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Biomedical subjects

N J Fortuin

Publications and source records attributed to N J Fortuin.

At least 55 records · Page 3Linked to original sources
PubMed1977

The evaluation of left ventricular function by echocardiography.

Echocardiographic assessment of left ventricular size and function correlates well with that made by cineangiography. The technic is particularly suited to the early detection and serial monitoring of left ventricular hypertrophy and dysfunction in valvular heart disease, hypertensive heart disease and the cardiomyopathies. It also has advantages over angiography in experimental situations in which frequently repeated or continuous assessment of left ventricular size and function may be required. The limited usefulness of a single ultrasound beam in segmental heart disease, such as ischemic heart disease, may be overcome in the future with improvements in two-dimensional echocardiographic technics.

Cardiac Output↗
PubMed1977

Echocardiographic features of mitral annulus calcification.

Ten patients with roentgenographically demonstrable mitral annulus calcification (MAC) were found to have distinctive echocardiographic patterns. MAC was confirmed at the time of cardiac catheterization in six of these patients. Standard M-mode echocardiograms revealed a dense band of echoes in the region of the mitral annulus in contrast to the thin and delicate echoes generally recorded from the normal mitral annulus. Intraoperative and pathologic confirmation of thickening and calcification limited to the mitral annulus was made in two patients who underwent mitral valve replacement for severe mitral regurgitation due to myxamatous "floppy" valve. Patients with marked MAC may have coexisting aortic valve or papillary muscle calcification which can be recognized by echocardiography. Over-attenuation of left ventricular wall echoes in patients with marked MAC, and reduction in E-F slope of the anterior mitral valve leaflet in others can simulate pericardial effusion and mitral stenosis, respectively. Thus, recognition of MAC can avoid confusion with similar echocardiographic patterns due to other common cardiac abnormalities.

Aged↗
PubMed1977

Hypercontractile cardiac states simulating hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) or idiopathic hypertrophic subaortic stenosis (IHSS) has been defined as an autosomal dominant myocardial disease characterized by specific physical findings, echocardiographic features, asymmetric septal hypertrophy and disordered myocardial architecture. Echocardiographic and scintiphotographic studies failed to reveal evidence of asymmetric septal hypertrophy in four patients with systolic anterior movement of the mitral valve and the typical ausculatory and peripheral pulse abnormalities characteristic of HCM. Postmortem examimination in one patient demonstrated mild concentric left ventricular hypertrophy and a normal arrangement of myocardial muscle fibers. These observations in four patients demonstrate that both systolic anterior movement of the mitral valve and the physical findings characteristic of HCM are not specific for the autosomal dominant myocardial disease characterized by asymmetric septal hypertrophy and abnormal septal histology.

Adult↗
PubMed1977

Echocardiographic assessment of a normal adult aging population.

Echocardiograms were performed on 105 male participants in the National Institutes on Aging's volunteer Longitudinal Study Program. All subjects (25--84 years of age) were physically active and had no evidence of hypertension or cardiovascular disease. Measurements were made of the initial diastolic (E-F) slope of the anterior mitral valve leaflet, the aortic and left ventricular cavity dimensions, and the thickness of the posterior left ventricular wall. Fractional shortening of the minor semi-axis of the left ventricle and the velocity of circumferential fiber shortening were also determined. It was found that increasing age correlated with a decrease mitral valve E-F slope and increased aortic root diameter and left ventricular wall thickness. Aging did not affect left ventricular cavity dimension, fractional shortening of the minor semi-axis, and velocity of circumferential fiber shortening. These findings suggest that aging in the normal male is associated with altered left ventricular diastolic filling, increased aortic root diameter and left ventricle hypertrophy but little change in contractile ability in the resting state.

Adult↗
PubMed1977

Echocardiographic recognition of silent aortic root dilatation in Marfan's syndrome.

Echocardiography has proven a useful and sensitive means to determine noninvasively the cardiac dimensions. This report describes the echocardiographic detection of progressive dilatation of the aortic root over an 18-month period, which led to death in a 33-year-old man with Marfan's syndrome; however, at no time was the aortic dilatation evident on chest x-ray films. This patient illustrates the sensitivity of the echocardiogram in detecting and assessing the severity of disease of the aortic root not readily assessed by other noninvasive techniques and the value of serial measurements of aortic dimensions in patients with proven or suspected dilatation of the aortic root.

Adult↗
PubMed1976

Evaluation of left ventricular function in patients with sickle cell anemia.

The echocardiographic measurements of cardiac chamber dimension, ejection phase indices of left ventricular function and the systolic time intervals of 23 adult patients with sickle cell anemia were compared to those of normal control subjects. Patients with sickle cell anemia had a significantly greater mean left ventricular systolic dimension index, left ventricular diastolic dimension index, left ventricular mass, stroke volume index, interventricular septal width, aortic root index and left atrial index. No significant differences were noted between the mean velocity of circumferential fiber shortening, ejection fraction or systolic time intervals. The anemic population was divided into two groups; one consisting of patients less than 30 years old and the other of patients over 30 years old. There was no significant differences between the ventricular dimensions, velocity of circumferential fiber shortening, ejection fraction and systolic time intervals of the two groups. These data indicate that the chronic volume overload of sickle cell anemia is well tolerated without development of left ventricular dysfunction.

Adolescent↗
PubMed1976

Systolic anterior motion of the mitral valve without asymmetric septal hypertrophy.

This report describes a patient with echocardiographic systolic anterior motion of the mitral valve causing the anterior mitral leaflet to contact the septum in systole. At necropsy a normal nonhypertrophied heart with normal-sized ventricular cavities and a normal outflow tract and mitral valve was found. Thus, asymmetric septal hypertrophy and abnormal mitral valvular placement are not requisites for systolic anterior motion of the mitral valve. During systole, a marked forward movement of the anterior mitral leaflet developed in our patient in the setting of hypovolemia and continuous intravenous administration of pressor drugs, suggesting, rather, that systolic anterior motion reflects a small, vigorously contracting ventricular cavity and that such dynamic subaortic obstruction is not pathognomonic of idiopathic hypertrophic subaortic stenosis.

Aged↗
PubMed1976

The influence of ventricular function on the results of aortic valve replacement for aortic stenosis.

Thirty-three patients who had aortic valve replacement (AVR) for isolated aortic stenosis (AS) were retrospectively evaluated to determine the influence of preoperative ventricular function on the results of operation. Patients were arbitrarily divided by ejection fraction (EF) into Group I having EF 0.46 or above and Group II having EF 0.45 or below. Group II had significantly lower mean EF and cardiac index and higher left ventricular end-diastolic volume index and end-diastolic pressure. There were two early and no late deaths in 21 Group I patients. There were no early and five late deaths in 12 Group II patients. All Group I survivors and six of 12 Group II patients were New York Heart Association (NYHA) functional Class I or II at follow-up evaluation. No preoperative hemodynamic index was predictive of which Group II patients would do well. Mortality was substantially higher in patients with severe preoperative disability. Early or late death occurred in five of 12 patients who were NYHA functional Class IV before operation but in only two of 21 patients who were functional Class II or III preoperatively. We conclude that patients with isolated AS and poor left ventricular function have a low hospital mortality but an increased risk of late death or poor functional result following AVR. Excellent functional results can be obtained after AVR in most patients with AS and good left ventricular function and approximately half of the patients with AS and poor left ventricular function.

Adult↗
PubMed1975

Report of the inter-Society Commission for Heart Disease Resources. Optimal resources for ultrasonic examination of the heart.

The echocardiographic examination is described and the current status of ultrasound in cardiac diagnosis is summarized. Planning guidelines are provided for hospital based echocardiography laboratories including resource criteria for professional personnel and training, equipment, space, and support systems. Minimal case loads for maintaining quality performance of the examiner are recommended and various administrative patterns for organizing an echocardiography service are discussed. Approaches for establishing professional fees and emerging applications of diagnostic ultrasound in cardiovascular medicine are briefly reviewed. There is a description of the procedure for conducting an adequate echocardiographic examination in children and adults.

Adult↗
PubMed1975

Atypical posterior leaflet motion in echocardiogram in mitral stenosis.

The echocardiographic diagnosis of mitral stenosis is based on the finding of a decreased early diastolic slope of the anterior mitral leaflet. This finding is also seen in other conditions in which the rate of left ventricular filling is reduced by decreased compliance of the ventricular myocardium rather than by mitral valve obstruction. Patients with "true" mitral stenosis have been differentiated from those with decreased ventricular compliance resulting in "false" mitral stenosis by the direction of movement of the posterior mitral valve leaflet. This report describes a patient with mitral stenosis proved at cardiac catheterization whose echocardiogram showed posterior motion of thickened posterior mitral leaflet during diastole, a finding previously considered to exclude organic mitral stenosis. This false negative echocardiographic finding in proved mitral stenosis has not previously been reported.

Adolescent↗
PubMed1975

Echocardiography.

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Cardiomegaly↗