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E Scharf-Bornhofen

Publications and source records attributed to E Scharf-Bornhofen.

15 recordsLinked to original sources

[Significance of the ejection fraction at rest and by stress using radionuclide ventriculography for the prognosis of myocardial infarct patients--comparison with other study methods].

We examined 221 patients with postmyocardial infarctions 8 weeks after MI using radionuclide ventriculography (RNVA) at rest (EFR) and during supine submaximal exercise (delta EF). Mortality rates were evaluated 2 1/2 and 3 1/2 years later by interviewing patients and/or their homephysicians. Sixteen patients were dead (6.7%) 2 1/2 years after MI, 28 (12.7%) were dead after 3 1/2 years. Thirty percent of patients with a resting EF less than 30% had died 2 1/2 years after MI, and 40% were dead within 3 1/2 years. The mortality rate was significantly higher than in patients who had EF greater than or equal to 30% 8 weeks after MI. Patients with a decrease of delta EF (greater than or equal to 5%) showed a 2 1/2 year mortality of 10.8% and after 3 1/2 years of 18.5%. Mortality was significantly higher in patients with decreasing EF during exercise than in those who increased their EF during exercise. This prognostic value of EFR and delta EF was compared with other parameters (angina pectoris, ECG at rest and during exercise, heart volume, Holter ECG, floating catheter PCP [rest and exercise], coronary angiography). Radionuclide ventriculography at rest and during exercise showed a tendency to be the best determining factor for prognosis, and is therefore recommended to determine prognosis in post-MI patients.

Adult↗

[Comparison of 99mTc-trend scintigraphy and left ventricular angiography in 33 patients (author's transl)].

In 33 patients (30 male, 3 female, mean age 48 years) 99mTc-Trend Scintigraphy (Schad) was compared with left ventricular angiography. 25 patients suffered of a chronic myocardial infarction. In 26 patients complete or partial agreement between the two methods was seen. The scintigraphy showed false negative results in the apical region and false positive results in the basal segments. The comparison of both methods shows that 99mTc-Trend Scintigraphy can be used to evaluate non-invasively the function of the left ventricle.

Coronary Vessels↗

[Intravenous fibrinolytic treatment in chronic ischemic heart disease (author's transl)].

In 13 male patients (mean age 49.1 years) with chronic ischemic coronary heart disease (7 transmural and 2 intramural myocardial infarctions), angina pectoris and signs of ischemia during exercise an intravenous streptokinase therapy was performed. The treatment was installed 18.9 months after infarction or after onset of angina pectoris. Before and after intravenous streptokinase therapy the following parameters were measured: history, heart volume, exercise-ECG, Swan-Ganz pulmonary artery measurements during exercise, aortic and left ventricular pressures, coronary angiography, left ventricular angiography. 1. Angina pectoris disappeared in 1 and became better in 4 patients. In none of the patients angina pectoris became worse. 2. The parameters for ischemia were not changed overall by the therapy. But in single patients signs of exercise-induced ischemia were influenced. 3. Mean values of left ventricular function (EF, LVEDP) were not changed. 4. Angiographic changes were discrete. 5. Complications of therapy and worsening of subjective parameters did not occur. 6. The angina pectoris behaviour in 5 patients (became better) is explained by changes of blood properties. The not-appearance of coronary artery occlusions is explained by the inhibition of platelet aggregation. 7. It is suggested that the effect of intravenous streptokinase therapy should be examined in patients with short-lasting angina pectoris and subgroups, such as initial angina pectoris.

Adult↗

[Social fate (return to work) after coronary heart surgery and/or aneurysmectomy (author's transl)].

The "return to work"-rate of 4 groups of patients with myocardial infarction (MI) is evaluated (all coronary angiography): Group 1: 314 patients after aorto-coronary bypass operation: mean age 50.5 years. Time after infarction 28 months, after surgery 18 months. The social fate of 52% were not yet decided. 20% got pension, 25% returned to work. Group 2: 86 patients after conservative treatment of myocardial infarction: mean age 42 years. Time after MI 18 months. The social fate of 21% was not yet decided, 41% got pension, 36% returned to work. Patients with one-vessel disease returned to work in 52%, with two-vessel disease in 20% and with three-vessel disease in 12.5%. Group 3: 24 patients after aneurysmectomy: mean age 47 years. Time after infarction 28 months, time after operation 11 months. Social fate of 8 out of 24 patients was not yet decided, 7 out of 24 got pension, 5 out of 24 returned to work. Group 4: 27 patients with conservatively treated left ventricular aneurysm: mean age 43 years. Time after infarction 42 months. The social fate of 2 out of 27 patients was not yet decided, 14 out of 27 got pension, and 8 out of 27 returned to work. Exercise-tolerance is no good indicator for the work status 18 months after myocardial infarction, 18 months after aorto-coronary bypass, 18 months after aneurysmectomy and 42 months after conservative treatment of left ventricular aneurysm. Selection of patients (all were examined by coronary angiography because of limitation by angina pectoris in daily life activities) may be partly responsible for the poor long-term work status. But more important seems to be the "tied social network". Decision for "return to work" or "pension" should be made 6 months after MI or after operation.

Activities of Daily Living↗

[Myocardial scintigraphy (thallium-201) and electrocardiography at rest and during exercise in angina pectoris. A comparison with coronary angiography (author's transl)].

Ecg (at rest and during exercise) was compared to Thallium-201 myocardial perfusion imaging (at rest and after exercise) in 65 patients with coronary heart disease (myocardial infarction in 53 patients) and angina pectoris. These results were compared to coronary angiography and left ventricular angiography. Group I: (48 patients, comparison of Ecg at rest and Thallium-201 imaging at rest): 33 patients showed agreement of results. In comparison to angiography the 201-Thallium imaging showed less false-negative results than the Ecg as rest. Group II: (23 patients, comparison of Ecg during exercise with Thallium-201 imaging after exercise): 8 patients showed agreement, 15 patients did not. In comparison to angiography the imaging showed better agreement in 20 of 23 patients, the exercise Ecg in 14 of 23 patients. Exercise-Ecg showed false-negative results in 7 patients, Thallium-201 imaging in none. Especially in 1-vessel-disease imaging was superior. Group III: (24 patients, comparison of Ecg at rest and during exercise to 201-Thallium at rest and after exercise): In 19 patients results agreed almost. Because of background-correction imaging is inferior to the Ecg in the apical region. Imaging is superior to the Ecg in the septal and inferior-myocardial regions. Combination of both methods gives best correlations. Sensitivity of Ecg-results is 77% and in imaging 93%.

Adult↗

[Longterm prognosis of 27 patients with left ventricular aneurysm and conservative treatment (author's transl)].

The results of a follow-up study (mean 42 months after infarction) of 27 patients with conservatively treated left ventricular aneurysms showed: 1. 3/27 patients died of sudden death. Only one of these three could be predicted (ventricular fibrillation during exercise). 2. 3/24 remaining patients developed congestive heart failure. This could be predicted in one patient because of global hypocinesia of the left ventricle. 3. The exercise tolerance (Swan-Ganz) of the remaining 21 patients decreased from approximately 100 to 70 watts. Thus, all patients were able to lead an almost normal live. 4. Therefore conservative treatment of left ventricular aneurysms in most cases is the method of choice, since high surgical mortality, financial burdens of the society and man power has also to be considered. 5. The development of complications which would lead to aneurysmectomy (sudden death, life threatening arrhythmias, embolisation, congestive heart failure) cannot be foreseen from history, non-invasive and invasive data. 6. The close "patient to physician-contact" (risk-factors, medication) may have influenced the relatively good long-term prognosis of this group.

Adult↗