Sarcoid heart disease--results of follow-up investigations.

52 patients thought to have sarcoid heart involvement have been followed up. By administration of a standardized glucocorticoid therapy we demonstrated improvement of patients' symptoms, ECG disturbances, thallium scan defects of left heart muscle and there was 60-70% regression of pulmonary sarcoidosis. There was a low death rate.

[Quantifying aortic valve insufficiency using color Doppler echocardiography].

Unlabelled: 51 consecutive patients with the clinical signs of aortic valve incompetence (AI) were evaluated by color-coded Doppler flow mapping (CDF) before angiography (AG). Quantitation of the severity of AI was performed by measurement of length and width of the extension of regurgitant jet (grade I-IV). After AG results both -AG and CDF- were compared.

[The value of endomyocardial biopsy in verifying the diagnosis of sarcoidosis of the heart].

The evaluation of the results of myocardial biopsy specimens of 24 patients highly suspected of having myocardial sarcoidosis revealed a sarcoid granuloma only in one case. In tapering frequency (60-33%) there has been myocardial scarring, generalized fibrosis, pathological count of mononuclear cells, nuclear hypertrophy, and perivascular fibrosis which all yield unspecific results, but because of lack of another cause are related to sarcoidosis. The specimens of 8 patients have been normal.

[Diagnostic value of lipids and apolipoproteins for assessment of atherogenic risk].

In 242 coronarographed male patients (51.7 +/- 7.6 years) with 0-, 1-, 2- or 3-vessel diseases as well as a clinically healthy control group (n = 68, 50.

[Diagnostic score in heart sarcoidosis].

Basis of the score is the empirical valuation of clinical and cardiac functional parameters. The degree of probability shall enable the applier either to temporize and conclude therapeutic steps or considering the diagnostic stage to add additional examinations in order to confirm the supposition. The importance of this diagnostic and therapeutic management rests on the vital danger to patients with heart sarcoidosis.

[Lipids and apolipoproteins in relation to the degree of coronary sclerosis].

86 male patients with 0-, 1-, 2- or 3 vascular disease who underwent coronary angiography as well as a control group were examined with regard to their lipoprotein constellation: total (TC-), LDL-, HDL-, beta- and alpha-cholesterol (C); triglycerides; apolipoproteins A, AI and B. Significant differences between the mean values of the control group and the patients with coronary disease were found for the groups with 2- and 3-vascular disease for the following parameters: TC, HDLC, TC/HDLC, LDLC/HDLC, alpha-C, TC/alpha-C, beta-C, alpha-C. The quotients TC/HDLC and TC/alpha-C most closely correlate with the degree of the coronary sclerosis.

[Heart antibodies in sarcoidosis].

By means of indicret immunofluorescence sera of 56 patients with pulmonary sarcoidosis of the x-ray stages I-III--among them 25 patients with additional heart involvement--were examined to detect heart antibodies. At all x-ray stages of pulmonary sarcoidosis muscle antibodies were identified. Patients who were treated with glucocorticosteroids showed more antibodies against heart musculature than those ones without therapy.

[Myocardial biopsy in suspected myocardial sarcoidosis].

24 patients with pulmonary sarcoidosis stage I or II, who above all on account of changes of the ECG roused the suspicion of the presence of a sarcoidosis of the myocardium, finally underwent an invasive examination with laevocardiography, coronarography and biopsy of the endomyocardium. While the unaimed taking of tissue from the left ventricle did not result light-microscopically in a reference to granulomas or other inflammatory changes, the biopsy in a female patient, on purpose taken from a hypokinetic area of the left ventricle, showed epitheloid-cellular granulomas with giant-cells. Evaluating these results and reports in literatur, we came to the conclusion that findings typical for sarcoidosis are promising success only when taken from cardiographically suspicious areas of the myocardium.

[Follow-up studies and special cardiologic diagnosis in patients with suspected heart sarcoidosis].

During a retrospective analysis of 1236 patients with pulmonary sarcoidosis who showed electrocardiographic disturbances or cardiomegaly the existence of a possible heart sarcoidosis was suspected. It was tried to confirm this suspected diagnosis in subsequent examinations of these patients by support of modern non-invasive and invasive cardiological methods. Thereby the differential diagnosis to the coronary heart disease is especially difficult in elderly.

[Biopsy confirmation of clinically suspected heart sarcoidosis].

Case report from a 57 years old woman with pulmonary and heart sarcoidosis. The diagnosis was confirmed by heartcatheterism with myocardial biopsy from the left ventricle.

[Thallium myocardial scintigraphy, hemodynamics and left ventricular wall kinetics in patients with suspected myocardial sarcoidosis].

The cardiological examination of 22 patients (pts) with suspected heart sarcoidosis (histologically established lung sarcoidosis, heart rhythm disturbances, cardiomegaly) has revealed thallium scan defects in 20 pts at rest and during exercise. In 19 pts we found pathologic left heart wall motions established by laevocardiography by applying the half axis method. The number of pathologic half axis shortenings correlated with ejection fraction, but not with left ventricular enddiastolic pressure and left ventricular enddiastolic volume index.

[Determination of enzyme activity in sarcoidosis--comparison of angiotensin convertase and collagen peptidase].

The diagnostic evidence of the ACE and CP activity alone is limited with regard to the specifity of sarcoidosis. In connection with the X-ray diagnostics and the histological ascertainment the determination of the two enzyme activities, however, is an enrichment of the programme of diagnostics. High ACE- and CP-values speak for the presence of numerous sarcoidosis granulomas and for the affection of many organs, respectively, when the sarcoidosis is ascertained.

[Retrospective evaluation of sarcoidosis patients 1970-1979 at the Bad Berka Central Clinic for Heart and Lung Diseases for the detection of possible heart involvement].

Cardiac involvement in pulmonary sarcoidosis was found in a higher percentage than formerly reported, by careful observation. In a retrospective analysis of 1 236 patients with pulmonary sarcoidosis we found a possible cardiac involvement in 15.1%.

[Heart involvement in lung sarcoidosis. Results of a retrospective analysis of clinical courses collected over a 10-year period].

Both the roentgenographic assessment of heart size (CTR) and the evaluation of serial ECG are simple methods in diagnosing possible heart involvement in patients with pulmonary sarcoidosis. Heart rhythm disturbances (ventricular ectopic beats, atrial and ventricular tachycardia, bundle branch block, high degree av-block) are of particular diagnostic value especially in view of intermittent occurrence or therapeutic disappearance. Other noninvasive methods as vectorcardiography, echocardiography and nuclear myocardial imaging are of worth in confirming the diagnosis.

[New aspects in the diagnosis of pulmonary sarcoidosis].

Due to the advances in endoscopic technique, gallium-67-scintigraphy, immunologic methods as well as particularly by measurement of ACE in recent years the way to a pathogenetically oriented diagnostics and therapy of pulmonary sarcoidosis became evident. In this case it is important to abandon the x-ray and bronchoscopic diagnostics and the therapy planning according to the x-ray and to introduce increasingly activity markers into the clinical routine. As to newer methods in this case above all the ACE-measurement and the diagnostic lavage are offered.

[Enlargement of the lower mediastinum: pericardiac or extracardiac origin? (author's transl)].

The radiographic findings in 9 patients who suffered from a non-myocardiac enlargement of the lower anterior mediastinum are discussed. By means of several diagnostic procedures consisting of radiography, fluoroscopy, roentgen-kymography, angiocardiography and needle-biopsy under visible control it is often possible to distinguish between primary pericardiac lesions and growths of the mediastinum lying in close contact to the heart. In most cases, however, final histological diagnosis will only be reached by thoracotomy with removement of the tumor.

The optimization of the pulse delivered by the pacemaker.

The results of stimulation threshold analysis carried out in 230 patients after the initial electrode implantation, and in 188 patients during pacemaker replacement, are presented. The electrodes investigated were the IE-60K-10 (279 cases), the IE-60-K (96 cases) and the ME-50 (26 cases). The chronic stimulation threshold voltage for the electrode IE-60K-10 (electrode surface area: 10 mm2) at a pulse width of 0.

[Possibilities of a routine prevention of arrhythmia in the early phase of acute myocardial infarct].

The frequency of the electric heart death in the early phase of the acute myocardial infarction demands a prophylactic use of antiarrhythmic remedies. In a guarded ward for coronary diseases since 1972 all patients with a fresh myocardial infarction or suspicion of infarction were treated with a continuous intravenous lidocain drip in a dosage of 100 mg/per hour for 48 hours. In 266 patients in a certain examination period ventricular fibrillation was observed only once and ventricular tachycardias twice.

[Results of the myocardial infarct registers in the German Democratic Republic and their significance for the reduction of early mortality in myocardial infarce].

From preliminary results of the registers of myocardial infarction in the GDR follows that the definitive myocardial infarction (classification of the WHO) occurs in Berlin with an incidence rate of 17 cases per 10,000 inhabitants and annum, in Erfurt 10 and at Pasewalk 11 cases per 10,000 inhabitants and annum. More than three fourths of all cases of myocardial infarction appear outside the hospital. After three months the lethality is 60%, whereby the half of all cases of death appears already in the prehospital phase.