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Biomedical subjects

H Trenckmann

Publications and source records attributed to H Trenckmann.

At least 37 records · Page 2Linked to original sources
PubMed1982

[Treatment of ventricular arrhythmias with mexiletine].

The development of new antiarrhythmic drugs allows to a certain extent the performance of a differential therapy and prophylaxis. This also concerns the lidocaine-like substance mexiletine, which according to Vaughan-Williams is to be classified into class I B of the antiarrhythmic drugs with direct membrane effect. It is effective in disturbances of the ventricular rhythm also in oral therapy, which in most cases are more life-endangering than the supraventricular ones. In own examination in 21 of 26 patients a complete or far-reaching suppression of accumulated extrasystoles and particularly of ventricular tachycardias could be achieved by an oral long-term therapy with 600--800 mg mexiletine. In the acute experiment short-term infusions were not effective in patients with ventricular tachycardias, since apparently no sufficient plasma level was obtained, wherefore also a following permanent drop infusion is recommended. The rate of side-effects was insignificant and in no case led to a withdrawal of the therapy.

Administration, Oral↗
PubMed1981

[Course and prognosis of pregnancy, delivery and childbirth in patients with congenital heart defects].

On the conditions of an optimal therapy and with reference to certain contraindications the prognosis of patients with congenital heart diseases and their children scarcely differs from that of the normal population during gestation. The rate of decompensation in pregnancy was 4.1%, with 3.9% the rate of gestosis was significantly below that of the other patients. The perinatal mortality of the children of patients with congenital vitium cordis os 2.23%, the rate of newborn of 11.2% and the proportion of hypotrophic children of 8.38% were also not increased compared with the totality. By changed diagnostic and therapeutic conditions the relation of the congenital to the acquired vitia cordis has much altered in favour of the congenital ones. With a high proportion of women who underwent an operation of the heart among our patients the results shows that, apart from the already generally accepted absolute contraindications for a pregnancy, the prognosis for patients with stenoses of the outlet is clearly worse than that of the patients with other congenital heart diseases.

Female↗
PubMed1981

[Evolution and prognosis of the adult Eisenmenger syndrome].

From the patients of the Cardiologic Department of the Medical Clinic of Leipzig University 34 adult patients aged 21 to 62 years with the diagnosis of Eisenmenger's syndrome confirmed by heart catheterization were established. The cases in question were 20 ventricular septum defects, 8 atrial septum defects and 6 open arterial ducts. In 26 of the 34 patients first symptoms appeared already during the preschool period, in 4 patients with atrial septum defect in the 12th year as well as between the 35th and 46th year of age, in 4 patients with ventricular septum defect twice in the 8th or 26th and 50th year of age, respectively. The average time of diagnostics from the beginning of the complaints to the heart catheterization was with 15 years and 3 months very long. The average survival time after diagnosis of shunt reversal by means of the heart catheter was 9.7 years in the ventricular septum defect, 5.6 years in the atrial septum defect and 3.8 years in the open arterial ducts. Since 19 of the 34 patients with Eisenmenger's syndrome are still alive and the moment of the shunt reversal does not correspond to the moment of the diagnostics, the average life expectancy is greater. It is higher than the values given in literature, which vary between 2 and 10 years after the beginning of the shunt reversal. The progressing of the clinical picture could be objectified by annual increases of various parameters, such as hemoglobin, hematocrit, angle alpha QRS, Sokolov's index for right hypertrophy and radiologically established sizes of surface and diameter of the heart and the pulmonary vessels. Correlations of abrupt enlargements and acute diseases were found only for the prominence of the pulmonary segment and the basal diameter of the heart. The examinations showed that in the course of Eisenmenger's syndrome the pulmonary hypertension, the polyglobulia, the right heart hypertrophy, the size of the heart and last not least the complaints increase continuously or in dependence of complications (heart insufficiency, carditis, pneumonia, embolism a.o.).

Adolescent↗
PubMed1981

[Possibilities of electrotherapy in tachycardial rhythm disorders].

The pacemaker therapy of tachycardiac disturbances of rhythm used a great number of different methods which are applied according to the kind of disturbance of rhythm. A specialised intracardiac diagnostics is frequently necessary in order to select the suitable stimulation technique. A short survey of the different technical stimulation methods is given which are known from literature and for which own experiences are present. In the perspective a high value is ascribed to the pacemaker therapy in tachycardias.

Cardiac Pacing, Artificial↗
PubMed1980

[Myocardial scintigraphy using technetium-99m-diphosphate in combination with selective coronary perfusion scintigraphy and coronary angiography].

The findings of the scintigraphy of the myocardium with Technetium-99m-diphosphonate (Tc-99m-DP) of 45 patients with nearly exclusively ischaemic heart disease were compared with those of the selective coronary angiography and those of the selective coronary perfusion scintigraphy. 12 patients exhibited an enlargement of the activity in the myocardium (positive scintigramme). These cases were particularly described in this paper. The levocardiogramme proved disturbances of the motility of the walls in 6 patients. In 5 patients a positive scintigramme of the myocardium was registered. Therefore, the scintigraphy of the myocardium with Tc-99m-DP is regarded as a supplementing, non-invasive method for the diagnosis of more pronounced disturbances of the motility of the heart wall. Furthermore, positive scintigrammes of the myocardium were registered in angina pectoris, condition after aorto-coronary bypass-operation, cardiomyopathy and myocarditis. Since the scintigraphy of the myocardium with Tc-99m-DP is a sensitive method for the poor of cell lesions of the myocardium, it allows a judgment of the floridity of the myocardial process. From this among other results that the scintigraphy of the myocardium may be a help for the indication to the aorto-coronary bypass operation. Clear relations between the scintigraphy of the myocardium, the number of the coronary-sclerotically changed heart vessels and the development of stenosation are not to be established. An immediate connection between the size of the disturbance of the perfusion and the results of the scintigraphy of the myocardium is also not to be recognized.

Adult↗
PubMed1980

[Current therapeutic principles as well as new therapeutic aspects of idiopathic hypertrophic subaortic stenosis. II. Chemotherapeutic and direct surgical therapy].

The severity of the functional obstruction of the outflow tract of an idiopathic hypertrophic subaortic stenosis is essentially determined by the contractility of the myocardium, the left-ventricular volume and the peripheral vascular resistance. Though in the acute experiment a clear reduction of the degree of stenosis by beta-receptor-blockers may be proved the long-term results of such a therapy are unsatisfactory, particularly in patients with obstruction in rest. The use of calcium antagonists seems to promise more favourable results. The progression of the disease is, however, scarcely influencible by pharmacological measures alone. Nitrobodies are not suitable for treatment and glycosides should be used only within a manifest insufficiency of the left heart. An effective reduction or removal of the ventriculo-ventricular pressure gradient as well as a decrease of the left-ventricular telediastolic pressure may be achieved on operative way. There is an indication to this, when the complaints increase despite medicamentous therapy. At present the transaortic myotomy under use of the heart-lung-machine is regarded as most favourable method. A simultaneous or only substitute of the mitral valve should be restricted only to those cases which, apart from the functional, still show an organically conditioned insufficiency of the mitral valve. The early and late results of the palliative surgical interventions are very favourable in experienced centres. However, secure long-term prognoses may not yet be derived from this.

Adrenergic beta-Antagonists↗
PubMed1980

[Current therapeutic principles as well as new therapeutic aspects of idiopathic hypertrophic subaortic stenosis. II. Pathophysiology, natural course and diagnosis].

Idiopathic hypertrophic subaortic stenosis is a noncompensatory hypertrophy of the myocardium which above all concerns the ventricular septum in its upper part near to the basis. The etiology is not yet sufficiently clarified, though a genetic component is regarded as ascertained on account of the proved familial accumulations. Haemodynamically the morphologic changes effect a systolic obstruction of the left-ventricular outflow, an insufficiency of the mitral valve and an aggravated diastolic filling of the left ventricle. Further pathophysiological symptoms of the functional subaortic stenosis are an extremely rapid ejection of blood in the early, not obstructive phase of the systole as well as a pathological forward movement of the mitral valve beginning in the midst of the systole. The disease has a bad prognosis. To be sure, the natural course is usually characterized only by a slow progression of the complaints, however, particularly in adolescents frequently sudden cases of death appear by disturbances of the cardiac rhythm or a relative coronary insufficiency. The disease which is already frequently to be diagnosed according to anamnesis, auscultation, ECG and form of the pulse curve may be ascertained using the ultrasound echocardiography as well as heart catheterization including angiography. Apart from a direct measurement of the ventriculo-ventricular pressure gradient during wuch examinations the size of the functional obstruction may further be characterized by certain pharmaca or physical methods which influence the volume of the ventricle or the afterload.

Angiocardiography↗
PubMed1979

[Abnormal myocardial blood flow distribution with a normal coronarogram in angina pectoris and after myocardial infarction].

It is reported on the selective coronary perfusion scintigraphy in 47 patients with angina pectoris and condition after myocardial infarction, which was performed simultaneously with the coronary angiography. For the paper were interesting the cases with normal coronarogram, but pathological perfusion scintigram. 3 of 25 patients with condition of infarction showed coronarographically inconspicuous vessels. In all cases the perfusion scintigram shows disturbances of regional perfusion, which corresponded with the electrocardiographic localisation of the infarction. In 3 of 22 patients with angina pectoris with normal coronarogram in the scintigram regional changes of the terminal vascular system were established. In 2 cases simultaneously a disturbance of rhythm and stimulus conduction was present, which showed a conspicuous correlation to the perfusion lesions in the septum. In the small intramural vessels haemodynamically effective changes take place which are below the coronarogram. Therefore, the only coronarography is not enough to confirm or to refuse a genuine angina pectoris or an infarction. The selecitve coronary perfusion scintigraphy gives the possibility to prove disturbances of the distribution of regional blood supply without a greater additional load of the patient as to coronary angiography. However, it cannot give evidence on the genesis of disturbances in the terminal vascular system in the normal coronarogram

Adult↗
PubMed1979

[Programmed stimulation for the analysis of arrhythmias].

On the basis of the examination of a left bundle-branch heart block depending on frequency, of a paroxysmal tachycardia in functional conduction dissociation in the atrioventricular node and a WPW-syndrome of type A is shown that and how by means of programmed stimulation of the right atrium in order to establish the times of conduction and the refractory periods of all conduction sections of the conduction system of the heart also under influence of medicaments the diagnostic repertoire is enriched for the analysis of disturbances of the rhythm without comprehensively or finally estimating the clinical valency of the method.

Adult↗
PubMed1979

[Clinico-diagnostic criteria for the evaluation of social aspects in acquired heart valve diseases].

In spite of the retrogression of the acute rheumatic fever the acquired valvular defects still play an essential role for the morbidity and mortality above all for the younger and middle decenniums of life. In the preliminary diagnostics it is the task of the family doctor to diagnose the valvular defect, to differentiate it from non-organic findings and to estimate its degree of severity. The diagnosis of a carditis renders special difficulties, particularly in its chronic recurrent form. Certain situations of life do not demand only an actual analysis of the findings, but also an individual prognostic estimation. For the choice of profession, the ability for military service and driving a car general references and regularities must be taken into consideration. The indication to operation of the valvular defect is generally given in degree of severity and with restriction also in stage IV. A mitral stenosis is operated already in stage II, when stronger complaints and haemodynamic changes are present. Patients with degree of severity III and IV should avoid a pregnancy, in stage I and II under common control by the internist and obstetrician the pregnant patient may not have any scruples to carry to full term.

Abortion, Therapeutic↗
PubMed1978

[A programmed universal stimulator for the diagnosis and therapy of bradycardial and tachycardial arrhythmias].

Special kinds of electrostimulation, particularly the so-called programmed stimulation, are necessary for the specialised diagnostics of disturbances of nervous impulses of the heart and of the conduction system with intracardiac ECG (His-electrocardiography). A pacemaker using constituents of microelectronics is described which apart from fixed frequent, coupled, P/R-linked, bifocal and higher frequent atrial stimulation makes possible a programmed stimulation according to a preelected programme. Apart from the use for diagnostics the stimulator is suited for the therapy of bradycardic disturbances of the rhythm and for the termination of tachycardias.

Bradycardia↗
PubMed1978

[Foundations and indications for selective coronary perfusion scintigraphy].

By means of coronarography in the most favourable case only the morphology and function of the vessels up to a diameter of 0.1 mm may be established. By the selective coronary perfusion scintigraphy this gap is closed, for it allows a judgment also of the terminal vascular system of the myocardium. The basis of this method is an occlusion of the arterioles and capillaries by radioactively labelled microspheres, in which case, however, only every 10,000th to 20,000th vessel is embolized for a short time. Thus the proper selective perfusion scintigraphy is for the patient a procedure which is not stressing, which, however, demands a sounding of the coronary vessels. On the basis of our own previous results this investigation method is indicated in the diagnostics of the ischaemic heart disease also in its atypical form, in the indication to the vascularisation operation with aortocoronary bypass and its postoperative control as well as in the cardiomyopathies. Also in load examinations and in pharmacological tests by their use as double nuclide method an enlarged information can be got. The importance of the perfusion scintigraphy is among others shown in patients with normal coronarogramme, but with perfusion disturbances which can be proved by means of this method. The most comprehensive invasive diagnostics in the diseases mentioned is at present achieved by the combination of coronarography, ventriculography and selective perfusion scintigraphy.

Cardiomyopathies↗