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Biomedical subjects

C E Rackley

Publications and source records attributed to C E Rackley.

At least 145 records · Page 8Linked to original sources

Left ventricular function in acute and chronic coronary artery disease.

The evaluation of left ventricular function in patients with acute myocardial infarction has shown: 1. Limitations in the use and interpretation of central venous pressure. 2. Pulmonary artery end-diastolic pressure reflects left ventricular end-diastolic pressure in the absence of pulmonary vascular or mitral valve disease. 3. Frequent elevations of left ventricular filling pressure in mild or clinically uncomplicated infarction. 4. Anterior infarctions present greater depression of left ventricular function than inferior infarctions. 5. Initial hemodynamic measurements in cardiogenic shock can predict prognosis with medical management. 6. Left ventricular function frequently improves during the early convalescent period. 7. Hemodynamic monitoring can be useful in following changes in left ventricular function and the response to therapy. The assessment of left ventricular performance in patients with chronic heart disease has shown: 1. Resting hemodynamic measurements are often normal but abnormalities can be observed in patients with disease of the left anterior descending coronary artery, diffuse coronary involvement, and after myocardial infarction. 2. Increases in end-diastolic volume or dilatation and left ventricular mass or hypertrophy can develop in severe coronary disease and after myocardial infarction. 3. The size of abnormally contracting segment after myocardial infarction is related to abnormalities in compliance, ventricular end-diastolic pressure, end-diastolic volume, and clinical manifestations of heart failure. 4. Exercise and atrial pacing can produce clinical and hemodynamic abnormalities. 5. The ejection fraction is significantly related to the slope of the ventricular function curve. 6. Angiographic abnormalities of left ventricular wall motion can be increased with atrial pacing and reduced with nitroglycerin or epinephrine.

Acute Disease↗

Relationship between echocardiography, cardiac output, and abnormally contracting segments in patients with ischemic heart disease.

Twenty-four patients with proven coronary artery disease and abnormally-contracting segments were studied by both echocardiography and biplane angiographic techniques. Comparison was made between the left ventricular biplane angiographic volumes and those obtained from echocardiographic measurements which were calculated from cubed function and regression equaltion methods. The percent abnormally contracting segment (ACS) was obtained from biplane left ventricular angiography and was calculated from the diastolic and systolic anteroposterior and lateral angiocardiograms. The angiographic end-diastolic volume correlated with that calculated from the echocardiographic dimensions with an r value of 0.865 and SEE of +/- 22.64 ml. The angiographic end-systolic volume and echo end-systolic volume did not correlate as well, with an r = 0.7063. The difference in stroke volume predicted by the diastolic and systolic echocardiographic dimensions and the actual stroke volume determined by Fick technique was related to the percent abnormally contracting segment of the left ventricle (r = 0.8967). The percent ACS could be estimated from echo and Fick stroke volume measurements by the cube function and regression equations. Echo ventricular volume determinations were analyzed for the cube function method and the regression equations of Fortuin et al. and Teichholz and coworkers, with the method of Fortuin et al. producing the most sensitive relationship: % ACS = 0.32 (SVecho - SVFick) % + 8.9%. The correlation coefficient for the estimate was 0.8967 with a SEE of +/- 4.78%. In patients with coronary artery disease and abnormally contracting segments, echocardiography can provide reliable measurements of left ventricular end-diastolic volume but estimates of end-systolic volume are less accurate. If mitral regurgitation or a ventricular aneurysm can be excluded, the difference in echocardiographic and forward stroke volume by an independent method is related to the angiographic and forward stroke volume by an independent method is related to the angiographic abnormally contracting segment, and this relationship permits estimation of the size of the abnormally, contracting segment.

Angiocardiography↗

Value of ventriculography in cardiac function and diagnosis.

The methods for calculating left ventricular volumes employing biplane angiocardiograms and the calculated parameters of left ventricular mass, pressure-volume diagrams, wall forces, compliance, and abnormally contracting segments are described. Examples of these calculations are given and the contributions to the assessment of cardiac function and diagnosis are discussed. Normal values and the alterations produced by volume overload, pressure overload, myocardial disease, and coronary artery disease are presented.

Angiocardiography↗