Intravascular ultrasound imaging in patients with acute myocardial infarction: comparison with chronic stable angina pectoris.

Background: Myocardial infarction is the result of acute thrombotic occlusion of a coronary artery, most likely secondary to rupture of an atherosclerotic plaque. Intracoronary ultrasonic (ICUS) examinations were performed in patients with acute myocardial infarction (AMI) in order to describe intraluminal ultrasonic findings at the site of acute coronary occlusion.

Methods: Coronary angiography and ICUS studies were performed consecutively within 6 h of the onset of chest pain in 30 patients with AMI prior to percutaneous transluminal coronary angioplasty (PTCA).

[Stress echocardiography: evaluation of left ventricular function after administration of the transpulmonary echo contrast medium SHU 508 A].

Stress echocardiography has recently gained increased importance as a method for assessment of left ventricular function. However, suboptimal image quality in some patients may limit use of this technique. In the present study, 10 patients with moderate image quality in the resting echocardiograms (apical 4-chamberview) were reinvestigated after administration of the intravenous transpulmonary saccharide-based left heart contrast agent SHU 508 A.

[Nuclear spin tomographic imaging of aortic aneurysms. Initial results].

Thirteen patients with aortic aneurysm (abdominal 7, thoracic 4, thoraco-abdominal 2) were evaluated by magnetic resonance tomography using a super-conducting magnet of a field strength of 0.35 tesla in transversal, coronal and sagittal planes. ECG gating was used in patients with thoracic aneurysm.

[Detection of regional hypertrophy in hypertrophic cardiomyopathy with ECG triggered nuclear magnetic resonance tomography--comparison with hypertensive patients and persons with healthy hearts].

Gated magnetic resonance tomography (MRT) was conducted in 40 patients (13 normal volunteers, 9 hypertensives and 18 patients with hypertrophic cardiomyopathy) using a 0.35 Tesla superconducting magnet. Multisectional spin echo imaging (35/400 msec) was obtained in coronal, transversal and sagittal planes.

[The value of two-dimensional echocardiography in the diagnosis of acute transmural primary infarctions].

The validity of two-dimensional echocardiography (2 DE) in the diagnosis of evolving myocardial infarction was assessed in 123 patients with a suspected acute myocardial infarction (chest pain for less than 4 hours). 84 patients developed a myocardial infarction, 39 did not. Detection and extent of a regional wall motion disorder in 2 DE were compared to ECG, enzymes, hemodynamics, coronary angiography and clinical data.

[Long-term observation in patients with mitral and aortic valve disease under conservative management].

127 patients with diagnosis of acquired mitral and aortic valve disease confirmed by cardiac catheterization were followed for 5-17 years (mean 10 years) under conservative management. At the end of the study, 80 patients were still alive, and 68 of them were examined again. 23 patients died, and no information was available on 24.

[Cardiac valve replacement in the aged (author's transl)].

Prosthetic valve replacement was performed in 113 patients above the age of 60 with advanced valvular heart disease, whose prognosis without surgical correction was extremely poor. Although there was high risk of early mortality in isolated aortic valve disease (20%), in isolated mitral valve disease (28%) and in multiple valve disease (50%), improvement for the survivors was evident. Late mortality was rather low.

[Long-term results after cardiac valve replacement (author's transl)].

The value of prosthetic valve replacement is determined not only by the improvement in life expectancy but also by the quality of life. This statement resulted from an analysis of 168 patients undergoing isolated aortic -- or mitral -- valve replacement between 1970 and 1976. Besides numerous complications -- probably often avoidable such as side effects of incorrect anticoagulation -- long term results of 125 surviving patients were satisfactory over a period of 3-9 years after surgery.

Recirculation dialysis (RD) (20 to 40 liters of dialysate) with venous bicarbonate buffering - an alternative procedure to hemofiltration (HF).

We report about a dialysis procedure, the circulation stability of which is comparable to hemofiltration treatment. Hemodynamic parameters were measured invasively and different procedures were compared for each patient. In RD and HF significant reduction in cardiac output (HF: --20%, RD: --21.

Hemodynamic studies in long-term peritoneal dialysis patients.

A study was undertaken to evaluate the acute hemodynamic effects in ten patients from this clinic's long-term peritoneal dialysis program. With a Swan-Ganz catheter, the following parameters were measured in each patient during peritoneal dialysis: cardiac index, pulmonary artery pressure, right atrial pressure, inferior vena cava pressure, heart rate and arterial pressure. Mean predialysis cardiac index, stroke volume index and heart rate were normal.

[Cardiac output and central-hemodynamic parameter under bencyclan (author's transl)].

In 17 patients with peripheral arterial occlusive disease the influence of intra-veinously applicated Bencyclane (Fludilat) on cardiac output and central-hemodynamic parameter has been investigated. While 100 mg (n = 8) of Bencyclane almost do not influence cardiac output, 200 mg (n = 9) cause a significant decrease of minute-volume of the heart by-17.22% and of heartfrequency by-8.

Hemodynamics during hemodialysis, sequential ultrafiltration and hemofiltration.

Circulatory parameters were determined by cardiac catheterization in patients on maintenance hemodialysis. They were studied in three groups during conventional hemodialysis, sequential ultrafiltration and hemofiltration. All three groups revealed significant reduction of cardiac output, stroke volume, pulmonary artery pressure and plasma volume.

Hemodynamic studies, acid-base status and osmolality in different hemodialysis procedures.

Three patients on maintenance dialysis were each treated with three different procedures: A) twenty-liter recirculation dialysis with bicarbonate buffering, B) recirculation-adsorption dialysis and C) single-pass dialysis. Hemodynamic parameters were measured invasively and procedures A, B and C were compared for each patient. In this intraindividual comparative study, the authors attempted to establish a relationship between the varying hemodynamic parameters and the changes in osmolality and acid-base status.

[Atrial septal defect in the aged (author's transl)].

The natural history of congenital heart disease in older patients will become increasingly difficult to delineate, since many of uncomplicated defects were repaired early in life. Therefore the frequency of clinical and hemodynamic progress in non-operated patients with atrial septal defects seems to be of great interest. We are able to compare 27 patients aged more than 60 years with a group between 40 and 59 years.

[Behavior of vasomotor tonus after lung autotransplantation].

In eight lung autotransplants and six normal lungs the vasomotor activity was tested with norepinephrine and acetylcholine. In autotransplants and normal lungs both substances elicit the same effects. The long-term interruption of the central innervation does not provoke a vasoconstriction in lung autotransplants.

[Arteriovenous aneurysm between the intercostal artery and subclavian vein in the presence of multiple arterial aneurysms (author's transl)].

An arteriovenous aneurysm of the fifth intercostal artery on the left, communicating with the left subclavian vein, is described. This has not been observed previously. It occurred in a 50-year old woman with multiple arterial aneurysms and stenosing aortic sclerosis.

[New methods of circulatory support: cardiac transplant as auxiliary pump (author's transl)].

A simple method of dystopic cardiac transplantation as a left-heart bypass was experimentally studied and details of the method are described. The hemodynamic investigation of this biological assisted circulation on the normal and failing heart, which was induced by subtotal occlusion of the asc. aorta, as well as its longtime support of the chronically damaged left myocardium showed the efficacy of this method.

[Dopamine effects on the pulmonary circulation of innervated and autotransplanted lungs (author's transl)].

The effects of dopamine on the pulmonary vascular resistance were investigated in 7 normal and 9 autotransplanted canine lungs during perfusion in situ. Dopamine (up to 13,5 gamma/kg BW, rapid injection) acts as a vasoconstrictor by alpha-receptor stimulation. Vasodilative effects could not be registered neither by very small amounts of dopamine nor during alpha-blockade with phentolamine.