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Biomedical subjects

J C Mohan

Publications and source records attributed to J C Mohan.

At least 19 recordsLinked to original sources
PubMed1992

Pulmonary venous flow dynamics before and after balloon mitral valvuloplasty as determined by transesophageal Doppler echocardiography.

The pattern of left atrial filling was studied in 14 patients with severe mitral stenosis in sinus rhythm before and immediately after successful balloon mitral valvuloplasty by transesophageal pulsed Doppler echocardiography of the left superior pulmonary vein. Mean mitral valve orifice area increased from 0.8 +/- 0.1 to 2.2 +/- 0.3 cm2 (p less than 0.0001), and left atrial mean pressure decreased from 30 +/- 5 to 12 +/- 4 mm Hg (p less than 0.0001) after the procedure. After balloon mitral valvuloplasty, significant increases in peak systolic pulmonary velocity (35 +/- 16 to 44 +/- 10 cm/s; p less than 0.01), systolic flow velocity time integral (3.3 +/- 1.5 to 5.9 +/- 2.0 cm; p less than 0.001) and the ratio of systolic/diastolic pulmonary venous flow velocity time integrals (0.8 +/- 0.4 to 1.4 +/- 0.5; p less than 0.001) were observed. An acute increase in mitral valve orifice area caused no significant changes in peak diastolic forward flow velocity (40 +/- 7 to 41 +/- 9 cm/s; p = not significant [NS]), diastolic forward flow velocity time integral (4.3 +/- 1.7 to 4.6 +/- 1.8 cm; p = NS) and atrial flow reversal velocity (30 +/- 3 to 35 +/- 3 cm/s; p = NS) compared with at baseline. The results suggest that in patients with severe mitral stenosis and sinus rhythm, left atrial filling is biphasic with a diastolic preponderance, and successful mitral valvuloplasty is associated with an immediate increase in pulmonary venous systolic forward flow.

Adult↗
PubMed1992

Doppler echocardiographic determination of aortic and pulmonary valve orifice areas in normal adult subjects.

Cross-sectional and Doppler echocardiography were performed in 36 healthy adult subjects (aged 19 to 50 yr, mean 28 +/- 9; male 23, female 13) to establish normal values for aortic and pulmonary valve orifice areas. Standard continuity equation using echo-determined ventricular outflow tract diameters and Doppler-determined flow-velocity integrals from the outflow tracts and the corresponding great arteries, was employed to calculate the valve areas. Mean left ventricular outflow tract diameter was 1.92 +/- 0.17 cm (range 1.5-2.3 cm) and right ventricular outflow tract diameter was 1.80 +/- 0.18 cm (range 1.5-2.2 cm). Calculated aortic valve orifice area was 2.63 +/- 0.31 cm2 (1.76 +/- 0.2 cm2/m2) and correlated poorly with body surface area (r = 0.31, p > 0.05). Mean pulmonary valve orifice area was 3.01 +/- 0.36 cm2 (2.02 +/- 0.20 cm2/m2) and had a modest correlation with body surface area (r = 0.38, p < 0.05). No difference was observed between males and females for indexed aortic and pulmonary valve orifice areas. These data provide normal values for echocardiographically determined semilunar valve orifice areas and question the practice of indexing valve area for body surface in adult subjects.

Aortic Valve↗
PubMed1992

Transoesophageal Doppler pulmonary venous flow pattern and left atrial spontaneous contrast in mitral stenosis.

The relationship between transoesophageal Doppler pulmonary venous flow pattern and spontaneous left atrial contrast was studied in 23 patients with isolated severe mitral stenosis (mitral valve area = 0.8 +/- 0.2 cm2). The patients with none or minimal (1+) spontaneous contrast (n = 15, group I) were compared with those with significant spontaneous contrast (grade 2+, n = 8, group II) with regard to peak systolic velocity (33 +/- 14 cm/s vs 28 +/- 12 cm/s, p = NS), peak diastolic velocity (36 +/- 14 cm/s vs 28 +/- 8 cm/s, p = NS) and peak atrial reversal velocity (19 +/- 4 cm/s vs 19 +/- 8 cm/s, p = NS), systolic forward flow velocity time integral (3.37 +/- 1.73 cm vs 2.78 +/- 0.9 cm, p = NS), diastolic forward flow velocity time integral (2.85 +/- 1.2 cm vs 2.65 +/- 1.87 cm, p = NS), ratios of peak systolic and diastolic velocity (0.91 +/- 0.21 vs 0.95 +/- 0.29, p = NS) and duration of diastolic deceleration (117 +/- 59 ms vs 132 +/- 106 ms, p = NS). The results show that the occurrence of spontaneous contrast in the left atrium in patients with mitral stenosis is not related to the Doppler-estimated pulmonary venous flow.

Adolescent↗
PubMed1991

Double outlet left ventricle with intact ventricular septum: a cross-sectional and Doppler echocardiographic diagnosis.

Double outlet left ventricle with intact ventricular septum, valvar pulmonary stenosis, an atrial septal defect within the oval fossa, dysplastic tricuspid valve and normally related great arteries are described in a four-year old male child presenting with cyanosis since birth. The diagnosis was made by cross-sectional and Doppler echocardiography and confirmed by cineangiocardiography.

Angiocardiography↗
PubMed1991

Assessment of mitral valvar stenosis by echocardiography: utility of various methods before and after mitral valvotomy.

Cross-sectional and Doppler echocardiography are currently the most important non-invasive tests for the evaluation of mitral stenosis. Recent experience has, however, shown that parameters that are reliable before mitral valvotomy may not be valid after the procedure. We have studied the validity of estimation of the area of the mitral valve by echo-planimetry, by Doppler pressure half time and the transmitral end-diastolic pressure gradient calculated by continuous wave Doppler in 100 patients (aged 10-30 years) before and after balloon mitral valvoplasty (n = 70) or surgical closed mitral valvotomy (n = 30). These patients underwent cardiac catheterisation and echocardiographic studies before, immediately after and 8-12 (9.3 +/- 2.2) weeks following balloon valvoplasty or closed valvotomy. The area as estimated echocardiographically correlated well with that obtained by the Gorlin formula before (r = 0.80), but not immediately after (r = 0.67) or on follow up after mitral valvotomy. There was good correlation between Doppler pressure half time and the area as estimated by the Gorlin formula before (r = 0.89) and on follow up after valvotomy (r = 0.82), but the correlation was not as good in the immediate period after valvotomy (r = 0.60). The end-diastolic pressure gradients obtained by Doppler examination and at cardiac catheterisation correlated well with each other before (r = 0.94), immediately after valvotomy (r = 0.92) and on follow up (r = 0.94). Hence, the reliability of estimation of the area of the mitral valve by echo-planimetry and by Doppler pressure half time varies according to the time at which the examination is performed following commissurotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Left ventricular volumes and function immediately after balloon mitral valvoplasty.

To evaluate acute changes in left ventricular volumes and function immediately after successful percutaneous balloon mitral valvoplasty, twenty young patients with isolated rheumatic mitral stenosis (male 9, female 11, mean age 22 +/- 6 years) were studied. The area of the orifice of the mitral valve following valvoplasty, increased from 0.97 +/- 0.27 cm2 to 2.46 +/- 0.75 cm2 (P less than 0.001). No significant change was observed in left ventricular end-diastolic volumes (117 +/- 27 ml to 119 +/- 29 ml, P greater than 0.10), end-systolic volumes (51 +/- 21 ml to 50 +/- 20 ml, P greater than 0.10), ejection fraction (0.57 +/- 0.10 to 0.58 +/- 0.10, P greater than 0.10) and left ventricular meridian wall stress (68 +/- 20.10(3) dynes/cm2 to 65 +/- 14, P greater than 0.10) immediately after valvoplasty. There was no acute change in heart rate, left ventricular end-diastolic pressure, cardiac index and grade of mitral regurgitation. Patients with depressed left ventricular ejection fraction (less than or equal to 0.55, n = 10) and those with normal ejection fraction (greater than 0.55, n = 10) had similar baseline left ventricular end-diastolic volumes and showed no significant change in volumes and ejection fraction after the procedure, although the former group had a greater orificial area after valvoplasty (P less than 0.05). We conclude that an acute increase in the orifice of the mitral valve in patients with rheumatic mitral stenosis is not associated with any significant change in left ventricular volumes and function.

Adolescent↗
PubMed1991

Left ventricular mass in normal adult Indians & its correlation with anthropometric parameters.

Important differences were found to exist between male and non-pregnant female Indian adults in the echocardiographically determined left ventricular mass (170.58 +/- 51.91 g vs 131.14 +/- 42.84 g, P less than 0.001) and relationship of left ventricular mass (LVM) to age, body weight, height, body surface area (BSA) and body mass index (BMI). In males, LVM has a fair to good correlation with age, body weight, height, BSA and BMI (P less than 0.001). However, in female subjects, LVM correlates modestly with age, weight, BSA, BMI (P less than 0.01) but not with height. LVM can be best expressed by indexing to body weight in both sexes, but differences persist when other anthropometric parameters are used as denominators.

Adult↗
PubMed1990

Unusual thrombi in the setting of rheumatic heart disease.

We report two patients with unusual intracavitary thrombi in association with rheumatic mitral stenosis. One patient had a large free-floating left atrial thrombus immediately after successful closed mitral valvotomy causing recurrent acute pulmonary oedema in the post-operative phase. The other patient was detected to have multiple, discrete and calcified left ventricular thrombi in the presence of severe left ventricular systolic dysfunction. The diagnosis in both cases was made by cross-sectional echocardiography.

Adult↗
PubMed1990

Cross-sectional echocardiographic diagnosis of discrete subaortic stenosis, ruptured congenital aneurysm of the right sinus of Valsalva, unruptured aneurysm of non-coronary sinus and a rudimentary left aortic leaflet.

A 7-year-old asymptomatic male child was found to have a shelf-like subaortic stenosis, congenital aneurysm of the right sinus of Valsalva communicating with the right ventricular outflow tract, an unruptured aneurysm of the non-coronary sinus and a small left aortic sinus with a rudimentary valvar leaflet causing moderate aortic regurgitation. The diagnosis was made by cross-sectional and Doppler echocardiography and confirmed by cineangiocardiography.

Aortic Aneurysm↗
PubMed1990

Contribution of atrial contraction to left ventricular filling in patients with sick sinus syndrome on AAI pacing.

Doppler echocardiographic evaluation of the contribution of atrial contraction to left ventricular filling, its determinants and relationship with early diastolic filling was studied in 20 patients with sick sinus syndrome without structural heart disease on AAI pacing over a wide range of physiological atrioventricular delays (PR intervals). The results were compared with 20 normal controls matched for age, sex and heart rate. Left ventricular filling pattern, and the contribution of left atrial contraction to diastolic filling, were similar in the two groups. AAI pacing restores the physiological dynamics of left ventricular filling in patients with sick sinus syndrome without organic heart disease.

Cardiac Pacing, Artificial↗
PubMed1990

Mitral atresia with double outlet right ventricle in an asymptomatic adult.

We report a 20-year-old male patient with mitral atresia, double outlet right ventricle, subaortic ventricular septal defect, valvar pulmonary stenosis and an aneurysm of atrial septum who presented with minimal effort tolerance and cyanosis. The morphological features were confirmed by cross-sectional echocardiography and cine-angiocardiography.

Adult↗
PubMed1990

Preliminary observations on effect of Lactobacillus sporogenes on serum lipid levels in hypercholesterolemic patients.

Short term hypolipidemic effects of oral L. sporogenes therapy (360 million spores/day in tablet form) were studied in 17 patients with type II hyperlipidemia in an open label fixed dose trial. Total serum cholesterol (330 +/- 55 mg/dl vs 226 +/- 46 mg/dl, P less than 0.001), LDL-cholesterol (267 +/- 58 mg/dl vs 173 +/- 54 mg/dl, P less than 0.001) and total cholesterol to HDL cholesterol and LDL-cholesterol to HDL-cholesterol ratios (P less than 0.001) were reduced significantly over a period of three months. HDL-cholesterol was marginally increased (43.6 +/- 7 mg/dl vs 46.8 +/- 8.9 mg/dl, P less than 0.05); however there was no change in serum triglyceride levels.

Adult↗