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Biomedical subjects

D Glogar

Publications and source records attributed to D Glogar.

At least 37 records · Page 2Linked to original sources
PubMed1991

Lyme borreliosis as a cause of myocarditis and heart muscle disease.

Lyme borreliosis (LB) is a multisystem disorder that may cause self-limiting or chronic diseases of the skin, the nervous system, the joints, heart and other organs. The aetiological agent is the recently discovered Borrelia burgdorferi. In 1980, cardiac manifestations of LB were first described, including acute conduction disorders, atrioventricular block, transient left ventricular dysfunction and even cardiomegaly. Pathohistological examination showed spirochaetes in cases of acute perimyocarditis. Recently, we were able to cultivate Borrelia burgdorferi from the myocardium of a patient with long-standing dilated cardiomyopathy. In this study, we have examined 54 consecutive patients suffering from chronic heart failure for antibodies to Borrelia burgdorferi. On ELISA, 32.7% were clearly seropositive. The endomyocardial biopsy of another patient also revealed spirochaetes in the myocardium by a modified Steiner's silver stain technique. These findings give further evidence that LB is associated with chronic heart muscle disease.

Antibodies, Bacterial↗
PubMed1991

Constrictive pericarditis without typical haemodynamic changes as a cause of oedema formation due to protein-losing enteropathy.

A 41-year-old man presented with physical signs of leg oedema and a laboratory value of decreased serum albumin of 2.4 g.dl-1. Loss of protein via the gastrointestinal tract was demonstrated by an increased faecal excretion of 51-chromium-labelled-albumin and by elevated stool clearance of alpha 1-antitrypsin. No anatomical lesions or intestinal disease were found to explain this protein loss. Constrictive pericarditis was suspected as the cause of protein-losing enteropathy but could not be confirmed by right heart catheterization, in which normal filling pressures and no sign of 'dip and plateau' pressure pattern were found. However, magnetic resonance imaging clearly demonstrated a thickening of the pericardium over the right heart and a tubular-shaped right ventricle as signs of constrictive pericarditis. Peripheral oedema disappeared and serum protein concentration returned to normal after pericardectomy. This demonstrates that moderate pericardial constriction not resulting in discernible pressure abnormalities in the right heart can be associated with protein-losing enteropathy and thus result in hypoproteinaemic peripheral oedema. In this condition a morphological investigation by magnetic resonance imaging is of importance in order not to miss the diagnosis of a potentially treatable disease.

Adult↗
PubMed1991

[Diagnosis of arrhythmogenic right ventricular disease using magnetic resonance tomography].

In our study, 12 patients with ventricular arrhythmias, but without any documented cardiac disease, and 10 healthy volunteers were investigated by spin echo magnetic resonance tomography (MRT) using a 0.5 Tesla magnet. Axial T1-weighted spin-echo sequences, as well as double angulated, multislice-multiphase sequences were acquired. Left- and right-ventricular volumes were then evaluated by outlining the endocardium in an end-systolic and an end-diastolic frame. The right-ventricular free wall and the right-ventricular outflow tract were investigated for myocardial thickness and intramural fat.

Adipose Tissue↗
PubMed1991

Borrelia burgdorferi as an etiologic agent in chronic heart failure?

Since 1980 cardiac manifestations of Lyme borreliosis have been described as selflimited conduction and transient left ventricular disorders or even cardiomegaly. An etiologic role of Borrelia burgdorferi in long-standing chronic heart disturbances is suggested by the cultivation of a strain of Borrelia burgdorferi which we were able to isolate from an endomyocardial biopsy of a patient with long-standing dilated cardiomyopathy. The aim of this study was to acquire information about the prevalence of serum antibodies to Borrelia burgdorferi in patients with dilated cardiomyopathy. By ELISA, we studied the sera of 72 consecutive patients with chronic heart failure due to dilated cardiomyopathy, of 55 patients with coronary heart disease, and of 61 healthy blood donors; positive ELISA values were determined in 26.4%, 12.7%, and 8.2% of serum samples, respectively. These findings further suggest an association or even an etiologic role for Borrelia burgdorferi in dilated cardiomyopathy.

Adult↗
PubMed1991

[Evaluating the function of aortocoronary bypasses with magnetic resonance tomography].

Following an aortocoronary bypass operation the differential diagnosis of chest pain of recent onset may be difficult (ischaemia, thoracotomy induced pain). At this point noninvasive methods are preferable to angiography in order to reach exact diagnosis. Magnetic Resonance Imaging (MRI), a new noninvasive imaging method, makes it possible to get anatomical and blood flow information without the use of ionizing radiation or contrast agents. It was the aim of our study to examine the diagnostic impact of MRI for the assessment of aortocoronary bypass graft patency. We compared three different acquisition techniques (a spinecho sequence and two fast-gradient echo sequences). 26 patients were examined, 49 bypass grafts were eligible for comparative evaluation. As compared with the spinecho technique, fast echo gradient sequences had a higher sensitivity (FISP 93%, FLASH 88%) than the spinecho technique 79%, and a higher accuracy (FISP 88%, FLASH 82%) versus 73%, respectively. We conclude that MRI may have a high diagnostic potential in the evaluation of early postoperative aortocoronary bypass graft patency.

Adult↗
PubMed1990

[Heart transplantation: indication, selection criteria and patient management].

Evaluation of potential candidates for cardiac transplantation is a difficult and wearisome process for both physician and patients. As long as we are confronted with the present situation of an increasing chronic donor unavailability, the importance of standardized, rational criteria for evaluation of heart transplantation candidates has to be emphasized, since the success of any organ transplantation depends on adequate selection of potential candidates.

Biopsy, Needle↗
PubMed1990

[Cine-MR for the quantification of regurgitation defects by a volume method].

We have examined 46 patients with angiographically confirmed regurgitant lesions (26 mitral insufficiency, 20 aortic insufficiency) using a 0.5 Tesla magnet. In each patient, multiplane and multiphase spin-echo sequences were obtained in a plane angled in the sagittal and coronal direction in the long axis of the heart; left and right ventricular volumes, ejection fractions and regurgitation fractions were calculated. In addition, a blood-flow sensitive gradient echo sequence was obtained in order to determine the direction and extent of the regurgitant jet. The data was compared with the results of angiography and echocardiography. By means of the gradient echo technique, MRI was able to show the regurgitant jet in every patient. There was a linear correlation between volumes determined by MRI and angiography. The best agreement was found for left ventricular contraction volume (R = 0.82, p is less than 0.0001). Comparison of the noninvasive and angiographic method showed a linear correlation for AI patients of R = 0.91 (p is less than 0.001), which is somewhat better than for patients with MI (R = 0.84, p less than 0.001). Semiquantitative grading of MI with a gradient echo technique showed a linear correlation with angiography of R = 0.73 (p less than 0.001), for AI there was agreement between both methods in 72% of cases. A comparison between MRI and colour Doppler sonography showed only moderately good correlation R = 0.69 (p less than 0.01).

Adult↗
PubMed1990

[MRT using Gd-DTPA in the diagnosis of tumor and pseudotumor intracardiac masses].

Magnetic resonance examinations were performed in 15 patients suffering from echocardiographically detected intracardiac masses. All patients were examined with a 1.5 T superconducting machine, using spin echo technique, including Gd-DTPA, and gradient echo sequences. The MR findings were confirmed partially by histology and angiography, otherwise by good correlation to clinical findings. MR results were divided into three groups: 1. tumour, 2. thrombosis, 3. pseudotumorous mass, and corresponded well with the final diagnosis: in 8 patients tumour, in 5 patients thrombosis, and in two patients pseudotumorous masses, including one hydatid cyst and one case of lipomatosis. Tumours showed in contrast to thrombosis marked enhancement after gadolinium injection, whereas the hydatid cyst and the lipomatosis demonstrated characteristic signal behaviour. Problems existed in differentiation mass vs slow flow, in the detection of very small masses, and in the assessment of wall-fixation and motion of a mass during cardiac cycle. The results demonstrate that MRI with Gd-DTPA can give important additional information in the differential diagnosis of echocardiographically detected intracardiac masses.

Adolescent↗
PubMed1990

Cardiac calcific deposits in patients with primary hyperparathyroidism: preliminary results of a prospective echocardiographic study.

To explain the incidence and significance of mitral and aortic valve calcification and calcific deposits in the myocardium, a prospective echocardiographic study was performed with 21 consecutive patients who had primary hyperparathyroidism (PHP) and with 21 age- and sex-matched control subjects with normocalcemia. Calcific deposits in the myocardium were seen in 13 patients (62%) with PHP, mainly in the interventicular septum, and in one control subject. Aortic valve calcification was observed in 12 patients (57%) with PHP and in one control subject. Calcification of the mitral valve was found in seven patients with PHP (33%) and three controls (14%). Calcification led to mild or moderate stenosis of the aortic valve in three patients with PHP and of the mitral valve in two patients with PHP. No stenosis was found in the subjects in the control group. Both calcification of the aortic and mitral valves and calcific deposits in the myocardium are common in patients with PHP and can be detected noninvasively by echocardiography. Because of the potential relationship of elevated calcium, calcification, and valvular heart disease, clinical evaluation of PHP should include echocardiographic studies before surgery is performed and during follow-up examination.

Adult↗
PubMed1989

Humoral regulation during cold-induced coronary arterial spasm.

Previous attempts to define the etiology of coronary arterial spasm have been focused on mechanisms such as autonomic nervous dysfunction and/or enhanced platelet activation. In the present study, humoral regulation was investigated in patients with vasospastic angina and scintigraphically documented transient myocardial perfusion abnormalities after a peripheral cold pressor test. Serial changes in angiotensin II, epi- and norepinephrine as well as thromboxane B2 (the stable derivate of thromboxane A2), and malondialdehyde were determined at baseline (I), immediately after 5 minutes cold water hand immersion (II), and following 10 minutes recovery (III). Angiotensin II and epinephrine remained unchanged during observation (I vs II, II vs III: P = NS). Norepinephrine was elevated after cold (I vs II: P less than 0.001) and normalized after 10 minutes (I vs III: P = ns). Thromboxane B2 and malondialdehyde increased continuously (I vs III: P less than 0.05 and I vs III: P less than 0.002, respectively). Further radiothin-layer chromatography results indicate an activation of platelet function during myocardial ischemia. Our results do not establish a cause-effect relationship but, together with other evidence, they may suggest that thromboxane A2 is unlikely to be the cause of spasm. It might, however, play an important role in the maintenance of vasoconstriction.

Angiotensin II↗
PubMed1989

Cine-MR in dissection of the thoracic aorta.

Magnetic resonance imaging (MRI) of the thoracic aorta, including cine-MRI, was performed in 25 patients suspected of having dissection of the thoracic aorta. MRI was correlated with echocardiography, CT and angiography. The sensitivity of MRI (100%) was most closely followed by CT and angiography (83% and 77% respectively). The specificity of MRI and angiography was equally good, at 100% each. MRI was able to demonstrate the intimal flap in all 9 cases of aortic dissection, and there were no false-positive results. Differentiation of thrombosis and slow flow was possible on proton density images, gradient echo images permitted detection of the entry and re-entry sites. The nature of the dissection was determinated correctly in 8 out of 9 cases. MRI is capable of providing all the relevant parameters necessary to decide appropriate treatment of dissecting aneurysms of the thoracic aorta.

Adolescent↗
PubMed1989

[Magnetic resonance tomography in the assessment of questionable aneurysm of the thoracic aorta with or without dissection of the intima].

To assess the value of MRI in the diagnosis of aneurysm of the thoracic aorta with suspected or known dissection 23 patients were imaged with cardiac gating. Seven patients (group 1) had known dissection of the thoracic aorta; in 16 patients (group 2) an aneurysm was suspected by chest x-ray or 2D-echocardiography. Reference methods were: x-ray, 2D-echocardiography, angiography, and computered tomography. In the first group MRI clearly identified the intimal flap, could differentiate between true and false lumen, slow flow, and thrombus, respectively. In the second group MRI could exclude a dissection of the ectatic part of the thoracic aorta in 11 patients and demonstrate paracardiac or mediastinal mass in five patients. MRI can serve as an important diagnostic tool in known or suspected aneurysm of the thoracic aorta.

Adolescent↗
PubMed1988

Determination of triacylglycerols in serum by capillary gas chromatography with trinonadecanoylglycerol as internal standard.

An accurate capillary gas-chromatographic method with trinonadecanoylglycerol as internal standard for determining triacylglycerols in human serum and other biological sources is described. After serum extraction, total triacylglycerol and triacylglycerol species (differing in the number of carbon atoms in the acyl radicals) are directly determined without any further sample manipulation. In addition, from the same gas-chromatographic run the data obtained by the integrator record are compared with those of a computer data acquisition system. Evaluation of the triacylglycerol values resulted in a coefficient of variation (CV) of 2.08% (computer evaluation). Simultaneous evaluation of data obtained from tripalmitoylglycerol and tristearoylglycerol standards resulted in CV of 2.04 and 1.99%, respectively (computer evaluation), and 6.63 and 4.84%, respectively (integrator evaluation). Gas chromatography at lower elution temperature resulted in better separations but enhanced CV values up to about 4%. Triacylglycerol values were not influenced by storage of plasma at -20 degrees C up to 4 days prior to extraction.

Chromatography, Gas↗
PubMed1988

Increase of pulmonary vascular resistance during cold provocation in patients with variant angina.

This study was performed to evaluate pulmonary vascular reactivity in patients with angiographically documented coronary vasospasm. Right heart catheterization was performed in 8 subjects with vasospastic angina without evidence of Raynaud's phenomenon: heart rate, systemic and pulmonary arterial pressure as well as cardiac output were determined at rest, during cold provocation and after 20 minutes recovery. Data were obtained both before and during treatment with nifedipine. During cold provocation pulmonary vascular resistance was elevated significantly (P less than 0.02 compared with baseline); systemic vascular resistance tended to increase; nifedipine blunted both vasoconstrictor effects. Our results indicate an abnormal vascular response of the pulmonary arteries to cold provocation in patients with symptomatic coronary artery spasm and suggest a primary vasospastic disorder with coronary and pulmonary manifestation.

Adult↗
PubMed1988

Characteristics of transient ischaemic episodes in patients with silent and symptomatic exercise-induced myocardial ischaemia.

To evaluate transient ischaemic episodes during daily life in patients with coronary artery disease and exercise-induced myocardial ischaemia, 38 patients underwent ambulatory ST-segment monitoring over 48 h. Sixteen patients had painless ischaemia during exercise and occasional angina, and 12 patients had symptomatic ischaemia and frequent angina during daily life. Ten patients with proven coronary artery disease but normal exercise electrocardiograms served as controls. The extent of coronary artery lesions and the prevalence of myocardial infarction were similar in all groups. ST-segment monitoring revealed 817 min and 98 episodes of ST depression in 13/16 patients of the asymptomatic group and 111 min and 21 episodes in 5/12 patients of the symptomatic group (P less than 0.03). Subjective scores for physical activity during Holter monitoring were significantly higher in the first group than in the second. The majority of ischaemic episodes in both groups was asymptomatic. No ischaemic ST changes occurred in control patients. Results indicate a higher frequency of transient ischaemic episodes related to a higher level of physical activity in patients with silent ischaemia than in patients with symptomatic exercise-induced ischaemia.

Angina Pectoris↗