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Biomedical subjects

V Wiegand

Publications and source records attributed to V Wiegand.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Increased primary success rate in coronary angioplasty using a guide wire with attached balloon (microprobe)].

In 15 cases of 350 consecutive coronary angioplasties conventional low profile balloon catheters did not traverse the stenosis or occlusion over the guide-wire. A balloon on a wire device ("Microprobe", 2 mm) passed the stenosis or occlusion easily with a good primary result in 14 cases. The angioplasty procedure could then be completed with a larger standard balloon catheter. Use of the balloon on a wire device expands the technical facilities of angioplasty and increases the primary success rate in technically difficult cases.

Angioplasty, Balloon↗
PubMed1988

[The cardioprotective effect of verapamil in acute percutaneous transluminal coronary angioplasty].

Verapamil improved the ischemic tolerance of the myocardium in experiments in animals. Therefore, 20 patients were examined during percutaneous transluminal coronary angioplasty (PTCA) of a proximal LAD stenosis in order to evaluate the ability of verapamil to improve the ischemic tolerance in man. Before the second dilatation, 1 mg verapamil was given intracoronarily to 10 patients, the other 10 patients received placebo ic. Before and after each of the three inflations, blood samples were obtained from the coronary sinus in five patients of each group to analyze the contents of lactate, pyruvate, and pH. Verapamil caused a significant prolongation of the inflation from 58 +/- 12 s to 83 +/- 20 s. This effect was persistent also during the following inflation (96 +/- 19 s). The onset of angina was delayed (p less than 0.05). ST-wave elevations and T-wave amplitudes were smaller after verapamil, in spite of the increased duration of inflation, as compared with the control group. The time until ST elevations of 0.1 mV occurred was increased from 17 +/- 3 s to 57 +/- 18 s (p less than 0.05). The increase in lactate in coronary sinus blood was less pronounced after verapamil (48% of control; p less than 0.05). Intracoronary verapamil before PTCA of the LAD improved the ischemic tolerance of the poststenotic myocardium significantly as evaluated by measurements of electrocardiographic and metabolic parameters. No side effects occurred during the injection of verapamil into the left coronary artery.

Adult↗
PubMed1988

[Coronary fistula of the right ventricular outflow tract as a complication of combined transaortic-trans-right ventricular myectomy in hypertrophic obstructive cardiomyopathy].

We report on a patient who showed a fistula between the first septal branch of the left anterior descending coronary artery and the right ventricular outflow tract, as a complication of combined trans-aortic right ventricular myectomy for treatment of hypertrophic obstructive cardiomyopathy (HOCM).

Aorta, Thoracic↗
PubMed1987

Acute haemodynamic effects of a specific bradycardic agent in patients with coronary heart disease and impaired left ventricular function.

Alinidine is a bradycardic agent, which appears to be of potential value in the therapy of coronary heart disease. It might be useful in patients with impaired left ventricular function, where use of other bradycardic agents such as beta-blockers is limited due to their negative inotropy. To assess if alinidine has the potential to worsen haemodynamics in patients with strongly reduced left ventricular function we have examined acute haemodynamic changes after alinidine (0.5 mg kg-1 i.v.) both in a group of patients with mildly and in a group with strongly reduced left ventricular function. A significant reduction of resting heart rate and cardiac index was observed in both groups. All other haemodynamic parameters, especially left ventricular filling pressures (LVEDP, PC) and enddiastolic volume index did not show any significant change; dp/dtmax was not significantly influenced by alkinidine, when the influence of heart rate lowering was eliminated by pacing. We conclude that administration of alinidine in the dosage used does not lead to a significant deterioration even in patients with strongly impaired left ventricular function.

Anti-Arrhythmia Agents↗
PubMed1987

Capillary density and oxygen supply in human dilated cardiomyopathy.

Human hearts with dilated cardiomyopathy (DCM) exhibit a hypertrophy of the myocytes; consequently, the intercapillary distance increases, which may impede the diffusionable metabolic supply. Therefore in the following study the microcirculation of living human hearts with DCM, excised during cardiac transplantation, was investigated. The hearts were reperfused with a FITC-stained salt-solution, this allowed the precise detection of all plasma perfused capillaries. Thus, functional capillary density, capillary distribution and its effect on oxygen supply could be determined. In eight human hearts, the average functional capillary density amounted to 1245 +/- 345 capillaries/mm2, while 50% of the tissue was within 12 micron from the nearest capillary. However, a small portion of the tissue (1%) might become anoxic under the assumption of a simple oxygen diffusion model. The results favor the view that capillary density is low in human DCM and tissue is at the border of hypoxia.

Biological Availability↗
PubMed1986

[Acute coronary angiography in therapy-refractory angina pectoris].

UNLABELLED: Emergency coronary angiography was performed in 188 patients with treatment-resistant unstable angina. Criteria analysed were: duration of angina less than 72 h; angina despite heparin and nitroglycerin infusion; no significant S-T segment elevation in the ECG; creatine-kinase rise up to 150 U/l. Coronary heart disease (CHD) was found in 130 patients (group A). In 47 of them a recent coronary occlusion was demonstrated angiographically (main stem: 1; anterior interventricular branch: 8; circumflex branch: 27; right coronary artery: 11 patients). An at least 90% occlusion of one coronary artery was found in 58 patients. A 75% stenosis of several vessels was found in 25 patients making it impossible to identify the vessel that had caused the angina. A bypass operation was performed in 62 patients within two weeks. During the acute coronary angiography, intracoronary streptokinase infusion was performed in 11 (success rate 55%), percutaneous transluminal coronary angioplasty in 26 (success rate 88%). In 58 patients (group B) CHD was excluded. The final diagnosis in these was: mitral valve prolapse (31); pericarditis (6), dilated cardiomyopathy (3); coronary anomaly (3); muscle bridge in the anterior interventricular branch (2): normal (13). CONCLUSION: It is not possible to decide with certainty, in the absence of typical infarction signs in the ECG and clinically, whether treatment-resistant angina is due to CHD or other causes. Acute coronary angiography is indicated in such cases, because even without S-T segment elevation an acute coronary occlusion is present in 25%, and in 50% of cases an acute therapeutic intervention is indicated.

Adult↗
PubMed1986

Comparative analysis of myocardial enzyme activities of the energy-supplying metabolism in patients with dilative cardiomyopathies and valve diseases.

We determined representative enzyme activities of glycogenolysis (glycogen phosphorylase) glycolysis (d-glyceraldehyde-3-phosphate dehydrogenase, GAPDH), beta oxidation of free fatty acids (1-3-hydroxyacyl CoA dehydrogenase, HADH), citric acid cycle (citrate synthase, CS), lactate fermentation (lactate dehydrogenase LDH), and creatine phosphate metabolism (creatine kinase, CK) in left ventricular samples of 36 patients to investigate if the metabolic capacities of the energy-supplying pathways are differently affected in different heart diseases. There were 17 patients with mitral valve diseases (MVD), 8 patients with aortic valve diseases (AVD), and 11 patients who suffered from dilative cardiomyopathies (DCM). The main metabolic characteristic on the level of enzymatic organization in patients with DCM was an increased ratio of GAPDH/HADH activities and a decreased ratio of HADH/CS activities compared to the valve-diseased patients. This result indicates that the capacity of glucose oxidation is enhanced at the expense of fatty acid metabolism in patients with DCM. Furthermore, we determined significantly lower myocardial CK activities in this group of patients, most probably reflecting a diminished content of myofibrils. Citrate synthase activity was lowest in patients with AVD. Although we cannot rule out that the impaired left ventricular function is in part responsible for the shift of the capacities of the energy-supplying metabolism in patients with DCM, we favor the assumption that it is a specific feature of this myocardial disease.

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed1986

[Occlusion of the common trunk of the left coronary artery. Physiopathological features and clinical findings].

The total occlusion of the left main coronary artery is rarely observed (approximately 0.05% of coronary angiographic studies). We have tried to draw the clinical and pathophysiological outline of this condition, starting from our experience and reviewing the published reports. A hard selection, principally by the high mortality in patients with left main coronary stenosis, limits the number of those who present total occlusion. These subjects show a remarkable variability in their clinical presentation. It is not possible to find out a significant correlation with a single risk factor, clinical manifestation or electrocardiographic picture. Therefore, these patients cannot be distinguished from other subjects affected by severe atherosclerotic ischemic heart disease. The angiographic finding of a dominant right coronary artery is most frequent. A rich collateral circulation to the left coronary is usually observed. From a pathophysiological point of view, the efficiency of coronary collateral circulation is confirmed by the significant correlation of its extent with the left ventricular function. An important role is also played by the rate of progression of left main stenosis in total occlusion and by the presence of right coronary lesions. Even if statistical evidence is still lacking, surgical treatment is unanimously indicated and achieves satisfying results. The use of nonsurgical recanalization techniques, such as intracoronary thrombolysis and transluminal angioplasty, may be lifesaving in those patients in whom left main coronary occlusion suddenly occurs.

Angiography↗
PubMed1986

[Hemodynamic findings in the adult form of type II glycogenosis].

This report describes a family with late-onset acid maltase deficiency. In two sisters a disturbed left ventricular function could be demonstrated, although skeletal muscle involvement with respiratory insufficiency was responsible for the clinical symptoms. The findings present evidence that myocardial involvement may exist in adult type II glycogenosis.

Cardiac Catheterization↗
PubMed1984

[Cardiomyopathy in female carriers of the Duchenne gene].

The present report describes a family with X-linked recessive muscular dystrophy. In two female carriers a myocardial involvement could be demonstrated, which dominated the clinical picture in one patient. Obviously a congestive cardiomyopathy may develop in female carriers of X-linked recessive muscular dystrophy of the Duchenne-type.

Adolescent↗
PubMed1983

Development of tolerance during nitrate therapy: dissociation of arterial and venous effects. A doppler echocardiographic study.

Using pulsed Doppler echocardiography as a noninvasive method to assess central venous return, nine healthy volunteers were studied before and after isosorbide dinitrate given four times daily for 8 days. First dose isosorbide dinitrate led to a drop in heart rate and mean arterial pressure, and right ventricular inflow velocities decreased. With sustained treatment effects on systemic venous return remained unaltered, whereas reduction in heart rate and in mean arterial pressure was lost. Regarding this disappearing response as indicating a form of tolerance, venous hemodynamic nitrate effects were unaltered by development of tolerance on the arterial side.

Adult↗
PubMed1981

[Virological and morphological results in patients with congestive cardiomyopathy (author's transl)].

In 30 patients with congestive cardiomyopathy, right ventricular biopsies were performed. The biopsy material was investigated by virological and morphological methods. In all cases it was impossible to isolate viruses from the right ventricular myocardium, corresponding to the lack of infiltrative changes as shown by morphology. Results point against a direct causative role of viruses in the genesis of congestive cardiomyopathy.

Adult↗
PubMed1979

[Reopening of infarct-occluded vessel by transluminal recanalisation and intracoronary streptokinase application (author's transl)].

Coronary angiography was performed 2 hours after onset of complaints in a 57-year-old patient with acute anteroseptal infarction. Using a wire spiral in the coronary catheter the acutely occluded anterior interventricular branch was reopened. With intracoronary streptokinase (120 000 units in 50 minutes) the recanalisation canal was enlarged. The clinical picture and electrocardiographic findings improved under the influence of treatment. An aorto-coronary bypass operation was performed on the following day. The post-operative angiogram showed marked improvement of left ventricular function. The results indicate that this intervention prevented widespread necrosis.

Angiography↗
PubMed1979

[Recanalization by catheter of the occluded artery after acute myocardial infarction (transluminal recanalization (author's transl)].

Using guide-wires and special catheters the occluded infarct-related coronary artery was recanalized in 10 patients with acute myocardial infarction 6.6 +/- 7.1 hours after the onset of symptoms. There were no complications. Immediately after recanalization there were 80-95% lesions at the site of the previous occlusion. Angiography, performed in 9 patients in the chronic stage of myocardial infarction, revealed patency of the recanalized vessel in all instances. There was a marked decrease in the narrowing at the time of the second angiogram in 6 patients. Changes in left ventricular function from the acute to the chronic stage were assessed in 8 patients: the ejection fraction increased in 6. The results of this pilot study indicate that transluminal recanalization of acutely occluded coronary arteries is possible without harmful side-effects. Early restoration of flow may salvage the jeopardized myocardium. Further application of this method of treatment in selected patients and efforts to improve the technique seem to be justified.

Adult↗