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Biomedical subjects

S Mattleman

Publications and source records attributed to S Mattleman.

12 recordsLinked to original sources
PubMed1984

Effects of angiographic contrast medium on left ventricular function: evaluation by contrast angiography and radionuclide angiography.

The purpose of this study was to evaluate the effect of angiographic contrast medium on left ventricular (LV) function in 26 patients undergoing diagnostic cardiac catheterization. Beat-by-beat analysis during contrast ventriculography showed that the ejection fraction (EF) was lower in the last beats than in the first beats (P less than .02). Radionuclide angiograms were obtained the day before, as well as 15 to 65 minutes after catheterization, which included contrast ventriculography and coronary anteriography. The EF by radionuclide angiography was lower after catheterization than before (43 +/- 14% vs 47 +/- 17%, P less than .01). The EF decreased by greater than or equal to 5% in 11 of the 26 patients (42%) after catheterization. The decrease in EF in some patients was observed up to 65 minutes after catheterization and was not associated with symptoms or ST-T changes. The EF decreased in only one of nine patients who received nitroglycerin during catheterization, whereas it decreased in 10 of 17 patients who did not receive nitroglycerin (P less than .05). The EF decreased in 9 of 14 patients (64%) who had normal resting LV function, whereas it decreased in only 2 of 12 patients (17%) who had abnormal resting function (P less than .05). Thus, contrast material may depress LV function up to 1 hr and is more frequent in patients with normal resting EF. The use of nitroglycerin during catheterization may mask this effect.

Adult↗
PubMed1984

Cardiac function in hyperthyroidism.

It is accepted that thyroid hormones, thyroxine and tri-iodothyronine have direct inotropic and chronotropic effects on the heart. However, the mechanisms of manifestations are still uncertain. The following discusses and evaluates some of the theories regarding the interaction of these hormones with cardiac function.

Adult↗
PubMed1984

Calcification of the tricuspid anulus diagnosed by two-dimensional echocardiography.

An 84-year-old female who previously underwent repair of an atrial septal defect had evidence of increased reflectiveness of the posterior tricuspid anulus in the apical four-chamber view and the right ventricular two-chamber view. In addition, the inferior vena cava was dilated and during contrast echocardiography, contrast echoes appeared during systole suggesting tricuspid regurgitation. Tricuspid annular calcification was confirmed by fluoroscopic examination. Tricuspid annular calcification is extremely rare and in the present series occurred in 1 of 80 patients with mitral annular calcification. Lateral resolution echoes from a calcified aortic valve and echoes originating from a calcified right coronary artery have to be distinguished from tricuspid annular calcification.

Aged↗
PubMed1984

Prognostic implications of rest and exercise radionuclide ventriculography in patients with suspected or proven coronary heart disease.

Rest and exercise radionuclide ventriculography were assessed for their value in predicting major cardiac events in patients with chest pain. Of 219 patients who were followed for up to 51 months, 42 had major cardiac events: 12 patients (5.5%) died, 5 (2.2%) sustained nonfatal myocardial infarction, and 25 (11.4%) had coronary arterial bypass grafting. Univariate and multivariate survival analysis revealed that exercise left ventricular ejection fraction was the best predictor for total major events and the resting ejection fraction to be the best predictor for death or nonfatal myocardial infarction. These two variables were strong predictors in the entire group of patients and in subgroups: patients with or without Q-wave infarction, patients with high probability of coronary artery disease and those with abnormal resting left ventricular function. Thus, radionuclide angiography provides important prognostic data that permits the physician to categorize patients with chest pain syndromes with respect to subsequent cardiac events. If validated, this model or a modification of it could identify patients at high risk of subsequent major cardiac events who are candidates for intensive follow up and therapy or further invasive evaluation, as well as patients at low risk of subsequent major cardiac events for whom standard follow up would be appropriate.

Angiography↗
PubMed1984

Resting kinetics of thallium-201 in patients with coronary artery disease.

The thallium washout was analyzed in 40 patients with angiographically documented CAD, using circumferential time-activity profiles of the initial and four-hour delayed images. A net washout pattern (fewer counts in delayed images than initial images) was observed in the distribution of normal and diseased vessels. A negative washout (wash-in) (a net increase in counts in the four-hour delayed images) was observed only in the presence of diseased vessels, even if the initial scans were normal. Quantitative analysis of thallium kinetics was shown to be important in rest images, and should be performed even if the initial images appear normal.

Adult↗
PubMed1983

Hemodynamic, angiographic and scintigraphic correlates of positive exercise electrocardiograms: emphasis on strongly positive exercise electrocardiograms.

The results of treadmill exercise electrocardiograms were analyzed in 179 patients with coronary artery disease (greater than or equal to 50% diameter narrowing of one or more vessels). Exercise thallium-201 images were available in 141 of these patients. The exercise electrocardiograms were strongly positive in 51 patients, mildly positive (1 to 1.9 mm ST depression) in 28 patients, falsely negative in 23 patients and uninterpretable in 77 patients. The degree of exercise-induced ST depression did not correlate with left ventricular function, extent of coronary artery disease, exercise heart rates and rate-pressure product and extent of exercise-induced thallium-201 perfusion abnormality. However, the presence of a strongly positive exercise electrocardiogram only at heart rates of 140 beats/min or more or stage III or higher of the Bruce protocol was predictive of less extensive coronary disease and perfusion abnormalities. Thus, the magnitude of ST depression as such during exercise is not predictive of the extent of coronary disease, even in patients with 3 mm or greater ST depression. However, a strongly positive exercise electrocardiogram in the first two stages of the Bruce protocol or at a heart rate of less than 140 beats/min was related to the extent of coronary artery disease and impaired myocardial perfusion, and identified patients with more extensive coronary artery disease and jeopardized myocardium. Therefore, caution should be used in interpreting prognostic data on the basis of the degree of exercise-induced ST depression alone.

Adult↗