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Biomedical subjects

H B Rose

Publications and source records attributed to H B Rose.

13 recordsLinked to original sources
PubMed1985

Angioscopic visualization of blood vessel interior in animals and humans.

The purpose of this study is to describe the use of angioscopes in flowing bloodstreams of animals and humans, to demonstrate the ability to precisely deliver laser energy to an intravascular target using visual guidance and to determine the information content and spatial content of angioscopy. Angioscopy was performed in 5 living dogs, 16 cadaver vascular segments, and 14 patients at the time of peripheral or coronary bypass surgery. Five canine femoral artery segments received angioscopically directed intravascular Nd:YAG laser irradiation. We were able to precisely direct the laser irradiation to predetermined intimal targets. Gross tissue injury varied from none to carbonization and vascular perforation, depending on incident energy. Using a variety of flexible fiberoptic endoscopes ranging in diameter from 1.5 to 3.7 mm, we were able to visualize intravascular structures including plaque, suture lines, venous valves, and thrombi in living patients. No patient incurred complications of any sort. We conclude that angioscopy using flexible endoscopes can be performed safely, can provide clinically useful information, and may provide a means for delivering visually directed intravascular laser irradiation.

Animals↗
PubMed1984

Lack of effect of cyclandelate in peripheral arterial disease.

While cyclandelate is widely used in the therapy of peripheral arterial disease, objective evidence of its efficacy remains controversial. For this reason, 12 patients with intermittent claudication (average age of 66.8 years) received both cyclandelate 400 mg qid and placebo in a double-blind crossover trial lasting two months. During the cyclandelate and placebo periods, the following peripheral hemodynamic measurements were obtained using a plethysmograph and treadmill claudication testing: mean calf blood flow, vascular resistance and venous capacitance; finger and toe blood flow, pulsation amplitude and temperature before and after vasodilating maneuvers; arm and leg arterial pulsation amplitudes, one and ten minute calf reactive hyperemia reaction; 30 pound/30 second calf active hyperemia reactions and times of onset of claudication as measured on a treadmill. No major significant difference could be demonstrated between placebo and cyclandelate on any subjective symptom or any objective measurement. It is concluded that cyclandelate 400 mg qid for 4 weeks was of little objective value in treating this group of 12 patients with peripheral arterial disease and suffering from intermittent claudication.

Aged↗
PubMed1983

Peripheral hemodynamics in patients with Fabry's disease.

Altered vasomotor activity has been reported as a clinically prominent feature of Fabry's disease (angiokeratoma corporis diffusum universale). While symptomatic cardiovascular involvement occurs eventually in most patients with this disorder, little is known concerning the effect of Fabry's disease on peripheral hemodynamics. Peripheral hemodynamics in the extremities and digits were studied in eight patients with Fabry's disease by means of segmental and venous occlusion pneumoplethysmography and thermal probes, and the results obtained were compared with those of 10 normal subjects. Forearm vascular resistance in Fabry's disease patients was significantly higher (p less than 0.01) than that in normal subjects. Forearm venous capacitance in Fabry's disease was significantly lower (p less than 0.01). Segmental pulse volume amplitudes showed no significant difference in any segments (upper arm, wrist, thigh, above and below knee, and the calf) between the two groups. Finger and toe blood flow, finger and toe pulse volume, and temperature in the resting state were all significantly less (p less than 0.01, p less than 0.05: p less than 0.01, p less than 0.01: p less than 0.05, p less than 0.05, respectively) than those in normal subjects. Finger and toe blood flow and pulse volume after vasodilation procedures were significantly less (p less than 0.05, p less than 0.01: p less than 0.05, p less than 0.01, respectively) than those in normal subjects despite equal elevation of digital temperature obtained after vasodilation in both groups. These findings indicate the presence of vasoconstrictive process in both resistance vessels and capacitances vessels in cutaneous and skeletal muscular beds. A limited response in the cutaneous circulation to vasodilation procedures also was seen. These data suggest the possibility that latent enhanced sympathoadrenal discharge as well as the accumulation of glycolipid in the autonomic nervous system and vessel walls plays an important role in the disturbed pathophysiology of this disorder.

Adolescent↗
PubMed1983

Observations on the relationship between digital heat loss and systemic hemodynamics in patients with heart disease.

A concomitant study of finger heat discharge and systemic hemodynamics was undertaken in a series of 19 patients (mean age 54 years) suffering from various forms of heart disease. Finger heat discharge, as measured by calorimetry, was found to correlate significantly with mean circulation time (-0.760), cardiac index (+0.649), systemic vascular resistance (-0.615), stroke work index (+0.649), mean pulmonary artery pressure (-0.596), mean pulmonary capillary wedge pressure (-0.554), stroke index (+0.541), appearance time (-0.502) and mean right atrial pressure (-0.453). There was no significant correlation between finger heat discharge and mean arterial blood pressure, LV dp/dtmax, and heart rate. An effect of heart failure on finger heat discharge was found. When evidence of forward failure and also possibly backward failure was found, mean finger heat discharge was significantly diminished. When both forward and backward failure were present together, mean finger heat discharge fell still further.

Blood Circulation Time↗
PubMed1983

Unloading effects of molsidomine on peripheral circulation and cardiac hemodynamics in patients with acute myocardial infarction.

The unloading mechanisms and side of peripheral action of the new antianginal drug molsidomine was compared with isosorbide dinitrate (ISDN) in 14 patients with acute myocardial infarction using a Swan-Ganz catheter and venous occlusion plethysmography. Sublingual molsidomine (2-4 mg) increased calf venous capacitance (CVC) (0.42 +/- 0.18 to 0.64 +/- 0.09 ml/100 ml, p less than 0.05) from 30 to 240 minutes, while simultaneously lowering of PCWP (25.9 +/- 4.9 to 15.8 +/- 7.3 mmHg, p less than 0.05) and CVP (9.3 +/- 3.7 to 5.8 +/- 3.5 cmH2O, p less than 0.05). Calf blood flow (CBF), calf vascular resistance (CVR), CI, TSPR and SWI were not affected significantly. Molsidomine reduced preload more than 240 minutes after its administration. Sublingual ISDN increased CBF into the initial 15 minutes (1.19 +/- 0.49 to 1.83 +/- 0.98 ml/100ml/min, p less than 0.05) and CVC from 5 to 60 minutes (0.42 +/- 0.19 to 0.68 +/- 0.24 ml/100ml p less than 0.01) while simultaneously lowering PCWP (24.3 +/- 2.2 to 14.6 +/- 4.5 mmHg, p less than 0.01) and CVP (9.0 +/- 2.8 to 5.5 +/- 3.5 cmH2O, p less than 0.05). Neither drug affected cardiac index, blood pressure or systemic vascular resistance. These data suggest that molsidomine significantly lowered elevated preload (PCWP/PCP) by dilating venous capacitance vessels. Its length of action was 240 minutes compared with 60 minutes obtained with ISDN, which suggests this new agent may be of marked benefit in the AMI patients suffering from backward failure uncomplicated by forward failure in whom continued preload reduction is necessary. (Results are expressed as the mean +/- standard deviation).

Adult↗
PubMed1982

Unloading effects of vasodilators on peripheral circulation and cardiac hemodynamics in patients with acute myocardial infarction.

Effects of three representative vasodilators on peripheral and cardiac hemodynamics were studied in 20 patients with heart failure due to acute myocardial infarction (PCWP greater than 18 mmHg, C1 greater than 2.20 L/min/m2) using venous occlusion plethysmography and a Swan-Ganz catheter. Sublingual isosorbide dinitrate (ISDN) significantly increased calf venous capacitance (CVC) from 5 to 60 min (p less than 0.01) and calf blood flow (CBF) in the initial 15 min (p less than 0.05), while simultaneously lowering PCWP (p less than 0.05) and central venous pressure (p less than 0.05). Calf vascular resistance (CVR), cardiac index, blood pressure, and total systemic peripheral resistance (TSPR) were not affected significantly. Nitroglycerin ointment (NGO) significantly decreased CVR (p less than 0.05) and increased CVC (p less than 0.05) from 60 to 240 min, simultaneously with lowering of PCWP (p less than 0.01), central venous pressure (p less than 0.05), and TSPR (p less than 0.05). Oral prazosin (Pz) increased CBF (p less than 0.01) and CVC (p less than 0.05) from 60 to 240 min, simultaneously with significant lowering of PCWP (p less than 0.01) and TSPR (p less than 0.05), resulting in increased stroke work index (p less than 0.05). These data confirm that ISDN predominantly causes capacitance vessel dilatation and reduce excessive venous return, while Pz and NGO dilate not only capacitance vessels but also resistance vessels, consequently reducing systemic vascular resistance and resulting in increased peripheral blood flow and cardiac performance. It was observed that the higher the base-line calf vascular resistance rose, the better the response to the vasodilator treatment appeared in terms of a decrease in calf vascular resistance.

Adult↗
PubMed1978

Cardiac arrhythmias associated with treadmill claudication testing.

Eighty-one consecutive patients of an average age of 58 years with suspected lower limb arterial disease underwent standard 5-minute treadmill claudication testing. Prior to, during, and after testing the patients were monitored electrocardiographically. The number of electrocardiographic abnormalities seen in 81 patients undergoing study increased from 33 (40.6%) at rest to 49 (60.5%) with exercise. The commonest abnormalities encountered with exercise were the development and increased incidence of paroxysmal beats and ST-T wave changes which, in some instances, became life-threatening, aborting the test. Since the principal hazard for patients with claudication appears to derive from an increase propensity to cardiac mortality and morbidity, rather than from the consequences of impaired circulation to the limb, electrocardiographic monitoring during treadmill claudication testing, though little practiced, is strongly advised.

Adolescent↗
PubMed1976

Effect of cardiac dysrhythmia on cerebral perfusion.

Extracranial carotid arterial obstructive disease has been the entity most commonly associated with transient cerebrovascular insufficiency. A nonobstructive, frequently overlooked cause of cerebral ischemia is cardiac dysrhythmia. We have explored this by observations of experimental animals and of man. Blood flow and pressure in the carotid arteries of dogs were shown to be decreased by mechnically induced premature ventricular contractions. The significance of the cardiogenic contribution to altered cerebrovascular perfusion was studied by ocular and brachial plethysmography in 210 patients suspected by history of having carotid arterial insufficiency. Of the 210 patients, 62 demonstrated abnormal ocular plethysmographic recordings, and of those, nine had dysrhythmias associated with significant deficits of ocular perfusion. Five patients whose recordings were technically suitable for publication are presented to demonstrate the bizarre ocular plethysmographic recordings seen during the dysrhythmic cycle.

Adult↗