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Biomedical subjects

M M Ibrahim

Publications and source records attributed to M M Ibrahim.

At least 73 records · Page 4Linked to original sources
PubMed1979

Left ventricular function in rheumatic mitral stenosis. Clinical echocardiographic study.

Echocardiography was used to examine the extent and significance of impairment in left ventricular function in 20 patients with rheumatic mitral stenosis. Indices of left ventricular performance--normalised mean rate of circumferential fibre shortening (Vcf), ejection fraction, normalised posterior wall velocity, and stroke volume were reduced. The impairment in left ventricular function was related to the degree of functional disability (NYHA), right ventricular dilatation, and left atrial enlargement. Vcf was inversely related to both the internal right ventricular diameter (r=-0.767, P less than 0.001) and the degree of left atrial enlargement (r=-0.554; P less than 0.05). The normalised velocity of the interventricular septum and the maximum systolic and diastolic endocardial velocities were also reduced. These results suggest that abnormalities in contractility of left ventricular myocardium are responsible for the impaired myocardial function in patients with mitral stenosis and that such impairment is clinically significant.

Echocardiography↗
PubMed1977

Electrocardiogram in evaluation of resistance to antihypertensive therapy.

The effect of blood pressure control on the evolution of electrocardiographic evidence of left ventricular hypertrophy was investigated 50 patients with hypertension who were followed up for an average period of nine years. Blood pressure response to treatment was determined both from casual office readings and from weekly averages of twice daily home readings. Changes in the ECG, judged from both alteration in QRS voltage and in ST-T segment, were related to the degree of arterial pressure control. Usually, both home and office arterial pressure responded similarly to antihypertensive therapy, but when there was a difference, electrocardiographic changes correlated best with home prssure averages. Reduction in maximum precordial QRS voltage (Sv1+Rv5-6) correlated best with changes in home systolic pressure (r = .460; P less than .001), but correlation with diastolic pressure variation either at home or in the office did not attain statistical significance (P greater than .10). The present data stress the importance of home pressure measurements in the management of some patients with hypertension and provide evidence that casual office readings may sometimes misjudge the effectiveness of antihypertensive therapy.

Adult↗
PubMed1976

Use of systolic time intervals in studying hypertension.

Systolic time intervals were measured in 54 hypertensive patients divided into three groups according to severity of hypertension, variability of blood pressure levels and presence or absence of a hyperkinetic heart. The three groups were: borderline hypertension (BLH), fixed essential hypertension (FEH) and hyperkinetic essential hypertension (HEH). Systolic time intervals (STI) provided information indicating an increased cardioadrenergic drive in BLH and HEH. This was supported by finding that propranolol abolished the increased contractility found at rest in BLH and HEH.

Adult↗
PubMed1975

Hyperkinetic heart in severe hypertension: a separate clinical hemodynamic entity.

A long-term study of established hypertension helped identify a well defined group of 10 patients who differed both clinically and hemodynamically from 59 patients with the more frequent form of this disease. Their cardiac output was significantly increased (P less than 0.001) despite a severe elevation of arterial pressure (average 212/125 mm Hg plus or minus 13.5/7.3[standard error[). All had labile hypertension of long standing (16.2 years average) that was difficult to control and always symptomatic; in all, the diagnosis of pheochromocytoma had to be specifically excluded. Increased myocardial contractility was suggested by (1) significant elevation of the rate of rise of isovolumic pressure (P less than 0.001), and (2) high ratio of cardiac output to cardiopulmonary volume (P less than 0.005). Beta adrenergic blockade with propranolol helped to alleviate symptoms and to control tachycardia but failed by itself to reduce arterial pressure.

Adult↗
PubMed1975

Localization of lesion in patients with idiopathic orthostatic hypotension.

The different components of the baroreceptor reflex were studied in 8 patients with idiopathic orthostatic hypotension. The reflex arc was interrupted in all patients and the lesion was most probably localized to the efferent sympathetic fibres. This was suggested by the negative cold pressor test, the absence of pressor response to mental arithmetic, and loss or reflex sweating. Selective sparing of sympathetic vasodilator fibres was probable in 2 patients. Cardiac acceleration after atropine was less than in normal subjects suggesting some degree of cardiac denervation. The present study indicates that lesions in efferent sympathetic fibres are a common cause of idiopathic orthostatic hypotension. Other components of the reflex arc were intact in this series of patients.

Aged↗