PubMed Health⌕ Search

Biomedical subjects

G T Gau

Publications and source records attributed to G T Gau.

At least 37 records · Page 2Linked to original sources
PubMed1987

Graded exercise testing and training after renal transplantation: a preliminary study.

Aerobic exercise training has been used as part of the treatment for a variety of chronic disorders, most notably cardiovascular disease. In order to determine the feasibility and utility of regular exercise after renal transplantation, the responses of 10 patients to graded exercise testing were compared before training (T1), immediately after a program of supervised exercise training (T2), and a mean of 2.2 years after completion of the supervised program (T3). Supervised exercise sessions began a mean of 17 days postoperatively and continued for a mean of 5.5 weeks. Patients were encouraged to continue regular unsupervised exercise thereafter. All patients easily tolerated the supervised exercise sessions, which consisted of treadmill walking and cycle ergometry. Exercise capacity improved 90% between T1 and T2 and an additional 12% between T2 and T3. On the average, patients achieved a normal exercise capacity by 8 weeks after transplantation. Of the 10 patients, 7 had continued regular exercise training at T3. The observed increase in aerobic exercise capacity was probably related to improved renal function, an increased hemoglobin concentration, and the surgical healing process as well as the exercise training. We conclude that supervised exercise training for selected patients after renal transplantation is feasible and worthwhile.

Adolescent↗
PubMed1987

Cardiac rehabilitation in patients with severe ischemic left ventricular dysfunction.

Twenty patients who had had a myocardial infarction and who had a resting left ventricular ejection fraction of 25% or less participated in an 8-week outpatient supervised exercise and education program. No morbidity or mortality occurred during the program, and most patients achieved a substantial improvement in exercise capacity. During a follow-up interval of a mean of 29.7 +/- 13.0 months, four patients died, an annualized mortality of 8 +/- 4%. The outcome of cardiac rehabilitation was assessed 19.1 +/- 4.4 months after completion of the supervised program. Of the 16 survivors, all of whom had been fully employed before their most recent myocardial infarction, 9 (56%) had returned to full-time work, 6 (38%) were medically disabled, and 1 was retired (age 73 years) but fully active. Of the 16 survivors, 13 (81%) completed a questionnaire about their perceptions of their current quality of life. Of the 13 patients, 12 (92%) had continued to exercise regularly. Four patients (31%) reported the ability to perform all desired activities without symptoms, whereas nine patients (69%) noted some impairment in their functional capacity. Thus, in this group of patients with profound left ventricular dysfunction, the rehabilitation potential, as evidenced by return to productive employment and the ability to perform desired activities-including exercise training-was generally favorable.

Electrocardiography↗
PubMed1983

Coronary artery disease in diabetic and nondiabetic patients: a clinical and angiographic comparison.

A comparison of data from 58 diabetic and 58 nondiabetic patients with arteriographic evidence of coronary artery disease showed that diabetic patients had a significantly greater frequency of major stenoses in the intermediate coronary artery segments but no significant differences in the proximal or distal segments. Thus, the diabetic patients did have more severe coronary disease, but the diabetic group did not have "more distal" disease as represented by the number of major or minor lesions in the distal segments. The diabetic patients had a significantly greater frequency of electrocardiographic intraventricular conduction defects and manifestations of left ventricular dysfunction. There was no significant difference in the severity of coronary artery disease between the diabetic patients with manifestations of myocardial decompensation and the diabetic patients without such manifestations, suggesting that the increased frequency of myocardial dysfunction in diabetic patients may be related to factors other than the greater severity of coronary artery disease.

Adult↗
PubMed1978

The management of acute quinidine intoxication.

A 16-year-old patient survived severe intoxication with quinidine. Hypotension, rapidly progressing to oliguria and shock, was resistant to the usual therapeutic interventions but responded favorably to the use of an intra-aortic balloon pump. Some hemodynamic implications are discussed. Pulmonary edema occurred and was treated with positive end-expiratory pressure. Electrocardiographic disturbances in conduction, transient bradycardia and recurrent ventricular arrhythmias characterized the initial 36-hour critical period. Unexplained electrolyte abnormalities occurred and further complicated management.

Adolescent↗
PubMed1977

Echocardiogram in common (single) ventricle: angiographic-anatomic correlation.

Common ventricle is a rare congenital anomaly in which the ventricular chamber receives blood from two separate atrioventricular (A-V) valves or a common A-V valve. Diagnosis of common ventricle was established in 55 patients aged 3 months to 33 years (mean 10 years) at cardiac catheterization in all 55 and at operation or autopsy in 24. In common ventricle with two angiographically demonstrable A-V valves (47 patients), the echocardiographic features included: (1) simultaneous recording (in the same sonic beam with the transducer held stationary) of the echoes of an anterior and a posterior A-V valve without an intervening septal echo (45 of 47 patients); (2) absence, on a base to apex scan, of the ventricular septal echo in the usual position separating the A-V valves (47 of 47 patients); (3) recording, in patients with common ventricle and outflow chamber, of this small outflow chamber anterior to the A-V valves (20 of 23 patients); and (4) recording of echographic continuity of the posterior A-V valve and great artery (27 of 31 patients). In common ventricle with a common A-V valve (8 patients), the echocardiographic features included: (1) a single demonstrable A-V valve, located posteriorly in the ventricle, which showed a large amplitude of excursion during diastole; and (2) absence of a second A-V valve echo or ventricular septal echo. Eight patients were studied postoperatively after surgical correction by ventricular septation. Echographic features included visualization of a prosthetic septum that produced a dense echo and divided the common ventricle into "right" and "left" ventricular chambers. This septum had a large excursion anteriorly during systole. Because common ventricle is now amenable to surgical correction, echocardiography should play an important role in assessment of ventricular anatomy in this complex congenital cardiac defect.

Abnormalities, Multiple↗
PubMed1976

Spectrum of echocardiographic findings in bacterial endocarditis.

Forty-seven echocardiograms were obtained in 32 patients with bacterial endocarditis. Preexistent abnormalities were found in 14 patients. In five of them thought to have bacterial endocarditis on normal valves, echocardiography showed mitral stenosis (one), bicuspid aortic valve (two), and prolapse of mitral valve (two). Definite vegetations were seen in 22 patients--on the aortic valve in seven, the mitral valve in 12, and both valves in three. Ten patients had milder changes suggestive but not diagnostic of vegetations. In 12 patients, surgery confirmed the echocardiographic findings. Fourteen had systemic embolic episodes and all had echocardiographic evidence of vegetations. Abnormalities secondary to bacterial endocarditis, other than vegetations, were common. Twenty-one patients had left ventricular volume overload. Ten had a flail posterior leaflet of the mitral valve, three of which were confirmed surgically. Eight had abnormal coarsely fluttering echoes in the left ventricular outflow tract consistent with a prolapsing aortic valve or underlying aortic vegetations; four were confirmed by surgery. Five had signs of severe aortic regurgitation of recent onset (premature mitral valve closure) and all had confirmation by surgery. Echocardiographic abnormalities persisted after successful medical treatment. We conclude that echocardiography is helpful in patients with bacterial endocarditis. It permits recognition of unsuspected preexistent lesions and the characteristic vegetations, as well as the extent and nature of valvular damage secondary to bacterial endocarditis. However, echocardiography does not differentiate between active and healed lesions.

Adult↗
PubMed1976

Atrial septal defect: echocardiographic observations. Studies in 120 patients.

Previous studies on small numbers of patients have indicated a high incidence of increased right ventricular dimension and abnormal ventricular septal motion in patients with atrial septal defect. However, recent evidence suggests that septal motion may be normal in as many as 46% of patients with atrial septal defect when observed at proper levels. We have analyzed the echocardiograms of 120 patients with sinus venosus or secundum atrial septal defect in an attempt to define sensitivity of the foregoing two echocardiographic abnormalities. Right ventricular dimension index was increased in 98% of patients. When both sides of the ventricular septum were analyzed, abnormal ventricular septal motion was observed in 87% of patients. It is important to observe both right and left septal echoes at all levels. Other measurements and observations were made when possible and are included in the study.

Adolescent↗
PubMed1976

Further echocardiographic observations in pericardial effusion.

Although the presence of fluid behind the left atrium, on echocardiography, has been used to differentiate pleural from pericardial effusions, five cases are reported showing that pericardial fluid can and does accumulate behind the left atrium. Abnormal valvular motion, as a result of free swinging of the heart in the pericardial sac, was also demonstrated in these patients.

Adult↗
PubMed1976

An unusual case of idiopathic hypertrophic subaortic stenosis.

Echocardiography revealed idiopathic hypertrophic subaortic stenosis in a patient previously operated on for calcific aortic valve disease. The echocardiography in addition showed symmetric left ventricular hypertrophy and unusual localization of the septal hypertrophy to the apical half of the septum.

Aortic Valve Stenosis↗
PubMed1975

Regional left ventricular wall dynamics before and after sublingual administration of nitroglycerin.

Regional wall dynamics of the left ventricle before and after sublingual administration of 0.6 mg of nitroglycerin were determined from left ventricular angiograms in 27 patients undergoing coronary arteriography. Regional wall dynamics were quantitatively measured from 60/sec determinations of wall thickness and derived peak rate of systolic wall thickening (peak dTw/dt) in selected sites of the left ventricle. A total of 70 regions were studied. Analysis of the same segment before and after administration of nitroglycerin revealed that the mean change in peak dTw/dt was +1.97 cm/sec in segments with an initial peak dTw/dt of less than 5 cm/sec, in contrast to a change of +0.66 cm/sec in segments with an initial control value of 5 cm/sec or greater. Akinetic or dyskinetic areas did not show improvements after nitroglycerin. In 11 left ventriculograms, an area that was initially hypokinetic manifested an increase in rate of wall thickening after nitroglycerin. The mean increase in peak dTw/dt in anterior segments with electrocardiographic evidence of myocardial infarction was 0.18 cm/sec (P less than 0.05) after nitroglycerin, compared with a mean change of 1.33 cm/sec in anterior segments without such evidence. This study presents evidence for a regional myocardial response to nitroglycerin with differing responses within the same ventricle apparently depending upon the functional state of the underlying myocardium.

Aged↗
PubMed1975

Relation of intraoperative or early postoperative transmural myocardial infarction to patency of aortocoronary bypass grafts and to diseased ungrafted coronary arteries.

Serial preoperative and postoperative electrocardiograms and vectorcardiograms were obtained in 500 patients undergoing saphenous vein aortocoronary artery bypass graft surgery. Evidence of transmural myocardial infarction was found early postoperatively in 67 patients (13 percent). Age and sex distributions, number of vessels diseased or vessels grafted, and preoperative and postoperative New York Heart Association functional classification (mean follow-up, 26 months) did not differ in the groups with and without infarction. Increased duration of cardiopulmonary bypass time (more than 120 minutes) was slightly greater in the group with infarction (P smaller than 0.05). Multivariate analysis revealed that 60 percent of patients in the group with infarction were identified by a 1st day serum glutamic oxaloacetic transaminase value greater than 100 U/liter; however, for each such patient identified, there was approximately one false positive result. Use of other values (creatine phosphokinase, cardiopulmonary bypass time and total anoxic rest time) did not improve discrimination. Twenty-five percent of all transmural infarctions occurred within the zone of myocardium supplied by a diseased ungrafted artery. In 32 patients with early evidence of transmural mycardial infarction in a zone of myocardium supplied by a grafted artery, postoperative angiography showed as many with patent as with occluded grafts. Of 154 patients in the group without infarction who had early postoperative graft angiograms, 30 (19 percent) had one graft occluded and yet no evidence of transmural infarction by our criteria. Therefore, early postoperative evidence of transmural myocardial infarction as defined in this study is an unreliable indicator of the status of the graft supplying the zone of infarction.

Adult↗
PubMed1975

Serum enzyme data in diagnosis of myocardial infarction during or early after aorta-coronary saphenous vein bypass graft operations.

In 397 cases, serum glutamic oxaloacetic transaminase (GOT) and creatine phosphokinase (CPK) values were determined on the first, second, and third days after aorta-coronary artery saphenous vein bypass graft operations. Electrocardiographic (ECG) or vectorcardiographic (VCG) evidence of postoperative transmural infarction was found in 48 cases. Multivariate analysis indicated that GOT and CPK concentrations on day 1 had substantial discriminatory value regarding infarction. Discrimination by GOT values was not significantly improved by addition of CPK. Of the 61 cases positive by GOT values measured 1 day postoperatively (greater than 100 U. per liter; normal smaller than 24), 32 (52 percent) were negative by ECG or VCG; of the 336 cases negative by GOT, 19 (6 percent) were positive by ECG or VCG. GOT and CPK values increased with the number of vessels grafted and with the use of ventricular rather than atrial vents. Total serum enzyme values lack specificty in diagnosis of transmural infarction after the saphenous vein bypass operation.

Adult↗