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Biomedical subjects

O A Nesje

Publications and source records attributed to O A Nesje.

13 recordsLinked to original sources
PubMed1980

Systolic time intervals in isolated ventricular septal defect in the adult.

Little information is available on the length of the systolic time intervals in adult patients with isolated ventricular septal defects (VSD). In the present study the external carotid pulse and the phono- and electrocardiogram were recorded in 17 patients, mean age 29 years, with angiographically proved VSD. They had unidirectional left-to-right shunts with ratios of pulmonary-to-systemic blood flow (Qp/Qs) of 1-5.22. Their right ventricular pressures were normal or only moderately elevated. Left ventricular ejection time was consistently abbreviated, the degree of abbreviation relating significantly with Qp/Qs (r = -0.70, p less than 0.01). The preejection period was prolonged but the relationship between its degree of prolongation and Qp/Qs did not reach statistical significance (r = 0.4), p greater than 0.05). The relationship between the preejection period/left ventricular ejection time ratio (PEP/LVET) and Qp/Qs was statistically significant (r = 0.51, p less than 0.05). We conlcude that in adult VSD patients with normal right ventricular pressures, a hemodynamically important shunting, i.e., Qp/Qs above 1.4 or left-to-right shunt exceeding 30% of pulmonary blood flow, may be excluded in the presence of a normal left ventricular ejection time or a normal PEP/LVET ratio.

Adolescent↗
PubMed1979

Impaired rate of left ventricular filling in idiopathic hypertrophic subaortic stenosis with atrial fibrillation.

The external carotid pulse and the phonocardiogram were recorded in a 48-year-old man with idiopathic hypertrophic subaortic stenosis and atrial fibrillation. The degree of obstruction of left ventricular outflow was assessed by the depth of the mid-systolic dip, the length of the left ventricular ejection time and the intensity of the systolic murmur. The correlation found between the degree of outflow obstruction and the length of the preceeding diastole was interpreted in terms of the Frank-Starling mechanism, i.e. augmented diastolic filling led to an increase in the force of contraction and hence to an increase in muscular obstruction to outflow. The observation that this relationship held also for long diastoles suggested that the left ventricle was not completely filled during diastoles of middle length, probably because of the low diastolic distensibility of the stuff and hypertrophic myocardium.

Aortic Valve↗
PubMed1978

Severity of aortic stenosis assessed by carotid pulse recordings and phonocardiography.

The external carotid pulse, the PCG, and the ECG were studied in 26 adult patients with valvular aortic stenosis whose systolic peak pressure gradients ranged from 18 to 165 mmHg. A significant correlation was found between the rapidity of the pulse upstroke, as measured by the T-time, and the location of the peak of the systolic murmur during ventricular ejection, on the one hand, and the gradient, on the other. The left ventricular ejection time (LVET) related directly and the pre-ejection period (PEP) indirectly with the gradient. There was a signficant inverse relationship between the PEP/LVET quotient and the pressure gradient but this quotient did not classify the patients according to the severity of the stenosis as well as the T-time and the location of the peak of murmur. When a combination of the T-time, the PEP/LVET, and the location of the peak of the murmur was used in each patient, a good discrimination between the patients was achieved. When the pressure gradient was above 50 mmHg, at lease one of the measurements was abnormal and when it exceeded 100 mmHg, at least two measurements were abnormal. The study further showed that it is possible to separate patients with valvular aortic stenosis from those with hypertrophic obstructive cardiomyopathy lidiopathic hypertrophic subaortic stenosis) or mitral insufficiency on the basis of carotid pulse tracings and PCGs.

Aged↗
PubMed1978

Serum levels and electrophysiological effects of N-acetlyprocainamide as compared with procainamide in the dog heart in situ.

The electrophysiological effects of procainamide and its major metabolite N-acetylprocainamide were tested and compared on the heart of the anaesthetized dog by means of His bundle electrography and programmed electrical stimulation. Both drugs exerted a negative chromotropic effect. They also increased intra-atrial and intraventricular conduction times; procainamide was, however, the more potent of the two drugs. In contrast to procainamide, N-caetylprocainamide did not increase His-Purkinje and atrioventricular nodal conduction times, and at the lowest dose employed, atrioventricular nodal conduction times were decreased during atrial pacing. Both drugs increased the functional and effective refractory period of the right atrium and ventricle. N-acetylprocainamide increased the functional refractory period of the atrioventricular node, but to a lesser extent than procainamide.

Animals↗
PubMed1977

External carotid pulse recordings in hypertrophic obstructive cardiomyopathy.

External carotid pulse tracings were examined in 15 patients with hypertrophic obstructive cardiomyopathy (HOCM), the diagnosis being confirmed by catheterization of the left heart. Of 12 patients with intraventricular gradients at rest, 9 had a typical bifid pulse with midsystolic dipping. In one patient without a gradient at rest, midsystolic dipping occurred only in beats following extrasystoles (Brockenbrough phenomenon). The upstroke of the pulse wave was rapid in all the patients, a finding that distinguishes them from patients with valvular aortic stenosis. There was a correlation between the length of the left ventricular ejection time and the intraventricular gradient (r = 0.71) but as more than half the patients had normal or shortened ejection times, the diagnosis of HOCM cannot be based on measurements of this parameter. It is concluded that carotid pulse registrations are of considerable diagnostic value in patients suspected of having HOCM. As the pulse changes are correlated to the degree of left ventricular outflow obstruction, it is suggested that repeated pulse tracings may be used as a means for controlling the degree of obstruction once the diagnosis has been established in the individual patient.

Adult↗