PubMed Health⌕ Search

Biomedical subjects

M S Sutton

Publications and source records attributed to M S Sutton.

59 records · Page 4Linked to original sources

Assessment of regional left ventricular long-axis motion with MR velocity mapping in healthy subjects.

The pattern of left ventricular long-axis motion during early diastole was assessed with magnetic resonance (MR) velocity mapping in 31 healthy volunteers. Regional long-axis velocity varied with time and position around the ventricle. During systole, the base descended toward the apex. The greatest magnitude of long-axis velocity occurred during early diastole. The lateral wall had the highest velocity (140 mm/sec +/- 40 [mean +/- standard deviation]); the anterior and inferior walls had lower velocities (96 mm/sec +/- 27 and 92 mm/sec +/- 34, respectively). The inferoseptal area consistently had the lowest velocities (87 mm/sec +/- 40). Absolute values of peak early-diastolic velocity declined with age (r = -.64, P < .001). Peak early-diastolic velocity was not dependent on heart rate (r = .014, P = .94). Regional variations in left ventricular wall motion were seen. MR velocity mapping is a useful technique for assessing regional left ventricular long-axis heart function.

Adult↗

Mitral valve flow measured with cine MR velocity mapping in patients with ischemic heart disease: comparison with Doppler echocardiography.

Diastolic function is an important element of overall left ventricular function. The pattern of flow across the mitral valve is commonly used as a measure of diastolic ventricular function. Magnetic resonance (MR) velocity mapping of blood flow across the mitral valve was compared with Doppler echocardiography. Nineteen patients with known coronary artery disease (mean age, 62 years; 11 with previous myocardial infarction) were studied. The mean value of peak early filling velocity (+/- standard deviation) was 60.1 cm/sec +/- 14.3 with the MR method and 59.4 cm/sec +/- 13.7 with echocardiography (P = .732). The mean difference between the two measurements (95% confidence interval) was -0.8 cm/sec (-5.2 cm/sec, +2.2 cm/sec). The mean value of early deceleration was 4.3 m/sec2 +/- 1.5 with the MR method and 4.0 m/sec2 +/- 1.5 with echocardiography (P = .073). The mean difference was -0.4 cm/sec2 (-0.92 cm/sec2, +0.05 cm/sec2). The mean value of peak atriosystolic velocity was 51 cm/sec +/- 14.6 with the MR method and 62 cm/sec +/- 17.2 with echocardiography (P = .002). The mean difference was -11 cm/sec (-18.1 cm/sec, -3.45 cm/sec). Peak atrial filling was consistently lower with the MR method than with echocardiography. Time-averaged measurements of ventricular filling with MR velocity mapping are an accurate measure of early diastolic filling but underestimate the velocity of atriosystolic filling.

Adult↗

Acute systolic and diastolic indices of left ventricular function after cardiomyoplasty in a chronic model of heart failure.

Recent experimental studies have suggested that the initial nonstimulated stage of dynamic cardiomyoplasty acutely impairs ventricular function. Those investigations were performed on normal hearts and primarily examined diastolic alterations as a result of the passive muscle wrap. The purpose of this study was to assess the acute systolic and diastolic effects of a nonstimulated muscle wrap in chronic heart failure induced by rapid ventricular pacing in canines. Pressure-volume analysis of ventricular function based on conductance catheter volume and micromanometer pressure data was used. Each animal was studied before rapid pacing, before cardiomyoplasty, and immediately after wrap. By the end of the pacing period and before wrap, left ventricular dysfunction developed in all dogs, manifested by significant deterioration of both systolic and diastolic indices of ventricular function, as well as progressive increases in left ventricular volumes. However, no further deterioration with load insensitive indices of systolic or diastolic indicators of ventricular function was found as a result of the passive muscle wrap. These results suggest that the cardiomyoplasty procedure can be safely performed on failing hearts without prohibitive acute impairment of ventricular function.

Animals↗

Homocysteine: evidence for a causal relationship with cardiovascular disease.

Elevated plasma homocysteine levels are associated with vascular disease and thrombosis. Premature atherosclerosis and thromboembolism are seen in children who are homozygotes for defects in enzymes responsible for the metabolism of homocysteine. Adults with heterozygous defects have less marked elevations of homocysteine, and onset of atherosclerosis and vascular disease are delayed into the fourth and fifth decade of life. Homocysteine can damage vascular endothelium, cause proliferation of vascular smooth muscle, activate platelets, promote lipid peroxidation, and activate the coagulation cascade. Epidemiologic studies have linked elevations in plasma homocysteine with coronary artery disease, cerebrovascular disease, and thromboembolism. Folic acid, in combination with vitamins B6 and B12, can normalize homocysteine levels in most patients. Although randomized trials assessing the efficacy of homocysteine reduction have yet to be completed, treatment with vitamin supplementation should be considered in all patients at risk for vascular disease.

Adult↗

Dissection of the thoracic aorta. A comparison between medical and surgical treatment.

We have reviewed 113 patients with acute thoracic aortic dissection seen between 1965 and 1979. There were no "diagnostic" symptoms or signs of acute dissection, and diagnosis could only be reliably made by aortography. The latter also allowed typing of the dissection (De Bakey classification) which permitted appropriate therapy to be instituted. Aortography should be performed early because of the high mortality of this condition within the first 24 hours. Early surgery is warranted in all patients with Type I dissection since it significantly increases long term survival: 40% 5 year-survival for surgical treatment compared with 13% survival for medical treatment (p less than 0.01). There is no significant difference in long or short term survival for patients with Type III dissection whether patients are treated medically or surgically.

Adult↗