Electrophysiologic testing after aortic valve replacement in two patients with aortic stenosis and preoperative ventricular fibrillation.

In two patients with severe aortic stenosis successful resuscitation from ventricular fibrillation was documented by Holter recording/ECG monitoring. After aortic valve replacement programmed ventricular stimulation was performed in both patients, but ventricular tachycardia/ventricular fibrillation was not inducible. The patients were left without antiarrhythmic therapy and have been free from cardiac events for 18 and 20 months, respectively.

[The effect of concomitant aortic valve insufficiency on the values of Doppler sonographic gradient determination in patients with aortic stenosis].

We examined the influence of concomitant significant aortic incompetence (AI) on Doppler-gradient measurements in valvular aortic stenosis (AS) by comparing catheter and Doppler gradients of 51 patients with isolated AS and of 24 patients with additional AI. In patients with additional AI there was a significantly greater overestimation of the peak-to-peak gradient by the maximal instantaneous Doppler gradient (AS + AI: overestimation 31.0 +/- 17.

Day to day reproducibility of Doppler sonographic measurements in patients with valvular aortic stenosis.

High reproducibility of Doppler gradient measurements is necessary for both the reliable noninvasive assessment of the severity of aortic stenosis and for repeated follow-up examinations in individual patients. We therefore studied day to day reproducibility of Doppler sonographically measured peak pressure drops in 46 patients with valvular aortic stenosis. Clinically stable patients were examined twice within 29 +/- 18.

[Electrophysiologic study in patients with syncope of unknown cause].

Electrophysiologic studies were performed in 51 patients with syncopes of unexplained origin. 25 patients (49%) had organic heart disease. Electrophysiologic testing included determination of corrected sinus node recovery time, AV-nodal effective refractory period, AH- and HV-intervals, and AV-nodal Wenckebach rate.

[Doppler echocardiographic determination of aortic valve gradients].

Doppler-echocardiography is the most important non invasive method for the assessment of the severity of aortic stenosis. After measuring the maximal transstenotic flow velocity (= Vmax) the maximal pressure drop between left ventricle and aorta (= maximal instantaneous gradient) can bei calculated according to a simple formula. The accurate determination of Vmax may be difficult and time consuming, however, and when interpreting the Doppler-data it is important to realize that there is always a systematic numerical difference between the instantaneous gradient and those gradients which one usually measures at catheterization (peak to peak and mean gradient respectively).

[Sudden cardiac death during long-term ECG monitoring of a patient with aortic stenosis].

Sudden cardiac death was documented on a Holter-monitor ECG in a 71-year-old man with known, but unoperated, calcific aortic stenosis (peak transvalvar gradient of 90 mm Hg). The tracing showed the development of a, presumably stress-induced, sinus tachycardia with broad QRSs and rapid transition to ventricular fibrillation. This rarely documented example of cardiac death in a patient with aortic stenosis during long-term ECG monitoring is of special interest because the patient had neither an inverse therapy effect nor impaired left-ventricular function.

Reproducibility of myocardial thallium-201 washout in studies applying a standardized dipyridamole stress protocol.

Thallium-201 (201Tl) washout analysis was proposed as an adjunctive tool to improve the detection of coronary artery disease (CAD). Since reproducibility of 201Tl washout in dipyridamole (DPM) stress studies is unknown, this item was evaluated in 32 patients (24 with CAD, 8 without CAD), who were scintigraphed twice within 1-2 weeks. At 2 minutes following DPM infusion (0.

[Doppler sonography quantification of mitral valve stenosis in patients with and without mitral valve insufficiency].

Fifty-three patients with mitral stenosis (MS) were examined by two dimensional (2DE) and Doppler echocardiography (Dop). Twenty-nine of them also had mitral insufficiency (MI) as judged by Dop. The mitral valve area (MVA) was calculated from Doppler using the "pressure half time" and was compared with MVA by 2 DE.

Structurally modified fatty acids: clinical potential as tracers of metabolism.

Recently 15-p-iodophenyl-beta-methyl-pentadecanoic acid (BMPPA) was proposed for use in myocardial scintigraphy, as a possible probe of metabolic processes other than beta-oxidation. In 19 patients (CAD/15, St.p.

Impact of thallium-201 imaging on clinical assessment and management of patients with chest pain.

The histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery disease present in percentages and to assess the need for coronary angiography on a five-point scale (1 = definitely not indicated, 5 = definitely indicated). After obtaining the results of thallium-201 imaging following dipyridamole (0.

[Changes in the left ventricular ejection fraction during exercise and in the thallium-201 perfusion after administration of dipyridamole in patients with coronary disease].

46 patients with coronary artery disease (at least 70% stenoses) were studied with thallium-201 imaging following dipyridamole (0.50 mg/kg bodyweight intravenously) with 4-hour control and by radionuclide ventriculography at rest and during symptom-limited bicycle exercise in supine position. 38 patients (83%) had positive thallium-201 findings with persistent defects in 18 and transient defects in 20 cases.

[Reproducibility of repeated measurements using M-mode echocardiography, radionuclide ventriculoradiography and systolic time intervals].

The reproducibility of M-mode echocardiography, radionuclide ventriculography, and systolic time intervals (PEP/LVET) was studied in 16 patients with symmetrically contracting left ventricles and no signs of coronary heart disease. The values were determined four times in these 16 patients: twice each on day 1 and day 8 at an interval of 2-3 h. The mean EF and PEP/LVET values were nearly identical in all 4 repeat studies.

Angiographic demonstration of tumor vascularity in left atrial myxoma: a case report.

We describe a 63-year-old woman with a large sessile left atrial myxoma and coexisting mitral valve stenosis and regurgitation. The diagnosis of a left atrial tumor was confirmed by echocardiography and coronary angiography. This case reveals the rare finding of tumor vascularity originating from both the right coronary artery and left circumflex artery.

The use of 123I-labeled heptadecanoic acid (HDA) as metabolic tracer: preliminary report.

The feasibility of using 123I-heptadecanoic acid (HDA) as a metabolic tracer was studied. Different administration routes of HDA were compared. An intracoronary bolus injection was given to calves (n = 3), and an intravenous injection was given to patients (n = 4).

[The leopard syndrome, a cardio-cutaneous syndrome].

A patient with the "leopard" syndrome presented with cardiomyopathy and a large arteriovenous shunt of the left renal vessels. The skin manifestations included multiple lentigines, junctional naevi, blue naevi, and one malignant lentigo. This syndrome is a rare entity, but in all patients with multiple lentigines the possibility of associated cardiovascular changes should be considered.

[Diagnostic value of 201-thallium imaging following dipyridamole in patients with a normokinetic left ventricle].

In 100 patients with a normokinetic left ventricle 201-thallium imaging following administration of dipyridamole (0.50 mg/kg body wt. i.

Evaluation of 99mTc-dichloro bis (1,2-dimethylphosphino) ethane (99mTc-DMPE) for myocardial scintigraphy in man.

99mTc-DMPE was used for myocardial scintigraphy in ten patients with coronary artery disease. As in 201T1 studies regional activity of 99mTc-DMPE was reduced in infarcted myocardium. However, activity accumulation of 99mTc-DMPE in the heart was faint, while that in the liver was prominent.

Thallium-201 imaging after dipyridamole in patients with coronary multivessel disease.

In 60 patients with angiographically documented 2- or 3-vessel disease (at least 70%) thallium-201 images after dipyridamole (0.50 mg/kg bodyweight i.v.