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J E Macioch

Publications and source records attributed to J E Macioch.

5 recordsLinked to original sources

Comparison of cine magnetic resonance imaging and Doppler echocardiography for evaluation of left ventricular diastolic function.

Cine magnetic resonance (MR) imaging of the heart detected evidence of left ventricular (LV) diastolic filling abnormality in patients with LV wall thickening but normal systolic function and normal diastolic function by routine Doppler echocardiography. Cine MR imaging may be more sensitive than routine echocardiography in detecting abnormalities of LV diastolic function.

Diastole↗

The effect of esmolol pretreatment on the incidence of regional wall motion abnormalities during electroconvulsive therapy.

Electroconvulsive therapy (ECT) is associated with dramatic increases in arterial blood pressure and heart rate (HR) that may precipitate new left ventricular regional wall motion abnormalities (RWMAs) suggestive of myocardial ischemia. The purpose of this study was to investigate the effect of pretreatment with esmolol on the incidence of RWMAs after ECT. Thirteen patients served as their own controls and, in a random fashion, received a standard succinylcholine/methohexital anesthetic for one of two ECT sessions, and an identical anesthetic with esmolol 1 mg/kg for their other ECT session. Systolic (SBP), diastolic (DBP), mean arterial pressures (MAP) and HR were recorded after drug administration and before ECT and at 1-, 2-, 4-, 5-, 10-, and 15-min intervals after ECT. Echocardiograms were obtained at baseline, after drug administration, 1 min after ECT, and at recovery 15 min later. All patients had significant increases in SBP, DBP, and MAP at 1, 2 and 4 min after ECT versus baseline, whereas HR was significantly faster at all times in the control sessions. HR was significantly slower after anesthetic induction until 2 min after ECT in the esmolol versus the control group (P < 0.05). New RWMAs were seen in only 1 of 26 (4%) ECT sessions, despite the presence of baseline RWMAs in 31% of the patients. We conclude that contrary to previously reported data, new RWMAs after ECT are uncommon. Consequently, this study was unable to demonstrate any beneficial effect of pretreatment with esmolol on the incidence of ECT-induced RWMAs.

Adrenergic beta-Antagonists↗

Dobutamine stress echocardiography: what role in today's ICU?

Changes in left ventricular systolic wall motion and thickness (systolic function) may develop in response to dobutamine infusions; such changes can be detected echocardiographically--a technique called dobutamine stress echocardiography (DSE). By mapping the changes to graded doses of dobutamine, DSE permits us to detect myocardial ischemia and to assess whether myocardial damage is reversible. As a result, this test can help predict which patients are likely to benefit from revascularization. DSE also allows us to determine a specific point at which evidence of ischemia begins. The test is highly accurate, safe, and comparatively inexpensive.

Coronary Disease↗

The technique of dobutamine stress echocardiography.

Dobutamine stress echocardiography (DSE) can be performed safely at the bedside and offers more immediate results and lower cost than other pharmacologic imaging methods. Applications in the intensive care unit include detection of coronary artery disease and assessment of myocardial viability. DSE is also a useful adjunctive study for examining valvular function or revealing obstructive cardiomyopathy. Dobutamine infusion is started at 5 mug/kg/min and peaks at 40 or 50 mug/kg/min. Four standard echocardiographic views are used to show left ventricular wall segment responses; both the extent of thickening and type of motion are assessed.

Coronary Disease↗