PubMed Health⌕ Search

Biomedical subjects

H Sebening

Publications and source records attributed to H Sebening.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Dissimilar course in the right and left ventricular function in a patient with dilated cardiomyopathy].

The case of a patient with severe dilative cardiomyopathy and cardiomegaly demonstrates that M-mode echocardiography and planar chest radiographs are not always sufficient to follow up the disease correctly. Using other non-invasive imaging modalities, in this case radionuclide ventriculography and NMR tomography, which provide more precise information with regard to morphology and function of both the right and the left heart, allows a more reliable follow-up of the disease.

Adult↗
PubMed1979

[Frequency of peripheral arterial occlusive disease in patients with coronary heart disease with and without infarction (author's transl)].

In 107 consecutive patients the frequency of peripheral arterial occlusive disease in coronary heart disease was assessed by selective coronary angiography and sonographic Doppler pressure estimation. Among 75 patients with coronary heart disease 21 (28%) had arterial occlusive disease, among 32 patients without coronary heart disease only one (3%). There was no statistically significant correlation between the severity of both diseases. 40 out of 75 patients with coronary heart disease had suffered from cardiac infarction. Infarction frequency showed a highly significant correlation with increasing severity of the coronary heart disease, but none with increasing severity or frequency of arterial occlusive disease. When there was no arterial occlusive disease all degrees of severity of coronary heart disease were found. Analysing the literature it becomes evident that coronary heart disease is frequently an isolated or premature manifestation of arteriosclerosis.

Adolescent↗
PubMed1979

[Value of 201-thallium serial myocardial imaging in coronary heart disease (author's transl)].

There has been clinical evidence that a perfusion defect on a stress image fills in over time. The diagnostic value of initial and 120 min post exercise redistribution thallium-201 myocardial images (RMI) was determined in 120 pts. with suspected coronary heart disease (CAD), all of whom had coronary arteriography. Significant (greater than or equal to 75%) lesions were present in 88 pts. 30 pts. without CAD showed a normal tracer uptake immediately after exercise. Scintigrams taken 120 min after exercise revealed a decrease of 201-Tl concentration in every area of the myocardium. 80 pts. with CAD showed an area of decreased tracer uptake in the initial scans. 120 min RMI in 51 pts. revealed a segnificant increase (p greater than 0.01) of countrate time ratio in previous underperfused area. In 37 pts. persistent defects were present, in every case the defect correlated with the site of a myocardial infarction as determined by the finding of an akinetic area in the left ventricular angiogram. Thus RMI following a single dose of 201 Tl can differentiate between scar- and exercise-induced transient ischemia.

Adult↗
PubMed1979

[Effects of acute beta-adrenoceptor blockage (metoprolol i.v.) on plasma norepinephrine concentration and hemodynamics in postmyocardial infarction patients].

The effect of acute beta-adrenoceptor blockage (Metoprolol) (M), 0.1 mg/kg i.v.) on left ventricular performance has been investigated at rest and during exercise in 15 patients with 2--3 months old transmural myocardial infarctions. Coronary venous and arterial norepinephrine (NE) concentrations were determined. There was no significant change in arterial and coronary venous NE concentrations (0.27 and 0.22 ng/ml, respectively) after blockage of beta-adrenoceptors (0.36 vs 0.26 ng/ml), which caused a fall of stroke volume from 79 to 68 ml, a reduction of ejection fraction from 62 to 55% and of circumferential fibre shortening form 1.2 to 0.9 circ/sec. During physical exercise the plasma NE concentration in the arterial (0.51 ng/ml) and coronary venous (0.6 ng/ml) blood increased significantly and increased even further to 0.65 and 0.76 ng/ml, respectively, following administration of Metoprolol. The arterio-coronary sinus difference in NE concentrations demonstrate a release of NE from the myocardium. As compared to control values, heart rate following Metoprolol was lower (116 vs 106/min), mean PCV pressure was slightly increased (from 21 to 23 mm Hg) and there was a fall of cardiac index from 6.3 to 5.2 l/min X m2. It is likely that the increased sympathetic activity after Metoprolol and during exercise is a compensatory reaction due to the hemodynamic effects of blockade of beta-adrenoceptors. Further studies are in preparation in order to find out if this is only a transient phenomenon during the early adaptation phase after blockade of beta-adrenoceptors.

Adult↗
PubMed1978

[Noninvasive assessment of left ventricular dynamics (author's transl)].

ECG triggered scintiphotography has established itself as a reliable, reproducible, noninvasive method for the determination of ventricular volumes, left ventricular ejection fraction, and regional ventricular wall motion. It can be used with sufficient precision and accuracy in severely ill patients who are not suitable for invasive diagnostic procedures. The method is useful for follow-up investigations of known heart disease. In comparison with left ventricular cineangiocardiography a correlation coefficient of r=0.78 could be found for enddiastolic voluumes, of r=0.92 for endystolic volumes, and of r=0.91 for ejection fraction. The sensitivity of the method for recognition of disturbances of regional ventricular wall motion is 94%, the specificity 86%. In comparison with left ventricular cineangiocardiography the resulting accuracy is 90%.

Adult↗
PubMed1978

[Non-invasive nuclear medical diagnosis in cardiology. 201T1-myocardial and ECG triggered heart ventricle scintigraphy].

201Thallium scintigraphy serves as a non-invasive method for visualizing regional perfusion, viability and configuration of the myocardium. Serial scans performed after injection during ergometric exercise allow to differentiate between irreversible cell damage, i.e. myocardial infarction or scar, and transient, reversible ischemia in patients with coronary heart disease. ECG-gated blood pool scans are an ideal adjunct as they represent the functional results of the pathologically altered myocardium. This method permits quantitative determination of the enddiastolic volume, endsystolic volume and left ventricular ejection fraction. Furthermore, regional and global wall motion may be judged qualitatively. Results of both methods show an excellent correlation with those obtained by invasive catheterization and cineangiocardiography. The clinical value is based on screening and follow up of a broad variety of cardiac diseases.

Electrocardiography↗
PubMed1978

[Initial systolic ejection rate as a parameter of ventricular function in valvular heart disease (author's transl)].

In patients with valvular heart disease the initial systolic ejection rate was determined in an attempt to characterize ventricular function in pressure and volume overload. By means of left ventricular cineangiography, the volume change during the initial third of the ejection phase was determined and the mean ejection rate of this period was calculated. A total of 40 patients were examined, 7 patients without heart disease, 15 patients with pure aortic regurgitation, 9 patient with pure aortic stenosis and 9 patients with pure mitral regurgitation. In patients with pure aortic regurgitation and high-normal values for ejection fraction and mean velocity of circumferential fiber shortening (mVcf) a significant increase in initial systolic ejection rate when compared to the group of normals was observed. The distribution of the stroke volume for each third of the ejection phase corresponded to the normal pattern. In contrast, in patients with low-normal values for ejection fraction and mVcf, a decrease in the initial systolic ejection rate below the normal value was observed, along with a pathological distribution of the stroke volume during the ejection phase. This finding was also noted in all patients with pure mitral regurgitation and pure aortic stenosis. In aortic stenosis, the decline in initial systolic ejection rate was regarded as a consequence of the outflow tract obstruction, whereas in volume overload, this was regarded as a sign of a decline in ventricular function which is not recognized with global parameters such as ejection fraction and mVcf.

Angiocardiography↗
PubMed1978

[Evaluation by means of ECG-gated cardiac blood pool scintigraphy of global and regional left ventricular function at rest and during exercise in patients with coronary artery disease (author's transl)].

ECG-gated cardiac blood pool scintigraphy permits a non-invasive determination of the end-diastolic and end-systolic ventricular volumes and of the ejection fraction as well as a qualitative description of regional ventricular wall motion at rest and during excercise. In 6 healthy persons a significant increase of the ejection fraction from 66 +/- 7% at rest to 78 +/- 3% during exercise (p less than 0.01) was observed. In contrast, the ejection fraction decreased in 15 out of 18 patients with coronary artery disease, with a significant (p less than 0.01) difference between patients with and without angina pectoris. Thus, the ejection fraction fell in 12 patients without angina during excercise from 60 +/- 11% to 52 +/- 11% (p less than 0.05) whereas in 6 patients with angina a decrease from 61 +/- 7% to 30 +/- 8% (p less than 0.01) was observed. This non-invasive technique makes it possible to demonstrate in a simple and safe manner changes of cardiac function during excercise in patients with coronary artery disease.

Adolescent↗
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

[Longterm results of mitral valve replacement (author's transl)].

210 patients were followed up by the actuary method for over 5 years after isolated mitral valve replacement or a double valve replacement. After isolated valve replacement the one month survival including the operative mortality was 92+/-2%. The survival after one year was 83+/-3% and after 5 years 66+/-7%. The five year survival of patients in preoperative class III (according to the NYHA) was 73+/-8% and of class IV 57+/-8% (P less than or equal to 0.1). A comparison of valve replacements for pure mitral stenosis or mitral insufficiency showed no statistically significant differences. In the 37 patients who had a double valve replacement the survival risk was not increased in comparison with those patients who had had a single valve replacement. Age above 45 years and a preoperative markedly raised pulmonary arteriolar resistance reduced the chances of survival.

Adolescent↗
PubMed1977

[Natural history in patients with mitral- and aorticvalve-disease (author's transl)].

Knowledge and due consideration of the natural history of valvular heart disease are prerequisites for their operative therapy. Presumptive mortality and morbidity of the surgical intervention must be weighted against the expected prognosis under medical treatment alone. The timing of the operation depends on these considerations. Mitral stenosis and the chronic forms of mitral and aortic incompetence have similar natural histories and for both signs and symptoms are good indicators for an eventual progression of the condition. The length of the period during which the patient is free of complaints may be quite variable but a critical change in the natural history comes about once the disease causes signs and symptoms. Surgical repair is indicated when the patient reaches stage III according to the NYHA-classification. The prognosis is worst for aortic stenosis, in particular due to the danger of sudden death. Patients with high pressure gradients are at particularly high risk; this holds even true for those patients which are not yet suffering from any complaints. The prognosis becomes even more serious, when signs such as dyspnea, anginal pain, or syncopal attacks occur. Prognosis and indication for surgical intervention cannot be evaluated reliably by considering only the clinical signs without knowledge of hemodynamic parameters. Acute mitral and aortic incompetence, in paricular when they occur during baterial endocarditis, must be observed very closely because of their most serious prognosis; if necessary, emergency surgery must be carried out in these cases.

Acute Disease↗