Search PubMed⌕ Search

Biomedical subjects

E Henze

Publications and source records attributed to E Henze.

At least 91 records · Page 5Linked to original sources
PubMed1990

[The effect of 3-dimensional data stabilization in radionuclide ventriculography on the statistical numerical error in the ejection fraction].

The suitability of a 3-dimensional filter in diminishing the statistical noise of left ventricular volume curves without any systematical error in the left ventricular ejection fraction (EF) was investigated. The EF values were compared in 50 studies on 24 patients. There was no significant systematical difference between the EFs before and after filtering. The filter diminishes the statistical uncertainty of the EF by a factor of 0.47. Therefore, the method may possibly be employed in processing the left ventricular volume curves.

Adult↗
PubMed1989

Aortic aneurysms as late sequelae of above-knee amputation.

The infrarenal aorta was examined by ultrasound in 329 men who had lost a leg in World War II and in 702 war veterans. The groups were similar in terms of age and risk factors for arteriosclerosis. Abdominal aortic aneurysms were found in 5.8% of the amputees compared with 1.1% of the non-amputees. Unilateral flow reduction after leg amputation causes an asymmetrical flow pattern at the aortic bifurcation, and this is probably the main cause of late damage to the aorta.

Aged↗
PubMed1989

The contraction fraction (CF) in myocardial studies with technetium-99m-isonitrile (MIBI)--correlations with radionuclide ventriculography and infarct size measured by SPECT.

Criteria for the detection of coronary artery disease in nuclear cardiology include visualization of perfusion defects and functional impairment of contraction. The purpose of this study is to combine both methods in one procedure with the new myocardial perfusion tracer, 99mTc-methoxy-isobutyl-isonitril (MIBI), reducing time and radiation burden to the patient. Following an uncomplicated recovery, ten patients with first myocardial infarction participated in this study. Radionuclide ventriculography (RNV) was performed at rest and during exercise. Within 2-3 days, 370 MBq 99mTc-MIBI were injected and SPECT acquisition commenced 1 h later. Data processing included a scar image in polar coordinates. Areas of significantly reduced tracer uptake were expressed as a percentage of the total myocardial area. Directly following SPECT, resting and maximum exercise gated planar LAO images were recorded and the contraction was quantified. The concept of the contraction fraction (CF) rested on the end systolic change in count distribution: their increase in density and their centripetal concentration. For comparison, geometrical inner edge detection techniques were also applied. All algorithms for describing an EF equivalent were verified by computer simulations, showing a perfect correlation over a wide range of preset EFs. When applied to the patient studies only the non geometric methods revealed a good correlation with the ejection fraction (EF) obtained by RNV, and with the infarct size measured by SPECT.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1989

Localization of enteral protein loss by 99m-technetium-albumin-scintigraphy.

Using 99mTc-Albumin scintigraphy in a patient with constrictive pericarditis and a highly positive Gordon test (35% albumin elimination in 5 days), it was possible to localize the protein loss in the small bowel for planning surgical treatment. Tc-HSA imaging is an easy method for qualitative investigation of protein losing enteropathy in the bowel. This technique is not as time consuming and cumbersome as the Gordon test and, in addition, allows the exact localization of protein loss.

Humans↗
PubMed1989

Acute hypothyroidism slows the rate of left ventricular diastolic relaxation.

The effect of acute thyroid hormone deficiency on left ventricular diastolic filling was studied by radionuclide ventriculography with simultaneous right heart catheterization in nine athyreotic patients without cardiovascular disease. The patients were studied when they were hypothyroid and when they were euthyroid on replacement therapy. Peak filling rate and the time to peak filling were used to characterize diastolic function. The time to peak filling was defined as the interval from end-systole on the radionuclide time-volume curve to the time of occurrence of peak filling. The peak filling rate was determined in absolute terms from the normalized radionuclide peak filling rate and from the end-diastolic volume, which was derived from the radionuclide ejection fraction and from the thermodilution stroke volume. In all patients, the values for peak filling rate were lower in the hypothyroid than in the euthyroid state (287 +/- 91 mL/s vs. 400 +/- 118 mL/s, delta = 41 +/- 13%, p less than 0.01). Peak filling always occurred during the first half of the diastolic interval. The time to peak filling was not significantly affected by the thyroid state (170 +/- 10 ms vs. 159 +/- 21 ms, delta = 7 +/- 10%). Left ventricular filling pressure as reflected by the pulmonary capillary wedge pressure and end-systolic volume were similar in both thyroid states (6 +/- 2 mmHg vs. 8 +/- 2 mmHg (1 mmHg = 133.32 Pa) and 32 +/- 11 mL vs. 32 +/- 7 mL, respectively). The data suggest that the rate of active diastolic relaxation is decreased in short-duration hypothyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

[The effect of a combination of ridazolol and molsidomine on hemodynamics and left ventricular function in dilated cardiomyopathy].

Haemodynamics and Left Ventricular Function in Patients with Dilated Cardiomyopathy after a Combination of Ridazolol and Molsidomine. To evaluate the haemodynamic properties of the new beta-blocker ridazolol alone and in combination with the vasodilator molsidomine a randomized study was carried out in 12 patients with dilated cardiomyopathy (NYHA II/III). beta-Blockade leads to a decreasing tendency in blood pressure and heart rate. Pulmonary capillary wedge pressure (PC) was not significantly altered and ejection fraction remained unchanged. Molsidomine showed a decrease of PC. The combination of both drugs revealed both the positive haemodynamic effects of molsidomine and the reduced heart rate of beta-blockade. Negative side effects could not be observed.

Adrenergic beta-Antagonists↗
PubMed1989

Renal angiolipomas combined with renal cystic disease in tuberous sclerosis.

A 19-year-old white man presented with tuberous sclerosis. Ultrasonography revealed enlarged kidneys with multiple echogenic and echo-free areas due to angiomyolipomas and cysts, respectively. This echographic appearance is extremely seldom, and it is thought to be specific for tuberous sclerosis. The literature is reviewed and problems of diagnosis and therapy are discussed.

Adult↗
PubMed1989

[Quantitative image analysis in nuclear cardiology as a decision aid in addition to visual assessment of findings].

Quantitative analysis of nuclear cardiology procedures has stimulated tremendous work in the past and will continue to do so in the future. The impact on routine patient care has grown at a slower pace and should be assessed separately for tissue perfusion and for myocardial contraction. The current status will be presented, focusing on patients with coronary heart disease. In the preinfarct period myocardial scintigraphy with thallium-201 and emission computer tomography (ECT) is the preferred method. The procedure for quantitation includes transfer of all data into a standard polar map and comparing the numbers with a normal, gender-matched data base. The result reveals areas of reduced tracer uptake, color-coded according to the level of significance. Interpretation of these colored polar maps might appear simple, but in fact requires a substantial amount of knowledge to avoid overinterpretation of the results. This has led us to a restricted use of this quantitative tool: following an initial step of reading the original data in terms of short and long axes slices of the left myocardium, the polar map is utilized for verification and for suggestions of any additional lesions. This has to be confirmed by a second reading of the slices, and only this last step defines the lesions to be reported. Quantitation used in this dialectic approach avoids inclusion of artefacts, and at the same time is useful experience for trainees. Furthermore, it allows easy presentation during the clinical conference and statistical analysis of groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1989

Quantification of amplitude images of gated radionuclide heart studies: a new universal method.

Absolute quantification in nuclear medicine is difficult because of the individual shape, size, and position of human organs. In this study, a general data processing procedure is presented that allows inter-individual comparison and definition of normal count density pattern of unevenly shaped scintigraphic structures. This new method is demonstrated on Fourier amplitude images of gated heart studies. The information contained in the original irregularly shaped left ventricular amplitude scans was transformed into a standard sized circle by interpolating the radiant profiles of varying length from the original left ventricular ROI into the radii of the standard circle using 720, 360, 180, and 72 sampling angles. Retransformation of the individual left ventricular amplitude image from the standard circle area is feasible with only approximately 1% error with the 180, 360, or 720 sampling steps. As a first application of this new method 20 normal amplitude studies were transferred into the standard circle, which allowed the definition of a statistically normal reference image against which individual left ventricular amplitude images may be compared for documenting areas of significantly depressed amplitudes quantitatively. This simple and unique approach may be applied to most organ-related scans such as brain, kidneys, lung, and liver both in planar and tomographic studies to first create a normal reference image and second, to quantify the significance of locally increased or decreased activity in routine scans automatically.

Heart↗
PubMed1989

[Quantification of the myocardial scar with technetium-99m-isonitrile (MIBI) in emission computerized tomography (SPECT)--comparison with serial creatine kinase determinations and radionuclide ventriculography].

Estimation of the size of myocardial infarction is of major interest for clinical patient management and a simple and reliable method is still searched for. In this study the potential of the new myocardial perfusion tracer, Technetium-99m (Tc-99m) methoxy-isobutyl-isonitril (MIBI) combined with emission computertomography (SPECT), is tested vs. the standard procedures of serial plasma creatine kinase (CK) measurements and radionuclide ventriculography (RNV). In 10 patients with first myocardial infarction, integral values for CK were obtained during the acute phase. Following three weeks of uncomplicated recovery the patient was referred for both types of myocardial imaging within four days. 370 MBq Tc-99m-MIBI were injected with the patient supine and at rest. One hour later SPECT acquisition commenced. The reconstructed slices were rearranged to long and short axes slices, which served to calculate a functional "scar image" in polar coordinates. The color-coded areas of significantly reduced tracer uptake were expressed in percent of the total myocardial area. RNV was performed with the patient supine and at rest, the left anterior oblique angle being optimized for septum visualization. Infarct localizations were antero-apical (three), anterolateral (two), postero-lateral (one), and posterior (four).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Studies of myocardial metabolism using P-31-NMR spectroscopy and a simple heart perfusion model of slaughtered animals--an approach to avoiding in vivo animal experiments].

In research cardiology large numbers of in vivo animal experiments, mostly with dogs or pigs, are necessary. It was the aim of this study to test a simple in vitro perfusion heart model from swine harvested in the slaughterhouse as a potential substitute for in vivo animal studies. 32 unselected hearts of slaughterhouse swine after 10 to 15 min of warm ischemia were subjected to reperfusion with warm oxygenized blood and were examined for mechanical recovery, which occurred in 56%, increasing to 95% if primarily using only hearts that were in relaxation. In 21 of selected relaxed heart models the energy phosphate pattern as an index of viability was measured by P-31 MRS on a 4.7 Tesla NMR tomograph in 37 experimental runs with the following perfusion protocols: 1) immediate cardioplegia with cold Bretschneider or Collins solution, transportation under cooling, MRS after approximately 1 h; 2) immediate cardioplegia, transportation, reperfusion with oxygenated warm blood, MRS; 3) immediate blood perfusion with genuine fresh arterial blood from the slaughterhouse, cold plegia perfusion, transportation, MRS; 4) immediate blood perfusion with transportation MRS; 4) immediate blood perfusion with genuinefresh arterial blood, cold plegia perfusion, transportation, reperfusion with oxygenated warm blood, MRS during reperfusion; 5) An experimental pig heart was made plegic in vivo and reperfused with oxygenated warm blood during MRS as reference.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1988

The Schilling test cannot be replaced by an absorption test with unlabeled vitamin B12.

It was the purpose of this study to evaluate the diagnostic usefulness of an oral absorption test using nonlabeled Vit B12 suggested by a commercial distributor as an alternative for the more expensive Schilling test (ST). Plasma levels of Vit B12 were measured with a commercial kit before and 4 h after oral administration of 1 mg Vit B12 in 32 normals, in 16 patients with normal ST, and in 14 patients with abnormal ST for determination of sensitivity and specificity with the ST as golden standard. In normals, a mean of 767 +/- 404 pg/ml before and 1096 +/- 776 pg/ml after oral Vit B12 with a mean increase of 331 +/- 453 pg/ml was measured. Because of the obvious large variation, no meaningful range for normal absorption could be established. In the two patient subsets, there was no Gaussian distribution of the results, with a meridian of Vit B12 increase after absorption of 142 pg/ml, range 27-2668 pg/ml, in the group with normal ST and a meridian of 244 pg/ml ranging from 40 to 2453 pg/ml in the group with abnormal ST. Statistical nonparametric analysis did not reveal any difference between the two groups. Assuming a minimum required increase of 100 pg/ml, as suggested by the kit distributor, a sensitivity of only 27% and a specificity of 75% was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Radionuclide ventriculography (equilibrium gated blood pool scanning)--its present clinical position and recent developments.

Myocardial scanning (MS) and radionuclide ventriculography (RNV) are the foundation of nuclear cardiology. These procedures aim in two completely different directions: RNV tries to image heart motion, that is, mechanical (pump) function, and therefore belongs to the group of first-order functional imaging (FI, imaging mechanical function), whereas MS is based on myocardial metabolism, and therefore can be attributed to third-order functional imaging (metabolism). This statement is relevant for the assessment of the clinical position of RNV: Third-order (metabolism) functional imaging is the domain of nuclear medicine (NM), whereas first-order FI has to face the competition of alternative noninvasive procedures such as ultrasound (US), digital subtraction angiography (DSA), computer tomography (CT), and nuclear magnetic resonance (NMR). The domain of RNV includes stages two (acute infarction) and three (postinfarction period) of coronary arterial disease (CAD). The advantageous combination of quantitative data on global, left ventricular (LV) function and imaging of regional motion ensures the superiority of RNV over US. However, RNV is inferior to MS in physical examinations in the preinfarction stage of CAD, whereas US is clearly inferior to both NM procedures. Recent progress could be attained by gated SPECT (GASPECT). A proposal is presented for simplification of this time-consuming procedure. Technetium-labeled isonitriles offer the chance for the combination of "perfusion-motion" imaging of the myocardium. However, even standard RNV offers new possibilities. The multitude of parameters produced by quantitation has not yet been exploited completely. This can be done by discriminant analysis. The computer finds out an optimal subset from the whole set of parameters for the solution of a significant clinical problem. The software "learns" to find the "label" of a special pathognomonic entity. This computer work is supported by a relational data bank (Oracle) and an optical disk. Two examples for the effectiveness of the computer in problem solving are presented. It is concluded that RNV, even in the very competitive class of first-order functional imaging, enjoys a preferred position. The future indeed seems brighter because labeled isonitriles offer the chance for the combination of perfusion-motion imaging of the myocardium.

Coronary Disease↗
PubMed1988

Long term inotropic effects of flecainide and propafenone.

This study was undertaken to evaluate the effect of flecainie (Fle) and propafenone (Pro) on rest and exercise myocardial contractility after prolonged oral administration. Standardized, fully automated, gated radionuclide angiograms at rest and during maximum exercise were performed single blinded and prospectively in 19 patients before and after oral treatment with either 150 mg b.i.d. of Fle or 150 mg t.i.d. of Pro. The left ventricular ejection fraction (EF%) as a hemodynamic indicator presented as follows: (Table: see text) In general, there was no significant effect of either drug on resting ventricular function. In only one patient of the Fle group with decreased baseline function did the left ventricular EF fall from 40% to 29%. During exercise, ventricular performance showed deterioration in the Pro group, but, interestingly, improvement in the Fle group. As a result of these opposite changes, the effect of the two drugs on the exercise response of ventricular function was significantly different (P less than 0.05). This study thus gives first evidence that no significant cardiodepressive effects are to be expected after prolonged application of Fle or Pro in normal hearts. There might even be a mild beneficial effect on exercise performance after Fle.

Administration, Oral↗
PubMed1988

[Hemodynamics and ventricular function in dilated cardiomyopathies following administration of the new beta-blocker ridazolol].

Recent reports in the literature indicate that beta-blockade may improve survival in patients with dilated cardiomyopathy (DCMP). This goal can obviously not be attained if the beta-blocker employed effects deleterious actions on the left ventricular function or hemodynamics. Accordingly, to assess the suitability of the new beta-blocker ridazolol for use in this regard, in nine patients with DCMP NYHA class II/III, studies were performed (by means of balloon-tipped pulmonary artery catheter and radionuclide ventriculography) at rest and during exercise prior to and one hour after oral administration of a 40 mg-dose of the agent. At rest, there was a decreasing tendency in systolic blood pressure from 123 +/- 18.5 mm Hg to 113 +/- 15.2 mm Hg and heart rate from 94 +/- 19 beats/min to 83 +/- 17 beats/min. Pulmonary capillary wedge pressure was not significantly altered at 16.2 +/- 7.9 mm Hg and 17.1 +/- 8.4 mm Hg, respectively. Ejection fraction remained unchanged with 29 +/- 14%. The slight decrease in cardiac output from 5.1 +/- 1.3 l/min to 4.5 +/- 1.3 l/min was not significant. During exercise, there were also decreasing tendencies in the heart rate from 128 +/- 21 beats/min to 102 +/- 22 beats/min and the systolic blood pressure from 148 +/- 20.5 mm Hg to 141 +/- 18.4 mm Hg. Essentially unchanged were the pulmonary capillary wedge pressure (26.1 +/- 7.2 mm Hg/27.8 +/- 5.0 mm Hg) and ejection fraction (30 +/- 10%/27 +/- 8%) during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1988

Differentiation between infarction and cardiomyopathy in left bundle branch block by parametric radionuclide imaging.

In LBBB the diagnosis of the underlying disease, i.e. infarction (MI) or cardiomyopathy (CMP), is still a challenge. In this study, the usefulness of radionuclide ventriculography (RNV) for solving this problem noninvasively was tested. The hypothesis was that quantitation of the space-time sequence of left ventricular (LV) contraction by Fourier analysis may differentiate among MI, CMP, and LBBB-specific wall motion abnormalities (WMA). Forty-seven patients (pts) with LBBB were divided into 3 groups: 1) 20 pts with MI, 2) 7 pts with CMP, 3) 20 pts without MI or CMP. Regional parametric amplitude and phase data of eight LV sectors were calculated and expressed in standard deviation units (SDU) of normal. Out of the many regional data only the values of the mean amplitude and the standard deviation of the mean phase shift showed high discriminative power for separating the three groups, with an average squared canonic correlation of 0.5 and a Wilks lambda of 0.22, respectively. In other words, 17 of 20 pts in group 1, 6 of 7 pts in group 2, and 19 of 20 pts in group 3 were truly diagnosed by RNV alone. Such a separation also seems reasonable physiologically, since the mean amplitude reflects global left ventricular function and standard deviation of phase is a measure of time homogeneity of contraction. Furthermore, there was a significant septal phase delay of -4.92 +/- 5.3 SDU in 15 pts with septal MI compared to group 3 pts, who had a subtle premature septal motion of +0.75 +/- 2.64 SDU, whereas the septal amplitude was not different and slightly decreased in both.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Radionuclide ventriculography and hemodynamic evaluation by right heart catheterization with exercise for assessing the functional significance of coronary artery stenoses. A comparative study.

A series of 13 patients with significant coronary stenoses but without prior myocardial infarction were simultaneously studied by right heart catheterization and radionuclide ventriculography to determine the extent to which abnormal responses in left ventricular ejection fraction and wall motion to maximum exercise are paralleled by abnormal left ventricular filling pressures. The correlations of the filling pressure as evaluated by the diastolic pulmonary artery pressure with both the exercise ejection fraction and the rest-to-exercise change in ejection fraction were high (r = -0.89, P less than 0.01 and r = -0.76, P less than 0.01, respectively). In addition, the filling-pressure response to stress separated the patients into distinct radionuclide categories. All the 7 patients with grossly abnormal filling pressures (P greater than or equal to 30 mmHg) developed regional wall motion abnormalities with exercise as evaluated by visual interpretation or quantitative phase analysis. These patients also had a decrease in ejection fraction from rest to exercise ranging from -9% to -32% together with an exercise ejection fraction below 50%. Conversely, these abnormalities were never found in patients with filling pressures below this threshold level. The data suggest that radionuclide ventriculography and measurement of left ventricular filling pressure with exercise yield corresponding results when assessing the functional significance of coronary stenoses in normotensive patients without prior myocardial infarction and normal global left ventricular function at rest.

Blood Pressure↗