Biomedical subjects

A Bouchard

Publications and source records attributed to A Bouchard.

At least 19 recordsLinked to original sources

PubMed1997

RESEARCH: Shrub Propagation Techniques for Biological Control ofInvading Tree Species

/ The use of relatively stable shrub communities to control invasionby trees could be an efficient way of reducing herbicide applications, andthus represents an environmental gain, in areas such as rights-of-way. Thequestion is how to favor the expansion of these relatively stable shrubcommunities using different propagation techniques. Three experimentaltreatments, cutting back, layering, and cutting back-layering were performedon Cornus stolonifera, Salix petiolaris, and Spiraea albaclones already located within the corridor of an electrical power line. Toestablish the efficiency of treatments, we examined the statisticaldifferences of growth traits between species and treatments.An analysis of the effects of layering shows, after the first growth season,differences for all growth traits in only one species, Spiraea alba.After the second growth season, we observed the development of new aerialstems. Layering favors horizontal expansion of shrubs over heightdevelopment. The third year after treatment, the effect of layering isreduced except for Cornus stolonifera, which continuously increases,as shown by the significant progression of the clone issued from the layereven five years after treatments. With the cutting back technique, weexpected a distinct vertical growth of the shrubs at the expense ofincreasing the crown diameter. This technique would be best associated withthe rejuvenation of clones, followed by a layering of new shoots to allow ahorizontal expansion of the shrubs. Therefore, the formation of a dense shrubcommunity by layering should be considered a valuable approach for thebiological control of undesirable trees in powerline rights-of-way.KEY WORDS: Layering; Cutting back; Right-of-way; Cornus stolonifera;Salix petiolaris; Spiraea alba; Quebec

Journal Article↗

PubMed1995

Impaired response of activated mononuclear phagocytes to interleukin 4 in inflammatory bowel disease.

BACKGROUND/AIMS: In inflammatory bowel disease (IBD), peripheral monocytes and intestinal macrophages show an increased state of priming and activation. The aim of this study was to test the hypothesis that the response of IBD mononuclear phagocytes to the contrainflammatory cytokine interleukin (IL) 4 may be altered. METHODS: The in vitro secretion of proinflammatory cytokines (IL-1 beta, tumor necrosis factor alpha [TNF-alpha], and IL-1-receptor antagonist [IL-1ra]) by peripheral monocytes and by intestinal lamina propria mononuclear cells (LPMNCs) was assessed by enzyme-linked immunosorbent assay. In parallel, superoxide anion release, macrophage mannose receptor, and IL-4 receptor expression were investigated. RESULTS: IBD peripheral monocytes and intestinal LPMNCs in vitro secrete increased amounts of proinflammatory cytokines (IL-1 beta and TNF-alpha) with decreased IL-1ra/IL-1 beta ratios. IL-4 down-regulates proinflammatory cytokine (IL-1 beta and TNF-alpha) and superoxide anion secretion in a dose-dependent manner. In contrast to normal and disease-specific controls, IBD peripheral monocytes and IBD intestinal LPMNCs show a diminished responsiveness to the inhibitory effect of IL-4. The IL-1ra/IL-1 beta ratios in normal monocytes are increased by IL-4, whereas in IBD monocytes low IL-1ra/IL-1 beta ratios persist after IL-4 treatment. IL-4-induced expression of macrophage mannose receptor, which is a molecule pivotal to macrophage-mediated host defense, again appeared to be impaired in IBD monocytes. CONCLUSIONS: IL-4-mediated regulation of mononuclear phagocyte effector functions is disturbed in IBD.

Cellular Senescence↗

PubMed1995

Quantitative comparison of prone and supine myocardial SPECT MIBI images.

The myocardial count distribution and the stress/rest ratio distribution were compared between prone and supine Tc-99m MIBI myocardial SPECT acquisitions. Ninety-nine male patients with a low stress supine inferior wall count underwent stress and rest acquisitions in the supine and prone positions successively. For each study, values depicting the inferior, anterior, septal, and lateral wall counts were extracted from a medioventricular normalized circumferential profile and underwent a statistical analysis (Student's paired t-test). On prone imaging, when compared to supine imaging, counts showed a highly significant mean relative increase of 11% +/- 1% in the inferior wall and of 7% +/- 1% in the septum. Conversely, these counts showed a significant mean relative decrease of 4% +/- 1% in the anterior wall and of 3% +/- 1% in the lateral wall. Moreover, the inferior wall stress/rest ratio showed a highly significant mean relative increase (6% +/- 2%). The prone position is probably preferable for interpreting the inferior wall and septum, where relative counts are enhanced, as with TI-201, and because the inferior stress-rest discrepancies are reduced in that position. But the anterior and lateral wall information is impaired in the prone position. The authors suggest, in case of a low stress supine inferior count, the combination of both positions, which is feasible with Tc-99m MIBI, in order to prevent a misleading interpretation.

Adult↗

PubMed1994

Shape preserving three-dimensional display of myocardial scintigraphic data.

A three-dimensional display has been developed which is specifically suited to the visualization of myocardial single photon emission tomographic (SPET) data. A set of radial maxima voxels, representative of the whole left ventricle uptake and shape is first extracted by cylindrical and spherical sampling of the short axis slices. A three-dimensional representation of these voxels is then obtained, with hues depicting the uptake amount and shades (i.e. intensity and saturation) depicting the shape. This technique is suitable for 201Tl and 99TCm-hexakis-2-methoxyisobutyl isonitrile (99TCm-sestamibi) myocardial images. It is proposed as an aid to interpreting myocardial SPET as it enables the physician to distinguish simultaneously the actual shape, the extent and the severity of perfusion defects on a single frame.

Computer Graphics↗

PubMed1993

Cigarette smoking and peripheral arterial occlusive disease.

BACKGROUND: The importance of cigarette smoking in the etiology of peripheral arterial occlusive disease is well known, but there have been few studies that have quantified this relationship. METHODS: A case-control study design was used in which the case subjects were men with a history of claudication for at least 1 year and abnormal findings on noninvasive blood flow studies or on arteriography; control subjects were men attending the same hospital for conditions other than cancer, with no history of cancer or vascular disease and with a normal ankle-brachial index. Case and control subjects were interviewed by a trained nurse interviewer using a pilot-tested questionnaire. Current smoking status was confirmed by serum cotinine level estimation. Univariate odds ratios for smoking and other potential risk factors were calculated, and their significance was tested by comparison with the chi-squared distribution. Logistic regression analysis was used to adjust the effect of smoking for confounding variables, and the regression equation was used to estimate the proportion of disease attributable to smoking. RESULTS: Of the patients approached, 94% of the eligible case subjects and 93% of the eligible control subjects agreed to participate. Recruitment ended with 102 cases of peripheral arterial occlusive disease and 99 controls. Most of the control subjects were attending clinics for other surgical specialties. Compared with men who had never smoked the relative risk was 7 for exsmokers and 16 for current smokers (p < 0.001). The relative risk increased directly with the lifetime number of cigarettes smoked, the chi-squared test for trend being highly significant (p < 0.001). Age, lipoprotein concentration, body mass index, and history of hypertension or heart disease were also significant risk factors. CONCLUSIONS: After adjustment for confounding variables the estimate of the fraction of disease attributable to smoking was 76%.

Arterial Occlusive Diseases↗

PubMed1992

Peripheral catabolism of CR1 (the C3b receptor, CD35) on erythrocytes from healthy individuals and patients with systemic lupus erythematosus (SLE).

The present study investigated the rate of catabolism of CR1 (the C3b receptor, CD35) on erythrocytes (E) in vivo, in relationship with the expressed number of CR1/E, the CR1.1 HindIII quantitative CR1 polymorphism, and cell age. The relationship between the number of CR1/E and cell age was analysed by measuring G6PDH activity in E that had been sorted according to high or low expression of CR1 (CD35), by assessing the expression of CR1 (CD35) on E separated according to cell density, and by comparing the number of CR1 (CD35) antigenic sites on reticulocytes and on E. A physiological catabolism of CR1 (CD35) manifested by a reduction in the number of CR1 (CD35) antigenic sites/E with cell ageing was consistently observed in healthy individuals. The number of CR1/E decreased with ageing of E according to a complex pattern that associated an exponential decay and an offset. Calculated half-lives of CR1 (CD35) ranged between 11 and 32 days in healthy individuals. A more rapid loss of CR1 (CD35) with cell ageing occurred on cells from individuals expressing high numbers of CR1/E. In patients with systemic lupus erythematosus (SLE), half-lives of CR1 (CD35) on E were in the same range as those of healthy individuals with a similar quantitative CR1 genotype; the number of CR1 (CD35) on reticulocytes was reduced and linearly related to the number of CR1/E, independently of the patients' quantitative CR1 genotype. Transfusion experiments with E bearing high or low amounts of CR1/E indicated the lack of preferential removal of E bearing high numbers of CR1 (CD35) in patients with SLE. These results indicate that the rate of loss of CR1 (CD35) from E with cell ageing is directly related to the quantitative CR1 phenotype and suggest that enhanced peripheral catabolism is not the sole mechanism of the acquired loss of CR1 (CD35) on E in patients with SLE.

Antigens, CD↗

PubMed1992

Assessment of postreperfusion myocardial hemorrhage using proton NMR imaging at 1.5 T.

BACKGROUND: Intramyocardial hemorrhage occurs frequently after reperfusion of acute myocardial infarction. However, its significance has not yet been established, mainly because of the lack of methods for detecting such hemorrhage. The following ex vivo study was carried out to assess the potential of nuclear magnetic resonance (NMR) imaging to detect and quantitate postreperfusion intramyocardial hemorrhage. METHODS AND RESULTS: Sixteen adult mongrel dogs underwent 3 hours of coronary occlusion followed by 1 hour of reperfusion, and three dogs underwent 4 hours of occlusion without reperfusion. Radiolabeled microspheres and 51Cr-labeled red blood cells were used to assess flow and evaluate the extent of hemorrhage. These results were later compared with both NMR and histology. Spin-echo NMR imaging was performed on the excised hearts using a 1.5-T system. Macroscopic assessment of the sliced myocardium revealed the existence of hemorrhage in 14 of the 16 dogs that underwent reperfusion but in none of those with occlusion only. In all 16 dogs with reperfusion, zones of increased signal intensity (SI) ratio (1.68 +/- 0.41 compared with control, p less than 0.05) were seen in regions relating to the distribution of the occluded coronary artery, whereas in 13 of the 16 dogs, areas of decreased SI within the zone of increased SI ratio (0.81 +/- 0.16 compared with control, p less than 0.05) were also seen, corresponding to regions with macroscopic hemorrhage. In contrast, in the three dogs without reperfusion, no macroscopic hemorrhage was observed, and likewise, no NMR zones of reduced SI were detected. Hemorrhage size by NMR (decreased SI zones), correlated well with hemorrhage size calculated from tissue slices (r = 0.96, SEE = 0.92%, p less than 0.01), or by 51Cr labeling (r = 0.78, SEE = 1.5, p = 0.1). In the reperfusion group, T2 relaxation times in the infarcted hemorrhagic zone (58 +/- 9 msec) were significantly lower than the infarcted zones without hemorrhage (98 +/- 13 msec, p less than 0.001). In contrast, when compared with control (964 +/- 72 msec), T1 relaxation times were significantly increased in both infarct zones, either with (1,284 +/- 176 msec) or without (1,266 +/- 103 msec) hemorrhage. The selective shortening of T2 relaxation times in the hemorrhagic regions is consistent with the paramagnetic effects of deoxyhemoglobin. CONCLUSIONS: NMR imaging may provide a noninvasive approach for the detection and quantitation of intramyocardial hemorrhage. This observation may provide a means to further characterize pathological processes associated with acute myocardial infarction and assess the role of myocardial hemorrhage after reperfusion therapy.

Animals↗

PubMed1991

Visualization of altered myocardial lipids by 1H NMR chemical-shift imaging following ischemic insult.

Acute myocardial infarction is associated with an accumulation of lipids. Spectroscopic and chemical-shift imaging strategies which can depict the spatial distribution of these chemical species are evolving. The present study was undertaken to test whether the Dixon method could detect spatially lipids known to accumulate in myocardium after an ischemic insult. Seven dogs underwent a 24-h coronary artery occlusion (LAD = 4, Cx = 3). Post mortem, hearts were removed and imaged ex vivo. Myocardial samples were also evaluated by high-resolution 1H NMR spectroscopy. Lipid images revealed regions of increased signal intensity, in the regions corresponding to the myocardial infarction, particularly in the periphery of the infarction. An increase in mobile lipids was observed by 1H NMR spectroscopy of myocardial samples with moderately reduced blood flow and corresponding to regions with increased signal intensity on the lipid image. This study shows that chemical-shift imaging may be useful for detecting alterations in myocardial lipid levels following an ischemic insult.

Animals↗

PubMed1990

Detection of intramyocardial hemorrhage using high-field proton (1H) nuclear magnetic resonance imaging.

Proton (1H) nuclear magnetic resonance (NMR) imaging has been used to define zones of myocardial infarction (MI), which appear as areas of relatively increased signal intensity (SI). However, zones of decreased SI have been observed within the areas of infarction and have been postulated to result from intramyocardial hemorrhage. To explore this phenomenon further, ex vivo spin-echo 1H NMR imaging at 1.5 Tesla was performed in 17 dogs after 24 hr (n = 9) and after 72 hr (n = 8) of coronary artery occlusion. In all dogs, a zone of increased SI (118 +/- 9% compared with normal myocardium) was observed in the distribution of the occluded coronary artery. In 12 of the 17 dogs, zones of decreased SI (92 +/- 8% compared with normal) were seen within or around the central zone of increased SI. Gross inspection and histological assessment of sliced myocardium usually disclosed hemorrhage in the regions of decreased SI. In three of the five dogs with no apparent zones of decreased SI on NMR, the infarct was small, and only minor hemorrhage was observed by gross inspection, whereas in the remaining two dogs no hemorrhage was seen. Myocardial flow in the hemorrhagic regions was significantly higher than in the necrotic core (59 +/- 29% vs. 31 +/- 24% compared with control, P less than 0.05). Image-derived calculation of T2 relaxation times in the different infarcted regions revealed a significant shortening of T2 in the infarcted hemorrhagic zones with decreased SI compared with the infarct zones with increased SI (49 +/- 8 msec vs. 66 +/- 8 msec, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1990

A randomized double-blind comparison of fentanyl- and sufentanil-oxygen anesthesia for abdominal aortic surgery.

Twenty-four patients undergoing abdominal aortic surgery for aneurysm or occlusive vascular disease entered a randomized, double-blind protocol comparing high-dose narcotic anesthesia with fentanyl (125 micrograms/kg) or sufentanil (25 micrograms/kg). All patients received perioperative beta-adrenergic blockade therapy. Hemodynamic and electrocardiographic (leads II and V5) responses to induction, intubation, skin incision, aortic cross-clamping, and declamping were studied. Sufentanil produced a transient decrease in mean arterial pressure and a significant reduction of systemic vascular resistance during induction. However, no significant hemodynamic differences were observed between the two groups during intubation, or at any other time during surgery. To maintain mean arterial pressure within 20% of the awake control value, the fentanyl group required an average infusion of 1.0 +/- 1.1 micrograms/kg/min of nitroglycerin compared with 1.7 +/- 2.8 micrograms/kg/min for the sufentanil group. Low-dose isoflurane was required in 30% of patients in the fentanyl group, compared with 41% of the sufentanil group, for control of blood pressure. The multiple-bolus technique of narcotic administration resulted in a wide but parallel range of plasma concentrations from induction to the end of surgery with both narcotics. Mean plasma fentanyl concentrations varied between 7.2 +/- 1.4 ng/mL and 26.5 +/- 7.9 ng/mL, and mean sufentanil plasma concentrations varied between 1.0 +/- 0.1 ng/mL and 10.6 +/- 7.2 ng/mL throughout surgery. Within this range of narcotic serum levels, the authors were unable to identify a specific threshold level for either narcotic above which hemodynamic responses were consistently attenuated. A low incidence (4.5%) of intraoperative myocardial ischemia was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Intravenous↗

PubMed1990

Left ventricular volume measurement using cardiac axis nuclear magnetic resonance imaging. Validation by calibrated ventricular angiography.

Proton nuclear magnetic resonance (NMR) imaging has the potential to serially assess left ventricular (LV) volumes with optimal accuracy because it is a high-resolution, three-dimensional, noninvasive modality. Previous NMR studies to assess LV volumes have been suboptimal, as they have used either planes aligned with the axes of the body, which are compromised by partial volume effects, or spin-echo techniques that have been time-consuming to acquire and analyze. Accordingly, for LV volume measurement, we developed a gradient-echo (cine) NMR strategy that uses two orthogonal planes intersecting along the intrinsic long axis of the heart (two-chamber and four-chamber). This approach was validated against calibrated contrast biplane LV cineangiography (CATH) and also compared with a previously reported short-axis spin-echo NMR method. Twenty-one patients underwent CATH and NMR (long-axis, n = 21; short-axis, n = 14) within a 3-day interval. Although both long- and short-axis NMR LV volumes and ejection fractions correlated well with CATH (r greater than 0.90, p less than 0.001 in all), end-diastolic volumes by both long-axis (161 +/- 85 ml) and short-axis (151 +/- 81 ml) NMR were systematically less than those by CATH (182 +/- 85 ml) (p less than 0.05). Consequently, ejection fractions by long-axis (48 +/- 17%) and short-axis (49 +/- 17%) NMR consistently underestimated those by CATH (54 +/- 16%, p less than 0.05). End-systolic volumes by long-axis (94 +/- 71 ml) and short-axis (87 +/- 72 ml) NMR were not significantly different from those by CATH (92 +/- 69 ml). Both NMR techniques had low intraobserver and interobserver variation (less than 11%); however, short-axis spin-echo NMR involved longer acquisition/reconstruction (35 versus 18 minutes) and analysis (25 versus 10 minutes) times. We conclude that both short-axis spin-echo and long-axis gradient-echo NMR approaches reliably estimate LV volumes. Currently, the long-axis strategy appears more practical for clinical use because the scan and analysis times are relatively short.

Adult↗

PubMed1990

Doppler echocardiographic evaluation of mitral regurgitation.

Evaluation of the severity and hemodynamic significance of mitral regurgitation remains an important and difficult problem. Cardiac ultrasound has emerged as the procedure of choice for the initial evaluation of mitral incompetence, as a result of its ability to confirm the diagnosis and provide a semiquantitative estimate of the severity of incompetence, determine its etiology, and assess the hemodynamic impact of the incompetence on ventricular function. This article reviews established as well as investigational methods of evaluating mitral incompetence by echocardiography and explores established and potential clinical applications of this evolving technology.

Blood Flow Velocity↗

PubMed1990

Effect of E. coli pyelonephritis on the intracortical accumulation kinetics of gentamicin and netilmicin in rats.

The role of serum levels on the intrarenal accumulation kinetics of gentamicin and netilmicin in normal and infected kidneys was evaluated in a short-term infusion model in conscious rats. Female Sprague-Dawley rats were infused over a period of 6 h with gentamicin and netilmicin achieving individual steady-state serum levels ranging from 0.5 to 120 micrograms/ml. The model of pyelonephritis used resulted in severe left pyelonephritis and mild right pyelonephritis. Only the right infected kidneys were studied. Gentamicin and netilmicin cortical concentrations were analysed as a function of serum levels by linear (least-squares regression analysis) and non-linear regression. For the non-linear regression analysis, the Michaelis-Menten kinetic was the best fitting curve. Steady-state elevation of serum concentrations of gentamicin and netilmicin was associated with a non-linear increase of cortical concentrations in normal kidneys, suggesting a saturable process. By contrast, in the mildly-infected right kidneys, the steady-state elevation of serum concentrations of gentamicin was associated with a linear increase of cortical concentrations while the accumulation kinetic of netilmicin showed a saturable process. At lower serum levels (therapeutic range, from 0.5 to 15 micrograms/ml) both gentamicin and netilmicin showed a first order kinetics of accumulation and netilmicin accumulated less than gentamicin in normal kidneys (p = 0.0004). By contrast, the uptake of netilmicin was higher in the right infected kidneys, as compared to the uptake of netilmicin in the normal kidneys, (p = 0.00005), and as compared to gentamicin in the respective kidneys. We conclude that renal infection modifies the intrarenal accumulation of aminoglycosides.

Animals↗

PubMed1989

Accuracy and reproducibility of clinically acquired two-dimensional echocardiographic mass measurements.

Left ventricular mass (LVM) measurements made by the truncated ellipsoid algorithm from clinical two-dimensional echocardiograms (2DE) were compared to autopsy weights in 37 patients. All six 2DE instruments were calibrated with an ultrasound phantom to standardize LVM measurements. Measurements were made by an experienced echocardiographer (LVME) and by an echocardiographer (LVMN) newly trained in LVM measurement from clinical 2DE tapes of patients with LV weights later confirmed at autopsy. LVME (r = 0.91, SEE +/- 41 gm) were more accurate than LVMN for all 2DE, but LVMN equalled LVME in accuracy for technically good 2DE. Interobserver variability was 36 gm, or 17% of LVM for all 2DE, and fell to 27 gm, or 12% of LVM for technically good 2DE. Segmental wall motion abnormalities and time from 2DE to death did not influence measurement accuracy significantly. LVM measurements by the 2DE truncated ellipsoid formula are accurate and reproducible in patients with normal and abnormal hearts.

Adult↗

PubMed1989

Assessment of myocardial infarct size by means of T2-weighted 1H nuclear magnetic resonance imaging.

Proton (1H) nuclear magnetic resonance (NMR) imaging is thought to depict zones of recent myocardial infarction in contrast to noninfarcted myocardium. This is related to T2 increases in infarct zones that have been verified previously by relaxometry measurements in excised myocardial samples. Accordingly the present study was undertaken to evaluate a 1H NMR imaging method to optimize T2 contrast and measure infarct size in a high-field imaging system (1.5 T). To accomplish this, NMR images were acquired every other R wave with echo times of 30 and 100 msec. The first echo image was used for myocardial border definition and the second echo image, which highlighted the myocardial infarction, for infarct border definition. This T2-weighted approach yielded a significant correlation between infarct size by NMR and pathologic methods. However, NMR imaging tended to overestimate infarct size, and the NMR image depicted abnormal signal well beyond the extent of the pathology-determined infarct. There was a significant relationship between NMR-imaged infarct size and myocardial mass with microsphere-determined reduction in blood flow of 25% or more. These data suggest that T2-weighted NMR imaging depicts not only infarct but also some reversibly injured myocardium.

Animals↗

PubMed1989

Value of color Doppler estimation of regurgitant volume in patients with chronic aortic insufficiency.

We studied 16 patients with chronic aortic insufficiency to compare a method for measuring regurgitant volume with color Doppler flow mapping to stroke count ratio determined by radionuclide ventriculography and to ventricular volumes assessed by two-dimensional echocardiography. A real-time color flow map of the left ventricular was obtained from an apical two- and five-chamber view and the maximal mosaic pattern of diastolic turbulent flow was planimetered as a reflection of the maximal regurgitant volume using biplane Simpson's rule. The maximal Doppler regurgitant volume evaluated by color Doppler flow mapping correlated with the stroke count ratio measured by scintigraphy (r = 0.86, SEE = 11 cc). There were significant relationships between maximal regurgitant volume measured by color Doppler and echocardiographic left ventricular end-diastolic volume (r = 0.88), left ventricular end-systolic volume (r = 0.77), and left ventricular mass (r = 0.71). Patients with larger regurgitant volumes tended to have a larger left ventricular end-diastolic volume-to-mass ratio (r = 0.56). Thus maximal aortic regurgitant volume can be estimated noninvasively with color Doppler flow mapping. The measurement appears to relate to left ventricular morphologic changes occurring in this condition and it may prove to be useful in assessing patients with chronic aortic insufficiency and in determining their long-term management.

Adult↗

PubMed1989

The value of cine nuclear magnetic resonance imaging for assessing regional ventricular function.

Previous nuclear magnetic resonance (NMR) imaging studies to assess left ventricular function have used multiple axial planes, which are compromised by partial volume effects and are time consuming to acquire and analyze. Accordingly, an imaging approach using cine NMR and planes aligned with the true cardiac axes of the left ventricle was developed in views comparable with left ventricular cineangiography. Cine NMR imaging was used to assess regional wall motion and was validated by comparison with biplane left ventricular cineangiography. Fifty-nine patients underwent cineangiographic and NMR studies within 72 h. A poor quality NMR study precluded analysis in 4. leaving a study group of 55 patients (mean age 58 +/- 12: 17 women). Cine NMR movie loops were acquired in two long-axis planes: 1) right anterior oblique plane, parallel to the septum, and 2) four chamber orthogonal plane, perpendicular to the septum (this view is comparable to the angiographic left anterior oblique view). To assess regional wall motion, the left ventricle in both cine NMR and cineangiographic images was divided into five segments and graded on a five point grading scale from 3 for normal through 0 for akinesia and -1 for dyskinesia. Regional wall thickening was used qualitatively to aid in the analysis of wall motion. For the 275 segments compared in the right anterior oblique view, agreement was within one grade in 263 (95.6%) of 275 segments, whereas absolute agreement was observed in 171 (62%) of 275 segments. In the left anterior oblique view, of 200 segments evaluated, agreement within one grade was achieved in 184 segments (92%) and agreement was complete in 132 (66%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Noninvasive assessment of cardiomyopathy in normotensive diabetic patients between 20 and 50 years old.

PURPOSE: To further the understanding of diabetic heart disease, we tested the hypothesis that an asymptomatic group of normotensive diabetic patients between 20 and 50 years old had a restrictive cardiomyopathy independent of clinically significant coronary artery disease. PATIENTS AND METHODS: Quantitative two-dimensional echocardiography and stress myocardial perfusion scintigraphy were performed to detect and characterize the cardiac abnormalities in this study group comprising 88 patients with rigorously classified diabetes and 65 volunteer control subjects. RESULTS: Diabetic patients were shown to have a mildly reduced left ventricular end-diastolic volume index: 50.1 +/- 8.2 and 52.1 +/- 14.7 mL/m2 for patients with type I and type II diabetes, respectively, versus 58.9 +/- 11.7 mL/m2 for control subjects. The left ventricular diastolic filling was also impaired in diabetic patients as reflected by a lower atrial emptying index: 0.73 +/- 0.24 and 0.76 +/- 0.3 for type I and type II diabetics, respectively, compared with 1.14 +/- 0.24 for control subjects. Exercise tolerance was normal in subjects with type I diabetes and slightly reduced in subjects with type II diabetes. Only one patient developed regional ischemia on thallium exercise testing. CONCLUSION: Using a comprehensive, noninvasive approach, we have shown that asymptomatic normotensive patients with type I or type II diabetes who were between 20 and 50 years old had a restrictive cardiomyopathy characterized by mildly reduced left ventricular end-diastolic volume and altered left ventricular compliance independent of critical coronary artery disease.

Adult↗