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Biomedical subjects

E L Rothfeld

Publications and source records attributed to E L Rothfeld.

At least 19 recordsLinked to original sources
PubMed1988

Asynchronous atrioventricular valve opening as it relates to right to left interatrial shunting in the normal newborn.

The opening of the tricuspid valve and the onset of right ventricular filling precede the opening of the mitral valve and the onset of flow in the normal adult. Sixty-five studies of atrioventricular flow with range-gated pulsed Doppler echocardiography, performed on 32 normal neonates, consistently demonstrated the reverse sequence. Further investigation showed that at the time of mitral valve opening, while the tricuspid valve was still closed, the valve of the foramen ovale began to bow posteriorly into the left atrium and remained posteriorly bowed for most of diastole. The magnitude of posterior bowing varied among the neonates but, concomitant with the more prominent grades of posterior bowing, right to left shunting across the foramen ovale was demonstrated on color flow mapping. Ultrasound studies in the normal fetus also revealed earlier opening of the mitral valve, bowing of the valve of the foramen ovale into the left atrium and right to left shunting across the foramen ovale. These findings indicate that in the normal immature heart isovolumic ventricular relaxation is completed earlier on the left than on the right side and that left ventricular compliance appears to be greater than right ventricular compliance. The relation of left and right ventricular compliance in the adult is different from that in the normal immature heart. Whereas systemic and pulmonary vascular resistance and pressure levels change rapidly in the newborn period, ventricular compliance matures over a longer period of time. As a result of the differential maturity, for a variable period of time in the normal neonate, a left to right ductal shunt coexists with a right to left atrial shunt.

Blood Flow Velocity↗
PubMed1977

Harbingers of paroxysmal ventricular tachycardia in acute myocardial infarction.

We examined the harbingers of 68 episodes of paroxysmal ventricular tachycardia in 42 patients with documented acute myocardial infarction. Late ventricular premature contractions initiated 46 bouts of paroxysmal ventricular tachycardia, while 17 were engendered by early ventricular premature contractions and five by atrial premature contractions. Paroxysmal ventricular tachycardia related to early ventricular premature contractions tended to last longer and failed to respond to therapy with lidocaine more often than paroxysmal ventricular tachycardia begun by late ventricular or atrial premature contractions. Ventricular fibrillation occurred in six cases of paroxysmal ventricular tachycardia due to early ventricular premature contractions but was absent in paroxysmal ventricular tachycardia related to late ventricular or atrial premature contractions. The "malignant" potential of a given ventricular premature contraction cannot be assessed from its degree of prematurity alone.

Acute Disease↗