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Biomedical subjects

R Aurisch

Publications and source records attributed to R Aurisch.

30 records · Page 2Linked to original sources
PubMed1990

[Localization and type of acute myocardial infarct in relation to myocardial infarct size--patients with acute re-infarct].

A differentiated estimation of the acute re-infarction is individually necessary for the estimation of risk and prognosis. Thereby the methodical approach is of particular importance, since the further restriction of the remaining function of the myocardium in re-infarction is of fundamental significance. A monitoring for the establishment of CKmax as well as the measuring of the ejection fraction globally (EFg) allow a semiquantitative determination of the size of the myocardial infarction. This forms the basis for the evidence of smaller acute Q-wave re-infarctions and also of smaller acute re-infarctions of the posterior wall localization. The increase of the risk in non-Q-wave infarction (mean risk) and Q-wave infarction (high risk) in re-infarction could be confirmed by the ejection fraction globally. Thus significant differences of the surviving persons after acute re-infarction in comparisons to the primary infarction were elaborated.

Cardiac Output↗
PubMed1990

[Site and type of acute myocardial infarct in relation to myocardial infarct size--dynamics of global ejection fraction in acute myocardial infarct].

By the ejection fraction global (EFg) statements concerning the remaining function of the myocardium in acute myocardial infarction and thus individually concerning the prognosis (classification of risk groups) become possible. For the valuation of the dynamics of the EFg in a period up to 6 months after an acute myocardial infarction the EFg was multifariously controlled. Only patients with first myocardial infarction in localization on the anterior wall and Q-wave showed a significant dynamics of the EFg between the measurements acute and third week as well as acute and 6th month (absolutely 5.2%). --In re-infarction/Q-wave this could be confirmed also for the localization of the posterior wall in the period acute till third week. For the localization on anterior and posterior wall a dynamics of the EFg could also be calculated for the period acute and 6th month. Thereby the absolute increase of the EFg was between 4.0 and 4.6%. The dynamics of the EFg in the region of the anterior wall was 5.2% for the first infarction and only 4% for the reinfarction. Thus it is below the dynamics of the EFg in an effective thrombolytic therapy.

Angina Pectoris↗
PubMed1988

[Use of walking and sauna therapy in the rehabilitation of hypertensive patients with ischemic heart disease following aortocoronary venous bypass operation with special reference to hemodynamics].

Rehabilitation results are reported concerning the behavior of blood pressure and heart rate, peripheral and central hemodynamics, after resting and during exercise and physical conditioning by running as training and sauna, respectively, in hypertensive patients with IHD after aortocoronary venous bypass (ACVB) surgery. Bicycle ergometric examinations an xenon wash-out (for the determination of the mean functional vessel cross section A) were performed in 43 male untrained patients before and after physical therapy. The left ventricular ejection fraction (EF) at rest was also determined in these patients. Significant increases in the ejection fraction at rest (on average by 7-8%) could be demonstrated in both therapy groups. The group average value for peripheral microcirculation improved only in the sauna group. Blood pressure after resting and on exercise was not influenced. Results are discussed on the basis of the literature and practical conclusions drawn.

Adult↗
PubMed1975

[Results of the myocardial infarct registers in the German Democratic Republic and their significance for the reduction of early mortality in myocardial infarce].

From preliminary results of the registers of myocardial infarction in the GDR follows that the definitive myocardial infarction (classification of the WHO) occurs in Berlin with an incidence rate of 17 cases per 10,000 inhabitants and annum, in Erfurt 10 and at Pasewalk 11 cases per 10,000 inhabitants and annum. More than three fourths of all cases of myocardial infarction appear outside the hospital. After three months the lethality is 60%, whereby the half of all cases of death appears already in the prehospital phase. More than 8 hours are passing before half of all patients with infarction are admitted into the hospital. The greatest retardation takes place between arrival of the physician and admission into the hospital. In the second place follows the interval onset of the infarction and demand of medical aid. An improvement of the early diagnostics and the transport of the patient as well as an adequate information and collaboration of the patient and his surroundings might contribute to a shortening of the prehospital phase and thus to a decrease of the early mortality in cases of myocardial infarction.

Germany, East↗
PubMedDate not supplied

[The significance of thrombolytic therapy in acute myocardial infarct in advanced age].

The thromboticgenesis and the close time dependence of the development of the acute myocardial infarction (AMI) are decisive findings of the dynamic development in the past ten years. Therapy started in time including the elimination of the thrombotic coronary occlusion as soon as possible leads to the reperfusion of the vessel affected by the infarction and thus to the limitation of the size of the myocardial infarction. Because of the temporally limited tolerance of ischaemia of the myocardium, an efficient thrombolytic therapy (TT) with an objectifiable improvement of the left-ventricular function (ejection fraction global-EFg) is possible up to the 4th ApS hour. The median value of the maximum creatine kinase activity (CKmax) time was 11.8 h with effective TT; with ineffective TT 21.5 h (p less than 0.001). There is no significant difference of the CKmax-t between the age groups (less than 60 and greater than 60 years). CKmax significantly differentiates between the deceased and ineffective/effective TT (p less than 0.001). Monitoring the EFg shows significant differences in the deceased (16.3), ineffective TT (34.0), and effective TT (42.5%) both in the acute phase and in the first weeks after AMI by the dynamism of the EFg. So, - EFg was verified to be 6% with effective TT to - EFg to be 1.6% (absolute) with ineffective TT. The percentage of cases of death was restricted also for patients greater than 60 years. After effective TT less patients are found in the high and medium risk group after AMI. 70% of the patients had an effective TT.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The acute phase of myocardial infarct in the elderly].

The percentage of older patients with AMI in the total of patients is predominating and is still increasing differentiatedly. The essential cause of there is an increase in complications and in mortality until the 28th day. In a prospective study over 48 months with n = 390 patients we analyzed the age groups less than 65 years (A) and greater than or equal to 65 years (B) regarding their different rates of complications. For the semiquantitative determination of myocardial infarction sizes we used: -Monitoring of ECG, creatinine kinase (CK), and ejection fraction global (EFg). In group A 81% survived, whereas in group B only 60% survived. The average age of the surviving patients was 56.2 years, that of the deceased 64.4 years. The percentage of surviving patients with transmural AMI was 96% in A and 57% in B. In both A and B. CKmax with p less than 0.01 was to be differentiated between non-transmural and transmural AMI. In the deceased CKmax was 89.7 (A) to 59.3 mumol/lxs (B) (p less than 0.05). The percentage with AMI extension was 4% in A and 43% in B, p less than 0.005. Patients of group B showed a significant difference (p less than 0.001) of EFg for non-transmural AMI 59.1 (36-70)%, transmural AMI 31.5%, and deceased 17.3%. In patients with Re-AMI EFg was generally measured to be less than 45%. Re-AMI could be diagnosed in 13% of A and in 29% of B (p less than 0.001). The ICU stay of the surviving patients of the total number of patients could be reduced by 1.1 days in the period from 1984 through 1987. With group B it could be reduced by 0.8 days. The overall stay in hospital (1984-1987) was 19.6 days (A = 18.3; B = 22.4). AMI extension and the Re-AMI result are the decivise factors to the essential increase in complications and cases of death with AMI at older age. The semiquantitative determination of the myocardial infarction size by monitoring makes up an efficient basis for the early assessment of the residual function of the myocardium and of the risk classification.

Aged↗
PubMedDate not supplied

[Perioperative risk of valve replacement surgery in the elderly].

The indication of surgical valva replacement also at older age (greater than 60 years) with chronically rheumatic valvular diseases requires both the assessment of the pre-operative constellation of findings and perioperative complications. From this combined point of view statements concerning the strategy of valve replacement at older age seem to be concludable. In the frame of a prospective study perioperative parameters were monitored in n = 90 patients with preoperative high-risk constellation out of a total of n = 300 patients for the quick recording of additional complications (such as perioperative myocardial damage, cardiac low output syndrome, and cases of death at the ICU). The average age of the whole group of patients was 52 years (25-68 years), that of the patients greater than 60 years was 63.6 years (61-68 years). In 72% of the older patients the preoperative high-risk constellation was confirmed by 50% deceased; 16% cLOS; 6% perioperative myocardial damage (PMD). On a total of 41% of the patients a combined operation was performed (valve replacement and bypass operation), there of 2/3 with aortic valve replacement and 1/3 with mitral valve replacement. The ejection fraction restricted heavily already before the operation (less than or equal to 30%) was the essential cause of perioperative complications (cases of death, cLOS) together with the combined operation. The immedicable pulmonary hypertension complicated the already preoperatively impaired left-ventricular function in a high percentage of patients with mitral valve replacement.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[Aortocoronary venous bypass operation in the elderly].

On the extended diagnosis for an aorto-coronary venous bypass operation, with a greater involvement of patients with instable angina pectoris symptomatik (inApS), left main artery disease (LAD), aneurysmal resection, and "bad" ventricle (ejection fraction global less than or equal to 30%), the preoperative risk was evaluated in n = 600 patients. In a total of n = 150 patients with preoperative high-risk constellation perioperative parameters were monitored to find complications (perioperative myocardial damage [PMD], cardiac low output syndrome [LOS]). Among them were n = 40 patients aged greater than 60 years (60-72), their average age being 62.9 years. In 30% of these older patients the preoperative high-risk constellation was confirmed: 15% PMD, 10% LOS, and 5% deceased. The further postoperative course (up to the 6th month) is objectified by the ejection fraction global (EFg) by multiple checks. As a whole, patients greater than 60 years with extended diagnosis for ACVB operation do not show any significant increase in hospital mortality, but an increase in PMD and LOS (p less than 0.001) compared to the age group less than 60 years. With corresponding individual intensive-therapeutic measures, however, both complications can be controlled in the majority of patients. Despite the demonstrated higher perioperative risk, the urgent ACVB operation proved to be strategically right (considering the results of EFg) for increasing the quality of life and improving the expectation of life also for patientes greater than 60 years, in particular with the operation indications of inApS and LAD.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗