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Biomedical subjects

J D Wachspress

Publications and source records attributed to J D Wachspress.

4 recordsLinked to original sources

Left ventricular mass regression after aortic valve replacement measured by ultrafast computed tomography.

Left ventricular mass and function were measured using ultrafast computed tomography, and were correlated with clinical status in 17 patients with aortic stenosis and/or insufficiency undergoing aortic valve replacement or balloon valvuloplasty. Wall mass was 159 +/- 38 gm/m2 initially, decreased 25% to 116 +/- 29 gm/m2 at 4 month (p less than 0.001), and decreased a total of 34% to 105 +/- 33 gm/m2 at 8 months after valve repair. By 8 months not only was the mean wall mass within the normal range, but only three patients retained abnormal hypertrophy. Ejection fraction increased 8% (p = 0.06). Clinical function improved in all patients, with only three patients remaining outside of New York Heart Association functional class 1 at 8 months. Regression of ventricular mass into the normal range correlated with attainment of class 1 functional status (p less than 0.02), despite a lack of increase of ejection fraction. The single patient followed for 8 months after valvuloplasty had minor wall mass regression and minor clinical improvement.

Aortic Valve Insufficiency↗

Systolic and diastolic performance in normal human subjects as measured by ultrafast computed tomography.

Ultrafast computed tomography (ultrafast-CT) is a minimally invasive imaging modality with very short acquisition time and excellent anatomic definition. It shows promise of providing precise measurement of right and left ventricular volumes, left ventricular mass, and left ventricular diastolic function with a single test. We expand on the knowledge regarding normal humans by studying ten normal volunteers in the short axis. Cardiac volumes and mass (mean +/- 1 S.D.) were as follows: 1) left ventricle: end-diastolic volume index (ml/m2) = 61 +/- 15, end-systolic volume index (ml/m2) = 19 +/- 7, stroke volume index (ml/m2) = 43 +/- 9, cardiac index (liters/min/m2) = 2.7 +/- .5, ejection fraction (%) = 70 +/- 7, end-diastolic mass (g/m2) = 95 +/- 15; 2) right ventricle: end-diastolic volume index (ml/m2) = 76 +/- 19, end-systolic volume index (ml/m2) = 35 +/- 13, stroke volume index (ml/m2) = 40 +/- 8, cardiac index (liters/min/m2) = 2.6 +/- .5, ejection fraction (%) = 55 +/- 6. Stroke volume index differed by 1.6 +/- 2.0 ml/m2 between ventricles. Measurement of global and segmental left ventricular diastolic function revealed: 1) Peak filling rate (end-diastolic volumes/second): global = 2.29 +/- .40, base = 1.78 +/- .49, midventricle = 2.49 +/- .57, apex = 3.13 +/- .39 (P less than .001, base vs. apex; P less than .01, base vs. midventricle and midventricle vs. apex); 2) time to peak filling rate (msec): global = 193 +/- 24, base = 192 +/- 20, midventricle = 194 +/- 26, apex = 190 +/- 19 (P = NS between levels).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Prosthetic valve visualization by cine-computed tomography: a case report.

The use of cine-computed tomography scanning is described in evaluating cardiac function in a patient with a bileaflet mitral valve prosthesis (St. Jude medical valve) and in a second patient with both mitral and aortic bileaflet prostheses. Both biventricular and prosthesis function were assessed successfully.

Aortic Valve↗

Signouts against medical advice from a coronary care unit.

Twenty-nine patients who were admitted to a Coronary Care Unit (CCU) but who subsequently discharged themselves against medical advice (AMA) were matched with a group of control patients who were admitted to the same unit but who remained in the hospital for the entire course of their treatment. The two groups were then compared on the basis of sociodemographic, medical, behavioral, and psychiatric variables. Results were that the AMA group differed significantly from the control group in a number of factors including age, number of previous AMA signouts, severity of medical problems, and self-reports of alcoholism and emotional difficulties. The relationship of these findings to the AMA behavior is discussed and intervention strategies are suggested.

Age Factors↗