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Biomedical subjects

J Slany

Publications and source records attributed to J Slany.

At least 127 records · Page 7Linked to original sources
PubMed1976

[Influence of spirolactone on the myocardial potassium balance following strophanthin in man (author's transl)].

In order to examine the question, whether improved digitalis tolerance by Spirolactone may be partially a result of antagonism on myocardial potassium balance, 6 patients without clinical signs of heart failure were given 400 mg, 3 were given 200 or 300 mg Spirolactone orally daily and 6 patients received placebo during a 5 to 7 days period. During cardiac catheterization hemodynamics and serum potassium concentrations were determined repeatedly prior to and following intravenous administration of 0,375 to 0,625 mg Strophanthin. Injection of Strophanthin resulted in a significant drop in left ventricular enddiastolic pressure and a rise in dp/dt max. In the control group a significant increase in arterial and coronary sinus potassium concentration was observed. Myocardial potassium balance was definitely negative from the third to the eighth minute. Values in the group receiving Spirolactone did not differ significantly from the placebo group. It is suggested that therapeutic doses of Strophanthin resllt in a loss of potassium from the myocardium by inhibition of the Na+, K+ membrane ATPase not influenced by pretreatment with Spirolactone.

Arrhythmias, Cardiac↗
PubMed1976

[Myocardial bridge - cause of cardiac phase-dependent coronary stenosis (author's transl)].

A 41 year-old man presented with anginal pain and a positive exercise electrocardiogram. Hemodynamic and angiographic evaluation disclosed mild hypertrophic obstructive cardiomyopathy and a conic stenosis of the proximal left anterior descending artery confined to the systolic phase of the heart action. The degree of constriction of the coronary artery was no longer evident. Pathophysiologic consequences suggest that surgical dissection of muscle bridges should be considered in symptomatic patients with severe coronary obstruction.

Adult↗
PubMed1976

[Evaluation of heart function in chronic coronary disease non-invasive methods].

In 58 patients with a clinical diagnosis of ischemic heart disease the value of Ecg, phonocardiogram, systolic time intervals and derived indices, apex-cardiogram (Acg), and kinetocardiogram (Kcg) in assessment of cardiac function was examined. In 52 patients coronary artery lesions were demonstrated on selective coronary angiograms, in 40 patients dyssynergy was seen on ventriculograms, and in 14 patients a left vencribular aneurysm was diagnosed. Ecg criteria indicated a normal ejection fraction with a sensitivity of 80% and a specificity of 84%, an ejection fraction less than or equal to 30% with a sensitivity of 72% and a specificity of 77%, a localized dyssynergy with a sensitivity and a specificity of 83% respectively, and a ventricular aneurysm with a sensitivity of 86% and a specifity of 92%. In respect to the latter diagnosis Q-wave criteria proved superior to ST- and T-alterations. An atrial gallop bore nor relationship to the parameters of cardiac function. A protodiastolic gallop proved to be a relative specific but insensitive sign of poor ventricular function. In the majority of cases the corrected injection time was diminished in respect to normal values; a moderate correlation was to be calculated between its shortening and the ejection fraction (r = -0.50). The quotient ejection time divided by preejection period allowed the estimation of an ejection fraction below 30% in 64% of cases without false positive results. There was a close correlation between this quotient and the ejection in the pathologic range below 50% (r = -0.69), whereas no correlation was to be found in the normal range of EF. An Acg could be obtained only in 72% of the patients. A moderate correlation was established to the left ventricular enddiastolic pressure (r = 0.42). The diagnostic score was poor in respect to ventricular aneurysms, which could be recognized in 43%, but were falsely assumed in 40%. Kcg records yielded relatively specific but insensitive indications of a normal fraction (specificity 84%, sensitivity 32%) and of an elevated left ventricular enddiastolic pressure (sensitivity 54%, specificity 80%). Large non-contractile ventricular segments and ventricular aneurysms were recognized with a sensitivity of 72% each and a specificity of 62% and 52% respectively. Multiple regression analysis between various non-invasive methods and hemodynamic data resulted in a closer correlation, but nontheless no exact prediction of the "true" values was possible in the single case. It is concluded that the accuracy of the parameters of the non-invasive methods under study in assessing left ventricular performance in coronary heart disease is worse than generally accepted giving reliable information only in patients with very poor and with excellent cardiac function.

Adult↗
PubMed1975

[Idiopathic, muscular, hypertrophic, sub-aortic stenosis].

The authors have seen 14 cases of idiopathic, hypertrophic, subaortic stenosis and they describe the pathology, the clinical and radiological diagnosis and the differential diagnosis of this condition. Their own findings are compared with those in the literature and substantial agreement is found. Some uncharacteristic clinical and radiological findings are associated with typical pressure curves in the left ventricle and marked abnormalities in the laevocardiogram. Variations in ventricular filling due to the difference in severity of the disease are discussed. The importance of a correct diagnosis is stressed, since the use of inotropic substance is this condition is contra-indicated.

Adolescent↗
PubMed1975

[Does obesity have an effect on heart function?].

Cardiac performance was studied in 14 obese but otherwise healthy young subjects during rest and submaximal ergometric exercise by means of Swan Ganz catheters. Cardiac output and stroke volume determined by the thermal dilution method were normal or slightly increased during rest rising on exercise in the usual range. However, mean pulmonary artery and pulmonary wedge pressures were increased above normal values in 50% of the patients during exercise indicating depressed left ventricular function. Patients with normal and abnormal hemodynamic response to exercise could not be separated by clinical findings. Repetition of studies in 11 patients following therapeutic starvation of 2-3 weeks duration revealed a statistically significant fall of pressures in the right atrium, the pulmonary artery and in the pulmonary wedge position during rest and exercise. In the majority of patients a moderate reduction in cardiac output and stroke volume suggested a decrease in preload due to loss of intravascular volume, but in a few instances with unaltered or increased cardiac output improvement of cardiac function had to be considered.

Adult↗