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Biomedical subjects

J Barmeyer

Publications and source records attributed to J Barmeyer.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Systemic fibrinolysis following resuscitation or temporary electrostimulation].

Short-term systemic thrombolytic treatment with 1.5 million I.U. streptokinase or 1.8 million I.U. urokinase or APSAC was carried out in 13 patients with acute myocardial infarction (11 men, 2 women, mean age 61 [44-73] years) after cardiopulmonary resuscitation (n = 11) or transvenous electrostimulation (n = 2). In seven of the patients the infarct vessel was found to be patent after the course of thrombolytic therapy. No haemorrhagic complications occurred. Two patients died: one of a reinfarct at 3 months and the other suddenly at home at 6 months. These results show that short-term high dosage systemic thrombolytic treatment can be successfully performed in individual cases even after resuscitation or central venous catheterization, provided that any serious traumatic lesions or inadvertent arterial punctures have been avoided.

Aged↗
PubMed1990

[Effect of AV synchronization and rate increase on hemodynamics and on atrial natriuretic peptide in patients with total AV block].

We studied nine patients (56 +/- 7 years) with complete AV-block and permanent dual-chamber pacemaker (DDD) under different pacing modes: ventricle pacing (VVI) 70 bpm, DDD 106 +/- 4 bpm, rate adaptive pacing (VVI-FA) 108 +/- 3 bpm. Exercise was performed supine on the bicycle ergometer at 50 watts for 5 min at each setting. DDD-paced patients showed significantly higher mixed venous oxygen saturation, being 45 +/- 2% after the fourth minute, (VVI 38 +/- 2%, p less than 0.01 and VVI-FA paced patients 40 +/- 1%, p less than 0.01). Pressures were normal under DDD pacing during exercise (RAP 7 +/- 2 mm Hg; PCP 14 +/- 3 mm Hg) and showed further increase to abnormal levels during VVI (RAP 13 +/- 2 mm Hg, p less than 0.01; PCP 21 +/- 3 mm Hg, p less than 0.02) and VVI-FA pacing (RAP 10 +/- 2 mm Hg, p less than 0.05; PCP 20 +/- 3 mm Hg, p less than 0.01). Stroke volume increased from 71 +/- 5 ml to 105 +/- 7 ml during VVI and from 64 +/- 7 ml to 81 +/- 7 ml during DDD pacing. Stroke volume remained unchanged (69 +/- 5 ml) during VVI-FA pacing. The peak levels of ANP during and after exercise were significantly higher under VVI (951 +/- 248 pg/ml) than under DDD pacing (650 +/- 140 pg/ml, p less than 0.01) and were not different between DDD and VVI-FA pacing (677 +/- 97 pg/ml). These results show that VVI pacing effects a more pronounced increase of ANP level than other pacing modes. Under moderate exercise, rate-responsive pacing compared to VVI pacing showed no differences in mixed venous oxygen saturation and in atrial pressures. Only DDD pacing showed higher oxygen saturation and a normalization of atrial pressures when compared to other types of single chamber pacing.

Atrial Natriuretic Factor↗
PubMed1990

[Prognosis in cor pulmonale: predictive value of two-dimensional echocardiography].

Cor pulmonale is a common complication and frequent cause of death in COLD. No published records are as yet available on the prognostic ranking of two-dimensional echo-cardiography in this group of patients. In 79 of 85 (93%) consecutively echocardiographically examined COLD patients it was possible to effect apical imaging of the four-chamber view to assess the size of the right ventricle, as well as a subcostal imaging to analyse the respiratory performance of the vena cava inferior (vci). Among the exclusion criteria of this prospective series were a diseased condition of the left heart or other associated cardiac diseases. The patients were classified into two risk groups (RG 0 and RG 1) depending upon whether they had a normal-sized right ventricle or a complete inspiratory collapse of the vci, or not. In RG 1 the pO2 values were lower (56.8 +/- 9.2 vs 66.0 +/- 8.8 mmHg, p less than 0.0005) whereas the values for the respiratory passage resistance were higher (8.01 +/- 3.92 vs 6.22 +/- 2.87 cm H2O/l/s; p less than 0.025) than with RG 0, the values for the intrathoracic gas volume not being significantly different from each other. Fatal cardiopulmonary results were covered over a period of 2-48 months (median 24 months) to perform life table analyses according to Breslow and Mantel. Patients with an enlarged right ventricle or incomplete respiratory collapse of the vci have a lower survival rate (43.7% respectively 61.9%) than patients with a normal-size right ventricle or complete respiratory collapse of the vci (90.5% respectively 88%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

The atrial pacemaker: retrospective analysis of complications and life expectancy in patients with sinus node dysfunction.

The safety of atrial pacemakers is still a remaining cause of controversy. Since 1972, we have implanted 111 atrial pacemakers and we were able to follow-up 100 patients continuously. Mean follow-up time was 47 +/- 36 months (maximum 154 months) with a total population time of 391 patient years. Over a period of 10 years, the cumulative incidence of complete atrioventricular block was 4% (2 patients). The cumulative incidence of atrial fibrillation was 11% (5 patients). Lead-related complications were strongly dependent on the type of the lead and the mode of fixation. The cumulative incidence of all lead-related problems was 19% over a period of 5 years and 33% over a period of 10 years. The cumulative survival rate was 85% for 5 years and 61% for 10 years. These survival rates were not different from the survival rate of a matched cohort of the normal population. We conclude that atrial pacing could be done in patients with sick sinus syndrome. The risk of developing a complete atrioventricular block seems to be rather low. The main problem of the atrial pacemaker is the fixation of the lead which could be reduced by using screw-in-type leads.

Adult↗
PubMed1987

[Risk of contrast medium reactions in cardiac diagnosis. Pretreatment with glucocorticoids and antihistaminics in known cases of intolerance to contrast media].

Among 4178 patients who between 1980 and 1986 had undergone left-heart catheterization with left-heart injections and coronary angiography there were 76 (1.8%) with previous reactions to contrast media. These latter patients were given, three days before the planned investigation, 6 alpha-methylprednisolone, 24 mg daily by mouth, and phenhydramine hydrogenmaleinate, 150 mg daily, and two hours before the investigation 80 mg 6 alpha-methylprednisolone hemisuccinate intravenously. The effect of this prophylactic regimen was tested prospectively. Diatrizoate 76% was the contrast medium used. Of 4102 patients without known contrast-medium intolerance 137 (3.34%) had a reaction, 27 of them (0.66%) severe enough to require treatment. Among the 76 patients with known previous reactions, nine (11.8%) had reactions, one very severe requiring treatment, the others mild. The described pre-injection regimen thus allows indicated left-heart contrast-medium injection to be undertaken at a justifiable risk.

Cardiac Catheterization↗
PubMed1987

[The atrial pacemaker as therapy in sinus node disease: retrospective analysis of complications and rate of survival].

The implantation of an atrial pacing device represents an established mode of therapy for bradycardia in sinus node dysfunction. However, controversial views remain concerning the safety of this type of pacing. To investigate this, we retrospectively analysed data from 81 patients, all of whom received an AAI pacing device between 1972 and 1984. Complete AV-block developed in two out of 81 patients (cumulative incidence after 10 years was 5 +/- 3%). Atrial fibrillation developed in three out of 81 patients (cumulative incidence after 10 years was 10 +/- 5%). Lead-related complications were strongly related to the type of lead tip and the mode of fixation. The overall incidence of lead-related problems was 20 +/- 5% after 5 years and 38 +/- 12% after 10 years. 82 +/- 6% of patients survived the first 5 years, 52 +/- 14% survived for 10 years. The 5 years' survival rate was not different from that of the normal population. From this we conclude that atrial pacing can be safely done with an AAI system as long as there are no signs of an AV-block. Atrial fibrillation develops less often on AAI pacing than on VVI pacing. The risk of developing an AV-block seems rather low.

Aged↗
PubMed1986

[Ventricular arrhythmias in cor pulmonale. The effect of oxygen treatment].

Long-term ECG monitoring was carried out on 36 patients with chronic obstructive airway disease and cor pulmonale. Ventricular extrasystoles were detectable in all patients with greater than 30/h occurring in 13. Multifocal ventricular extrasystoles were seen in 29 patients, couplets in 16, runs in 6 and early (R-on-T) extrasystoles in 8 patients. When the ventricular extrasystoles exceeded 30 per hour the average oxygen partial pressure (paO2), determined in capillary blood, was 59.5 mm Hg, whereas it was higher, 66.4 mm Hg (P less than 0.0125), when there were less than or equal to 30/h. Oxygen (2 l/min) was administered to 13 patients between 20.00 h and 08.00 h and then room-air the following night via a nasal tube. After the administration of oxygen mean paO2 was 72.3 mm Hg and after breathing room-air 62.6 mm Hg (P less than 0.01). During the administration of oxygen, extrasystoles appeared less frequently than after breathing room-air (927 vs 1211; P less than 0.05). These results show that ventricular extrasystoles appear more often with decreasing paO2 and that oxygen therapy can reduce their frequency.

Aged↗
PubMed1981

[Experience with 208 "screw-in" type pacemaker leads with particular reference to atrial positioning (author's transl)].

In 190 patients, 208 "screw-in" type pacemaker leads were implanted; 147 in the right ventricle and 61 in the right atrium. There was no significant difference in the time required for atrial (54.7 +/- 19 min) or ventricular fixation (56.0 +/- 25 min). Similarly, fluoroscopy times for both atrial (6.3 +/- 4 min) and ventricular positioning (8.1 +/- 6 min) were equivalent. In the subsequent follow-up period ranging from one to 23 months, only one dislocation of a "screw-in" type atrial lead was seen, and that in a patient with "twiddler syndrome". Otherwise, in patients in whom the lead was securely implanted, no evidence of dislocation has been observed. In one patient "under-sensing" developed subsequent to repositioning for exit-block. In this patient population, the use of "screw-in" type electrodes, in particular through facilitation of atrial positioning, has substantially lessened the rate of pacemaker complications.

Electrocardiography↗
PubMed1980

Postmortem angiographic and pathologic-anatomic findings in coronary heart disease: a comparative study using planimetry.

Comparisons of the results of angiographic and pathologic-anatomic estimations of the degree of coronary artery stenosis are rare and the findings contradictory. In the present study, postmortem examinations were carried out on 26 hearts with coronary artery disease. Quantitative planimetric measurements of 203 coronary artery cross-sections were performed and compared with the results of postmortem coronary angiograms. Using a score rating scale, a highly significant difference (P < 0.001) between the angiographic and morphologic findings was detected, with the degree of stenosis and underestimated angiographically in 96 of the 203 sections (47%), overestimated in 18 (9%), and correctly estimated in 89 (44%). The tendency to underestimation was equal in all of the coronary arteries (left anterior descending, circumflex, and right coronary arteries); there were no statistically significant differences (P < 0.20, P < 0.30, P < 0.10). The frequency of angiographic underestimation of the degree of morphologic stenosis--especially in critical stenoses of more than 60%)--has important implications in the assessment of whether coronary artery surgery is warranted.

Coronary Angiography↗
PubMed1978

[Myocardial infarction "with angiographically normal coronary arteries (author's transl)].

Within a cohort of 121 patients with clinical picture and electrocardiographic pattern of myocardial infarction four cases (3%) had normal coronary arteried demonstrated by selective coronary angiography. Two patients revealed no risk factors, two patients were heavy cigarette smokers. Mean age of patients was 34 years. Exact analysis of clinical, hemodynamic and angiographis data confirmed assumption of regional myoaggressive myocarditis as the underlying disease in one patient and suggested regional myocarditis with high probability in another case. The two other patients however could not be classified as having coronary or primary myocardial disease. The investigation suggests that some cases with the clinical and electrocardiographic pattern of "myocardial infarction" with normal coronary arteries may be due to regional myoagressive myocarditis.

Adult↗
PubMed1977

[Heart size and left ventricular function in coronary artery disease: I. Heart size, exercise tolerance, cardiac output and filling pressures (author's transl)].

The possible relationship between the cardiac volume, as determined radiologically in the supine position in 119 patients with angiographically proven coronary artery disease, and the results of ergometry and balloon catheterization was investigated. There was no relationship between the heart size on the one side and the maximum exercise tolerance and the maximum cardiac output on the other, except for the fact, that these parameters tended to decrease with increasing heart size. This was especially true in patients with angina. The maximum cardiac output of patients with angina was always below the value of patients without angina but comparable heart size. Reduced cardiac output under exercise (exertional cardiac insufficiency) was present in 50% of patients with enlarged hearts but already in 22% of patients with heart volumes in the lower range of normal. The diastolic pulmonary artery pressure, determined under exercise, was the only parameter with a significant relationship to the heart size: The larger the heart size, the higher the diastolic pulmonary artery pressure. On the other hand: the diastolic pulmonary artery pressure at rest was abnormal with significant frequency only, when the heart was enlarged. Our data suggest, that the hemodynamics are determined by 2 factors: Myocardial scarring secondary to infarction and coronary insufficiency (ischemia). Of these two factors only the former influences cardiac size. Therefore, determination of the heart volume helps evaluating the respective role of these two factors in individual cases.

Adult↗