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J Timperley

Publications and source records attributed to J Timperley.

12 recordsLinked to original sources
PubMed2005

Semi-automatic boundary detection to improve reporting of regional left ventricular function.

AIMS: The reporting of regional left ventricular function is based on subjective assessment of endocardial motion and thickening and has a significant learning curve. We hypothesized that the use of an semi-automatic boundary detection system generating images with superimposed moving endocardial borders and a fixed end-diastolic reference border could improve the reporting of regional function. METHODS: We obtained 58 resting contrast images of 15 patients and using a new boundary detection system (Quamus), generated images with superimposed endocardial borders. The contrast images, images with additional Quamus borders and Quamus borders alone were assessed by two level 1 and two level 2 echocardiographers. They scored regional function and results were compared to two level 3 experienced stress echocardiography readers. RESULTS: The addition of borders improved the agreement of level 1 echocardiographers (weighted Kappa increased from 0.55 to 0.64) but did not change for level 2 echocardiographers (0.63 to 0.64) and has the potential to be a useful training tool.

Contrast Media↗
PubMed2005

Current indications for contrast echocardiography imaging.

UNLABELLED: The assessment of regional ventricular function is dependent on good endocardial definition. Suboptimal images can be converted to diagnostic recordings in the majority of patients by contrast agents, which have become an indispensable aid in rest and stress echocardiography. In particular for stress echocardiography image quality is essential and contrast administration is of great importance. However this diagnostic procedure must be performed following the indications which reflect the risks of the procedure and consider the benefits of an accurate diagnosis on further patient management. The contraindications recently introduced in the use of the echo-contrast agent SonoVue for acute cardiac patients reflect the same contraindications which have been applied in stress echocardiography for several years. Clinical trials and post-marketing surveillance have demonstrated that this approach is safe with no fatalities reported. For all ultrasound contrast media, side effects have been reported but they are usually mild. However, rare allergic and potentially life threatening reactions may occur and the investigators have to be prepared for such an event with appropriate drugs stored in the echo department. In a recent retrospective analysis in 751 consecutive stress echocardiograms the use of contrast during dobutamine stress echocardiography was not associated with an increased risk of side effects. The incidence of side effects was very low and different in patients receiving Optison, SonoVue or without contrast agent. CONCLUSION: Ultrasound contrast agents are licensed for improvement of endocardial border definition. Data from clinical trials and wide clinical experience indicate an excellent risk/benefit ratio if the current contraindications are applied.

Echocardiography↗
PubMed2004

Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts.

AIMS: To assess transthoracic echocardiography (TTE) using second harmonic imaging with Valsalva manoeuvre compared to transesophageal echocardiography (TEE) for the diagnosis of right to left cardiac and pulmonary shunts. METHODS AND RESULTS: One hundred and ten patients referred for TEE underwent TTE with bubble contrast. Bubbles in the left atrium within three cardiac cycles were considered diagnostic for a patent foramen ovale (PFO) and later as a pulmonary shunt. Greater than 20 bubbles in the left atrium was considered a large shunt and less than 20 a small shunt. TEE was performed immediately afterwards and read blinded to the TTE results. Pick-up rates were similar with 19 TEE positive (13 PFO) and 18 TTE positive (14 PFO) patients. There were five TEE positive/TTE negative cases who had significantly poorer TTE image quality score (2.7 +/- 0.8 vs 1.9 +/- 0.6, p < 0.05). There were six TEE negative/TTE positive cases, two cases requiring Valsalva manoeuvre to become positive. The Valsalva manoeuvre significantly increased the number of bubbles shunting (10 +/- 11 vs 20 +/- 19, p < 0.005). CONCLUSION: TTE with Valsalva manoeuvre is as good as TEE in diagnosing shunts. Valsalva manoeuvre increases the size of shunt. Both techniques produce false negative results.

Aged↗
PubMed2003

Primary cardiac lymphoma.

We present a case of primary cardiac lymphoma, which is a rare condition compared with secondary metastatic involvement and is associated with poor prognosis. This case demonstrates the use of transthoracic echocardiography for the assessment of tumour regression in response to chemotherapy.

Aged↗
PubMed1992

Effect of cup geometry and the presence of cement on acetabular component fixation.

Two series of implanted conical, polyethylene Ring cups were studied clinically and radiographically. In one series the cups were uncemented while in the second cement was used. The results using cemented conical cups were then compared with results using a cemented cup of hemispherical design to study the effect of cup geometry. At 7-8 years a total of 3.8% of the cemented conical series and 2.9% of the uncemented were revised for aseptic loosening. At 9 years survivorship was identical. Migration of the sockets occurred in approximately 25% of both series and was directly related to cup cover of less than 80% (P < 0.001). The series of cemented hemispherical cups were reviewed after an identical period. Although the numbers revised for loosening were comparable in this and the cemented conical group, radiological migration was statistically greater in the latter (P < 0.001). Alternative methods of socket preparation and cement technique were thought to be the most likely explanation for the observed differences.

Acetabulum↗