Biomedical subjects

G P Leitl

Publications and source records attributed to G P Leitl.

3 recordsLinked to original sources

PubMed1981

Clinical recognition of giant left ventricular aneurysm.

The noninvasive diagnosis of left ventricular aneurysm has markedly improved with gated blood pool scintigraphy. However, in patients with giant anterior ventricular aneurysms, the gated blood pool scintigram performed in two standard views (anterior and 40 degree left anterior oblique) may incorrectly suggest ischemic cardiomyopathy. We retrospectively identified five patients who underwent resection of a ventricular aneurysm over a 2 1/2 year period and who had preoperative scintigraphic studies that appeared to show severe diffuse left ventricular dysfunction. contrast ventriculography demonstrated preserved wall motion in septal, inferior and lateral segments not seen by gated blood pool scintigraphy and showed extraordinarily large anterior aneurysms. M-mode or two-dimensional echocardiograms showed intact posterior wall function in all patients, suggesting severe regional myocardial disease rather than global dysfunction. Two-dimensional echocardiography showed additional segments with preserved function as well as discrete aneurysms in all patients. We conclude that gated blood pool scintigraphy, when performed in two standard views, may fail to correctly diagnose some patients with very large anterior wall aneurysms. M-mode echocardiography, two-dimensional echocardiography and additional scintigraphic views that visualize the posterior portions of the left ventricle improve noninvasive diagnosis of patients with resectable giant left ventricular aneurysms.

Aged↗

PubMed1981

The echocardiographic assessment of cardiomyopathy: diagnosis, classification and problems.

Two-hundred-and-sixty-three patients with cardiomyopathy were studied by M-mode echocardiography. Measurements of left ventricular cavity size, wall thickness and myocardial contraction were used to classify cardiomyopathy into "congestive" (212 patients) and "hypertrophic" (50 patients) groups; the "hypertrophic" group was further divided into asymmetric septal hypertrophy (37) and symmetric (concentric) mural thickening (13). Using clinical and electrocardiographic information as well as echocardiographic data, the latter group could then be further classified into "concentric infiltrative cardiomyopathy" (9) and "concentric hypertrophic cardiomyopathy" (4). The former either presented with signs of restriction or were known to have systemic amyloidosis; the electrocardiograph showed low voltage and myocardial contraction was impaired in advanced cases. The latter had evidence of severe left ventricular hypertrophy and resembled asymmetric septal hypertrophy clinically. Problems encountered with the echocardiographic diagnosis of congestive cardiography were mainly concerned with proper clinical interpretation of the echocardiographic data whilst technical difficulties in recording the echocardiogram and in interpretation of tracings were a common problem in hypertrophic cardiomyopathy.

Cardiomyopathies↗

PubMed1980

Monitoring cardiac function with nuclear techniques.

Noninvasive imaging with radioactive tracers has become widely used since its introduction in the early 1970s. Improvements continue to be made in the techniques and the clinical applications. Much of the information provided by these techniques is new. The first transit studies are used mainly in the evaluation of pulmonary transit time, detection of intracardiac shunting, evaluation of right ventricular function, measurement of ejection fraction and detection of wall motion abnormalities at rest and after exercise. The gated blood pool study is found to be most useful in assessment of global left ventricular function, regional wall motion, valve regurgitation and right ventricular function. The techniques of nuclear cardiac imaging are noninvasive, simple, successfully performed in almost 100 percent of cases. They are easy to interpret, able to be quantified and able to be almost totally automated. Their use is likely to become more widespread in the future.

Coronary Disease↗