J Buss

Universität Heidelberg, Heidelburg, Baden-Württemberg, Germany

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Publications (37)264.83 Total impact

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    ABSTRACT: Differentiation between hypertrophic cardiomyopathy and hypertensive heart disease is a diagnostic challenge. Asymetric septal hypertrophy has been emphazied as a characteristic but not specific feature of hypertrophic cardiomyopathy. This diagnostic dilema is created in patients with systemic hypertension and marked left ventricular hypertrophy. We performed discriminanz analysis in order to select those M-mode echocardiographic and 2-D echocardiographic parameters which permit the best distinction between the two diseases. The combined critera of the clasical M-mode echocardiographic septal thickness and septal to posterior wall ratio, left ventricular mass index as well as the 2-D echocardiographic defind septal and/or anterior free wall segment and the 2-D echocardiographically assessed left ventricular mass index improve the diagnostic specificity.
    No preview · Article · Mar 1996
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    ABSTRACT: Patients with hypertrophic cardiomyopathy and additional diastolic flow abnormalities are relatively rare. This report describes a case of apical ventricular hypertrophy with complete systolic obstruction and holodiastolic intraventricular pressure gradient.
    No preview · Article · Apr 1993 · European Heart Journal
  • P Berlit · M Härle · J Buss · C Klötzsch

    No preview · Article · Feb 1993 · Advances in Experimental Medicine and Biology
  • J Buss · V Grimm · K Huck · W Jaschke · D L Heene
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    ABSTRACT: Six months after a pneumonectomy for myeloma, which had preoperatively been indistinguishable from bronchial carcinoma, a 50-year-old man presented with shortage of breath, cyanosis and episodes of syncope on standing or walking, symptoms which improved on lying down (platypnea). On one occasion these symptoms necessitated controlled artificial ventilation, but even at an inspiratory oxygen saturation of 100%, blood gases only partially improved (pCO2 27 mm Hg, pO2 67 mm Hg, O2 saturation 93%). Right heart catheterization in recumbency revealed a right to left shunt at atrial level of 37% of systemic flow. Contrast medium injection into the inferior vena cava near the heart demonstrated cardiac displacement and rotation. Part of the inferior vena cava flow passed into the left atrium via a patent foramen ovale: it is likely that this shunt increased in the upright position. After surgical closure of the patent foramen ovale and partial relocation of the heart (with a vicryl net) the patient has now remained free of symptoms for 5 years.
    No preview · Article · Jan 1993 · DMW - Deutsche Medizinische Wochenschrift
  • J Buss · J J Lasserre · D L Heene

    No preview · Article · Jan 1993 · New England Journal of Medicine
  • J Buss · J.J. Lasserre · D.L. Heene

    No preview · Article · Sep 1992 · The Lancet
  • J. Buss · V. Grimm · K. Huck · W. Jaschke · D. L. Heene

    No preview · Article · Jan 1992 · DMW - Deutsche Medizinische Wochenschrift
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    G Stehle · J Buss · D L Heene

    Preview · Article · Apr 1991 · Stroke

  • No preview · Article · Nov 1990 · The Lancet
  • C S Kortsik · U Staedt · T Stein · G Geiger · J Buss
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    ABSTRACT: A prospective clinical trial was performed on the effects of a three hour infusion of 500 ml 6% low-molecular-weight hydroxyethyl starch in patients with acute ischemic stroke. Hemorheology and conjunctival oxygen tension were found to be disturbed prior to treatment. After the infusion there was a marked improvement of the pertinent parameters, indicative of an increase in cerebral microcirculation and oxygen supply. Even 3 h later persistent significant effects were observed. The infusion was well tolerated. Blood pressure and cardiac index remained unchanged.
    No preview · Article · May 1990 · Infusionstherapie (Basel, Switzerland)
  • P. Berlit · J. Buss · B. Pohlmann-Eden

    No preview · Article · Feb 1990 · Aktuelle Neurologie
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    ABSTRACT: Differentiation between hypertrophic cardiomyopathy and hypertensive heart disease is a diagnostic challenge. M-mode echocardiography only permits assessment of hypertrophy in limited areas of the left ventricular wall. 2-D echocardiography allows visualization of most of the myocardium. To assess the reliability of conventional M-mode echocardiographic and 2-D echocardiographic criteria in patients with hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HY), 30 patients with hypertrophic cardiomyopathy and 30 patients with hypertension and severe cardiac hypertrophy were examined using M-mode and 2-D echocardiography. Although the M-mode echocardiographic features showed statistically significant differences between the mean values in the two groups, the degree of overlap made the differentiation of the individual patients difficult. The diagnostic sensitivity and specificity of classic echocardiographic features were assessed: ventricular septal thickness ≥1.5 cm, 90% and 43% (sensitivity and specificity, respectively); ventricular septal thickness to posterior wall ratio ≥1.5, 83% and 56%; cross-sectional area at papillary level >21 cm 2m -2, 80% and 73%; septal segment of the myocardial ring at papillary level >6.5 cm 2 m -2, 80% and 87%; and the combined criteria of cross-sectional area at papillary level >21 cm 2 m -2 and septal segment >6.5 cm 2 m -2, 77% and 93%. Quantitative 2-D echocardiography is useful to differentiate patients with hypertrophic cardimyopathy from those with secondary myocardial hypertrophy due to hypertension. Hypertrophic cardiomyopathy is characterized by a spectrum of different morphological patterns of hypertrophy. Patients with the predominant region of hypertrophy in the anterolateral free wall or the apical region of the left ventricle were not detected with our quantitative method. Patients with this type of hypertrophy are relatively rare in the western population.
    No preview · Article · Feb 1990 · European Heart Journal
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    ABSTRACT: Zusammenfassung In einer prospektiven Studie untersuchten wir bei 12 Patienten mit akutem zerebralem Insult die Wirkung einer dreistündigen Infusion von 500 ml 6%iger niedermolekularer Hydroxyathylstarke. Die an-fangs gestörte Hämorheologie wurde deutlich verbessert, ebenso der anfangs erniedrigte konjunktivale Sauerstoffpartialdruck. Dies kann als Hinweis auf eine Steigerung der zerebralen Mikrozirkulation und Sauerstoffversorgung gewertet werden. Auch 3 h nach Infusionsende waren noch signifikante Veränderungen nachzuweisen. Die Volumen-belastung durch die Infusion wurde gut toleriert. Blutdruck und Herzminutenvolumen blieben stabil.
    No preview · Article · Jan 1990 · Transfusion Medicine and Hemotherapy
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    ABSTRACT: Cardiovascular alterations such as increased heart rate, high cardiac output, reduced systemic vascular resistance, and in most of the cases, increased contractility parameters have been recognized in patients with advanced liver disease. Some investigators define a cirrhotic cardiomyopathy as a hyperdynamic failure of the heart. Consequently, in patients with cirrhosis, the risk of developing further circulatory deterioration may be increased in situations which stress the cardiovascular system. After opening a portocaval shunt, it is expected that a large amount of blood will be distributed from the splanchnic to the pulmonary circulation and put a strain on the heart. This two-dimensional echocardiographic study was made in 30 patients with cirrhosis and in 20 patients who were chronically treated (range: 16 to 156 months) with portasystemic shunt for prevention of hemorrhage from esophageal variceal bleeding. Patients with portasystemic shunts revealed a change in hemodynamic pattern. There was a significant increase in the left ventricular end-diastolic volume index and also a slight increase in the left ventricular end-systolic index. Cardiac output remained high despite a significant decrease in heart rate due to an elevated left ventricular stroke volume index. The parameters of systolic ventricular performance were normal. In contrast to the acute opening of the portacaval shunt, the chronic shunt volume put no strain of clinical significance on the heart.
    No preview · Article · May 1988 · Hepatology
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    ABSTRACT: Forty patients with coronary artery disease and scintigraphically proven myocardial ischemia were randomized into 2 groups receiving 4 weeks of treatment with either 120 mg of isosorbide dinitrate (ISDN) release or 60 mg of nifedipine release. Control exercise testing and myocardial scintigraphy were continued until anginal pains occurred, and repeated at identical individual workloads at the end of the 4 weeks of drug therapy. Myocardial scintigrams were evaluated by quantitative recording of counts in 60 segments/frame. Twenty patients in the ISDN group (group I) exhibited 47 significantly ischemic areas. The remaining 20 patients (group II), treated with nifedipine, had 50 ischemic areas before therapy. In the ischemic areas in group I, there was a mean difference of 30.9% between counts at rest and during exercise in the pretreatment period, and a difference of 18.1% after therapy (39.0%). In group II, the pretreatment difference was 28.8%, decreasing to 20.6% after therapy (17.8%). Both groups of patients were subsequently subdivided into 3 subsets: (1) significantly improved perfusion, (2) significant worsening, and (3) unchanged myocardial perfusion. Group I had 59.5% of areas with significant improvement and 10.6% of areas with significant worsening. In 29.7% of the areas, the findings were unchanged. Group II had improvement in 40% of areas, of significantly worsened areas in 6%, and unchanged areas in 54%, in both groups myocardial ischemia was reduced by therapy, but ISDN improved myocardial perfusion to a considerably greater extent than did nifedipine.
    No preview · Article · Apr 1988 · The American Journal of Cardiology
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    ABSTRACT: A 28-year-old male with hereditary angioedema died of an extensive stroke. Autopsy revealed cicatricial aortitis with narrowing of the coronary ostia, myocardial infarctions, and a left ventricular mural thrombus. There was neither acute inflammation of the aorta nor systemic vasculitis. A possible association of the aortitis with the hereditary angioedema is discussed.
    No preview · Article · Oct 1987 · Klinische Wochenschrift
  • R Elfner · J Buss · J Kraatz · D L Heene
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    ABSTRACT: We compared the annotation of the AHA and MIT databases beat-to-beat with the classification preformed by the microprocessor of a 24-hour ambulatory electrocardiographic device, based on real-time analysis. Sensitivity and positive predictive accuracy for QRS detection were 99.9% (99.9%) and 99.9% (99.8%) for the AHA database (MIT database respectively). Sensitivity and positive predictive accuracy were 99.1% (96.6%) and 98.3% (94.9%) for ventricular ectopic beats, 98.3% (91.8%) and 96.0% (63.0%) for couplets and 96.4% (74.2%) and 99.2% (41.1%) for salvoes. On 90% of the AHA tapes (MIT tapes) sensitivity and positive predictive accuracy were at least 93.8% (76.6%) and 92.7% (65.5%) for ventricular ectopic beats, at least 98.0% (96.3%) and 54.5% (0%) for couplets and at least 100% (66.6%) and 100% (0%) for salvoes. A sensitivity of 100% was achieved for ventricular ectopic beats on 56% (45%), for couplets on 90% (82%) and for salvoes on 95% (84%) of the AHA tapes (MIT tapes). A positive predictive accuracy of 100% was achieved for ventricular ectopic beats on 49% (52%), for couplets on 76% (61%) and for salvoes on 97% (75%) of the AHA tapes (MIT tapes). Real-time analysis of the Oxford Medilog 4500 proved sufficient for QRS detection and classification of ventricular ectopic beats. The quantification of frequent couplets and salvoes was sufficient, too. Sporadic false-positive detections of complex ventricular ectopic beats produced the false Lown grade IVA/IVB on 10% of the tapes as a consequence. The final computer report must hence be edited by a physician.
    No preview · Article · Sep 1987 · Zeitschrift für Kardiologie

  • No preview · Article · Aug 1987 · American Heart Journal
  • H Keller · B Stegaru · J Buss · K Genth · D Heene

    No preview · Article · Nov 1985 · American Heart Journal
  • H Keller · B Stegaru · J Buss · K Genth · D L Heene
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    ABSTRACT: The feasibility of estimating the mean pulmonary capillary pressure by simultaneous noninvasive recording of the ECG, the aortic and mitral valve echocardiogram was tested in 50 patients with miscellaneous heart lesions. The Q-MVC-/AVC-E ratio was measured from the onset of the QRS-complex in the ECG, the closure point of the aortic valve, the early diastolic opening of the anterior mitral valve (E-point) and the systolic closure of the mitral valve leaflets on the echocardiogram (C-point). A linear correlation exists between the mean pulmonary artery wedge pressure and the Q-MVC-/AVC-E ratio (n = 50, r = 0.75, p less than 0.001). The echocardiographic derivate index (Q-MVC-/AVC-E) is useful in assessing an elevated left ventricular filling pressure, but the individual data revealed variation in the predicted relation between Q-MVC-/AVC-E and left ventricular end-diastolic pressure. The Q-MVC-/AVC-E ratio is not a useful parameter in predicting left ventricular end-diastolic pressure in patients suffering from a left ventricular aneurysm or an acute transmural myocardial infarction with extensive regional abnormal wall motion. Many criteria such as mitral valve disease, atrial fibrillation, atrioventricular block and left bundle-branch block suggest that the Q-MVC-/AVC-E ratio is of limited clinical value. The left atrial emptying index was measured by using the amplitude of the posterior aortic wall motion occurring in the first third of the passive emptying period.(ABSTRACT TRUNCATED AT 250 WORDS)
    No preview · Article · Aug 1985 · Zeitschrift für Kardiologie