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Biomedical subjects

R Jenni

Publications and source records attributed to R Jenni.

At least 271 records · Page 15Linked to original sources
PubMed1980

[Correlation of preoperative hemodynamics on late postoperative outcome in chronic aortic insufficiency].

92 patients with severe chronic aortic regurgitation underwent surgery between 1973 and 1977. Patients with coronary artery disease and significant postoperative prosthesis dysfunction were excluded from the study. The overall mortality during the follow-up (1.5-7 years, average 3.5 years) was 8.7%. It was not higher in patients undergoing reoperation or additional operation for aneurysm of the aorta ascendens. The preoperative left ventricular ejection fraction, end-diastolic volume index and end-diastolic pressure, and the cardiac index and cardio-thoracic ratio in chest roentgenogram, did not reliably predict a fatal late outcome. The late postoperative outcome in patients with severely impaired left ventricular ejection fraction (less than 40%), high enddiastolic pressure (greater than 25 mm Hg), low cardiac index (less than 2.2 l/min/m2) and high cardio-thoracic ratio (greater than 0.60) was not worse than in the entire group of patients. Higher postoperative mortality was seen only in patients with a severely elevated left ventricular end-diastolic volume index (greater than 220 ml/m2).

Adult↗
PubMed1980

[How reliable is echocardiography in evaluating the severity of mitral stenosis].

40 patients with mitral stenosis were examined by M-mode and 2-dimensional echocardiography. E-F slope, mitral valve closure index and mitral valve area were compared with the invasively determined mitral valve area. E-F slope and closure index correlated with the valve area by an r of 0.65 and 0.62 respectively. The mitral valve area as calculated by 2D echocardiogram showed a correlation with the invasively determined valve area of 0.86 and was even better in patients with sinus rhythm (0.91). However, in severe mitral stenosis (less than 1 cm2) this correlation was only 0.62 by estimating 22% of patients with severe mitral stenosis as only moderate (greater than 1 cm2). It is concluded that whereas E-F slope and closure index are not of use in the quantification mitral stenosis, determination of mitral valve areas by 2D echo is reliable. However, in the severe mitral stenosis group 22% of mitral valve areas were estimated purely numerically by 2D echo as moderate (greater than 1 cm2).

Adult↗
PubMed1980

[Is echocardiography useful in assessing long term prognosis after valve replacement in patients with left ventricular volume overload?].

Echocardiographic recordings in 87 patients with chronic volume overload of the left ventricle (32 pure aortic incompetence, 18 mixed aortic lesions with predominating regurgitation, 17 mitral incompetence and 20 combined aortic and mitral incompetence) who underwent valve replacement between 1975 and 1976 were reassessed to determine the prognostic interest of echocardiography in the long-term postoperative period. The follow-up was a least 2.5 years (average 2.8 years). Patients with coronary artery disease or paravalvular leaks were excluded from the study. The evaluation of the echocardiogrammes comprised the measurement of the end diastolic left ventricular internal dimension (Dd) and the end systolic dimension (Ds) and the calculation of the percentage systolic shortening of the internal dimension (p. 100 Sh) and of the ratio, radius/thickness in end diastole (Dd/2th). A poor surgical result was defined by a postoperative work capacity of less than 60 p. 100 normal or by postoperative death (7 deaths, one of which was in the perioperative period). 21 patients had poor results (group I) and 66 patients, good results (group II). None of the individual echocardiographic parameters differed significantly in groups I and II. In a sub-group of 50 patients, with isolated aortic incompetence, the preoperative echocardiographic data could not distinguish between patients with good and poor postoperative courses. On the other hand, the 4 patients with chronic aortic incompetence who died before operation were characterised by a Dd > 80 mm and Ds > 60 mm, although p. 100 sh was only < 25 p. 100 in one of these 4 cases. In conclusion, M mode echocardiography in patients with chronic volume overload of the left ventricle did not appear to have any value in the prediction of the long-term postoperative result. In patients with chronic aortic incompetence, greatly increased left ventricular internal dimensions indicate a compromised natural prognosis and are an urgent indication for surgical intervention.

Adolescent↗
PubMed1980

PDA by Doppler echo.

Explore the source record for details and available documents.

Ductus Arteriosus, Patent↗
PubMed1979

[The value of echocardiography in the diagnosis of cardiac diseases].

Single beam echocardiography is now an established diagnostic tool in non-invasive cardiology. The principle indications are valvular diseases, pericardial effusion, aneurysm of the ascending aorta, and congenital heart disease. In the absence of regional contraction disorders, left ventricular function can be assessed by the extent of systolic shortening of the left ventricular diameter. More recently, two-dimensional echocardiography has made a very significant contribution to anatomical and functional evaluation of the heart and the great vessels, since the cardiac structures can be visualized in various cross-sections. This technique is especially helpful for the assessment of left ventricular regional contraction disturbances, the diagnosis of dysfunction of artificial valves and bioprotheses, the detection of dissecting aneurysm, and the estimation of mitral valve area in mitral stenosis. Since various left ventricular axes can be determined, the quantitation of left heart volumes appears to be within the capability of the two-dimensional technique.

Aortic Aneurysm↗
PubMed1978

[Left ventricular function in hypertension treated with beta blockers].

In 14 patients with essential hypertension, left ventricular function was assessed echocardiographically before and after 4 and 8 weeks of treatment with the betablocking agent atenolol. Atenolol was given orally in a dose of 100 mg/day. After 4 weeks of treatment systolic blood pressure decreased from 160 to 138 mm Hg(p less than 0.001) and diastolic pressure from 105 to 91 mm Hg(p less than 0.001). Heart rate decreased from 76 to 64 beats/min (p less than 0.05). Systolic shortening of the left ventricular transverse diameter declined from 41 to 36% (p less than 0.01), though in no instance did it fall below the lower limit of normality (30%). After 8 weeks of betablocking therapy, blood pressure and heart rate remained essentially unchanged. Systolic shortening increased slightly but insignificantly to 38%. The left ventricular enddiastolic diameter did not change throughout the study. It is concluded that longterm betablocking therapy is associated with a significant reduction of left ventricular function which improves in the later stage of treatment. Since the diminution of left ventricular function is slight, the induction of left heart decompensation is unlikely, at any rate in patients with initially normal left ventricular function.

Adrenergic beta-Antagonists↗
PubMed1977

[Abeurysm of the septum membranaceum].

Between 1968 and 1977 5000 angiocardiographies revealed an aneurysm of the membranous septum (AMS) in 20 patients. In 11 patients the AMS was accompanied by a usually minor ventricular septal defect, in 4 by aortic valve disease, in 3 by coronary heart disease and in the remainder by some other rare heart disease. The diagnosis of AMS was established by angiocardiography, but in 3 patients it was detected by echocardiography. In one case a sepsis lenta with cerebral embolization was observed.

Adolescent↗
PubMedDate not supplied

Quantitative MR signal behavior in cardiac cine loops as a function of heart rate.

To evaluate the heart cycle-dependent signal intensity changes in the cardiac chambers, the aorta, and the pulmonary artery, five healthy volunteers were studied with gradient-echo magnetic resonance cine loops at different heart rates. Quantitative evaluation of signal intensity on each side of the cardiac valves showed that there were changes in signal intensity due to section-entry and spin-phase phenomena but none due to the increase in heart rate. The authors conclude that there is no heart rate-dependent signal loss in healthy persons that simulates valvular dysfunction, thus suggesting that signal intensity change can be used as an indicator for this disease, independent of heart rate.

Adult↗
PubMedDate not supplied

Epidural anesthesia for a cesarean section in a patient with pulmonary atresia and ventricular septal defect.

The perioperative management and the pathophysiology of a parturient with pulmonary atresia, ventricular septal defect, patent ductus arteriosus Botalli (PDA), and pulmonary hypertension are described. The patient previously had a cesarean section under general anesthesia and was currently managed with an epidural block. The outcome was successful for the mother. The postoperative period of the premature infant was characterized by hyaline membrane disease, with its typical sequelae.

Abnormalities, Multiple↗
PubMedDate not supplied

Coronary pseudoaneurysm: diagnosis by intravascular ultrasonography.

A pseudoaneurysm after percutaneous coronary angioplasty (PTCA) of the left anterior descending coronary artery is reported in a 52-year-old woman who underwent PTCA for exertional angina and a significant isolated stenosis of the left anterior descending coronary artery. Intravascular ultrasonography during repeat coronary angiography clearly identified a localized coronary dilation at the PTCA site in conventional coronary angiography as a pseudoaneurysm that was confirmed during surgery.

Aneurysm, False↗
PubMedDate not supplied

Intraventricular blood flow during isovolumetric relaxation and diastole in hypertrophic cardiomyopathy.

Forty patients with hypertrophic cardiomyopathy were investigated by Doppler echocardiography for intraventricular blood flow abnormalities. None had a bundle branch block. The patients were recruited on the basis of the presence of at least one of four different types of abnormal left ventricular blood flow movements during systole, isovolumetric relaxation, and diastole (time after mitral valve opening). The abnormal blood flow patterns were composed of the following: (1) systolic left ventricular outflow and midventricular obstruction in 20 of 40 and in 6 of 40 patients, respectively; (2) retrograde isovolumetric relaxation flow (IVRFretro; mean velocity, 0.7 +/- 0.3 m/sec), that is, flow toward the apex of the left ventricle, in 28 of 40 patients; (3) antegrade isovolumetric relaxation flow (IVRFante; mean velocity, 1.6 +/- 1.0 m/sec), that is, flow toward the left ventricular outflow tract, in 3 of 40 patients; and (4) diastolic antegrade flow (DFante; mean velocity, 0.9 +/- 0.3 m/sec), that is, flow opposite to mitral inflow, in 10 of 40 patients. There were significantly fewer patients with asymmetric septal hypertrophy (group 1) than with apical hypertrophic cardiomyopathy (group 2) showing DFante (1/29 versus 9/11, p less than 0.01). IVRFretro and DFante revealed higher velocities in patients with marked left ventricular asymmetric hypertrophy than in those with mild hypertrophy. Thus, in hypertrophic cardiomyopathy and especially in patients with marked asymmetric hypertrophy, there are different types of abnormal intraventricular blood flow movements during isovolumetric relaxation and disatole. This phenomenon is probably caused by asynchronous relaxation of the asymmetrically distributed, hypertrophied myocardium. DFante is more often observed in the apical cardiomyopathy than other forms of hypertrophic cardiomyopathy probably attributable to apically localized left ventricular cavity obliteration.

Adolescent↗
PubMedDate not supplied

A reversible form of apical left ventricular hypertrophy associated with pheochromocytoma.

A patient with pheochromocytoma was found to have typical features of apical left ventricular hypertrophy similar to apical hypertrophic cardiomyopathy of the Japanese type. The electrocardiogram showed giant negative T waves (1.0 mV), and echocardiography as well as angiographic examination revealed left ventricular hypertrophy confined to the apex. Surgical removal of the tumor resulted in striking regression of apical hypertrophy and essential normalization of the electrocardiogram within 1 year of operation. These findings emphasize the possible role of catecholamines in the cause of apical hypertrophic cardiomyopathy and illustrate the potential reversibility of this condition in association with pheochromocytoma. It is suggested that patients with signs of apical left ventricular hypertrophy should undergo thorough screening for a pheochromocytoma.

Adrenal Gland Neoplasms↗