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Biomedical subjects

T Cochrane

Publications and source records attributed to T Cochrane.

At least 37 records · Page 2Linked to original sources
PubMed1989

The effect of flow on Doppler estimates of bioprosthetic mitral valve function in vitro.

In order to assess the effect of flow on peak transmitral velocity and pressure half time and to test the Hatle orifice area formula, four Carpentier-Edwards mitral prostheses were studied in a positive displacement flow simulator at 20 different stroke volume/rate combinations using a constant left ventricular filling curve. Peak transmitral velocity was directly related to mean flow and differed significantly between the individual values (F79 = 38; p less than 0.00001). There was, however, no significant difference in pressure half time between the four values (F79 = 0.04; p = 0.99). Pressure half time was directly related to diastolic time interval (r = 0.98, y = 0.41x - 17.84; p less than 0.00001), but was independent of stroke volume. There was only a moderate inverse correlation between pressure half time (T1/2) and orifice area (r = 0.56, y = 0.67 + 69/T1/2; p less than 0.0001). These results are consistent with the suggestion that pressure half time is more closely related to the shape of the left ventricular filling curve than to orifice area in normally functioning bioprostheses.

Bioprosthesis↗
PubMed1988

Reduced hyperaemic response under the diabetic neuropathic foot.

Diabetic neuropathic ulcers typically occur at high pressure sites. Microvascular blood flow has been assessed on the plantar surface of the foot in three matched groups each of 12 subjects free from macrovascular disease: (a) patients with diabetic neuropathy with abnormal foot pressures and previous neuropathic ulceration; (b) non-neuropathic diabetic patients; (c) non-diabetic control subjects. Resting flow was measured at the highest pressure point under the metatarsal heads (defined by pedobarograph) using laser doppler flowmetry, and the hyperaemic response was assessed at the same site following 3 min standing. Peak flow was significantly reduced in neuropathic patients (2.3 +/- 1.4 (SD) volts) compared with control subjects (4.0 +/- 2.0 volts; p less than 0.03). The time for blood flow return to baseline was significantly prolonged in neuropaths (159 +/- 72 s) compared with normal subjects (93 +/- 18 s; p less than 0.01), with a significant delay also seen in non-neuropaths (151 +/- 38 s; p less than 0.0001 compared with normal).

Adult↗
PubMed1987

Rapid autonomic tone regulation of atrioventricular nodal conduction in man.

The changes in P-P intervals and atrioventricular nodal (AVN) conduction during the Valsalva maneuver were studied in 17 patients. In spite of a significant decrease in the sinus P-P interval during phase II of the maneuver (733 +/- 143 to 520 +/- 86 msec, p less than 0.005) and prolongation during phase IV (884 +/- 171 msec, p less than 0.01), there was no change in the AH interval (control: 78 +/- 15: phase II: 76 +/- 15: phase IV: 72 +/- 14 msec, N.S.). In six patients consecutive P-P intervals during phase II were recorded in solid-state memory and were used to trigger pacing of the high right atrium at rest. This showed a significant increase in the AH interval (75 +/- 10 to 123 +/- 45 msec, p less than 0.05). Valsalva maneuver during constant rate atrial pacing resulted in a significant decrease in the AH interval during phase II (115 +/- 36 to 80 +/- 15 msec, p less than 0.001). During phase IV there was prolongation of the AH interval (156 +/- 58 msec) but in 11 patients (61%) a variable degree of Wenckebach periodicity appeared. Thus autonomic tone modulates the changes in AVN conduction induced during physiologic heart rate variation, resulting in maintenance of adequate 1:1 AVN conduction.

Adolescent↗
PubMed1987

A one-dimensional model of atrioventricular nodal conduction.

A computer model of the cardiac conduction process and an integral equation mathematical model have been employed to study the functions of the atrioventricular (AV) node. Special attention has been paid to the dependence of conduction delay on cycle length. The models have been used to evaluate the question as to whether simple cycle length dependences of AV nodal conduction could cause the oscillations of cycle length which are sometimes observed in AV reentry tachycardia. The models consider the AV node as a linear structure in which the depolarisation wavefront radiates in one dimension only. A model representing the node by two parallel linear structures has also been examined. Some results obtained do not conform with those of natural circumstance and clinical experiments, suggesting that the above hypotheses of AV nodal function are too simple and restricted to explain the natural processes.

Atrioventricular Node↗
PubMed1987

Comparison of laser Doppler and Doppler ultrasound in lower limb vascular diagnosis.

This study represents a preliminary investigation into the use of laser Doppler flowmetry in lower limb vascular diagnosis. The method is compared with the accepted method of continuous wave Doppler ultrasound. Fifty-six patients with symptoms of lower limb vascular disease were investigated consecutively and independently using both techniques. In approximately two-thirds of patients the two methods showed broad agreement in their classification of disease severity (correlation coefficient = 0.63, P less than 0.001, n = 41). However, about 30% of those studied had impaired microvascular responses on laser Doppler evaluation with no detectable major vessel disease on continuous wave ultrasound investigation. The results indicate that more information is obtained about a subject's vascular status when results from both methods are combined. Thus laser Doppler flowmetry may be useful adjunct to Doppler ultrasound and segmental pressure measurements in the vascular laboratory.

Adult↗
PubMed1986

Computer simulation of cardiac rhythm and artificial pacemakers using a ten-element heart model.

This paper describes a universal simulation system which enables simulation models of cardiac rhythm disturbances and of artificial pacemaker actions to be constructed. Three types of heart element are introduced according to the way in which excitation impulses are propagated or produced. Cycle rate dependence of repolarization periods and of impulse transmission speeds is incorporated. Random and predetermined deviations from natural behavior are also allowed for in the model. Using the universal system, a model of simple configuration has been developed. There are five physiological and five pathological heart components joined together by uni- and bidirectional connectors. Additional bidirectional channels allow a variety of pacemakers to be "implanted" in the simulated heart.

Arrhythmias, Cardiac↗
PubMed1986

Laser Doppler flowmetry: in the assessment of peripheral vascular disorders? A preliminary evaluation.

Skin is a representative microvascular bed providing easy access for the study of capillary haemodynamics. In this preliminary evaluation we have used laser Doppler flowmetry to measure the response of skin capillary blood flow to local thermal stimulation. The purpose of our study was to see if such measurements can be used to derive useful clinical information. Thirty subjects, 15 male and 15 female, were selected to establish "normal' patterns of behaviour. All normal subjects studied showed similar patterns of response. There was a slight downward trend in red-blood-cell flux with age. Periods of vasomotor activity were present at rates ranging from 4-17 cycles/min. The mean temperature rise in the heated skin area was 4 degrees C. Blood flow over this range increased by a factor of 10 or more. Clinical cases studied were strictly limited to three categories of disease with known or suspected microvascular changes: algodystrophy, lower-limb ischaemia and diabetic neuropathy. All the clinical cases studied showed deviations from the normal pattern. Patients with algodystrophy had impaired peripheral vascular function in the affected area. Patients with lower-limb ischaemic problems all had poor peripheral perfusion. In the limited number of diabetic neuropathic feet studied two patterns emerged: patients with no evidence of ulceration displayed striking vasomotor activity; those with more severe problems had reduced red-blood-cell flux and little evidence of vasomotor control.

Adolescent↗
PubMed1985

Shell computer model of cardiac electropotential changes.

A discrete process computer model has been developed to simulate the electropotential changes of heart musculature and the operation of the cardiac conduction system. The model is implemented on an ICL-4/72 computer and is oriented to cardiac rhythm studies, allowing practically all rhythm pathologies, including pacemaker applications, to be simulated. The paper describes in detail the principles on which the model is based, compares the model with other models of the same system and shows concisely some results of simulation experiments in the form of computer generated ECG records.

Atrioventricular Node↗
PubMed1985

A report generator package for routine laboratory tests in a hospital cardiology department.

A simple report generating package is described. The package is designed for hospital computing personnel who wish to develop fast, easy access, easy-to-use report generating programs for use by non-computer specialists. Use of the system is illustrated by examples from three sections within a hospital cardiology department: nuclear cardiology, M-mode echocardiography and reporting of 24-hour ambulatory electrocardiogram tapes.

Cardiology↗
PubMed1983

Computer simulation of the cardiac conduction system.

A discrete computer model simulating the operation of the cardiac impulse transmission apparatus and the electropotential changes of the heart musculature has been developed on a NORD-100 minicomputer. The model is written in NORD-FORTRAN and allows description of practically all basic pathologies of the transmission apparatus. A simulated ECG curve is produced in each case. The current version of the model is especially suited for studies of heart rhythms. Pacemaker descriptions (of most important pacemaker types) have been introduced into the model and the computer computations make it possible to assess the effects of different pacemaker modes under different pathological situations. The principles on which the model is based is described and the paper shows concisely several examples in the form of simulated ECG records.

Arrhythmias, Cardiac↗
PubMed1983

Cardiac electrophysiological studies: computer analysis using a digitiser and interactive visual display unit.

Recording of localised intracardiac electrical potentials provides useful and important information on conduction disease in man. Analysis of intracardiac recordings involves measurement of large numbers of timing intervals representing the sequence of activation of the various part of the cardiac conduction system. In this paper we describe a semi-automatic computer based analysis system tailored to the specific requirements of cardiac electrophysiological measurement. A digitising tablet is used in conjunction with a visual display oriented data handling package to input data directly to computer memory for sorting and further analysis. Particular attention is paid to providing the user with a system that is simple to learn yet is robust and flexible in use. The computer software is written entirely in the high level FORTRAN language. It is modular in design and is therefore easily adapted for the changing needs of a research oriented department.

Arrhythmias, Cardiac↗
PubMed1983

Ambulatory monitoring of pulmonary artery pressure. A preliminary clinical evaluation.

Traditional measurement and recording methods are inadequate for continuous monitoring of ambulatory pulmonary artery pressure. Therefore a new miniaturised solid state system has been developed and assessed. A manometer tipped catheter, inserted via a subclavian or cephalic vein, was used together with an isolated amplifier and peak detectors to determine systolic and diastolic pressures. Pressures were averaged over 30 seconds and stored in digital memory. After a 24 hour recording period data were rapidly transferred to a microcomputer for numerical or graphical display. Thirteen patients had continuous ambulatory monitoring performed for between 24 and 96 hours, in seven to evaluate symptoms of dyspnoea in subjects with valvular or coronary disease (group 1), and in six to achieve optimal oral treatment for left heart failure (group 2). The catheter was calibrated before insertion and was rechecked after removal. There was less than 1% zero level drift and similar gain stability. Systolic pressures ranged from 10 to 97 (mean 39.5) mmHg, and diastolic from 1 to 46 (mean 15.3) mmHg. Four patients in group 1 had symptoms of dyspnoea associated with normal pressures, while three had raised pressures. Four of the six patients monitored in group 2 had major alterations in their treatment based on data obtained during monitoring. There were no complications. This system, which allows safe, reliable, and prolonged recording of ambulatory pulmonary artery pressure, represents a considerable advance in the ability to assess the cause of dyspnoea and to manage left heart failure.

Adult↗