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Biomedical subjects

W Rutishauser

Publications and source records attributed to W Rutishauser.

At least 145 records · Page 8Linked to original sources
PubMed1975

[Proceedings: Determination of the severity of aortic insufficiency with pulsed Doppler-ultrasound in the common carotid artery].

The severity of aortic incompetence can be assessed by quantifying the alteration of blood flow in the common carotid artery. The use of a pulsed multichannel ultrasonic Doppler device in 41 patients with aortic valve disease yielded a satisfactory correlation between the ultrasonic parameters and the maximal aortic regurgitation distance. Correlations between Doppler parameters and regurgitation (thermodilution) were less strict.

Adult↗
PubMed1975

[The effect of aneurysm resection on left ventricular function].

The effect of successful aortocoronary artery bypass surgery on left ventricular (LV) function was studied by angiography in 13 patients with coronary-artery disease and resection of a ventricular aneurysm. The following were calculated from single-plane right anterior oblique LV cine-angiograms: LV end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), percentage shortening of the medial perpendicular short axis (deltaM), mean velocity shortening of the circumferential fibres (VCF). The changes in the five hemi-axes of the anterior LV wall, and five of the inferior wall were averaged to give a value for relative anterior wall motion (SMV) and inferior wall motion (SMH). Changes in apical motion (SMS) were calculated from the percentage changes in the base-to-apex axis. The following mean values (x plus or minus s) were obtained four months before and 11 months after aneurysmectomy: EDVI (ml/m2) 154 plus or minus 27 (126 plus or minus 23), ESVI (ml/m2) 107 plus or minus 28 (56 plus or minus 15), SVI (ML/M2) 46.5 plus or minus 12.7 (69.9 plus or minus 23.1), EF (%) 32.6 plus or minus 8.0 (54.6 plus or minus 12.0), SMV (%) 6.1 plus or minus 10.0 (25.0 plus or minus 13.4), SMH (%) 25.9 plus or minus 13.1 (31.2 plus or minus 11.1), SMS (%) 5.1 PLus or minus 3.4 (13.1 plus or minus 4.2). These results indicated significant improvement in ventricular pumping action and wall motion after aneurysm resection and aortacoronary bypass surgery in patients with coronary-artery disease and severe cardiac failure.

Adult↗
PubMed1975

Abnormal segmental contraction velocity in coronary artery disease produced by isometric exercise and atrial pacing.

Since isometric exercise by sustained handgrip leads to a sizable increase in aortic pressure this maneuver was used in addition to atrial pacing to increase the imbalance between oxygen demand and supply in two groups of patients. Both groups were studied by left heart catheterization and cineangiography in the right anterior oblique projection, at rest, during atrial pacing and during combined pacing and handgrip exercise. Group 1, the control group, consisted of 10 patients without coronary artery disease having an ejection fraction of 0.61 to 0.82. Group 2 was composed of 10 patients with definite obstructive disease of one or more of the three main coronary arteries. At rest, ejection fraction was normal or nearly normal (range 0.54 to 0.78). Regional myocardial contraction performance was assessed by determining mean segmental shortening velocities at the basal (VSB), middle (VSM) and apical (VSA) short ventricular axes. Whereas at rest there was no significant difference between the two groups or any of the three velocities, during pacing, VSM and VSA were significantly smaller in Group 2 than in Group 1 (P smaller than 0.02). During pacing combined with handgrip exercise the difference between the two groups was clearly accentuated, all three velocities being highly significantly decreased in Group 2 (VSB, P smaller than 0.01; VSM and VSA, P smaller than 0.001). When evaluated individually the patients of Group 2 had in 9 segments during pacing values for VSB, VSM and VSA that were below the range of the normal subjects. During pacing combined with handgrip a newly abnormal shortening velocity was observed in 12 segments (VSB abnormal in 3 of 7, VSM in 4 of 7 and VSA in 5 of 7 instances). In conclusion, the combination of atrial pacing and handgrip exercise appears to be a useful stress maneuver to identify temporarily dysfunctioning segments in patients with coronary artery disease in whom atrial pacing alone is not sufficient to induce ischemic contraction disorders.

Angiocardiography↗
PubMed1975

[Clinical observations and angiographic findings before and after aortocoronary benous bypass grafting (author's transl)].

37 patients (mean age 51 +/- 8 years) were investigated clinically, mechanocardiographically and angiocardiographically before and 336 +/- 166 days after implantation of an aortocoronary vein graft. The bypass patency rate was 78%. Postoperatively 57% of the patients were free of symptoms, 35% were improved and 8% unimproved or worse. The postoperative incidence of angina pectoris during exercise testing was significantly lower in the groups with an improved vascularization-index, open vein grafts and a lack of preoperative myocardial infarction. For separating the patients only the vascularization-index and the bypass patency seem to be of value.

Adult↗
PubMed1975

Time relation between apex cardiogram and left ventricular events using simultaneous high-fidelity tracings in man.

In 10 patients without left heart valvular disease and having normal function of the left ventricle, the left ventricular apex cardiogram with its first derivative (dA/dt), left ventricular pressure with its first derivative (dP/dt), aortic pressure, electrocardiogram, and phonocardiogram were reocrded simultaneously during cardiac catheterization. The apex cardiographic tracings were obtained by means of a transducer with infinite time constant and very high resonant frequency and the LV and aortic pressures with catheter tip-manometers. The onset of the systolic rise of apex cardiographic and LV pressures were found to occur almost simultaneously with the upstroke of LV pressure, preceding that of the apex cardiogram by only 2 +/- 4 ms (mean +/- 1 SD). The summit of the systolic upstroke of the apex cardiogram (called E-point) occurred 37 +/- 9 ms after opening of the aortic valve and 41 +/- 9 ms after peak dP/dt. The peak of dA/dt preceded peak dP/dt by 10 +/- 4 ms. The protodiastolic nadir of the apex cardiogram (called-O-point) occurred slightly earlier (19 +/- 16 ms) than the nadir of the LV pressure curve, with considerable variation. In conclusion, this study using external and internal transducers with similar characteristics gives a new definition of the time relation between the externally recorded apex cardiogram and the haemodynamic events within the left heart in human subjects with normal left ventricular function.

Adult↗
PubMed1975

A selective coronary indicator dilution technique with fiberoptic recording.

A new method of accurately measuring myocardial circulation times is described: dye injections were made selectively into the left coronary artery while the passage of dye was recorded instantaneously in the coronary sinus with a fiberoptic catheter. The appearance time was found to be shorter than previously estimated (2.2 +/- 0.8 sec). The mean transit time in patients with left coronary artery disease and/or myocardial disease was significantly prolonged (p less than 0.01) and was found in all patients to shorten with increasing heart rate (p less than 0.01). Deformed dyd dilution curves were only obtained with stenotic lesions of the left coronary artery.

Arteries↗
PubMed1975

[Cineangiographic left ventricular dimensional analysis in normal subjects and patients with coronary disease].

The cineangiographically determined left ventricular function was studied in normals and in CAD-patients with one- and three-vessel disease. From single plane RAO-LV-cineangiograms following parameters were calculated; LV-volumes (EDV, ESV) according to the area-length method, ejection fraction (EF), percentage shortening of the medial perpendicular short axis delta (M,deltaMpl), mean velocity of circumferential fiber shortening (V(CF), V(CFPL)). It can be concluded that there is 1. no correlation between the severity of coronary heart disease and the morphological left ventricular wall lesions, 2. a depressed left ventricular function in coronary heart disease and normal ventriculograms, 3. a more impaired left ventricular function when cineangiograms show hypokinesis or aneurysms, 4. hypokinesis or aneurysms in the anterior wall leads to a more depressed left ventricular function than the same lesions in the posterior wall.

Angiocardiography↗
PubMed1975

Left ventricular contraction and relaxation in patients with coronary heart disease.

The relationship of left ventricular relaxation and compliance to the mechanism of elevation of left ventricular enddiastolic pressure during ischemia was investigated. Isovolumic left ventricular contraction, relaxation, and diastolic pressure-volume relationship were studied in controls and in coronary heart disease patients. Patients were studied at similar heart rates during ergometric exercise and pacing. Diastolic aortic, left ventricular systolic, and incisural pressure were not significantly different in both groups at rest, pacing, and exercise. Left ventricular dP/dtmax increased during pacing and exercise in controls (P smaller than 0.05; P smaller than 0.01) and in coronary heart disease patients (P smaller than 0.01 for both); whereas left ventricular dP/dtmin increased only in controls during exercise (P smaller than 0.01). Peak measured velocity of shortening (Vpm) and of lengthening (Vpmr) of the contractile elements was calculated as (dP/dt)/p. Vpm and Vpmr increased in controls during both pacing (P smaller than 0.05; P smaller than 0.02) and exercise (P smaller than 0.01 for both). In coronary heart disease patients Vpm increased during pacing (P smaller than 0.01) while Vpmr did not differ significantly. During exercise both Vpm and Vpmr were unchanged. In patients with coronary heart disease paced to angina, diastolic logarithmic pressure-volume relationship showed change in slope (P smaller than 0.05) of the regression line and upward shift in intercept b (+0.25; P smaller than 0.001). Ischemia produced an impaired contractile state, delayed relaxation and generation of active diastolic tone in the intact ventricle.

Adult↗
PubMed1975

[Cinegeometric analysis of left ventricular function in normals and in patients with isolated stenosis of the ramus anterior descendens (author's transl)].

The left ventricular function was evaluated by a cineangiographic method. 28 normals and 36 patients with an isolated stenosis of the anterior descending branch of the left coronary artery underwent this procedure. From single plane RAO-LV-cineangiograms following parameters were calculated: LV-volumens (EDV, ESV) according to the area-length method, ejection fraction (EF), percentage shortening of the medial perpendicular short axis (delta M, delta MPL), mean velocity of circumferential fiber shortening (VCF, VCFPL). Patients with comparable ramus anterior descendens branch findings can have normal- or abnormal pattern of LV-contraction. The critical cineangiographic parameters of left ventricular function are significantly decreased at rest in ramus anterior descendens lesions with normal systolic anterior wall motion in comparison to the normal collective. Hypokinesis, Akinesis and aneurysms deteriorate parameters of LV-function.

Angiocardiography↗
PubMed1975

[Course of pressure in isovolumetric relaxation of the left ventricle in man during rest and under acute pressure load].

Isovolumic relaxation of the left ventricle was investigated in man at rest and during pressure loading with methoxamine after blocking the autonomous nervous system with propranolol and atropine. Pressure course at rest and under methoxamine showed two distinct phases: first pressure fell steeply, then a gradual decrease of pressure course occurred without abrupt changes in slope. During pressure loading P and dP/dt increased markedly while the quotient (dP/dt)/P as a measure of contractile element velocity decreased. It was demonstrated that (dP/dt)/P during the second phase of relaxation did not show a plateau (no exponential pressure decay) but a "shoulder". If isovolumic ventricular pressure decay corresponds to isometric relaxation it can be stated that lengthening velocity of contractile elements increases gradually during the second phase of relaxation. The conclusions derived from isolated papillary muscle experiments would therefore not correspond to intact ventricle in man.

Atropine↗
PubMed1975

[Left atrial parasystole].

A case of atrial parasystole is described in a 55-year-old female with multivalvular heart disease, treated with high doses of digitalis and showing first-degree av block. The left atrial origin of the parasystolic P waves was supported by their distinctive morphology, especially in lead V1, and the sequence of left and right atrial activation. Depending on the refractory state of the myocard, there was a greater shortening of the av conduction time during the parasystolic discharge than during sinus beats indicating a caudal localization of the parasystolic center.

Arrhythmias, Cardiac↗