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Biomedical subjects

P Bjerle

Publications and source records attributed to P Bjerle.

At least 55 records · Page 3Linked to original sources
PubMed1987

Noninvasive determination of the valvar area in aortic valve disease by Doppler echocardiography and radionuclide angiography.

To assess the severity of outlfow obstruction in patients with aortic valve disease, the aortic valvar area was noninvasively determined in 22 patients with isolated aortic stenosis or combined stenosis and regurgitation. The ejection time (ET), maximal velocity (Vmax), and systolic velocity integral (SVI) of the aortic flow was obtained by continuous wave Doppler ultrasound. Left ventricular stroke volume (SV) was determined by radionuclide angiography, using a counts-based nongeometric technique with individual attenuation correction. Aortic valve area (AVA) was calculated using a modified Gorlin formula; AVA = SV/(71.2 X ET X Vmax), and also by dividing the stroke volume by the systolic velocity integral; AVA = SV/SVI. The two noninvasive determinations correlated closely with the valve areas obtained by invasive measurements; r = 0.95, SEE = +/- 0.13 cm2 by the modified Gorlin formula, and r = 0.94, SEE = +/- 0.14 cm2 by the integration method. The two noninvasive calculations showed almost uniform results; r = 0.98, SEE = +/- 0.09 cm2. In conclusion, aortic valve area can be determined with reasonable accuracy by combining Doppler echocardiography and radionuclide angiography. This noninvasive approach may reduce the need for invasive measurements in patients with suspected aortic valve disease. In addition, radionuclide angiography provides important information about left ventricular function.

Adult↗
PubMed1986

Bladder wall mechanics and micturition before and after subtotal and total hysterectomy.

Twenty-two women were assigned at random to subtotal (n = 11) or total (n = 11) hysterectomy. The frequency of micturition was recorded and urodynamic investigation was performed before, and 6 weeks and 6 months after the operation. After hysterectomy the frequency of diurnal micturition decreased and the urethral conductance increased in all patients. After total hysterectomy an increased bladder volume was found. The two operative methods did not differ with respect to pre- and postoperative changes of urinary frequency or urodynamics. The bladder function was not altered by either operation.

Adult↗
PubMed1985

Prevalence of coronary artery disease in patients with valvular heart disease.

To evaluate the usefulness of preoperatie coronary angiography in patients undergoing preoperative investigation because of valvular heart disease, we performed coronary angiography in a consecutive series of 329 patients. The prevalence of significant coronary artery disease was 32%. Asymptomatic coronary artery disease was present in 13%. Angina pectoris proved to be a poor predictor of coronary artery disease in aortic valve disease. In mitral valve disease, however, the specificity was high. A cost-benefit calculation was carried out in order to assess what advantage routine coronary angiography might have. According to this, coronary angiography should be performed in all patients suffering from valvular heart disease with angina pectoris, whereas it can be omitted in younger patients without angina. A cut-off point of 60 years seems appropriate for aortic valve disease and 65 years for mitral valve disease.

Adult↗
PubMed1984

Cardiopulmonary function in sarcoidosis.

Hemodynamics, angiocardiographic findings and lung function were evaluated in 10 patients with clinically, radiologically and histopathologically established sarcoidosis. All 10 patients had cardiac symptoms and/or abnormal ECG. Right and left heart catheterization, angiocardiography, spirometry and diffusion capacity were performed in all patients. Pulmonary hypertension was present in the two patients with stage III sarcoidosis and in 7 of 8 patients with stages I and II. Right ventricular end-diastolic pressure was elevated in 6 patients. Seven patients had findings compatible with a failing left ventricle with elevated end-diastolic pressure and/or elevated pulmonary capillary wedge pressure. None of the patients had entirely normal hemodynamic findings. Angiocardiography showed a low ejection fraction in 6 patients but no wall asynergy. Right ventricular angiography and coronary angiography were normal in all patients. Findings compatible with failure of the left and right ventricle of the heart was common in our sarcoid patients with cardiac symptoms and/or abnormal ECG. Impairment of the pulmonary function does not seem to be the only reason for the hemodynamic findings, thus indicating the possibility of myocardial sarcoidosis.

Angiocardiography↗
PubMed1984

Disturbances of cardiac rhythm and conduction in familial amyloidosis with polyneuropathy.

Sixteen consecutive patients with familial amyloidosis with polyneuropathy of varying duration and severity underwent 24 hour ambulatory electrocardiographic monitoring. A high incidence of sinus node dysfunction, supraventricular and ventricular arrhythmias, and disturbances of atrioventricular conduction was found. Considerably more arrhythmias and disturbances of conduction were detected by long term electrocardiographic monitoring than by conventional 12 lead electrocardiograms. During a follow up period of three to 14 months five patients needed treatment by a pacemaker, three of them because of symptomatic complete heart block, one because of second degree heart block with heart failure, and one because of symptomatic dysfunction of the sinus node. The tachyarrhythmias did not require specific treatment. Long term electrocardiographic monitoring is a useful adjunct in the evaluation of patients with familial amyloidosis with polyneuropathy as it may detect otherwise unrecognised symptomatic disturbances of heart rhythm. The results may be valid also for other forms of amyloidosis involving the heart.

Adult↗
PubMed1984

Non-invasive assessment of the presence and severity of cardiac amyloidosis. A study in familial amyloidosis with polyneuropathy by cross sectional echocardiography and technetium-99m pyrophosphate scintigraphy.

Twelve patients with familial amyloidosis with polyneuropathy were examined both by cross sectional echocardiography and by technetium-99m pyrophosphate scintigraphy to assess involvement of the heart non-invasively. All 12 patients had echocardiographic abnormalities. The most prominent findings were highly refractile myocardial echoes, thickened heart valves, and increased thickness of the heart walls. Four patients had abnormal myocardial uptake of technetium-99m pyrophosphate. The remaining eight had equivocal or no myocardial uptake and were considered to have normal scintigrams. A certain amount of amyloid is probably required to produce an abnormal scintigram, although lesions with less amyloid can evidently be identified by echocardiography. Neither the duration of polyneuropathy nor its severity showed any relation to the echocardiographic or scintigraphic findings. It is concluded that cross sectional echocardiography is superior to technetium-99m pyrophosphate scintigraphy in detecting cardiac involvement in familial amyloidosis with polyneuropathy and that these results may also be applicable to other forms of amyloidosis.

Adult↗
PubMed1983

ECG abnormalities in patients with sarcoidosis.

The frequency and type of some abnormal ECG findings in 86 consecutive patients with intrathoracic sarcoidosis were studied and compared with 86 age- and sex-matched healthy controls. All ECGs from the patients and controls were mixed and evaluated blindly by one of the investigators. Ectopic beats were seen in 6 patients in the sarcoidosis group and in 3 individuals in the control group. Patients with stage III sarcoidosis had more conduction defects compared with stage I and II patients and with the controls. Repolarization disturbances were found in 17 patients and 6 controls. These disturbances were more common in patients with stage I and II than in those with stage III sarcoidosis. The total number of patients with some ECG abnormality was 27 compared to 12 controls.

Adult↗
PubMed1982

Cor triatriatum.

Explore the source record for details and available documents.

Adult↗
PubMed1982

Hemodynamic and angiocardiographic observations in familial amyloidosis with polyneuropahy.

Eleven patients with familial amyloidosis with polyneuropathy were studied by heart catheterization; eight of them also by right and left ventriculography and selective coronary angiography. Signs of congestive heart failure, often reported as typical of cardiac amyloidosis, were found in only one patient. The systolic function was relatively unimpaired, but in several patients hemodynamic data suggested restrictive cardiomyopathy. Six patients showed signs of right or left ventricular outflow tract obstruction. Thus, no uniform hemodynamic pattern could be identified, but the changes found indicate impaired diastolic function.

Aged↗
PubMed1982

Renal function in familial amyloidosis with polyneuropathy.

The renal function is assumed to be normal in most patients with familial amyloidosis with polyneuropathy (FAP) type 1. In the present study of 24 patients with FAP type 1, estimation of the urinary concentrating capacity and 51Cr-EDTA clearance demonstrated that the glomerular clearance and the concentrating capacity were imparied in most patients. The concentrating capacity was significantly correlated with the clearance values. Urine electrophoresis indicated a glomerular cause for the proteinuria. It is suggested that the renal dysfunction should be attributed to deposition of amyloid substance in the glomeruli.

Adolescent↗
PubMed1977

Fluid turnover in renal cysts.

Cystic puncture was performed percutaneously in 18 patients with solitary renal cysts and in 22 with multiple, congenital renal cysts. With the aid of tritiated water it was possible to estimate the fluid turnover in the cysts and compare it with their volume, pressure and potassium and creatinine levels. Fluid turnover was rapid in all the renal cysts. Two to five hours after i.v. injection of tritium, the tritium concentration in cystic fluid averaged 88% of the concentration in plasma fluid in patients with polycystic kidneys and 73 percent in patients with solitary cysts. Fluid turnover was more rapid in small than in large cysts, but there was no such difference between cysts with high and low pressure. It is possible that the fluid turnover was slightly faster in cysts with high potassium and creatinine levels than in those with low levels. The results show that the fluid turnover in a renal cyst of 10 ml is considerable--probably more than 100 ml/24 hours. This indicates that fluid inflow to the cyst comes mainly from cells in the cyst wall and not from a single glomerule. Fluid probably leaves the cyst actively via cells in the cyst wall, since the fluid turnover does not increase with high cyst pressure. The fluid turnover is probably secondary to the active solute transportation, which is performed by the cyst cells. This means that these cells have a tubular cell-like function and should respond to pharmacotherapy.

Adult↗
PubMed1976

Peripheral circulation, particularly heat regulation reactions, in patients with amyloidosis and polyneuropathy.

As patients with amyloidosis and polyneuropathy often have signs and symptoms of circulatory disturbances in the extremities, especially the legs, we have examined such patients and controls with oscillometry and digital pulse plethysmography in order to estimate the occurrence of any arterial circulatory insufficiency. No signs of significant obliterative arterial changes were found. Skin temperature was also determined in fingers and toes during body-cooling and at subsequent indirect heating. At low environmental temperature the skin temperature was higher in patients than in controls. In a few patients there was almost no decrease in skin temperature, despite a long period of cooling and a low rectal temperature. Indirect heating elicited a marked increase in the skin temperature of the toes and fingers of the controls. In most patients this reaction was completely absent in the toes and absent or reduced in the fingers. These deviations can be explained by nerve damage caused by amyloid deposition in the nerves. Amyloid deposits in the wall of small blood vessels may be an additional factor. Maximum blood flow in the anterior tibial muscle after combined ischemia and exercise, investigated with radioactive xenon, was reduced in half of the patients.

Adult↗