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Biomedical subjects

F Schwarz

Publications and source records attributed to F Schwarz.

At least 163 records · Page 9Linked to original sources
PubMed1981

[Ventricular arrhythmias in patients with aortic valve disease (author's transl)].

In order to investigate the incidence of severe ventricular arrhythmias, the 24-h ambulatory ECG of 55 patients with aortic valve disease (NYHA classes I-IV; stenosis: n = 24; regurgitation: n = 18; mixed lesions: n = 13) without coronary heart disease were evaluated with regard to the number of premature ventricular beats and according to the Lown classification. Ventricular arrhythmias were found in 73% of all patients (Lown classes III-V: 38%; Lown classes IV-V: 20%). A significant relation between the degree of arrhythmias and the gradient or severity of regurgitation of the aortic valve could not be established. However, there was a significant linear correlation between the left ventricular ejection fraction and the degree of arrhythmias (stenosis: r = 0.60; regurgitation: r = -0.72; mixed lesions: r = 0.78; all p less than 0.005). Complex arrhythmias of Lown classes III-IV are rare (less than 10%) in patients with good left ventricular function (LVEF greater than 60%). There was a history of palpitations in 81% of patients with Lown classes III-V. According to these data, ventricular arrhythmias are present in a large number of patients with aortic valve disease. The degree of arrhythmia does not correlate to the transvalvular stenosis or the severity of regurgitation, but is strongly influenced by the myocardial performance. Therefore in patients with aortic valve disease significant arrhythmias are frequently a sign of impaired LV function.

Adolescent↗
PubMed1981

[Ultrastructural changes in human myocardium with hypertrophy due to aortic valve disease and their relationship to left ventricular mass and ejection fraction (author's transl)].

Biopsies from hypertrophied left ventricles were obtained intraoperatively from patients undergoing valve replacement for aortic valve disease. The tissue was immediately fixed in glutaraldehyde and, after appropriate preparation, examined by light and electron microscopy. Morphologic characterization was carried out with respect to 1. qualitative alterations within myocytes, mostly degenerative, 2. measurement of cell diameter and the percentage of interstitial tissue volume within the total myocardium, 3. determination of volume densities of mitochondria, myofibrils, and cytoplasm in myocardial cells by morphometric techniques. Data from hypertrophied hearts were compared with those from normal hearts (control group). Analysis of morphologic and clinical data yielded the following results: 1. The increase in the clinically determined left ventricular muscle mass due to hypertrophy in aortic valve disease is caused by an increase in cellular diameter as well as an increase in interstitial tissue; 2. The morphologic correlate of the reduction of left ventricular function (EF) with increasing degrees of hypertrophy consists of an increase in interstitial tissue, i.e. fibrosis, and a marked relative loss of myofibrillar components from hypertrophied myocardial cells which is accompanied by an increase in cytoplasm-filled areas.

Aortic Valve Insufficiency↗
PubMed1981

[Natural history of chronic aortic valve. Significance of hemodynamic findings (author's transl)].

The natural history of chronic aortic valve disease is well known from non-invasive data, but invasive data documenting the natural course of this disease are lacking. We studied hemodynamic data of 45 patients who had chronic aortic valve disease and were in functional class III or IV. All patients were candidates for prosthetic aortic valve replacement, but refused operation. These patients document the natural course of aortic valve disease. Invasive hemodynamic data were obtained by heart catheterization. Patients with aortic stenosis who died during the observation period had a transvalve gradient of 83 +/- 40 mm Hg, which was comparable to the gradient of survivors (70 +/- 16 mm Hg, p greater than 0.05), but left ventricular end-diastolic pressure, mean left atrial pressure and pulmonary artery pressure were higher indicating impaired left ventricular function. Patients with aortic stenosis who were repeatedly studied with heart catheterization (n = 7, average interval between studies 3.3 years) showed a significant increase of left ventricular filling pressure and of pulmonary arteriolar resistance and a fall of cardiac index. Patients with aortic insufficiency who died during the observation period had higher left ventricular filling pressures than survivors. Patients with aortic insufficiency who were repeatedly studied with heart catheterization (n = 5, average interval 2.9 years) showed no change of hemodynamic parameters. The latter group showed symptomatic deterioration although hemodynamics were unchanged. We conclude, in chronic aortic valve disease hemodynamic parameters regarding left ventricular function have prognostic implications.

Adult↗
PubMed1981

[The effect of tricuspid insufficiency on right ventricular performance in patients with valvular heart disease (author's transl)].

The hemodynamic effect of tricuspid insufficiency on right ventricular function was studied in 25 patients with rheumatic heart valve disease. 10 patients had mixed valve disease without tricuspid insufficiency (group A), and 15 patients had mixed mitral valve disease with tricuspid insufficiency (group B). Mitral valve area (1.76 vs. 1.66 cm2) and mitral regurgitant fraction (55 vs. 45%) were not significantly (p greater than 0.05) different between groups. Patients of group B revealed higher right atrial and right ventricular end-diastolic pressures than patients of group A. Right ventricular ejection fraction was lower in group B as compared to group A (44 vs. 52%, p less than 0.05). During ergometric exercise right atrial pressure was higher in group B as compared to group A (19 vs. 14 mm Hg, p less than 0.05), but mean pulmonary artery pressure (48 vs. 51 mm Hg, p greater than 0.05), cardiac index (3.3 vs. 3.31/min . mi2, p greater than 0.05) and stroke index (27 vs. 25 ml/m2, p greater than 0.05) were not significantly different. In mixed mitral valve disease associated with tricuspid regurgitation, right ventricular function is impaired when compared to mixed mitral valve disease of equal severity but without tricuspid regurgitation. Exercise induces a further augmentation of right atrial pressure in these patients with tricuspid regurgitation. We conclude, right atrial pressure elevation is not only the consequence of tricuspid regurgitation in group B but also the consequence of impaired right ventricular function. Impairment of right ventricular function is further augmented during exercise.

Adult↗
PubMed1981

[The end-systolic pressure-volume relationship in the assessment of left ventricular function (author's transl)].

This investigation was undertaken to determine whether the left ventricular (LV) end-systolic pressure and end-systolic volume, as measured under clinical conditions, are linearly correlated and whether the slope of the end-systolic pressure-volume relationship (P-Ves) is a meaningful parameter in the assessment of left ventricular function. The studies were performed in twelve patients (eleven with coronary artery disease and one with congestive cardiomyopathy) during which autonomic reflex responses were minimized by propranolol (0.15 mg/kg i.v.) and atropine (1 mg i.v.). Three left ventricular angiograms (at rest, after 10 mg isosorbide dinitrate and during an infusion of 2 mg/min methoxamine) were obtained from which the three respective P-Ves data points were calculated and subjected to linear regression analysis (r greater than or equal to 0.96). The slope k of the linear P-Ves relation correlated most closely with the resting ejection fraction (EF) as an exponential function (r = 0.94). The end-systolic pressure could be interchanged with the peak systolic pressure which is more easily obtained. The theoretical end-systolic volume at end-systolic pressure = 0 (V0) was not related to the resting ejection fraction. Post-extrasystolic potentiation, resulting in an acute inotropic incrementation, shifted the P-Ves toward similar volumes and steepened its slope.

Atropine↗
PubMed1981

[Effect of intracoronary fibrinolysis on left ventricular diastolic function in patients with acute myocardial infarction (author's transl)].

In 22 patients with acute myocardial infarction, intracoronary infusion of streptokinase was begun 3.2 +/- 1.4 hours after the onset of symptoms. In 71% of patients recanalization of a completely occluded artery could be achieved. In 12 successfully treated patients left ventricular hemodynamics (left ventricular diastolic compliance and regional wall motion) were compared before and 4 weeks after recanalization. 4 weeks after intracoronary fibrinolysis left ventricular end-diastolic pressure had fallen (from 20 to 15 mm Hg, p less than 0.05), diastolic compliance had improved (p less than 0.05) and infarct size was reduced (p less than 0.05) compared to the acute stage of myocardial infarction. Left ventricular hemodynamics of 16 patients without heart disease (group A) and 22 patients with chronic myocardial infarction treated medically (group B) were compared to the findings of patients with acute myocardial infarction (group C). Group B and C showed reduced diastolic compliance as compared to group A (p less than 0.001). When group B and c were compared with identical size of akinesis (as measured by the number of asynergic hemiaxes), there was no significant difference of diastolic compliance. Reduction of diastolic compliance correlated linearly with infarct size (r = 0.73, r = 0.78). The results indicate that successful early reperfusion of acute myocardial infarction leads to a reduction of infarct size.

Adult↗
PubMed1981

[Quantitative ultrastructural findings of the myocardium in the failing heart. I. Aortic valve insufficiency (author's transl)].

Quantitative ultrastructural changes of the left ventricular (LV) myocardium and contractile function were studied in 9 symptomatic patients with severe aortic insufficiency (AI). The volume fractions of myofibrils, sarcoplasm, and mitochondria in myocardial cells were determined by electron microscopic morphometry in small LV tissue samples. Interstitial fibrosis was measured by light microscopic morphometry. Transmural biopsies of the LV free wall perfused by the left anterior descending coronary artery (LAD) were obtained during aortic valve replacement. Biopsies from the LAD-perfusion area of 10 surgical patients with coronary artery disease but moderate LAD-stenosis and normal regional motion of LAD-area were taken as controls for morphometric data. LV-function was analyzed from preoperative heart catheterization. In initial reproducibility studies of biopsy samples of 17 patients a sampling error for evaluation of myocardium was defined and differences exceeding 6.2% transmural fibrosis and 6.5% myofibrils were considered biologically significant differences. Patients with AI had higher LV end-diastolic volume (180 versus 77 ml/m2, p less than 0.001), and lower LV ejection fraction (51 versus 69%, p less than 0.001) than 10 control individuals. The volume fraction of myofibrils was lower in AI than in controls (44 versus 53%, p less than 0.01), and sarcoplasm was higher (33 versus 21%, p less than 0.01). Mitochondria and interstitial fibrosis did not differ between groups (p greater than 0.05). Thus reduction in the volume fraction of myofibrils was the major ultrastructural finding in LV biopsy samples of patients with heart failure due to aortic insufficiency.

Adult↗
PubMed1980

[Radiological diagnosis of pyelonephritis].

The standard examination method of the radiological diagnostics of pyelonephritis is the EU. In restricted function of the kidney the intensive urography is to be used. Above all decent changes of form and tonus in the hollow system show diagnostic problems. Concerning a pyelonephritis they can be classified only in connection with clinical data. In more than 90% of the examinations the chronic pyelonephritis is to be recognized in the EU. It is referred to aspects of the radiation load in the EU.

Chronic Disease↗
PubMed1980

Ultrastructural evaluation of the effects of global ischemia and reperfusion on human myocardium.

During open-heart surgery, myocardial biopsies were taken from 31 patients undergoing aortic valve replacement on total cardiopulmonary bypass. The first needle biopsy was taken before the induction of cardiac arrest (Kirsch cardioplegia), the second at the end of global ischemia, and the third during the reperfusion period. The tissue was investigated by electron microscopy using a semiquantitative scoring system for changes in both myocytes and blood vessels. Mitochondrial volume and surface density were determined by morphometry. Reversible ischemic injury of moderate to severe degree occurred in cardiac cells and in small blood vessels. On reperfusion, signs of damage regressed earlier in myocardial than in vascular tissue. Morphometry revealed significant mitochondrial swelling during the reperfusion phase, but this was not present after ischemia alone. It is concluded that Kirsch cardioplegia as applied here, is unable to protect the heart from ischemic cellular damage.

Biopsy↗
PubMed1980

Conjunctival incision for herniated orbital fat.

The approach to herniated orbital fat of the lower eyelid through a conjunctival incision is described. This is an effective method of removing the herniated fat pads in patients who do not have redundant lower eyelid skin and results in excellent cosmesis. The candidates for this procedure are usually in a younger age bracket.

Adipose Tissue↗
PubMed1980

[Differential diagnosis of pyeloureteritis cystica, follicularis et granularis].

At the instance of the observations of two patients the differential-diagnostic difficulties in the pyeloureteritis cystica and the ureteritis follicularis or granularis are described. Here first of all the following other diseases must be excluded: 1. neoformations in the upper urinary tract, 2. uro-tuberculosis, 3. X-ray-negative calculi, 4. HWI with gas-producing germs. The knowledge of the X-ray diagnostic criteria of the individual diseases is often of life-important significance for making a certain diagnosis for the patient. For this reason also the performance of a retrograde ureteropyelogramme may be indicated, if, exhausting all possibilities of the excretion urography, a diagnostic ascertainment is not possible.

Adult↗
PubMed1979

[Overnutrition].

Explore the source record for details and available documents.

Adult↗
PubMed1979

[Possibilities and limitations of gastrointestinal radiography].

The picture intensifier television radioscopy, picture intensifier initial level photography, double contrast method and pharmacoradiography together with endoscopy further the optimation of the diagnostics of the diseases of oesophagus, stomach and intestine. The value of the X-ray diagnostics for the recognition of the biliary diseases and of the incleared jaundice is high. In diseases of liver and pancreas the X-ray diagnostics may further the finding of decision. Ways for a better interdisciplinary cooperation are demonstrated.

Cholangiography↗