PubMed Health⌕ Search

Biomedical subjects

H Schaedel

Publications and source records attributed to H Schaedel.

At least 19 recordsLinked to original sources
PubMed1991

Sarcoid heart disease--results of follow-up investigations.

52 patients thought to have sarcoid heart involvement have been followed up. By administration of a standardized glucocorticoid therapy we demonstrated improvement of patients' symptoms, ECG disturbances, thallium scan defects of left heart muscle and there was 60-70% regression of pulmonary sarcoidosis. There was a low death rate. We conclude that our diagnostic measures are reliable, and that glucocorticoid therapy is efficacious in the early stages of the disease.

Adult↗
PubMed1990

[Quantifying aortic valve insufficiency using color Doppler echocardiography].

UNLABELLED: 51 consecutive patients with the clinical signs of aortic valve incompetence (AI) were evaluated by color-coded Doppler flow mapping (CDF) before angiography (AG). Quantitation of the severity of AI was performed by measurement of length and width of the extension of regurgitant jet (grade I-IV). After AG results both -AG and CDF- were compared. In 36 patients the results of both methods concurred exactly by use length in CDF. With CDF, the regurgitation was overestimated in 7 cases by one grade and underestimated in 8 patients also by one grade. Width of regurgitant jet relative to size of outflow space is a useful parameter to distinguish between mild and severe A1 (limit 0.50). CONCLUSION: CDF is a suitable method for semiquantitative assessment of AI. In presence of unequivocal CDF signs and in consideration of clinical and other patients findings AG will be dispensable before aortic valve replacement.

Adolescent↗
PubMed1989

[The value of endomyocardial biopsy in verifying the diagnosis of sarcoidosis of the heart].

The evaluation of the results of myocardial biopsy specimens of 24 patients highly suspected of having myocardial sarcoidosis revealed a sarcoid granuloma only in one case. In tapering frequency (60-33%) there has been myocardial scarring, generalized fibrosis, pathological count of mononuclear cells, nuclear hypertrophy, and perivascular fibrosis which all yield unspecific results, but because of lack of another cause are related to sarcoidosis. The specimens of 8 patients have been normal. In contrast to communications in the literature, we cannot recommend endomyocardial biopsy as a routine method to establish heart sarcoidosis, but as a method to exclude other myocardial processes.

Adolescent↗
PubMed1988

[Diagnostic value of lipids and apolipoproteins for assessment of atherogenic risk].

In 242 coronarographed male patients (51.7 +/- 7.6 years) with 0-, 1-, 2- or 3-vessel diseases as well as a clinically healthy control group (n = 68, 50.6 +/- 8.5 years) the lipoprotein pattern was investigated: total-, LDL-, HDL-, HDL2-, HDL3-, beta-, pre-beta-alpha-cholesterol, triglycerides, apolipoproteins (Apo) A-I, A-II, B, (A-I)HDL, Lp(a). With regard to the separation of patients with diseases of the coronary vessels and healthy persons out of the individual parameters Apo A-I (turbidimetrically), HDL3 and HDL cholesterol had the greatest significance (maximal diagnostic efficiency: 0.81, 0.76, 0.72). For the assessment of the severity of the change of the coronary vessels the quotient total/HDL cholesterol was most suitable (efficiency: 0.67). Differences in the diagnostic significance were established in the determination of a parameter by means of different methods. The intake of beta-receptor blockers increased the concentration of the triglycerides and pre-beta-cholesterol.

Apolipoproteins↗
PubMed1987

[Diagnostic score in heart sarcoidosis].

Basis of the score is the empirical valuation of clinical and cardiac functional parameters. The degree of probability shall enable the applier either to temporize and conclude therapeutic steps or considering the diagnostic stage to add additional examinations in order to confirm the supposition. The importance of this diagnostic and therapeutic management rests on the vital danger to patients with heart sarcoidosis. We arranged the score according to the clinical significance intentionally applying strict standards mainly with regard to the differential diagnosis of the coronary heart disease. Due to our results the myocardial biopsy seems to be unnecessary.

Adult↗
PubMed1986

[Lipids and apolipoproteins in relation to the degree of coronary sclerosis].

86 male patients with 0-, 1-, 2- or 3 vascular disease who underwent coronary angiography as well as a control group were examined with regard to their lipoprotein constellation: total (TC-), LDL-, HDL-, beta- and alpha-cholesterol (C); triglycerides; apolipoproteins A, AI and B. Significant differences between the mean values of the control group and the patients with coronary disease were found for the groups with 2- and 3-vascular disease for the following parameters: TC, HDLC, TC/HDLC, LDLC/HDLC, alpha-C, TC/alpha-C, beta-C, alpha-C. The quotients TC/HDLC and TC/alpha-C most closely correlate with the degree of the coronary sclerosis. In the apolipoproteins A, B and the index Apo B/A the patients with coronary disease of the groups 0-3 possess equally lowered or increased serum levels and number values, respectively, in comparison to the control group. The apolipoproteins do not show any relationship to the degree of severity of the coronary sclerosis. By means of the parameters combination (Apo A + TC/alpha-C) with a diagnostic sensitiveness of 0.83 and a specificity of 0.87 a coordination coronary disease--healthy could be performed. The classification according to risks should then be performed by means of a cholesterol quotient (TC/alpha-C or TC/HDLC).

Apolipoproteins↗
PubMed1985

[Heart antibodies in sarcoidosis].

By means of indicret immunofluorescence sera of 56 patients with pulmonary sarcoidosis of the x-ray stages I-III--among them 25 patients with additional heart involvement--were examined to detect heart antibodies. At all x-ray stages of pulmonary sarcoidosis muscle antibodies were identified. Patients who were treated with glucocorticosteroids showed more antibodies against heart musculature than those ones without therapy. By reason of the results of the indirect immunofluorescence no reliable differentiation was possible between a group with pulmonary sarcoidosis and a group with pulmonary sarcoidosis and additional heart involvement. Similar results could be obtained by use of both animal muscle antigen and human myocardiac antigen so that the use of human myocardiac tissue does not seem to be necessary in order to demonstrate antibodies in case of sarcoidosis. The frequency of the proof of antibodies against muscle antigen draws the attention to an early or systemic affection of the muscular system in sarcoidosis.

Adult↗
PubMed1985

[Myocardial biopsy in suspected myocardial sarcoidosis].

24 patients with pulmonary sarcoidosis stage I or II, who above all on account of changes of the ECG roused the suspicion of the presence of a sarcoidosis of the myocardium, finally underwent an invasive examination with laevocardiography, coronarography and biopsy of the endomyocardium. While the unaimed taking of tissue from the left ventricle did not result light-microscopically in a reference to granulomas or other inflammatory changes, the biopsy in a female patient, on purpose taken from a hypokinetic area of the left ventricle, showed epitheloid-cellular granulomas with giant-cells. Evaluating these results and reports in literatur, we came to the conclusion that findings typical for sarcoidosis are promising success only when taken from cardiographically suspicious areas of the myocardium.

Adult↗
PubMed1985

[Thallium myocardial scintigraphy, hemodynamics and left ventricular wall kinetics in patients with suspected myocardial sarcoidosis].

The cardiological examination of 22 patients (pts) with suspected heart sarcoidosis (histologically established lung sarcoidosis, heart rhythm disturbances, cardiomegaly) has revealed thallium scan defects in 20 pts at rest and during exercise. In 19 pts we found pathologic left heart wall motions established by laevocardiography by applying the half axis method. The number of pathologic half axis shortenings correlated with ejection fraction, but not with left ventricular enddiastolic pressure and left ventricular enddiastolic volume index. IHD could not be found in coronarography in any case. Myocardial biopsy did not show myocarditis. Cardiomyopathies, other specific heart muscle diseases or rheumatic myocarditis could not be excluded as causes of the results mentioned above. The follow-up examinations of the patients will give more detailed information on the etiology of the pathologic cardiac findings.

Arrhythmias, Cardiac↗
PubMed1985

[Follow-up studies and special cardiologic diagnosis in patients with suspected heart sarcoidosis].

During a retrospective analysis of 1236 patients with pulmonary sarcoidosis who showed electrocardiographic disturbances or cardiomegaly the existence of a possible heart sarcoidosis was suspected. It was tried to confirm this suspected diagnosis in subsequent examinations of these patients by support of modern non-invasive and invasive cardiological methods. Thereby the differential diagnosis to the coronary heart disease is especially difficult in elderly. This problem represents a permanent diagnostic challenge because of the therapeutic chance in case of heart sarcoidosis.

Adult↗
PubMed1984

[Determination of enzyme activity in sarcoidosis--comparison of angiotensin convertase and collagen peptidase].

The diagnostic evidence of the ACE and CP activity alone is limited with regard to the specifity of sarcoidosis. In connection with the X-ray diagnostics and the histological ascertainment the determination of the two enzyme activities, however, is an enrichment of the programme of diagnostics. High ACE- and CP-values speak for the presence of numerous sarcoidosis granulomas and for the affection of many organs, respectively, when the sarcoidosis is ascertained. This fact is valuable in the diagnostics of sarcoidosis of the myocardium. For therapy controls or investigations of the course of the disease the two enzymes are to be used, since they give references to the activity of the disease. In this case the sensitivity of the ACE-determination seems to be larger than that one of the collagen peptidase.

Adult↗
PubMed1984

[Heart involvement in lung sarcoidosis. Results of a retrospective analysis of clinical courses collected over a 10-year period].

Both the roentgenographic assessment of heart size (CTR) and the evaluation of serial ECG are simple methods in diagnosing possible heart involvement in patients with pulmonary sarcoidosis. Heart rhythm disturbances (ventricular ectopic beats, atrial and ventricular tachycardia, bundle branch block, high degree av-block) are of particular diagnostic value especially in view of intermittent occurrence or therapeutic disappearance. Other noninvasive methods as vectorcardiography, echocardiography and nuclear myocardial imaging are of worth in confirming the diagnosis. There are some difficulties in differential diagnosis of other cardiomyopathies and ischaemic heart disease.

Arrhythmias, Cardiac↗
PubMed1984

[Retrospective evaluation of sarcoidosis patients 1970-1979 at the Bad Berka Central Clinic for Heart and Lung Diseases for the detection of possible heart involvement].

Cardiac involvement in pulmonary sarcoidosis was found in a higher percentage than formerly reported, by careful observation. In a retrospective analysis of 1 236 patients with pulmonary sarcoidosis we found a possible cardiac involvement in 15.1%. In cases of pulmonary sarcoidosis or lymph node sarcoidosis combined with sarcoid lesions in other organs (liver, eyes, skin etc.) cardiac involvement is possible. Heart sarcoidosis was found in all roentgenographic stages and without sex difference. Patients with possible heart sarcoidosis suffer from dyspnoe , thoracical pain, heart discomfort, or angina pectoris in a higher part than without it. Enlargement of the heart and/or cardiac failure are signs of sarcoid involvement in patient with sarcoidosis, also in elderly patients. There are some difficulties in differential diagnosis of sarcoid cardiac involvement and ischaemic heart disease.

Adult↗
PubMed1983

[New aspects in the diagnosis of pulmonary sarcoidosis].

Due to the advances in endoscopic technique, gallium-67-scintigraphy, immunologic methods as well as particularly by measurement of ACE in recent years the way to a pathogenetically oriented diagnostics and therapy of pulmonary sarcoidosis became evident. In this case it is important to abandon the x-ray and bronchoscopic diagnostics and the therapy planning according to the x-ray and to introduce increasingly activity markers into the clinical routine. As to newer methods in this case above all the ACE-measurement and the diagnostic lavage are offered. The latter method may still be applied in one bronchological session for the purpose of the still important histological ascertainment. Also the lung function tests and particularly the oxyergometry should increasingly be used in this sense. Great clinical attention must be paid to the problem of myocardial sarcoidosis, since very much depends upon the well-timed and consequent therapy. Indeed, it is above all the heart sarcoidosis which decisively deteriorates the prognosis of the altogether benign disease. The newer immunologic techniques, including the elaboration of the lavage fluid are at present above all still of theoretical interest.

Cardiomyopathies↗