Search PubMed⌕ Search

Biomedical subjects

J Takkunen

Publications and source records attributed to J Takkunen.

At least 37 records · Page 2Linked to original sources
PubMed1980

Cardiovascular responses to static and dynamic effort three weeks after myocardial infarction.

Left ventricular responses to dynamic and static exercises were compared in 20 patients three weeks after myocardial infarction. Radiocardiography was used to determine the ventricular volumes at rest and during hand grip and bicycle exercise tests. The dynamic exercise increased cardiac output (p less than 0.001), and the end-diastolic volume of the left ventricle increased (p less than 0.005) from the resting value while the ejection fraction decreased (p less than 0.005). Static hand grip exertion did not increase cardiac output or the end-diastolic volume. Decrease of the stroke volume and the ejection fraction (p less than 0.001 both) again reflected pump dysfunction during the afterload stress. Our data revealed that patients with recent myocardial infarction had a range of ventricular responses to dynamic exercise. Poor response in the ejection fraction was noted in anterior infarction and in those patients using digoxin and/or diuretics after infarction. During static exercise, on the other hand, impairment of cardiac performance was constant, irrespective of the site of infarction. Reduction of the ejection fraction was greater during static exercise in the patients receiving digoxin and/or diuretics than in those not taking these drugs.

Adult↗
PubMed1979

Effect of aortic valve replacement on the left ventricle. A ciné-angiographic evaluation.

Heart catheterization and quantitative left ventricular ciné-angiography data on thirty patients with aortic vlave disease were analyzed pre-operatively and 12 months after insertion of a Björk-Shiley tilting disc valve. The pre-operative and postoperative data were compared and also with a control group of 22 patients with no organic heart disease. According to the functional NYHA classification, 14 patients had improved, 14 were unchanged and 2 had deteriorated. Regurgitation had been totally corrected in 27 patients, and the high or moderate pressure gradient between the left ventricle and aorta had been reduced, but the valve itself caused a gradient of 5 to 35 mmHg. The pre-operatively abnormal pump function, hypertrophy, dilatation and impaired myocardial function had all become markedly more normal. The most obvious changes were an improvement in stroke work relative to end-diastolic volume and myocardial mass (p less than 0.001) and reductions in end-diastolic volume (p less than 0.001), pump power (p less than 0.001) and myocardial mass (p less than 0.001). Aortic valve replacement seems to be an appropriate procedure in cases where the left ventricular performance and haemodynamics are sufficiently disturbed.

Adult↗
PubMed1979

Postpericardiotomy syndrome diagnosed by echocardiography.

In order to evaluate the present incidence of post-pericardiotomy syndrome (PPS) and the reliability of conventional diagnostic methods in its detection, 194 consecutive patients were studied by echocardiography one month after cardiac surgery and thereafter every third month up to one year, and also during hospitalization if symptoms or signs of PPS appeared. PPS was diagnosed on the basis of pericardial effusion demonstrated by echocardiography and was found in 15 patients (8%) 7-142 days (mean 44 days) after operation. Four of these patients (27%) were without symptoms. In 7 patients (47%) there were no diagnostic signs on the electrocardiogram and the chest X-ray and in 6 of those patients the pericardial friction rub was missing. Hence in 40% of the patients echocardiography was the only way to make correct diagnosis. In the investigation of a patient with chest pain and/or fever after cardiac surgery, echocardiography seems very useful since the conventional electrocardiogram and the chest X-ray are often unreliable because of the changes caused by the cardiac surgery per se.

Adolescent↗
PubMed1979

Left ventricular response to dynamic and static exercise: evaluation by radiocardiography in healthy men.

The effects of dynamic and static exercise on left ventricular haemodynamics were compared in 13 healthy male volunteers using single detector radiocardiography. Static hand grip effort was performed for four minutes at 30% of the maximum contraction. During dynamic exercise the subjects bicycled on an ergometer to 85% of the predicted heart rate for their age. Static exercise increased the heart rate, systolic and diastolic blood pressure and cardiac output (p less than 0.001 for all), but there were no significant changes in the stroke volume, left ventricular end-diastolic volume or ejection fraction from the resting values. Dynamic exercise in a supine position clearly increased the heart rate, systolic blood pressure and cardiac output (p less than 0.001 for all) to a greater extent than the hand grip, together with a significant augmentation of the stroke volume (p less than 0.001) and the ejection fraction (p less than 0.01). The dynamic exercise produced only an insignificant increase in left ventricular end-diastolic volume. Thus, the normal left ventricular volume response to the increase in preload during dynamic exercise was a significant augmentation of stroke volume and ejection fraction. On the other hand, the static exercise in the same subjects mainly increased the left ventricular afterload while the left ventricular volume changes remained minimal.

Adult↗
PubMed1978

Ergospirometry and coronary arteriography in young patients with angina pectoris or atypical chest pain.

A bicycle ergospirometric test was performed on 57 women and 26 men of age 40 or less in combination with coronary arteriography for angina pectoris or chest pain atypical for ischaemia severe enough to affect their working capacity. Nine men and 14 women had angina pectoris with coronary artery narrowings of 50% or more (Group I) and 5 men and 22 women had angina pectoris without obvious coronary artery narrowings (Group II). This means an incidence for coronary changes of 64% for men and 38% for women for angina pectoris. Group III consisted of 12 men and 21 women with a chest pain atypical for ischaemia and without coronary artery narrowings. Minor changes were found on angiographic examination in some patients. Four men and 11 women could not do the ergospirometry adequately. The patients with coronary artery narrowings had a lower maximal oxygen consumption than the others, even though only the mean values for the women showed a statistically significant difference. They also had lower maximal heart rates and their total work and maximum load were lower. The highest proportion of ST segment depressions of 0.5 mm or more was also found in the same patients. The pressure rate product did not show any clear difference with regard to the patient groups or the ST segment changes. As a purely diagnostic tool ergospirometry does not give more information about possible ischaemia in cases of chest pain than a routine upright bicycle test, but for following up patients with angina pectoris and evaluating treatment it gives valuable data about working capacity.

Adult↗
PubMed1977

Angina pectoris in young patients: clinical appraisal and evaluation by exercise, atrial pacing, and myocardial lactate metabolism.

Young patients with a symptom complex of angina pectoris constitute a problematic group in medicine. Many of them require a detailed investigation. By combining electrophysiologic and metabolic measurements with dynamic clinical experiments, one can distinguish with great probability between normal and pathological findings. Exercise ECG, atrial pacing and simultaneous sampling of blood from artery and coronary sinus were undertaken in 57 patients aged 40 or less. Although the patients were selected according to a history of effort angina, results were normal in four and in seven other only one test was pathological. The sensitivity was highest in atrial pacing (78%) and somewhat lower in exercise ECG (75%) and lactate extraction (67%). The specificity of the tests in series was about 53%. Concordant results made a diagnosis of ischemic heart disease highly probable. Discrepancies and probably false negative results in individual cases are evident. The need for angiographic evaluation of coronary arteries and left ventricular function is clear. The stepwise advance from the usual physical examination to more demanding investigations provides a possibility of classifying the patients according to the needs of an accurate medical appraisal.

Adult↗
PubMed1977

Echocardiography in assessment of mitral valve disease II. Left atrium and left ventricle.

79 patients studied by cardiac catheterization were also studied by echocardiography to evaluate the reliability and usefulness of echocardiography in making left atrial and ventricular measurements in patients with mitral valve disease. The left atrium was larger than normal in all the patients and especially in those with mitral regurgitation. There was a significant correlation between the mean pulmonary capillary wedge pressure and the left atrial diameter in the patients with a stenotic component, and the left atrial diameter seems to correlate better than the cineangiographic left atrial size with the atrial pressure as the anterior-posterior atrial dilatation is more pressure dependent. In atrial fibrillation the left atrial diameter was greater than in the patients with sinus rhythm, but there was a great overlap in atrial diameters between these patient groups. In 37% of the patients with a mitral regurgitation component a systolic bulge caused by a regurgitant jet was found in the posterior left atrial wall, the appearance and magnitude of which depended more on the properties of the atrial wall and the direction of the regurgitant jet than on the amount of regurgitation. The results concerning left ventricular size and function agreed well with the previous cineangiographic studies. There was good correlation between the cineangiographically and echocardiographically measured left ventricular volumes and ejection fractions, but left atrial dilatation made the correlation less close.

Adult↗
PubMed1977

Surgical treatment of cardiac myxoma. A case report.

A patient with a left atrial myxoma operated on successfully three years ago is reported. The symptomatology and diagnosis of the tumour and surgical considerations are briefly discussed, and the necessity of a long follow-up period is stressed.

Female↗
PubMed1977

Intraoperative determination of the aortic valve area (Gorlin) by flowmetry.

The aortic area (Torlin) for diseased stenotic aortic valves was calculated in 10 patients using two different methods; data obtained in preoperative cardiac catheterization and by intraoperative flowmetric and aortic and left ventricular pressure-recording measurements, and their mutual correlation was tested. The correlation between the aortic valve areas obtained by these methods was very good (r = 0.992), confirming the valve and reliability of the intraoperative flowmetric and pressure recording measurements in clinical work.

Aortic Valve↗
PubMed1977

Echocardiography after mitral valve replacement and criteria of paraprosthetic regurgitation.

19 patients with Björk-Shiley mitral tilting disc valve prostheses were studied by echocardiography before the valve replacement operation and postoperatively every three months up to one year. In 14 patients with normal prosthetic function the left atrial diameter decreased markedly after operation (p less than 0.001), but echocardiographic dimensional indices of left ventricular performance remained unchanged. Paradoxical or markedly hypokinetic motion of the interventricular septum was observed within 3 months of operation in 46% of the patients, but in only 28% in studies performed 9 - 12 months after the replacement. The ampliture of the disc was on average 11 +/- 2 mm. In 5 patients with paraprosthetic regurgitation the left atrial diameter increased with the development of regurgitation and decreased again after successful reoperation. In these patients the left ventricular end diastolic and stroke volumes were great (p less than o.01) than in patients with normal prostheses. The septal motion was in the normal direction in all these 5 patients and the septal amplitudes were greater (p less than 0.01) than in the patients with normal prostheses. The amplitudes of the disc were normal, but abnormal anterior movement of the disc at the beginning of the diastole was observed. These data demonstrate that echocardiography is useful in the diagnosis of paraprosthetic mitral valve regurgitation.

Adult↗
PubMed1976

Four years' experience of valve replacement with the Björk-Shiley tilting-disc prosthesis.

105 valve replacements with the Björk-Shiley tilting-disc prosthesis have been performed in 99 patients with an overall mortality of 12%. The hospital mortality for 73 single aortic valve replacements was 10%, for 24 single mitral valve replacements 13%, and for 5 double valve operations 20%. One late death (1%) occurred in a case with single aortic valve replacement. The follow-up period of the first patients with aortic valve replacement is 4 1/2 years, and that of those with mitral valve replacement over 2 1/2 years. The most common late complication in patients with mitral valve replacement was a paravalvular leak (19%), whereas in patients with aortic valve replacement slight haemolytic anaemia (4%) and late thromboembolism (3%) occurred most frequently. 84 of the 87 survivors showed manifest clinical improvement in their preoperative status and increased exercise tolerance.

Adolescent↗
PubMed1975

Aortic valve replacement with the Björk-Shiley tilting disc valve prosthesis. Clinical experiences in 50 cases.

Single aortic valve replacement with the Björk-Shiley tilting disc valve prosthesis has been performed in 50 patients since April 1971. None of the total of six deaths (12.0%) was attributable to malfunction of the prosthesis or to embolic complications. Follow-up examination showed insignificant or moderate prosthetic regurgitation in two patients and moderate paravalvular leakage in one patient. A slight intravascular haemolysis was found in two cases, one of them without marked regurgitation, and a slight reversible cerebral thrombo-embolism in two. Clinical improvement was observed in 43 of the 44 survivors during the 6 to 12 months of follow-up. Objective evidence of improvement was verified by cardiac catheterization following the replacement of aortic valve with the Björk-Shiley tilting disc prosthesis.

Adolescent↗