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Biomedical subjects

P Wilde

Publications and source records attributed to P Wilde.

69 records · Page 4Linked to original sources

Estimation of left ventricular end-diastolic pressure by pulsed Doppler ultrasound.

Left ventricular end-diastolic pressure (LVEDP) measured at cardiac catheterisation and simultaneous mitral flow patterns obtained by pulsed Doppler ultrasound scanning were assessed in twenty patients (fourteen males) with ischaemic heart disease. The ratio of passive and active components of mitral flow showed a significant linear correlation with LVEDP. Active (left atrial) mitral flow diminished as left ventricular end-diastolic pressures increased. Mitral flow ratios greater than 2 were always associated with LVEDP greater than 20 mmHg. This application of Doppler echocardiography provides a simple non-invasive method of estimating LVEDP.

Adult↗

Superior vena caval abnormalities: their occurrence rate, associated cardiac abnormalities and angiographic classification in a paediatric population with congenital heart disease.

Angiography of the superior systemic veins was performed on 510 patients with congenital heart disease. An analysis of these angiograms was carried out and a simple angiographic classification of superior vena caval anomalies is presented. Eleven per cent of cases had complete bilateral superior vena cavae, a frequency of occurrence higher than that previously reported. An analysis of associated congenital heart lesions revealed a higher than average association of bilateral superior vena cavae with atrioventricular septal defects and double-outlet right ventricle, but this was seen rarely in cases of transposition of the great arteries. Bilateral superior vena cavae also occurred very frequently (72%) in patients with situs abnormalities. Femoral vein catheterisation is likely to facilitate diagnosis and appropriate radiological signs are discussed.

Adolescent↗

The assessment of an edge detection algorithm in determining left ventricular ejection fraction using radio-nuclide multiple gated acquisition and contrast ventriculography.

The application of an edge detection algorithm (EDA) in defining the boundary of the left ventricle (LV) in multiple gated (MG) cardiac studies has been assessed by comparison of the left ventricular ejection fraction (LVEF) derived from X-ray contrast ventriculography (CV) in a series of patients. The results demonstrate good correlation between methods irrespective of the projection and LV status when an EDA is used, such that the correlation in anterior and left anterior oblique (45 degrees) views is 0.91 and 0.86 respectively.

Adult↗

Thallium myocardial imaging: recent experience using a coronary vasodilator.

Thallium-201 myocardial imaging is an important test in the assessment of patients with suspected coronary artery disease. Techniques differ in detail, reliability and in patient acceptability. Three techniques have been compared. Thirty-two-patients were studied in three groups. In the first group (15 patients) exercise thallium scans were compared with scans following an intravenous vasodilator (dipyridamole). In the second group (12 patients) intravenous dipyridamole and oral dipyridamole thallium scans were compared. In the third group (five patients) combined oral dipyridamole and exercise scans were assessed. There were no major differences in the first two groups but the combined test showed a marked increase in image quality and diagnostic yield. Thallium scanning is simplified considerably by the use of oral dipyridamole, without loss of diagnostic quality of safety. It promises to be the method of choice for stress scanning, and is ideal in patients unable to tolerate maximum exercise. The combined exercise--dipyridamole scan helps to evaluate complex problems, particularly those with less severe coronary insufficiency, and can be done without the use of a treadmill.

Administration, Oral↗

An edge detection algorithm for use in radionuclide imaging.

A method is described whereby the edges of computerised radionuclide images can be located by the application of an edge detection algorithm. Results obtained using computer simulated phantoms and radioactive distributions demonstrate the potential accuracy of incorporating such as algorithm into clinical studies.

Computers↗

Congenital coronary artery fistulae: six new cases with a collective review.

Primary congenital coronary artery fistula is diagnosed in two of every thousand patients investigated by angiocardiography. Males and females are equally affected and most frequently present under the age of 10 years. Fistulae originate from right and left coronary arteries in almost equal proportion but over 90% drain to the right side of the heart. Over half the patients present without symptoms but with a continuous murmur; as age increases so does the incidence of complications. Cardiac failure is the commonest complication. Three-quarters of patients presenting over the age of 40 have symptoms of cardiac failure. The clinical picture closely resembles that of patient ductus arteriosus but in a proportion of cases the physical signs and chest radiograph may suggest the diagnosis. A hitherto undescribed association of cardiac failure and a fistula from the left coronary artery to the left ventricle is reported. High-quality angiocardiography, preferably with selective coronary arteriography, is essential. Surgical correction carries a low mortality (2.2%) and is curative. The incidence of complications increases with age and prophylactic surgery is advocated before symptoms develop.

Adolescent↗

Management of postinfarction ventricular septal defect.

Postinfarction ventricular septal defect is an acute emergency which carries a very high mortality. Appropriate early intervention, however, can significantly increase the survival rate. This article discusses how to approach and manage this condition.

Aged↗