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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 388 (1980), S. 289-311 
    ISSN: 1432-2307
    Keywords: Intramyocardial microarteriopathy ; Age ; Frequency ; Risk factors ; Functional significance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary 1. Two basic types of arterial vessels can be distinguished in the myocardium. a) Compacta or Ventricular Wall Type. Intramyocardial microarteries with ring musculature of the media. b) Papillary Muscle Type. Arteries with longitudinal musculature arranged as bundles in the broad media. 2. The manifestation of intramyocardial microarteriopathy differs in these vessel types. PAS-positive and elastica-rich cushion-like thickening of the intima mainly occurs in the compacta type. Arterial vessels of the trabecular portion additionally show hyperelastosis of intima and media. The degenerative lesions of the papillary muscle type are characterized by early degeneration of the smooth muscle cells and hyperfibroelastosis of intima and media. 3. Pathological vascular lesions in the compacta and papillary muscle type occur more frequently in the left ventricle, and increase with age. 4. Slight and medium lesions are in the majority. Severe vascular changes are seen in the 7th to 9th decade in about 5–10% (compacta type) and in 30–35% (papillary muscle type) respectively. 5. Hypertension seemed to raise the frequency of slight and medium lesions in the compacta type vessels. In the papillary muscle type the degenerative lesions frequently extend from the top to the bottom of the papillary muscles. 6. No significant difference between frequency and severity of vascular lesions in diabetics and in the control group could be demonstrated. 7. It appears that pathological vascular lesions occur less frequently in compacta type vessels in cases of high-grade stenosis due to extramural coronary artery sclerosis. 8. Impairment of the quality of myocardial circulation is only encountered in the presence of severe pathological vascular lesions.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Virchows Archiv 366 (1975), S. 237-247 
    ISSN: 1432-2307
    Keywords: Chronic Cor pulmonale ; Left Ventricle ; Hypertrophy ; Dilatation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In 25 Fällen von chronischem Cor pulmonale wurden die Inhalte beider Ventrikel sowie die Gewichte des freien Anteils des rechten Ventrikels und die Gewichte des linken Ventrikels mit gesamtem Septum bestimmt. Das Gewicht des freien Anteils des rechten Ventrikels lag in allen Fällen über 100 g. Der rechte Anteil des Ventrikelseptums zeigte immer eine deutliche Hypertrophie. Die Gewichte des linken Ventrikels mit dem gesamten Septum sind deshalb bei chronischem Cor pulmonale oft erhöht. Mit einer von Müller angegebenen Methode wurde das relative Gewicht des rechtsseitigen Anteils des Kammerseptums berechnet. Dieser Wert wurde von dem Gewicht des linken Ventrikels mit gesamtem Septum abgezogen. Nach dieser Korrektur zeigte sich nur dann eine Gewichtsvermehrung des linken Ventrikels, wenn eine arterielle Hypertonie oder eine Arterio- und Arteriolosklerose der Nieren festgestellt wurde. In einem Fall mit Linksherzhypertrophie konnte ein Hypertonus nicht ausgeschlossen werden. In der Mehrzahl der Fälle wurde eine deutliche Dilatation des linken Ventrikels nachgewiesen. Die stärksten Dilatationsgrade fanden sich besonders bei Patienten mit Bronchiektasen der Lungen. Unsere Befunde können dafür sprechen, daß bei chronischem Cor pulmonale ein vergrößertes Shuntvolumen über bronchopulmonale Anastomosen für die Entstehung der strukturellen Dilatation des linken Ventrikels eine Rolle spielt.
    Notes: Summary The volume of both ventricles was estimated in 25 hearts with chronic cor pulmonale. Also, the weight of the left ventricle, including the whole septum and the free part of the right ventricle, was determined to be 100 g. Distinct hypertrophy of the right ventricular part of the septum could be demonstrated in all cases. A weight increase of the left ventricle, including the whole septum, is frequently caused by the hypertrophic ventricular part of the septum. The relative weight of the right ventricular portion (calculated according to Müller's method) was subtracted from the weight of the left ventricle plus the whole septum. After this weight correction, a hypertrophy of the left ventricle could only be demonstrated in cases with hypertension or renal arterio- and arteriolosclerosis. In one case of left ventricular hypertrophy, hypertension could not be ruled out. In most of the cases a distinct dilatation of the left ventricle could be found. The highest degrees of dilatation were found in patients with bronchiectases of the lungs. Our results indicate that the structural dilatation of the left ventricle may be due to an increased shunt-volume by bronchopulmonary anastomoses.
    Type of Medium: Electronic Resource
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