Biomedical subjects

T Sueselbeck

Publications and source records attributed to T Sueselbeck.

4 recordsLinked to original sources

PubMed2005

Diagnostic value of stress echocardiography for the detection of restenosis after PTCA.

Stress echocardiography (SE) has become a widely accepted clinical tool for the non-invasive diagnosis of coronary artery disease (CAD). Previous studies have confirmed that SE has superior diagnostic value compared to exercise ECG testing. SE has also emerged as a cost-effective alternative to nuclear imaging techniques in patients where symptoms and/or conventional ECG stress testing have provided ambiguous results. Several studies have investigated the value of SE to detect significant restenosis after PTCA. However, in these studies, different methods have been used to induce cardiovascular stress such as physical exercise by bicycle or treadmill, pharmacologic stress testing (with dipyridamole or dobutamine) or transoesphageal atrial pacing. This review evaluates the published database of SE to detect restenosis in patients after successful PTCA. It includes 13 studies with a total of 989 patients performed at 3-6 months after the primary intervention. The diagnostic value, utility and limitations of SE is presented and discussed. The data show that SE has a high diagnostic value for detecting significant restenosis after PTCA. Mean sensitivity of SE was 74% (CI 69-79%), mean specificity was 87% (CI 84-89%). The positive predictive value (PPV) of SE was 83%, the overall negative predictive value (NPV) 97%. We conclude that, in the follow-up of patients after PTCA, SE has distinct advantages over other non-invasive methods and is a recommended method for the detection of those to be considered for repeat angiography.

Angioplasty, Balloon, Coronary↗

PubMed2005

Automated impedance cardiography for detecting ischemic left ventricular dysfunction during exercise testing.

UNLABELLED: Automated impedance cardiography (ICG) is an attractive method for noninvasive hemodynamic evaluation. The objective of our study was to evaluate the feasibility and diagnostic value automated ICG in patients with suspected coronary artery disease (CAD). We measured stroke index (SI) and cardiac index (CI) in 65 patients with suspected CAD at rest and during bicycle exercise testing. All patients underwent subsequent cardiac catheterization including coronary angiography (CA). Depending on the results of CA, patients were divided into three groups, patients without significant CAD (group 0), single vessel disease (group 1) or multivessel disease (group 2-3). In a subset of 20 patients, automated ICG was compared to measurements of CI by the thermodilution (TD) method. RESULTS: There were no significant differences in SI and CI at baseline between the three groups. At 75- and 100-watt exercise, patients in group 2-3 showed significantly lower mean values of SI and CI as compared to patients of group 0 and group 1 (all p < 0.05), indicating exercise-induced ischaemic left ventricular (LV) dysfunction. Three patients had to be excluded because of inappropriate quality of the ICG signals during exercise. Comparison of automated ICG with TD measurements of CI showed good correlations between both methods at rest (r = 0.73) and during exercise (r = 0.89-0.91). CONCLUSIONS: We conclude that hemodynamic monitoring by automated ICG is both feasible and practical during exercise testing. Automated ICG can provide reliable and valuable additional diagnostic information on LV function during exercise which is helpful for selecting those patients for angiography who are likely to benefit from coronary interventions.

Adult↗

PubMed2005

Comparison of impedance cardiography and thermodilution-derived measurements of stroke volume and cardiac output at rest and during exercise testing.

BACKGROUND: Non-invasive evaluation of haemodynamic variables remains a preferable and attractive option in both pharmacologic research and clinical cardiology. OBJECTIVES: The objective of this study was to evaluate the correlation, feasibility and diagnostic value of haemodynamic measurements by ICG with the thermodilution (TD) method at rest and during exercise testing. METHODS: We measured stroke volume (SV) and cardiac output (CO) with both methods in 20 patients with suspected coronary artery disease (CAD). All measurements were performed simultaneously at rest and during bicycle exercise. RESULTS: There was a highly significant correlation (p < 0.001) for measurements of SV between both methods at rest (r = 0.83) and during exercise (r = 0.85-0.87) with 50-100 watts. For measurements of CO, the respective correlations were r = 0.85 at rest and r = 0.92-0.94 during exercise. The mean difference for measurements of SV were 3.8 +/- 12.6 ml at rest and 6.5+/- 11.4 ml during exercise. For measurements of CO, the mean difference between both methods was 0.9 +/- 1.0 l/min at rest and 1.0+/- 0.8 l/min during exercise. Compared to TD measurements, ICG had a bias to overestimate SV and CO of approximately by 5-10%. One patient had to be excluded because of inappropriate quality of the ICG signals during exercise. CONCLUSIONS: ICG is a feasible and accurate method for non-invasive measurements of SV and CO. Haemodynamic measurements by ICG were correlated highly significant to simultaneous measurements by the TD method.

Aged↗

PubMed2004

Paradoxical coronary embolism causing non-ST segment elevation myocardial infarction in a case of pulmonary embolism.

We describe the case of a 61-year-old woman who simultaneously suffered a pulmonary embolism and a myocardial infarction due to paradoxical coronary artery embolism. Transesophageal echocardiography with injection of agitated hydroxyethyl starch revealed a patent foramen ovale. Thrombophlebistis of the left saphenous vein with extension of thrombus into the femoral vein could be identified as the source of embolism. Paradoxical coronary embolism is an underrecognized cause of MI. Diagnosis is particularly difficult, when MI and PE coincide, because of the similarity in clinical signs and symptoms of both entities. A high level of clinical suspicion and echocardiography, especially if performed soon after presentation, can be the clue to early diagnosis of PDE.

Angioplasty, Balloon, Coronary↗