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J A Rumberger

Publications and source records attributed to J A Rumberger.

83 records · Page 5Linked to original sources
PubMed1988

Sectional and segmental variability of left ventricular function: experimental and clinical studies using ultrafast computed tomography.

In this study, ultrafast computed tomography, a new high spatial and temporal resolution imaging system, was employed to define the range of sectional (tomographic) and segmental left ventricular function in 11 normal anesthetized dogs and 11 normal human volunteers. After intravenous infusion of contrast agent, multilevel tomographic images of the left ventricle (apex to base) were acquired at a rate of 17 frames/s. Analysis of these studies demonstrated substantial but predictable heterogeneity in left ventricular contraction from apex to base. In dogs and humans, for example, the average tomographic ejection fraction of the most basal level of the left ventricle was 40% less than that of the most apical level (p less than 0.05). In humans, circumferential segmental cavity contraction at the mid-papillary muscle level was relatively homogeneous (range 50 to 92% for 12 wedge-shaped segments around the tomographic circumference) if the reference system employed an endocardial centroid, but was less uniform if it used an epicardial centroid (range 22 to 98%). It is concluded that contraction of the normal left ventricle in dogs and humans is heterogeneous both between levels (apex to base) and within a single level (circumferential cavity contraction). However, the patterns of cavity contraction from apex to base and circumferential segmental cavity contraction within a given level as defined by ultrafast computed tomography are sufficiently narrow and predictable in normal individuals that these variables may be useful to define regional contraction abnormalities in pathologic conditions.

Adult↗
PubMed1987

Use of ultrafast computed tomography to quantitate regional myocardial perfusion: a preliminary report.

The purpose of this study was to assess the potential for rapid acquisition computed axial tomography (Imatron C-100) to quantify regional myocardial perfusion. Myocardial and left ventricular cavity contrast clearance curves were constructed after injecting nonionic contrast (1 ml/kg over 2 to 3 seconds) into the inferior vena cava of six anesthetized, closed chest dogs (n = 14). Independent myocardial perfusion measurements were obtained by coincident injection of radiolabeled microspheres into the left atrium during control, intermediate and maximal myocardial vasodilation with adenosine (0.5 to 1.0 mg/kg per min, intravenously, respectively). At each flow state, 40 serial short-axis scans of the left ventricle were taken near end-diastole at the midpapillary muscle level. Contrast clearance curves were generated and analyzed from the left ventricular cavity and posterior papillary muscle regions after excluding contrast recirculation and minimizing partial volume effects. The area under the curve (gamma variate function) was determined for a region of interest placed within the left ventricular cavity. Characteristics of contrast clearance data from the posterior papillary muscle region that were evaluated included the peak myocardial opacification, area under the contrast clearance curve and a contrast clearance time defined by the full width/half maximal extent of the clearance curve. Myocardial perfusion (microspheres) ranged from 35 to 450 ml/100 g per min (mean 167 +/- 125). Two flow algorithms derived from characteristics of the contrast clearance curves showed a good correlation with regional myocardial flow determined by microspheres: the ratio of the peak myocardial opacification from baseline to the area under the left ventricular cavity curve (r = 0.7, p less than 0.001, SEE = 44.4 ml/min), and the ratio of the left ventricular cavity to posterior papillary muscle curve areas divided by the full width/half maximal contrast transit time in the region of the posterior papillary muscle (r = 0.82, p less than 0.001, SEE = 52.2 ml/100 g per min). The form of these two flow algorithms was derived from classical indicator dilution theory. In conclusion, indices derived from these data correlated well with regional myocardial perfusion in the posterior papillary muscle region of the dog as assessed by microspheres. This approach offers promise for the quantitation of regional myocardial perfusion and myocardial flow reserve in patients.

Algorithms↗
PubMed1987

Quantitative determination of aortic regurgitant volumes in dogs by ultrafast computed tomography.

Current imaging modalities can provide only a qualitative or semiquantitative measure of the severity of aortic regurgitation. Ultrafast computed tomography (CT) has the capability of rapid imaging (17 frames/sec) coupled with high spatial resolution (1.5 mm2). Eight millimeter thick images can be acquired to interrogate simultaneously the right and left ventricles. End-diastolic and end-systolic tomograms can be reconstructed serially from apex to base by Simpson's rule to provide end-diastolic and end-systolic volumes from which the right and left ventricular stroke volumes can be derived. To determine whether the difference between left and right ventricular stroke volume measured with ultrafast CT could be used to estimate the volume of experimentally induced aortic regurgitation, we studied six dogs in which proximal aortic electromagnetic flow probes had been implanted. Varying degrees of aortic regurgitation were induced by manipulation of a basket catheter through the aortic valve. During suspended respiration in the control state in the absence of aortic regurgitation, right and left ventricular stroke volumes measured with ultrafast CT were nearly identical (mean difference 1.0 +/- 1.2 ml [mean +/- SE]). In the presence of varying degrees of aortic regurgitation, regurgitant volume derived by ultrafast CT as the difference between right and left ventricular stroke volumes correlated closely to the regurgitant volume measured by the electromagnetic flow probe (r = .99, slope = .92, y intercept = 0.98 ml, SEE = 1.02 ml, n = 16). Regurgitant fraction also correlated closely to the regurgitant fraction measured by the electromagnetic flow probe (r = .94, slope = .98, y intercept = 0.66%, SEE = 4.73%, n = 16).(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed1987

Quantification of coronary artery bypass flow reserve in dogs using cine-computed tomography.

Routine coronary angiographic assessment of bypass graft patency does not allow quantification of bypass graft flow reserve. This study was designed to evaluate the use of cine-computed tomography (cine-CT) to determine relative bypass graft flow velocities and flow reserve. Saphenous vein grafts from the left innominate to the midleft circumflex coronary artery were placed in 5 dogs. The proximal portion of the left circumflex was then ligated. A 20-mHz Doppler probe to assess graft flow velocity, a cuff-type vascular occluder to provide variable graft occlusion, and an infusion line for selective drug administration were placed at the midgraft position. Electrocardiographically triggered scans were performed at levels of the aortic root and cardiac base following bolus inferior vena cava contrast administration. Continuous recordings of Doppler velocity and aortic pressure and intermittent measurements of cardiac output were obtained throughout the studies. Selective increases and decreases in coronary artery bypass graft flow velocity from control were performed using combinations of intragraft adenosine and/or variable graft occlusion. Simultaneous contrast clearance curves were generated from a region of interest in the ascending aorta and in the coronary artery bypass graft. Subsequent determinations of a parameter, delta PT (the time difference between peak opacification in the aorta and the bypass graft), were found to highly correlate with individual values of relative coronary bypass graft flow velocity (r = 0.74-0.97, n = 54). This study suggests that cine-computed tomography can be used to noninvasively quantify relative bypass graft flow velocities in individual dogs and eventually in patients.

Animals↗
PubMed1986

Heart evaluation by cine CT: use of two new oblique views.

Two new oblique views on cine computed tomography for examination of the left ventricle of the heart are described. A short-axis view sections the left ventricle transversely, demonstrating all the ventricular walls; a long-axis view sections the left ventricle longitudinally, demonstrating the mitral valve, proximal aortic root, aortic outflow tract, and ventricular apex. These views are produced by a combination of table slew and patient positioning. Reproducible short-axis views were obtained in 16 healthy volunteers and 11 patients. Long-axis views were obtained in 11 patients. Patient studies in the long-and short-axis views were compared with results from angiocardiography, with nearly identical findings.

Adult↗
PubMed1986

Precision of measurements of right and left ventricular volume by cine computed tomography.

Precise determination of left and right ventricular stroke volumes is limited with conventional imaging techniques. We determined whether right and left ventricular stroke volumes could be precisely measured with cine computed tomography (CT). Cine CT enables simultaneous imaging of the right and left ventricles at an 8 mm slice thickness with a maximal scanning rate of 17 frames/sec (50 msec acquisition intervals). In eight dogs, true right ventricular and left ventricular stroke volumes were determined by dividing thermodilution cardiac output by heart rate and/or with the use of an aortic electromagnetic flow probe implanted over a long term. After at least 5 sec of suspended respiration, cine CT images were acquired during central venous injection of a nonionic contrast agent. Multiple perturbations in stroke volume were induced in each dog by the administration of dobutamine, sodium pentobarbital, or sodium nitroprusside or by coronary artery occlusion. Right and left ventricular stroke volumes were obtained by Simpson's reconstruction of end-diastolic and end-systolic short-axis tomograms from apex to base. The cine CT left ventricular stroke volume (range 11 to 45 ml) correlated highly with the true left ventricular stroke volume (r = .99, slope = 1.01, y intercept = -0.2 ml, SEE = 1.5 ml, n = 25). The cine CT right ventricular stroke volume (range 11 to 34 ml) also correlated highly with the true right ventricular stroke volume (r = .98, slope = 0.9, y intercept = 2.2 ml, SEE = 1.7 ml, n = 15). In 12 studies, the mean difference between nearly simultaneous right and left ventricular stroke volumes by cine CT was 1.1 ml (range 0.1 to 3.2 ml). Calculation of right and left ventricular stroke volumes from data from cine CT were highly reproducible. Intraobserver variability in measurements of right ventricular stroke volume (r = 1.0, slope = 0.99, y intercept = 0.19 ml) and left ventricular stroke volume (r = 1.0, slope = 1.02, y intercept = -0.21 ml) was minimal. Interobserver variability in measurements of right ventricular stroke volume (r = .98, slope = 0.90, y intercept = 1.66 ml) and left ventricular stroke volume (r = .99, slope = 0.97, y intercept = -0.02 ml) was likewise minimal. Thus, precise and highly reproducible measurements of right and left ventricular stroke volumes can be obtained with cine CT.

Animals↗
PubMed1985

Determination of left ventricular mass in dogs with rapid-acquisition cardiac computed tomographic scanning.

The development of left ventricular hypertrophy in patients with heart disease often has far-reaching clinical implications with respect to overall morbidity and mortality. Approaches used to assess left ventricular mass include electrocardiography, echocardiography, contrast ventriculography, single photon-emission tomography, and conventional computed tomography. However, all of these modalities suffer from some major draw back that precludes widespread application to all patients. In this study we assessed the accuracy of determinations of left ventricular mass in 22 dogs by rapid-acquisition (50 msec) computed axial tomography (RACAT), an ultrafast computed tomographic (CT) instrument. Electrocardiographically triggered, end-diastolic, short-axis cardiac scans were obtained from apex to base during administration of intravenous iodinated contrast. Myocardial edges were determined for each tomographic scan by two methods: the regional half-contour method (the CT density half way between that of the left ventricular myocardium and adjacent ventricular cavities or lung) and "interactive plateau thresholding" of the cardiac borders. Left ventricular mass by RACAT was calculated as the sum of the mass of each individual scan from apex to base (modified Simpson's rule). Postmortem left ventricular mass ranged from 58 to 160 g. The correlation between true left ventricular mass and tomographically determined mass was excellent (r = .99), with the slope and y intercept not statistically different from 1 and 0, respectively. The standard error of the estimate was 4.1 g. Interobserver and intraobserver variability for determining left ventricular mass demonstrated excellent agreement (r = .99 and r = .99, respectively). We conclude that quantitative assessment of left ventricular mass can be accurately and reproducibly performed in dogs by rapid acquisition CT scanning. It is likely that this technique will be readily transferable to the clinical settings and prove to be an important method for quantifying left ventricular mass in patients.

Animals↗
PubMed1984

Validation of a third-generation Doppler system for studies of detailed aortic flow.

A multigated, third-generation Doppler velocity system has been developed and validated for detailed studies of aortic hemodynamics. The Doppler system employs a single 3-mm, 5-MHz crystal applied to the aorta at a fixed angle with respect to the flow axis and is capable of measuring velocity profile, blood vessel diameter, and integrated volume flow on a continuous, real-time basis. This represents a major developmental advance over existing first-generation, continuous-wave and second-generation, single-gated pulsed Doppler systems. Validation studies have been performed in vitro and in dogs. Aortic diameter was measured simultaneously with the volumetric Doppler system and with sonomicrometer probes. During changes in aortic diameter between 8 and 18 mm (n = 18), produced by temporary pulmonary artery occlusion or epinephrine infusion, quantitative agreement between the Doppler and sonomicrometer probes was found (r = 0.96). Velocity profile measurements and axial velocity values made with the Doppler system compared favorably with hot-film anemometry studies in vitro and in vivo. Although the current system is nondirectional, measurements of phasic aortic volume flow and absolute-time-averaged changes in flow rates showed an excellent correlation with chronically placed electromagnetic flow probes over a broad range of flow rates in vivo (1-5 l/min, n = 36, r = 0.95). This third-generation Doppler system should prove useful in clinical and research studies of detailed aortic hemodynamics.

Animals↗
PubMed1979

Coronary artery pressure development and wave transmission characteristics in the horse.

Measurements of the pressure waveform development and the wave transmission characteristics in the left extramural coronary arteries of the horse have been carried out. Near the ostium the left coronary pressure waveforms are seen to be virtually identical to the corresponding aortic root waveforms; however, the present of low frequency, relatively large amplitude pressure oscillations (on the order of 5 to 10 Hz) gradually become the dominant diastolic feature as one proceeds distally from the left ostium, and these eventually completely mask the incisura. In a limited number of experiments, these oscillations have been simultaneously observed on both centerline velocity and phasic flow signals. These are felt to be primarily due to wave reflection phenomena, but may represent a combined effect of wave reflections and the natural oscillatory motion of the heart mass. Peak systolic pressures were found to remain relatively unchanged as one proceeds distally; however, the end-diastolic pressures were found to decrease steadily, thus giving rise to an increasing pulse pressure and a gradually decreasing mean pressure. Wave speeds in the coronary arteries were found to range between 4 and 11 m.s-1, and the data obtained indicate the wave speed to be highly dependent on both local intralumenal pressure and spatial location.

Animals↗
PubMed1976

Hot film coronary artery velocity measurements in horses.

Coronary velocity measurements have been carried out in anaesthetized, open-chest horses using a constant-temperature, hot-film anemometer system. L-shaped needle probes inserted by direct vessel puncture have been used to measure velocity profiles in the left common, left anterior descending (LAD), and left circumflex coronary arteries. The flow conditions were characterized by peak Reynolds numbers from approximately 200 to 1500 and values of the unsteadiness parameter from 3 to 10. These measurements indicate that in the left common coronary artery the profile is in general skewed towards the outer wall as would be expected for fully viscous flow in a curved tube. In the left anterior descending and left circumflex coronary arteries just distal to the bifurcation, the skewing was found in general to be away from the flow divider. However, in regions of the LAD and left circumflex 5-6 diameters downstream of the bifurcation, the peak systolic and diastolic profiles were indicative of a more fully developed, Poiseuille type flow with only slight skewing observed. The results of this study indicate that the flow in the coronary system, though in general laminar and disturbance free, is extremely varied in character and may exhibit large amplitude, low frequency flow oscillations. Furthermore, for these vessels which all lie on the surface of the myocardium, large systolic flows were observed to be present, even though the major portion of the volume flow was reserved for the diastolic period.

Animals↗