Search PubMed⌕ Search

Biomedical subjects

D Sapoznikov

Publications and source records attributed to D Sapoznikov.

At least 73 records · Page 4Linked to original sources
PubMed1985

Can total coronary occlusions be predicted from a previous coronary arteriogram?

We studied the site, severity, and coronary angiographic morphology of coronary lesions and their ability to predict progression of coronary narrowing and obstruction of coronary arteries. Twenty-six patients who had 94 lesions at the time of first angiography were followed for a mean of 29 +/- 17 (SD) months. Progression of disease or obstruction of a vessel occurred in 11 lesions (12%): eight new total obstructions (8.5%) and three subtotal (3%). Narrowings of greater than 75% of the luminal diameter were more likely to become totally obstructed than less severe narrowings (P = 0.01), but three total occlusions occurred at sites where mild disease had been present previously. Lesions in patients with double or triple vessel disease showed a marginally greater tendency to become totally occluded than in patients with single vessel disease (P less than 0.1). We found no relationship between new total obstructions and the angiographic morphology of the lesion (smooth or irregular) nor with its length or position in the artery or the extent of atheroma in the vessel.

Adult↗
PubMed1983

Localization of lesions in the coronary circulation.

The location of coronary artery narrowings in coronary disease (CAD) is of considerable importance in assessing the mass of myocardium at risk as well as patient prognosis. The detailed distribution of coronary lesions was mapped in 302 patients with CAD who had coronary angiography for chest pain. All identifiable coronary lesions were measured manually and the site and degree of narrowing were stored in a computer-based multisegmental model of the coronary tree. A high prevalence of CAD was found in proximal vessels and especially at, or adjacent to, proximal points of branching. In the left anterior descending coronary artery, the lesions were most prevalent immediately after the first diagonal branch and at the origin of this branch. In the right coronary artery, there was a high prevalence of narrowing between the infundibular and acute marginal branches and specifically around the origin of the right ventricular branch. In the left circumflex coronary artery, there was a predilection for narrowing in and around the origin of the first marginal branch. When a ramus intermedius was present, its origin was frequently the site of narrowing.

Adult↗
PubMed1983

A graphic computerized system for reporting and analysis of coronary angiograms.

A graphic computer based system for coronary angiographic reporting and data storage has been developed. It uses a multisegmental model of the coronary tree so that precise localization of coronary lesions can be made in relation to major branches. The percentage narrowing of the vessel, the length of the lesion, and diameter of the distal coronary vessel can be measured. Collateral vessels, coronary artery bypass grafts, and coronary artery spasm are recorded. The system is simple to use and useful for routine clinical reporting and for detailed analysis of coronary lesions.

Angiography↗
PubMed1983

Frame by frame analysis of left ventricular function. Quantitative assessment of regional and temporal function.

We made a frame by frame analysis of the left ventricular cineangiogram to quantitate normal regional left ventricular function. Two different methods were used: contraction of the left ventricle towards a fixed point at the center of its long axis, and a pattern of contraction normal to the outline of the ventricle. Each method was used with and without correction for rotation and translational movement during systole. Left ventricular contraction and relaxation were represented graphically on a three-dimensional perspective plot and also using contour mapping techniques. The normal values and standard deviation were calculated for the extent, velocity and time course of ventricular contraction and relaxation in each region of the ventricle. The study provided a graphic visual display of the regional contractile pattern of the normal ventricle.

Adult↗
PubMed1982

Regional left ventricular ejection fraction from real-time two-dimensional echocardiography.

We studied regional left ventricular contraction patterns and ejection fraction from real-time two-dimensional echocardiograms in 8 normal subjects, 11 patients with coronary artery disease and 2 with congestive cardiomyopathy. The ventricle was divided into 12 regions and for each region, we calculated ejection fraction using a method which integrated the incremental volumes of a series of hemicylinders constructed within that region. The data obtained were displayed graphically to provide a detailed picture of regional ventricular function. Normal subjects had a uniform regional ventricular pattern (regional ejection fraction 54-74%). In patients with coronary disease, we found varying degrees of regional ventricular contraction abnormalities. In congestive cardiomyopathy global hypokinesis was present, and regional ejection fraction was reduced in all areas (11-39%). The study showed that two-dimensional echocardiography is a useful non-invasive bedside technique which may provide detailed quantitative information relating to regional left ventricular contraction abnormalities.

Adolescent↗
PubMed1982

Left ventricular filling and emptying patterns in anemia due to beta thalassemia. A computer-assisted echocardiographic study.

Patterns of left ventricular (LV) filling and emptying were studied in 17 patients with chronic anemia due to beta thalassemia and in 8 normal subjects. M-mode echocardiograms were recorded in each patient and digitization and computer analysis of the tracings provided data relating to the systolic and diastolic performance of the LV. LV diameter was increased. The rate, pattern and time relationships of LV systolic emptying were normal or increased in patients with thalassemia especially in those with thalassemia major requiring a large number of blood transfusions. Peak LV filling rate and the time course of early diastolic ventricular filling were also normal or increased in most patients but an abnormality of diastole was present in 3; this may have been due to abnormal early diastolic relaxation or to right-sided overload altering the LV filling pattern.

Adolescent↗
PubMed1982

Quantitation of regional ventricular asynergy using real-time two-dimensional echocardiography.

Real-time two-dimensional echocardiography was used to identify and quantitate regional left ventricular dysfunction in 12 patients with coronary artery disease. THe extent of regional ventricular asynergy was expressed as the percentage of the left ventricular circumference contracting abnormally. The findings were compared with those obtained from cardiac catheterization and left ventriculography. The severity and extent of echocardiographic asynergy correlated closely with that observed on the angiocardiogram (r = 0.96, P less than 0.001). There was also a significant relationship between echocardiographic and angiocardiographic ventricular volume (r = 0.81, P less than 0.001) and ejection fraction (r = 0.79, P less than 0.01). Real-time two-dimensional echocardiography provided a useful noninvasive technique for the identification and quantitation of the extent of regional ventricular dysfunction.

Aged↗
PubMed1982

Studies of left-ventricular function in anemia due to beta-thalassemia.

Left-ventricular (LV) function was studied in 23 patients with anemia due to beta-thalassemia, of whom seven had thalassemia intermedia and the remainder thalassemia major. Two-thirds of the patients wih thalassemia intermedia and almost all the patients with thalassemia major were in clinical congestive heart failure. Despite this, resting measurements of ventricular size and systolic ventricular function were normal, indicating high-output cardiac failure. However, effort testing showed a flat response or decrease in the LV shortening fraction in patients with thalassemia major, and serial studies showed a decrease in the shortening fraction over a 4-yr period in some patients. LV diastolic function was studied by calculating peak LV filling rate and the pattern of LV filling in early diastole. Three patient with thalassemia major showed a pattern indicating abnormal LV distension. Since LV end-diastolic dimension was increased, volume overload was present in all patients. The results indicate that the following factors contribute to the genesis of cardiac failure in beta-thalassemia: 1) diminished response of systolic ventricular performance to exercise and later at rest; 2) ventricular volume overload; and 3) abnormal ventricular distension in diastole. Although the ventricular filling suggests abnormal LV compliance, the effect of right-ventricular volume overload or a pericardial factor cannot be excluded.

Adolescent↗
PubMed1981

Regional ejection fraction of the normal left ventricle.

Regional ventricular function is important in assessing the functional significance of muscle fibrosis and ischemia in coronary artery disease. We have investigated three different methods of computerized quantification of the regional left ventricular function in 20 normal subjects. Method 1 divided the left ventricle into eight rectangular regions and corrected for rotatory and translational movement of the heart during systole. Method 2 was similar to Method 1, but corrected for shortening of the long axis of the left ventricle. Method 3 assumed radial inward contraction using a polar system of coordinates after correcting for rotatory and translational movement. The values obtained for the regional ejection fraction and regional volumes were calculated and compared for each region.

Cardiac Catheterization↗
PubMed1980

Isovolumic relaxation period in man.

Isovolumic relaxation period (IRP) was measured noninvasively from the onset of the aortic component of the second heart sound on the phonocardiogram to the point of separation of the mitral leaflets on the echocardiogram. IRP was measured in 83 patients with different cardiac diseases. The duration of IRP was 58 +/- 11 msec. in normal subjects. It was prolonged in hypertension (p < 0.001), HOCM (p < 0.001), in aortic stenosis (p < 0.05), and aortic incompetence (p < 0.001), and was shortened in congestive cardiomyopathyl (p < 0.05) and mitral stenosis (p < 0.01). In patients with coronary artery disease and normal over-all systolic LV function, IRP was prolonged (p < 0.001); IRP was shortened in four patients with coronary disease who had severe LV dysfunction and severe additional mitral incompetence. IRP was related to systemic blood pressure, percentage shortening of the LV in systole, and to the mitral EF slope. It tended to increase with increasing heart rate and a regression equation was developed for predicting IRP in relation to blood pressure and heart rate in normal sbjects. There was no relation to the PR-Ac time or to isovolumic contraction time. IRP is a useful measurement of LV dynamics in early diastole.

Aortic Valve Insufficiency↗
PubMed1977

High fidelity ECG in the diagnosis of occult coronary artery disease: a study of patients with normal conventional ECG.

High fidelity (HF) electrocardiography (ECGY) was performed on four groups of patients with a normal resting electrocardiogram (ECG). Two groups (A and B) consisted of normal subjects over or under the age of 40, while the other two groups of patients (C and D) underwent coronary arteriography because of chest pain. HR ECG components within the initial portion of the QRS complex were significantly more common among patients with advanced coronary disease. The difference between the normal groups and the group with documented coronary artery disease (CAD) became more significant when the number of leads showing the HF ECG components was counted. Precordial leads were more sensitive in predicting the presence or absence of CAD than limb leads. HF ECG components in the terminal portion of the QRS complex did not differentiate between normals and patients with coronary artery disease, unless the number of leads showing these HF ECG components was considered. It seems that abnormal HF ECG components can point to minor areas of fibrosis caused by coronary artery disease even if the resting conventional ECG is normal.

Adult↗