Biomedical subjects
Publications and source records attributed to G Linss.
In 3 out of 133 patients suffering from prostatic cancer and treated with depot estrogens a porphyria cutanea tarda was found after a follow-up ranging from few months to 10 years. Therefore, a defect of the uroporphyrinogen decarboxylase has been postulated. The therapy could be continued under small doses of chlorochin diphosphate.
In a prospective study we tested the possibility to differentiate myocardial tissue by means of the quantitative texture analysis of two-dimensional echocardiographic images. 12 patients with a bioptically ascertained myocarditis and 12 healthy patients of a control group were echocardiographically examined. The results demonstrated that the echocardiographic image texture in myocarditis is characterized by an increase of the texture parameters entropy, second difference moment and long-run emphasis as well as by a decrease of the parameters angular second moment, inverse difference moment and run-length nonuniformity as well as by different values of the ring and sector sums of the power spectre. The digital image processing of echocardiography images seems thus to open a new way to the noninvasive diagnostic of myocarditis.
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In 30 patients the influence of ionic (Amidotrizoate) and non-ionic (Iopromide) contrast agents on the heart parameters contractility, relaxation, perfusion and the rate of extrasystoles was investigated. They were significantly less influenced by Iopromide than by Amidotrizoate. A negative inotropic action was detectable only for Amidotrizoate. It is concluded that non-ionic contrast media should be used especially for critical patients.
In 36 patients with angina pectoris during complex invasive diagnostic procedure the changes of global and regional systolic heart function by intravenous application of 200 mg pentoxifylline were examined. We observed a significant decrease of preload (reduction of LVEDP and MCS, LVEDV was not influenced) and an improvement of myocardial pump function, possibly combined with a favourable influence on alterated myocardial blood supply. In case of perfusion disturbances of the LV anterior wall the pentoxifylline injection was followed by signs of coronary-steal-mechanism in the LV posterior wall region. We did not found significant changes of afterload. Thus the acute hemodynamic effects of an intravenous application of pentoxifylline are comparable with those of nitrates and non-glycoside-cardiotonic substances with a predominant myocardial effect.
The combination of coronary heart disease (CHD) with increased left ventricular wall mass (LVWM) appears associated with prolonged isovolumetric relaxation (IVR) and consequently, alterations in the rapid filling phase. Methylxanthine-substances may improve relaxation through inhibition of phosphodiesterase activity. Accordingly we examined multiple indexes of left ventricular diastolic function before and after administration of 200 mg pentoxifylline (Trental) intravenously to 18 patients (51.3 +/- 9.0 years, 15 males, three females) with stable angina pectoris and positive exercise-ECG in NYHA class I or II and LVWM greater than 160 g (n = 9) and less than or equal to 160 g (n = 9). Left ventricular pressure (P) and volume (V) measurements were made with a high-fidelity-micromanometer before and twelve minutes after administration of pentoxifylline. The time constant of left ventricular isovolumic relaxation (T), usual global left ventricular volumes and derived indexes such as peak filling rate (PFR), time to peak filling rate (TPFR), segmental (relaxation and rapid filling phases) and total pressure-volume relationship before and after pentoxifylline were calculated. Significant differences between these two groups (greater than/less than or equal to 160 g LVWM) were found for end-diastolic volume (68.7 +/- 19.0 to 90.8 +/- 22.6 ml/sqm), end-systolic volume (21.7 +/- 16.0 to 36.1 +/- 14.7 ml/sqm), end-diastolic pressure (15.0 +/- 4.8 to 15.7 +/- 5.1 mm Hg), PFR (3.25 +/- 1.18 to 2.66 +/- 0.71 s-1), T (46.0 +/- 5.7 to 52.7 +/- 7.2 ms), the linear regression of lnP-V (lny = -0.117 x + 4.59 to lny = -0.091 x + 4.75) in the IVR-phase (dp/dtmin less than or equal to x less than or equal to 80 ms) (leftward shift in p-V-relationship when less than or equal to 160 g) and the complet p-V-areas. After pentoxifyl-line-administration there were significant decreases in T in patients with increased LVWM (52.7 +/- 7.2 to 47.7 +/- 5.9 ms) and the P-V-product over the time in the rapid filling phase in patients with LVWM less than or equal to 160 g. Total peripheral resistance and heart rate did not change. These changes in parameters of left ventricular diastolic function in combination with significant improvement of pump function especially in patients with LVWM greater than 160 g after administration of pentoxifylline suggest that improved diastolic function is the result of a direct myocardial effect of pentoxifylline.
77 unselected patients were examined simultaneously by impedance cardiography and radiocardiography in the recumbent position during dynamic exercise (bicycle ergometry). In all cases evaluable impedance curves were registered till the 100 W load. Stroke volume, estimated by impedance cardiography, is at rest and during exercise by about 30% lower compared to its value determined by radiocardiography. However, the percent increase during exercise is not significantly different with the use of either method. The stroke volumes estimated by both methods correlate significantly at rest and during exercise. This fact shows the usefulness of impedance cardiography for estimating central haemodynamics during dynamic exercise.
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77 unselected patients were examined synchronously by impedance and radiocardiography in recumbent position during dynamic exercise. In all cases the load of evaluable impedance curves was possible till 100 watts. Stroke volume, estimated by impedance cardiography, is lower about 30% at rest and during exercise compared to its estimation by radiocardiography. But the percentual increase during exercise is not significantly different between the methods. The stroke volumes, estimated by both methods, correlate significantly at rest and during exercise. This fact shows the usefulness of impedance cardiography for estimating central haemodynamics during dynamic exercise.
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