PubMed Health⌕ Search

Biomedical subjects

H Lambertz

Publications and source records attributed to H Lambertz.

At least 73 records · Page 4Linked to original sources
PubMed1985

[Analysis of right atrium function in patients with chronic pressure overload of the right ventricle].

Right atrial function was evaluated in 16 patients with and without chronic right ventricular pressure overload. A simultaneous right atrial pressure recording using a catheter-tip-micromanometer and right atrial volume determination using cross-sectional echocardiography were performed. The pressure-volume curve of the right atrium was composed of an a-loop and a v-loop. The ratio of active atrial emptying to right ventricular stroke volume in patients with right ventricular pressure overload was significantly larger than in the control group (36 +/- 6% vs. 23 +/- 5%, p less than 0.04). The right atrial work was also significantly greater in patients with right ventricular pressure overload (6.2 +/- 2.0 mWs) than in normal subjects (4.2 +/- 2.0 mWs, p less than 0.04). The ratio of active atrial emptying to ventricular stroke volume and right atrial work were significantly related in both control group and patients with right ventricular pressure overload (r = 0.83). Right atrial work also showed a significant linear correlation with right atrial work before active atrial emptying (r = 0.92). We conclude that in patients with right ventricular pressure overload the right atrium shows more pronounced active emptying and contributes to better diastolic filling of the right ventricle.

Angina Pectoris, Variant↗
PubMed1985

[Pathophysiology of tricuspid insufficiency: analysis of the motion of the tricuspid valve annulus using 2-dimensional echocardiography].

We investigated tricuspid annular motion in patients with pulmonary hypertension and in normal controls to determine the greatest minimal diameter and percentage shortening of the tricuspid annulus required for functional tricuspid regurgitation. 73 patients were studied by 2-dimensional echocardiography: a control group of 30 patients (group I); 43 patients had pulmonary hypertension, 9 of whom were still in sinus rhythm (group II), the other 34 patients had atrial fibrillation. 19 of these showed competent tricuspid valve with contrast echocardiography (group III), whereas the 15 remaining patients had functional tricuspid regurgitation (group IV). An analysis of shape and position changes of tricuspid annulus during the heart cycle was performed. The maximal diameter (mm/m2) in the apical 4 chamber view was in group I 17.5 +/- 1.4, in group II 20.7 +/- 3.2 (vs. group I p less than 0.05), in group III 19.0 +/- 3.4 (vs. group II NS) and in group IV 25.7 +/- 6.0 (vs. group III p less than 0.001). The values for the minimal annular diameter (mm/m2) were in group I 13.7 +/- 1.2, in group II 17.4 +/- 3.5 (vs. group I p less than 0.01), in group III 16.6 +/- 3.3 (vs. group II NS) and in group IV 23.6 +/- 5.7 (vs. group p less than 0.001). The percent decrease (%) in group I was 21.5 +/- 3.3, in group II 17.0 +/- 6.9 (vs. group I p less than 0.05), in group III 12.8 +/- 4.7 (vs. group II p less than 0.05) and in group IV 7.9 +/- 3.4 (vs. group III p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Echocardiography↗
PubMed1984

[Heart lesions caused by blunt trauma. Echocardiographic follow-up studies].

The increased traffic has been accompanied by increased risk of blunt thoracic trauma. Trauma caused by the steering wheel leads to thoracic damage with serial rib fractures frequently involving cardiac damage. Apart from routine estimation of MB-CK and daily recording of the ECG echocardiographic follow-up is of considerable importance. Cardiac trauma may be recognised more promptly than by ECG and potential late complications can be outlined in time.

Aged↗
PubMed1984

Long-term hemodynamic effects of prenalterol in patients with severe congestive heart failure.

In a controlled, randomized, double-blind study we investigated the long-term effects of the beta 1-adrenoceptor agonist prenalterol in 16 patients with severe congestive heart failure (NYHA class III or IV). Previous to and 1 week, 3 months, and 6 months after continuous oral intake of 40 to 120 mg prenalterol a day, catheterization of the right heart combined with an ergometer test was carried out; M mode and two dimensional echocardiograms as well as systolic time intervals were also recorded. With prenalterol the heart rate increased within 1 week from 81 +/- 7 to 90 +/- 7 beats/min (mean +/- SD) (p less than .05) and remained increased after 3 months (93 +/- 9 beats/min, p less than .01) and 6 months (91 +/- 6 beats/min, p less than .05). After 1 week the cardiac index rose from 2.7 +/- 0.7 to 3.3 +/- 0.7 l/min/m2 (p less than .01), and after 3 and 6 months it fell again to 3.0 +/- 0.9 l/min/m2 and 2.9 +/- 0.7 l/min/m2, respectively. In the ergometer test the improvement in performance was not significant. The mean velocity of circumferential fiber shortening initially increased from 0.58 +/- 0.20 to 0.79 +/- 0.28 circumferences/sec (p less than .01), but dropped after 3 months to 0.62 +/- 0.31 circumferences/sec. The ejection fraction determined from the two-dimensional echocardiogram rose after 1 week from 20 +/- 10 to 27 +/- 12% (p less than .05), but decreased again after 3 months (23 +/- 11%) and 6 months (20 +/- 10%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗
PubMed1984

[Determination of the size of the right atrium in patients with pulmonary hypertension using 2-dimensional echocardiography].

Normal values for right atrial area and tricuspid annular diameter and their percentage shortening measured from the two-dimensional echocardiographic four-chamber view are now available. In this study right atrial size of patients with pulmonary hypertension is evaluated and the results compared with the M-mode findings of the right ventricle in order to detect pulmonary hypertension. Hemodynamics and echocardiograms of 60 patients (mean age 57 +/- 10 years) with mitral stenosis III-IV NYHA and concomitant pulmonary hypertension were examined. 20 patients in group I with atrial fibrillation had additional functional tricuspid incompetence. Unlike the 20 patients in group II, who had atrial fibrillation, the remaining 20 in group III were still in sinus rhythm. The mean pulmonary artery pressure was 44.1 +/- 9.3 mmHg in group I, in group II 33.9 +/- 6.3 mmHg (grp. I vs. grp. II p less than 0.001) and in group III 33.2 +/- 7.1 mmHg (grp. II vs. grp. III ns). The end-systolic index of the right atrial area in group I was 19.6 +/- 5.7 cm2/m2 and thus significantly greater than in group II with 10.6 +/- 2.3 cm2/m2 (p less than 0.001) and in group III with 9.1 +/- 2.5 cm2/m2 (p less than 0.001). The maximal diameter of the tricuspid annulus measured 24.6 +/- 5.5 mm/m2 in group I, 18.9 +/- 3.5 mm/m2 in group II (grp. I vs. grp. II p less than 0.001) and 20.2 +/- 2.2 mm/m2 in group II (grp. I vs. grp. II p less than 0.001) and 20.2 +/- 2.2 mm/m2 in group III.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1984

[Determination of the size of the right atrium using two-dimensional echocardiography].

Echocardiographical and functional parameters of the right ventricle have been established. In addition, to improve the analysis of right heart dynamics, normal values for right atrial dimensions and the tricuspid valve anulus diameter are required. We therefore examined 30 normal adult subjects, 15 males (aged 31 +/- 10 years, mean +/- SD) and 15 females (aged 28 +/- 8 years) using two-dimensional echocardiography in the apical 4-chamber view. The contour of the right atrium was delineated with a light pen, and the end-diastolic and end-systolic areas were calculated using a computerized integration method; the percentage area shortening fraction was determined as end-systolic area - end-diastolic area/end-systolic area. The diameter of the tricuspid anulus was measured in the ECG-triggered two-dimensional stop frame; the greatest diameter was reached immediately after the end of the P-wave in the ECG and the smallest diameter at midsystole. Thus it was possible to calculate the anulus shortening fraction as greatest diameter - shortest diameter/greatest diameter. For determination of the circumference of the tricuspid valve anulus a circular geometry was assumed. The mean values, the standard deviation and the 95% upper confidence bound for the 90th percentile were calculated. The end-diastolic right atrial area in the apical 4-chamber view was 3.0 +/- 0.8 cm2/m2 in the whole study group (males 3.4 +/- 1.8 cm2/m2 and females 2.6 +/- 0.5 cm2/m2) and the end-systolic area was 6.9 +/- 1.0 cm2/m2 (males 7.1 +/- 1.1 cm2/m2 and females 6.6 +/- 0.9 cm2/m2); the calculated value of the area shortening fraction was 56.7 +/- 9.7%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Echocardiographic monitoring of acute myocardial infarct following intracoronary streptolysis treatment].

Two-dimensional echocardiography is helpful in the detection of wall motion abnormalities and in the evaluation of time courses of regional function due to interventions. Of 301 patients with acute myocardial infarction treated with selective intracoronary infusion of streptokinase, 229 (76%) revealed a totally occluded infarct related vessel at the first angiography. In 64 patients a two-dimensional apical long-axis view of good technical quality could be obtained after admission, on the 1st, 2nd and 3rd day and again in the 4th to 6th week and the 9th to 14th month after the acute intervention. The collective was divided into two subgroups according to the different time interval between the beginning of symptoms of infarction and the reopening of the occluded vessel. 35 patients had a total time of occlusion of less than 4 hours (group A), while in 29 others this time exceeded 4 hours or thrombolysis was unsuccessful (group B). Using a computer system, the center of gravity of the end-systolic frame of the left ventricle was used as an inner fix point. 10 end-systolic and end-diastolic area segments were constructed. Regional wall motion was determined as a percentual change of the enclosed area, normalized to the end-diastolic area (% delta F). The ejection fraction was calculated using a disc method. In group A the ejection fraction increased from initially 46 +/- 9% to 51 +/- 8%, 52 +/- 8% (p less than 0.05) and 53 +/- 8% (p less than 0.01) on the 1st, 2nd and 3rd day, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed1984

[Functional tricuspid insufficiency in patients with severe heart failure; follow-up study using echocardiography].

We prospectively studied 104 patients with severe congestive heart failure (NYHA class III-IV) on admission and after clinical improvement. Clinical and echocardiographic data regarding the presence of secondary tricuspid incompetence were collected. Contrast echocardiographic and morphometric analyses of the inferior vena cava with determination of the diameter, the pulsation, and respiratory changes were carried out and the results were compared to those in a control group. Initially, tricuspid incompetence was present in 57% of the patients as shown by contrast echocardiography, and persisted in 34% after 31 +/- 5 days of appropriate medical treatment. In 43% of the patients, regurgitation of the tricuspid valve could not be clinically detected even though the incompetence was of moderate degree in 6 of these cases. Morphometric changes in the inferior vena cava were a sensitive indicator of the clinical response of the initiated therapy with diuretics and cardiac glycosides. The diameter of the inferior vena cava decreased from 14 +/- 0.8 mm/m2 (mean +/- SEM) to 12 +/- 0.9 mm/m2 (p less than 0.01, the systolic pulsation increased from 3.6% +/- 0.5% to 6% +/- 1% (p less than 0.05), and the respiratory change in diameter correspondingly increased from 16% +/- 3% to 26% +/- 4% (p less than 0.02). There was a linear correlation between the decrease in diameter of the inferior vena cava and in mean right atrial pressure (r = 0.734). The inspiratory increase in the right atrial V-wave was 87% +/- 8% in patients with tricuspid incompetence, whereas patients without tricuspid incompetence showed an inspiratory increase of 63% +/- 11%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[Emergency diagnosis of acute aortic insufficiency using one- and two-dimensional echocardiography].

Acute aortic valve insufficiency generally leads to an emergency situation followed by surgery. Using echocardiography pathological findings of the aortic valve or the ascending aorta leading to acute aortic insufficiency could be differentiated exactly and rapidly in 12 out of 13 cases. Dissecting aneurysms of the aorta and bacterial endocarditis were the most frequent causes (50 and 43%). Our results showed clear-cut superiority of combined use of one- and two-dimensional echocardiography to M-mode techniques. Both methods complement each other with their advantages and disadvantages. With their help recognition of causes of aortic insufficiency is possible more rapidly, safer and with a higher sensitivity than with the M-mode method alone. Invasive diagnostics may thus become unnecessary in the appropriate cases.

Adult↗
PubMed1983

[2-dimensional echocardiography in acquired heart valve defects].

A fundamental improvement in the diagnosis of acquired valvular defects has been achieved by the introduction of two-dimensional echocardiography. For the first time, it has now become possible to visualize the underlying morphological changes direct and true to anatomy. Additional information is supplied by a detailed study of the dynamics of the affected valve. At present, limited information only can be obtained in respect of the haemodynamic severity of the defect. In the near future, however, we may expect advances also in quantitative respect, from a combination of this method with Doppler echocardiography or contrast echocardiography.

Aortic Valve Insufficiency↗
PubMed1983

Echoventriculography -- a simultaneous analysis of two-dimensional echocardiography and cineventriculography.

Two-dimensional echocardiography underestimates left ventricular volume compared with cineventriculography. To exclude the influence of difference in heart rate, blood pressure, respiration phases and any effect of the contrast material on left ventricular function, simultaneous studies of two-dimensional echocardiography and cineventriculography-echoventriculography were performed in 46 patients. Apical two-dimensional echocardiograms in the right anterior oblique (RAO) equivalent view were recorded before and during cineventriculography in the 30 degrees RAO projection. End-diastolic and end-systolic volumes (EDV and ESV) were calculated using a disc method with a semiautomatic computer system. The echo transducer position relative to the left ventricular apex and long axis was analyzed. For EDV determined by two-dimensional echocardiography and cineventriculography, the linear regression equation was y = 0.659x + 0.8, SEE = +/- 26.2 ml, r = 0.907. For ESV, the regression equation was y = 0.571x + 17.8, r = 0.938, SEE = +/- 18.6 ml, and for ejection fraction (EF) it was y = 0.606x + 13.0, r = 0.803, SEE = +/- 9.1%. Injection of contrast material resulted in only a small increase of stroke volume, caused by an increase of EDV as analyzed by echoventriculography. In all but two patients, the transducer position was found to be anterior and superior to the left ventricular anatomic apex, as evaluated by filming the echo transducer position during cineventriculography in 46 patients in the 30 degrees RAO projection and in 15 patients consecutively in the 60 degrees left anterior oblique and 30-40 degrees cranial projections. Thus, tangential cuts of the ventricle resulted in underestimation of diameters, long axis and ventricular volumes. These methodologic problems are exacerbated by slice-thickness artifacts. Furthermore, different outlining of left ventricular contour -- outer border of ventricular trabeculae for cine ventriculography and inner border for two-dimensional echocardiography -- seemed to result in underestimation of volume by echocardiography.

Adult↗
PubMed1982

[Ventricular septal defect in acute myocardial infarction].

Ventricular septal rupture is the fourth-common cause of death after cardiac arrhythmia, acute congestive failure and rupture of the cardiac wall in acute myocardial infarction. Generally it can be easily diagnosed by a systolic jet sound in the 4th and 5th intercostal space parasternally on the left side. Differential diagnostic difficulties occur in the acute phase of infarction regarding papillary muscle rupture. Myocardial rupture does not occur immediately after the onset of the pectanginous state and not within the first day of illness, but generally within the first week. Vasodilatory treatment permits only short-term stabilisation of vascular problems, however, time is made available for diagnostic measures, usually catheterisation of both sides of the heart and coronary angiography. Immediate operation and occlusion of the defect, if necessary accompanied by a saphenous vein bypass, is presently considered treatment of choice. Out of the three patients with this complication the ruptured site could be occluded surgically in two, one of whom had severe cardiogenic shock. Shock symptoms regressed immediately and the postoperative course was unremarkable. In the third patient no operation was performed due to his age of 77 years and general vascular sclerosis. He died of cardiogenic shock 11 hours after admission to hospital.

Aged↗
PubMed1982

Haemodynamic effects of prenalterol in patients with severe congestive heart failure--NYHA III-IV.

In 12 patients with severe congestive heart failure due to ischaemic heart disease (n = 6) and due to congestive cardiomyopathy (n = 6) the haemodynamic effects of a new beta 1-agonist, prenalterol, were studied. Left ventricular (LV) function was studied before and 20 min after infusion of 12 mg prenalterol. Heart rate was kept constant by atrial pacing at a rate of 100 min-1 unless intrinsic heart rate exceeded it. As a sign of positive inotropic support, prenalterol enhanced peak rate of LV pressure development (dP/dt) from 1160 +/- 100 mm Hg/s to 1590 +/- 190 mm Hg/s (p less than 0.005). In the mean LV end-diastolic and end-systolic volume determined by cineventriculography and two-dimensional echocardiography decreased. LV stroke work index measured with both methods increased with 4 ml/m and 5 ml/m, respectively (p less than 0.02). LV ejection fraction was improved by 6% and 8% (p less than 0.005). Increase of peak fall of left ventricular pressure (dP/dt) (1050 +/- 60 mm Hg/s to 1270 +/- 100 mm Hg/s, p less than 0.005) and shortening of time constant (T) of pressure fall from 64.5 +/- 5.0 ms to 44.5 +/- 6.0 ms (p less than 0.005) demonstrated the improved LV relaxation. Analysis of LV volume and myocardial compliance revealed decrease of left ventricular stiffness. Thus, LV filling pressure was reduced from 22.1 +/- 4 mm Hg to 14 +/- 3.5 mm Hg (p less than 0.001). Pressure volume analysis showed a significant increase of LV power and work, as well as a slight decrease of wall stress. Our study could demonstrate, even in patients with severe heart failure, a sustained positive inotropic effect of prenalterol leading to an improved left ventricular contractility, relaxation and compliance. LV power and work was enhanced. The increase of oxygen demand seemed to be counterbalanced by an improved perfusion of particularly subendocardial layers indicated by an increased transmyocardial pressure gradient.

Adrenergic beta-Agonists↗