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R Arbogast

Publications and source records attributed to R Arbogast.

14 recordsLinked to original sources
PubMed1992

Increase in radionuclide left ventricular ejection fraction after cardioversion of chronic atrial fibrillation in idiopathic dilated cardiomyopathy.

To assess the potential improvement in left ventricular ejection fraction after cardioversion of chronic atrial fibrillation to sinus rhythm in idiopathic dilated cardiomyopathy, we studied prospectively 17 patients, aged 58 +/- 6 years, by radionuclide angiocardiography at rest. Left ventricular ejection fraction was determined before treatment and at a mean delay of 4.7 months after cardioversion. Return to sinus rhythm was obtained in 12 patients, pharmacologically or by electrical cardioversion. Five patients remained in atrial fibrillation. No clinical, echocardiographic or haemodynamic finding could predict the success of cardioversion. In chronic atrial fibrillation, the ejection fraction did not change significantly: 30.0 +/- 9.1% (19 to 44%) at the first evaluation and 29.5 +/- 8.3% (22 to 41%) after 4.7 months. After successful cardioversion, left ventricular ejection fraction improved from 32.1 +/- 5.3% (24 to 41%) to 52.9 +/- 9.7% (37 to 71%) (P less than 0.001). The difference was 20.8 +/- 11.3% and left ventricular ejection fraction was normalized in 50% (6/12) of the patients. There was a significant reduction in the cardiothoracic ratio on chest X-rays and of the left ventricular end-diastolic diameter on echocardiography; fractional shortening increased (27.7 +/- 4.3% vs 20.3 +/- 2.7%, P less than 0.01). A third evaluation was realized after a mean delay of 11.7 months in the patients with successful cardioversion. Sinus rhythm was present in 83% (10/12) of the patients: seven patients were reevaluated by radionuclide angiography. The improvement in left ventricular function observed at the 4.7 months evaluation was still present. In two patients with recurrence of atrial fibrillation, there was a severe deterioration of left ventricular systolic function.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Acute myocardial infarction: immediate coronary angioplasty for failure or contra-indications of thrombolytic therapy. Apropos of a series of 100 cases].

One hundred patients admitted to a centre of interventional cardiology with acute myocardial infarction of less than 6 hours, underwent coronary angioplasty of first intention because of contra-indications to thrombolytic therapy (n = 20) or after thrombolytic therapy with streptokinase (n = 54), acylenzymes (n = 12) or tissue type plasminogen activator (n = 14). The indication of angioplasty were those of the TIMI (Thrombolysis in Myocardial Infarction) classification (occluded artery, TIMI grade 0) (n = 60) (suboccluded artery, TIMI grade 1) (n = 40). The criterion of success of angioplasty was an increase greater than 1 of TIMI grade. Reperfusion of the coronary artery was obtained by angioplasty in 95% of failures of thrombolysis and in 90% of patients with contra-indications to thrombolytic therapy. The early reocclusion rate at D1 was 2%. Repeat angioplasty at D1 was successful in both these cases and the arteries were still patent at D21. The reocclusion rate at the third week in 75 patients who underwent control coronary angiography was 5.3%. In patients with arterial occlusion, immediate angioplasty attained two objectives in the same procedure: a high rate of emergency myocardial reperfusion and a low rate of reocclusion. The average left ventricular ejection fraction (all arteries) significantly improved (+9.2% in absolute values) when the artery remained patent (p less than 0.001), especially when the initial ejection fraction was low. In the patients who had occluded arteries at control angiography at 3 weeks, the ejection fraction decreased (-4% in absolute values) (NS). The following complications were observed: 4 coronary artery dissections and haematomas at the site of femoral puncture in patients who had received thrombolytic therapy (10 drained surgically). The hospital mortality was 3% and global mortality after an average follow-up period of 19.6 months was 5%. Coronary angioplasty in acute myocardial infarction carries a low risk and seems to be beneficial in patients with contra-indications to or failure of thrombolysis.

Adult↗
PubMed1990

[Left ventricular filling in treated essential hypertension. A study using Doppler echocardiography].

The first stigmata of left ventricular involvement in hypertension are changes in diastolic filling. Early detection of these abnormalities is important as some antihypertensive agents may have beneficial effects on left ventricular distensibility and filling, in addition to lowering the blood pressure. This study compares parameters of left ventricular filling recorded by pulsed Doppler echocardiography in 44 treated hypertensives (average blood pressure: 157 +/- 20/93 +/- 12 mmHg) without any other coronary risk factors with 33 age-matched (52 +/- 13 years and 48 +/- 13 years) control normotensive subjects (average blood pressure: 130 +/- 11/80 +/- 7 mmHg). The main findings were an increase of the peak. A wave velocity after atrial contraction and of the A/E ratio in the hypertensive group (66 +/- 16 cm/s vs 53 +/- 14 cm/s, p less than 0.05 and 0.99 +/- 0.34 vs 0.78 +/- 0.24, p less than 0.05, respectively). These changes were more pronounced in patients with left ventricular hypertrophy. The rapid filling phase was unchanged (maximum E wave velocity = 68 +/- 18 cm/s vs 70 +/- 14 cm/s). The influence of age on peak A wave velocity and A/E ratio was obvious in control subjects and hypertensives without left ventricular hypertrophy r = 0.80; p less than 0.05). The age factor was not significant in the presence of left ventricular hypertrophy (r = 0.18). A weak linear correlation was observed between the peak A wave velocity, diastolic septal thickness (r = 0.44; p = 0.04) and left ventricular mass (r = 0.44; p = 0.05) in hypertensive patients with left ventricular hypertrophy.

Adult↗
PubMed1990

Alterations in left ventricular diastolic function in chronic ischemic heart failure. Assessment by radionuclide angiography.

Using radionuclide angiography at rest, we studied several parameters of left ventricular systolic and diastolic function in 60 patients divided into three groups, a control group (G1) of 15 patients and two groups of patients with chronic ischemic heart disease and previous anterior wall myocardial infarction but without aneurysm or dyskinetic wall motion, a second group (G2) of 23 patients with no history of heart failure, and a third group (G3) of 22 patients in New York Heart Association (NYHA) class II or III of heart failure. Ejection fraction, peak emptying, and peak filling rates, in addition to times to reach peak rates, were evaluated after constructing a global time-activity curve and its first time derivative. In addition, we computed the first time-derivative curves for each image pixel and obtained functional images (MIN/MAX images) representing the distribution of times to peak emptying or filling rates Using a left ventricular region of interest, time histograms were generated, and indexes of dispersion of times to peak rates, defined as the full width at half maximum of the histograms, were obtained. Significant (p less than or equal to 0.01) differences were observed among all groups for ejection fraction, peak emptying rate, and peak filling rate. The decrease of the peak filling rate still remained significant from group G1 to group G3 even after adjustment for differences in ejection fraction and heart rate. Peak filling rate was linearly correlated with ejection fraction in the population with ischemic heart disease (G2 + G3) (r = 0.68, p less than or equal to 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1989

[Isolated ST-segment depression in precordial leads V2 to V4. An early electrocardiographic sign of posterolateral myocardial infarction].

The authors report the cases of two men, 62 and 66 years-old, who both presented a posterolateral myocardial infarction which, in the first two days, as only electrocardiographic sign, consisted in a baseline offset of the ST segment in precordial leads V2 to V4. Necrosis and its topography were confirmed in each case by elevated myocardial enzymes, the progression of the electrocardiogram and bidimensional ultrasound cardiography exploration. Coronary angiography performed in both cases, revealed, in the first case, an isolated narrow stenosis of a first marginal artery, and in the second case, significant stenoses of the circumflex and right coronary artery without lesion of the anterior interventricular artery. These cases, along with those recently published in the literature, suggest that such alterations of ventricular repolarization which represent the reciprocal projection of a high posterior sub-epicardiac lesion current, could complete the electrocardiographic criteria of really thrombolysis in a context of prolonged precordial pain.

Arrhythmias, Cardiac↗
PubMed1979

An auditory von Restorff effect.

In this experiment 60 undergraduates were given a serial learning task to assess the possibility of an auditory von Restorff effect. Fifteen males and 15 females learned a list of nine words presented aurally (recorded) with the same male voice (control groups). Fifteen males and 15 females (experimental groups) learned the same list as the control groups except that the sixth word was spoken by a female voice: i.e., it was isolated. The results of this study parallel the results of studies using visual stimuli. The von Restorff effect was demonstrated with auditory stimuli in that one of the experimental groups (female) learned the list with significantly fewer errors than the comparable control group. No difference was found between the male groups.

Female↗
PubMed1978

Effects of acute ethanol on the contractile state of normal and failing cat papillary muscles.

The direct effects of 100, 300 and 500 mg/100 ml ethanol on contractility of isolated, supported right ventricular papillary muscles were evaluated from 10 normal or failing cat hearts. In isometrically contracting muscles, 500 mg% ethanol decreased maximum tension in normal and failing hearts from 7.1 to 4.3 g/mm2 (P less than 0.001) and 3.4 to 2.3 (P less than 0.01) respectively, and lowered maximum tension rise from 30.4 to 20.2 g/mm2/sec (P less than 0.001) and 10.2 to 0.8 (P less than 0.01), without alterations of time to peak tension. In isotonically contracting muscles, 500 mg% ethanol reduced contractile element velocity at 0.5 g/mm2 load in normal and failing ventricles from 1.27 to 0.97 L/sec (P less than 0.001) and 0.59 to 0.39 (P less than 0.001) respectively. Thus, clinically meaningful doses of ethanol clearly, exerted dose-related negative inotropic actions on both normal and failing myocardium, thereby indicating that ethanol ingestion may exacerbate heart failure in diseased hearts.

Animals↗
PubMed1976

[Contractility of the left ventricle in experimental septicemia].

In experimental septicemia a decrease of myocardial contractility could be demonstrated. Periodically a correlation between disturbance of contractility and endotoxinemia exists. Starting point of infection and type of bacteria were of no detectable influence. As far as the disturbance of contractility is concerned one must take into consideration the cardiotoxic effect of endotoxin, the influence of shock mediators, lacticemia as well as the decrease of coronary perfusion pressure.

Animals↗
PubMedDate not supplied

Acute hemodynamic effects of piroximone (MDL 19,205) in patients with moderate congestive heart failure: comparison with sodium nitroprusside.

Piroximone (MDL 19,205), a new imidazolone derivative, was given intravenously to 14 patients with congestive heart failure (NYHA class II-III), while under constant daily doses of digitalis and diuretics. In the first 3 patients, we determined the dose safely eliciting a favorable hemodynamic response. The subsequent 11 patients received 1 mg/kg of piroximone intravenously, and the hemodynamic effects were compared with those of sodium nitroprusside (SN) at a dose-lowering mean blood pressure by 10-20 mm Hg. Piroximone increased heart rate (13.2 +/- 2.0 beats/min, mean +/- SEM) and lowered mean arterial pressure (9 +/- 2.3 mm Hg). Both agents reduced similarly wedge pressure (6.5 +/- 2.9 and 9 +/- 2.9 mm Hg, respectively, for SN and piroximone) and total peripheral resistance. Cardiac index was increased less by SN (15%) than piroximone (48%) (p less than 0.001), and stroke work index significantly enhanced only by piroximone (p less than 0.001). The changes in loading conditions induced by the two agents being similar, it is likely that piroximone not only acts by peripheral vasodilation, but also possesses positive inotropic properties. Myocardial oxygen demand, assessed indirectly by tension-time index, was not affected by piroximone. Thus, piroximone appears to combine well-balanced vasodilator and inotropic properties which make this new agent potentially very useful for the management of congestive heart failure.

Adult↗
PubMedDate not supplied

[Traumatic ruptures of the diaphragma. Diagnostic and therapeutic problems (author's transl)].

Between 1970 and 1976, 34 cases of traumatic ruptures of the diaphragma were observed and treated at the Surgical Clinic of the University of Würzburg: 23 acute ruptures and 11 delayed diagnostic ruptures. The etiology and mechanism of the rupture are discussed. A predominency of left over right ruptures occured in 90% of cases. In only one case there was an open rupture of the right side. Among associated abdominal lesions, ruptures of the spleen are the most frequent. Among skeletal associated lesions, one observes most frequently, fractures of the ribs. In 4 acute cases, there were no herniated organs. In the 11 patients were diagnosis was delayed we always found herniated viscera. Symptoms and diagnostic means are discussed. Traumatic rupture of the diaphragm is an absolute surgical indication. In acute cases we attempt the repair through a laparotomy; delayed cases should be treated by thoracotomy. Among 23 cases operated in emergency, 3 died because of associated lesions. Operative mortality was zero in the 11 patients with delayed diagnosis.

Abdominal Injuries↗