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Biomedical subjects

A Sheikhzadeh

Publications and source records attributed to A Sheikhzadeh.

At least 55 records · Page 3Linked to original sources
PubMed1994

Systemic embolism in aortic arch atheromatosis.

The role of aortic atheromatosis as a risk factor for systemic embolism and its relationship to other potential sources of embolism was examined in 335 patients undergoing transoesophageal echocardiography for various clinical reasons. Multiple logistic regression analysis revealed a significant correlation between embolism and moderate (atheroma protruding less than 5 mm into the aortic lumen, grade 2) to complex (atheroma protruding at least 5 mm into the vessel lumen with or without mobile components, grade 3) atherosclerosis of the aortic arch. Odds ratios were 4.0 for grade 2 atheromatosis (95% CI 1.1-14.4; P < 0.05) and 9.7 for grade 3 atheromatosis (95% CI 1.5-61.0; P < 0.05). Other significant associations were found with cardiac thrombi (odds ratio 4.0, 95% CI 1.7-9.3; P < 0.005) and hypertension (odds ratio 1.8, 95% CI 1.0-3.3; P < 0.05). In a subset of 163 patients in whom results of an ultrasound examination were available, atherosclerosis of the carotid arteries was another significant marker of embolism (odds ratio 2.0, 95% CI 1.2-3.3; P < 0.01). In conclusion, aortic arch atheromatosis, which was predominantly recognized in patients with cerebrovascular events of undetermined cause, seems to carry a risk of embolism that is comparable to cardiac and carotid atherosclerosis.

Aorta, Thoracic↗
PubMed1993

Quantification of trunk muscle performance in standing, semistanding and sitting postures in healthy men.

The purpose of this study was to determine trunk muscle performance in the sitting, semistanding, and standing postures during isometric and dynamic extension and flexion movements. Twenty-five male subject volunteers, with no previous history of back pain participated in the study. A triaxial dynamometer that measures torque, angular position, and velocity was used to measure isometric and dynamic motor output. The dynamometer allows testing in the sitting and standing postures. A custom-designed module also allowed testing in the semistanding posture. Each subject was tested in two sessions. The first session included the physical examination and three trials of isometric maximum voluntary contractions in the three postures. The second session included the dynamic performance against a resistance equal to 50% of the effort, as measured in the first session. Subjects were instructed to perform five repetitive flexion and extension cycles as fast and accurately as possible with maximum effort. An analysis of variance with repeated measures design was used to investigate the effects of the postures (standing, semistanding and sitting), the direction of exertion (flexion and extension), and the interaction effects of the isometric and dynamic parameters (maximum and average torque, velocity, power, and range of motion). The effects of direction (F = 98, P < 0.0001) and the interaction of posture and direction (F = 7.9, P < 0.001) were significant. The maximum isometric flexion strength was significantly higher in the standing posture than in semistanding and sitting. The maximum isometric extension was not affected by the posture (sitting, semistanding and standing).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Primary angiosarcoma of the heart. Report of a case and review of the literature.

We report on a 44-year-old male with primary cardiac angiosarcoma who died 11 months after onset of nonspecific symptoms (thoracic pain and general fatigue) of intracerebral metastases. A right atrial tumor mass and a pericardial effusion could be demonstrated by transthoracic and transesophageal echocardiography. Cardiac angiography showed a right atrial hemangioma, fed by the right coronary artery. In a review of 108 cases of primary cardiac angiosarcoma we summarize clinical features, diagnostic means, therapeutic approaches and life expectancy of this rare disease.

Adult↗
PubMed1993

[Bilateral coronary-pulmonary artery fistula and accessory vascular connection of the thoracic aorta to the right lower pulmonary artery].

A 41-year-old man presenting with atypical chest pain was admitted to hospital with suspected pericarditis after a common cold disease. A complex risk profile for arteriosclerotic coronary artery disease was taken into account in differential diagnosis. Cardiac catheterization revealed large bilateral coronary artery-pulmonary artery fistulas as well as an accessory vessel with origin of the thoracic aorta both draining into the lower right pulmonary artery. The vessel anomalies showed a remarkable plexus-like morphology before entering into the pulmonary artery. Arteriosclerotic coronary artery disease was not found. No evidence of myocardial ischemia was found in the furthermore asymptomatic patient, therefore surgical correction of the vessel anomalies was not performed. To our knowledge the present case report represents the first case with bilateral coronary artery-pulmonary artery fistulas and an accessory communication of the thoracic aorta to the pulmonary artery vasculature.

Adult↗
PubMed1991

[Pacemaker syndrome with AV-synchronized stimulation of the heart].

Characteristic signs of the pacemaker syndrome occurred in a 69-year-old woman with intermittent 3 degrees atrioventricular (AV) block after implantation of a dual-chamber AV-synchronized pacemaker. Cannon beats due to inappropriate atrial timing were the main haemodynamic finding. Their development and size depended on the programmed AV interval and AV-synchronized mode of stimulation. Very long AV intervals in the DDD mode at a heart rate of 100/min caused very unpleasant palpitations and pulsations in the upper thorax. The symptoms due to the cannon beats were avoided by changing to a short AV interval. The clinical and haemodynamic events were thus the consequence of preserved sinus node function with subsequent atrial triggering.

Aged↗
PubMed1991

Effects of spinal flexion and extension exercises on low-back pain and spinal mobility in chronic mechanical low-back pain patients.

It has been estimated that one fourth to one half of all patients treated in physical therapy clinics suffer from low-back pain. The purpose of this study was to compare the effects of spinal flexion (Group I) and extension (Group II) exercises on low-back pain severity and thoracolumbar spinal mobility in chronic mechanical low-back pain patients. Both groups had significantly less low-back pain after treatment (P less than .10). There was no significant difference, however, between the spinal flexion and extension exercises in reduction of low-back pain severity. The results indicated a significant difference between the groups in increasing the sagittal mobility (P less than .10). The results did not indicate any significant difference between and within groups in increasing the coronal and transverse mobility of the thoracolumbar spine. Either the spinal flexion or extension exercises could be used to reduce chronic mechanical low-back pain severity, but the flexion exercises had an advantage in increasing the sagittal mobility within a short period of time.

Adult↗
PubMed1990

[Chronic ventricular aneurysm. The sensitivity and specificity of persistent ST-T elevations on the electrocardiogram].

The value of persistent ST-T elevations in the standard 12-lead ECG for the diagnosis of left-ventricular aneurysm (VA) was retrospectively analysed for 200 patients (171 males and 29 females) who had sustained a myocardial infarction at least 12 weeks previously. 105 patients (group 1) had a left-ventricular aneurysm confirmed by ventriculography; in 95 patients (group 2) an aneurysm had been excluded by ventriculography. Persistent ST-T elevations were present in 98 patients of group 1 (sensitivity 93.3%) and in 26 of group 2 (specificity 72.6%). In the 26 patients without VA, ST-T elevations occurred in at most three leads, but in 60 with aneurysm in four to nine leads. In addition, the area under the ST-T elevations and its height 1 mm after onset of the elevation and its maximal height were measured. The sums of the values in the limb and chest leads were statistically significantly different between the two groups for all three parameters. These measurements thus contribute to a reliable differentiation between patients with and without VA. The results also emphasize the importance of the 12 standard leads in the diagnosis of VA.

Chronic Disease↗
PubMed1990

The relationship of torque, velocity, and power with constant resistive load during sagittal trunk movement.

Strength and fitness studies have been used to determine the predictability of back pain episodes. Tests have demonstrated that isometric strength displays little prognostic value in the development of low-back pain. Static isometric tests have achieved widespread usage due to the simplicity and safety of protocols, the readily available technology, and the low administrative costs. Dynamic lifting models have, however, predicted significantly higher spinal loads than those derived from static models. The objectives of this study were twofold: to investigate the relationship of the torque, velocity, and power to the resistive load during trunk flexion and extension, and to develop predictive models for these relationships for the subject's performance of the 10th, 50th, and 90th percentile distribution. The results of the study found that the flexion/extension torque had a positive linear correlation with the set resistance; the velocity displayed a negative linear correlation, while power had a quadratic relationship with the resistance.

Adult↗
PubMed1990

Right ventricular endomyocardial fibrosis. Diagnosis and management.

The clinical course, noninvasive and invasive diagnostic findings in 4 patients (pt) with endomyocardial fibrosis are reported. All patients (16-50 years) were in functional class III-IV (NYHA). Central venous pressure with large a- and v-waves was elevated in all; liver enlargement and peripheral edema were also noticed in all pts, and ascites in 3. An apical 2/6 systolic murmur was present in 2, and a right parasternal pansystolic murmur 2-4/6 with positive Carvallo's sign in all pts. ECG was non-specific and chest x ray showed right atrial enlargement in every case. A right-sided diastolic plateau which was higher than left ventricular end-diastolic pressure was present in all pts. Echo-, angiocardiography and computed tomography of the heart revealed obliteration of the right ventricular cavity, predominantly localized at the apex. Two pts who underwent endocardial resection and tricuspid valve replacement are alive and well after 9 and 8 years, respectively. One pt died early in the postoperative period and one died waiting for surgical therapy. In conclusion, echo-, angiocardiography and computed tomographic findings are diagnostic. A satisfactory differentiation from other cardiac disorders with restrictive hemodynamics and right-sided heart failure is possible.

Adolescent↗
PubMed1988

Heterotopic heart transplantation: current indications for the procedure, with results in 10 patients.

From January 1986 to September 1987, we performed 27 orthotopic and 10 heterotopic cardiac transplantations at our institution. Of the 10 heterotopic transplantation recipients, 9 were men; ages ranged from 36 to 65 years; and indications for transplantation were ischemic cardiomyopathy in 8 patients and dilatative cardiomyopathy in 2 patients. Five of the 10 heterotopic transplantation recipients received donor hearts under emergency conditions, when no hearts of suitable size for orthotopic transplantation were available. In 3 of the 10 heterotopic procedures, we performed pure left ventricular (rather than biventricular) bypass in patients with chronic conditions requiring only aneurysmectomy, or aneurysmectomy in combination with an aortocoronary graft. During postoperative hospitalization, the following complications occurred in the 10 heterotopic-transplantation recipients: 10 infectious episodes in 6 patients; 1 episode of severe graft rejection; and 1 episode of severe gastrointestinal bleeding. All these complications were overcome, and no patient in the heterotopic-transplantation group died. Fifteen months postoperatively, one male in the group lost his graft, but his own heart had by then recovered function, despite dilatative cardiomyopathy. More commonly, late investigation (6 months or longer after transplantation) has yielded ambiguous overall evaluations of pump performance of the recipients' native hearts, showing slight improvement in some instances and further deterioration in others. We conclude that heterotopic heart transplantation is a life-saving procedure in urgent cases when only small donor hearts are available, and that it offers a good chance of hemodynamic and functional improvement not only in emergency cases, but also in cases of chronic cardiomyopathy when there is salvageable myocardium.

Journal Article↗
PubMed1987

Right ventricular obstruction in various types of hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is most probably a genetically transmitted disease with different clinical and hemodynamic features. In hypertrophic obstructive cardiomyopathy (HOCM) the obstruction is predominantly in the left ventricular outflow tract (IHSS). In a minority of cases the obstruction is strictly located in midventricle (midventricular obstruction, MO). Hypertrophic nonobstructive cardiomyopathy (HNCM) includes asymmetric septal hypertrophy (ASH) and apical hypertrophy (AH). Right ventricular hypertrophic obstruction (RVHO) is an uncommon type of HCM and is almost always combined with other types of left ventricular HCM. We describe in the present report 1 case of RVHO with IHSS, 2 cases with MO and, to our knowledge, the first case with AH.

Adult↗
PubMed1987

[Right ventricular endomyocardial fibrosis].

The clinical course, non-invasive and invasive diagnostic findings from a 50-year-old patient with endomyocardial fibrosis are reported. The patient died in cardiogenic shock. In Europe, endomyocardial fibrosis is a rare event. An exclusively right ventricular involvement is a seldom manifestation. The clinical, echocardiographic and computed tomographic features are diagnostic; therefore a satisfactory differentiation from other cardiac disorders with restrictive hemodynamic signs is possible. An echodense mass as cavity obliteration, with predominantly apical localization, was present at echocardiography; the computed tomography showed a hypodense area instead of the right ventricular cavity.

Echocardiography↗
PubMed1986

Midventricular obstruction--a form of hypertrophic obstructive cardiomyopathy--and systolic anterior motion of the mitral valve.

Hypertrophic cardiomyopathy (HCM) has various manifestations with respect to the localization of the hypertrophy. In this study we report clinical, electrocardiographic (ECG), echocardiographic (echo), and hemodynamic findings in midventricular obstruction (MO), an uncommon form of hypertrophic obstructive cardiomyopathy (HOCM) in 9 patients. The prevalence of systolic anterior motion of anterior mitral leaflet (SAM) in MO, an echocardiographic diagnostic hallmark in HOCM, was another purpose of this study. All patients had complete clinical, ECG, echo, and hemodynamic workup, including left ventricular (in 4 patients simultaneous biventricular, SBVA) and coronary angiograms. All patients had dyspnea and palpitations, chest pain, 2 had syncope. In the ECG, atrial fibrillation was present in 2, and left ventricular hypertrophy in 9 patients. Septal and left ventricular free wall thickening was significantly present in all patients in echo, and SAM in 1 patient. The intraventricular gradient (IVG) was 40-176 mmHg, in 1 case 40 mmHg by provocation, Brockenbrough was positive in all patients. Two patients had right ventricular IVG. A positive beta-blocking agent effect was present in 6 cases. The best localization of the obstruction was possible with SBVA and 2D-echo. We conclude that MO has all the signs of HOCM, but SAM in echocardiography is uncommon. SAM is occasionally present and is not a necessary factor to produce an intraventricular pressure gradient in HOCM, especially in MO. It seems that hypertrophic right ventricular obstruction is relatively common in MO (2 of 9 cases), and may have the same obstructive mechanism.

Adolescent↗
PubMed1986

Generalized coronary arterio-systemic (left ventricular) fistula. Case report and review of literature.

A coronary artery-to-left ventricular fistula is a rare finding; to the best of our knowledge, a total of only 35 cases have been reported. Only 5 cases of a generalized arterio-systemic fistula with three vessel involvement have been reported in the literature. We describe another case involving all major coronary arteries. A review of the literature is presented and the data of the reported cases are analyzed. A 55 year old woman was examined because of recurrent chest pain which had persisted for 2 years. On physical examination, the only abnormal finding was a fourth heart sound. Exertional chest pain, a positive exercise stress test, and the results of a lactate extraction study suggested severe myocardial ischemia. Thallium myocardial scintigraphy showed no evidence of a perfusion defect. Cardiac catheterization revealed an irregular left ventricular endocardial pattern (Thebesian veins). Selective coronary angiography showed communicating fistulae of all three major coronary arteries with the left ventricular cavity. We assume that this vascular anomaly causes a coronary steal phenomenon and subsequent myocardial ischemia.

Angina Pectoris↗
PubMed1985

[Left ventricular ejection dynamics in apical hypertrophy, a form of hypertrophic nonobstructive cardiomyopathy].

The left ventricular (LV) cineangiograms of ten patients with apical hypertrophy (AH, group I) as a form of hypertrophic nonobstructive cardiomyopathy (HNCM) were analyzed. The left ventricular ejection dynamics, the extent and pattern of left ventricular contraction were compared with eight patients with secondary myocardial hypertrophy due to arterial hypertension (group II) and eight normal subjects (group III). End-diastolic, end-systolic and stroke volumes were significantly lower in group I. The analysis of left ventricular ejection dynamics with frame-by-frame-analysis revealed the typical ejection pattern of hypertrophic nonobstructive cardiomyopathy: Left ventricular ejection was completed within two thirds of the systolic ejection period. This ejection pattern is of diagnostic value when compared with the dynamics in group II. Although the apical segment in group I shows a good fiber shortening, the overall contribution to systolic performance is low; systolic function in apical hypertrophy is maintained by a compensatory increase in regional wall motion of the basal and midzonal part of the left ventricular free wall. There is no striking difference between apical hypertrophy with and without giant negative T waves with respect to the ejection pattern. Within these subgroups, the only difference was the greater left ventricular mass in patients with giant T wave inversion. Thus, the ejection dynamics in apical hypertrophy is typical of hypertrophic nonobstructive cardiomyopathy. Global parameters of systolic left ventricular performance revealed supernormal values even though systolic function is impaired. Segmental analysis of ejection phase was most sensitive in establishing the diagnosis.

Angiocardiography↗
PubMed1985

[Noninvasive and invasive study procedures in hypertrophic cardiomyopathy].

Noninvasive and invasive diagnostic procedures permit a differentiated insight into the hypertrophic cardiomyopathies. For a better understanding of the disease, classification according to morphologic and functional criteria was introduced. It has proven useful to subdivide hypertrophic obstructive cardiomyopathy into two types: idiopathic hypertrophic subaortic stenosis and midventricular obstruction; hypertrophic nonobstructive cardiomyopathies can be subdivided into two forms designated as asymmetrical septal hypertrophy and apical hypertrophy. Combined forms can also be recognized. With a high degree of accuracy, it is possible to differentiate between hypertrophic obstructive and hypertrophic nonobstructive cardiomyopathy by means of noninvasive procedures such as clinical examination, electrocardiography, mechanocardiography and, above all, echocardiography. Experience has shown that two-dimensional echocardiography, in particular, has assumed an especially important role, the value of which approaches that of cardiac catheterization. In this overview, emphasis is placed on the diagnostic peculiarities of idiopathic hypertrophic subaortic stenosis as well as the findings in midventricular obstruction and apical hypertrophy. In the past, only relatively little attention has been focused on the latter subgroups even though they can be diagnosed with a high degree of accuracy with noninvasive as well as invasive procedures.

Angiocardiography↗