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Biomedical subjects

R Jenni

Publications and source records attributed to R Jenni.

At least 253 records · Page 14Linked to original sources
PubMed1985

[Follow-up of familial idiopathic dilatation of the right atrium].

In 1979 the diagnosis of idiopathic enlargment of the right atrium had been made in four members of a family, living in the northeastern part of Switzerland. A 5-year follow-up study of these four patients by ECG, chest X-ray, bicycle-ergometry and echocardiography showed a variable evolution: One of the two patients with the originally largest atria, showed further massive enlargement of the right atrium, combined with tricuspid insufficiency. One presented unchanged echo findings. In the other two patients with originally smaller atria a discrepancy of the course was also observed: in one right atrial size increased considerably (with appearance of atrial flutter), in the other patient the size of the atrium remained unchanged. In both patients a pericardial effusion occurred. Subjective symptoms and physical working capacity did not change in the four patients.

Adult↗
PubMed1984

[The course of endomyocardial fibrosis following surgical endocardial decortication].

Between 1971 and 1983 the authors observed 10 patients with left ventricular (n = 3) and biventricular (n = 7) endomyocardial fibrosis (7 women and 3 men). Seven of the 10 patients underwent open heart surgery with endocardial decortication of the left (n = 5) or left and right (n = 2) ventricle combined with mitral (n = 6) and tricuspid (n = 2) valve replacement. In 1 patient left ventricular endocardial decortication was performed without valve replacement. Three of the 10 patients were treated medically because functional limitation was only mild. One of the medically treated patients died 4 years later from congestive heart failure. Postoperative follow-up was 4.4 years. Two of the 7 patients who had undergone surgery died due to recurrence of endomyocardial fibrosis with blood eosinophilia of 46% (Löffler's endocarditis) in one, and due to severe left ventricular heart failure in the other. Annual mortality was 6.4%. NYHA classification was 3.4 pre- and 2.0 (p less than 0.005) postoperatively. Four patients were recatheterized 10 months after surgery: left ventricular end-diastolic pressure had decreased significantly from 24.6 to 13.6 mm Hg, cardiac index had increased slightly from 1.9 to 2.4 l/min/m2, left ventricular end-diastolic volume had increased from 69 to 84 ml/m2 (ns) and left ventricular ejection fraction remained unchanged pre- and postoperatively (59% and 57% respectively). It is concluded that endomyocardial fibrosis involves both ventricles in 70% of all patients, and that women are affected more frequently than men. Endocardial decortication with AV-valve replacement is regarded as the therapy of choice.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Aneurysm of the membranous septum. Angiocardiographic study].

Amongst 9000 patients on whom angiocardiograms had been carried out, a membranous septum aneurysm (MSA) was found in 47. In nine patients out of 27 the MSA could be demonstrated by sonography. The most common abnormalities accompanying this lesion were disturbances in rhythm and conduction (in 29 patients), ventricular septal defect in 29 and aortic insufficiency in 14. Complications included bacterial endocarditis in five patients (three with aortic insufficiency and two with sepsis lenta), aortic insufficiency (which was not of rheumatic or bacterial origin in three patients with conduction defects) and thirteen patients with abnormalities of cardiac rhythm with small VSDs.

Adolescent↗
PubMed1984

A comparison between single gate and multigate ultrasonic Doppler measurements for the assessment of the velocity pattern in the human ascending aorta.

The velocity pattern in the ascending aorta of 15 healthy adults was measured quasisimultaneously from the Doppler-shifts produced in 16 gates distributed equally within the cross-section along a narrow ultrasound beam which centrally traversed the vessel upstream of the brachiocephalic trunk. A comparison between the time integrals of the velocities in gates 9 (centre line), 4 and 13 (off centre) and the time integral of the weighted mean of the velocities of all gates correlated with r = 0.90, SEE = 1.05 (gate 9), r = 0.90, SEE 0.88 (gate 4) and r = 0.92, SEE 0.94 (gate 13). A better correlation (r = 0.96, SEE = 0.60) was found between the linear mean of all gates and the weighted mean. These results show that Doppler measurements in single small gates are not appropriate to determine the average cross-sectional blood flow velocity in healthy adults.

Adult↗
PubMed1984

[Lipoma of the left ventricle and insulinoma of the pancreas].

In a 59-year-old woman with cerebral attacks a left ventricular tumor was detected by two-dimensional echocardiography and confirmed by angiocardiography. The tumor was considered a source of embolism and resected. It proved to be a lipoma. Recurrent cerebral attacks finally led to the diagnosis of an insulinoma of the pancreas. After resection the cerebral attacks ceased.

Adenoma, Islet Cell↗
PubMed1983

[Asymmetric septal hypertrophy in patients with arterial hypertension].

Asymmetric septal hypertrophy (ASH) is the characteristic finding in patients with hypertrophic cardiomyopathy. The purpose of the present study was to examine the effect of chronic pressure overload on left ventricular hypertrophy and ASH in 34 patients with arterial hypertension. 15 patients (Group 1) showed normal blood pressure values (less than 140/90 mm Hg) under antihypertensive treatment but blood pressure remained elevated in 19 patients (Group 2) despite antihypertensive therapy. Left ventricular septal and posterior wall thickness, left ventricular internal diameter and systolic shortening of the internal diameter were measured in all patients by our standard technique. Systolic and diastolic blood pressure were significantly (p less than 0.001) elevated in Group 2 (164/98 mm Hg) as compared to Group 1 (128/84 mm Hg). Septal (1.7 versus 1.1 cm; p less than 0.01) and posterior wall thickness (1.2 versus 1.0 cm; p less than 0.01) as well as the septal/posterior wall ratio (1.4 versus 1.1; p less than 0.001) were significantly increased in Group 2 as compared to Group 1. Left ventricular internal diameter and systolic shortening of the internal diameter did not significantly differ between the two groups. ASH (septal/posterior wall ration greater than or equal to 1.3) was found in 10 patients of Group 2 (55%) and 1 patient of Group 1 (7%). It is concluded that asymmetric septal hypertrophy can be observed in one third of all patients with severe arterial hypertension. Asymmetric septal hypertrophy seems to be dependent on the duration and severity of hypertension and does not appear to be related to hypertrophic cardiomyopathy.

Adrenergic beta-Antagonists↗
PubMed1983

[Diagnosis, etiology and clinical course of acute and chronic pericarditis].

Between 1976 and 1982 18 patients with acute and 13 with chronic pericarditis (excluding constrictive pericarditis) were seen at the Medical Outpatient Clinic, University Hospital, Zürich. The prominent symptom in acute pericarditis was chest pain (15/18 patients versus 0/13 in chronic pericarditis, p less than 0.001) and in chronic pericarditis dyspnea (7/13 patients versus 1/18 in acute pericarditis, p less than 0.005). Pericardial friction rub and ST elevation were significantly more frequent in acute than in chronic pericarditis. In contrast, elevation of venous pressure occurred more often in the chronic than in the acute form. During the follow-up of 3.2 years the NYHA class decreased from 2.5 to 1.2 (p less than 0.001) in the group with acute pericarditis although 7 recurrences occurred in 3 patients within the first two years. The follow-up in the patients with chronic pericarditis was 4.4 years and the NYHA class decreased from 2.4 to 1.4 (p less than 0.05). There were, however, two deaths in the group with chronic pericarditis and pericardiocentesis and/or pericardiectomy had to be performed in 8/13 patients.

Adult↗
PubMed1983

[Mediastinal pancreatic pseudocysts. Report of 2 cases and review of the literature].

Mediastinal pancreatic pseudocysts are rare complications occurring in the course of pancreatitis. Two patients are described with chronic alcoholic pancreatitis who developed mediastinal pancreatic pseudocysts. The most prominent clinical findings were, respectively, recurrent pericardial and pleural effusions and dysphagia. The elevated amylase values in serum and urine and in the pericardial and pleural effusions pointed to pancreatic disease. The mediastinal pancreatic pseudocysts were found preoperatively by ultrasound and endoscopic retrograde cholangiopancreatography. Surgery was performed. In one case the pseudocyst was treated by external drainage and in the other case by marsupialization into the left pleural space. In each case pancreaticojejunostomy was performed in addition. Etiology, symptoms, diagnosis and therapy in 32 published cases are discussed on the basis of experience with these two patients.

Alcoholism↗
PubMed1983

[Hypertrophic obstructive cardiomyopathy: spontaneous course in comparison to long-term therapy with propranolol and verapamil].

The effect of long-term medical treatment in patients with hypertrophic obstructive cardiomyopathy (HOCM) is still controversial, and it is not clear whether propranolol or verapamil should be recommended in these patients. We therefore observed 49 patients (mean age 34.8 years) with hypertrophic cardiomyopathy and mostly mild obstruction for a mean follow-up period of 7.4 years. 13 patients died (10 suddenly and 3 in congestive heart failure) during the observation period (annual mortality rate 3.6%). According to medical treatment the patients were divided into 3 groups: group I consisted of 20 patients who received no medical treatment, group II of 15 patients receiving an average daily dose of 175 mg propranolol, and group III of 14 patients receiving an average daily dose of 360 mg verapamil. The mean follow-up was 6.4 years for group I, 7.0 years for group II, and 3.7 years for group III. 8 patients in group I died during the observation period (annual mortality rate 6.3%), 4 patients died in group II (annual mortality rate 3.8%), and 1 patient died in group III (annual mortality rate 1.8%). Functional limitation was similar in all 3 groups at the beginning and at the end of the study, and mean NYHA class was 1.9 in all 49 patients at the beginning and 1.8 at the end of the follow-up period. Left ventricular peak systolic and enddiastolic pressure were similar during heart catheterization (n = 41) in all 3 groups. Systolic outflow tract gradient at rest was 44 mmHg in group I, 32 mmHg in group II, and 11 mmHg in group III (difference not significant). The actuarial survival curves showed a significant difference (p less than 0.025) between group I and groups II or III.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

[Spurious aneurysm after myocardial infarct].

False aneurysms of the left ventricle after myocardial infarction arae the result of perforation, which usually require early surgical treatment. The clinical features are not characteristic. The chest x-ray may provide important evidence for the diagnosis. Non-invasive diagnosis is possible by means of echocardiography and computer tomography; it is confirmed by angiocardiography. The authors experience with nine cases is described.

Adult↗
PubMed1982

[Pseudocoarctation of the aorta (author's transl)].

Pseudocoarctation is an anomaly of the aortic arch, in which the aorta extends abnormally far cranially and then passes caudally in a double curvature. At the level of the distal curvature the lumen is indentated in a variable extent. In contrast to coarctation, a hemodynamically relevant stenosis and a collateral circulation are absent. We have observed a pseudocoarctation in three adults. All three had a systolic ejection murmur. Pseudocoarctation was combined in three cases with a bicuspid aortic valve and left axis deviation in the ECG. Two cases had slight aortic valvular disease ad an aneurysm of the membranous septum with a left anterior hemiblock in the ECG. According to the chest x-rays the differential diagnosis includes especially coarctation, an aortic aneurysm and a tumor of the mediastinum. Isolated pseudocoarctation requires no specific treatment.

Aged↗
PubMed1981

[Idiopathic familial right atrial dilatation].

In a 53-year-old woman with cardiomegaly and atrial fibrillation, cineangiography revealed idiopathic enlargement of the right atrium and mitral valve prolapse. Two-dimensional echocardiography was carried out in the entire family, which lives in the northeastern part of Switzerland. In 2 of the 4 siblings of the proposita, idiopathic enlargement of the right atrium, mitral valve prolapse and supraventricular rhythm disturbances were found. In one child of the patient with the largest right atrium, idiopathic enlargement of the right atrium associated with mitral valve prolapse was also present. To our knowledge this is the first report on familial occurrence of idiopathic enlargement of the right atrium accompanied by mitral valve prolapse.

Arrhythmias, Cardiac↗