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Biomedical subjects

L Hatle

Publications and source records attributed to L Hatle.

90 records · Page 5Linked to original sources
PubMed1976

Immunoglobulins and complement in chronic myocardial disease. A myocardial biopsy study.

Autoimmune mechanisms have been suggested to be of significance in chronic myocardial diseases. However, the frequency and importance of these factors are unknown. In the present study, endomyocardial biopsy specimens from 21 patients with chronic myocardial disease have been examined by direct immunofluorescence for the presence of immunoglobulins and complement factor C3. Positive staining for immunoglobulin and/or complement was observed in 7 cases. None of the specimens stained for albumin or amyloid. The immunoglobulin deposits were located on the surface of the myofibre and in all but one case, complement was found in the same location. The presence of the complement together with immunoglobulin, and also the lack of albumin, may suggest an immune reaction and not just a passive deposition secondary to heart muscle damage. The localization along the fibres further suggests that the deposits represent an autoimmune reaction to antigens on the fibres and not a trapping of circulating antigen-antibody complexes. It is not known whether the deposits are primary or secondary events, but they may be of importance in initiating or maintaining derangement in heart function.

Aged↗
PubMed1976

Sinoatrial disease in acute myocardial infarction. Long-term prognosis.

Of 32 patients with acute myocardial infarction complicated by sinoatrial disease, 23 survived. All 23 had inferior infarction. During follow-up lasting 4 to 6 years only one patient developed severe chronic sinoatrial disease (sick sinus syndrome) necessitating permanent pacemaker treatment; twelve others died during this time. In 2 of them death was sudden 5 and 6 months after infarction. Atrial pacing studies in 7 of the 11 patients still alive showed no gross abnormalities. A review of 71 patients with chronic sinoatrial disease treated with a permanent pacemaker revealed only 5 with previous documented infarction. The present data suggest that sinus node dysfunction in patients surviving acute infarction is most often only temporary as is atrioventricular block. Occasionally, however, severe chronic sinoatrial disease requiring a permanent pacemaker may develop later, and this course of events is most likely to occur in those patients who had additional complications during the acute infarct.

Adult↗
PubMed1976

Chronic myocardial disease. I. Clinical picture related to long-term prognosis.

The prognosis in chronic myocardial disease is not well defined, partly because of a wide spectrum of clinical courses, and partly because of relatively short observation periods. This paper describes 106 patients followed for 2-12 years. Development or worsening of symptoms after intercurrent infections was associated with a more severe outlook than an insidious debut. The ability to develop myocardial hypertrophy appeared to be an important factor in deciding the prognosis. Pump failure was the cause of death in 80% of the patients, while 16% died suddenly. A favourable course was often noted in patients with ECG signs of left ventricular hypertrophy. This was also the case in patients who developed systemic hypertension. The presence of low voltage, especially in combination with left atrial enlargement, was associated with a malignant development.

Adolescent↗
PubMed1976

Chronic myocardial disease. II. Haemodynamic findings related to long-term prognosis.

Haemodynamic findings in 106 patients with chronic myocardial disease have been related to the course of the disease during a follow-up period of 2-12 years. A high filling pressure, especially when combined with low cardiac output, suggested a severe development. The worst outlook was noted in patients who in addition had raised pulmonary arteriolar resistance. On the other hand, a low filling pressure even if cardiac output was reduced, was generally associated with a more benign course. An increase in left ventricular wall thickness as determined angiographically suggested a better outlook than normal wall thickness.

Blood Pressure↗
PubMed1971

Sinus arrest in acute myocardial infarction.

The results are given of a 4-year prospective study regarding the occurrence, clinical pattern, and treatment of sinus arrest in patients with acute myocardial infarction. The arrhythmia was observed in 32 of 1665 patients. The detection rate increased from below 1 per cent in the first year to 5 per cent in the last due to better facilities for monitoring. All patients except one had inferior infarction. Paroxysmal atrial fibrillation was observed in 12, corresponding to a frequency approximately similar to that previously reported in patients with sinus arrest unrelated to myocardial infarction. Syncope due to sinus arrest occurred in 7 and hypotension in 19 patients. Small doses of isoprenaline given intravenously were usually effective in restoring normal heart rate, but pacemaker therapy was necessary in 3 patients.

Adult↗
PubMedDate not supplied

Maximal blood flow velocities--haemodynamic data obtained noninvasively with CW Doppler.

With continuous wave (CW) Doppler the maximal velocity in intracardiac jets can be recorded and simultaneous imaging makes the localization of these jets easier and unambiguous. The image may indicate the angle to the velocity, but the Doppler signal should be used to obtain the smallest angle and the highest velocity. Corrections for an assumed angle should be avoided since this may cause overestimation. With the maximal velocity a pressure drop can be calculated across obstructions and between chambers in regurgitations and shunts. The combined anatomic and haemodynamic information obtained with simultaneous two-dimensional echo and CW Doppler provides a good noninvasive assessment of most congenital and valvular lesions, including prosthetic valves.

Aortic Valve Insufficiency↗
PubMedDate not supplied

Cross-sectional left ventricular outflow tract velocities before and after aortic valve replacement: a comparative study with two-dimensional Doppler ultrasound.

To assess whether aortic valve replacement (AVR) results in changes in the flow velocity distribution in the left ventricular outflow tract (LVOT), 10 patients undergoing AVR for aortic stenosis were studied. By extracting velocity information from color flow maps as digital data, instantaneous cross-sectional velocity profiles were constructed. Velocity profiles obtained 1 to 3 days before AVR were compared with recordings made 3 months later. The LVOT velocity profiles were variably skewed both before and after surgery, and no systematic or uniform changes could be detected after AVR. The highest velocities were most often localized in the region from the center of the outflow tract diameter toward the septum both before and after surgery. At the time of peak flow the ratio of the maximum to the cross-sectional mean velocity was 1.38 +/- 0.13 before and 1.39 +/- 0.08 after AVR (NS), and the ratio of the maximum to the mean velocity time integral was 1.47 +/- 0.10 before and 1.56 +/- 0.10 after (NS). We conclude that AVR in patients with aortic stenosis does not result in a change in LVOT velocity profiles that will influence stroke volume estimates with the Doppler technique.

Aged↗
PubMedDate not supplied

Thrombotic disc impediment in a Medtronic-Hall aortic valve prosthesis diagnosed by Doppler echocardiography followed by successful reoperation.

A case with impeded disc movement caused by thrombus formation in a Medtronic-Hall aortic valve prosthesis is reported. A correct diagnosis, including both mechanism and severity of the prosthesis failure, was established by Doppler echocardiography. The patient was promptly referred for surgery without invasive or other supplementary investigations.

Aortic Valve↗
PubMedDate not supplied

The velocity distribution in the aortic anulus in normal subjects: a quantitative analysis of two-dimensional Doppler flow maps.

The velocity distribution in the aortic anulus is commonly assumed to be uniform. A skewed velocity profile may have consequences for the accuracy of volume flow estimates by the Doppler echocardiographic technique. To assess this issue, the velocity distribution in the aortic anulus in 12 normal subjects was studied by computer analysis of digital velocity data from two-dimensional Doppler ultrasound flow maps. The velocity profiles in the aortic anulus were found to be flat but slightly skewed, with the highest velocities toward the septum. There was little interindividual variation. Our findings imply that the centerline velocity is the best estimate for the spatial mean velocity at the aortic anulus in normal subjects. The importance of this finding in patients is unknown. In normal subjects, the results suggest that stroke volume might be overestimated by approximately 15% by Doppler echocardiography if the cross-sectional velocity profile is not accounted for.

Adult↗
PubMedDate not supplied

Extrinsic obstruction of a Carbomedics prosthesis in the mitral position: echocardiographic and surgical findings.

In this article a case of malfunction of a Carbomedics mitral prosthesis in a patient with mild symptoms is described. Although there was evidence by echocardiography of a thrombus in proximity to the prosthesis and leaflet immobility assumed to be caused by the thrombus, it was demonstrated, at the time of surgery, that the immobility of the prosthetic leaflet was due to a chorda tendineae stuck between the leaflet and the sewing ring. This is the first report of this occurring in a bileaflet prosthesis. It is likely that the restricted mobility of the leaflet had contributed to the thrombosis of the prosthesis.

Adult↗
PubMedDate not supplied

Interobserver and intraobserver variation for analysis of left ventricular wall motion at baseline and during low- and high-dose dobutamine stress echocardiography in patients with high prevalence of wall motion abnormalities at rest.

Interobserver and intraobserver variation for analysis of left ventricular regional wall motion during dobutamine stress echocardiography was assessed. Computer-displayed cineloops from 33 patients, 25 with baseline wall motion abnormalities, were analyzed by two observers blinded for patient data. Assessment included (1) baseline wall motion abnormalities, (2) evidence of myocardial viability at 10 micrograms/kg/min dobutamine, and (3) evidence of myocardial ischemia at 30 to 40 micrograms/kg/min. Wall motion score index was calculated at each stage. Interobserver and intraobserver agreement for baseline wall motion abnormalities was 100%. Interobserver agreement for viability and ischemia was 84% and 82%, respectively; intraobserver agreement was 92% and 85%, respectively. Mean interobserver differences in wall motion score index ranged from 0.06 +/- 0.14 at baseline to 0.09 +/- 0.20 at high doses (p < 0.05 at all levels); mean intraobserver differences ranged from 0.001 +/- 0.14 to 0.01 +/- 0.15 (difference not significant at all levels).

Adult↗