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Biomedical subjects

H De Geest

Publications and source records attributed to H De Geest.

At least 127 records · Page 7Linked to original sources
PubMed1986

Detection of ventricular tachycardia and fibrillation using ECG processing and intramyocardial pressure gradients.

The automatic termination of malignant tachyarrhythmias and of ventricular fibrillation by an implantable device requires a reliable sensing of these episodes of abnormal ECG. Therefore, we induced tachyarrhythmias and fibrillation in eleven dogs and recorded electrograms and intramyocardial pressure. The electrograms were analyzed using the autocorrelation function and the probability density function. Intramyocardial pressure was monitored as a hemodynamic parameter. Results show that in the case of sinus rhythm, all methods are reliable, but in the case of VT and VF, electrogram processing only is insufficient. It is concluded that combined monitoring of ECG processing and a hemodynamic parameter may increase the sensitivity of an automatic tachycardia-fibrillation detection system.

Animals↗
PubMed1986

Relationship between left ventricular pressure and the calibrated apexcardiogram during abrupt outflow obstruction.

In order to study the influence of sudden left ventricular pressure rise on the calibrated apexcardiogram, 181 acute aortic occlusions were performed during systole in 7 dog experiments. For each beat preceding (CO) an occlusion and each occlusion (OC), peak systolic amplitude of left ventricular pressure (CO: 118.5 +/- 17.8 mm Hg; OC: 205.8 +/- 38.7 mm Hg) and apexcardiogram (CO: 48.8 +/- 16.7 mm Hg; OC: 63.0 +/- 25.8 mm Hg) were measured. Pressure gradients, ratios and surface areas of all tracings were digitally calculated. The cross-correlation function between pressure and apexcardiogram was also calculated in order to determine time lags. Significant correlations were found: between surface ratios and pressure gradient of pressure (r = 0.80, p less than 0.001) and of apexcardiogram (r = 0.79, p less than 0.001); between surface ratios of pressure and surface of apexcardiogram (r = 0.52, p less than 0.001). The data suggest that during isovolumic systole, the time integral of the left ventricular pressure and its change during the ejection phase define to a large extent the general shape and size of the apexcardiogram.

Animals↗
PubMed1986

The mechanism of disappearance of the physiologic third heart sound with age.

To study the mechanism of disappearance of the physiologic third heart sound (S3) with advancing age, combined phonoechocardiographic and phonomechanocardiographic recordings from 165 normal subjects between 6 and 62 years old were quantitatively analyzed. Nearly all individuals under 40 years old had a recordable S3. Although recordable in 38.6% of the 44 subjects over 40 years old, the physiologic S3 found in adults was less intense and occurred later in diastole when compared with that in children and adolescents. Marked changes in left ventricular filling hemodynamics were observed with aging, including an increase in left ventricular wall thickness and mass, a prolongation of the left ventricular isovolumetric relaxation period, a decrease in left ventricular early diastolic filling and wall thinning rates, and a reduction in the height and steepness of the rapid filling wave measured on the calibrated left apexcardiogram (linear correlation with age significant at p less than .001 for all parameters). Although less pronounced, these changes were very similar to the diastolic abnormalities found in patients with pressure overload left ventricular hypertrophy. Therefore, the higher pressure load imposed on the left ventricular wall due to the well-known gradual increase in blood pressure that occurs during normal growth and adulthood appears to be the most likely explanation for the observed changes in diastolic filling. It is concluded that the later occurrence, the diminishing amplitude, and the eventual complete disappearance of the physiologic S3 with age results from a decrease in early diastolic left ventricular filling and subsequent deceleration of inflow caused by the development of relative left ventricular hypertrophy in adulthood as compared with childhood.

Adolescent↗
PubMed1986

The relationship between the longitudinal pressure gradient and the blood flow velocity in the canine superior vena cava.

In the superior vena cava of anaesthetized open chest dogs the axial pressure gradient (delta P) was measured simultaneously with the blood flow velocity (V) under a variety of preload conditions. Both delta P and V curves showed distinct systolic and diastolic waves. Peak delta P ranged between 26 and 93 P/cm (0.2-0.7 mm Hg/cm) and V varied between 0.095 and 0.19 m/s. Peak systolic delta P, but not peak diastolic delta P was significantly linearly correlated to respectively peak systolic V and peak diastolic V. The shape of delta P and V curves corresponded fairly well but variations of delta P preceded the variations of V. Both the shape correspondence and the phase lag between delta P and V were evaluated by means of the normalized cross-correlation technique. During volume expansion the shape correspondence improved and the phase lag decreased. It is concluded that the transient vena caval blood velocity variations are directly related to the pulsatile axial pressure gradient.

Animals↗
PubMed1986

Correlation between mechanical properties and wall composition of the canine superior vena cava.

The mechanical properties (modulus of elasticity and stress-relaxation) of different venous segments of the canine superior vena cava were determined as well as the composition of the vessel wall by means of physical, biochemical and histological methods. It was found that the wall of the vena cava was structurally and mechanically a function of the metric position with respect to the right heart: the modulus of elasticity increased, the stress-relaxation decreased, the concentration of hydroxyproline, collagen and elastin increased and the amount of muscle fibres decreased with increasing distal distance from the right heart. A significant linear correlation coefficient was observed between the modulus of elasticity and the structural wall components. The data presented show the axial heterogeneity and the dependency of the mechanical properties upon the venous vessel wall composition.

Animals↗
PubMed1986

Outlet strut fracture of the 27 mm convexoconcave Björk-Shiley mitral valve prosthesis. Report of 2 cases.

Two patients with outlet strut fracture of the convexoconcave Björk-Shiley mitral valve prosthesis are described and all published cases are reviewed. The pertinent clinical, diagnostic and therapeutic features are discussed. Prompt recognition of this complication is essential and broader dissemination of information to the medical community on this problem is necessary.

Female↗
PubMed1985

Multivariate survival analysis for the assessment of prognostic factors and risk categories after recovery from acute myocardial infarction: the Belgian situation.

Twenty-one and a half per cent of the patients with acute myocardial infarction, admitted consecutively to the coronary care unit of the University Hospitals of Leuven in the period 1973-1979, died within 28 days. The 1,669 who recovered were followed between three and nine years. The mortality rate was 13.1% during the first year and fell to below 5% in the succeeding yearly intervals. Univariate and life table analysis were performed on noninvasive, clinical data collected during the coronary care unit stay for the total population and various subgroups. The Cox proportional hazards model was applied to the data in order to determine the prognostic factors for long-term survival. Of the 34 initially selected variables, the most dominant factors were age, Killip class III and IV, peripheral vascular disease, abnormal chest x-ray findings, previous infarction, and the use of digitalis or diuretics. The model, which was validated extensively, allowed the establishment of risk categories. Mortality five years after the acute event was 8.2 times more frequent in the highest risk quintile than in the lowest one. From this study one may conclude that multivariate techniques based on noninvasive variables collected during the coronary care unit stay are valuable for the determination of the long-term prognosis of patients with myocardial infarction.

Actuarial Analysis↗
PubMed1985

Measurement of pacing threshold.

Thresholds in constant current and constant voltage are reported for 405 CPI 4118 (Cardiac Pacemakers, Inc.) tined leads. In 98% of the cases, the constant current threshold was equal to or lower than 0.6 mA. A constant voltage threshold was equal to or lower than 0.5 V in 96% of the cases. Three external pacemakers and two pacing system analyzers were evaluated as threshold testing devices. For analyzing the waveforms of current and voltage stimuli, a calibrated isolation amplifier was used. We could not find a definite difference between the value, at which pacing is lost with reduction of the pulse generator output, and the value at which increase reestablishes pacing.

Pacemaker, Artificial↗
PubMed1985

Catheter technique for electrical ablation of the atrioventricular conduction system.

Seven patients with recurrent supraventricular arrhythmias, resistant to conventional drug therapy, were treated with electrical ablation of the atrioventricular (AV) conduction system. Permanent AV block was produced in five patients. Restoration of AV conduction occurred in two patients. The procedure of electrical ablation was well tolerated, without complications.

Adult↗
PubMed1985

Plasma concentrations of thyroid hormones in dogs: influence of sampling hour, breed and age.

Thyroxine (T4) and triiodothyronine (T3) plasma concentrations have been determined during 24-hr sampling periods in six mongrels (age 12-36 months), six beagles (age 35-37 months), three labradors (age 3.5 months) and three beagles (age 5 months). The mean T4 levels of the labradors were significantly lower than the values found for mongrels or older beagles (P less than 0.05), whereas T3 was higher in the 5 month old beagles compared to the mongrels (P less than 0.001), young beagles (P less than 0.05) or labradors (P less than 0.01). Circadian and ultradian rhythmicities have been evaluated by cosinor and Fourier analysis. Mongrels and older beagles did have a 12-hr rhythmicity in plasma T4 (P less than 0.05), whereas 5 month old beagles had a circadian one (P less than 0.01). A 12-hr rhythmicity was also found for T3 in the older Beagles (P less than 0.05). However, Fourier analysis indicated that the daily variation in T4 and T3 plasma levels was inadequately mathematically described by single sinusoidal rhythm and that more harmonic components are to be taken into account. The obtained data during a 24-hr period indicate that T4 and T3 concentrations in plasma may vary according to breed, age and sampling hour.

Aging↗
PubMed1985

Emergency bypass surgery: late effects on size of infarction and ventricular function.

Using thallium myocardial scintigraphy and radionuclide ventriculography, we assessed size of infarction and left ventricular function at late follow-up (greater than 2 months) in 13 patients who underwent emergency coronary artery bypass surgery (ECABS) during evolving myocardial infarction and in 26 controls who received conventional treatment for acute infarction. Thallium scans were quantitatively analyzed. The thallium defect, expressed as a numerical value in arbitrary units, was smaller after early revascularization (within 4 hr of the onset of symptoms, n = 10) than in the controls: 397 +/- 232 vs 2779 +/- 972 for anterior infarction (p less than .001) and 475 +/- 511 vs 1454 +/- 960 for inferior infarction (p less than .05). The patients undergoing revascularization late (4 to 5 hr after the onset of symptoms, n = 3) had thallium defects comparable to those in the controls. Regional ejection fraction of the involved left ventricular segment was higher after early revascularization (41 +/- 9% vs 21 +/- 8% for anterior infarction, p less than .005; 67 +/- 14% vs 51 +/- 11% for inferior infarction, p less than .01). Global ejection fraction was higher after early revascularization in patients with anterior infarction (57 +/- 10% vs 37 +/- 9%, p less than 0.02), but not in those with inferior infarction (60 +/- 11% vs 54 +/- 8%, p greater than .05). After late revascularization, regional and global ejection fraction were comparable to those in controls. In selected patients, early reperfusion of acutely ischemic myocardium by ECABS can limit size of infarction and preserve left ventricular function, but time constraints may be severe.

Adult↗
PubMed1985

Intramyocardial pressure in the canine heart. An experimental study.

During 11 acute open-chest experiments with dogs, intramyocardial pressure was measured in the anterior wall of the left ventricle with a miniature pressure transducer mounted on a 1.6 mm diameter needle. Pressures were measured at the subendocardium (+/- 10 mm), midwall (+/- 7.5 mm), and subepicardium (+/- 5 mm). Simultaneous recordings of left ventricular pressure and two measures of intramyocardial pressure were made during control, acute volume overload, and after administration of verapamil. Maximal amplitude of the subendocardial pressure was higher and the maximal amplitude of the subepicardial pressure was lower than maximal left ventricular pressure for all interventions (p less than 0.001 and p less than 0.01). During volume overload left ventricular pressure increased more than intramyocardial pressure (left ventricular pressure 34%, subendocardial pressure 6%, midwall pressure 14%, and subepicardial pressure 14%). After the administration of verapamil intramyocardial pressure decreased more than left ventricular pressure (left ventricular pressure 16%, subendocardial pressure 26%, midwall pressure 13%, subepicardial pressure 32%). Positive and negative first derivatives of subendocardial pressure were higher than those of left ventricular pressure during control and after verapamil (between p less than 0.01 and p less than 0.001). Positive and negative first derivatives of subepicardial pressure were lower than those of left ventricular pressure during all interventions (p less than 0.001). The timing of the C-point (onset of mechanical contraction) and the positive first derivative of all tracings was synchronous within 8 msec in all interventions. The 0-point (crosspoint of the tangent to the diastolic plateau and the tangent to the relaxation slope; early diastole) of intramyocardial pressure came later than the 0-point of left ventricular pressure, indicating longer relaxation times in the myocardium (subendocardial pressure: control, p less than 0.001, volume, p less than 0.05, verapamil, no significance; midwall pressure: between p less than 0.05 and p less than 0.001; subepicardial pressure: between p less than 0.01 and p less than 0.001).

Animals↗
PubMed1984

Bradycardia, ventricular pauses, syncope, and sports.

16 athletic patients were examined because of syncope, Stokes-Adams attacks, or both. The life-threatening condition required pacemaker implantation in 7 patients. 8 of the 9 other subjects became symptom-free after stopping heavy physical training. 37 top-ranking athletes underwent 24 h Holter monitoring. Pauses longer than 2 s occurred in 19% and resulted from sinus arrest. The longest pause lasted 2.5 s. Second-degree atrioventricular block was noted in 13%.

Adams-Stokes Syndrome↗
PubMed1984

Systolic time intervals in coronary heart disease at rest and during exercise: effect of physical training with and without beta blockade.

Systolic time intervals (STIs) were measured in recumbency at rest and in the sitting position at rest and during exercise, before and after a physical training program, in 28 patients with coronary heart disease. Fifteen patients were treated with a beta-blocking drug and 13 were not. After training, oxygen uptake at peak exercise increased similarly in both groups, by 41% and 37%, respectively, whereas heart rate at rest and during submaximal exercise decreased in both groups. Left ventricular (LV) ejection time (ET) adjusted for heart rate was not significantly affected by training. The rate-corrected preejection period (PEP) and the PEP/LVET ratio decreased after training. The changes in the STI after training were not related to the level of physical activity during testing and were similar in the patients treated with beta-blocking drugs and in those not so treated. The changes after training in STI at rest and at exercise in both treatment groups suggest that LV function improves during the training period and that beta-blockade does not alter this outcome.

Adrenergic beta-Antagonists↗
PubMed1984

Influence of physical training on blood pressure, plasma renin, angiotensin and catecholamines in patients with ischaemic heart disease.

Eighteen patients with ischaemic heart disease were trained for 3 months, three times a week. The effectiveness of the training programme was demonstrated by increases of 27% in peak oxygen uptake and 29% in exercise duration, and by a decrease in resting and submaximal heart rates. Blood pressure, however, was not significantly affected during the training period. At rest and at submaximal exercise plasma renin activity (PRA) was lower after training. Plasma angiotensin I concentration (PA I) and angiotensin II concentration (PA II) were not significantly affected. Plasma aldosterone concentration (PAC), only measured at rest, was not significantly changed after the training period, while plasma norepinephrine (PNE) and epinephrine (PE) concentrations were significantly decreased, but only at high levels of exercise. A reduced sympathetic tone after training, suggested by the lower heart rates and the tendency to a decrease in PNE, is a likely explanation for the decrease in PRA. However, despite this decrease, PA I, PA II, and PAC were not significantly changed after training; the reason for this disrepancy is unknown.

Angiotensins↗