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Biomedical subjects

J N Brunt

Publications and source records attributed to J N Brunt.

5 recordsLinked to original sources
PubMed1992

Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas' Atherosclerosis Regression Study (STARS)

To assess the effect of dietary reduction of plasma cholesterol concentrations on coronary atherosclerosis, we set up a randomised, controlled, end-point-blinded trial based on quantitative image analysis of coronary angiograms in patients with angina or past myocardial infarction. Another intervention group received diet and cholestyramine, to determine the effect of a greater reduction in circulating cholesterol concentrations. 90 men with coronary heart disease (CHD), who had a mean (SD) plasma cholesterol of 7.23 (0.77) mmol/l were randomised to receive usual care (U, controls), dietary intervention (D), or diet plus cholestyramine (DC), with angiography at baseline and at 39 (SD 3.5) months. Mean plasma cholesterol during the trial period was 6.93 (U), 6.17 (D), and 5.56 (DC) mmol/l. The proportion of patients who showed overall progression of coronary narrowing was significantly reduced by both interventions (U 46%, D 15%, DC 12%), whereas the proportion who showed an increase in luminal diameter rose significantly (U 4%, D 38%, DC 33%). The mean absolute width of the coronary segments (MAWS) studied decreased by 0.201 mm in controls, increased by 0.003 mm in group D, and increased by 0.103 mm in group DC (p less than 0.05), with improvement also seen in the minimum width of segments, percentage diameter stenosis, and edge-irregularity index in intervention groups. The change in MAWS was independently and significantly correlated with LDL cholesterol concentration and LDL/HDL cholesterol ratio during the trial period. Both interventions significantly reduced the frequency of total cardiovascular events. Dietary change alone retarded overall progression and increased overall regression of coronary artery disease, and diet plus cholestyramine was additionally associated with a net increase in coronary lumen diameter. These findings support the use of a lipid-lowering diet, and if necessary of appropriate drug treatment, in men with CHD who have even mildly raised serum cholesterol concentrations.

Angina Pectoris↗
PubMed1992

The measurement of blood flow waveforms from X-ray angiography. Part 1: Principles of the method and preliminary validation.

The principles and implementation of a method for measurement of blood flow waveforms from X-ray angiography are described. Contrast medium mass values are obtained at multitudinous positions along individual vessels and from numerous images in a time sequence. These values are represented as a matrix of grey levels in a parametric image. This image is normalized to represent contrast medium concentration, and the movement over time of isoconcentration portions of the contrast bolus is recovered to determine blood flow. Preliminary validation has been undertaken using parametric images generated in two ways: synthesis from a computer model of vascular pulsatile flow and analysis of cine-angiograms of physical models (plastic and perspex tubes) carrying known pulsatile flows. Two distinct methods for interrogation of parametric images by digital image processing were employed; both provided accurate flow measurements.

Blood Flow Velocity↗
PubMed1992

The measurement of blood flow waveforms from X-ray angiography. Part 2: Application to video recordings of digital subtraction angiography.

A method of measuring blood flow from X-ray angiograms recorded on cine film, by obtaining contrast mass values at numerous positions along individual vessels and at multiple instants of time, has been previously reported. In the present work it was hypothesized that the signal-to-noise limitations of recordings on video tape could be overcome by recording already-subtracted angiograms from a digital subtraction angiographic (DSA) system and that the spatial resolution of video was adequate to use a similar measurement method. Validation experiments were recorded, in which flows measured using a calibrated electromagnetic flowmeter passed through tubes of 4-7 mm diameter, during injections of 2-5 ml contrast medium. The video sequences were computer analysed and produced angiographic flow measurements agreeing with the electromagnetic flows to within 5 per cent. A case study of a clinical carotid artery DSA in a patient with secondary carcinoma metastases in the brain is described. It is concluded that accurate flow measurements can be made from DSA video recordings.

Algorithms↗
PubMed1979

Computerised image analysis of split-drop micropuncture data.

A technique is described for rapid and reproducible analysis of split-drop micropuncture sequences recorded on film. Automatic identification of the droplet menisci in each cine frame, and subsequent evaluation is performed by a computerised T.V. image analysis system. In comparison with a more conventional technique, the improvement in reproducibility of the analysis is achieved without loss of accuracy and is accompanied by a three fold increase in speed.

Animals↗