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Biomedical subjects

A Schinz

Publications and source records attributed to A Schinz.

At least 19 recordsLinked to original sources
PubMed1983

[Electrocardiogram and M-mode echocardiography in the diagnosis of chronic transmural infarct. Correlations and determination of the accuracy of both methods based on quantitative levocardiography].

In a comparative study of 121 consecutive patients who had had coronary angiography for coronary heart disease, the diagnostic informations obtained by M-mode echocardiography and electrocardiography in chronic transmural infarction were compared. Wall excursion by echocardiography did not allow sufficient separation of normal and asynergic segments. Changes in systolic wall thickness, on the other hand, provided satisfactory sensitivity and good specificity in the recognition of segmental contraction disorders: posterior wall thickening of 0.64 and 0.76, respectively, septal thickening of 0.45 and 0.91, respectively. In 53% of patients the ECG and echocardiogram provided findings similar to those by angiography. False-positive findings occurred in 10% of electrocardiograms, 14% of echocardiograms. False-negative findings in the ECG occurred in 13%, in the echocardiogram in 25%. Both methods combined had a specificity of nearly 100% with regard to the diagnosis of posterior-wall and anterior-wall infarction, and a positive predictive value of 0.92 (posterior) and 0.93 (anterior wall infarction). M-mode echocardiography and ECG findings provide reliable diagnosis of both the anterior and posterior wall chronic transmural infarction.

Adult↗
PubMed1983

Proximal left anterior descending coronary heart disease and complex ventricular arrhythmias.

In this study, 87 consecutive patients with angiographically proven coronary artery disease (CAD, stenosis greater than 75%) underwent 24-h Holter monitoring, 76 of them having had transmural myocardial infarction, a mean of five months before evaluation. Of the total, 51 patients showed single-vessel disease, in 31 (61%) of them with involvement of the left anterior descending (LAD) artery. In 26 patients with proximal LAD stenosis or occlusion and usually large aneurysms and subsequently impaired left ventricular function relatively low prevalence of significant ventricular premature contraction (VPC, Lown greater than or equal to III) was seen. On the contrary in 19 patients with multivessel disease and proximal LAD stenosis advanced forms of VPCs were present in 63% (p less than 0.01). Further both groups differed significantly in the frequency of postinfarction angina (30% vs. 100%; p less than 0.001) and their incidence in positive exercise stress tests (15% vs. 84%; p less than 0.001). Ejection fractions were comparable in both groups (mean 45% vs. 52%). Finally 17 patients with multivessel disease but without proximal LAD lesion did not differ in any of the above mentioned parameters, when compared to the patients with single-vessel disease and proximal LAD stenosis. We conclude that impaired left ventricular function does not sufficiently explain the high risk of sudden death in postmyocardial infarction patients. The coronary and functional status of the surviving myocardium has to be taken into consideration as well.

Adult↗
PubMed1983

[Significance of the E point-septum distance for the evaluation of left ventricular function in coronary disease--a study using M-mode echocardiography].

In 121 patients (pts) with angiographically proven coronary artery disease, left ventricular (LV) cineangiograms were quantitatively evaluated. 79 pts showed regional wall abnormalities. In this group the relationship between echocardiographic parameters of global (LV) function (mitral-septal separation, systolic and diastolic diameter, and fractional shortening) and ventriculographic parameters was investigated. Mitral-septal separation showed the best correlation to the angiographic ejection fraction (EF) (r = -0.72). The measurement of this parameter allows the diagnosis of a reduced EF independently of the dilatation of the left ventricle, and is easy to perform and to reproduce. Mitral-septal separation discriminated well between the reference group and all infarction subgroups (posterior wall, anterior wall, and double infarction) with reduced EF. The modification of the mitral-septal separation measurement according to D'Cruz et al. showed no advantage over that proposed by Massie et al. Both are clearly dependent upon septal excursion, which has to be taken into consideration when mitral-septal separation is being evaluated. The sensitivity of mitral-septal separation (greater than 7 mm) for the detection of reduced LV function (less than 55%) was 0.66; the specificity was 0.80. There was greater sensitivity for anterior wall infarctions than for posterior wall infarctions (0.73 vs 0.44). Because of the relatively high number of false negatives, only a pathologic mitral-septal separation is diagnostically useful.

Adult↗
PubMed1981

Finger pulse plethysmographic effects of two oral sustained-release formulations of isosorbide dinitrate in normal man.

Two sustained release formulations of 40 mg isosorbide dinitrate, encapsulated pellets and a tablet, were compared double blind following oral administration of single doses in terms of response on finger pulse plethysmography in nine healthy male volunteers. Following both formulations there was a distinct effect on the depth of b-wave in the first derivative of the finger pulse up to 9 h after administration. This change of the parameter of nitrate action was significantly different from placebo for both formulations. The onset of action was more rapid and the peak response greater for the capsule than for the tablet. The overall effects in terms of area under the effect-time curves was also greater for the capsule than for the tablet, however, not statistically significant. Furthermore, the results show that the method of finger pulse plethysmography can be used to determine onset and duration of action nitrate compounds, after single dose administrations.

Administration, Oral↗
PubMed1981

[Ventricular arrhythmias and left ventricular function in coronary artery disease. A study by M-mode echocardiography and 24-hour Holter-monitoring (author's transl)].

In 82 patients with coronary artery disease, most of them having had transmural myocardial infarction, left ventricular function was studied with M-mode echocardiography. Furthermore 24-hour Holter-monitoring was done to determine the maximal degree of ventricular premature contractions (VPC's) according to the classification of Lown. The degree of VPC's was then plotted against echocardiographic parameters of left ventricular function. Confronting the subgroup of patients with Lown grade 0--II with those of grades III and IV, for all parameters significant differences of the mean values could be demonstrated. Parameter "distance E-point of the anterior mitral leaflet--left ventricular septal wall" shows 84% sensitivity; fractional shortening gives 88% specificity. Combination of all four parameters shows 90% specificity, which makes M-mode echocardiography a valuable diagnostic method in identifying those patients with coronary artery disease and malignant arrhythmias who have an increased risk of sudden death.

Adult↗
PubMed1978

[Mode of action of cardiovascular drugs. Echocardiographic studies (author's transl)].

Echocardiography--combined with additional non-invasive methods--has proved a sensitive tool for measuring hemodynamic and left ventricular function parameters. This study was undertaken to measure by these methods the effect of digoxin, isoproterenol, of the beta-receptorblocker sotalol, sodium nitroprusside and isosorbide dinitrate on the hemodynamics and left ventricular contractility in various patients and normal volunteers. Besides the good reproducibility of results of recent invasive investigations, partly in animal experiments, new aspects about the mode of action of the individual substances were obtained.

Cardiovascular System↗
PubMed1978

Hemodynamic effects of cutaneously administered isosorbide dinitrate ointment.

With a view to testing the hemodynamic effects of a 10% isosorbide dinitrate ointment, about 40 mg of the drug was applied to the skin of nine cardiologically healthy volunteers. The ensuing hemodynamic changes were followed up for six hours by means of noninvasive techniques including echocardiography. As early as 30 min after drug application, significant decreases in heart rate, cardiac output, systolic blood pressure and intracardiac diameters were recorded. Only systolic blood pressure had returned to initial values by the end of the observation period. Isosorbide dinitrate ointment diminished myocardial oxygen consumption for a duration beyond six hr, by reducing pressure and heart-rate work of the left ventricle.

Administration, Topical↗
PubMed1977

[Hypertrophic cardiomyopathies (author's transl)].

Because of their rapidly changing hemodynamic inconstancy depending on many, sometimes competing, processes, hypertrophic cardiomyopathies present a clinical picture extraordinary among the cardiac diseases, with severely altered diastolic compliance of the left ventricle and a functional stenosis in the obstructive forms. They are of increasing importance for the doctor in hospital or general practive, particularly because they are among the very few diseases in which the usual cardiac therapy with digitalis or else the administration of sympathomimetics is contraindicated.

Atrial Fibrillation↗
PubMed1977

[Treatment of arterial hypertension with sotalol, a beta-blocker (author's transl)].

Plasma concentrations and the effect of sotalol, a beta blocker, on arterial blood pressure and other haemodynamic variables (determined by echocardiography) were measured in 15 patients with arterial hypertension of different severity, after acute administration and during long-term treatment for 3 to 16 months. Sotalol absorption was relatively constant, the correlation coefficient between plasma concentrations and administered dose being r=0.67. The biological half-life was about eight hours, The effects of the drug on blood pressure, heart rate and other haemodynamic variables were small after acute administration. But in ten patients blood pressure returned to normal during chronic treatment with sotalol alone, while in five others it was necessary to combine sotalol with a diuretic and dihydralazine. These results show that sotalol is suitable for long-term treatment of arterial hypertension.

Adult↗
PubMed1977

Time sequence of direct vascular and inotropic effects following intravenous administration of digoxin in normal man.

The effects of a bolus injection of digoxin upon hemodynamics and left ventricular function were studied in 5 normal volunteers using cardiac ultrasound, ECG, carotid pulse pressure, and arterial blood pressure recording. Whereas the injection was followed by an immediate rise of the systemic vascular resistance, the inotropic action upon the myocardium followed with a delay of 10 to 30 minutes after injection.

Adult↗