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H A Baltaxe

Publications and source records attributed to H A Baltaxe.

90 records · Page 5Linked to original sources

Comparison of left ventricular ejection fraction and regional contractility fraction pre and post coronary angiography.

Thirty patients [four normals, eight with mild and 18 with severe coronary artery disease (CAD)] were studied to evaluate left ventricular function type and post coronary angiography. The end diastolic volume (EDV), end systolic volume (ESV), ejection fraction (EF) and the regional contractility fractions (RCF) of eight ventricular segments were evaluated by left ventriculography. The RCF's were analyzed, in addition to the EF's to ascertain the effect of contrast material upon normal and scarred or ischemic segments of the left ventricle, and to rule out spurious findings in the EF due to coexistent reciprocal changes in RCF's. There was good correlation (r = .45 to .97 and p less than .01 to less than .001) in the above parameters of left ventricular function in patients with and without CAD before and after angiography. Thus, although intraventricular and intracoronary injections of contrast material produce transient changes in myocardial contractility, in a clinical setting left ventriculography may be performed prior to or following coronary angiography without danger of spurious results in normals and in patients with CAD.

Adult↗

Effects of the intracoronary and intraventricular injections of a commonly available vs. a newly available contrast medium.

Two contrast media (Renografin 76 and Isopaque 370) were used in a double-blind study for coronary angiography and left ventriculography. Fifty-eight patients with presumed coronary artery disease were studied. The effects of the contrast media upon the myocardium and upon ventricular function of patients with and without coronary artery disease were assessed. Pre and post angiography myocardial enzymes were obtained. Cardiac output was determined before and after the angiograms. Hemodynamic and electrocardiographic changes were continuously monitored during the procedure. The study showed that both contrast media produced similar changes; however, the "maximum" decrease in T wave amplitude was more marked in the normal group when Renografin 76 (as compared with Isopaque 370) was injected (p = 0.05) on the right. Renografin 76 injection into the left coronary artery produced a higher median T wave amplitude in lead II relative to Isopaque 370 only in the abnormal group (p = 0.01). The heart rate dropped more severely in the normal patients when the left coronary artery was injected with Renografin 76 than with Isopaque 370 (p = 0.05).

Angiocardiography↗

Regional ejection fractions in patients with patent and thrombosed grafts after coronary artery vein bypass surgery.

Twenty-six patients who had received 43 grafts were studied before and after coronary artery vein bypass surgery. Cine ventriculograms taken in the right anterior oblique projection were analyzed and regional ejection fractions calculated. Single and multiple grafts were considered separately as were thrombosed and patent grafts. Patients were also divided into those with regional ejection fractions below 50% and those with regional ejection fractions above 50%. No statistically significant improvement of the relevant segments was demonstrated in any group. However, those with a regional ejection fraction above 50%, whose grafts had thrombosed, deteriorated from a mean of .66 to .39. There is a significant trend here (p less than .05) and a t test significance at the 7% level.

Cineangiography↗

A proposed mechanism for transient increases in arterial pressure and flow during angiographic injections.

In a series of animal experiments, we have confirmed the observation that arterial pressure and flow increase distal to the injection site during power injections through non-obstructing catheters. Our data suggest that the phenomenon is secondary to the transient production of turbulence. Thus, for a given injection rate, catheters with smaller end holes create more fluid velocity, which increases the Reynolds number and causes augmentation of downstream pressure and flow. The addition of side holes decreases the fluid velocity of the injectate and minimizes the hemodynamic effects. The discussion deals with factors contributing to the generation of local turbulence, the magnitude of pressure and flow changes caused by the injections, and the clinical implications of these artifacts.

Angiography↗

An angiographic assessment of left ventricular function in isolated mitral valvular prolapse.

Angiographic studies demonstrating alterations in left ventricular contraction have been cited as evidence that isolated mitral valve prolapse (MVP) may be associated with a cardiomyopathy. We studied 17 patients with isolated MVP undergoing cardiac catheterization who had chest pain, palpitations, and/or a murmur of mitral regurgitation. Eleven of 13 patients (85%) with no or mild (Grade 1+) mitral regurgitation had normal left ventricular hemodynamic measurements, while three of four patients (75%) with moderate or marked (Grades 2+-4+) regurgitation had abnormal left ventricular hemodynamic measurements. An increased mean rate of circumferential fiber shortening (greater than 1.9 circumferences/sec) was observed in nine of 13 patients (70%). Systolic ventricular wall motion was analyzed from left ventriculograms by methods which quantitate percent shortening of ventricular areas, transverse chords, and radial axes. Marked variations in the number and location of alterations in ventricular contraction were obtained by the different methods used to analyze the ventriculograms, with segments of hypokinesis being detected in from 0-14 patients studied, depending upon the method used. Localization of alterations in contraction predominantly in the basal and mid-segments of the left ventricular and the association of hemodynamic abnormalities with mitral regurgitation suggest that changes in ventricular contraction are primarily related to an alteration of mitral valve function in this condition.

Adult↗