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Biomedical subjects

U Tietze

Publications and source records attributed to U Tietze.

11 recordsLinked to original sources
PubMed1990

Importance of quantitative analysis of ventricular arrhythmias for predicting the prognosis in low-risk postmyocardial infarction patients. European Infarction Study Group.

In 378 placebo patients enrolled in the European Infarction Study (EIS), a secondary prevention study after acute myocardial infarction, 24-h baseline Holter monitoring was done 14 to 31 days after MI, and the relationship of electrical (ventricular arrhythmias) and mechanical (clinical signs of ventricular dysfunction) risk factors was analysed on the basis of mortality during the subsequent 2 years of follow-up. There was a rather low overall 2-year mortality rate of 6.9%. Consecutive arrhythmias (ventricular pairs and runs of ventricular premature beats) and left-ventricular dysfunction alone were associated with a low mortality of 4.0% and 3.6%, respectively. However, the combination of both defined a high-risk group characterized by a 2-year mortality rate of 16.7%. Additionally, the risk of dying was dependent on the frequency of consecutive arrhythmias: 22.2% of the patients with greater than 10 ventricular pairs per day died during the follow-up period in contrast to 9.9% of those with only 1-10 ventricular pairs per day. Thus, only the combination of electrical and mechanical risk factors, and especially the frequency of consecutive VPB, is helpful in identifying a subgroup of postMI patients with poor clinical outcome. An intervention study should restrict itself to this risk population only.

Arrhythmias, Cardiac↗
PubMed1986

The determination of mineralocorticoid receptors in human mononuclear leukocytes from patients with mineralocorticoid excess: physiological and pathological implications.

The affinity and the capacity of mineralocorticoid receptors (MR) in human mononuclear leukocytes (HML) were determined in 9 patients with Conn's syndrome (PA) and in 3 patients with pseudohypoaldosteronism (PHA). The number of binding sites per cell was 136 +/- 39 (mean +/- SD) in PA. One case with PHA had no MR, and of the other 2 patients, one had 50 and the other 55 receptors per cell. The capacity of normal controls ranged from 200 to 400 receptors per cell (n = 20). We conclude that the etiology of PHA is due to a lack of MR in the target tissues and that a down regulation of MR may exist in PA.

Adult↗
PubMed1986

Noninvasive monitoring of cardiac allograft rejection by intramyocardial electrogram recordings.

Rejection after cardiac transplantation was monitored in nine patients by control of intramyocardial electrogram (IMEG) recordings transmitted by an implanted telemetric pacemaker. Under immunosuppression with cyclosporin A and prednisolone, 33 out of a total of 119 endomyocardial biopsy specimens showed moderate rejection (infiltrate with myocytolysis). Twenty-nine of these rejection episodes could be correctly predicted from IMEG recordings with a voltage drop above 15% used as a criterion (sensitivity 87.9%). Eighty-three of 86 negative biopsy results corresponded to negative IMEG results (specificity 96.5%). In this group of patients, amplitude of body surface electrocardiograms was not useful for the diagnosis of rejection because of the broad range of spontaneous variation. Control of IMEG voltage amplitude appears to be more accurate than body surface electrocardiogram amplitude in the detection of rejection episodes. Thus the onset of rejection during biopsy intervals is more readily detected and treatment is instituted earlier. The method is suitable for ambulatory patient monitoring by the patient's local physician.

Biopsy↗
PubMed1985

Effect of oxprenolol on ventricular arrhythmias: the European Infarction Study experience.

In 736 patients, 24 hour electrocardiographic recordings were performed 14 to 36 days after acute myocardial infarction before the start of randomized treatment with 320 mg of slow release oxprenolol (n = 358) or placebo (n = 378). Follow-up 24 hour electrocardiographic recordings were obtained 5 to 12 days (median 10) and 3, 6 and 12 months after the first administration of the study medication. Oxprenolol-treated patients had a significantly lower daytime heart rate as compared with the placebo group, whereas no difference was found at night. At baseline, 22.1% of the patients allocated to oxprenolol treatment and 29.6% of the placebo group had more than 30 ventricular extrasystoles in 1 hour at least once during 24 hour monitoring; multiform ventricular extrasystoles were present in 58.4 and 62.7%, ventricular couplets in 29.6 and 33.9% and ventricular tachycardia (3 or more consecutive ventricular extrasystoles) in 21.5 and 20.9% of the oxprenolol-treated and placebo-treated patients, respectively. During the 1 year follow-up period, the prevalence of these arrhythmias did not change significantly in either treatment group. There was a trend toward a reduction in the daytime frequency of ventricular couplets in the oxprenolol group. After 3 and 6 months, only multiform ventricular extrasystoles were significantly less frequent in the oxprenolol group than in the placebo group (47.4 and 42.7% versus 59.7 and 57.9%, respectively). Twelve months after the acute event, however, multiform ventricular extrasystole frequency was the same in both groups of patients (52.1 versus 51.0%, respectively). Thus, oxprenolol had a weak suppressant effect on ventricular tachyarrhythmias in survivors of myocardial infarction.

Adult↗
PubMed1983

Invasive dysgerminoma in a girl with 45,X/46,X; mar mosaicism.

We report a 16-year-old girl with features of Turner's syndrome from whom an invasive dysgerminoma was removed. Cytotoxic drugs were given for the next 12 months. Mosaicism of two karyotypes (45,X/46,X; mar) was found in various tissues. The literature is reviewed with special regard to cytogenetic findings and prognosis of malignant growth and differentiation of dysgenetic gonads.

Adolescent↗
PubMed1983

[Spondylocostal dysostosis. Report of 5 cases including siblings and an atypical case].

Spondylocostal Dysostosis (sp. c. D.) is characterized by multiple morphological anomalies of the vertebrae and ribs which are frequently fused. This is due to malsegmentation of the axial skeleton probably before the 20th day of embryonic development. There are severe and moderate forms. The etiology is heterogeneous since dominant, and more frequently recessive inheritance has been noted and phenocopies should be expected. Sp. c. D. may be part of a genetic malformation syndrome. Five observations are reported, three typical including sibs, and two atypical ones. The sixth case demonstrates rachischisis anterior (et posterior) of the entire spine.

Abnormalities, Multiple↗
PubMed1981

[Computer compatible long-term ECG analysing system for quantitative detection of low grade and complex dysrhythmias--Methods and evaluation of the analysing accuracy (author's transl)].

On the basis of a commercially available analyser2) a long-term ECG analysing system for quantitative detection of the following events was developed: all QRS complexes, ventricular premature beats (VPB), VPB with different coupling intervals (including the R/T phenomenon), paired VPB, salvos of VPB, ventricular tachycardias, ventricular bigeminy, supraventricular premature beats, supraventricular tachycardias, and asystoles. These dysrhythmias are detected simultaneously at 60-fold speed and counted within predeterminable time intervals, the results being printed out and at the same time stored on punch tape, thus allowing off-line computer processing of the data. The accuracy of the analysing system working in a fully automatic mode was evaluated by comparison to the results obtained by two cardiologists. The predictive value of the analyser was 99.9% for all QRS complexes and 97.2% for aberrantly shaped QRS complexes. The corresponding values of the sensitivity were 99.7% and 95.3%. For paired VPB or salvos of VPB and ventricular bigeminy the predictive value was 91.8% and 95.1%, respectively, the sensitivity being 93.4% and 87.9%, respectively. For the detection of asystoles, in spite of a 100% sensitivity a predictive value of only 45.6% was found. Therefore these events may well be detected automatically, but the false positive counts will have to be sorted out by visual inspection on the oscilloscope or ECG write-out.

Arrhythmias, Cardiac↗