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R Zotz

Publications and source records attributed to R Zotz.

28 records · Page 2Linked to original sources
PubMed1989

[Right heart ventriculography using Gelifundol].

Forty patients (14 women, 26 men, mean age 58 years) with suspected anomaly of the right heart and suspected tricuspid insufficiency or atrial septal defect were given four injections of Gelifundol in five-minute intervals via the right cubital vein. Before, during, and after each injection an echocardiogram was obtained (four-chamber-view). One subcostal view was recorded. Contrast echocardiograms were analyzed according to a subjective score scheme by two independent observers and by video-intensitometry. After injection of contrast medium no patient showed ECG changes, nor did any patient report side effects after the injection of Gelifundol. Concerning the subjective parameters there were no significant differences between both observers. Score points varied between 5.2 to 5.5, intensitometric maxima lay between 54.6 and 58.0 relative intensity units, and the half-time of the intensity maximum (T1/2) varied between 7.2 s and 8.1 s. There were no statistical differences between the two observers. In all patients a diagnotic improvement could be achieved. A tricuspid insufficiency which was not diagnosed in the native echocardiogram could be diagnosed in 13 patients with Gelfundol. Thus, Gelifundol seems well suited for the assessment of right ventricular lesions in man.

Adolescent↗
PubMed1987

Color superposition: a new modality for contrast echocardiography.

To improve the estimation of endocardial borders in echocardiography, a technique has been developed to combine images from contrasted and noncontrasted echocardiograms of the same heart-phase using a color superposition mode. This method allows both experienced as well as less experienced examiners to define the endocardial borders more reproducibly and objectively. This is achieved by displaying tissue structures as gray level images while the ventricular cavity is marked selectively by the color display of the contrast material zone. Results of volume estimations of the left ventricle by different examiners using several imaging modes including color superposition display are presented.

Cardiac Volume↗
PubMed1987

[Left ventricular contrast echocardiography using Gelifundol--assessment of hemodynamics, contractility and ECG].

The aim of this study was to analyze the effect of left ventricular injections of an agitated oxypoly-gelatine solution (Gelifundol) on hemodynamic and contractility parameters in humans. In 19 patients, aged from 23 to 68 years, 53 left ventricular and 31 aortic injections were performed during routine left heart catheterization for suspected coronary artery disease. Within a period of 20 heart cycles, no significant changes in end-diastolic and end-systolic left ventricular pressure as well as in aortic pressure or left ventricular contractility (dP/dtmax, dP/dtmin) were observed. Except for three asymptomatic ST-segment changes, no side effects or changes in heart rate were detected.

Adult↗
PubMed1987

[Coronary insufficiency in type II aortic dissection].

After coronary sclerosis, aortic dissection represents an important differential diagnosis in the evaluation of acute thoracic pain. We report on a 55-year-old patient with aortic dissection, type II, in whom the diastolic collapse of the true aortic lumen was verified by angiography and transesophageal echocardiography. The collapse led to a temporary perfusion deficit of the left coronary artery with clinical symptoms and ECG changes. Clinical symptoms, additional diagnostic procedures and follow-up of this patient, as well as the value of transesophageal echocardiography, are presented.

Aortic Dissection↗
PubMed1986

Right ventricular volume determination in isolated human hearts.

For right ventricular volume determination a new method was developed that took into account right ventricular imaging by apical two-dimensional echocardiography in the four- and two-chamber views. Right ventricular volume was calculated by subtraction of the partial volume of the left ventricle and interventricular septum from the total heart volume of the right and left ventricles including the interventricular septum. Accuracy of the subtraction method was evaluated in isolated human hearts by two-dimensional echocardiography and radiography. Regression analysis indicated that for both the echocardiographic and radiologic procedures, the subtraction method gave the best correlation with the right ventricular filling volume. The correlation coefficients obtained using the echocardiographic procedure were 0.964, 0.848, and 0.851 for the subtraction method, pyramid method, and Simpson's rule method, respectively. For the radiographic procedure, these values were 0.946, 0.860, and 0.872. Percentage difference calculations indicated that the subtraction method systematically underestimated (-7.4%) the filling volume in the echocardiographic procedure, but this was not seen with the radiologic procedures. The random error associated with the subtraction method was only half (10.5%, 13.9%) of that seen with the other two methods in both the echocardiographic and radiological procedures. These results indicate that right ventricular volume determination by the subtraction method seems to be suitable for apical two-dimensional echocardiography and is more accurate than the pyramid method and Simpson's rule method.

Echocardiography↗
PubMed1986

Methods for non-invasive detection of ventricular late potentials--a comparative multicenter study.

To evaluate the methodological problems of the non-invasive registration of late potentials the results obtained with four different averaging devices in the same 109 patients were compared. The high-resolution ECG was obtained from the body surface, high-gain amplified and filtered. With the averaging technique, the improved signal-to-noise ratio was able to detect low-amplitude cardiac activity. The incidence of late potentials detected with the four averaging systems, whose characteristics are described, ranged between 12% and 21%. Corresponding positive results were obtained in 5.5%, corresponding negative results in 68.8%. The reasons for differing results were mainly due to differences in visual or automatic interpretation of the registered fractionated electrical cardiac activity. Additionally, the determination of the end of QRS using the QRS width, obtained from reference leads, may influence the specificity of the methods.

Cardiac Complexes, Premature↗
PubMed1983

[Repetitive ventricular response and left ventricular wall motion in patients with coronary heart disease].

As the first results of a prospective study on the value of programmed ventricular stimulation, the incidence of repetitive ventricular response with 3 or more consecutive beats (RVR3) in 136 patients (122 males, 14 females, age 51 +/- 8 years) with coronary artery disease is reported. 38 patients (group A) had no evidence of previous myocardial infarction, 31 patients (group B) had myocardial infarction less than 3 months and 67 patients (group C) more than 3 months before entry into the study. Programmed electrical stimulation included single (S2) and double (S2 S3) ventricular premature beats following ventricular drive at 3 cycle lengths (500, 600 and 430 msec) and was defined as positive (+PES) when RVR3 was induced. +PES was related to the extent and the degree of abnormal left ventricular wall motion, determined by left ventricular angiography (30 degrees RAO view) and quantified by a wall motion score. After single premature stimuli no RVR3 was observed in group A, but in 7% of group B and in 19% of group C (p less than 0.01). After double premature stimuli RVR3 occurred in 17% of group A, 42% of group B and 34% of group C (p less than 0.1). All 3 groups differed with respect to mean wall motion score and number of akinetic wall segments (p less than 0.001). Patients with positive (+PES) or negative (-PES) results could not be separated when the extent of wall motion abnormalities (wall motion score, number of akinetic segments) was considered. However, a relation (p less than 0.01) to the degree of abnormal wall motion classified according to the presence of normokinesis, hypokinesis, akinesis or dyskinesis could be demonstrated for +PES after single but not after double premature stimuli.

Coronary Disease↗
PubMedDate not supplied

Prediction of rapid versus prolonged healing of infective endocarditis by monitoring vegetation size.

The diagnostic value of transesophageal echocardiography in monitoring the clinical course has been evaluated in 83 patients with echocardiographic evidence of infective endocarditis. A total of 103 vegetations attached to the aortic or mitral valves were detected by use of the transesophageal approach. The patients were monitored for a mean of 74 weeks and underwent a minimum of two consecutive transesophageal echocardiographic examinations. Group A included patients with increasing or remaining constant size of vegetation (8.2 +/- 1.5 to 11.2 mm, p less than 0.05) during 4 to 8 weeks of antimicrobial therapy, whereas group B was formed by patients with decreasing vegetation size (8.3 +/- 0.8 to 4.9 +/- 0.8 mm, p less than 0.05). The incidences of complications after diagnosis and onset of therapy was higher in group A than in group B: valve replacement (45% versus 2%, p less than 0.05), embolic events (45% versus 17%, p less than 0.05), perivalvular abscess formation (13% versus 2%, p less than 0.05), and mortality (10% versus 0%, respectively, p less than 0.05). Staphylococcus aureus was the most frequent organism isolated in group A (44% versus 11% in B, p less than 0.05) and Streptococcus viridans in group B (33% versus 18% in A, p less than 0.05). Blood cultures were negative in nearly 50% of the patients in each group. There was no difference in the incidences of complications in patients with positive or negative blood cultures. We conclude that an increase in vegetation size during antibiotic therapy predicts a prolonged healing phase of infective endocarditis. This prolonged healing period is associated with a significantly increased risk of complications, independent of blood culture results. Monitoring vegetation size contributes important information concerning prognosis and stage of risk, and it aids in the choice of patient management in infective endocarditis. Because embolic events after diagnosis and onset of treatment are less frequent in rapid-healing endocarditis, surgery cannot be recommended to prevent further events taking into account the high risk of surgery.

Abscess↗
PubMedDate not supplied

Recombinant growth hormone therapy in patients with ischemic cardiomyopathy : effects on hemodynamics, left ventricular function, and cardiopulmonary exercise capacity.

BACKGROUND: We studied the effects of recombinant growth hormone (rhGH) on exercise capacity and cardiac function in patients with ischemic cardiomyopathy. METHODS AND RESULTS: Seven patients (aged 55+/-9 years) with mild to moderate congestive heart failure (ejection fraction 31+/-4%) who were on standard therapy were included. The patients were studied at baseline, after 3 months of rhGH treatment, and 3 months after rhGH discontinuation. Cardiac function was assessed by exercise capacity, right heart catheterization at rest and after submaximal exercise, MRI, echocardiography, and Holter monitoring. When administered at a dose of 2 IU/d, rhGH doubled the serum concentration of insulin-like growth factor-I. rhGH improved clinical symptoms and exercise capacity significantly (New York Heart Association class 2.4+/-0.5 initially versus 1.4+/-0.5 at 3 months [mean+/-SD], P<0.05; VO2max 13.6+/-3.8 versus 17.4+/-5.4 mL. kg-1. min-1, P<0.05). Additionally, pulmonary capillary wedge pressures at rest and after submaximal exercise were reduced significantly. Cardiac output increased, particularly at rest (5.0+/-1.1 versus 5.8+/-1.3 L/min; P<0.05). Posterior wall thickness was increased (1.08+/-0.1 versus 1. 24+/-0.3 cm; P<0.05), and the end-diastolic and end-systolic volume indexes decreased significantly after rhGH treatment. There was no significant increase in left ventricular ejection fraction. The improvements were partially reversed 3 months after rhGH discontinuation. CONCLUSIONS: The administration of rhGH for 3 months in patients with ischemic cardiomyopathy results in significant improvement in hemodynamics and clinical function. The attenuation of left ventricular remodeling persisted 3 months after discontinuation of treatment.

Combined Modality Therapy↗