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Biomedical subjects

V S Mathur

Publications and source records attributed to V S Mathur.

At least 19 recordsLinked to original sources
PubMed1979

Clinical standardization of the new dual cardiac probe.

A new mobile dual cardiac probe has been introduced for measurements of the left ventricular ejection fraction (LVEF). In 28 patients, correlation between LVEFs measured by the dual probe and biplane contrast ventriculography was 0.83. Central and peripheral injections yielded comparable curves, and the resultant LVEFs correlated well (R = 0.95). Correlation between LFEVs determined by the probe and by gated blood pool imaging in 43 patients was also 0.83. In 21 patients given three serial injections of 99mTc-albumin, the mean variation of the ejection fraction was 4.2 +/- 3.2%; however, reproducibility was unsatisfactory using 99mTc-sulfur colloid due to sequestration in hepatic background tissue.

Heart Ventricles↗
PubMed1979

Scintigraphic, electrocardiographic, and enzymatic diagnosis of perioperative myocardial infarction in patients undergoing myocardial revascularization.

To assess the incidence of perioperative myocardial infarction, 214 consecutive patients were evaluated 1-5 days after coronary bypass surgery, using Tc-99m pyrophosphate (TcPPi) myocardial imaging, serial electrocardiograms (ECG), and enzyme levels (SGOT, LDH, CPK). On the basis of the clinical course and scintigraphic, enzymatic, and ECG changes, the diagnosis of perioperative infarction was definite in 17 of 241 cases (7.9%) and probable in six of 241 (2.8%). In all of these 23 patients, TcPPi scans were abnormal; one additional patient had a false-positive scintigram. Only 13 of the 23 had ECG evidence of infarction, but there were no false positives. We set the threshold for abnormality of enzyme changes quite high, owing to experience in more than 900 postoperative patients (SGOT greater than 200, LDH greater than 500, CPK greater than 500 on the same day). Using these criteria, 22 of the 23 infarct patients had abnormal enzymes, and six others were falsely positive. These results indicate a relatively low sensitivity for the ECG in diagnosing perioperative infarction, but the lack of false positives suggests high specificity. The sensitivity and specificity of the enzymes and the TcPPi image were both excellent and quite similar; the main difference was a reduction of certainty of infarction with the enzyme criteria, caused by the six patients whose enzyme values were falsely positive. Considering its sensitivity, specificity, and ability to locate and to a certain extent quantitate necrosis. TcPPi imaging is probably the most valuable means of diagnosing perioperative myocardial infarction.

Clinical Enzyme Tests↗
PubMed1978

Is the treadmill exercise test useful for evaluating coronary artery disease in patients with complete left bundle branch block?

To aid in the study of coronary artery disease, 57 patients with complete left bundle branch block underwent clinical evaluation, treadmill exercise testing and cardiac catheterization. The patients were classified into two groups according to coronary angiographic findings: 30 patients with significant stenosis (70 percent or greater luminal narrowing) of at least one major vessel and 27 with no significant coronary artery disease. There was no difference in age, presenting symptoms or previous medical treatment between the two groups. There were more men in the group with coronary artery disease. Exercise-induced S-T changes were similar in the two groups; the sensitivity and specificity of these changes for the diagnosis of coronary artery disease were unacceptable irrespective of the criterion chosen. With additional S-T depression of either 1 or 2 mm below the baseline value, the predictive accuracy was only 53 percent. Combined exertional chest pain and 1 mm S-T depression increased the predictive accuracy of exercise testing to 71 percent. These data indicate that exercise-induced electrocardiographic changes do not facilitate detection of coronary artery disease in patients with complete left bundle branch block.

Angina Pectoris↗
PubMed1978

Late deterioration in tetralogy of Fallot: unusual findings and successful correction.

A patient with tetralogy of Fallot who underwent a successful Blalock shunt procedure as a child was evaluated 28 years later because of clinical deterioration. Results of cardiac catheterization and angiography disclosed, in addition to a functioning shunt, evidence of an infundibular, subvalvular tumor and a large anastomosis between the left circumflex coronary artery and the bronchial arteries of the right lung with the possibility of "coronary steal". At operation, the Blalock and coronary-to-bronchial artery anastomoses were ligated; and total correction was performed including resection of the pulmonary valve and infundibulum, excision of the tumor, closure of the ventricular septal defect, and application of an outflow patch to enlarge the pulmonary annulus. The patient was discharged nine days after surgical correction.

Adult↗
PubMed1977

The clinical significance of atrial pacing-induced Mobitz I atrioventricular block in patients with coronary artery disease.

Two hundred consecutive patients with a history of chest pain undergoing cardiac catheterization, coronary angiography and atrial pacing have been analyzed to assess the clinical significance of Mobitz I atrioventricular (A-V) block developing with the stress of atrial pacing. Of 160 patients with coronary artery disease, 26 (16%) developed Mobitz I A-V block at rates below 140 beats/min. Eighteen of these 26 patients (69%) had electrocardiographic evidence of old inferior wall myocardial infarction, compared to only 34 of the remaining 134 patients (29%) (P = less than 0.01). During the mean follow-up of 29.5 months (range 18-50 months) none of the 26 patients has developed spontaneous second or third degree A-V block. Twenty-three of the 26 patients had an exercise test within one week of the pacing study. No A-V block was noticed during or immediately following exercise, although the mean heart rate attained during exercise was higher than the mean pacing rate at which the A-V block occurred (136 +/- 5 vs 122 +/- 3, P = less than 0.01). Eighteen of these 23 achieved heart rates equal to or higher than the pacing rate at which A-V block developed. Nineteen (83%) shortened their P-R interval during exercise and 4 (17%) did not change the P-R length. Although atrial pacing-induced Mobitz I A-V block may indicate a latent A-V nodal conduction abnormality in some cases, its demonstration does not necessarily predict the occurrence of spontaneous advanced A-V block. Exercise should not be restricted in these patients on the basis of such a finding during a pacing study.

Atrioventricular Node↗
PubMed1977

Pharmacokinetic study of antipyrine in malnourished children.

Plasma half-life and metabolic clearance rate of antipyrine administered intravenously in a dose of 16 mg/kg body weight was studied in 10 children suffering from protein calorie malnutrition and five normal children matched in age and sex. Plasma half-life was increased and metabolic clearance rate was decreased in malnourished children (10.4 hr and 47.1 ml/hr per kg, respectively) in comparison to controls (6.3 hr and 70.1 ml/hr per kg, respectively). This observation indirectly reflects the lowered activity of microsomal oxidative enzyme of liver. Five children were restudied after nutritional rehabilitation of 17 to 25 days. Antipyrine plasma half-life decreased to 6.6 hr and metabolic clearance rate increased to 66.5 ml/hr per kg. These values were similar to those in normal children indicating biological recovery. The drug therapy in children with protein calorie malnutrition requires reconsideration in light of these observations.

Antipyrine↗