of these patients used diuretics. Potassium sparing diuretics had been used in 65 patients (group A) and non-potassium sparing diuretics in 48 patients (group B). From the 425 patients not on diuretics a random sample of 56 (group C) was drawn. Blood samples were taken routinely on admission to the coronary care unit. The serum potassium values found for group A, B and C were 3.77 +/- 0.55, 3.44 +/- 0.69 and 4.14 +/- 0.48, respectively, and the prevalence of hypokalaemia (less than 3.6 mmol) 40, 65 and 14% respectively. Rate ratio [95% confidence interval (CI)] for hypokalaemia when compared to group C was 2.6 (1.2-5.6) for group A and 4.9 (2.4-10.1) for group B. The prevalence of hypokalaemia was higher for women than for men (rate ratio, 95% CI: 1.4, 0.9-2.2). Patients already on beta-blocker therapy showed a 10% lower prevalence of hypokalaemia (rate ratio, 95% CI: 0.7, 0.5-1.1). These data were compared with serum potassium values of 104 patients with stable angina, who reported to the outpatient clinic. These patients were also divided into three groups according to the use of diuretics. Only in 15% of the patients using non-potassium sparing diuretics was hypokalaemia observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Basic Research in Cardiology, 1988

The effect of captopril on energy-rich phosphates and pH during normothermic ischemic arrest, hyp... more The effect of captopril on energy-rich phosphates and pH during normothermic ischemic arrest, hypothermic cardioplegic arrest and subsequent reperfusion was investigated in the isolated rat heart using 31P-nuclear magnetic resonance. The hearts remained in the probe during all perfusion procedures and captopril (80 ml. 1 -j) treatment was started directly after cannulation.

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2013

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2010

Objectives. We aimed to compare the rate of apoptosis after cardiopulmonary bypass (CPB) and card... more Objectives. We aimed to compare the rate of apoptosis after cardiopulmonary bypass (CPB) and cardioplegic arrest during coronary artery bypass grafting (CABG) surgery between atrial and ventricular tissue.Methods. During CABG surgery with CPB and cardioplegic arrest, sequential biopsies were taken from the right atrial appendage and left ventricular anterior wall before CPB and after aortic cross clamp release. Change in number of apoptotic cells and biochemical markers of myocardial ischaemia and renal dysfunction were assessed.Results. CPB was associated with a transient small, but significant increase in CK (1091+/-374%), CK-MB (128+/-38%), troponin-T (102+/-13%) and NT-proBNP (1308+/-372%) levels (all: p<0.05). A higher number of apoptotic cells as assessed by caspase-3 staining was found in the ventricular biopsies taken after aortic cross clamp release compared with the biopsies taken before CPB (5.3+/-0.6 vs. 14.0+/-1.5 cells/microscopic field, p<0.01). The number of ap...

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2008

It has been postulated that bone marrow derived endothelial progenitor cells (BM-EPCs) are essent... more It has been postulated that bone marrow derived endothelial progenitor cells (BM-EPCs) are essential for neovascularisation and endothelial repair and are involved in pharmacological treatment, and even its potential targets. There is no doubt that the ultimate success of angiogenic cell therapy will be determined by an appropriate stimulation of certain angiogenic progenitor cell subpopulations. Unfortunately, the biology of EPCs is still poorly understood. In particular, the understanding of endogenous microenvironments within the progenitor cell niches is critical, and will provide us with information about the signalling systems that supply a basis to develop rational pharmacotherapy to enhance the functional activity of endogenous or transplanted progenitor cells. The final success of clinical improvement of progenitor cell-mediated vascular repair and angiogenic therapy depends on a better understanding of EPC biology and a smart therapeutic design. In the first part of this r...

Journal of thrombosis and haemostasis : JTH, Jan 13, 2015

Anemia may predispose to thromboembolic events or bleeding in anticoagulated patients with AF. To... more Anemia may predispose to thromboembolic events or bleeding in anticoagulated patients with AF. To investigate if anemia is associated with thromboembolic events and bleeding in patients with atrial fibrillation (AF). We retrospectively analyzed the RE-LY trial database that randomized 18,113 patients with AF and a risk of stroke to receive dabigatran or warfarin for a median follow-up of 2 years. Cox regression analysis was used to determine if anemia predicted cardiovascular events and bleeding complications in these patients. Anemia was present in 12% of the population at baseline and the presence of anemia was associated with higher risk of thromboembolic cardiovascular events, including the composite endpoint of all-cause mortality or myocardial infarction (adjusted hazard ratio (adj.HR) 1.50, 95% confidence interval (95%CI) 1.32-1.71) and the primary RE-LY outcome of stroke or systemic embolism (adj.HR 1.41 95%CI 1.12-1.78). Anemia was also associated with a higher risk of majo...

European Heart Journal, 2013

European Heart Journal, 1998

In a double-blind randomized trial in unstable angina it was shown that intravenous diltiazem red... more In a double-blind randomized trial in unstable angina it was shown that intravenous diltiazem reduced ischaemic events in the first 48 h after inclusion better than intravenous nitroglycerin. The present study was performed to establish the long-term prognosis of the randomized patients, with respect to their initial treatment assignment. One year follow-up data on ischaemic end-points and anti-ischaemic medication were recorded. Results were available for all of the 121 randomized patients. One hundred and sixty-seven primary endpoint events were recorded, of which 54 occurred in the first 48 h and 113 during the follow-up. Survival analysis showed that event-free survival was significantly better in the diltiazem group (45.0%) than in the nitroglycerin group (34.4%), P=0.04. The incidence rate after 48 h and one year for cardiac death are, respectively, 0% and 4.1%. The trend in anti-ischaemic medication was higher in the nitroglycerin group. For beta-blockers, this trend became significant after 12 months (P=0.03). These results show that the initial benefit obtained by early treatment with intravenous diltiazem was preserved during the first year after the initial hospitalization, and that, despite the high risk of cardiac events in our population, the overall mortality 12 months after inclusion was low.

European Heart Journal, 1996

Journal of cardiovascular pharmacology, 2000

Dopaminergic agonists remain of interest in the treatment of heart failure; however, concomitant ... more Dopaminergic agonists remain of interest in the treatment of heart failure; however, concomitant stimulation of alpha- and beta-receptors should be avoided. This study evaluates the dopaminergic and adrenergic (vasodilating) properties of Z1046, epinine (the active metabolite of ibopamine), and dopamine. Isotonic contraction experiments were performed on human internal mammary artery rings in vitro. alpha1-Antagonistic effects of Z1046 were demonstrated by performing cumulative dose-response curves with the selective alpha1-agonist phenylephrine in the presence of Z1046. Furthermore, both alpha1- and dopamine-mediated receptor effects of Z1046, epinine, and dopamine were studied by performing cumulative dose-response relations both at baseline and in precontracted artery rings both with and without the D1-like antagonist SCH23390. In contrast to both epinine and dopamine, Z1046 is devoid of alpha1-receptor-mediated contraction. Furthermore, Z1046, epinine, and dopamine induced direc...

Journal of cardiovascular pharmacology, 1992

In this study the effect of the angiotensin converting enzyme (ACE) inhibitor captopril on beta-r... more In this study the effect of the angiotensin converting enzyme (ACE) inhibitor captopril on beta-receptor responsiveness was investigated in failing rat hearts after experimental myocardial infarction. Infarcted rats were treated for 8 weeks with either captopril added to the drinking water (100 mg/kg/day; n = 5) or drinking water alone (n = 7). Treatment was started 2-3 days before myocardial infarction. A third group of untreated rats without myocardial infarction served as control (n = 6). At the end of the treatment period the hearts were perfused as described by Langendorff, and a cumulative dose-response curve of isoprenaline was obtained in each heart. In comparison with noninfarcted hearts, the response of heart rate and peak pressure rate (dP/dt) to isoprenaline stimulation was significantly depressed in hearts of infarcted rats. Chronic treatment with captopril significantly attenuated the reduced responsiveness to isoprenaline stimulation. This improved responsiveness in c...

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Nederlands tijdschrift voor geneeskunde, Jan 13, 2008

To determine the efficacy of 2 nurse-directed programmes of different intensity for the counselli... more To determine the efficacy of 2 nurse-directed programmes of different intensity for the counselling and follow-up of patients hospitalised for heart failure, compared with standard care by a cardiologist. Multicentre randomised clinical trial (www.trialregister.nl: NCT 98675639). A total of 1023 patients were randomized after hospitalisation for heart failure to 1 of 3 treatment strategies: standard care provided by a cardiologist, follow-up care from a cardiologist with basic counselling and support by a nurse specialising in heart failure, or follow-up care from a cardiologist with intensive counselling and support by a nurse specialising in heart failure. Primary end points were the time to rehospitalisation due to heart failure or death and the number of days lost to rehospitalisation or death during the 18-month study period. Data were analysed on an intent-to-treat basis. Mean patient age was 71 years, 38% were women, 50% had mild heart failure and 50% had severe heart failure...

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2007

The use of invasive procedures has mostly been studied in retrospective (multi)- national registr... more The use of invasive procedures has mostly been studied in retrospective (multi)- national registries. Limited evidence exists on the association between microalbuminuria and coronary artery disease (CAD). The incidence of major adverse cardiac events (MACE) and invasive cardiac procedures was registered between 1997 and 2003 in 8139 subjects, without prior documented CAD, in the PREVEND cohort study (the Netherlands), in which the focus is on microalbuminuria and cardiovascular risk. Qualitative coronary angiographic analysis was performed. During 5.5 years of follow-up, a first MACE occurred in 271 (3.3%) and a first coronary angiography (CAG) was performed in 264 (3.2%) subjects. Of these, 216 CAGs were available for qualitative angiographic analysis. Indications for CAG were stable angina in 129, acute coronary syndrome (ACS) in 55 and ST-elevation myocardial infarction (STEMI) in 32 subjects. Obstructive coronary artery disease was present in 61, 53 and 30 subjects, respectively...

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2003

to examine the effect of angiotensin converting enzyme inhibition (ACEI) on soluble intercellular... more to examine the effect of angiotensin converting enzyme inhibition (ACEI) on soluble intercellular adhesion molecule 1 (sICAM-1) and C-reactive protein (CRP) in patients requiring coronary artery bypass grafting (CABG). subgroup analysis of 42 patients randomised to Quinapril (40 mg daily determined) and 45 to placebo. sICAM-1 and CRP were > or = 4 weeks before and 1 year after surgery. there was no difference in sICAM-1 at baseline (142.2 microg/L vs 136.6 microg/L). There was significant reduction in s-ICAM-1 in patients receiving quinapril (142.2+/-10.8 microg/L vs 125.6+/-9.4 microg/L, p<0.05) but not placebo (136.6+/-10.2 microg/L vs 131.2+/-11.7 microg/L, p=NS). Levels of C-reactive protein remained unchanged in both groups (3.70+/-0.85 vs 2.73+/-0.32 mg/L, 2.85+/-0.48 vs 3.16+/-0.50 mg/L). ACEI reduces sICAM-1 in patients undergoing CABG. The benefits of ACEI may partly be due to a reduction of the vascular inflammatory response.