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Biomedical subjects

U Tebbe

Publications and source records attributed to U Tebbe.

At least 181 records · Page 10Linked to original sources
PubMed1984

[Slow flow in the coronary system and ST elevation in the ECG in left atrium catheterization].

A complication of transseptal left atrial catheterization is a transient ST-elevation in the ECG with unknown cause. In this case simultaneous angiography showed a so-called "slow flow" of dye dilution in the coronary artery. A coronary spasm or an embolic occlusion of the coronary artery could be excluded. The reason for this phenomenon might be a reflex increase of the arteriolar resistance with transient ischemia.

Aged↗
PubMed1983

[Recanalization of an acutely occluded coronary bypass: combined local and systemic streptokinase administration].

Renewed severe angina occurred in a 57-year-old patient 14 months after a quadruple aortocoronary graft. Angiography demonstrated acute occlusion of a posterolateral graft. After 120 minutes of local streptokinase infusion (2000 IU/min) there was partial recanalization, with complete thrombolysis and graft recanalization after subsequent intravenous streptokinase infusion (30 000 IU/min for 90 minutes). Contrary to the situation in early postoperative graft thrombosis, acute late occlusion can be successfully lysed without increased risk of bleeding (haemopericardium).

Coronary Angiography↗
PubMed1983

High dose intravenous streptokinase in acute myocardial infarction.

Early recanalization of infarct-related coronary arteries has been attempted in 40 patients with acute myocardial infarction (AMI) and angiographically proven total occlusion by brief high dose intravenous streptokinase infusion (IVSK). In 24 patients (60%) recanalization was achieved after 48 +/- 14 min of IVSK at an infusion rate of 30,000 to 40,000 IU/min (group A), in 16 patients there was a late (greater than 2 h) or no recanalization (group B). The total dose of SK was 1.7 +/- 0.48 Mio IU in group A and 1.74 +/- 0.41 Mio IU in group B, the time from the onset of symptoms to peak myocardial enzyme of creatine phosphokinase (CKMB) 11 +/- 3 h in group A and 22 +/- 6 h in group B (p less than 0.001). Biplane left ventricular ejection fraction increased from 55 +/- 9% at the time of acute angiography to 58 +/- 10% after 14 to 24 days in group A (p less than 0.1) and decreased from 49 +/- 11 to 41 +/- 11% in group B (p less than 0.005). There were four reocclusions in group A, two could be reopened by i.v. urokinase (1 Mio IU over 30 min). During a follow-up period of 18 +/- 8 months one patient in group A died from an early ventricular rupture 2 hours after recanalization, and one patient in group B from heart failure 7 months after IVSK. There was no serious bleeding or other complication related to IVSK. We conclude that IVSK is an effective and safe means of early recanalization of coronary thrombosis in AMI, and feasible in the majority of patients with AMI.

Adult↗
PubMed1983

Nitrates in aortic valve disease: acute and chronic effects.

The beneficial effect of Nitroglycerin (NTG) on myocardial oxygen-supply-demand ratio in severe aortic stenosis has been already demonstrated. But the chronic administration of isosorbide dinitrate (ISDN) does not reduce the increase in left ventricular filling pressures during exercise. Therefore in severe aortic stenosis, the effects of chronic nitrate administration on left ventricular hemodynamics during exercise do not correspond to the beneficial acute effects of NTG. In aortic insufficiency, sublingual NTG has only minor effects on left ventricular volumes, heart rate and cardiac output. A moderate reduction in pressures results in a significant reduction of wall stress, while there is no major change in regurgitant fraction.

Aortic Valve Insufficiency↗
PubMed1983

[Prognostic value of thallium scintigraphy in diagnostic problem cases].

Quantitative myocardial scintigraphy was performed in 40 patients with a medium prevalence of coronary artery disease (CAD), i.e. in cases with diagnostic difficulties. The results were compared with those of coronary angiography and ventriculography performed within 6 months thereafter. Sensitivity of scintigraphy in 16 patients with CAD was 88% and specificity in 14 individuals without heart disease was 93%. But in 10 patients with non-coronary heart disease specificity decreased to 30%. Scintigraphic evidence of ischemia increased specificity to nearly 100% including patients with non-coronary heart disease but sensitivity was reduced to 69%. The results demonstrate that myocardial scintigraphy with 201Tl is useful in cases with suspected CAD if diagnostic difficulties arise during the early phase of investigation. But there are limitations due to a rather high prevalence of non-coronary heart disease in such groups.

Adult↗
PubMed1983

[Ventricular septal defect as a complication of myocardial infarct].

Between 1978 and 1982 emergency closure of postinfarction ventricular septal defect was performed in 4 patients (51--74 years) on the 3rd-7th day after acute myocardial infarction. All patients had a large left-to-right shunt and were in intractable acute heart failure; all of them survived the operation (3 patients had additional aortocoronary bypass grafts), and follow-up (0.5--4.5 years) was uncomplicated. The favorable clinical and functional results of surgical therapy indicate that postinfarction ventricular septal defects should be operated on even in patients over 70 years of age.

Aged↗
PubMed1982

[Left ventricular contraction and relaxation in patients with congestive cardiomyopathy during exercise].

UNLABELLED: Left ventricular (LV) contraction and relaxation were analysed in 16 patients with congestive cardiomyopathy (COCM) at rest (R) and during supine bicycle ergometer exercise (E), and were compared with 10 normals (N). In patients with COCM, left ventricular ejection fraction (EF) was significantly reduced at rest, but during exercise like in the normal patients there were no significant changes (EFCOCM: 34 +/- 12% (R) and 35 +/- 10% (E);EFN: 72 +/- 5% (R) and 74 +/- 5% (E). LV-enddiastolic volume in COCM was more than 100% larger than in N. Left ventricular filling pressures (PLVed) were elevated already at rest, the increase during exercise was very similar to that of the normal group (COCM: 20.5 +/- 9.0 (R), 33.3 +/- 7.6 (E) mm Hg, p less than 0.001; normal group: 11.1 +/- 2.2 (R), 18.7 +/- 5.9 (E) mm Hg, p less than 0.001). The increase of maximum dP/dt during exercise as an index of contractility reserve was distinctly lower in COCM (delta means COCM: + 51%; delta means N: + 105%). Left ventricular relaxation as measured from minimal dP/dt was significantly impaired already at rest in COCM (COCM: -1109 +/- 329; N: -1832 +/- 468 mm Hg X s-1, p less than 0.001), the increase of dP/dtmin during exercise (COCM + 37%) was similar to that of normal patients (+ 35%). The time constant T of isovolumic pressure fall was significantly prolonged at rest in COCM, and there were no changes during exercise. After correction for the right atrial pressure rise during exercise, the time contant T' was significantly shortened to the same extent in the normal group (COCM: (R) 44 +/- 9, (E) 36 +/- 10 ms; N: (R) 33 +/- 5, (E) 25 +/- 5 ms, p less than 0.001). CONCLUSIONS: In patients with COCM, changes of left ventricular ejection fraction during exercise are inconsistent; in the individual patient, changes in global LV function during exercise cannot be predicted from EF at rest. At rest, LV relaxation is prolonged, the lack of shortening of the time constant T during exercise is thought to be mainly due to the pressure rise in the pericardial space.

Adult↗
PubMed1982

[Changes of global and regional left-ventricular function by reperfusion in acute myocardial infarction].

UNLABELLED: Biplane ventriculography was performed during the acute and chronic stage (3 weeks) of myocardial infarction in 54 patients. Early recanalisation was attempted by intravenous streptokinase in 33, by intracoronary streptokinase in 15 and by catheter manipulation in 6 patients. In patients with successful recanalisation (n = 37) biplane LV ejection fraction (EFbi) increased slightly from 53 +/- 10 to 56 +/- 9% on the average, with late recanalisation or permanent occlusion EFbi decreased significantly from 47 +/- 11 to 39 +/- 8% (p less than 0.001). Correspondingly the akinetic segment length (AKS) and the number of akinetic radians (Sak) (semiautomated system) decreased with early recanalisation and increased with permanent occlusion. Comparing global and regional LV function, EF and Sak correlated closely (r = 0.81) while EF and AKS revealed only a loose correlation (r = 0.59). Biplane and RAO single plane EF correlated with an r-value of 0.88, Sy,x however was 9.9%. There was a considerable scatter in the relation between the parameters of regional wall motion, AKS and Sak (r = 0.80; Sy,x = 10.6). CONCLUSIONS: On the average there is a slight improvement in LV function after successful early reperfusion, which seems to be independent of the method of recanalisation. Changes of regional akinesis after reperfusion cannot be assessed accurately by angiographic determination.

Coronary Circulation↗
PubMed1981

[The effect of molsidomin on the arterial windkessel (author's transl)].

The antianginal effect of Molsidomin is due to a reduction of preload. The decrease of aortic pressure is interpreted by the diminuation of the cardiac output. It is not yet known whether there is an additional primary reduction of afterload, caused by a change of the elastic properties of the arterial windkessel. Therefore in ten patients the effects of Molsidomin were investigated. After Molsidomin the pulmonary capillary pressure decreased by 58%, and the cardiac index by 12%. Mean aortic pressure was diminished by 12%, too, The capacity of the windkessel C was determined from the diastolic pressure decay in the thoracic descending aorta. After Molsidomin there was a decrease of C by 21%. This decrease was due to a reduction in the filling-state but not to altered elastic properties of the arterial windkessel.

Angina Pectoris↗
PubMed1980

[Local streptokinase treatment in acute pulmonary embolism with shock (author's transl)].

Streptokinase (290 000 U/2 h) was directly infused under angiographic control into the predominantly affected right pulmonary artery in a 71-year-old patient with acute pulmonary embolism and persistent shock. This led to immediate complete remission of shock symptoms and lasting stabilisation of the patient. If, as this case demonstrates, embolectomy is not possible and high-dose intravenous streptokinase is contraindicated, localised use of streptokinase in low dosage offers a possibility for treatment of life-threatening pulmonary embolism.

Aged↗
PubMed1980

Changes in left ventricular diastolic function in coronary artery disease with and without angina pectoris assessed from exercise ventriculography.

In 11 normals and 43 patients with coronary artery disease left ventricular (LV) diastolic pressure-volume (P-V) curves were obtained from biplane ventriculograms and simultaneous high fidelity pressure measurements. During exercise ventriculography 20 patients had angina pectoris (group B), and 16 patients were asymptomatic (group A). At rest there were no akinetic segments in 28 patients (group C), and an akinetic segment was found in 15 (group D). With different total work loads (951 +/- 134 and 2100 +/- 245 kpm in groups B and A), LV minimal and end-diastolic pressures and corresponding ventricular volumes increased to a similar extent in patients with and without angina during exercise ventriculography. With comparable work loads (1,296 +/- 221 and 1,494 +/- 195 kpm in groups C and D) the mean increase in diastolic pressure and volume was larger in group D, which corresponded to the more depressed LV resting function.

Adolescent↗
PubMed1980

Solubility of inert gases in dog blood and skeletal muscle.

Solubility of H2, Ar, CH4 and SF6 was determined at 310 K (37 degrees C) in water, in saline (0.154 mol NaCl/l H2O), in plasma and whole blood of dogs, and in homogenates of the dog gastrocnemius muscle. The liquids were equilibrated with pure gases, and the dissolved gases were extracted and measured by gas chromatography as described previously (Meyer, M.: Pflügers Arch. 375, 161--165, 1978). In saline, the solubilities were 4% (SF6) to 15% (Ar) lower than in water. For dog blood the following mean values for the solubility coefficient (in mumol . 1(-1) . kPa-1) were found: for H2, 6.44; for Ar, 9.94; for CH4, 11.44; for SF6, 2.62. The red cell/plasma and the muscle/blood solubility ratios were near unity for H2, Ar and CH4 (ranging from 0.9 to 1.3); for SF6, however, they were much higher (about 2.1), apparently due to the high solubility of SF6 in hydrophobic substances (lipids).

Animals↗