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Biomedical subjects

R Erbel

Publications and source records attributed to R Erbel.

At least 613 records · Page 34Linked to original sources
PubMed1981

[Congenital left-sided pericardial defects (author's transl)].

Left-sided pericardial defects appear to be more common than is generally thought. Five such patients have been seen in the last two years. The typical findings on x-ray, CT and cardiac ultrasound are described. Proof of the condition is the increased mobility of the left cardiac contour and of its dorsal margin as shown by left and right decubitus films, by films of the supine patient taken with a horizontal beam, fluoroscopy in inspiration and expiration and computer tomography of the heart in left and right decubitus position. Recognition of the anomaly is of importance, since it may spare the patient surgical treatment.

Adult↗
PubMed1981

Detection of left atrial thrombi by echocardiography.

A group of 111 patients with mitral valve disease was studied by M-mode and two-dimensional echocardiography. Five left atrial thrombi were demonstrated, two of which had probably been the source of previous embolic events. Two-dimensional echocardiography was superior to M-mode in providing spatial orientation. Using multiple cross-sections the exact localisation and the size of the thrombus formation could be estimated. Thrombus localisations at the upper, lateral, and septal atrial walls, normally inaccessible to the single-beam technique, were successfully imaged. Even two-dimensional echocardiography, however, constitutes an imperfect method. By comparison with the findings at surgery only one-third of confirmed thrombi could be detected non-invasively. According to their localisation seven clots in the appendage were missed by the ultrasound method. One further thrombus fixed to the upper left atrial wall near the entrance of the upper pulmonary veins was also undetected by echocardiography. Despite these limitations, the information provided by echocardiography can be most helpful in patient management. M-mode, in combination with two-dimensional echocardiography, is therefore recommended in all patients with mitral stenosis before diagnostic or therapeutic procedures are undertaken.

Adult↗
PubMed1981

Two-dimensional echocardiographic diagnosis of papillary muscle rupture.

A 69-year-old man developed a rupture of the papillary muscle on the fifth day of acute posterior myocardial infarction. The two-dimensional echocardiographic features of ruptured papillary muscle included (1) mobile mass of echos attached to normal chordae tendineae in the left ventricle, (2) absent tip of papillary muscle, and (3) mitral valve prolapse. Noninvasive, two-dimensional echocardiography can reveal correct diagnosis of ruptured papillary muscle suspected clinically.

Acute Disease↗
PubMed1980

Left ventricular volume and ejection fraction determination by cross-sectional echocardiography in patients with coronary artery disease: a prospective study.

In a prospective study the accuracy of cross-sectional echocardiography for determination of left ventricular (LV) volume and ejection fraction (EF) was analyzed in 53 patients with coronary artery disease and compared to that of cineangiocardiography (angio). From the apex of the heart phased-array wide-angle (84 degrees) electronic echocardiograms were received in the RAO-equivalent view. Angios were obtained in a 30 degree RAO view. Using Simpson's rule, end-diastolic (EDV) and end-systolic (ESV) LV volumes were calculated and the EF derived. Left ventricular long axis was transected in eight segments, yielding seven diameters. In 50 of the 53 patients cross-sectional echocardiograms could be recorded. The correlation between cineangiocardiography and cross-sectional echocardiography for EDV was highly significant: r = 0.936, y = 0.667x + 27.1, standard error of estimate (syx) +/- 22.2 ml; for ESV: r = 0.970, y = 0.699x + 14.7, syx +/- 14.5 ml; for stroke volume: r = 0.721, y = 0.503x + 11.3, syx +/- 15.3 ml; for EF: r = 0.909, y = 0.740x + 11.3, syx +/- 6.0%. Angio mean long axis was 10.2 +/- 1.2 cm, cross-sectional echocardiographic long axis 8.7 +/- 1.3 cm. Mean LV diameter determined by cineangiocardiography was longer than when determined by cross-sectional echocardiography. The mean difference reached 2.0 cm in the middle of the LV. Our prospective comparative study revealed that LV volumes and EF were underestimated by cross-sectional echocardiography compared to cineangiocardiography because of a methodological systematic error caused by a tangential cut of the heart. In the RAO-equivalent view the "true" long axis was missed. The high corrleation coefficients, however, indicate that the "true" LV volume and EF can be calculated from the given regression equation. Serial measurements should be legitimated.

Angiocardiography↗
PubMed1980

[The diagnostic value of echocardiography in coronary artery disease--1. M-mode echocardiogrpahy (author's transl)].

The hallmarks of coronary artery disease are wall motion abnormalities. If the disturbances of wall motion are located in the septum and the posterior wall near the basis of the heart, they can be detected by M-mode echocardiography. Isolated asynergies of the left ventricle in the anterior wall and the apex of the heart are missed. The amplitude, the change in wall thickness during contraction, and the velocity of wall motion can be analysed for quantitative evaluation of regional function. Only pathological findings can be used for diagnostic purposes. Stress-tests increase the sensitivity of the method. Left ventricular volume determinations are not possible in patients with coronary artery disease by M-mode echocardiography because of methodical problems. Only left ventricular dimensions and fractional shortening should be measured. An altered closure of the mitral valve reflects a significant increase in left ventricular filling pressure.

Cardiac Volume↗
PubMed1979

Efficacy of propranolol versus placebo in long-term treatment in patients with mitral valve prolapse.

In 60 patients with mitral valve prolapse syndrome a randomized controlled interindividual double-blind study of propranolol (p) was performed. Patients received p 80 mg (A), 160 mg (B) and placebo (C) orally for 4 weeks. Prior to and after treatment, heart rate (HR) and blood pressure (RR) as well as systolic time intervals (STI) were measured and corrected for heart rate--electromechanical systole (QS2I), left ventricular ejection time (LVETI), and preejection period (PEPI). The ratio PEP/LVET was calculated. Plasma levels were measured by an optimized fluorimetric method. 1. STI lay in the upper part of the normal range, indicating that some patients had a hyperkinetic cardiac function. 2. P had no influence on QS2I and LVETI in A and B. PEPI was prolonged (A: +13.2 ms, B: +14.2 ms) and PEP/LVET was increased (A: +0.040, B: +0.050). 3. As indicated by the changes in HR, RR, PEPI, and PEP/LVET p showed in B compared to A only minor additional effects. 4. Plasma levels of p were in B three times higher than in A (A: 89.2 +/- 10.0 nmol/l B: 246.7 +/- 30.5 nmol/l). With a dose of 80 mg propranolol a point close to the plateau of maximum efficacy was reached, where a higher dose resulted only in small additional negative inotropic effects.

Clinical Trials as Topic↗