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Your search keyword '"BUELL, UDALRICH"' showing total 11 results
Start Over Author "BUELL, UDALRICH" Journal journal of the american college of cardiology
11 results on '"BUELL, UDALRICH"'

7. Myocyte degeneration and cell death in hibernating human myocardium

Author

Schwartz, Ernst R., primary, Schaper, Jutta, additional, vom Dahl, Juergen, additional, Altehoefer, Carsten, additional, Grohmann, Beate, additional, Schoendube, Friedrich, additional, Sheehan, Florence H., additional, Uebis, Rainer, additional, Buell, Udalrich, additional, Messmer, Bruno J., additional, Schaper, Wolfgang, additional, and Hanrath, Peter, additional

Published
1996
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8. Recovery of Regional Left Ventricular Dysfunction After Coronary Revascularization Impact of Myocardial Viability Assessed by Nuclear Imaging and Vessel Patency at Follow-Up Angiography11This study was supported by Collaborative Research Grant 910576 from the North Atlantic Treaty Organization. It was presented in part at the 43rd Annual Scientific Session of the American College of Cardiology, Atlanta, Georgia, March 1994

Author

vom DAHL, JUERGEN, ALTEHOEFER, CARSTEN, BUECHIN, PETRA, UEBIS, RAINER, MESSMER, BRUNO J, BUELL, UDALRICH, HANRATH, PETER, and SHEEHAN, FLORENCE H

Abstract

Objectives. This study sought to evaluate an imaging approach using technetium-99m sestamibi scintigraphy and positron emission tomography with fluorine-18 fluorodeoxyglucose for assessment of myocardial viability proved by serial quantitative left ventricular angiography. Furthermore, the influence of successful long-term revascularization on functional recovery was studied.Background. Previous studies using positron emission tomography of myocardial perfusion and metabolism have demonstrated accurate identification of myocardial viability. However, most of these studies used a qualitative or semiquantitative wall motion analysis approach.Methods. Nuclear imaging with semiquantitative analysis of tracer uptake was performed in 193 patients with regional wall motion abnormalities. Regions were categorized as normal, viable with perfusion/metabolism mismatch, viable without mismatch (intermediate) and scar. Seventy-two of 103 patients with subsequent revascularization underwent follow-up angiography. In 52 of 72 patients, changes in regional wall motion were measured by the centerline method from serial angiography.Results. Wall motion improved in mismatch regions from −2.2 ± 1.0 to −1.1 ± 1.4 SD (p < 0.001). In contrast, regions with an intermediate pattern and those with scar did not improve. Restenosis or graft occlusion influenced functional outcome because regions with preoperative mismatch and successful long-term revascularization improved at follow-up (from −2.3 ± 1.0 to −0.8 ± 1.4 SD, p < 0.001), whereas wall motion did not change with recurrent hypoperfusion. Metabolic imaging added diagnostic information, particularly in regions with mild and moderate perfusion defects.Conclusions. This imaging approach allows detection of viability in regions with myocardial dysfunction. Wall motion benefits most in myocardium with perfusion/metabolism mismatch and successful long-term revascularization.

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11. Cardiac resynchronization therapy homogenizes myocardial glucose metabolism and perfusion in dilated cardiomyopathy and left bundle branch block.

Author

Nowak B, Sinha AM, Schaefer WM, Koch KC, Kaiser HJ, Hanrath P, Buell U, and Stellbrink C

Subjects
Aged, Bundle-Branch Block diagnostic imaging, Cardiomyopathy, Dilated diagnostic imaging, Female, Heart Atria diagnostic imaging, Heart Atria metabolism, Heart Atria physiopathology, Heart Ventricles diagnostic imaging, Heart Ventricles metabolism, Heart Ventricles physiopathology, Hemodynamics physiology, Humans, Male, Middle Aged, Tomography, Emission-Computed, Tomography, Emission-Computed, Single-Photon, Bundle-Branch Block metabolism, Bundle-Branch Block therapy, Cardiac Pacing, Artificial, Cardiomyopathy, Dilated metabolism, Cardiomyopathy, Dilated therapy, Coronary Circulation physiology, Glucose metabolism, Myocardium metabolism
Abstract

Objectives: We investigated whether cardiac resynchronization therapy (CRT) affects myocardial glucose metabolism and perfusion in dilated cardiomyopathy (DCM) and left bundle branch block (LBBB)., Background: Patients with DCM and LBBB present with asynchronous left ventricular (LV) activation, leading to reduced septal glucose metabolism. Cardiac resynchronization therapy recoordinates LV activation, but its effects on myocardial glucose metabolism and perfusion remain unknown., Methods: In 15 patients (10 females; 61 +/- 13 years) with DCM and LBBB (QRS width 165 +/- 15 ms), gated (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and technetium-99m ((99m)Tc)-sestamibi single-photon emission computed tomography were performed before and after two weeks of CRT. Uptake of FDG and (99m)Tc-sestamibi was determined in four LV wall areas. Ejection fraction and volumes were calculated from gated PET., Results: Baseline FDG uptake was heterogeneous (p < 0.0001), with lowest uptake in the septal region (56 +/- 12%) and highest uptake in the lateral region (89 +/- 6%). During CRT, septal and anterior increases (p < 0.01) and lateral decreases (p < 0.01) resulted in homogeneously distributed glucose metabolism. Baseline heterogeneity (p < 0.0001) in (99m)Tc-sestamibi uptake was modest (lowest septal 65 +/- 10%; maximum lateral 84 +/- 5%) and also reduced with CRT, although some heterogeneity (p < 0.05) remained. The septal-to-lateral ratio increased with CRT for FDG (0.62 +/- 0.12 to 0.91 +/- 0.26, p < 0.001) and (99m)Tc-sestamibi uptake (0.77 +/- 0.13 to 0.85 +/- 0.16, p < 0.01). The LV end-diastolic and end-systolic volumes decreased from 293 +/- 160 to 272 +/- 158 ml (p < 0.05) and from 244 +/- 164 to 220 +/- 160 ml (p < 0.01), respectively. Ejection fraction increased from 22 +/- 12% to 25 +/- 13% (p < 0.01)., Conclusions: Glucose metabolism is reduced more than perfusion in the septal compared with LV lateral wall in patients with DCM and LBBB. Cardiac resynchronization therapy restores homogeneous myocardial glucose metabolism with less influence on perfusion.

Published
2003
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