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Biomedical subjects

R J Ferguson

Publications and source records attributed to R J Ferguson.

At least 55 records · Page 3Linked to original sources
PubMed1982

Skeletal muscle and cardiac changes with training in patients with angina pectoris.

Cardiovascular and skeletal muscle adaptations were studied before and after 6 mo of physical training in patients with coronary artery disease and exertional angina pectoris. Symptom-limited exercise capacity increased by 41% (470 +/- 30 to 665 +/- 35 kg.m.min-1; n = 29, P less than 0.001) with training as did skeletal muscle succinate dehydrogenase activity (1.75 +/- 0.24 to 3.31 +/- 0.24 IU; n = 23, P less than 0.001) and the areas of muscle fibers (type I from 43.6 +/- 3.3 to 54.4 +/- 3.3 micrometers 2 X 10(2); n = 21, P less than 0.05 and type II from 43.9 +/- 2.4 to 57.2 +/- 5.1 micrometers 2 X 10(2); P less than 0.01). At the same submaximal exercise intensity (mean 355 +/- 100 km.m.min-1), plasma catecholamines (1.31 +/- 0.14 to 1.07 +/- 0.09 ng.ml-1; n = 13, P less than 0.05), heart rate (115 +/- 3 to 97 +/- 3 beats/min; n = 29, P less than 0.001), and systolic blood pressure (171 +/- 4 to 143 +2- 4 mmHg; n = 29, P less than 0.001) were significantly reduced after training. Maximal coronary sinus blood flow (192 +/- 10 to 208 +/- 9 ml.min-1; n = 29, P less than 0.05) and left ventricular oxygen consumption (23.2 +/- 1.5 to 25.8 +/- 1.6 ml.min-1; n = 24, P less than 0.05) were increased by 8 and 11%, respectively, after training. The improvement in exercise capacity with training in patients with exercise is secondary to a reduction in myocardial oxygen requirements during subangina levels of exercise and partly to a small increase in maximal myocardial oxygen consumption. The skeletal muscle adaptations with training were not related to other indices of training such as the reduced exercise heart rate or increased symptom-limited exercise capacity.

Adult↗
PubMed1982

Diagnostic accuracy of exercise ECG lead systems in clinical subsets of women.

The diagnostic accuracy of 14-lead exercise electrocardiography was evaluated in 112 women who had no history of myocardial infarction and underwent coronary angiography. The sensitivity of ST-segment displacement of 0.1 mV or more in any of 14 ECG leads was 0.79 for coronary artery stenosis of at least 70%; the specificity was 0.66. Results were similar using bipolar ECG leads CC5 and CM5 or 11 standard ECG leads. The ST-segment shifts that occurred only during exercise were associated with a 77% false-positive rate (10 of 13). Downsloping ST-segment depression did not provide more diagnostic information than horizontal ST-segment depression in the three clinical subsets of women. In women with typical angina pectoris, ST-segment depression of at least 0.15 mV for 0.08 second after the J point or a final treadmill time less than 360 seconds was predictive of proximal left or multivessel coronary artery disease. In the women with probable angina or nonspecific chest pain, this finding was not of diagnostic value. ST-segment elevation of 0.1 mV or more in leads V1-2 or a VL predicted proximal stenosis of at lest 80% in the left anterior descending coronary artery in all six women with typical angina pectoris. Maximal exercise testing in women with typical angina provides important diagnostic information when 11 standard ECG leads are recorded. In women with probable angina or nonspecific chest pain, diagnostic exercise testing is less useful and bipolar leads CC5 and CM5 are sufficient for most clinical purposes.

Adult↗
PubMed1982

Increased exercise tolerance and reduced electrocardiographic ischemia with diltiazem in patients with stable angina pectoris.

Diltiazem is a calcium slow-channel blocking drug that may be effective in the treatment of chronic stable angina pectoris. To evaluate the therapeutic efficacy 3 hours after a single oral dose of 120 mg, 12 men with chronic stable angina pectoris performed a maximal exercise test on a bicycle ergometer after ingesting either placebo or diltiazem administered in a double-blind fashion. During submaximal exercise at a fixed work load, diltiazem decreased the average heart rate response from 119 +/- 17 to 107 +/- 14 beats/min (p less than 0.01), systolic blood pressure from 182 +/- 15 to 175 +/- 15 mm Hg (p less than 0.05) and the rate-pressure product from 21.8 +/- 4.2 to 18.8 +/- 3.2 x 10(-3) units (p less than 0.01). The average submaximal work load at which significant ST-segment depression (0.1 mV) first appeared was increased from 355 +/- 142 to 525 +/- 143 seconds (p less than 0.01) after diltiazem. At peak exercise after diltiazem, the average depth of ST-segment depression in any one lead and the extent of myocardial ischemia observed in all 12 ECG leads were decreased (p less than 0.01), even though the average work load was increased by 29% (p less than 0.01). Peak heart rate, systolic blood pressure and rate-pressure product were similar with placebo and diltiazem. The plasma diltiazem concentration was 13.9 +/- 29 ng/ml 3 hours after ingestion and was significantly (p less than 0.05) related to the increased time to the onset of important ST-segment depression (r = 0.65) and to the decrease in the extent of myocardial ischemia observed in all 12 ECG leads (r = -0.61) compared with placebo. Thus, diltiazem is effective in treating chronic stable angina pectoris. It decreases myocardial oxygen requirements during upright exercise and appears to increase myocardial oxygen delivery.

Angina Pectoris↗
PubMed1982

Skeletal muscle adaptation in adolescent boys: sprint and endurance training and detraining.

The purpose of the present study was to investigate the effects of 3-month sprint and endurance training programs on the vastus lateralis muscle fiber area and the activities of glycolytic (phosphofructokinase; PFK) and oxidative (succinate dehydrogenase; SDH) enzymes of adolescent boys. Enzyme activities were also determined after a subsequent 6-month detraining period. Endurance training resulted in significant increases in VO2max (58.4 to 64.3 ml . min-1 . kg-1), in ST and FTa fiber area (6.0 to 7.3 and 8.0 to 10.4 microns 2 x 10(3), respectively), and in SDH activity (6.4 to 9.1 IU). After detraining VO2max and SDH activity returned to pretraining levels. Sprint training resulted in a significant increase only in PFK activity (28.1 to 33.9 IU), which was also abolished in the detraining period. These data demonstrate that in adolescent boys skeletal muscle enzyme changes are specific to the mode of training and that they are similar in direction but different in magnitude to those found in adults.

Adolescent↗
PubMed1982

Left ventricular size following endurance, sprint, and strength training.

Left ventricular size following endurance, sprint, and strength training. Med. Sci. Sports Exercise, Vol. 14, No. 5, pp. 344-347, 1982. Left ventricular dimensions in adolescent boys were determined before and after three types of training regimens: endurance (END), N = 8, means = 16.8 yr; sprint (SPR), N = 8, means = 16.3 yr; strength (STR), N = 12, means = 18.7 yr. With training the END group significantly increased VO2max in 1 X min-1 (3.71 +/- 0.27 to 4.16 +/- 0.57, P less than 0.05) and in ml X min-1 X kg-1 (58.4 +/- 5.6 to 64.2 +/- 5.5, P less than 0.05). The SPR group increased VO2max in 1 X min-1 (3.63 +/- 0.63 to 3.98 +/- 0.78, P less than 0.05) but not in ml X min-1 X kg-1 (59.5 +/- 4.1 to 63.2 +/- 5.4) because body weight increased from 61.2 +/- 10.5 to 63.1 +/- 10.7 kg (P less than 0.05) with no change in percent body fat. The STR training group significantly improved upper body strength. Despite these specific training adaptations no significant modifications were found for interventricular and left ventricular posterior wall thickness or for left ventricular internal diameter in either training group. However, calculated left ventricular mass was slightly but significantly higher by 10% and 4% in the END and STR training groups, respectively. These small increases in calculated left ventricular mass with short-term training are probably caused by small but insignificant increases in left ventricular internal diameter secondary to a training bradycardia (END group: 76 +/- 8 to 64 +/- 1 beats X min-1) and to increased diastolic filling time rather than to true cardiac hypertrophy. Significant increases in aerobic capacity and in strength can occur without modification of left ventricular dimensions.

Adolescent↗
PubMed1981

Giant serpentine intracranial aneurysm.

Giant serpentine aneurysms are considered a distinct subgroup of giant aneurysms because of their characteristic angiographic appearance and clinical behavior. A case of this unusual vascular abnormality showing progressive enlargement documented by computed tomography and cerebral angiography is presented, along with a review of the literature. Etiology, pertinent radiological findings, and a probable mechanism of serpentine channel formation are discussed.

Adult↗
PubMed1980

Exercise capacity, residual abnormalities and activity habits following total correction for tetralogy of Fallot.

The maximal oxygen consumption (VO2 max) of 68 patients, at a mean of 5.6 years after total correction for tetralogy of Fallot, was lower than that of normal subjects (36.3 +/- 7.5 and 43.1 +/- 9.0 ml/kg-min). At the time of treadmill evaluation only the female patients were less active in daily life than the normals. Patients having had an elevated right ventricle to pulmonary artery resting systolic pressure gradient, evaluated at a mean of 2.2 years after surgery, had lower VO2 max than those with lesser residual gradients (34.7 +/- 7.2 and 38 +/- 7.3 ml/kg-min). No significant differences in VO2 max were found between patients with none or slight versus moderate to severe pulmonary regurgitation as well as between patients with and without a residual left-to-right ventricular shunt.

Activities of Daily Living↗
PubMed1979

Lidoflazine and physical training in the treatment of stable angina pectoris.

An additive effect in the treatment of angina pectoris by combining lidoflazine and physical training was postulated. Twenty-four patients were randomly divided into placebo and drug groups and subsequently underwent a 6-month physical training program. The drug group had a significantly greater reduction in submaximal heart rate than the placebo group. Similar improvements in symptom-limited exercise capacity were observed in both groups. Resting and maximal exercise coronary sinus blood flow and left ventricular oxygen consumption were not significantly changed with training in either group. Physical training and lidoflazine appear to influence exercise tolerance in the same manner.

Angina Pectoris↗
PubMed1978

Improved efficiency of treadmill exercise testing using a multiple lead ECG system and basic hemodynamic exercise response.

One hundred consecutive men with a normal ECG at rest had a maximal treadmill test using 14 leads during and post-exercise. Coronary arteriography performed the following day revealed coronary stenoses greater than or equal to 70% in 66 patients. Test results obtained from a V5 lead were compared to different lead combinations and were correlated with arteriographic findings. A positive exercise test occurred in 37 men using an isolated V5 lead compared to 50 men (P less than 0.05) using 11 leads, 52 men (P less than 0.05) using a combined CM5, CC5, Cl (inferior) lead system and 58 (P less than 0.001) men using all 14 leads. The predictive value of a positive test varied between 89-95% and was not changed significantly by the addition of multiple leads. The 14 lead ECG was positive in 43/45 (96%) patients with multivessel disease. Parameters which helped to predict multivessel disease using 14 leads were 1) the time that ischemia first appeared 2) the pressure-rate product at the time ischemia first appeared, and 3) the maximum workload that could be attained. In general, the magnitude of ST-segment depression and the time required for a positive ECG to return to normal postexercise were not useful predictors of multivessel disease. We conclude that the use of multiple leads improves the sensitivity and efficiency of the maximal treadmill exercise test. The usefulness of exercise test results can be further improved if multiple leads are combined with physiologic data collected during exercise.

Adult↗
PubMed1977

External counterpulsation: coronary hemodynamics and use in treatment of patients with stable angina pectoris.

External pressure counterpulsation (ECP) has been reported to improve the clinical status of patients with angina pectoris. To document the mechanisms for such an improvement left ventricular oxygen consumption and lactate metabolism, coronary sinus blood flow, and cardiac index were studied in 10 patients with angina pectoris 1) prior to and during ECP; and 2) during right atrial pacing before and after 4 consecutive 2-hour sessions of ECP treatment. During ECP peak early and mean arterial diastolic pressures were significantly raised above control values by 32 and 13% respectively. However, coronary sinus blood flow, left ventricular oxygen consumption and left ventricular lactate extraction, mean systolic arterial pressure and cardiac index were not significantly altered by ECP. Right atrial pacing at 140 beats/min increased coronary sinus blood flow 70% over control values and induced angina and ischemic ST segment changes in 8 patients before and after 4 consecutive treatments of ECP. ECP treatment did not significantly modify the above metabolic and hemodynamic responses at rest or during atrial pacing. Although 5 patients reported improvement in angina symptoms the effect was transitory. No significant improvement over pre ECP-treatment exercise angina threshold was observed immediately following or at 1 and 3 months post treatment. This method of noninvasive circulatory assistance appears to be of doubtful value in the management of patients with stable angina pectoris.

Adult↗
PubMed1977

Catecholamines in coronary sinus during exercise in man before and after training.

Coronary patients exercised on an ergometric bicycle before and after physical training. Plasma catecholamines were sampled simultaneously at the arterial and coronary sinus levels and assayed with a radioenzymatic method. The increase in the level of coronary sinus catecholamines exceeded the increase in the arterial level, indicating a liberation of catecholamines by the myocardium and an activation of the peripheral sympathetic fibers during exercise. With high work loads, these values no longer differed, suggesting that the additional increase in circulating catecholamines originate from extra-myocardial stores, presumably the adrenal medulla. Arterial catecholamine levels were significantly correlated with work loads, heart rate, changes in systolic blood pressure, and rate-pressure product. After physical training, arterial catecholamine increases for various work loads were lower; these lower elevations were associated with diminished responses in heart rate and systolic blood pressure, resulting in a lower rate-pressure product. Physical training results in diminished sympathetic responses for a given level of exercise, which could be associated with the clinical improvement of these patients.

Adult↗