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Biomedical subjects

H Sebening

Publications and source records attributed to H Sebening.

At least 19 recordsLinked to original sources
PubMed1990

[Reduction in left ventricular volume and improvement in hemodynamics following intravenous administration of pimobendan (UDGG 115 BS) in dilated cardiomyopathy].

Acute cardiovascular effects of 5 mg (group I, n = 6) and 10 mg (group II, n = 6) i.v. pimobendan (UDCG 115 BS) were studied by right and left heart catheterizations in patients suffering from idiopathic dilated cardiomyopathy (NYHA II and III). Before and 2.5 h after application of pimobendan left ventricular volumes and left ventricular dP/dtmax were evaluated by left heart catheterization. Right atrial pressure (RAP), pulmonary capillary wedge pressure (PCP), cardiac output (CO), heart rate, and systemic blood pressure were assessed before and 2.5, 4, and 6 h after administration of pimobendan. PCP was reduced from 12.2 +/- 7.5 to 8.3 +/- 7.1 mm Hg (p less than 0.05) by 5 mg of pimobendan, and from 18.3 +/- 6.2 to 6.2 +/- 3.4 mm Hg (p less than 0.005) by 10 mg of pimobendan. Reduction of RAP was significant only in group II (from 6.2 +/- 3.2 to 1.2 +/- 0.9 mm Hg; p less than 0.05). In contrast to other hemodynamic parameters, the significant increase of CO exhibited no dose-dependency. Only 10 mg of pimobendan induced a temporary reduction of mean arterial blood pressure. An increase in heart rate occurred only in group I and was merely transient. Left ventricular end diastolic and end systolic volume indices were clearly reduced by 5 mg as well as by 10 mg of pimobendan. A significant rise of left ventricular ejection fraction occurred only in group II. However, left ventricular dP/dtmax was increased significantly in both groups. No adverse effects were noted during acute administration of pimobendan. Therefore, intravenous pimobendan may be a useful drug in the treatment of acute cardiac failure.

Adult↗
PubMed1989

Diagnosis of constrictive pericarditis by pulsed Doppler echocardiography of the hepatic vein.

The diagnostic value of hepatic venous flow patterns was evaluated for constrictive pericarditis by pulsed Doppler. A characteristic flow pattern was assumed to be associated with the well-known atrial pressure curve. Thirteen patients with constrictive pericarditis were compared to 13 control subjects and to 25 patients with right ventricular pressure overload including 13 patients with tricuspid regurgitation. The characteristic finding in constrictive pericarditis was a W-wave pattern of flow velocities in the dilated hepatic veins, with abrupt reversal of flow late in systole and diastole before the A wave (100% specificity, 68% sensitivity). This depends, however, on the absence of tricuspid regurgitation (for its systolic component) or fast sinus rhythm (for its diastolic component). Additional diagnostic markers were systolic deceleration time of forward flow (40 to 130 ms) and systolic integral of flow velocities (4.3 to -4.0 cm) (sensitivity and specificity greater than or equal to 92%). In the presence of tricuspid regurgitation, diastolic deceleration time less than 150 ms and diastolic integral of flow velocities less than 6 cm were useful diagnostic signs. If combined, these criteria had 100% sensitivity and specificity for the diagnosis. Thus, pulsed Doppler assessment of flow velocities in the hepatic vein facilitates the diagnosis of constrictive pericarditis in clinical routine, using an auxiliary site with unlimited diagnostic access to the characteristic flow velocity pattern, which reflects right atrial pressure curve and filling abnormalities.

Adolescent↗
PubMed1989

Effect of intravenous pimobendan (UDCG 115 BS) on hemodynamics and left ventricular volumes in idiopathic dilative cardiomyopathy.

Acute cardiovascular effects of 5 mg (group I, n = 6) and 10 mg (group II, n = 6) intravenous pimobendan (UDCG 115 BS) were studied by right and left heart catheterizations in patients suffering from idiopathic dilative cardiomyopathy (NYHA II and III). Before and 2.5 h after application of pimobendan, left ventricular volumes and left ventricular dP/dtmax were evaluated by left heart catheterization. Right atrial pressure (RAP), pulmonary capillary wedge pressure (PCP), cardiac output (CO), heart rate (HR), and sytemic blood pressure (BP) were assessed before and 2.5, 4, and 6 h after administration of pimobendan. PCP was reduced from 12.2 +/- 7.5 to 8.3 +/- 7.1 mm Hg (p less than 0.05) by 5 mg pimobendan, and from 18.3 +/- 6.2 to 6.2 +/- 3.4 mm Hg (p less than 0.005) by 10 mg pimobendan. Reduction of RAP was only significant in group II (6.2 +/- 3.2 to 1.2 +/- 0.9 mm Hg; p less than 0.05). In contrast to other hemodynamic parameters, the significant increase of CO exhibited no dose dependency. Only at 10 mg pimobendan induced a temporary reduction of mean arterial blood pressure (MAP). An increase in HR occurred only in group I and was merely transient. Left ventricular end-diastolic (EDVI) and end-systolic volume (ESVI) indices were clearly reduced by 5 mg, as well as by 10 mg pimobendan. However, a significant rise of left ventricular ejection fraction (EF) only occurred in group II. On the other hand, left ventricular dP/dtmax was increased significantly in both groups. No adverse effects were noted during acute administration of pimobendan.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Acute effects of intravenous UD-CG 115 BS (pimobendan) on the cardiovascular system and left ventricular pump function.

Acute hemodynamic effects of 5 and 10 mg i.v. UD-CG 115 BS (pimobendan) were studied by right and left heart catheterization in idiopathic dilated cardiomyopathy (NYHA classes II and III; 5 mg = group I, n = 6; 10 mg = group II, n = 6). Effects on left ventricular function were evaluated by left ventricular angiograms and measurement of left ventricular dp/dtmax before and 2.5 h after administration of UD-CG 115 BS. Right atrial pressure (RAP), pulmonary capillary wedge pressure (PCP), cardiac output (CO), heart rate (HR), and systemic blood pressure (BP) were assessed before and 2.5, 4, and 6 h after administration of UD-CG 115 BS. PCP was maximally reduced by 10 mg of UD-CG 115 BS from 18.3 +/- 6.2 to 6.2 +/- 3.4 mm Hg (p less than 0.005) and by 5 mg from 12.2 +/- 7.5 to 8.3 +/- 7.1 mm Hg (p less than 0.05). Maximum reduction of RAP was significant only in group II (p less than 0.05). CO increased in a similar way after both doses (group I: from 5.5 +/- 1.9 to 7.8 +/- 1.3 L/min, p less than 0.005; group II: from 5.0 +/- 1.3 to 7.5 +/- 1.8 L/min, p less than 0.05). Mean arterial blood pressure was slightly reduced only by 10 mg of UD-CG 115 BS. Heart rate rose from 84 +/- 11 to 100 +/- 14 beats/min in group I (p less than 0.05), whereas after 10 mg no change in heart rate was noted. Left ventricular end-diastolic (EDVI) and end-systolic volume (ESVI) indices were clearly reduced by both 5 and 10 mg of UD-CG 115 BS.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomyopathy, Dilated↗
PubMed1989

[The significance of heart rate for stress hemodynamics following heart transplantation].

Since 1985, orthotopic heart transplantation had been carried out in 20 patients. Seventeen patients are still alive. 341 +/- 156 days after cardiac transplantation hemodynamics at rest were normalized. Left ventricular ejection fraction at rest and during exercise was within normal ranges for all patients except one. During symptom-limited bicycle exercise (121 +/- 35 Watt), pulmonary capillary wedge pressure (PCP) and right atrial pressure (RAP) increased to unphysiological high levels (PCP: 8.2 +/- 2.7 mmHg at rest, 19.1 +/- 4.9 mmHg at exercise; RAP: 4.1 +/- 2.3 mmHg at rest, 12.1 +/- 3.9 mmHg at exercise), whereas cardiac index was elevated to a normal level (3.6 l/min.m2 at rest; 6.9 l/min.m2 at exercise). Increase in heart rate, however, was subnormal (from 90 +/- 13/min at rest to 122 +/- 15/min at exercise). To examine the influence of heart rate on hemodynamics, in 8 patients with normal tricuspid valve function, heart rate was gradually increased by atrial stimulation during continuous exercise; PCP maximally could be reduced from 19.1 +/- 4 mmHg to 10.8 +/- 2.7 mmHg (p less than 0.01) at an optimum heart rate of 139 +/- 9/min. Reduction of RAP was by far less pronounced and normalization could not be achieved (from 12.2 +/- 3.7 mmHg to 9.5 +/- 3.4 mmHg, p less than 0.01), suggesting an impaired right ventricular function. By atrial stimulation stroke volume was reduced from 109.8 +/- 17.7 ml to 91.8 +/- 14.2 ml (p less than 0.01). These results indicate that, at exercise, the denervated transplanted heart, to a large extent, increases cardiac output by means of the Frank-Starling mechanism.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed1989

[Asymptomatic course of severe tricuspid valve insufficiency with ateroseptal infarct, coronary fistula and ventricular septum defect as a sequela of blunt thoracic trauma].

Traumatic tricuspid valve insufficiency is a rare in vivo finding, especially in combination with other traumatic cardiac injuries like ventricular septal defect, myocardial infarction, and traumatic coronary fistula. Two-dimensional and, more recently, colorcoded Doppler echocardiography have gained importance for the diagnosis of tricuspid insufficiency. Patients with traumatic tricuspid insufficiency who survive the acute trauma, may remain asymptomatic for many years and even decades. If symptoms develop, tricuspid valve replacement appears feasible even after many years.

Adult↗
PubMed1989

[Heart valve surgery: an analysis of the causes and peri- and postoperative course].

From a total of 1,152 consecutive patients with heart valve replacement (1964-87) 108 patients (9.4%) had to be reoperated. Mechanical valves had to be replaced (n = 89) mainly because of perivalvular leakage followed by prosthetic stenosis and dysfunction. The lowest reoperation rate was found with Björk-Shiley prostheses (3.4%). Bioprostheses (reoperation rate 8.2%) had to be reoperated predominantly as a consequence of dysfunction. Ten years following implantation 30% of bioprostheses had to be replaced. Patients with reoperations demonstrated, in comparison to patients with singular valve replacement, no significant change in early mortality during the last 6 years (6.8% vs 5.4%). Furthermore, both patient groups revealed similar survival rates (10 years; 78% vs 76%) and improvement of life quality. However, non-lethal peri- and postoperative complication rates were higher in reoperated patients compared to patients with first valve replacement.

Adolescent↗
PubMed1987

Palliative endobronchial tumor reduction by laser therapy. Procedure--immediate results--long-term results.

Over a period of 3 years, 224 laser treatments were performed on 105 patients. 84% were carried out under local anesthesia and 16% under general anesthesia. A neodymium-YAG laser (MBB-AT) was used. In 74% of the cases complete or partial tumor removal was possible. 72% of the successfully recanalized stenoses were still open after 4-6 months. In 19% of the cases low-grade complications occurred. The mortality was below 1%. The chief indications for endobronchial laser treatment are exophytic endobronchial tumors in the area of the trachea and primary bronchi. Endobronchial laser coagulation is indicated when surgery is no longer possible. It serves primarily to improve ventilation and bronchial drainage and in particular to prevent retention pneumonia.

Bronchial Neoplasms↗
PubMed1979

[Frequency of peripheral arterial occlusive disease in patients with coronary heart disease with and without infarction (author's transl)].

In 107 consecutive patients the frequency of peripheral arterial occlusive disease in coronary heart disease was assessed by selective coronary angiography and sonographic Doppler pressure estimation. Among 75 patients with coronary heart disease 21 (28%) had arterial occlusive disease, among 32 patients without coronary heart disease only one (3%). There was no statistically significant correlation between the severity of both diseases. 40 out of 75 patients with coronary heart disease had suffered from cardiac infarction. Infarction frequency showed a highly significant correlation with increasing severity of the coronary heart disease, but none with increasing severity or frequency of arterial occlusive disease. When there was no arterial occlusive disease all degrees of severity of coronary heart disease were found. Analysing the literature it becomes evident that coronary heart disease is frequently an isolated or premature manifestation of arteriosclerosis.

Adolescent↗
PubMed1979

[Value of 201-thallium serial myocardial imaging in coronary heart disease (author's transl)].

There has been clinical evidence that a perfusion defect on a stress image fills in over time. The diagnostic value of initial and 120 min post exercise redistribution thallium-201 myocardial images (RMI) was determined in 120 pts. with suspected coronary heart disease (CAD), all of whom had coronary arteriography. Significant (greater than or equal to 75%) lesions were present in 88 pts. 30 pts. without CAD showed a normal tracer uptake immediately after exercise. Scintigrams taken 120 min after exercise revealed a decrease of 201-Tl concentration in every area of the myocardium. 80 pts. with CAD showed an area of decreased tracer uptake in the initial scans. 120 min RMI in 51 pts. revealed a segnificant increase (p greater than 0.01) of countrate time ratio in previous underperfused area. In 37 pts. persistent defects were present, in every case the defect correlated with the site of a myocardial infarction as determined by the finding of an akinetic area in the left ventricular angiogram. Thus RMI following a single dose of 201 Tl can differentiate between scar- and exercise-induced transient ischemia.

Adult↗
PubMed1979

[Effects of acute beta-adrenoceptor blockage (metoprolol i.v.) on plasma norepinephrine concentration and hemodynamics in postmyocardial infarction patients].

The effect of acute beta-adrenoceptor blockage (Metoprolol) (M), 0.1 mg/kg i.v.) on left ventricular performance has been investigated at rest and during exercise in 15 patients with 2--3 months old transmural myocardial infarctions. Coronary venous and arterial norepinephrine (NE) concentrations were determined. There was no significant change in arterial and coronary venous NE concentrations (0.27 and 0.22 ng/ml, respectively) after blockage of beta-adrenoceptors (0.36 vs 0.26 ng/ml), which caused a fall of stroke volume from 79 to 68 ml, a reduction of ejection fraction from 62 to 55% and of circumferential fibre shortening form 1.2 to 0.9 circ/sec. During physical exercise the plasma NE concentration in the arterial (0.51 ng/ml) and coronary venous (0.6 ng/ml) blood increased significantly and increased even further to 0.65 and 0.76 ng/ml, respectively, following administration of Metoprolol. The arterio-coronary sinus difference in NE concentrations demonstrate a release of NE from the myocardium. As compared to control values, heart rate following Metoprolol was lower (116 vs 106/min), mean PCV pressure was slightly increased (from 21 to 23 mm Hg) and there was a fall of cardiac index from 6.3 to 5.2 l/min X m2. It is likely that the increased sympathetic activity after Metoprolol and during exercise is a compensatory reaction due to the hemodynamic effects of blockade of beta-adrenoceptors. Further studies are in preparation in order to find out if this is only a transient phenomenon during the early adaptation phase after blockade of beta-adrenoceptors.

Adult↗
PubMed1978

[Noninvasive assessment of left ventricular dynamics (author's transl)].

ECG triggered scintiphotography has established itself as a reliable, reproducible, noninvasive method for the determination of ventricular volumes, left ventricular ejection fraction, and regional ventricular wall motion. It can be used with sufficient precision and accuracy in severely ill patients who are not suitable for invasive diagnostic procedures. The method is useful for follow-up investigations of known heart disease. In comparison with left ventricular cineangiocardiography a correlation coefficient of r=0.78 could be found for enddiastolic voluumes, of r=0.92 for endystolic volumes, and of r=0.91 for ejection fraction. The sensitivity of the method for recognition of disturbances of regional ventricular wall motion is 94%, the specificity 86%. In comparison with left ventricular cineangiocardiography the resulting accuracy is 90%.

Adult↗
PubMed1978

[Non-invasive nuclear medical diagnosis in cardiology. 201T1-myocardial and ECG triggered heart ventricle scintigraphy].

201Thallium scintigraphy serves as a non-invasive method for visualizing regional perfusion, viability and configuration of the myocardium. Serial scans performed after injection during ergometric exercise allow to differentiate between irreversible cell damage, i.e. myocardial infarction or scar, and transient, reversible ischemia in patients with coronary heart disease. ECG-gated blood pool scans are an ideal adjunct as they represent the functional results of the pathologically altered myocardium. This method permits quantitative determination of the enddiastolic volume, endsystolic volume and left ventricular ejection fraction. Furthermore, regional and global wall motion may be judged qualitatively. Results of both methods show an excellent correlation with those obtained by invasive catheterization and cineangiocardiography. The clinical value is based on screening and follow up of a broad variety of cardiac diseases.

Electrocardiography↗
PubMed1978

[Initial systolic ejection rate as a parameter of ventricular function in valvular heart disease (author's transl)].

In patients with valvular heart disease the initial systolic ejection rate was determined in an attempt to characterize ventricular function in pressure and volume overload. By means of left ventricular cineangiography, the volume change during the initial third of the ejection phase was determined and the mean ejection rate of this period was calculated. A total of 40 patients were examined, 7 patients without heart disease, 15 patients with pure aortic regurgitation, 9 patient with pure aortic stenosis and 9 patients with pure mitral regurgitation. In patients with pure aortic regurgitation and high-normal values for ejection fraction and mean velocity of circumferential fiber shortening (mVcf) a significant increase in initial systolic ejection rate when compared to the group of normals was observed. The distribution of the stroke volume for each third of the ejection phase corresponded to the normal pattern. In contrast, in patients with low-normal values for ejection fraction and mVcf, a decrease in the initial systolic ejection rate below the normal value was observed, along with a pathological distribution of the stroke volume during the ejection phase. This finding was also noted in all patients with pure mitral regurgitation and pure aortic stenosis. In aortic stenosis, the decline in initial systolic ejection rate was regarded as a consequence of the outflow tract obstruction, whereas in volume overload, this was regarded as a sign of a decline in ventricular function which is not recognized with global parameters such as ejection fraction and mVcf.

Angiocardiography↗