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Biomedical subjects

R Erbel

Publications and source records attributed to R Erbel.

At least 559 records · Page 31Linked to original sources
PubMed1985

[Normal values for two-dimensional echocardiography].

In 51 normal subjects (26 men, 25 women, age range 15-38 years), normal values for longitudinal axis and diameters of left and right ventricle and left and right atrium were determined by 2-D echocardiography. Both left parasternal longitudinal and cross-sectional cuts were used. Tolerance values to determine normal range were recorded, in addition to mean values and standard deviations. Diastolic and systolic diameters (DD/DS) in the left parasternal longitudinal and cross-sectional cuts gave similar results to those in the 4-chamber view from the apex: DD 2.7 +/- 0.4 (2.3-3.1) cm/m2, DS 1.8 +/- 0.4 (1.4-2.2) cm/m2, and DD 2.7 +/- 0.4 (2.3-3.1) cm/m2, DS 1.7 +/- 0.3 (1.4-2.0) cm/m2, respectively. Sizes of the right ventricle (1.8 +/- 0.4/1.4-2.2 cm/m2) and right atrium (2.4 +/- 0.5/1.9-2.9 cm/m2) could only be obtained in the 4-chamber view. Values for the left atrium (2.3 +/- 0.7/1.6-3.0 cm/m2) were obtained also in the left parasternal cross-section. Correcting for body surface, differences between males and females were reduced to the extent that there was no significant difference between them. These normal values make it possible to standardize the measurement of intracardiac dimensions by 2-D echocardiography and classify individual values.

Adolescent↗
PubMed1985

Combined medical and mechanical recanalization in acute myocardial infarction.

A technique of combined medical and mechanical recanalization was employed in 96 patients with acute transmural myocardial infarction. The mean time between onset of symptoms and admission to hospital was 170 +/- 65 min (X +/- SD). After 10 +/- 16 min, 250,000 U streptokinase was administered intravenously for 20 min. Intracoronary thrombolysis was commenced within 38 +/- 14 min. First coronary angiograms demonstrated reperfusion, an open vessel in 25/96 patients (26%). In 15/71 patients (21%) reperfusion occurred during thrombolysis therapy, before mechanical recanalization could be performed. Recanalization was achieved mechanically in 37/71 patients (52%) with occluded coronary vessels. In 8/71 patients (11%) mechanical recanalization failed but the vessel opened during thrombolysis. In 12/96 patients (12%), the coronary vessel remained occluded. Thus, reperfusion could be achieved in 88% of the patients. Reperfusion rate was 76% in the first 38 patients and 95% subsequently. After reperfusion, coronary thrombi were found in 25/96 patients (26%) but dissolved during thrombolysis in 16/25 patients (64%). Peripheral coronary embolism was observed in 3/25 patients (12%). For the whole group, reocclusion occurred in 8/84 patients (10%). By combined medical and mechanical recanalization, the recanalization rate could be increased with low reocclusion rate. Trends showed an improvement in regional and global left ventricular function in patients with anterior myocardial infarction.

Aged↗
PubMed1985

Hemichorea associated with varicella-zoster reinfection and endocarditis. A case report.

A 20-year-old woman developed transient right-sided hemichoreatic movements after household exposure to varicella-zoster. Some days before the appearance of involuntary movements a vesicular rash had occurred. About 6 months later an elevated IgG serum titer against varicella virus was found and two-dimensional echocardiography showed signs of an endocarditis. During the following 2 months the IgG value returned to within the normal range and the choreatic movements disappeared almost totally. The possibility is discussed that endocarditis had been caused and maintained by serum antibodies to varicella-zoster virus which cross-reacted with valvular tissue. Embolization to the region of the left striatum and/or postinfectious encephalitis in this region are assumed to be the most plausible causes of the transient hemichorea.

Adult↗
PubMed1985

Sequential intervention procedures after intracoronary thrombolysis; balloon dilatation, bypass surgery, and medical treatment.

After successful intracoronary thrombolysis of an acute myocardial infarction in 145 patients subsequent intervention procedures were evaluated. In 48 of 62 patients (43%), percutaneous transluminal coronary angioplasty was performed successfully (success rate 77%), 41 patients (28%) were operated on and 56 patients (39%) were treated only medically. During the hospital phase in the angioplasty group, 4 reinfarctions were noted and 3 repeat angioplasties were required, while 41 of the 48 successfully treated patients (85.4%) remained clinically stable. In the surgical group, one cardiac failure occurred, while 40 patients (97.6%) were without cardiac event. In the medical group, 5 patients died (8.9%), 8 patients (14.3%) had a reinfarction, and 76.8% were clinically stable. During the follow-up period in the surgical group of 6 months 37 patients (90.2%) were clinically stable, all in functional classes I and II. In the angioplasty group 33 patients were stable (68.8%), and in the medical group 26 patients were stable (46.6%). In the whole group of 145 patients the hospital mortality together with that in the 6 months follow-up period was 9.7% with a reinfarction rate of 22.8%.

Adrenergic beta-Antagonists↗
PubMed1985

Sensitivity of cross-sectional echocardiography in detection of impaired global and regional left ventricular function: prospective study.

In order to establish the sensitivity and specificity of cross-sectional echocardiography for detection of global and regional left ventricular function a prospective study was performed in 80 patients suspected of having coronary artery disease. Twenty four hours before heart catheterization, cross-sectional echocardiograms were recorded in the apical RAO-equivalent view and high quality echocardiograms were obtained in 71/80 patients (89%). M-mode echocardiograms of the left ventricle could be performed in 56/71 patients (79%). Based on normal values sensitivity and specificity of cross-sectional echocardiography were calculated in comparison to cineventriculography. For fractional shortening (normal value greater than 25%) sensitivity measured 46% and specificity 93%, and when the E-point septal separation was measured (normal value less than 7 mm), sensitivity increased to 73% and specificity was 84%. For detection of increased end-diastolic volume (less than 155 ml) sensitivity reached 84% and specificity 98% and for increased end-systolic (less than 70 ml) volume it was 86 and 97%, respectively. A depressed left ventricular ejection fraction (greater than 49%) was found with a sensitivity of 93% and specificity of 100%. Regional left ventricular wall motion, analyzed by an area method, revealed for anterior wall motion a sensitivity of 68% and a specificity of 94%, whereas for posterior wall motion sensitivity reached 80% and specificity 96%. Regression equation between the number of pathological segments and left ventricular ejection fraction for cineventriculography was given by Y = -4.06 X + 73.4, r = 0.93 and for cross-sectional echocardiography by Y = -3.69 X + 62.6, r = 0.85. We conclude that cross-sectional echocardiography can be used as a screening method to detect impaired left ventricular function. It is superior to M-mode echocardiography. Reduced regional function of the posterior wall can be found with high sensitivity, but depressed motion of the anterior wall may be overlooked.

Adult↗
PubMed1985

[Quantitative cardiac computed tomography].

The scope and limitations of quantitative cardiac CT have been evaluated in a series of experimental and clinical studies. The left ventricular muscle mass was estimated by computed tomography in 19 dogs (using volumetric methods, measurements in two axes and planes and reference volume). There was good correlation with anatomical findings. The end-diastolic volume of the left ventricle was estimated in 22 patients with cardiomyopathies; using angiography as a reference, CT led to systematic under-estimation. It is also shown that ECG-triggered magnetic resonance tomography results in improved visualisation and may be expected to improve measurements of cardiac morphology.

Animals↗
PubMed1985

[Computed tomography, magnetic resonance tomography and echocardiography in hypertrophic cardiomyopathy].

The value of echo-cardiography, CT and magnetic resonance tomography was evaluated in 10 patients with hypertrophic cardiomyopathy. Echocardiography made the diagnosis in most cases. The diagnostic criteria depended on functional and morphological changes. CT and magnetic resonance can show thickening in the myocardium, either symmetrical or asymmetrical. Magnetic resonance tomography provides excellent demonstration of the myocardium and accurate delineation of the degree of hypertrophy. It is well suited for measuring cardiac wall thickness.

Adolescent↗
PubMed1985

[Improved occlusion tolerance time by continuous coronary perfusion with a modified Grüntzig coronary angioplasty catheter].

We evaluated the modified Grüntzig coronary angioplasty catheter, which allows for continuous antegrade coronary perfusion during balloon occlusion without the use of an external pump. During in vitro tests the flow rates for effective pressure differences between aorta and distal coronary vessel in the range between 25 and 100 mm Hg were determined. During in vivo tests in 10 dogs the effect of balloon occlusion with continuous perfusion (OM) was compared with conventional occlusion without perfusion (OC). The occlusion tolerance time (OTZ) as determined by the appearance of unequivocal signs of ischemia in the ECG, was 486 +/- 77 s for OM versus 256 +/- 82 s for OC with a relative, individual increase of 191 +/- 54% (p less than 0.01, data are given +/- SEM). Observed ST-elevation was less with OM than with OC (0.22 +/- 0.05 versus 0.33 +/- 0.06, p less than 0.05). Occlusion related pressure difference between aorta and occluded coronary vessel was less with OM than with OC (31 +/- 8 mm Hg versus 40 +/- 10 mm Hg, p = 0.05). In selected cases such a prolongation of the intracoronary balloon occlusion time may represent a distinct advantage.

Angioplasty, Balloon↗
PubMed1985

Percutaneous transluminal coronary angioplasty (PTCA) following thrombolysis.

After successful intracoronary and intravenous thrombolysis in acute myocardial infarction in about 90% of all cases highgrade organic stenoses of the diseased vessels can be found. These obstructions may impede coronary blood flow and be the reason for recurrent angina in the rehabilitation phase. In a prospective, controlled, randomized study with 127 patients (pts) with acute myocardial infarction 64 pts were treated with streptokinase (group I) and 63 pts were treated with streptokinase and additional PTCA procedures (group II). The patients of both groups did not differ with respect to age, distribution of sex and diseased vessels, time between onset of symptoms and start of lysis or time to maximum of CPK-curve. In group I 59 out of 64 pts had recanalized vessels (92%), in group II 56 out of 63 pts (89%). In 55/56 pts PTCA was attempted (success rate 65%) with an artificial reocclusion in two pts (4%). After four weeks in group I 47 pts were controlled angiographically. The stenosis rate did not differ between the acute phase and the control study (78.6 +/- 11.8% vs. 78.0 +/- 15.2%). Five reocclusions had occurred. In group II the resting stenosis after thrombolysis (81.7 +/- 6.6%) was diminished by PTCA to 33.0 +/- 18.2%. In the control study the remaining stenosis was 31.9 +/- 24.4%. The difference between groups I and II at the four week control was highly significant (p less than 0.001). In group I there were ten deaths during the hospital phase, nine of them of cardiac origin. In group II nine pts died, three from shock lung and five from cardiac causes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

[Detection of aneurysms of the atrial septum using transesophageal echocardiography].

In 7/340 patients (2.1%) examined by transesophageal echocardiography, aneurysms of the intraatrial septum were observed. In no patient were additional shunts present. In 3/7 patients mitral valve and in 2/7 patients tricuspidal valve prolapse was found. Intraatrial septum aneurysms seem to have a higher frequency than that indicated by transthoracical echocardiography. The incidence observed by transesophageal echocardiography corresponds to the incidence of pathological findings.

Adolescent↗
PubMed1985

[Brain abscess in a bidirectional atrial septal defect in adulthood].

An abscess of the brain is a serious complication in patients with congenital heart malformation. The great majority of cases are limited to cyanotic congenital heart disease and a peak in the age distribution can be seen in childhood. We report on a 40-year-old man with progressive right hemiparesis due to an abscess in the left basal ganglia. Clinical aspects and additional diagnostic assessment are described. By cardiologic examination including transoesophageal cross-sectional echocardiography a bidirectional sinus-venosus defect could be detected. This finding supported the diagnosis of a so-called 'paradoxical' brain abscess.

Adult↗
PubMed1984

Effects of heart rate changes on left ventricular volume and ejection fraction: a 2-dimensional echocardiographic study.

The influence of heart rate on left ventricular (LV) volumes and ejection fraction (EF) using 2-dimensional (2-D) echocardiography during atrial pacing was analyzed. The study was performed in 13 normal control subjects, 23 patients with coronary heart disease and 8 patients with dilated cardiomyopathy. An electronic sector scanner (2.25 MHz, 84 degrees) was used. Under constant scanning of the left ventricle, heart rate was increased, in steps of 20 beats/min, from 80 to 140 beats/min. The 2-D echocardiograms were stored on videotape and analyzed off-line. The end-diastolic and end-systolic volumes (EDV and ESV) were determined using a disc method. Stroke volume (SV) and EF were calculated. Constant LV scanning was possible during atrial stimulation, as shown by the analysis of simultaneously recorded 2-D echocardiograms and cineventriculograms at different heart rates, revealing a constant position of the echocardiographic transducer. Simultaneous recordings of cineventriculography and 2-D echocardiography at 80 and 120 beats/min showed that despite differences in absolute values, percent changes of LV volumes and EF determined with both methods were similar. Thus, changes of LV function can be analyzed by 2-D echocardiography. In normal control subjects, an increase in heart rate of 10 beats/min reduced EDV by 4 ml, ESV by 2 ml, SV by 2 ml and EF by 1%, corresponding to percent reductions of 4, 2, 5 and -2%, respectively. In contrast, the absolute decreases in the patients were 6 ml, 1 ml, 5 ml and 2% and the percent changes 2%, 1%, 8% and 5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Intracoronary thrombolysis with an acylated streptokinase-plasminogen activator (BRL 26921) in patients with acute myocardial infarction.

The fibrinolytic efficacy and systemic effects on coagulation variables of intracoronary administration of an acylated streptokinase-plasminogen complex (BRL 26921) were assessed in 23 patients with an acute transmural myocardial infarction. The infarct vessel was totally occluded in 22 patients and subtotally stenosed in 1 patient. Reperfusion was achieved in a total of 17 patients (74%), in 2 patients with the use of a guide wire. Reperfusion time in those patients treated with BRL 26921 alone amounted to 42 +/- 37 minutes. Reocclusion occurred in two patients subsequently. Four patients died; in two of these, intracoronary thrombolysis was unsuccessful. Reptilase time increased from 13 +/- 3 to 49 +/- 31 seconds (p less than 0.001), fibrinogen levels decreased from 280 +/- 65 to 126 +/- 76 mg% (p less than 0.001). Factor V decreased from 96 +/- 11 to 53 +/- 26% (p less than 0.001), and factor VIII from 99 +/- 1 to 55 +/- 36% (p less than 0.001). Peripheral hyperplasminemia, defined as a reduction of fibrinogen (less than 100 mg%) with a reduction of factor V and VIII (less than 75%) simultaneously occurred in eight patients. Six (75%) of these 8 patients demonstrated reperfusion, whereas 9 (64%) of 14 patients without peripheral hyperplasminemia were also successfully reperfused. Bleeding complications occurred in two patients who demonstrated hyperplasminemia. Thus, effective intracoronary thrombolysis could be achieved with only minor effects on peripheral coagulation variables in the majority of patients.

Aged↗