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Biomedical subjects

H Sebening

Publications and source records attributed to H Sebening.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1978

[Evaluation by means of ECG-gated cardiac blood pool scintigraphy of global and regional left ventricular function at rest and during exercise in patients with coronary artery disease (author's transl)].

ECG-gated cardiac blood pool scintigraphy permits a non-invasive determination of the end-diastolic and end-systolic ventricular volumes and of the ejection fraction as well as a qualitative description of regional ventricular wall motion at rest and during excercise. In 6 healthy persons a significant increase of the ejection fraction from 66 +/- 7% at rest to 78 +/- 3% during exercise (p less than 0.01) was observed. In contrast, the ejection fraction decreased in 15 out of 18 patients with coronary artery disease, with a significant (p less than 0.01) difference between patients with and without angina pectoris. Thus, the ejection fraction fell in 12 patients without angina during excercise from 60 +/- 11% to 52 +/- 11% (p less than 0.05) whereas in 6 patients with angina a decrease from 61 +/- 7% to 30 +/- 8% (p less than 0.01) was observed. This non-invasive technique makes it possible to demonstrate in a simple and safe manner changes of cardiac function during excercise in patients with coronary artery disease.

Adolescent↗
PubMed1977

[Hypertrophic cardiomyopathies (author's transl)].

Because of their rapidly changing hemodynamic inconstancy depending on many, sometimes competing, processes, hypertrophic cardiomyopathies present a clinical picture extraordinary among the cardiac diseases, with severely altered diastolic compliance of the left ventricle and a functional stenosis in the obstructive forms. They are of increasing importance for the doctor in hospital or general practive, particularly because they are among the very few diseases in which the usual cardiac therapy with digitalis or else the administration of sympathomimetics is contraindicated.

Atrial Fibrillation↗
PubMed1977

[Longterm results of mitral valve replacement (author's transl)].

210 patients were followed up by the actuary method for over 5 years after isolated mitral valve replacement or a double valve replacement. After isolated valve replacement the one month survival including the operative mortality was 92+/-2%. The survival after one year was 83+/-3% and after 5 years 66+/-7%. The five year survival of patients in preoperative class III (according to the NYHA) was 73+/-8% and of class IV 57+/-8% (P less than or equal to 0.1). A comparison of valve replacements for pure mitral stenosis or mitral insufficiency showed no statistically significant differences. In the 37 patients who had a double valve replacement the survival risk was not increased in comparison with those patients who had had a single valve replacement. Age above 45 years and a preoperative markedly raised pulmonary arteriolar resistance reduced the chances of survival.

Adolescent↗
PubMed1977

[Natural history in patients with mitral- and aorticvalve-disease (author's transl)].

Knowledge and due consideration of the natural history of valvular heart disease are prerequisites for their operative therapy. Presumptive mortality and morbidity of the surgical intervention must be weighted against the expected prognosis under medical treatment alone. The timing of the operation depends on these considerations. Mitral stenosis and the chronic forms of mitral and aortic incompetence have similar natural histories and for both signs and symptoms are good indicators for an eventual progression of the condition. The length of the period during which the patient is free of complaints may be quite variable but a critical change in the natural history comes about once the disease causes signs and symptoms. Surgical repair is indicated when the patient reaches stage III according to the NYHA-classification. The prognosis is worst for aortic stenosis, in particular due to the danger of sudden death. Patients with high pressure gradients are at particularly high risk; this holds even true for those patients which are not yet suffering from any complaints. The prognosis becomes even more serious, when signs such as dyspnea, anginal pain, or syncopal attacks occur. Prognosis and indication for surgical intervention cannot be evaluated reliably by considering only the clinical signs without knowledge of hemodynamic parameters. Acute mitral and aortic incompetence, in paricular when they occur during baterial endocarditis, must be observed very closely because of their most serious prognosis; if necessary, emergency surgery must be carried out in these cases.

Acute Disease↗
PubMed1976

[Indications for selective coronary angiography].

At present, selective coronaro-angiography offers the only means of establishing the seriousness, extent and site of coronary sclerosis. It has led to the development of coronary surgery, itself a considerable advance in the treatment of coronary disease. The method is also of considerable assistance in the differential diagnosis of inexplicable ECG changes and other heart diseases. It is relatively free from risk if performed by experienced staff with suitable equipment and in line with the correct indications.

Angina Pectoris↗
PubMed1976

[Haemodynamic effect of dobutamine in cardiac failure (author's transl)].

Dobutamine, a new catecholamine with a positive inotropic action, was given by infusion to 9 patients with cardiac failure in a dosage of 5 and 7.5 mug/kg-min over a period of 15 minutes. An improvement of left ventricular function was proven by an increase of cardiac output by 33%, a reduction of end-diastolic pressure from 21 to 14 mm Hg, an improvement of left ventricular ejection fraction from 29 to 39% and of the mean circumferential fibre contraction velocity from 0.4 to 0.8 circ/s. The systolic aortic pressure increased by a mean of 14% (5 mug/kg-min) and 23% (7.5 mug/kg-min). However, the resistance of the systemic circulation decreased from 1858 to 1439 and 1444 dyn-s-cm-5. Cardiac frequency remained unchanged with a dosage of 5 mug/kg-min and increased by a mere 7 beats/min with a dosage of 7.5 mug/kg-min. There was no increased tendency for arrhythmia. Dobutamine thus appears to act relatively selectively on myocardial beta-1 receptors. Results so far indicate therapeutic success in patients with severe cardiac failure, particularly in the low-output syndrome.

Adult↗
PubMed1976

[Indications for selective coronary angiography (author's transl)].

At the present time, selective coronary angiography is the only diagnostic possibility for establishing the severity, extent and localization of coronary arteriosclerosis in the living human. It has led to the development of coronary surgery which is a significant acquisition to the treatment of coronary heart disease. In the differential diagnosis of obscure electrocardiographic changes and other clinical cardiological pictures, it is a considerable help. Selective coronary angiography carries relatively little risk if suitable personnel and technical facilities are available and a careful indication for its performance is observed.

Angiography↗
PubMed1976

[Regional contraction of the left ventricle in congestive cardiomyopathy].

Regional analysis of ventricular angiograms obtained at diagnostic cardiac investigation was undertaken in 22 patients with congestive cardiomyopathy and 16 healthy subjects. Applying the concept of radial motion, directed towards the centre of the left ventricle, akinetic zones of 20 to 50% of left ventricle circumference were found in more than half the cases of congestive myopathy. The greater the area of regional abnormal motion, the greater the reduction in haemodynamic variables and left ventricular function. The clinical status of nearly all patients with large akinetic areas deteriorated in the subsequent period of observation (6-48 months, averaging 26 months). But in patients without additional abnormal regional wall motion the clinical condition remained stable. A large akinetic area in congestive myopathy indicates severe reduction in left ventricular function and is an unfavourable prognostic sign.

Adult↗
PubMed1976

[Clinical features and course of congestive cardiomyopathy of unknown aetiology (author's transl)].

Clinical, haemodynamic and angiographic findings in 50 patients with congestive cardiomyopathy were related to subsequent clinical course (mean observation period of 40 months). Ejection fraction and changes in mean pulmonary "wedge" pressure on ergometric exercise proved to be the most reliable criteria for judging left-ventricular function. During the period of observation 11 patients had died, in 15 the clinical state had deteriorated by one or two functional classes, and in 24 there had been no change. Patients with progressing disease differed from those clinically unchanged by having a smaller cardiac index, increased end-diastolic left ventricular pressure, higher pulmonary arterial pressure and smaller ejection fraction. Prognosis was no worse with atrial fibrillation than with sinus rhythm. Four of 13 patients with left bundle branch block died during the observation period and in seven the clinical state had deteriorated by one or two functional classes. The tested variables apparently have a good prognostic value.

Adolescent↗