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Biomedical subjects

F Leisch

Publications and source records attributed to F Leisch.

70 records · Page 4Linked to original sources
PubMed1982

[Variant angina non-invasive assessment of coronary morphology].

The predictability of coronary morphology was investigated in 28 patients with variant angina using clinical symptomatology, effectiveness of nifedipine an appropriate ECG changes. Using coronary angiography seven patients had shown normal or not significantly stenosed coronary arteries (group 1), 21 had significant coronary stenoses (greater than 70%) (group 2). Six patients of group 1 showed resting angina only, 11 out of group 2 had in addition exertional angina and 4 had to be assigned clinically to threatening infarct enlargement. Treatment with nifedipine was successful in 6 patients of group 1, however, only in 6 out of 17 patients in group 2. In no case did treatment with nifedipine lead to success in multiple vascular involvement. Normal control ECGs were present in 6 patients of group 1, a pathologic ECG with Q spikes or T inversions was seen in 20 patients of group 2. Results indicate good diagnostic accuracy for normal coronary vessels in the presence of angina at rest, effective treatment with nifedipine and normal control ECGs. Significant coronary stenoses may be assumed when angina at rest and during exertion, ineffective treatment with nifedipine and pathologic control ECGs are demonstrable. Using these parameters prediction of coronary morphology with non-invasive methods was possible in 14 of the 28 patients with variant angina.

Angina Pectoris, Variant↗
PubMed1982

[Clinical and angiographic evaluation after aortocoronary bypass surgery (author's transl)].

The analysis of the first 125 patients, having coronary artery bypass surgery at the community hospital of Linz/Austria, revealed a perioperative mortality of 3% (n = 4) and a myocardial infarction incidence of 4% (n = 5). The angiographic restudy after surgery in 109 patients demonstrated 89% (n = 174) of the 196 vein grafts patent. The degree of revascularisation was 74% and the mean number of grafts per patient 1.8. The ejection fraction of the left ventricle was unchanged postoperatively (preop.: 61%, postop.: 64%). 3 to 6 months after surgery 55% of the patients were without angina pectoris-symptoms, 37% were clinically improved and 8% remained unchanged or deteriorated with respect to chest pain. There was a significant difference in patency rate and degree of revascularisation between pain free (90 resp. 88%) and improved patients (70 resp. 54%, p less than 0.001) and the unchanged (20 resp. 17%, p less than 0.001). Aortocoronary bypass surgery provides relief of pain or improvement in a high percentage (92%). The results are important influenced by graft function and degree of revascularisation.

Angina Pectoris↗
PubMed1981

[Clinical, angiographic and therapeutic aspects of variant angina (author's transl)].

A report is given on seven patients with Prinzmetal's variant angina. Rest angina occurred in all patients. In contrast, exertional angina was observed only on patients with significant (greater than 70%) coronary stenosis. Likewise, electrocardiographic changes (negative T) were only demonstrable in patients with severe coronary obstruction. The coronary angiogram was normal in one patient, demonstrated insignificant lesions in two and significant stenosis in four cases. In patients with insignificant coronary lesions obstructive coronary spasm was provoked by ergonovine maleate and this group responded well to a combination of nifedipine and isosorbide dinitrate therapy. The patients with significant coronary stenosis were free from pain after coronary bypass surgery; one of these suffered a perioperative anterior myocardial infarction. On the basis of these observations promising therapy is possible if the coronary morphology is known.

Adrenergic beta-Antagonists↗
PubMed1981

[Nitroglycerin-application in order to differentiate a spastic from an organic coronary obstruction in a case of Prinzmetal's variant angina (author's transl)].

We report on a patient with Prinzmetal's variant angina. The coronary angiogram demonstrated a subtotal stenosis in the left anterior descending artery. The provocative test with Ergonovine increased the stenosis to a higher degree and the patient became symptomatic (Angina pectoris, ST-elevation). The angiographic control after Nitroglycerin revealed a normal vessel so that the stenosis was identified of spastic origin. To avoid misinterpretation in asymptomatic coronary artery spasm an angiographic control after Nitroglycerin is necessary in patients with Prinzmetal's variant angina and coronary stenosis.

Angina Pectoris, Variant↗
PubMed1980

[Effects of Imolamin on hemodynamics and pacing induced angina pectoris (author's transl)].

10 patients with exertional angina pectoris were examined to evaluate the hemodynamic effects of 100 mg parenteral applied Imolamin. In 4 out of 7 patients the pacing-induced angina was improved after Imolamin. No significant changes were found in heart rate, mean pulmonary artery pressure, left ventricular systolic and enddiastolic pressure. The compatibility of Imolamin was good.

Angina Pectoris↗
PubMed1980

[R amplitude changes and ST segment lowering in the exercise ECG compared with angiographic findings (author's transl)].

The results of exercise ECG and coronary angiography in 73 patients (20 without, 53 with significant coronary stenoses) were compared in a retrospective study. A sensitivity of 47%, 58% and 60% and a specificity of 90%, 90% and 65% was found in the 3 criteria used, i.e. ST lowering, R amplitude change and pectanginous symptoms. Combination of ST lowering and (or) R amplitude change showed a higher sensitivity by 11% and a better specificity by 15% when compared to ST lowering and (or) angina pectoris. Taking all 3 criteria of ischaemia into account (occurring singly or in combination) sensitivity increased to 91%, however, specificity decreased to 55%. The high accuracy of R amplitude change is caused by recognition of patients with diminished exercise tolerance (low pressure-frequency product). Patients with positive R amplitude changes do not differ from those with decreasing R amplitude as regards left ventricular enddiastolic pressure and ejection fraction during rest.

Adult↗
PubMed1980

[Mitral valve prolapse syndrome].

Within one and a half year 24 patients with arrhythmias or chest pain were investigated to detect a mitral valve prolapse syndrome which was found in 9 cases by echocardiography. Within this group 6 patients complained of fatigue, dizziness, dyspnea or syncope, 6 had chest pain, 7 paroxysmal tachycardia and 2 patients premature beats. Auscultation revealed in 3 cases a systolic click, in 1 case a systolic click with late systolic murmur and in 5 cases a systolic murmur only. The ECG showed premature ventricular contractions in 2 patients, ST-T abnormalities in 6 patients. Echocardiography showed a late systolic prolapse in 6 and a pansystolic prolapse in 3 patients. In 3 cases also an angiography was performed and in this way a mitral valve prolapse detected; hemodynamics and coronary arteries were normal in all 3 cases but in one case a mitral insufficiency and in one case an asynergy of the anterior wall was found. Pathophysiology, clinical symptoms and phonocardiographic, echocardiographic and angiographic findings in mitral valve prolapse syndrome are discussed.

Adult↗
PubMed1980

[Effects of aortocoronary bypass surgery on left ventricular wall motion. Ventriculographic results (author's transl)].

In order to evaluate the effects of aortocoronary bypass surgery on left ventricular contraction pattern the ventriculograms of 29 patients were analyzed. For the entire group no changes were found by the evaluation of left ventricular volumes, ejection fraction and circumferential fiber-shortening velocity. The analysis of the regional wall motion (number of asynergic segments, ventricular score, percentual shortening of the hemiaxis) demonstrated positive effects on regional contraction pattern--especially in subgroups. We conclude: 1. a normal left ventricular function associated with successful bypass grafting remains unchanged postoperatively (n = 8); 2. occluded grafts result in a depression of left ventricular function, sometimes accompanied by perioperative myocardial infarctions (n = 13); 3. in a high degree (75%) it is possible to improve or normalize a preoperative depressed ventricular performance in patients without electrocardiographic evidence of a myocardial infarction (n = 12); 4. patients with preoperative myocardial infarctions and successful bypass surgery can have beneficial effects on left ventricular function by an increase in wall motion in additional areas with asynergy without infarction scare (n = 4).

Coronary Artery Bypass↗
PubMed1979

[Acute rupture of the interventricular septum in posterior wall infarction (author's transl)].

A rupture of the interventricular septum, as described in a case report, is found in 2% of myocardial infarctions. Clinical symptom loud systolic murmur audible at the left sternal border associated with a thrill and with signs of cardiogenic shock. The diagnosis is made by right heart catheterisation which shows a typical oxygen stepup between right atrium and right ventricle, by which the rupture of the interventricular septum can be differentiated from acute papillary muscle rupture. The therapy should be at first hemodynamic stabilisation by drugs and intraaortic balloon pump for 4 to 6 weeks and then closure of the ventricular septal defect by operation.

Diagnosis, Differential↗
PubMed1979

[Successful nifedipine therapy in coronary spasm].

A 51 year old male, with typical "Prinzmetal-Angina", is presented. The ECG during the attacks exhibits ST-Elevation and concomitant ventricular ectopies. The coronary arteriography reveals a spasm in the normal left anterior descendens artery. The therapeutic combination of Nifedipine and Isosorbiddinitrat is effective and the patient has been free of pain since 9 months.

Angina Pectoris↗
PubMed1978

[Haemodynamic response to antihypertensive treatment with atenolol in patients with hypertension (author's transl].

The antihypertensive effect of atenolol, a cardioselective beta-blocker, was examined in 8 patients with essential hypertension. The most important haemodynamic changes observed were a significant reduction in heart rate (reduction in maximum heart rate at the end of symptom-limited exercise by 23% p less than 0.01) and a moderate fall in systolic blood pressure (reduction at submaximum level of exercise by 22%, p less than 0.01). The antihypertensive effect was attributable in half the patients to a drop in peripheral vascular resistance and in the other half evenly to a predominant reduction in cardiac output or to a reduction in both parameters. In view of the compensatory rise in stroke volume a significant reduction in cardiac output was not found. Symptom-limited exercise tolerance was increased in all patients. These results lead to the conclusion that the antihypertensive action of the cardioselective beta-blocker, atenolol is based on a lowering of the increased peripheral vascular resistance and a reduction in cardiac output; the latter mechanism is predominantly found in patients with hyperkinetic features.

Adolescent↗