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Biomedical subjects

H Just

Publications and source records attributed to H Just.

At least 379 records · Page 21Linked to original sources

Wall motion characteristic of the right pulmonary artery in the suprasternal echocardiogram.

This study describes the motion pattern of the right pulmonary artery (RPA) as it can be assessed from the suprasternal echocardiogram. The motion characteristic of the RPA is dependent on hemodynamic factors within the lumen of the RPA and those within the left atrium and the aortic arch. During atrial contraction the superior wall of the left atrium separates from the inferior wall of the RPA (IWRPA) and produces an "a" dip in the wall motion of the IWRPA. During isovolumic contraction the RPA is shifted upward (IC point). The incisura in the pulmonary artery pressure curve reflecting pulmonic valve closure can be seen by a sudden decrease in the diameter of the RPA (PC point). In conditions coinciding with pulmonary arterial hypertension, the overall diameter of the RPA increases, and the IC and PC points are flattened or even absent. Thus, changes in hemodynamics caused by pulmonary or cardiac disease may be analyzed noninvasively on the basis of altered wall motion of the RPA.

Adult↗

Haemodynamic effects of a single intravenous dose of lorcainide in patients with heart disease.

The cardiovascular effects of a single i.v. dose (2 mg/kg over 5 min) of lorcainide were studied in 14 patients with heart disease. In the haemodynamic part of the study (6 patients), the aortic and pulmonary systolic, diastolic and mean pressures, left ventricular systolic and end-diastolic pressures, cardiac output and the rate of rise of left ventricular pressure were measured before and for 30 min after administration of the drug. Lorcainide produced a slight and short-lasting decrease in the aortic and pulmonary systolic pressures, and all other pressure values remained unchanged. The cardiac output and systemic vascular resistance were not altered by lorcainide. It consistently depressed the rate of rise of left ventricular pressure (maximum mean decrease 19%). In the angiographic part of the study (8 patients), the ejection fraction and the mean velocity of circumferential fiber shortening were measured before and 5 min after lorcainide. In all but one patient, lorcainide decreased the ejection fraction (mean decrease 11.6%), and the mean velocity of circumferential fiber shortening was uniformly diminished by lorcainide (mean decrease 29.7%). Thus, lorcainide moderately impaired myocardial performance in patients with normal and reduced left ventricular function without producing hypotensive side effects.

Adult↗

Echocardiographic control of Swan-Ganz catheters.

In 68 patients, subxiphoidal, percordial, and suprasternal echocardiography was used to trace the Swan-Ganz catheter during its passage to the pulmonary artery and to localize its position. The localization of the catheter could be exactly identified in 62 out of 68 patients in whom we managed to obtain a suprasternal echocardiogram. In one patient, the catheter was found (by chest x-ray film) in the left pulmonary artery (LPA) and was regarded to be in the right pulmonary artery according to suprasternal echocardiography. In two patients, the catheter could not be localized by suprasternal echocardiography although it was positioned in the LPA. In three patients, the catheters could not be advanced to the pulmonary circulation and were visualized within the right ventricular cavity by precordial and subxihpoid echocardiogarphy. Thus, echocardiography, particularly the suprasternal approach, has proven a safe, reliable, and easy way for position control of Swan-Ganz catheters.

Catheterization↗

Antiarrhythmic effect of lorcainide during chronic treatment.

The effect of oral N-(4-chlorophenyl)-N-[1-(1-methylethyl)-4-piperidinyl]benzene acetamide (lorcainide) was studied in 12 patients with frequent and stable ventricular arrhythmias resistant to a number of other antiarrhythmic agents. Ambulatory electrocardiograms were obtained before and during treatment with lorcainide and in some patients after discontinuation of the drug. Lorcainide suppressed ventricular premature contractions by more than 90% in all but one patient. The daily doses were 200 mg (N = 8), 300 mg (N = 1), 400 mg (N = 1)and 600 mg (N = 2). Plasma concentrations of lorcainide and of the dealkylated metabolite ranged from 0.13 to 0.27 microgram/ml and 0.25 to 0.95 microgram/ml, respectively. Side effects such as insomnia and excessive perspiration were seen in 7 and 3 patients, respectively. Lorcainide is an effective antiarrhythmic agent against ventricular arrhythmias otherwise difficult to treat.

Adult↗

Deductive echocardiography in a case of ruptured sinus valsalva aneurysm into the right ventricle.

The echocardiographic features of ruptured sinus of valsalva aneurysm were described in a 32-year-old man. The diagnosis was established deductively using the precordial, subxiphoidal and suprasternal approach. Despite careful scanning no discontinuity between the anterior aortic wall and the interventricular septum could be observed, thus demonstrating directly the perforated part of the aneurysm. However, the abnormal motion pattern of the tricuspid valve on the subxiphoid echocardiogram and the enlarged right ventricular cavity suggested involvement of the right ventricle. Pre- and postoperative findings were compared.

Adult↗

[Short-term and long-term therapy with slow-release ISDN. Echographic, vector cardiographic and ergometric findings (author's transl)].

The effect of slow-release isosorbide dinitrate (Maycor retard) on the myocard was investigated in a short-term study (single dose of 20 mg slow-release ISDN) and in a long-term study (2 X 20 mg slow-release ISDN daily) in 10 patients with coronary heart disease. The parameters assessed were heart rate, blood pressure and skin temperature at rest, load ECG, orthogonal ECG and VCG by computer and UCG echocardiography. The reductions of diastolic and systolic ventricular diameter are statistically significant in the short-term and long-term trials. The ejection time decreases. The velocity of circumferential fiber shortening as a measure of myocardial contractility increases highly significantly. R peak and T wave amplitude in the Y lead change significantly. These findings can be interpreted as an expression of improved myocardial tension and a normalization of the contraction and relaxation.

Blood Pressure↗

Diagnosis of dissecting aortic aneurysm with suprasternal echocardiography.

A 33 year old woman with Marfan's syndrome and aortic root dissection was studied with precordial and suprasternal echocardiography. The precordial approach revealed some typical features of aortic root dissection. With suprasternal echocardiography it was possible to visualize the characteristic diagnostic feature of this disease: within the aortic lumen an m-shaped pattern--the aortic intimal flap--moving downward to the posterior aortic wall during systole. The diagnosis was confirmed with aortic cineangiography and intraoperative findings. Thus, suprasternal echocardiography can be a useful method of detecting aortic root dissection, especially in patients with aortic arch dissection alone.

Adult↗