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Research paper thumbnail of Head-up tilt and hemodynamic changes during orthostatic hypotension in patients with supine hypertension

Journal of the American College of Cardiology, 1994

Research paper thumbnail of 53. Sensitivity and specificity of the head-up tilt test in adults

Journal of Hypertension, 1991

Research paper thumbnail of Angiotensins and the failing heart. Enhanced positive inotropic response to angiotensin I in cardiomyopathic hamster heart in the presence of captopril

Circulation Research, 1990

We examined the hypothesis that the positive inotropic effect of angiotensin I (Ang I) may be ret... more We examined the hypothesis that the positive inotropic effect of angiotensin I (Ang I) may be retained in the presence of angiotensin converting enzyme inhibitors so that it may have a direct beneficial effect on the heart. Accordingly, isolated perfused hearts (Langendorff preparation) of 300-day-old cardiomyopathic hamsters (a model of spontaneous cardiomyopathy) and age-matched normal hamsters (controls) were infused with Ang I in the presence of captopril; propranolol was added to the perfusing medium to block catecholamine-mediated effects of angiotensins on the heart. Left ventricular developed pressure and the rate of increase in left ventricular developed pressure increased significantly (p less than 0.001) in both the cardiomyopathic and the normal hamster heart despite concomitant reduction in myocardial flow rate favoring a direct inotropic effect of Ang I in both normal and myopathic hearts; these changes were significantly higher by almost threefold in the cardiomyopath...

Research paper thumbnail of Echocardiographic studies of regression of left ventricular hypertrophy in hypertension

Hypertension, 1987

The availability of echocardiography has allowed direct determinations of left ventricular wall t... more The availability of echocardiography has allowed direct determinations of left ventricular wall thickness and calculation of left ventricular mass. As a result, the past decade has witnessed a remarkable evolution in our understanding of structural changes in the heart. Moreover, cardiac hypertrophy was found to be reversible by some forms of therapy. In general, reduction of left ventricular mass became evident after 8 to 12 weeks of antihypertensive therapy. Sympatholytics (including methyldopa and reserpine), converting enzyme inhibitors (captopril and enalapril), and calcium entry blockers led to significant regression of left ventricular hypertrophy. On the other hand, arteriolar vasodilators (hydralazine, trimazosin, and minoxidil) were not associated with regression of hypertrophy despite adequate blood pressure control. Finally, data regarding diuretics and beta-blockers are controversial. These differences in results among various antihypertensive drugs reflect the multipli...

Research paper thumbnail of The usefulness of head-up tilt testing and hemodynamic investigations in the workup of syncope of …

Pacing and Clinical Electrophysiology

ABI-SAMRA, F,M,, ET AL.; The usefulness of head-up tilt testing and hemodynamic investigations in... more ABI-SAMRA, F,M,, ET AL.; The usefulness of head-up tilt testing and hemodynamic investigations in the workup of syncope of unkown origin. To enhance the ciinical evaiuation of patients su^ering from recurrent syncope of unknown origin, the integrity of mechanisms controiling blood pressure was examined in 151 patients utilizing a screening tiJt test. Ninety-eight patients had an abnormal blood pressure and/or heart rate response to tilt testing, including provoked syncopal attacks in 63 patients. Whenever indicated, the screening tiJt test was followed by blood voiume and hemodynamic determinations, as well as autonomic nervous system testing to identify contributing pathophysioiogical abnormalities (hypovolemia, venous pooling, autonomic dysfunction). Detailed analysis of this battery of tests allowed us to conclude that: (1) The tilt test is commonly a provocative tool in the workup of patients with recurrent syncope due to vasovagal-vasodepressor reactions and other abnormalities of blood pressure regulation; (2) Its usefulness is augmented by associated hemodynamic and blood volume evaluations; (3) The identification of contributory pathophysiological mechanisms of blood pressure control facilitates specific therapeutic interventions. (PACE, VoL 11, August 1988} vasovagal and vasodepressor syncope, tilt table testing, scopoiamine Dr. Abi-Samra was a recipient of a NASPE Young Investigator's Award for this work, May, 1987.

Research paper thumbnail of Head-up tilt and hemodynamic changes during orthostatic hypotension in patients with supine hypertension

Journal of the American College of Cardiology, 1994

Research paper thumbnail of 53. Sensitivity and specificity of the head-up tilt test in adults

Journal of Hypertension, 1991

Research paper thumbnail of Angiotensins and the failing heart. Enhanced positive inotropic response to angiotensin I in cardiomyopathic hamster heart in the presence of captopril

Circulation Research, 1990

We examined the hypothesis that the positive inotropic effect of angiotensin I (Ang I) may be ret... more We examined the hypothesis that the positive inotropic effect of angiotensin I (Ang I) may be retained in the presence of angiotensin converting enzyme inhibitors so that it may have a direct beneficial effect on the heart. Accordingly, isolated perfused hearts (Langendorff preparation) of 300-day-old cardiomyopathic hamsters (a model of spontaneous cardiomyopathy) and age-matched normal hamsters (controls) were infused with Ang I in the presence of captopril; propranolol was added to the perfusing medium to block catecholamine-mediated effects of angiotensins on the heart. Left ventricular developed pressure and the rate of increase in left ventricular developed pressure increased significantly (p less than 0.001) in both the cardiomyopathic and the normal hamster heart despite concomitant reduction in myocardial flow rate favoring a direct inotropic effect of Ang I in both normal and myopathic hearts; these changes were significantly higher by almost threefold in the cardiomyopath...

Research paper thumbnail of Echocardiographic studies of regression of left ventricular hypertrophy in hypertension

Hypertension, 1987

The availability of echocardiography has allowed direct determinations of left ventricular wall t... more The availability of echocardiography has allowed direct determinations of left ventricular wall thickness and calculation of left ventricular mass. As a result, the past decade has witnessed a remarkable evolution in our understanding of structural changes in the heart. Moreover, cardiac hypertrophy was found to be reversible by some forms of therapy. In general, reduction of left ventricular mass became evident after 8 to 12 weeks of antihypertensive therapy. Sympatholytics (including methyldopa and reserpine), converting enzyme inhibitors (captopril and enalapril), and calcium entry blockers led to significant regression of left ventricular hypertrophy. On the other hand, arteriolar vasodilators (hydralazine, trimazosin, and minoxidil) were not associated with regression of hypertrophy despite adequate blood pressure control. Finally, data regarding diuretics and beta-blockers are controversial. These differences in results among various antihypertensive drugs reflect the multipli...

Research paper thumbnail of The usefulness of head-up tilt testing and hemodynamic investigations in the workup of syncope of …

Pacing and Clinical Electrophysiology

ABI-SAMRA, F,M,, ET AL.; The usefulness of head-up tilt testing and hemodynamic investigations in... more ABI-SAMRA, F,M,, ET AL.; The usefulness of head-up tilt testing and hemodynamic investigations in the workup of syncope of unkown origin. To enhance the ciinical evaiuation of patients su^ering from recurrent syncope of unknown origin, the integrity of mechanisms controiling blood pressure was examined in 151 patients utilizing a screening tiJt test. Ninety-eight patients had an abnormal blood pressure and/or heart rate response to tilt testing, including provoked syncopal attacks in 63 patients. Whenever indicated, the screening tiJt test was followed by blood voiume and hemodynamic determinations, as well as autonomic nervous system testing to identify contributing pathophysioiogical abnormalities (hypovolemia, venous pooling, autonomic dysfunction). Detailed analysis of this battery of tests allowed us to conclude that: (1) The tilt test is commonly a provocative tool in the workup of patients with recurrent syncope due to vasovagal-vasodepressor reactions and other abnormalities of blood pressure regulation; (2) Its usefulness is augmented by associated hemodynamic and blood volume evaluations; (3) The identification of contributory pathophysiological mechanisms of blood pressure control facilitates specific therapeutic interventions. (PACE, VoL 11, August 1988} vasovagal and vasodepressor syncope, tilt table testing, scopoiamine Dr. Abi-Samra was a recipient of a NASPE Young Investigator's Award for this work, May, 1987.