Search PubMed⌕ Search

Biomedical subjects

J Turina

Publications and source records attributed to J Turina.

72 records · Page 4Linked to original sources
PubMed1977

[Left ventricular function in chronic pulmonary hypertension].

10 patients with chronic pulmonary hypertension (PH) consequent to primary or secondary pulmonary vascular disease and 12 control subjects were studied by left ventricular (LV) micromanometry and cineangiography. At rest, LV "total pressure" Vmax and volumetric parameters (RAO position) of the patients with PH were within normal limits. LV end-diastolic pressure, was, however, significantly increased. Biplane cineangiographic evaluation in 6 patients with PH revealed a significantly reduced LV transverse diameter in the LAO as compared to the RAO position. This finding was confirmed by echocardiography. The thickness of the LV lateral and posterior wall was normal, whereas septal thickness was significantly increased in the patients with PH. During isometric exercise Vmax increased significantly in PH but not in the controls. It is concluded that (1) in chronic PH LV function is normal at rest, (2) LV contractile reserve is inpaired and (3) apparent LV compliance is reduced due to both septal hypertrophy and abnormal LV geometry.

Cardiac Volume↗
PubMed1977

[Echocardiography in the evaluation of ventricular function].

The ultrasonic beam used for quantitative assessment of left ventricular (LV) function traverses the heart in a projection similar to the familiar angiographic left anterior oblique projection. It crosses the anterior wall of the right ventricle, the right ventricular cavity, the interventricular septum, the LV cavity and the posterior wall of the left ventricle. Whereas the cyclic changes of the right ventricular diameter are rarely clearly determined by echocardiography, the easily assessed cyclic changes of the LV endocardial transverse diameter are useful measure of LV FUNCTION. Of practical importance are the percentage of systolic shortening of the LV diameter (%Sh) and the mean velocity of circumferential fiber shortening (VCF). There are several factors, such as placing of the ultrasonic transducer, the shape and size of the LV cavity and rotational movements of the heart as a whole, that influence echocardiographic determination of the transverse LV diameter. In patients with asynergic contraction, %Sh and VCF cannot be used as measures of overall LV performance, but localized contraction disturbances of the septum and the posterior wall may be detected from the reduced extent of wall motion in a given LV segment during a full sweep from the base to the apex. The most important indications for echocardiographic assessment of LV function are valvar diseases with chronic LV pressure or volume overload, and congestive cardiomyopathy. Echocardiography has proved useful in serial evaluation of LV function in patients undergoing valvar heart surgery. Assessment of LV volume by standard echocardiography using the cubic formula is not satisfactory. More accurate determination of volumes is provided by formulas that include the actual ratio of the LV long axis to the minor axis.

Aortic Valve↗
PubMed1976

[Clinical course of congestive cardiomyopathy].

In 30 patients with the clinical, hemodynamic and angiographic findings of congestive cardiomyopathy, physical working capacity (PWC) and left ventricular (LV) ejection phase indexes at rest (EI), assessed by LV ejection fraction, enddiastolic volume, and mean rate of circumferential fiber shortening were determined. Based on PWC and EI, the following 3 functional groups were obtained: group 1 (n = 6) with normal PWC and borderline EI (subclinical congestive cardiomyopathy), group 2 (n = 10) with normal PWC and decreased EI, and group 3 (n = 14) with reduced PWC and severely depressed EI. The clinical course was followed for 24 months. In group 1 the functional state remained unchanged in all 6 patients. In group 2, 3 patients, changed to functional group 3 and 2 died during the observation period. In group 3, 3 patients improved and changed to functional group 2, 5 remained unchanged and 6 died after an observation period of 16 months. It is concluded (1) that PWC in congestive cardiomyopathy may be preserved despite depressed LV function, and (2) that the functional classification has important prognostic implications, in view of the fact that annual mortality in group 1 was 0%, in group 2 7% and in group 3 32%.

Adult↗
PubMed1976

[Diagnosis and differential diagnosis of pericardial effusion].

The clinical, hemodynamic and radiologic signs of pericardial effusion are reviewed. From the symptomatic point of view low pressure (lax) pericardial effusion and compressive effusion (tamponade) are to be distinguished. Echocardiography is today the preferred method for study of patients with suspected pericardial effusion. This technique also provides insight into ventricular performance and is therefore helpful in the differential diagnosis of cardiomegaly due to pericardial effusion, heart failure or both. In our material uremic pericarditis, malignant tumors and leukemia were the predominant causes of pericardial effusion.

Adult↗
PubMed1976

[Late results of surgery in muscular subvalvular aortic stenosis].

Pre- and postoperative clinical and hemodynamic findings of 35 patients operated for hypertrophic obstructive cardiomyopathy are presented. One early death and three av-blocks necessitating a permanent pacemaker have to be mentioned as surgical complications. In all cases, an outflow tract obstruction was abolished or greatly diminished and symptoms disappeared or were considerably improved. Two patients died after recurrence of congestive heart failure during the late follow-up. Furthermore, the occurrence of reappearance of different arrhythmias up to 10 years postoperatively are evidence of the progression of the disease despite of surgical treatment. Sudden death has not occurred in a total of 150 patient-years of postoperative follow-up. Thus, the operation abolishes the stenosis and relieves symptoms; on the other hand, it cannot be stated to what degree surgery improves the prognosis.

Adolescent↗
PubMed1975

[Left ventricular cineangiography and echocardiography in patients with the mesosystolic click-telesystolic murmur syndrome].

Twenty-three patients with the midsystolic click - late systolic murmur syndrome were investigated by right and left heart catheterization, cineangiography and echocardiography. Most had symptoms such as atypical chest pain and arrhythmias. Except in one patient, slight to moderate mitral incompetence was present at rest (20 patients) or during stress testing by the infusion of aramine or rapid atrial pacing (2 patients). In all cases, an abnormal systolic mitral valve motion was found by left ventricular cineangiography. In 14 of 15 technically satisfactory echocardiograms a systolic prolapse of one or both mitral leaflets was observed. A minority of the patients had localized abnormal wall motion in the posterobasal area or moderate generalized hypokinesis.

Cineangiography↗
PubMed1975

[Proceedings: Left ventricular cineangiography and echocardiography in patients with the mesosystolic click-telesystolic sound syndrome].

Twenty-three patients with the syndrome of midsystolic click--late systolic murmur were investigated by right and left heart catheterization, cineangiography and echocardiography. Most of the patients had symptoms such as atypical chest pain and arrhythmias. Except in one patient, slight to moderate mitral incompetence was found at rest or during stress testing by infusion of aramine or rapid atrial pacing (2 patients). In all cases, an abnormal systolic mitral valve motion was found in left ventricular cineangiography. In 14 of 15 technically satisfactory echocardiograms a systolic prolapse of one or both mitral leaflets was observed. A minority of the patients had localized abnormal wall motion in the postero-basal area or moderate generalized hypokinesis.

Cineangiography↗
PubMedDate not supplied

Improved life expectancy after coronary artery bypass grafting in elderly.

From 1981 to 1990, 204 patients (165 male, 35 female) aged 70 years and older (mean 72.4 +/- 2.4 years [+/- SD], range, 70 to 81 years) underwent isolated coronary artery bypass surgery with an average of 3.8 +/- 1.2 grafts per patient. Seven patients (3.5%) were in NYHA functional class I, 52 (25.5%) were in class II, 1237 (62%) were in class III, and 18 patients (9%) were in class IV preoperatively. The operative mortality (30-day mortality) was 6.8% (14 patients). The NYHA class improved in these patients from a mean preoperative value of 2.8 +/- 0.65 to 1.4 +/- 0.6 postoperatively (p < 0.0001). The actuarial survival (+/- SD) of the entire group was 92 +/- 2% and 86 +/- 4% at 1 and 5 years, respectively, and of the patients surviving operation, excluding those who died in the hospital, it was 98.5 +/- 1.0% and 93 +/- 3.5% at 1 and 5 years, respectively. We concluded that coronary artery bypass grafting in elderly patients can be performed with acceptable operative mortality and good late results.

Aged↗
PubMedDate not supplied

Coronary artery-right ventricular fistula in a heart transplant patient.

Routine coronary angiography 2 years after heart transplantation in a 48-year-old patient revealed a fistula from a septal branch of the left anterior descending artery to the right ventricle. This finding was not present at coronary angiography 1 year before. This coronary-ventricular fistula is most probably the result of repeated endomyocardial biopsies.

Angiography↗