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K Lindvall

Publications and source records attributed to K Lindvall.

71 records · Page 4Linked to original sources
PubMed1983

Quantification of left ventricular wall dysfunction by M-mode echocardiographic mapping in heart failure following acute myocardial infarction.

Echocardiographic mapping was performed in 44 patients on arrival in hospital and day 2 following acute myocardial infarction (AMI). To evaluate left ventricular (LV) function the per cent deviation of the mean systolic wall velocity (PD-V) from the normal was measured from 16 LV segments. Adequate data were obtained from 89% of the segments. The number of hypokinetic segments was somewhat higher in anterior than inferior AMI, reaching significance (p less than 0.05) on day 2. Dyskinetic segments were also more common in patients with anterior infarction (p less than 0.001), who also had significantly higher enzyme maxima than patients with inferior AMI (p less than 0.01). Enzyme maxima correlated well with the sum of PD-V from all hypokinetic segments on day 1 (r = 0.79, p less than 0.01). Compensatory hyperkinesia was more common in inferior than anterior AMI (p less than 0.001). Global LV function, estimated by subtracting the number of hyper- from hypokinetic segments (score sigma S:Adj), was significantly related to heart failure (Killip classification) (p less than 0.01) and the respiratory rate (r = 0.71, p less than 0.01) in the acute phase as well as to heart failure during the first post AMI month (New York Heart Association classification).

Aged↗
PubMed1983

Ventricular arrhythmias and left ventricular dysfunction in familial cardiomyopathy.

In familial cardiomyopathy (CM), different forms of myocardial abnormalities including asymmetric and symmetric hypertrophy and dilated left ventricles are presented, mostly showing varying hereditary penetrance. This study presents a family with CM including three major clinical manifestations: severe ventricular arrhythmias, repolarization abnormalities and left ventricular hypertrophy. This triad was strikingly consistent in the two generations examined. The familial pattern with an autosomal dominant inheritance did not show any linkage to the HLA region.

Adult↗
PubMed1981

Serial M-mode echocardiography in evaluation of the cardiovascular effects of tiapamil and their relationship to plasma levels in patients with coronary heart disease.

Tiapamil (Ro 11-1781) is a new calcium antagonist. Several investigators have reported about its efficacy against cardiac arrhythmias and angina pectoris. However, there was no study that assessed a possible relationship between hemodynamic effects and plasma concentration. Our study was aimed to investigate any possible relationship between cardiovascular effects of tiapamil and its plasma concentration. We selected 8 coronary; patients (6 males and 2 females) with a mean age of 61.9 yr and a mean weight of 70.9 kg. Tiapamil was administered per os at the dose of 250 mg t.i.d. for 4 consecutive days. Hemodynamic data were obtained by means of echocardiography, ECG and sphygmomanometry. Plasma concentrations of Ro 11-1781 and its major metabolites were measured by means of high pressure liquid chromatography. With tiapamil, the morning systolic BP fell from 130.6 +/- 19.5 (mean +/- SD, pretreatment) to 114.4 +/- 18.2 mm Hg on day 4, the change being clinically and statistically significant (P less than 0.02 by paired t-tests). Diastolic BP and HR remained unchanged. LVEDD and LVESD were not affected to any relevant extent, but VCF was significantly (P less than 0.05) and persistently increased. Tiapamil was well absorbed, but large interindividual variations were observed. As a general rule, no direct relationship between plasma concentrations and hemodynamic effects could be demonstrated. However, the number of patients is too small to allow general conclusions. At the above dose, tiapamil did not elicit any clinically detectable negative inotropic or negative chronotropic effect, probably because of its lowering effect on systolic BP.

Aged↗
PubMed1981

Early exercise tests after uncomplicated acute myocardial infarction before early discharge from hospital.

As part of an early mobilization and early discharge scheme, 76 consecutive low-risk patients were selected from a population of 298 acute myocardial infarction (AMI) patients, to undergo an exercise test. The test was done on the 7th day after an AMI. The patients were 57 men and 19 women of mean age 57 and 68 years, respectively. Twelve patients were unable to complete the test, but no serious complications were observed. Average heart rate during the highest exercise load (50 W) was 106 beats/min. The following risk indices (RI) were considered abnormal and were looked for during or after exercise: 1) heart rate greater than 125 (n = 12), 2) major ventricular arrhythmias (n = 3), 3) angina pectoris (n = 9), 4) ST deviation of more than 1 mm (n = 11). Two RIs were found in 9 patients during the exercise test which led to prolonged hospitalization. One RI was found in 26 patients (34%). Eighty-eight per cent (n = 36) of the patients with normal exercise test had an uneventful recovery during the six-month observation period, in contrast to 35% (n = 9) of patients with heart rate greater than 125 recovered normally, a significantly lower number (p less than 0.05) than among patients with a normal exercise test. Reinfarction occurred in one patient with normal exercise test and in six (23%) of those with one RI (p less than 0.01) and two of those with two RIs (N.S.). We conclude that a submaximal bicycle exercise test seven days after an AMI is a safe and useful selection instrument for early discharge from hospital as well as a useful predicting instrument of future complications.

Adult↗
PubMed1981

M-mode echocardiographic mapping in differentiation of normal from dysfunctioning left ventricular myocardium. A study of patients with severe myocardial infarction and healthy controls.

Seventeen severely ill patients with acute myocardial infarction (AMI) (12 men and 5 women; mean age 65) and 37 healthy persons with similar age and sex distribution were investigated. Regional left ventricular wall motion was studied in terms of mean wall velocity, in 16 segments, 8 basal and 8 apical, by M-mode echocardiographic (Echo) mapping from 6 probe positions. Adequate Echo registrations were obtained from 88% of the total of 864 segments. The best classification (88.5%) of normal and infarcted segments was obtained with a -30% deviation of mean systolic wall velocity (Vmean) values from the mean values of the control segments (CS). Non-infarcted segments (NIS) in the AMI group had significantly lower Vmean values than the CS (p less than 0.001). Subendocardially (SIS) and transmurally (TIS) infarcted segments could be clearly separated from both CS and NIS (p less than 0.001). Per cent deviation of Vmean from the mean value of the control segments (PD-V) for SIS varied considerably overlapping CS, NIS and TIS. With a PD-V between 0 and -30% the probability of NIS is 94%, SIS 6% and TIS less than 1%. A PD-V more than -66% was rarely seen among NIS (2%) but was the normal finding in TIS (94%).

Aged↗
PubMed1981

Mitral annulus calcification, systolic anterior motion of the anterior mitral leaflet and outflow obstruction in two patients without hypertrophic cardiomyopathy. An echocardiographic report.

Systolic anterior motion of the anterior mitral leaflet (SAM) and concomitant left ventricular outflow obstruction (LVOFO) are commonly seen in hypertrophic cardiomyopathy. However, SAM has also been described together with extensive anteroseptal wall infarction, pericardial exudation and in hypovolemic situations. This report presents two patients examined with M-mode echocardiography which demonstrates that SAM with LVOFO can also occur in association with mitral annulus calcification (MAC). A possible mechanism behind this entity would firstly be the anterior displacement of the mitral ring commonly seen in MAC. Secondly, extension of calcifications to the posterior wall will furthermore impair the LV contraction leading to loosely stretched chordae tendineae during systole and hence a motion of the anterior mitral valve along the blood stream (SAM) leading to LVOFO.

Adult↗
PubMed1980

Familial cardiomyopathy--a 15-year follow-up.

In 1961--1962 five families including 53 members with a familial form of cardiomyopathy (CMP) were examined. Fifteen years later a reinvestigation of the previously examined families was carried out using community registers; mortality as well as new family members were registered. Another 50 family members were thereby added. Three out of 6 young subjects who were diagnosed as having definite (2) or suspected (1) CMP at the initial examination died during the follow-up period. Four of the five families, totalling 39/41 members, were given a thorough noninvasive clinical examination including ECG, phonocardiogram exercise test, measurement of systolic time intervals and carotid arterial pulse curves, and echocardiography (Echo). A high number (17/39) of suspected or definite pathologic echocardiographic changes consistent with CMP was observed on reinvestigation. Eleven of these 17 were asymptomatic. Except for Echo, the non-invasive methods used in this study did not contribute to the diagnosis of CMP, but the non-Echo methods confirmed the Echo findings in those patients with symptoms of cardiac disease. The four reexamined families revealed a very heterogenous pattern of CMP, with both symmetric and asymmetric hypertrophy (ratio symmetric/asymmetric = 15 : 2). It may be questioned whether asymptomatic subjects with borderline changes, indicative of symmetric hypertrophy, will develop definite symmetric CMP or whether their symptoms constitute an early stage of asymmetric CMP. Echocardiographic findings may well fit with the theory of a dominant mode of inheritance.

Adolescent↗
PubMed1979

Comparison of Staphylococcus aureus carriage and skin infection rates in hospital and office employees.

The incidence of Staphylococcus aureus in the nose, throat and superficial wound infections of 99 office staff, 129 psychiatry staff and 115 surgical staff was studied over a 4-week period with the purpose of assessing the potential risk to hospital personnel of staphylococcal infection. Incidence rates, both average and cumulative, were essentially similar in the three groups but certain differences in the ecology of the staphylococcal phage groups were observed. Surgical staff appeared to have a more labile pattern of carriage. As in other Scandinavian studies throat carriage rates were high. Staphylococcal carriage seems largely to depend on individual characteristics rather than environmental factors.

Adult↗
PubMed1979

Non-invasive beat-to-beat analysis of stroke volume and digital pulse volume in patients with complete heart block and artificial pacing.

This study presents a beat-to-beat analysis of digital arterial pulse volume (DAPA), left ventricular end-diastolic diameter (LVEDD), and stroke volume (SV) and their correlation to PQ interval in ten patients with complete heart block and artificial cardiac pacing. DAPA was measured by strain-gauge plethysmography and LVEDD/SV by echocardiography. A close relationship was found between SV and DAPA (R = 0.83-0.97) in seven patients, who all drew considerable benefit from atrial contraction as regards SV and DAPA (increase with 35-94%). The optimal PQ interval was calculated to approximately 240 msec for DAPA and 180 msec for LVEDD and SV. It may be concluded that the present study demonstrates a close relationship between beat-to-beat variations of SV measured by echocardiography and plethysmographically recorded digital arterial pulse volume. These variables may be useful in clinical practice for assessing the hemodynamic effect of atrial contribution in patients with various forms of cardiac conduction disturbances. The two methods may, for instance, be useful for screening in order to pick out patients who may benefit from AV synchronous rather than ventricular pacing.

Adult↗
PubMed1979

Early mobilization and discharge of patients with acute myocardial infarction. A prospective study using risk indicators and early exercise tests.

Consecutive patients (n=184) surviving 48 hours in a coronary care unit were divided into one rapidly (RM) (n=55, 30%) and one conventionally mobilized (CM) group (n=129, 70%). The selection of RM patients was based on the absence of five early risk indicators (RI), reflecting electrical and mechanical heart dysfunction. During after-care, five late RIs were evaluated, including a submaximal bicycle exercise test to 50 W, which excluded nine (16%) additional patients from the RM group. After excluding four patients for non-cardiac reasons, the remaining 42 RM patients were rapidly mobilized and discharged after a mean of nine days, in contrast to a mean of 19 days in the CM group, comprising 121 patients. No RM patient dies in hospital and only one patient died during a six-month follow-up, compared to 17 (p less than 0.01) and 28 (p less than 0.01) patients respectively, in the CM group. Both reinfarction and mortality increased with the number of positive RIs. The early exercise test excluded four patients from the RM group. Altogether 22 of 45 patients showed some abnormality during exercise. Half of these 22 patients were readmitted due to cardiac complications during the follow-up period. These findings indicate that it is possible to identify a group of patients with AMI suitable for early discharge, and that an early exercise test in selected good risk patients is safe and identifies a group prone to complications during the early follow-up period.

Aged↗
PubMed1978

Complete heart block due to granulomatous giant cell myocarditis: report of 3 cases.

3 patients with chronic complete AV block were found at autopsy to have granulomatous giant cell myocarditis (GGCM). In 1 patient an unusual clinical course led to more extensive investigation including echocardiography which revealed ventricular septal abnormalities. A review of the literature is presented. Although GGCM is a rare disease echocardiography may be a useful screening procedure in patient with AV block especially in the presence of immunological disorders.

Adult↗
PubMedDate not supplied

Cardiac filling pressures in acute inferior myocardial infarction with and without right ventricular involvement.

Right heart and pulmonary artery pressures were measured in 28 patients with inferior acute myocardial infarction, 12 of whom also had ECG evidence of right ventricular involvement (RVI). Those with RVI had significantly higher mean right-sided filling pressures 9.3 mm Hg, SD +/- 4.5 than those without RVI, 4.3 mm Hg, SD +/- 1.9. A steeper relationship between right ventricular enddiastolic and mean pulmonary artery pressures was seen in patients with RVI in contrast to those without, where no marked rise in right-sided filling pressures with increasing mean pulmonary artery pressures was seen.

Adult↗