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Biomedical subjects

T Riggs

Publications and source records attributed to T Riggs.

31 records · Page 2Linked to original sources

Spectral analysis of the normal electrocardiogram in children and adults.

We performed spectral analysis of the X-lead Frank VCG from six normal adults (Group A) and eight normal children (Group B) using a Fast Fourier Transform. The Group A magnitudes were consistently and significantly lower than Group B in the 20--90 Hz region. Similarly, the -40 dB point was 75 Hz for Group A and 107 Hz for Group B. The P waves of the two groups had similar spectra, as did their T waves. When the entire cardiac cycle was analyzed, there was again a consistent and significant difference in the frequencies from 25--80 Hz. Despite the significant differences in the Group A and B spectra, the vast majority of the information contained in the ECG signal was confined to frequencies below 100 Hz. Therefore, a bandwidth of 100 Hz is probably adequate for accurate recording of the ECG signal from children, as well as from adults.

Adult↗

Echocardiographic abnormalities in infants of diabetic mothers.

In order to evaluate the presence of myocardial hypertrophy and/or abnormalities of postnatal cardiovascular adaptation, echocardiograms were performed on 34 infants of diabetic mothers. Based on cardiopulmonary assessment, the IDM were divided into three groups: Group I with congestive heart failure predominating: Group II with respiratory distress predominating: Group III asymptomatic. Hypertrophy of the interventricular septum and of the walls of left and right ventricles was frequently present in IDM: this change was most notable in association with clinical CHF. Six IDM, four of whom were found to have CHF, had additional echocardiographic signs of subaortic stenosis. All IDM had normal indices of left ventricular performance, despite the presence of CHE. In IDM with respiratory distress, the right ventricular pre-ejection period to ventricular ejection time ratio was elevated, suggesting an abnormality of the transitional pulmonary circulation. Poor maternal diabetes control and maternal systemic hypertension were closely correlated with evidence of myocardial hypertrophy in the infants.

Birth Weight↗

Ventricular septal defect in infancy: a combined vectorgraphic and echocardiographic study.

Echocardiograms (echo) and vectorcardiograms (VCG) from 40 infants with ventricular septal defects (VSD) were compared with cardiac catheterization data to assess noninvasively the hemodynamics of VSD. The specific aim was to use VCG parameters of right ventricular hypertrophy and echo parameters which reflect pulmonary artery pressure to identify all patients with a nonrestrictive VSD. The configuration of the QRS vector in the horizontal plane was more reliable than individual voltages in assessing right ventricular systolic pressure. Among patients older than 2 months with a clockwise or anterior two-main-vector horizontal loop, 73% (eight of 11) had a nonrestrictive VSD. However, a counterclockwise or posterior two-main-vector loop was also frequently found (43%, six of 14) in infants with a nonrestrictive VSD. The most useful echo parameter was the ratio of right ventricular preejection period-to-right ventricular ejection time (RPEP/RVET), which closely (r = 0.74) reflected the pulmonary artery diastolic pressure. An elevated RPEP/RVET to greater than 0.30 was always associated with a nonrestrictive VSD, although many patients (36%, five of 14) with a nonrestrictive VSD had a normal ratio. By combining both echo and VCG parameters, a nonrestrictive VSD was correctly identified in all patients, while a restrictive VSD was correctly identified in 81% (21 of 26).

Cardiac Catheterization↗

Echocardiographic estimation of ventricular hypoplasia in complete atrioventricular canal.

Echocardiograms from 10 patients with complete atrioventricular canal (CAVC) were compared with autopsy specimens to determine the capabilities of echocardiography in identifying patients with ventricular hypoplasia. On the basis of echographic ventricular size, patients could be divided into three groups: 1) "balanced" CAVC patients had both increased right and left ventricular end-diastolic dimensions (RVED and LVED) and an increased RVED/LVED ratio; 2) "dominant left ventricular" CAVC patients had an increased LVED and small or normal RVED and a diminished RVED/LVED ratio; 3) "dominant right ventricular" CAVC patients had an increased RVED, but small LVED, and increased RVED/LVED. There was complete agreement between echographic ventricular dominance and pathologic findings. This study demonstrates that echocardiography may be valuable in assessing ventricular dominance in the presence of CAVC.

Child, Preschool↗

Assessment of the pulmonary vascular bed by echocardiographic right ventricular systolic time intervals.

Echocardiography was used to measure right ventricular systolic time intervals (RVSTI) in 85 normal children (group I) and in 229 patients undergoing cardiac catheterization (group II). Corrected right ventricular pre-ejection period (RPEPC) and right ventricular ejection time (RVETc) (based on regression analysis of group I) and RPEP/RVET were each correlated with pulmonary artery (PA) diastolic and mean pressures and pulmonary vascular resistance (PVR). The best correlation (0.83) was between a second degree polynomial of the RPEP/RVET and PA diastolic pressure. The RPEP/RVET allowed prediction of PA diastolic pressure within 10 mm Hg in 85% of the patients. The utility of RPEP/RVET was confirmed in sequential data of 22 patients, in whom alteration in RPEP/RVET accurately reflected the changing PA diastolic pressure. The RPEP/RVET could not be used to assess PA pressure in six patients with congestive cardiomyopathy nor in 18 patients with complete right bundle branch block (CRBBB).

Adolescent↗

Echographic ventricular systolic time intervals in normal term and preterm neonates.

Right ventricular and left ventricular systolic time intervals (RVSTIs and LVSTIs) were measured in normal term and preterm infants from 1 hour to 90 days of life. LVSTIs in both term and preterm infants were similar in the first five days of life. The ratio of left pre-ejection period (LPEP) to left ventricular ejection time (LVET) was lower in preterm infants older than age 5 days. Estimated gestational age had no influence on LVSTI. The ratio of right pre-ejection period (RPEP) to right ventricular ejection time (RVET) was lower in preterm infants (0.32) than in term newborns (0.37). The preterm RPEP/RVET ratio decreased with age, but at a slower rate than in term babies. This was consistent with the lower pulmonary vascular resistance present in preterm infants.

Echocardiography↗

Persistence of fetal circulation syndrome: an echocardiographic study.

Serial echocardiograms were performed on 17 infants with persistence of fetal circulation syndrome to measure right ventricular systolic time intervals from pulmonic valve echograms and left ventricular systolic time intervals from aortic valve echograms. Right ventricular pre-ejection period/right ventricular ejection time ratio was prolonged in PFCS when compared to that in normal newborn infants, and diminished with clinical improvement. Left ventricular pre-ejection period/left ventricular ejection time ratio was prolonged in infants with PFCS. Echographic RPEP/RVET was consistent with the elevated pulmonary artery pressure and pulmonary vascular resistance of PFCS; elevated LPEP/LVET suggested left ventricular dysfunction.

Blood Circulation↗

Neonatal circulatory changes: an echocardiographic study.

Serial echocardiograms were performed in the first three days of life on 38 normal full-term infants. Right ventricular systolic time intervals were measured from the pulmonic valve echogram and left ventricular systolic time intervals were determined from the aortic valve echogram. The heart rate, left ventricular pre-ejection period (LPEP), left ventricular ejection time (LVET), and LPEP/LVET ratio showed insignificant variation with increasing postnatal age. The right ventricular pre-ejection period (RPEP) shortened, the right ventricular ejection time (RVET) lengthened, and the RPEP/RVET ratio decreased with increasing age. The findings suggested that alterations in the RPEP/RVET ratio reflected the decreasing pulmonary artery diastolic pressure and pulmonary vascular resistance of the early neonatal period and may be valuable in the noninvasive evaluation of the newborn's pulmonary vascular bed.

Age Factors↗

Respiratory distress syndrome: echocardiographic assessment of cardiovascular function and pulmonary vascular resistance.

Echocardiograms were performed for 82 preterm infants comprising 22 normal infants, 29 with mild respiratory distress syndrome (RDS), and 31 with severe RDS. Left ventricular systolic time intervals were measured from aortic valve echograms and right ventricular systolic time intervals from pulmonic valve echograms. Left ventricular performance seemed to be altered early in postnatal adaptation of preterm infants, but played no demonstrable role in the outcome of RDS. The right ventricular preejection period/right ventricular ejection time (RPEP/RVET) ratio was prolonged in 17 out of 31 patients with severe RDS, consistent with increased pulmonary vascular resistance or right ventricular dysfunction. Prolonged RPEP/RVET identified a subgroup with increased mortality and morbidity.

Echocardiography↗

In utero diagnosis of pericardial tumor with successful surgical repair.

A large intrapericardial tumor with pericardial effusion was diagnosed by ultrasound examination in a 32-week gestation fetus. Serial in utero examinations excluded fetal hydrops and normal labor ensued at 38 1/2 weeks. After delivery by Caesarian section, pericardiocentesis and subsequent successful surgery were performed. The tumor was found to be a cavernous hemangioma arising within the pericardium and adherent to the right atrial wall.

Adult↗

Spontaneous closure of atrial septal defects in premature vs. full-term neonates.

Our hypotheses were that the following factors influenced closure of atrial septal defects (ASDs) detected in neonates: estimated gestational age (EGA), the presence of a persistent ductus arteriosus (PDA), severity of pulmonary disease, gender, and the initial size of the ASD. Our population consisted of 82 newborns (38 premature and 44 term) who were found before the age of 1 month to have an ASD. Closure of ASDs was analyzed using both Kaplan-Meier survival analysis and the Cox proportional hazards model, each with the five covariates. The hazard ratio (or ratio of instantaneous closure rates) of term vs preterm infants was 3.60 (95% CI = 1.80-7.20), whereas the hazard ratio for infants with a PDA (compared to infants with no PDA) was 2.41 (95% CI = 1.28-4.54). Multivariate analysis showed that each of these terms (PDA and EGA) were independent predictors of ASD closure. The hazard ratio of ASD closure for each of four levels of pulmonary disease was 0.632 [95% CI = 0.453-0.881]. We conclude that the majority of neonatal ASDs will close, with EGA and PDA acting as important influences on closure.

Chi-Square Distribution↗