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Biomedical subjects

H Sebening

Publications and source records attributed to H Sebening.

At least 55 records · Page 3Linked to original sources
PubMed1976

[Indications for selective coronary angiography].

At present, selective coronaro-angiography offers the only means of establishing the seriousness, extent and site of coronary sclerosis. It has led to the development of coronary surgery, itself a considerable advance in the treatment of coronary disease. The method is also of considerable assistance in the differential diagnosis of inexplicable ECG changes and other heart diseases. It is relatively free from risk if performed by experienced staff with suitable equipment and in line with the correct indications.

Angina Pectoris↗
PubMed1976

[Haemodynamic effect of dobutamine in cardiac failure (author's transl)].

Dobutamine, a new catecholamine with a positive inotropic action, was given by infusion to 9 patients with cardiac failure in a dosage of 5 and 7.5 mug/kg-min over a period of 15 minutes. An improvement of left ventricular function was proven by an increase of cardiac output by 33%, a reduction of end-diastolic pressure from 21 to 14 mm Hg, an improvement of left ventricular ejection fraction from 29 to 39% and of the mean circumferential fibre contraction velocity from 0.4 to 0.8 circ/s. The systolic aortic pressure increased by a mean of 14% (5 mug/kg-min) and 23% (7.5 mug/kg-min). However, the resistance of the systemic circulation decreased from 1858 to 1439 and 1444 dyn-s-cm-5. Cardiac frequency remained unchanged with a dosage of 5 mug/kg-min and increased by a mere 7 beats/min with a dosage of 7.5 mug/kg-min. There was no increased tendency for arrhythmia. Dobutamine thus appears to act relatively selectively on myocardial beta-1 receptors. Results so far indicate therapeutic success in patients with severe cardiac failure, particularly in the low-output syndrome.

Adult↗
PubMed1976

[Indications for selective coronary angiography (author's transl)].

At the present time, selective coronary angiography is the only diagnostic possibility for establishing the severity, extent and localization of coronary arteriosclerosis in the living human. It has led to the development of coronary surgery which is a significant acquisition to the treatment of coronary heart disease. In the differential diagnosis of obscure electrocardiographic changes and other clinical cardiological pictures, it is a considerable help. Selective coronary angiography carries relatively little risk if suitable personnel and technical facilities are available and a careful indication for its performance is observed.

Angiography↗
PubMed1976

[Regional contraction of the left ventricle in congestive cardiomyopathy].

Regional analysis of ventricular angiograms obtained at diagnostic cardiac investigation was undertaken in 22 patients with congestive cardiomyopathy and 16 healthy subjects. Applying the concept of radial motion, directed towards the centre of the left ventricle, akinetic zones of 20 to 50% of left ventricle circumference were found in more than half the cases of congestive myopathy. The greater the area of regional abnormal motion, the greater the reduction in haemodynamic variables and left ventricular function. The clinical status of nearly all patients with large akinetic areas deteriorated in the subsequent period of observation (6-48 months, averaging 26 months). But in patients without additional abnormal regional wall motion the clinical condition remained stable. A large akinetic area in congestive myopathy indicates severe reduction in left ventricular function and is an unfavourable prognostic sign.

Adult↗
PubMed1976

[Clinical features and course of congestive cardiomyopathy of unknown aetiology (author's transl)].

Clinical, haemodynamic and angiographic findings in 50 patients with congestive cardiomyopathy were related to subsequent clinical course (mean observation period of 40 months). Ejection fraction and changes in mean pulmonary "wedge" pressure on ergometric exercise proved to be the most reliable criteria for judging left-ventricular function. During the period of observation 11 patients had died, in 15 the clinical state had deteriorated by one or two functional classes, and in 24 there had been no change. Patients with progressing disease differed from those clinically unchanged by having a smaller cardiac index, increased end-diastolic left ventricular pressure, higher pulmonary arterial pressure and smaller ejection fraction. Prognosis was no worse with atrial fibrillation than with sinus rhythm. Four of 13 patients with left bundle branch block died during the observation period and in seven the clinical state had deteriorated by one or two functional classes. The tested variables apparently have a good prognostic value.

Adolescent↗
PubMed1976

Experience with 201 thallium in detection of myocardial infarction.

Our preliminary experimental and clinical results with 201Tl myocardial scanning are presented. 48 patients with normal coronary vessels, acute trasmural myocardial infarction, localized and diffuse coronary heart diseases and congestive myocardiopathy were investigated. Results of scans and the usual cardiological investigations were in good agreement thus justifying further use of 201Tl myocardial scintigraphy as an adjunctive method in cardiology.

Animals↗
PubMed1976

[Clinical and experimental investigations with 201tl for noninvasive myocardial scintigraphy (author's transl)].

The biological distribution of 201Tl after intravenous injection was studied experimentally in 42 rats. It was found (see figure 1) that the kidneys showed the greatest affinity for 201Th, reaching an activity concentration of 6.6% per gramme of tissue, almost independently of time. Within the first 30 minutes of injection, myocardial activity exceeds that of the surrounding structures (10 min. p.i.: 4.24%/g; 30 min. p.i.: 2.58%/g). During this time the myocardium can be well demonstrated by "image processing". The relatively fast myocardial kinetics of 201Tl (half value time 33 minutes) make it necessary, strictly speaking, to use a scintillation camera. The clinical value of this method is illustrated by a number of case histories.

Animals↗
PubMed1975

[Sinus-node recovery time in the sick-sinus syndrome (author's transl)].

Sinus-node recovery times were measured, before and after atropine administration, in 21 patients with the clinical diagnosis of sick-sinus syndrome. The results were compared with those reported by other workers. It is concluded that sinus-node recovery times of more than 1 400 ms are most likely due to sinus-node damage (sick-sinus syndrome); normal recovery times are rare in such patients. The diagnosis of the syndrome is strengthened if the recovery time remains abnormally long even after atropine. Further useful diagnostic information can be obtained from the total stimulation phase (duration until restoration of the basic rhythm), this being overall longer in patients with the syndrome than in normal subjects. The increased incidence of A-V nodal rhythms before restoration of the basic rhythm is another indication of organic damage to the sinus node, especially if it also occurs after atropine. The significance of a recovery time which is prolonged before but normal after atropine is less clear: a raised sensitivity to vagotonic influences may be the determining factor here.

Adult↗
PubMed1975

[Autoantibodies against heartmuscle sarcolemma in sera of patients with an idiopathic cardiomyopathy (author's transl)].

68 patients with clinical and hemodynamical diagnosis of idiopathic cardiomyopathy (CM) were analysed for antibody in their sera using an immunofluorescence sandwich technique after titration of the sera in tissue sections. 60 of these patients had antibodies against heart muscle sarcolemma with titers up to 1:64. Out of these, the antibodies in 9 sera could be absorbed with group A streptococci. The antibodies reacted in no case with striated or smooth muscle sarcolemma. The 25 patients with an obstructive type of CM showed the highest titers and 12 of them, in addition, had antinuclear factors in their sera. These findings suggested an auto-allergic etiology for most cases of idiopathic CM.

Animals↗
PubMed1975

[Sinus node syndrome].

Recently disorders of sinus node function have found increasing interest in clinical medicine thanks to new diagnostic and therapeutic developments. This paper represents a comprehensive review of these conditions, combined under the name "Sick Sinus Syndrome" (SSS). Besides a detailed analysis of 63 cases seen at our institution, the results of other groups are compared and extensively discussed. The clinical picture of the SSS is characterized by a wide variety of bradycardiac and tachycardic atrial arrhythmias, occurring separately or in combination. These can be classified in three subgroups: Patients with exclusive sinus bradycardia; patients with sinoatrial exit block or transient episodes of sinus arrest with or without AV escape rhythms; and finally patients with the bradycardia/tachycardia-syndrome, which are complicated by additional atrial tachyarrhythmias. The symptomatology of the SSS is multiform and extends from symptomless cases and those with only general signs of reduced cardiac function to patients with recurrent severe syncopal attacks which may lead to cerebral damage and even death. Besides the typical history, the diagnosis of the SSS primarily rests upon the ECG, especially the long term ECG recorded continuously on a 24 hrs. tape (Holter technique). Also the exercise ECG is of some value, characteristically showing an inadequate increase in the sinus rate, sometimes with AV escape systoles and -rhythms. In addition various provocative tests have been devised which are of help to differentiate between a pathologic and a normal sinus node function. Among these the determination of the sinus node recovery time following overdrive atrial pacing has gained wide acceptance. In most cases the exact etiology of the SSS is not known. In addition to coronary and inflammatory heart diseases a primarily degenerative lesion of the sinus node, comparable to cases with "primary heart block" are discussed. There is also a remarkably frequent past history diththeria. Rarer causes of the condition represent cases with cardiomyopathy, thyreotoxic heart disease, collagen and other disorders and also a familial manifestation of the SSS has been described. Therapeutically, pharmacologic treatment with vagolytic, beta-adrenergic or the common antiarrhythmic drugs is often unsuccessful, especially in the treatment of the Brady-Tachy-Syndrome. Digitalis glycosides, however, are frequently of some value, as they represent an effective prophylactic agent against atrial tachyarrhythmias without prolonging the sinus node recovery time or reducing significantly the sinus rate. While a few patients do not require any treatment, an artificial cardiac pacemaker has to be inserted in most cases. Atrial stimulation may be superior to ventricular on-demand pacing in some patients, and also a special system for the treatment of the SSS combined with significant AV block (binodal disease) has been designed, the bifocal sequential pacemaker.

Age Factors↗