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Biomedical subjects

A Van Tosh

Publications and source records attributed to A Van Tosh.

7 recordsLinked to original sources
PubMed1989

Pulsed and continuous wave Doppler echocardiographic assessment of valvular regurgitation in normal subjects.

To assess the prevalence and flow characteristics of valvular regurgitation detected by Doppler echocardiography in normal subjects, pulsed and continuous wave Doppler studies were performed in 100 adult volunteers without evidence of heart disease. Evidence of valvular regurgitation was present in 73% of subjects. There were 46 subjects with regurgitation of one valve, 24 with regurgitation of two valves and 3 with regurgitation of three valves. Right-sided regurgitation was significantly more common than was left-sided regurgitation (81 versus 22 valves, p less than 0.01). Regurgitant flow was never detected farther than 1 cm from the valve by pulsed Doppler study. Tricuspid regurgitation was detected in 50 subjects and was characterized by a holosystolic velocity signal; a complete spectral envelope was recorded in 32 subjects. The peak velocity of the regurgitant jet for this group was 1.7 to 2.3 m/s (mean 2.0 +/- 0.2). Thirty-one subjects were found to have pulmonary regurgitation with a peak velocity of 1.2 to 1.9 m/s (mean 1.5 +/- 0.2); no subject demonstrated regurgitant flow in early diastole. There were 21 subjects with mitral regurgitation; continuous wave Doppler signals were always of low intensity with a poorly defined spectral envelope and an absence of high velocities. Peak velocities ranged from 1.1 to 4.4 m/s (mean 2.3 +/- 0.9) and in 19 subjects were less than 3.5 m/s. The mean age of subjects with mitral regurgitation was significantly higher than that of subjects without mitral regurgitation (p = 0.01). Aortic regurgitation was detected in only one subject. This study provides further evidence that valvular regurgitation is frequently detected by Doppler echocardiography in normal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Unsuspected cardiac abnormalities in the acquired immune deficiency syndrome. An echocardiographic study.

To investigate the frequency of unsuspected cardiac abnormalities in AIDS, M-mode and two-dimensional echocardiograms were performed on 27 homosexual males with this syndrome. Twenty-one homosexual males without the disease were used as controls. Subjects with clinical heart disease or a history of intravenous drug abuse were excluded. Fractional shortening was reduced in eight patients (30 percent) and in one control (5 percent) (p less than 0.05). Pericardial effusions were found in seven patients (26 percent); one control subject had a small effusion (5 percent) (p = 0.05). Overall, echocardiographic abnormalities were found in 13 of 27 patients (48 percent) compared with 2 of 21 control subjects (10 percent) (p less than 0.02). We conclude that although often not diagnosed clinically, the incidence of cardiac involvement in AIDS is high.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Use of continuous-wave Doppler ultrasound to evaluate and manage primary pulmonary hypertension.

Doppler ultrasound was used to assess the response to serial drug testing in a patient with primary pulmonary hypertension. There was a close correlation between the pressure estimated by Doppler and the pulmonary arterial systolic pressure measured invasively (r = 0.98). Continuous-wave Doppler ultrasound, although not a substitute for initial Swan-Ganz catheterization, may obviate the need for repeat invasive procedures and permit closer monitoring of patients during treatment.

Adult↗
PubMed1985

Quantitative assessment of pulmonary hypertension in patients with tricuspid regurgitation using continuous wave Doppler ultrasound.

Doppler ultrasound examination was performed in 69 patients with a variety of cardiopulmonary disorders who were undergoing bedside right heart catheterization. Patients were classified into two groups on the basis of hemodynamic findings. Group I consisted of 20 patients whose pulmonary artery systolic pressure was less than 35 mm Hg and Group II consisted of 49 patients whose pulmonary artery systolic pressure was 35 mm Hg or greater. Tricuspid regurgitation was detected by Doppler ultrasound in 2 of 20 Group I patients and 39 of 49 Group II patients (p less than 0.001). Twenty-six of 27 patients with pulmonary artery systolic pressure greater than 50 mm Hg had Doppler evidence of tricuspid regurgitation. In patients with tricuspid regurgitation, continuous wave Doppler ultrasound was used to measure the velocity of the regurgitant jet, and by applying the Bernoulli equation, the peak pressure gradient between the right ventricle and right atrium was calculated. There was a close correlation between the Doppler gradient and the pulmonary artery systolic pressure measured by cardiac catheterization (r = 0.97, standard error of the estimate = 4.9 mm Hg). Estimating the right atrial pressure clinically and adding it to the Doppler-determined right ventricular to right atrial pressure gradient was not necessary to achieve accurate results. These findings indicate that tricuspid regurgitation can be identified by Doppler ultrasound in a large proportion of patients with pulmonary hypertension, especially when the pulmonary artery pressure exceeds 50 mm Hg. Calculation of the right ventricular to right atrial pressure gradient in these patients provides an accurate noninvasive estimate of pulmonary artery systolic pressure.

Adult↗
PubMed1985

Radiographic pseudofracture of bipolar pacemaker wire.

We present a case in which the radiographic appearance of a bipolar pacing lead mimics a wire fracture. Recognition of this normal finding--due to lead construction--will help avoid erroneous diagnosis of wire fracture on chest x-ray films.

Aged↗