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The judgment of the function of the left ventricle is computer-tomographically possible using the ECG-regulated cardio-computer-tomography in a temporary resolution of about 0.1 sec. The qualitative and quantitative evaluation of the systolic and diastolic changes of the ventricle in patients with normal CT-findings, with idiopathic hypertrophic subaortic stenosis and with disturbances of motility in chronic ischaemic heart disease confirms the possible functional evidence known from literature. The quantitative parameters, in particular the systolic abbreviation of the axis, allow an estimation of the motility. The measurement of the thickness at the interventricular septum and at the lateral wall of the myocardium as well as the systolic abbreviation of the axis and the left-ventricular ejection fraction are essentially higher in the idiopathic hypertrophic subaortic stenosis than in the normal group. The values of the patients with disturbances of motility in the ischaemic heart disease were clearly below. The diagnosis of the idiopathic hypertrophic subaortic stenosis with response of the size of obstruction by the telesystolic and telediastolic pictures is possible in a high percentage. Sequelae of the chronic ischaemic heart disease, e.g. scars, become visible by a narrowing or an absence of the normal edge of the myocardium. Global and localized disturbances of motility are diagnosable by phase-referred systolic and diastolic ECG-regulated pictures.

The systemic character of the rheumatoid arthritis and the collagenoses includes an extraarticular organ manifestation. Since the symptomatology of an organ participation is often covered over with dominating joint troubles its diagnostics is difficult. In 34 patients (22 with rheumatoid arthritis, 12 with collagenoses) with the help of non-invasive methods (computed tomography and sonography) is tried to recognize a participation of the heart--particularly of the pericardium. Our examinations show that by means of the computed tomography in 13.6% of the cases an effusion in the pericardium (9.1% of them clinically not conspicuous) could be proved in rheumatoid arthritis, however, the frequency of 30% of the echocardiographically diagnosed pericardial effusions described in the literature could up to now not be confirmed. The classification of the changes of the pericardium as a complication of a rheumatoid arthritis or a collagenosis may be performed only in connection with the adequate clinical and biochemical immunological findings excluding other cardiac diseases.

Cardial and paracardial space occupations need a rapid, possibly non-invasive diagnosis. The echocardiography and the computer tomography are practically available. At the instance of 17 intracardial space occupations (4 solid tumours and 13 thrombi), which were found in a total number of 600 cardio-computer-tomographies, and several selected peri- und paracardial space occupations the high diagnostic significance of the computer tomography is demonstrated. With the computer tomography a standardized method independent of the investigator is available which in qualitative respect appears of the same value as to echocardiography in the diagnostics of the intracardial space occupations and in the peri- and paracardial space occupations the non-invasive method is the method of choice.

In individual cases the computed tomography renders possible the ascertainment of the coarctation of the aorta. Despite modified examination method (secondary section technique, continuous application of contrast medium) the reliability is insignificant. Therefore, the method cannot be recommended for the primary diagnostics of the coarctation of the aorta. The computed tomography is extraordinarily suited for the detection of aneurysms of anastomoses after operation of coarctations of the aorta. In 50 computed-tomographic examinations of 48 patients 11 times an aneurysm could be ascertained. This high proportion of late postoperative complications is above all to be traced back to the surgical suture material used in the sixties. There were only two falsely positive findings, in which cases also here relevant pathological changes were present. The computed tomography can more exactly than the aortography adopt a definite attitude to the question of the dissection of prostheses or to pseudoaneurysms.

51 patients with rheumatoid arthritis and high rheumatoid factors (mean titres 928) underwent examination for the demonstration of an extraarticular organ manifestation within the scope of the cooperation between the Department of Medicine of the Karl-Marx-University Leipzig and the Institute for Rheumatology of the Academy of Medical Sciences of the USSR in Moscow. The frequency of nodous rheumatism (about 60%) is comparable with the frequency of polyneuropathy. In 20% of the patients a systemic muscle atrophy, a hepatomegaly as well as a Raynaud-syndrome were stated. By means of skin biopsy in 28% perivascular infiltrates were found. Altogether in 6 patients (12%) a participation of the lungs and the pleura, respectively, could be proved. Only rarely a clinically manifest heart disease caused by the rheu-we we found an pericardial effusions in 3 cases. In systemic manifestation, such as myositis, participation of the eyes or vasculitis of the digital arteries with necrosis, were only sporadically to be established. Among 22 patients we found an pericardial effusions in 3 cases. In systemic manifestation in most cases increased parameters of activity were found. From the practical point of view apart from increased titers of the rheumatoid titres and circulating immune complexes (C1q-BT) increased concentrations of the C-reactive protein are prognostically significant. The presence of high rheumatoid factor titres alone as well as the isolated presence of rheumatic nodes must not always be connected with an unfavourable prognosis. When severe extraarticular manifestations are present a possibly early, intensive occasionally extracorporeal treatment is indicated.

Because of the possibility of life-threatening late complications by anastomotic aneurysms and the danger of their rupture, all patients in whom a coarctation of the aorta was resected and replaced by a vascular prosthesis must be followed up continuously for life. Their chest x-rays show-in addition to unequivocally normal or pathological findings-sometimes questionable variations of the aortic outline, which must be diagnosed definitely by further investigations. By means of computerized tomography, the suspicion of an anastomotic aneurysm can either be refuted or confirmed in almost all cases. Thus, the invasive examination by aortography, which is desirable before operation of an aneurysm, may be omitted in the group of unsuspicious patients. Out of 198 patients, who received a vascular prosthesis for correction of an aortic coarctation in the time from 1960 to 1980, 27 were examined by computerized tomography because of irregular findings in their chest x-rays. In 6 patients the suspicion of an anastomotic aneurysm was confirmed and could be proved by aortography and reoperation. In 21 patients an aortography could be omitted because of its unsuspicious findings by computerized tomography.

It is reported on an at present 32-year-old male patient, in whom at the age of 30 years an excessive mediastinal lipoma was excised. For 12 years the cardiological diagnosis was not clear and could completely be clarified only with the help of the computed tomography of the heart.