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Biomedical subjects

J M Foult

Publications and source records attributed to J M Foult.

41 records · Page 3Linked to original sources
PubMed1985

Alterations in contrast medium-induced coronary reactive hyperemia after bepridil in patients with coronary artery disease.

The acute effects of an intravenous infusion of bepridil (BEP) (4 mg . kg-1) on left ventricular (LV) hemodynamics, coronary sinus blood flow (CSBF), and myocardial metabolism were studied in eight patients with coronary artery disease. In contrast with data previously reported with calcium channel blockers, BEP induced an elevation in LV end-diastolic pressure from 12.0 +/- 7.1 to 20.1 +/- 7.2 mm Hg (mean +/- SD, p less than 0.001) and a fall in LV dp/dt max from 1339 +/- 302 to 1177 +/- 251 mm Hg . sec-1 (p less than 0.01). This significant alteration in LV function is likely to be explained by the lack of effect on heart rate and aortic pressure observed after an acute intravenous infusion of BEP. Myocardial oxygen consumption (MVO2) increased from 448 +/- 272 to 498 +/- 273 mumol . min-1/100 g LV (p less than 0.05) as did CSBF from 79.5 +/- 42.7 to 92.1 +/- 45.1 ml X min-1/100 g LV (p less than 0.01). Lactate extraction fell from 0.33 +/- 0.17 to 0.15 +/- 0.17 (p less than 0.05). A contrast medium-induced coronary reactive hyperemia (HPR) evidenced an increased hyperemic volume from 9.5 +/- 3.6 to 12.1 +/- 4.5 ml/100 g LV (p less than 0.01) and HPR duration from 23.3 +/- 6.9 to 32.3 +/- 15.4 sec (p less than 0.05) after BEP. However, the peak/resting CSBF ratio was blunted after BEP from 1.74 +/- 0.18 to 1.61 +/- 0.12 (p less than 0.05), evidencing a net effect of BEP on HPR.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Nifedipine and alpha 1-adrenergic blockade in Raynaud's phenomenon.

The efficacy of nifedipine and prazosin in the treatment of Raynaud's phenomenon was assessed in a prospective double-blind randomized cross-over trial in 15 patients. Each patient received one week of nifedipine 20 mg TID, one week of prazosin 1 mg TID, and 2 weeks of placebo. Nifedipine was shown to be effective in reducing both the frequency and the severity of Raynaud's phenomenon, whereas prazosin was ineffective. Before initiation of therapy in the 15 patients, pressor responses to the intravenous alpha 1-agonist phenylephrine were assessed in the basal state, 30 min after 20 mg oral nifedipine, and 30 min after 1 mg oral prazosin; the shift to the right of the log dose-vasopressor response curves to phenylephrine was similar with nifedipine and prazosin.

Adult↗
PubMed1981

Non-invasive diagnosis of mitral regurgitation by Doppler echocardiography.

The value of Doppler echocardiography for the non-invasive diagnosis of mitral regurgitation was studied blindly in 161 consecutive invasively investigated adult patients. Regurgitation was graded from 0 to 3 at selective left ventricular angiography. The Doppler echocardiographic examination was considered to be positive when a disturbed systolic flow was found within the left atrium behind the aorta or the anterior leaflet of the mitral valve. The test was considered to be negative in the absence of a regurgitant jet. The level of the signal to noise ratio was checked by the recording of the ventricular filling flow. The study was performed in 131 cases from the left side of the sternum and in 101 cases from the apex. There were no false positives and thus the specificity was 100 per cent. The 20 false negatives were all in patients with grade 1 regurgitation. Thus only some (33%) instances of mild regurgitation were misdiagnosed, and the sensitivity for moderate to severe mitral regurgitation was 100 per cent.

Adolescent↗
PubMedDate not supplied

Residual area at risk after anterior myocardial infarction: are ST segment changes during coronary angioplasty a reliable indicator? A comparison with technetium 99m-labeled sestamibi single-photon emission computed tomography.

BACKGROUND: The aim of this study was to assess whether, after anterior myocardial infarction, ST segment changes during percutaneous transluminal coronary angioplasty (PTCA) of the left anterior descending coronary artery correlated with the amount of ischemic myocardium in the area at risk, measured with 99mTc-labeled sestamibi single-photon emission computed tomography (SPECT) during balloon inflation. METHODS AND RESULTS: Quantitative continuous monitoring of the ST segment was performed during PTCA of the left anterior descending coronary artery in 11 patients, and corresponding SPECT imaging was compared with a rest acquisition performed before PTCA. SPECT was quantified by a bull's-eye analysis according to main criteria: (1) the planimetered defect size during PTCA as an indicator of the size of the area at risk, (2) the change in the pathologic/normal area count ratio in the area at risk as an index of the severity of ischemia, and (3) the difference between the size of the defect during PTCA and at baseline. ST segment changes were correlated to the variation in pathologic/normal area count ratio (19% +/- 14%; r = 0.61; p < 0.05) but not to the sizes of the scintigraphic defects. CONCLUSION: ST segment changes induced by occlusion of the infarct-related coronary artery during PTCA are related mostly to the severity of ischemia rather than to the size of the area at risk.

Adult↗