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Biomedical subjects

H Kreuzer

Publications and source records attributed to H Kreuzer.

18 recordsLinked to original sources
PubMed1979

[Radioimmunoassay for human myoglobin: methodology and diagnostic significance in myocardial infarction (author's transl)].

A radioimmunoassay was developed to determine serum myoglobin (SMb). 50 healthy persons showed values between 0 and 90 ng/ml. Serial tests of 10 patients following acute myocardial infarction or during angina pectoris (AP) indicated that SMb reached pathological values before CK and CK-MB (average 250 +/- 95 ng/ml at the time of hospitalisation which corresponds to 3.3 +/- 1.4 h after beginning of angina pectoris). At hospitalisation the simultaneously determined CK was within normal limits and reached pathological values only 6.2 +/- 1.9 h after the onset of angina. Maximum of SMb was 506 +/- 194 ng/ml occurring 8.8 +/- 2.8 h after beginning of AP, maximum of CK was 905 +/- 475 mU/ml occurring 20.0 +/- 7.8 h after AP. CK-MB and CK differed only slightly in their time course. One patient with severe AP had pathologically increased SMb values whilst all other enzymes were completely normal. Methodical and clinical results are discussed.

Adult↗
PubMed1979

Initial experience with transluminal recanalization of the recently occluded infarct-related coronary artery in acute myocardial infarction -- comparison with conventionally treated patients.

In 7 patients, the recently occluded infarct-related vessel was recanalized by transluminal catheter techniques during acute myocardial infarction (Group A). 4 patients had single-vessel disease, 2 patients two-vessels disease and one, involvement of three vessels. Control angiography was performed in 6 patients, 8 days to 7 months later. Changes of coronary artery anatomy and left ventricular function were compared with a group of 9 conventionally treated patients, who were found to have occlusion of the infarct-related vessel in the acute stage (Group B). Five Group B patients had one-vessel disease, 3 patients two-vessel disease and 1 patient, involvement of all three vessels. In the chronic stage, all transluminally recanalized vessels were found to be patent in Group A. There was spontaneous recanalization of the infarct vessel in 4 of 9 Group B patients. In Group A, the length of the akinetic segment (AKS) decreased significantly (p less than 0.05) from 145.4 +/- 48.5 mm to 73.2 +/- 73.4 mm (mean +/- SD). Volume parameters did not change significantly. In Group B, length of the AKS did not change significantly, EDVI increased significantly from 81.1 +/- 19.8 to 106.8 +/- 4.6 ml/m2 (p less than 0.05); ESVI increased significantly from 41.7 +/- 13.7; ml/m2 to 66.8 +/- 37.9 ml/m2 (p less than 0.01). In the acute stage, length of the AKS and volume parameters did not differ significantly between the two groups. In the chronic stage, AKS was significantly shorter (A: 73.2 +/- 63.4 mm; 144.9 +/- 59 mm (p less than 0.0025) and EF was significantly higher (A: 54.6 +/- 11.6%; B: 40.9 +/- 14.5% (p less than 0.05) in Group A. Peak CPK was lower in Group A (A: 1009 +/- 827 U/l; B: 1324 +/- 655 U/l), but this difference did not achieve statistical significance. Results of this pilot study suggest that transluminal recanalization in the early phases of acute myocardial infarction might result in limitation of myocardial injury. However, further research will be needed to improve the technique and to test its results.

Adult↗
PubMed1979

[Removal of an acute occluding coronary thrombosis by means of a Sones-catheter (author's transl)].

In a 60-year-old male patient thrombotic occlusion of a dominant right coronary artery was recanalized by means of a Sones-Catheter (8F) two hours after the clinical onset of myocardial infarction. Before recanalization the inferior wall of the left ventricle was akinetic. After recanalization this akinesia and the clinical symptoms of myocardial infarction was almost completely relieved. As evidenced by ECG and enzymes there was only a minor necrosis of the inferior wall. After one week ventricular function angiographically was completely normal. In the right coronary artery there was a 50 percent proximal stenosis, thrombi were completely abolished. Possible implications of this case are discussed.

Acute Disease↗
PubMed1979

[The determination of the left ventrical volume curve without background correction and its validation by direct intercomparison with the ejection fractions as determined by biplane laevocardiography (author's transl)].

Background corrections applied on the left ventricular volume curve determined by the "gated blood pool"--method are based on an estimated rather than on a directly measured background. This imposes an uncertainty on the values determined from the volume curve, especially on the ejection fraction. A method which does not require background correction may be applied if all available measurement and evaluation facilities are utilized fully. High temporal and spatial resolution is of fundamental importance, permitting the exact determination of the time-dependent scintigraphic contour variations of the left ventricle during the mechanical action of the heart. A good criterion of the validity of the volume curves with respect to interfering background radiation is the ejection fraction calculated from these curves. The direct intercomparison of 10 ejection fractions obtained by an expanded "gated blood pool"-method, employing cardiac catheterization, immediately before a biplane laevocardiography demonstrated very good agreement. A small systematic underestimation of the ejection fraction by the nuclear method was observed. This understimulation shows that the influence of the true background is small if other interfering count rate contributions or methodical uncertainties are excluded systematically.

Angiography↗
PubMed1979

[Quantitative exercise scintigraphy of the myocardium with 201Tl--methods and normal values (author's transl)].

Quantitative myocardial scintigraphy was performed in 20 normal individuals after maximum exercise and after two hours of rest. A mobile Anger camera with converging collimator and a Data-General computer with a 128 x 128 matrix were used. Quantitative analysis of data was performed on the basis of a 14-halfsegment model. Quantitative normal values after exercise and after redistribution of activity during rest are presented.

Adult↗
PubMed1979

[Left ventricular diastolic pressure-volume relations during exercise (author's transl)].

UNLABELLED: Left ventricular diastolic pressure-volume relations (PVR) were analysed from biplane ventriculograms and simultaneous pressure measurements in 33 patients at rest (R) and during ergometer exercise (E) (8 normals [N], 8 patients with coronary artery disease [CAD], 8 patients with congestive cardiomyopathy [COCM], 5 patients with aortic insufficiency [AI] and 5 patients with pressure overload (4 with aortic stenosis [A-St.] and 1 coarctation of the aorta). In N and AI diastolic PVR was essentially unchanged with E, the time constant of isovolumic relaxation (T) decreased significantly (N: delta T = -24.4 +/- 11.6%, p less than 0.001; AI: delta T = -27.3 +/- 6.8%, p less than 0.005). In CAD diastolic PVR was shifted upwards in all cases with angina pectoris during E (7/8), minimal rate of left ventricular pressure change (dp/dtmin) and T did not change significantly. In COCM diastolic PVR was shifted upwards in 4 cases, while dp/dtmin increased significantly (R = -1107 +/- 327, E = -1508 +/- 626 mm Hg-s-1, p less than 0.05), T on the average was unchanged (R = 53 +/- 10.5, E = 51 +/- 14.2 msec). In A-St. in 3 of 4 cases diastolic PVR was significantly shifted upwards with E, dp/dtmin increased (R = -1633 +/- 93, E = -2093 +/- 170 mm Hg-s-1, p less than 0.001), T in contrast to N and AI was prolonged (R = 33.8 +/- 4, E = 39.9 +/- 1.9 msec). CONCLUSION: In N and AI diastolic ventricular function is not altered with exercise. In COCM and especially in A-St., however, there are similar alterations like in CAD with angina pectoris. Changes in T indicate that shifts of the PVR with exercise in non-ischemic heart disease are related to a disturbed ventricular relaxation.

Adolescent↗
PubMed1979

[Echocardiographic dimensions of the left ventricle during ergometric exercise: results in normal subjects (author's transl)].

10 healthy men aged 18 to 32 years underwent M-mode-echocardiographic studies at rest, during exercise and recovery. Semisupine bicycle exercise was performed using work loads of 25, 50, 75, and 100 W with measurements taken every minute. With increasing exercise, heart rate rose significantly (p less than 0.01) from 68/min to a maximum of 132/min, blood pressure as obtained by sphygmomanometry rose from a mean of 83 torr to 102 torr. Left ventricular enddiastolic dimension (EDD) did not change significantly with exercise, left ventricular endsystolic dimension (ESD) decreased from a group mean of 34.8 mm to 30.5 mm. This paralleled an increase in stroke dimension from 18.3 to 22.6 mm and of fractional shortening (FS) from 0.34 to 0.43. Mean velocity of circumferential fiber shortening (MVCF) rose from 1.01 circ/s to 2.06 circ/s. During recovery, heart rate and blood pressure returned faster to resting levels than did ESD, FS, and MVCF. Again EDD did not change. These data indicate that heart rate contributes more to the increases in cardiac output observed with ergometric exercise than does stroke volume; with moderate exercise levels this increase in stroke volume is produced by diminishing endsystolic volume whilst enddiastolic volume remains unchanged.

Adolescent↗
PubMed1978

Acute coronary occlusion with impending infarction as an angiographic complication relieved by a guide-wire recanalization.

In a 45 year old male patient with a history of previous inferior myocardial infarction and unstable angina pectoris, coronary angiography revealed two-vessel disease: a 60-70% lesion in the middle third of the LAD, and a 90% lesion in the middle third of the very large RCA. There was only a small akinetic segment in the posterobasal region of the left ventricle. During angiography total occlusion of the RCA occurred followed the clinical and electrocardiographic signs of impending inferior reinfarction. Recanalization of the occluded vessel was accomplished by using a guide-wire, which was passed through a Sones catheter, placed in the RCA. The patient's symptoms subsided and the electrocardiographic signs of acute ischemia reverted within eight minutes. Aortocoronary bypass surgery with revascularization of the LAD and RCA was performed within 3 hours after recanalization. Postoperatively there was no evidence of major tissue loss by enzyme or electrocardiographic criteria. Control angiography, performed on the ninth day postoperatively, revealed the graft to the RCA to be widely patent. Left ventricular function was unchanged. It is concluded, that the combined approach of early transluminal recanalization of the acutely occluded RCA followed by successful construction of a graft to this vessel, has averted necrosis of a major portion of the left ventricle. However, general use of this technique does not seem advisable at the present time.

Acute Disease↗
PubMed1975

[Estimation of ventricular volume derived from three transverse diameters and the longitudinal axis, compared with an area-longitudinal axis method (author's transl)].

The difficulty of automatic volume estimations of the left ventricle from cine-ventriculography lies in the accurate definition of the ventricular contour during the whole of the cardiac cycle. On the other hand, automatic determination of the long axis of the ventricle, and of three transverse diameters, is feasible. An attempt was therefore made to see whether accurate ventricular volume estimations could be obtained from these measurements. Two different geometrical models were examined: a) A complete rotational ellipsoid b) A half rotational ellipsoid. Examination of ten cine-ventriculograms (totalling 546 frames) has shown that the ventricular volume can be determined with an adequate accuracy by this method. The half ellipsoid model produced better mean results than the full ellipsoid. Its mean deviation from the area-long axis method was only minus 1.2%, that of the complete ellipsoid was minus 3.3%.

Heart Function Tests↗