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Biomedical subjects

O Kamp

Publications and source records attributed to O Kamp.

65 records · Page 4Linked to original sources
PubMed1992

Identifying patients for rate responsive atrial pacing: a new method for patient selection and pacemaker programming.

In patients with sinus node disease (SND) and chronotropic incompetence, atrial rate adaptive stimulation (AAI,R pacing) is regarded as the most appropriate pacing mode. Since coronary artery disease is the most common etiology in these patients, we evaluated a new technique combining two-dimensional transesophageal echocardiography and atrial transesophageal pacing to detect pacing induced wall motion abnormalities and assess safe upper rate limits. Thirty-five patients were studied: 26 with and 9 without angiographic coronary artery disease. Stable atrial capture was achieved in all patients using 12 +/- 3 msec pulse width and 12 +/- 4 mA current strength. Sensitivity and specificity for the detection of coronary artery disease was highest for transesophageal echocardiography during pacing (sensitivity 81%, specificity 100%). Simultaneous 12-lead ECG during pacing had lower values (sensitivity 57%, specificity 75%). Pacing induced wall motion abnormalities preceded ST segment changes in all patients. Exercise stress testing showed similar values (sensitivity 62%, specificity 89%). It is concluded that simultaneous transesophageal echocardiography and transesophageal pacing is a safe and useful technique in selecting patients for AAI,R pacing and for the detection of safe upper rate limits, particularly when coronary artery disease is suspected.

Algorithms↗
PubMed1991

Transesophageal echocardiography and magnetic resonance imaging for the assessment of saccular aneurysm of the transverse thoracic aorta.

We report a patient who initially presented with hoarseness and was admitted to our hospital with chest pain, caused by a saccular aneurysm of the thoracic aortic arch. The initial diagnosis was made by cross-sectional echocardiography, the extension and morphology of the saccular aneurysm being detected by transesophageal echocardiography. Magnetic resonance imaging confirmed the measurements of the aneurysm and clearly showed the anatomic relation with surrounding structures and arch vessels. The patient refused operation and died during in-hospital stay. A rupture of the thoracic aneurysm was the cause of death.

Aged↗
PubMed1991

Feasibility of emergency surgery for the treatment of an echocardiographically detected right atrial thrombus in a patient over 80 years of age presenting with shock.

We report the case of an 83-year old woman, presenting with progressive shock, in whom a right atrial thrombus was diagnosed by cross-sectional echocardiography. Doppler echocardiography demonstrated diastolic interruption of tricuspid inflow. Emergency thrombectomy was successful and without major complications despite the advanced age.

Aged↗
PubMed1991

Effects of nisoldipine on systolic and diastolic function in postinfarction patients with reduced left ventricular function: a randomized, double-blind, placebo controlled study.

The long-term effects of oral nisoldipine or placebo on clinical variables, exercise test results and echo Doppler-determined systolic and diastolic functions were studied in 30 consecutive patients with reduced left ventricular function (predischarge echocardiographic wall motion score greater than or equal to 8) following myocardial infarction. Groups were comparable in clinical variables, exercise results, echo Doppler measurements and coronary anatomy. During 6 months follow-up, death, reinfarction and bypass surgery or balloon angioplasty were equally distributed. A significant increase in exercise duration and time to onset of ST-depression was found in the nisoldipine treatment group, compared to the placebo group after 3 and 6 months. Time to onset of angina was not significantly different. Echocardiographic indices of left ventricular systolic function (ejection fraction and wall motion score) were unaltered; however, the time-velocity integral of the early diastolic filling phase and the early vs late diastolic flow velocity ratio were significantly increased while the atrial time-velocity integral vs total time-velocity integral was significantly decreased in the nisoldipine treatment group after 3 and 6 months of follow-up. In conclusion, nisoldipine reduced exercise-induced ischaemia, improved exercise capacity and diastolic left ventricular function in postinfarction patients with reduced left ventricular function.

Cardiac Catheterization↗
PubMed1989

Short-, medium-, and long-term follow-up after percutaneous transluminal coronary angioplasty for stable and unstable angina pectoris.

The first 840 consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) performed in the same institution were retrospectively assessed at an average follow-up period of 25 months after the initial procedure. The study population consisted of 506 patients with stable angina pectoris (group 1) and 334 patients with unstable angina pectoris (group 2). Clinical end points were death, nonfatal myocardial infarction, recurrent angina pectoris necessitating bypass surgery or repeat PTCA, and event-free survival. The two groups were comparable with respect to age, sex, previous myocardial infarction, ejection fraction, and number of diseased vessels. PTCA was successful in 83.0% of group 1 and 87.1% of group 2. Follow-up rates were expressed as events per attempted PTCA in a patient group. No difference in survival was observed between the two groups, the mortality rate being approximately 2.8% at 25 months. In the group with stable angina pectoris there was a lower incidence of nonfatal myocardial infarction within the first 24 hours after angioplasty; 4.3% vs 9.0% (p less than 0.01). During long-term follow-up the increase in the incidence of nonfatal myocardial infarction was similar, resulting in an overall long-term follow-up infarction rate of 8.3% and 14.2%, respectively (p less than 0.01). A higher event-free survival was observed in group 1 within 24 hours after PTCA: 93.7% vs 84.2% (p less than 0.01). During subsequent follow-up the difference in event-free survival between the two groups was no longer significant: 68.5% vs 61.2%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Transesophageal color flow Doppler mapping in the assessment of native mitral valvular regurgitation: comparison with left ventricular angiography.

Transesophageal echocardiography (TEE) was performed within 24 hours after cardiac catheterization in 45 patients for assessment of native mitral valvular regurgitation. Color flow mapping was used in evaluating systolic regurgitant jet sizes. A jet demonstrated by TEE was 96% sensitive and 44% specific for angiographic mitral regurgitation. The presence of angiographic mitral regurgitation was best predicted by (single measurement) (1) a holosystolic jet, (2) a jet length greater than 2.5 cm, and (3) a jet area greater than 2 cm2. Severe angiographic mitral regurgitation (grades 3 and 4) was best predicted by (single measurement) (1) a jet area greater than 5 cm2, and (2) a jet length greater than 4 cm. It is concluded that the assessment of angiographic mitral regurgitation by TEE is improved by the measurement of these jet parameters, which have a high sensitivity and higher specificity than the presence of a jet alone. Furthermore, with TEE one is able to differentiate severe (grades 3 and 4) from absent or mild mitral regurgitation (grades 0, 1, and 2).

Adult↗
PubMedDate not supplied

Value of pulmonary venous flow characteristics in the assessment of severity of native mitral valve regurgitation: an angiographic correlated study.

To evaluate the relation between left ventricular angiography and pulmonary venous flow velocity in native mitral valve regurgitation, 28 patients with sinus rhythm and valvular and/or coronary artery disease underwent transesophageal echocardiography within 24 hours after cardiac catheterization. Group I consisted of 17 patients, seven patients without (grade 0) and 10 patients with angiographically mild to moderate mitral regurgitation (grades 1 and 2). Group II consisted of 11 patients with angiographically severe mitral regurgitation (grades 3 and 4). Mitral regurgitation by transesophageal echocardiography was evaluated by measuring the regurgitant jet sizes and color-guided pulsed Doppler pulmonary venous flow velocities. Multivariate analysis revealed that the most powerful predictor (p less than 0.001) of angiographically severe (grades 3 and 4) mitral regurgitation was reversed systolic flow into the left upper pulmonary vein (sensitivity 82%, specificity 100%, positive predictive value 100%). If this variable was excluded from analysis, jet area and jet length (p less than 0.001) were the next best predictors for angiographically severe mitral regurgitation. Mean values of systolic peak pulmonary venous flow velocities were significantly lower in patients from group II, 13.0 +/- 11.1 cm/s versus 43.4 +/- 20.6 cm/s (group I) with p less than 0.005. This finding was also true for systolic time velocity integral, 1.3 +/- 1.3 cm (group II) versus 7.8 +/- 5.3 cm (group I) with p less than 0.005.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗