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Biomedical subjects

O Danne

Publications and source records attributed to O Danne.

At least 19 recordsLinked to original sources
PubMed1992

Left ventricular hypertrophy regression during antihypertensive treatment.

For more than 20 years hypertrophy regression has been in the focus of hypertension research. Many studies in animals have shown impressive reduction of left ventricular hypertrophy after medical treatment of hypertension. The most important result seems to be that hypertrophy can be almost completely reversed in young animals, whereas in older animals regression of left ventricular hypertrophy appears to be less complete. Hypertrophy regression in man seems much more difficult to prove. The direct correlation between left ventricular muscle mass and ECG changes has been disappointing in many studies. Echocardiography is able to show a comparatively good impression of left ventricular muscle mass and therefore can also demonstrate regression of left ventricular hypertrophy within its methodological limits. There is no doubt that today magnetic resonance imaging has by far the best imaging quality of all the clinical methods and is able to demonstrate both hypertrophy and its regression with incomparable accuracy. In the present clinical study hypertrophy regression has been demonstrated after 6 months of treatment with Carvedilol.

Adrenergic beta-Antagonists↗
PubMed1991

[Effect of smoking on relaxation and filling behavior of the left ventricle in healthy probands. An echocardiography study].

UNLABELLED: To examine the impact of acute nicotine consumption echocardiographic examination was performed in 22 healthy subjects (nine women, 13 men, 20 to 50 cigarettes/day over a minimum of five years) without any evidence of organic heart disease (normal 2D and Doppler echo, normal ECG at rest and during exercise) aged 20 to 51 years (mean +/- SD: 37 +/- 9 years) before and after cigarette smoking (0.9 mg nicotine). Left ventricular filling parameters were derived by transmitral pulsed Doppler ultrasound with the flow profile along the mitral valve being characterized by the early diastolic (E-wave) and late diastolic (A-wave) inflow into the left ventricle. The isovolumetric relaxation period was determined by simultaneous M-mode registrations over the aortic and mitral valve. During smoking the early diastolic peak velocity decreased from 56 to 52 cm/s (p less than .01) and the early diastolic flow integral fell from 64 to 56 mm (p less than .01). The A/E ratio of the peak velocities rose from 68 to 82% (p less than .001), the A/E ratio of the flow integrals increased from 46 to 56% (p less than .001) and the atrial contribution to ventricular filling rose from 33 to 36% (p less than .001). Furthermore during cigarette smoking the isovolumetric relaxation period rose from 70 to 77 ms (p less than .001). - CONCLUSION: In healthy subjects cigarette smoking causes an increase of the atrial contribution to ventricular filling and the isovolumetric relaxation period. Thus, acute nicotine consumption significantly impairs the energy-consumpting process of early diastolic relaxation, independently of its role as a risk factor for atherosclerosis.

Adult↗
PubMed1991

[Non-invasive detection of left ventricular diastolic function in variously trained endurance athletes during a marathon run with pulsed Doppler sonography].

UNLABELLED: To evaluate left ventricular (LV) diastolic function in long distance runners LV filling parameters were assessed by Doppler echocardiography during marathon race in 23 male subjects. On the basis of their personal record the athletes were divided into two groups: 12 endurance athletes (END; 218 min over 42 km) aged 34 years (29/37, median and 25%/75%-percentiles) and 11 ultra endurance athletes (ULTRA; 152 min over 42 km) aged 32 years (28/37). At rest 21 healthy untrained subjects (UT) aged 33 years (28/37) served as control group. In long distance runners the values for LV mass and LV mass index were significantly higher in END with 210 (168/253) g rsp. 110 (87/135) g/m2 and in ULTRA with 225 (179/267) g rsp. 118 (93/142) g/m2 as compared to UT with 129 (105/162) g rsp. 68 (57/79) g/m2 (p less than 0.001 each). Doppler-derived mitral flow was characterized by the early passive (E wave) and late (A wave) diastolic inflow. In particular atrial filling fraction (AFF) as the relative atrial contribution to LV filling was measured. At rest and at km 21 we saw a normal filling behaviour (AFF = 27% bzw. 28%) in both groups of long distance runners with an AFF of 27 (26/29)% in END and an AFF of 28 (26/29) in ULTRA. In END AFF rose to 42 (38/47)% at km 42 (p less than 0.001) and remained significantly elevated with 37 (35/42)% until 30 min post marathon (p less than 0.05). Only 60 min post exercise AFF returned to baseline values with an AFF of 28 (25/39)% in END. In contrast at km 42 in ULTRA AFF was significantly lower and at baseline levels with 26 (25/29)% compared to END (p less than 0.001) and did not significantly change in the further course of the post running period. CONCLUSION: Long distance runners show a normal LV filling behaviour at rest despite significant LV hypertrophy. In contrast to top class athletes (ULTRA) there is a shift of LV filling from early (E wave) to late (A wave) diastole in less trained runners (END) during marathon. Thus, the results indicate an impairment of early diastolic LV filling in amateur endurance athletes (END) during extreme physical exercise.

Adult↗
PubMed1990

[Scintigraphic quantification of pulmonary pressure increase in mitral valve stenoses based thallium uptake by the lung].

30 patients (24 fm, 6 m) with angiographically proven mitral stenosis as well as 10 healthy controls were investigated by wedge catheterism and thallium-201-scintigraphy to calculate the heart-lung quotient of the isotope. All patients with mitral stenosis could be discriminated from controls by a pathological increase of isotope concentration in the lungs. 4 groups could be subdivided: the first consisted of 8 patients with normal pulmonary artery pressure of x = 13.06 mm Hg and a normal heart-lung quotient less than 1.1. The second group of 15 patients showed passive pulmonary hypertension with a PAm of x = 27.57 mm Hg and heart-lung quotients between 1.1 and 1.4. A third group of 9 patients showed PAm of 36.76 mm Hg with reactive hypertension and a HLQ between 1.4 and 1.6. The last group of patients showed pulmonary hypertension of x = 45 mmHgPAm and a heart-lung quotient of greater than 1.6. Scintigraphy alone allowed classification of the patients, so the value of this method is proven for pre- and postoperative strategy.

Exercise Test↗
PubMed1990

[Noninvasive detection by Doppler and M-mode echocardiography of acute rejection reaction after heart transplantation: preliminary results of a prospective study].

Diagnosis of acute cardiac allograft rejection is still based on the results of endomyocardial biopsy. The objective of this study was to evaluate changes of left ventricular (LV) diastolic function associated with rejection using Doppler and M-mode echocardiography. The study patients, consisting of 29 cardiac allograft recipients (12 female, 17 male) aged 27 to 58 (mean 41) years, were classified into two groups on the basis of histopathologic findings: 13 patients without rejection (mean age 40 years) and 16 patients with moderate to severe allograft rejection (mean age 42 years) at myocardial biopsy. All patients underwent serial echocardiographic examination 4-10 weeks after transplantation and 8 +/- 2 days later on the day of myocardial biopsy. Twenty-five healthy volunteers (11 female, 14 male; mean age 39 years) served for assessing normal values. Echocardiographic assessment included peak velocity (PEV), pressure half-time (PHT), velocity-time integral (VTI-E) of early mitral flow (E-wave), and isovolumic relaxation period (IVRP). In transplant recipients, significantly higher values as compared to normals were found for PEV (72 vs 55 cm/s; p less than 0.01), PHT (51 vs 42 ms; p less than 0.001), VTI-E (71 vs 56 mm; p less than 0.001), and IVRP (91 vs 73 ms; p less than 0.001). During rejection, heart rate increased significantly from 78 to 93 beats/min (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

[Possibilities for imaging intracardiac thrombi with indium 111 thrombocyte scintigraphy].

Intracardiac thrombi can be localized and quantified by indium-111-labelling of thrombocytes with a high sensitivity and specificity. The scintigraphic procedure has a complementary evidence to echocardiography. Scintigraphy shows activity and age of thrombosis, whereas echocardiography seems to be superior in determination of mass and localization. In older thrombi scintigraphy fails because of organisation and endothelialization of the thrombus surface. For the reason of determination of the age of an intraventricular thrombus this method might have an increasing acceptance.

Aged↗
PubMed1989

Imaging of acute myocardial infarction by magnetic resonance tomography (MRT) using the paramagnetic relaxation substance gadolinium-DTPA.

Twenty-six patients admitted to the Free University of Berlin University Hospital catheterization laboratory with acute myocardial infarction were studied. The diagnosis was confirmed by angiography, but acute revascularization was unsuccessful in every case. MR imaging was performed within 7 days of the acute event in 11 patients with uncomplicated clinical courses after acute infarction. Imaging was performed within 3 weeks in three additional cases, while the remaining 12 patients underwent studies more than 3 weeks after infarction. We determined signal intensity at three points within the area of infarction and at three other points in adjacent myocardial tissue. Decreased signal intensity within the area of infarction was found in native scans in 60% of all cases. Administration of gadolinium-DTPA 0.1 mmol/kg body weight was followed by a mean 70% increase in signal intensity within the zones of acute infarction, as compared to a 20% increase in surrounding myocardial tissue. In cases of subacute and chronic infarction, there was no significant signal enhancement after administration of gadolinium-DTPA. Uptake of the substance in the area of acute infarction may be a positive marker of acute myocardial necrosis and as such may prove useful in the clinical setting.

Acute Disease↗
PubMed1989

Regression of left ventricular hypertrophy under ramipril treatment investigated by nuclear magnetic resonance imaging.

Thirty-two hypertensive subjects with diastolic blood pressure greater than 95 mm Hg were treated with ramipril over a period of 3 months. To determine the effective decrease of blood pressure and for reliable and reproducible demonstration of regression of myocardial hypertrophy during ramipril treatment, we performed parallel measurements with magnetic resonance imaging (MRI) and echocardiography. Measurements were carried out before treatment, 4 h after the first dose, and after 14 days and 3 months of treatment. MRI slices showed a significant decrease of interventricular septal thickness from 19.57 to 15.20 mm, whereas echocardiography demonstrated an equivalent decrease from 18.78 to 14.57 mm. At each measuring point, quantification of wall thickness was performed three times and the means were calculated. The septum and the posterior wall of the left ventricle were also measured at three different points. The values were obtained with negligible scatter and the changes with ramipril treatment were highly significant (p less than 0.001). A concomitant decrease of blood pressure was also observed. The therapeutic aim to reduce diastolic blood pressures below 90 mm Hg was achieved in all patients. In addition to the significant reduction in blood pressure, the angiotensin converting enzyme (ACE) inhibitor ramipril caused a significant regression of pathologic left ventricular hypertrophy demonstrated by magnetic resonance imaging and echocardiography.

Adult↗
PubMed1989

[Imaging of intra-cardiac thrombi with indium 111 scintigraphy].

Intracardiac thrombi can be localized and quantified by Indium-111-labelling of thrombocytes with a high sensitivity and specificity. The scintigraphic procedure has a complementary evidence to echocardiography. Scintigraphy shows activity and age of thrombosis, whereas echocardiography seems to be superior in determination of mass and localization. In older thrombi scintigraphy fails because of organisation and endothelialization of the thrombus surface. For the reason of determination of the age of an intraventricular thrombus this method might have an increasing acceptance.

Aged↗
PubMed1989

[Lung thallium uptake for non-invasive assessment of increased pulmonary pressure in mitral valve stenosis].

30 patients (24 females, 5 males) with angiographically proven mitral stenosis as well as 10 healthy controls were investigated by wedge catheterism and thallium-201-scintigraphy to calculate the heart-lung quotient (HLQ) of the isotope. All patients with mitral stenosis could be discriminated from controls by a pathological increase of isotope concentration in the lungs. 4 groups could be subdivided: the 1st group consisted of 21% of the patients with normal pulmonary artery pressure of x = 13.06 mm Hg and a normal HLQ less than 1.1. The 2nd group of 39% of the patients showed passive pulmonary hypertension with a PAm of x = 27.57 mm Hg and HLQ between 1.1 and 1.4 A 3rd group showed PAm of 36.76 mm Hg with reactive pulmonary hypertension and a HLQ between 1.4 and 1.6. The last group showed pulmonary hypertension of x = 45 mm Hg PAm and a HLQ of greater than 1.6. Scintigraphy alone allowed classification of the patients, so the value of this method is proven for pre- and postoperative strategy.

Exercise Test↗
PubMed1988

Amitriptyline-induced prolonged cholestasis.

We report the case of a patient in whom amitriptyline administration for 5 wk was followed by prolonged cholestasis. Jaundice and pruritus lasted 19 and 20 mo, respectively. Three liver biopsies were performed at different stages of the disease showing the course of liver lesions. Cholestasis initially located in the region of the hepatic venule came to be associated with the progressive development of portal tract lesions consisting of inflammatory infiltration, fibrosis, and disappearance of interlobular bile ducts. Amitriptyline hydroxylation and dextromethorphan O-demethylation are deficient in subjects with the poor metabolizer phenotype of debrisoquine. Drug oxidation phenotyping with dextromethorphan showed that this patient had the extensive metabolizer phenotype. This observation demonstrates that amitriptyline can induce prolonged cholestasis and suggests that the susceptibility to develop liver injury while taking this drug may not be related to a genetic deficiency of its hydroxylation.

Adult↗
PubMed1988

[Multiple proximal coronaro-pulmonary fistulae. Review of the literature apropos of a new case].

The authors report a new case of multiple proximal coronaro-pulmonary fistula between right coronary arteries, anterior interventricular artery and the trunk of the pulmonary artery, in a 64 year-old female patient with chest pain and a continuous murmur located in the third left intercostal space. The coronary steal is demonstrated by a myocardial scintigraphy during stress with return to normal after surgical ligation. A review of the literature enabled to find 33 cases of this major congenital anomaly of the coronary arteries, defined as an abnormal communication between at least two main coronary vessels and the trunk of the pulmonary artery. This results in a left-right shunt, usually minor without any repercussions on the right cavities and pulmonary pressures. The entire clinical, electrocardiographic, radiological, sonographic, scintigraphic, haemodynamic and angiographic picture is reported for these 33 cases. A physiopathological discussion is proposed. The course of this disease is usually favorable (only one case of myocardial infarction was published, without cardiac failure. Osler's endocarditis or sudden death); this seems to authorize simple monitoring as a logical therapeutic approach except when a myocardial ischemia secondary to coronary steal is demonstrated, imposing a surgical correction.

Arterio-Arterial Fistula↗
PubMed1988

[Comparative clinical studies of myocardial blood flow in coronary heart disease with two nifedipine preparations].

Clinical, ergometric and scintigraphic examinations were performed before and after oral administration of a commercially available nifedipine preparation used as a standard (reference preparation; dosage: 3 x 10 mg/d) in 21 patients with angiographically verified coronary artery disease. In an open comparison study the same parameters were investigated after a 4 week course of a different nifedipine preparation as a test preparation (Corotrend; dosage: 3 x 10 mg/d). The study was performed in order to determine whether there were quantitative differences in myocardial microperfusion when different galenical preparations of nifedipine were used. There were no statistically significant differences between the two nifedipine preparations in the test parameters recorded. Both substances were associated with highly significant increases in microperfusion as compared to findings in the washout phase. Clinical effects on incidence of chest pain and on reductions in blood pressure were comparable. Patients demonstrated slightly better exercise tolerance with the reference agent, and computerised impulse-rate analysis of the tomoscintigrams demonstrated somewhat better microperfusion with this drug, though the differences between the two agents did not attain statistical significance. As the result of this analysis the two drugs would appear to be equivalent in clinical potency.

Aged↗
PubMed1988

Microperfusion in coronary artery disease under treatment with the calcium antagonist gallopamil.

The calcium antagonistic principle, i.e. the inhibition of calcium influx into the heart muscle cell and smooth muscle cell, in this particular case gallopamil as an example of a drug with this principle of action, can certainly be regarded as one of the most important concepts in modern coronary therapy. On account of the increase of myocardial perfusion, which is ascribed to this calcium antagonist, gallopamil may be administered as an adjunct to postoperative therapy. It is even a drug alternative to bypass grafting. Previous investigations of the ST segment and subjective ischemic parameters have not always shown coherent findings. The purpose of this study was to objectify clinical improvement after therapy with gallopamil (Procorum) by means of reliable methods and reproducible measurements. Myocardial perfusion was analysed in 31 patients by longitudinal tomoscintigraphy before and after therapy with 2 x 2 mg gallopamil intravenously and 6 weeks at 3 x 50 mg/d orally followed by placebo control. The computerized circumferential mapping of impulse rates showed a significant increase of impulse density in ischemic segments after both intravenous and oral therapy with gallopamil.

Administration, Oral↗
PubMed1983

Fluorouracil (F), Adriamycin (A), and cisplatin (P) (FAP): combination chemotherapy of advanced esophageal carcinoma.

Twenty-one patients with advanced epidermoid carcinoma of the esophagus were treated with a combination of 5-fluorouracil (F) 600 mg/m2 day 1 and day 8; Adriamycin (A) 30 mg/m2 day 1; and cisplatin (P) 75 mg/m2 day 1 (FAP) with hydration and mannitol-induced diuresis. Each course was repeated every 4 weeks. All 21 patients are evaluable for response: 7 patients had an objective response (33%). Two of these responses were complete remissions according to negative endoscopic and pathologic results; five patients had a partial response; all 7 responding patients had metastasis prior to treatment. Median survival of the 21 patients was 8 months. Median survival of 9 months for responders is superior to 4.5 months for nonresponders. No severe myelosuppression or nephrotoxicity was observed. This FAP regimen is useful in the treatment of advanced esophageal tumors.

Adult↗
PubMed1982

[Treatment of advanced epidermoid carcinoma of the oesophagus with combined 5-fluorouracil, adriamycin and cis-platinum (FAP)].

Twenty-one patients with advanced, inoperable epidermoid carcinoma of the oesophagus were treated with combined 5-fluorouracil (F, 600 mg/m2, days 1 and 8), adriamycin (A, 30 mg/m2, day 1) and cis-platinum (C, 75 mg/m2, day 1), together with hydratation and mannitol-induced diuresis. Each course was repeated after 4 weeks. Response could be assessed in all 21 patients and was objective in seven (33%), who had metastasis prior to treatment. Two of these 7 patients went into complete remission confirmed by negative endoscopy and pathology; 5 showed partial response. Median survival of the 21 patients was 8 months; it fell to 4.5 months in non-responders and rose over 9 months in responders. Three patients survived for more than 16 months. No severe bone marrow depression or nephrotoxicity was observed. The 3-drug combination appeared to be more effective than the additive effects of each drug given separately. It is concluded that the FAP regimen is useful in the treatment of advanced oesophageal tumours.

Adult↗