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Biomedical subjects

J Jue

Publications and source records attributed to J Jue.

At least 19 recordsLinked to original sources
PubMed2006

Treating the right patient at the right time: Access to echocardiography in Canada.

The Canadian Cardiovascular Society is the national professional society for cardiovascular specialists and researchers in Canada. In the spring of 2004, the Canadian Cardiovascular Society Council formed the Access to Care Working Group ('Working Group') to use the best science and information available to establish reasonable triage categories and safe wait times for access to common cardiovascular procedures. The Working Group decided to publish a series of commentaries to initiate a structured national discussion on this important issue, and the present commentary proposes recommended wait times for access to echocardiography. 'Emergent' echocardiograms should be performed within 24 h, 'urgent' within seven days and 'scheduled' (elective) within 30 days. A framework for a solution-oriented approach to improve access is presented.

Canada↗
PubMed1998

Diastolic filling in human severe sepsis: an echocardiographic study.

OBJECTIVE: To determine if nonsurvivors have a more abnormal pattern of left ventricular relaxation than survivors with severe sepsis. DESIGN: Prospective, observational, cohort study. SETTING: Intensive care unit in a university-affiliated tertiary care hospital. PATIENTS: Twenty-four adults with severe sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Baseline clinical and hemodynamic variables, Acute Physiology and Chronic Health Evaluation (APACHE) II scores and Doppler echocardiographic mitral inflow pattern (analyzed for normalized peak early filling rate [E/VTI, systolic volumes/sec], deceleration time [msec], and early to atrial filling velocity ratio [E/A]). There were seven deaths. The patients did not differ in baseline demographics, inotropic infusions, hemodynamic measurements or ventilatory settings or variables. Nonsurvivors had a more abnormal pattern of left ventricular relaxation (E/VTI, 4.7 [range 3.8 to 5.8] vs. 5.8 [range 3.8 to 8.9], p= .04; deceleration time, 235 [range 209 to 367] vs. 182 [range 155 to 255], p = .002). E/A showed a nonsignificant trend in the same direction (0.9 [range 0.8 to 1.6] vs. 1.2 [range 0.7 to 1.9], p = .12). In a multivariate analysis, deceleration time (p< .004) and APACHE II score (p < .02) were the only independent predictors of mortality. CONCLUSION: Severe sepsis nonsurvivors have a more abnormal echocardiographic pattern of left ventricular relaxation than survivors.

APACHE↗
PubMed1998

The natural history and rate of progression of aortic stenosis.

One of the challenges in clinical cardiology is to determine the optimal time of valve replacement surgery in patients with aortic stenosis. To meet this challenge, one requires an accurate knowledge of the natural history and rate of progression of the disease. This review will summarize the natural history of aortic stenosis in terms of symptoms, mortality, and stenosis progression.

Aortic Valve Stenosis↗
PubMed1997

Anomalously placed papillary muscle masquerading as a left ventricular apical mass.

A 63-year-old man was seen with a history of nonfluent dysphasia and headaches. His blood tested positive for anticardiolipin antibodies. Transthoracic echocardiography showed a mass in the left ventricular apex. The transgastric five-chamber view identified this mass as an anomalously placed papillary muscle. In the presence of an apical mass, if the transthoracic echocardiogram is equivocal, a transesophageal echocardiogram, using the transgastric five-chamber view may be helpful in making the correct diagnosis.

Antiphospholipid Syndrome↗
PubMed1995

Left ventricular morphologic features and function in nonhospitalized cocaine users: a quantitative two-dimensional echocardiographic study.

To determine whether left ventricular (LV) hypertrophy or dysfunction is present in nonhospitalized cocaine users, we performed quantitative two-dimensional echocardiography in 20 intravenous cocaine users and 20 age- and sex-matched controls. Cocaine users were normotensive, had begun taking cocaine an average of 14 years earlier, and had used cocaine an average of 8 times/mo during the preceding year. There were no significant differences between cocaine users and control subjects for LV mass index (79 vs 74 gm/m2, respectively), mean wall thickness (0.95 vs 0.91 cm), end-diastolic volume index (55 vs 56 ml/m2), end-systolic volume index (17 vs 19 ml/m2), or ejection fraction (70 vs 66%; p > or = 0.09 for all comparisons). Moreover, none of the cocaine users or control subjects had significant regional wall motion abnormalities, and none of the subjects or controls had ejection fractions < 55%. Thus we found little evidence that significant LV hypertrophy or dysfunction is present in nonhospitalized cocaine users. From these results we speculate that cocaine-associated LV hypertrophy and dysfunction may be restricted to certain high-risk groups of chronic cocaine users.

Adult↗
PubMed1995

Identification of viable myocardium with technetium-99m-MIBI infusion.

A 50-yr-old man was evaluated using standard stress/rest 99mTc-methoxyisobutylisonitrile (MIBI) perfusion imaging, rest thallium infusion imaging and rest 99mTc-MIBI infusion imaging prior to revascularization. Resting 99mTc-MIBI infusion imaging demonstrated hibernating myocardium which was not detected with standard stress/rest 99mTc-MIBI imaging. The implication from this observation is that resting 99mTc-MIBI infusion scintigraphy can provide useful information when evaluating patients for the presence of hibernating myocardium. A prospective comparison of resting 99mTc-MIBI infusion scintigraphy with other noninvasive techniques used to identify viable myocardium may be warranted.

Coronary Artery Bypass↗
PubMed1993

Left ventricular function immediately after intravenous cocaine: a quantitative two-dimensional echocardiographic study.

OBJECTIVES: We tested the hypothesis that intravenous cocaine, in doses commonly self-administered in nonmedical settings, causes acute myocardial ischemia and left ventricular dysfunction. BACKGROUND: Cocaine-induced cardiac complications are responsible for a growing number of deaths in young people, but the mechanism by which cocaine induces these complications is unclear. METHODS: We performed 12-lead electrocardiography and quantitative two-dimensional echocardiography in 20 subjects before and after single intravenous doses of high dose cocaine (1.2 mg/kg body weight), low dose cocaine (0.6 mg/kg) and placebo. RESULTS: At 2 to 7 min after cocaine administration, the rate-pressure product was increased significantly from baseline (high dose 73%, low dose 63%, placebo 8%, p < 0.001 for either dose vs. placebo). During this time, electrocardiography demonstrated dose-related nonspecific changes (high dose in 14 of 20 subjects, low dose in 9 of 20 subjects, placebo in 2 of 20 subjects, p < 0.002 for either dose vs. placebo). In contrast, echocardiography showed that the frequency of hyperdynamic left ventricular wall segments doubled after high dose cocaine compared with placebo (34% [108 of 318] vs. 16% [51 of 319], respectively, p = 0.0001) but that there was no change in either left ventricular ejection fraction (high dose 66 +/- 9%, placebo 67 +/- 6%, p = NS) or wall motion score index (high dose 0.67 +/- 0.44, placebo 0.85 +/- 0.30, p = NS). CONCLUSIONS: We conclude that intravenous cocaine, in doses commonly self-administered in nonmedical settings, does not cause acute myocardial ischemia or left ventricular dysfunction. We speculate that cocaine-induced cardiac complications are caused by idiosyncratic coronary artery vasospasm, by exceptionally high dosages or by cocaine-induced coronary artery thrombosis.

Adult↗
PubMedDate not supplied

Pulsed Doppler characterization of left atrial appendage flow.

Recent evidence suggests that left atrial (LA) appendage velocities may provide clues to the thrombogenic potential of this structure. Pulsed Doppler evaluation of LA appendage flow during transesophageal echocardiography was performed in 109 patients to evaluate the effects of rhythm, mitral regurgitation, and spontaneous contrast. During sinus rhythm, there was a forward LA appendage contraction wave of 46 +/- 18 cm/sec followed by a retrograde filling wave of 46 +/- 17 cm/sec. In 40% of the patients in sinus rhythm, additional forward and retrograde velocities of 23 +/- 10 and 22 +/- 11 cm/sec, respectively, were seen. In contrast, atrial fibrillation was associated with reduced forward and retrograde flows in an irregularly irregular pattern. In sinus rhythm moderate to severe mitral regurgitation did not appear to affect the LA appendage velocities. Last, although forward LA appendage velocities were found to be significantly reduced in patients with spontaneous contrast by univariate analysis, multivariate analysis demonstrated that only the presence of atrial fibrillation was a significant predictor for spontaneous contrast.

Atrial Fibrillation↗
PubMedDate not supplied

Embolic occlusion of a patent foramen ovale: a cause of false negative contrast echocardiogram.

A 74-year-old man who had dyspnea and cyanosis demonstrated venous thrombosis and multiple lung ventilation-perfusion mismatches suggesting pulmonary emboli. Transthoracic echocardiography demonstrated a right atrial mass and a microbubble contrast study did not reveal right-to-left shunt. Transesophageal echocardiography revealed an embolus entrapped in the foramen ovale projecting into the left atrium that was subsequently removed. Embolic occlusion of patent foramen ovale is an important cause of false negative microbubble contrast study.

Aged↗