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Biomedical subjects

D J McBrien

Publications and source records attributed to D J McBrien.

6 recordsLinked to original sources
PubMed1990

Brachioradial delay: a new clinical indicator of the severity of aortic stenosis.

During the assessment of patients with severe or symptomatic aortic stenosis, a clinically detectable delay between the brachial and radial pulses was observed. This delay was not present in normal subjects. The timed delay of 53.5 (SE 2.6) ms in severe aortic stenosis was significantly longer than that in normal volunteers 22.6 [1.3] ms) or in patients with low cardiac output. This increased delay was clinically detectable before the occurrence of left ventricular failure and often before the onset of symptoms.

Age Factors↗
PubMed1988

Changes in the impedance cardiogram occurring with change in posture in patients with heart disease.

The response of the heart to changes in posture from supine through sitting to standing was recorded by impedance cardiography. The study comprised 22 normal subjects and 74 patients with a variety of heart diseases. The results demonstrate that in normal subjects acceleration of blood in systole decreased on sitting and standing. In subjects with impaired cardiac function this acceleration increased on sitting and standing from the supine position. This clear-cut difference in response provides a subtle method of detecting impaired function and in addition, provides a method of monitoring the effects of vasodilator or other treatment.

Cardiography, Impedance↗
PubMed1986

The use of impedance cardiography in heart failure.

The suitability of the impedance cardiograph for studying patients with cardiac failure in a District General Hospital was assessed over a 12-month period. Over 200 recordings were made from 60 patients. Stroke volume, using the derived formulation of Kubicek and his colleagues, and the Heather Index (a measure of cardiac contractility) were calculated in each case. Serial recordings provided an objective assessment of the efficacy of treatment. An abnormal diastolic O wave was found in the majority of patients. This may indicate an excessive accumulation of blood in the thorax as a result of myocardial dysfunction.

Cardiography, Impedance↗
PubMed1982

Carotid sinus syncope treated by pacing. Analysis of persistent symptoms and role of atrioventricular sequential pacing.

Seventy patients have been paced for carotid sinus syndrome over four years. Twelve patients had persistent symptoms despite adequate ventricular pacing. Patients with persistent symptoms were found to have a significant vasodepressor response, a significant hypotensive response to ventricular pacing (pacemaker effect), and a severe hypotensive response to carotid sinus massage with introduction of ventricular pacing, which reproduced symptoms in all patients. A group of 14 asymptomatic paced carotid sinus patients was found to have a significantly lower vasodepressor response, pacemaker effect, and combined vasodepressor response plus pacemaker effect than the group with persistent symptoms. Atrioventricular sequential pacing was shown to eliminate the hypotensive effect of ventricular pacing and is considered to be the treatment of choice for patients with carotid sinus syndrome who have both cardioinhibitory and significant vasodepressor responses.

Aged↗