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Biomedical subjects

L E Watts

Publications and source records attributed to L E Watts.

At least 19 recordsLinked to original sources
PubMed1989

Diastolic mitral regurgitation in acute but not chronic aortic regurgitation: implications regarding the mechanism of mitral closure.

In acute aortic regurgitation, left ventricular pressure rises rapidly during diastole, which produces presystolic mitral valve closure. This does not occur in chronic aortic regurgitation. Since normal, nonregurgitant mitral valve closure may depend on properly coordinated atrial and ventricular contractions, we hypothesized that abnormal mitral valve closure occurring before systole in acute aortic regurgitation may produce diastolic mitral regurgitation detectable by Doppler echocardiography. Accordingly, we performed ultrasonic Doppler examination of seven patients with acute aortic regurgitation and 12 patients with chronic aortic regurgitation. Regurgitant aortic flow was severe in all cases. Doppler sampling within the left atrium demonstrated regurgitant mitral flow in late diastole in all patients with acute aortic regurgitation. The onset of diastolic mitral regurgitation coincided with mitral valve preclosure in patients with acute aortic regurgitation and occurred regardless of the position of the mitral leaflets at the initiation of closure. In contrast, none of the 12 patients with chronic aortic regurgitation had mitral valve preclosure or diastolic mitral regurgitation (p less than 0.05 versus acute aortic regurgitation). We conclude that diastolic mitral regurgitation accompanies mitral valve preclosure, which occurs in acute but not chronic aortic regurgitation. Thus diastolic mitral regurgitation may be a Doppler sign of acute aortic regurgitation, in the absence of a markedly prolonged PR interval. Furthermore, this observation suggests that normal, nonregurgitant mitral closure requires more than an increase in left ventricular pressure above left atrial pressure, regardless of the position of the mitral leaflets before closure.

Acute Disease↗
PubMed1985

Left atrial myxoma and atrial septal defect with recurrent pulmonary emboli.

We have reported a case of left atrial myxoma in association with an atrial septal defect in a patient followed up over a number of years for recurrent sterile pleural effusions and chronic obstructive lung disease of undetermined cause. During hospitalization for pneumonia, an intracardiac mass and atrial septal defect were found by echocardiography, and verified at operation to be a left atrial myxoma.

Echocardiography↗
PubMed1984

Left atrial myxoma associated with rheumatic mitral stenosis.

The rare occurrence of mitral stenosis and coexistent left atrial myxoma is reported. The patient had a 25-year history of rheumatic heart disease and was referred for evaluation of progressive mitral stenosis without clinical suspicion of left atrial myxoma. The tumor was discovered by routine echocardiography in the course of evaluation of mitral stenosis. However, prior to surgery the patient experienced an episode of embolization of the tumor without major clinical sequelae. The utility of echocardiography in this case and in patients with mitral stenosis is discussed as well as the patient's spontaneous "cure."

Echocardiography↗
PubMed1983

Assessment of the antihypercholesterolemic drug, Probucol, in benign prostatic hyperplasia.

Seventy patients were administered either Probucol, an anti-cholesterol agent or a placebo in a double blind manner for a period of 1 year in an effort to assess the effectiveness of this agent in treating benign prostatic hyperplasia. Sensation of incomplete voiding and peak and mean voiding flow rates showed a trend which indicated a therapeutic effect, however, this effect was comparable for both placebo and the drug group. This is interpreted as indicating the effectiveness of standard urologic therapy, and double blind trials are therefore needed in assessing different agents for the medical management of benign prostatic hyperplasia.

Cholesterol↗
PubMed1981

Evaluation of aortocoronary bypass graft status by computed tomography.

The efficacy of contrast-enhanced computed tomography to define graft patency status was studied in 42 patients with 100 aortocoronary vein grafts. The status of each graft had been determined earlier by angiography. A rotary fan beam whole body scanner with a 2 second scan duration was used. Initial scans determined the optimal level for study of the graft; patency was assessed by computed tomographic enhancement of the graft after intravenous bolus injection of 30 ml meglumine and sodium diatriazoate. The computed tomographic studies were evaluated without knowledge of the angiographic findings; graft status by computed tomography was interpreted as patent, occluded or equivocal. Overall, computed tomography correctly defined graft patency status in 79 of the 100 grafts and incorrectly identified it in 9; in 12 grafts, the computed tomographic diagnosis was equivocal. Computed tomography correctly identified 61 of 74 patent grafts and 18 of 26 occluded grafts. Patency status was correctly defined by computed tomography in 35 of 37 grafts to the left anterior descending artery, 23 of 30 grafts to circumflex branches and 19 of 31 grafts to the right coronary artery. These data indicate that computed tomography is a promising noninvasive method of determining patency of aortocoronary bypass grafts, especially of grafts to the left anterior descending artery.

Coronary Angiography↗
PubMed1981

Amyloid heart disease.

We have presented two patients with heart failure due to cardiac amyloidosis. The diagnosis was suspected from the echocardiogram and was confirmed by rectal biopsy. The echocardiogram features, which include thickening of the heart walls and other intracardiac structures, differentiate cardiac amyloidosis from other forms of heart disease. Thus, echocardiography should be helpful in the preliminary evaluation of patients with obscure heart failure and may obviate the necessity for more invasive studies.

Aged↗
PubMed1980

Left ventricular lipoma: echocardiographic and angiographic features.

We have presented an unusual case of a left intraventricular cardiac tumor which was detected during cardiac catheterization, done to evaluate unexplained chest pain. An echocardiogram showed the tumor to be continuous with the interventricular septum and in front of the mitral valve. At operation, the lesion was attached to the interventricular septum and, microscopically, proved to be a lipoma. This is believed to be the first reported intraventricular lipoma detected ante mortem and successfully removed.

Angiography↗
PubMed1979

Cardiac involvement in rheumatoid arthritis. Followup study.

Initial studies from Bowman Gray School of Medicine showed that 18 of 30 patients with classic rheumatoid arthritis (RA) had cardiac involvement from their disease. These abnormalities were detected by echocardiography and consisted of mitral valve and/or pericardial abnormalities. All patients were followed for 4 years from the initial workup. Mitral valve abnormalities were seen on followup in 63% of the patients who initially showed this abnormality, while pericardial effusion remained in 20%. Pericardial thickening persisted in 6 of 7 patients. None of the patients developed constrictive pericarditis or heart failure. There was no definite correlation between persistence of these abnormalities and other clinical data, but it was noticed that patients who had persistent pericardial effusion and mitral valve abnormalities showed a higher number of involved joints and a higher erythrocyte sedimentation rate. The cardiac abnormalities described in this study have remained clinically insignificant in this population of RA patients.

Arthritis, Rheumatoid↗
PubMed1979

Echocardiographic assessment of mitral stenosis by the left atrial emptying index.

Echocardiograms were performed in 35 patients prospectively with mitral stenosis to determine the usefulness of the left atrial emptying index (AEI) in estimating mitral valve orifice area (MVOA). Twnety-five control patients without evidence of cardiac disease had an AEI of 0.91 +/- 0.01. In the mitral stenosis group, the mean AEI was 0.47 +/- 0.09, with Gorlin and Gorlin calculated MVOAs of 1.44 +/- 0.56. There was close correlation between the AEI and MVOA (r = 0.93). The AEI did not correlate well with the left atrial size (r = 0.10), or the EF slope of the mitral valve (r = 0.20). The AEI was useful in separating patients with mitral stenosis into mild, moderate, and severe groups. Twelve out of 12 patients with severe mitral stenosis (MVOA less than or equal to 1.0 sq cm) had an AEI of less than or equal to 0.42. Ten out of 13 patients with moderate mitral stenosis (MVOA of 1.1--1.5 sq cm) had an AEI of 0.43 to 0.51. Eight out of ten patients with mild mitral stenosis (MVOA greater than or equal to 1.6 sq cm) had an AEI of greater than or equal to 0.52. The overall predictive value of the AEI in subclassifying the severity of mitral stenosis was 86 percent. In conclusion, the AEI appears to be a sensitive index in estimating MVOA in mitral stenosis.

Adult↗
PubMed1978

Cardiopulmonary manifestations of systemic lupus erythematosus.

Nine of 17 patients (52%) with systemic lupus erythematosus participating in a controlled prospective study were found to have maximal mid-expiratory flow rates suggestive of obstructive or obstructive and restrictive pulmonary disease. Cigarette smokers with systemic lupus erythematosus had significantly lower (P less than .05) maximal mid-expiratory flow rates than either non-smokers with systemic lupus erythematosus or smokers with degenerative joint disease. By echocardiography, pericardial thickening was seen in six of 17 patients (41%) and mitral valvular abnormalities were noted in four of 17 (24%) patients with systemic lupus erythematosus. Echocardiography was found to be an effective means of detecting pericardial disease in patients with systemic lupus erythematosus.

Adolescent↗