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P D Lindower

Publications and source records attributed to P D Lindower.

8 recordsLinked to original sources
PubMed2000

Reproducibility of left ventricular measurements with acoustic quantification: the influence of training.

Acoustic quantification (AQ) of two-dimensional (2-D) echocardiograms provides online estimation of left ventricular (LV) size and function. However, edge detection with AQ is influenced by gain settings and is therefore operator dependent. Our purpose was to compare AQ and conventional 2-D echo measurements of LV size and function obtained by different operators and to evaluate the influence of training on these measurements. A cardiac sonographer without previous experience with the AQ system was trained by an experienced operator. Twenty-two normal males (age, 28 +/- 4 years) participated in the study. Images were recorded with conventional 2-D and AQ echo from the short-axis and apical four-chamber views. During the initial training period, five subjects were imaged by the sonographer under the supervision of the trainer. At the initial study session, 12 subjects were imaged independently by the two operators. Following a second training period with five different subjects, the same initial 12 subjects were again imaged at a second study session. LV cavity areas were traced from the conventional 2-D echocardiograms and measured from the AQ waveforms at end-diastole and end-systole. Volumes were calculated using the single-plane area-length method. Ejection fraction (EF) was calculated from volumes. Reproducibility was determined by comparing the variability of AQ and conventional 2-D echo measurements obtained at the two sessions. A second training session reduced the operator variability only of the short-axis end-diastolic area measurement (17 +/- 11% vs 6 +/- 5%, P < 0.025). We conclude that a single training session may be adequate for the reproducible estimation of ventricular volumes with the AQ method.

Adult↗
PubMed2000

Inhalation of amyl nitrite and the measurement of left ventricular outflow velocity: studies in normal, young adults.

Amyl nitrite inhalation is useful in the identification of patients with provocable left ventricular (LV) outflow tract obstruction. However, there are no prospective studies that assess the normal change in LV outflow velocity during this intervention. Eighteen normal subjects (mean age, 34+/-5 years; 9 men and 9 women) inhaled amyl nitrite during measurement of LV outflow velocity. Peak velocity increased from 109+/-16 cm/s to 144+/-24 cm/s (P<0.001). There were no significant gender differences in velocity measurements at baseline or at peak. Our study provides prospective data that may be useful when evaluating young adults for LV outflow tract obstruction with Doppler echocardiography during amyl nitrite inhalation.

Administration, Inhalation↗
PubMed1998

Transition metal chelators reduce directly measured myocardial free radical production during reperfusion.

Transition metals such as iron and copper are present in the myocardium and can act as catalysts for the formation of oxygen free radicals during reperfusion after myocardial ischemia. Previous studies suggested that transition metal chelators such as desferrioxamine reduce the production of such radicals and may thereby attenuate postischemic myocardial dysfunction. These studies used spin trapping agents, commonly nitrone compounds, which may themselves influence the severity of the ischemia and reperfusion events being studied. We evaluated two transition metal chelators, desferrioxamine, an iron chelator, and bathocuproine, a copper chelator, by using a new electron paramagnetic resonance technique that does not require the administration of spin traps. We measured ascorbate free radical, an index of free radical production, in the great cardiac vein effluent. Twenty-eight open-chest dogs underwent 20 min of coronary artery occlusion and 30 min of reperfusion. Ten dogs received no drug, 10 dogs received 750 mg bathocuproine, i.v., and eight dogs received 700 mg desferrioxamine, i.v. Both bathocuproine and desferrioxamine blunted the postreperfusion increase in ascorbate free radical generation: no drug, 36+/-8% increase; desferrioxamine, 13+/-5% increase; bathocuproine, 21+/-6% increase (p < 0.05 vs. baseline). Thus direct free radical measurements indicate that chelation of the transition metals iron and copper reduces free radical generation during reperfusion.

Animals↗
PubMed1996

Prolonged coronary artery occlusion-reperfusion sequences reduce myocardial free radical production: an electron paramagnetic resonance study.

Our purpose was to determine whether prolonged myocardial ischemia attenuates free radical production after early reperfusion. Twenty-two mongrel dogs underwent left anterior descending coronary artery occlusion for 20, 40, or 60 minutes followed by 30 minutes of reperfusion. Electron paramagnetic resonance spectroscopy was used to measure ascorbate free radical in the coronary vein effluent. Ascorbate free radical production during reperfusion was significantly (p < 0.05) reduced in the dogs undergoing 60 minutes of coronary artery occlusion compared with the dogs undergoing 40 and 20 minutes of occlusion. We conclude that prolonged myocardial ischemia results in less free radical production on reperfusion than do shorter periods of ischemia followed by reperfusion.

Animals↗
PubMed1996

Variability of regurgitation in Björk-Shiley mitral valves and relationship to disc occluder design: an in vitro two-dimensional color-Doppler flow mapping study.

BACKGROUND AND AIMS OF THE STUDY: Normal prosthetic valves have regurgitation that varies according to valve type and design. The Björk-Shiley prosthetic mitral valve is a tilting disc valve that has undergone design changes since its introduction. From 1969 to 1981, Delrin, was used to make the disc occluder. After 1971, the occluder was made from Pyrolite (i.e. Conical and Radiopaque-Spherical valves). Our aim was to quantify the regurgitation of Delrin and Radiopaque-Spherical Björk-Shiley prosthetic mitral valves with color-Doppler flow mapping in an in vitro model that simulates transesophageal echocardiography imaging. MATERIALS AND METHODS: Normal unimplanted Björk-Shiley Delrin (BSD), Björk-Shiley Radiopaque-Spherical (BSS) and explanted (17 +/- 3 yrs) BSD valves (25, 27, and 29 mm) were studied in a pulse duplication system. The regurgitant leakage volume of the valves was measured with an electromagnetic flow probe at flow rates of 3.0, 5.0, and 7.0 L/min, a pulse rate of 70 beats/min, and a mean systemic pressure of 100 mmHg. Color-Doppler flow mapping was performed with a 3.7 MHz transducer positioned on the atrial chamber at an image depth of eight centimeters. The maximal regurgitant jet areas were measured offline and averaged from three beats. RESULTS: Maximal jet area, measured with color-Doppler flow mapping, correlated with regurgitant leakage volume (r = 0.82). Normal unimplanted and explanted BSD valves had greater regurgitant leakage volumes and jet areas than BSS valves for all sizes and flow rates studied. Regurgitant jet areas of normal unimplanted and explanted BSD valves were similar. CONCLUSION: Knowledge of the type of Björk-Shiley valve is important in the clinical evaluation of regurgitation severity by transesophageal echocardiography. The echocardiographic appearance of regurgitation of BSD valves does not necessarily imply valve dysfunction.

Blood Flow Velocity↗
PubMed1994

Quantification of left ventricular function with an automated border detection system and comparison with radionuclide ventriculography.

Quantification of 2-dimensional echocardiograms with a recently developed automated border detection (ABD) system provides on-line estimation of left ventricular (LV) function. Previous studies showed that short-axis cavity area measurements with the ABD system approximate manually traced cavity areas obtained with conventional 2-dimensional echocardiography. Further clinical validation needs a comparison of LV function between the ABD system and established methods. Fractional area change and ejection fraction measured by the ABD system were compared with ejection fraction measured by radionuclide ventriculography. Echocardiographic measurements were obtained from LV short-axis views at the level of the papillary muscles. Calculation of ejection fraction by the ABD system was based on an algorithm using a modified ellipsoid model. Forty-six patients underwent echocardiography on the same day as radionuclide ventriculography. Patients were included in the study if > or = 75% of the endocardium was visualized with conventional 2-dimensional echocardiography. Twenty-seven of 46 patients (59%) had a technically adequate, conventional echocardiogram. Fractional area change with the ABD system was highly correlated with ejection fraction from radionuclide ventriculography (r = 0.92; SEE 8.4%). Ejection fraction determined by the ABD system and radionuclide ventriculography also showed a strong linear relation in the 23 patients without severe wall motion abnormality (r = 0.90; SEE 9.5%). It is concluded that LV function measurements by the ABD system and radionuclide ventriculography have a strong linear relation.

Adolescent↗
PubMed1994

Detection of cardioembolic sources with echocardiography.

Cerebral ischemic events remain a common cause of morbidity and mortality in the United States. Although the majority of patients with strokes have cerebrovascular disease, up to 20% of stroke patients have a cardioembolic source, especially younger patients or those with associated cardiac disease. TTE offers limited potential for identifying a cardioembolic source. In contrast, TEE is superior in detecting most cardioembolic sources and should be considered in stroke patients in whom there is a high clinical suspicion for a cardiac source of embolus and whose TTE is technically difficult or negative (Table 3).

Echocardiography↗