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C L Wolfe

Publications and source records attributed to C L Wolfe.

58 records · Page 4Linked to original sources
PubMed1984

Determination of left ventricular mass by single-photon emission computed tomography with thallium-201.

To test the hypothesis that single-photon emission computed tomography (SPECT) might permit accurate, noninvasive measurement of LV mass, SPECT measurements of LV mass to LV weight were compared in 20 mongrel dogs. Projection images of the left ventricle were acquired after intravenous injection of thallium-201 (TI-201). Transverse sections were reconstructed using filtered backprojection. Coronal sections were extracted from the reconstructed volume. The boundary of LV uptake of TI-201 in each coronal section was defined automatically using a threshold detector. Scintigraphic LV mass [total number of volume elements (voxels) showing TI-201 uptake X voxel volume X specific gravity of myocardium] was compared to actual LV weight. There was good correlation between scintigraphic LV mass and LV weight. Mean LV weight was 68 +/- 20 g (+/- standard deviation) (range 27 to 94). Mean SPECT LV mass was 66 +/- 19 g (range 28 to 100). Linear regression analysis yielded the following relation: SPECT LV mass = 0.87 X LV weight + 6.79 (r = 0.91, root-mean-square deviation from regression = 7.5). SPECT measurements were reproducible, with a coefficient of variation of 0.24%. Thus, SPECT of LV TI-201 distribution can be used to measure LV mass in canine myocardium.

Animals↗
PubMedDate not supplied

Right ventricular infarction: recognition and assessment of its hemodynamic significance by two-dimensional echocardiography.

To evaluate the ability of two-dimensional echocardiographic indexes to determine the hemodynamic significance of the right ventricular infarction, 24 patients with electrocardiographic evidence of right ventricular infarction were studied. Hemodynamic significance was defined as a jugular venous pressure greater than 17 cm H2O or a right atrial pressure greater than 13 mm Hg. Patients with hemodynamically significant right ventricular infarctions (group I, n = 9) had a 56% incidence of hypotension (blood pressure less than 90 mm Hg) with a mean systolic blood pressure of 93 +/- 23 mm Hg, whereas patients with nonhemodynamically significant right ventricular infarctions (group II, n = 15) had no hypotension and a mean systolic blood pressure of 121 +/- 18 mm Hg (p less than 0.01). The ratio of right atrial to pulmonary capillary wedge pressure was 1.1 +/- 0.6 in group I and 0.6 +/- 0.2 in group II (p less than 0.05). Echocardiography demonstrated right ventricular free wall motion abnormalities in seven patients in group I and in 10 patients in group II. The descent of the right ventricular base was 0.7 +/- 0.2 cm in group I, 1.3 +/- 0.4 cm in group II, and 2.0 +/- 0.2 cm in a group of 20 normal control patients (p less than 0.001 for all comparisons). The respiratory caval index (percentage of collapse of the inferior vena cava with inspiration) was 22% +/- 11% in group I, 45% +/- 15% in group II, and 64% +/- 17% in the control subjects (p less than 0.05 for all comparisons).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Cardiogenic shock: thrombolysis or angioplasty?

Cardiogenic shock (CGS) occurs in 3 to 20% of patients presenting with acute myocardial infarction (MI), and it generally involves dysfunction of at least 40% of the total myocardial mass. Prior to the advent of balloon angioplasty and thrombolysis, in-hospital mortality was greater than 75%. This mortality rate has been consistent in reported series despite the advent of cardiac intensive care units, vasopressor, inotropic, and vasodilator therapy. Intra-aortic balloon counterpulsation therapy provides hemodynamic improvement, and it may provide some mortality benefit when used in conjunction with appropriate revascularization. Survival studies have shown that patency of the infarct-related artery is a strong predictor of survival. No randomized trials have been completed to examine which reperfusion therapy best treats this emergent situation. Subgroup analysis of large scale, multicenter trials, although underpowered, has shown no improvement in mortality with use of thrombolytic agents, leading many to advise use of mechanical intervention. In patients who present with acute MI with contraindications to thrombolysis, primary angioplasty is the treatment of choice. At selected centers, primary angioplasty is comparable to or better than thrombolytic therapy for patients presenting with acute MI, with or without CGS. Studies examining angioplasty in patients with CGS have shown high procedural success rates (75%) and reduced in-hospital mortality (44%), particularly in those patients with successful revascularization. Emergency bypass surgery may improve survival, but it is costly, unavailable to many, and often leads to excessive delays in therapy. If available, we believe that primary angioplasty is the treatment of choice for patients with CGS.

Angioplasty, Balloon↗