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Biomedical subjects

W C Roberts

Publications and source records attributed to W C Roberts.

At least 253 records · Page 14Linked to original sources
PubMed1988

Serial electrocardiographic changes in idiopathic dilated cardiomyopathy confirmed at necropsy.

Serial electrocardiographic changes in necropsy-proven idiopathic dilated cardiomyopathy are evaluated and a method of predicting heart weight using QRS amplitudes is described. In 34 patients with multiple electrocardiograms (mean 3/patient) progressive prolongation of PR interval (0.18 +/- 0.03 to 0.21 +/- 0.03, p less than 0.001) and QRS duration (0.10 +/- 0.02 to 0.13 +/- 0.03, p less than 0.0001) was noted. Progressive conduction abnormalities were common (82%). QTc interval and QRS- and T-wave axes did not change. In 50 patients with electrocardiograms within 60 days of death, total 12-lead QRS and V1 through V6 QRS amplitude correlated better with heart weight (r = 0.51, p less than 0.0001 and r = 0.55, p less than 0.0001) than the Estes-Romhilt score did. The mean total 12-lead QRS amplitude was 138 mm with a mean of 106 for V1 through V6. In 31 patients cardiac mass index was calculated and showed significant correlation with 12-lead and V1 through V6 QRS amplitudes (r = 0.68, p less than 0.0001 and r = 0.75, p less than 0.0001, respectively). The QRS amplitudes remained constant during the illness. By using total 12-lead QRS or frontal plane QRS amplitude, heart weight can be predicted as early as 2 years before death. Use of body surface area and QRS amplitude criteria increases the accuracy of heart weight prediction. Thus, progressive electrocardiographic changes are common in patients with idiopathic dilated cardiomyopathy and QRS amplitude criteria are more accurate in the prediction of left ventricular hypertrophy than standard criteria.

Adolescent↗
PubMed1988

Acquired ventricular septal defect during acute myocardial infarction: analysis of 38 unoperated necropsy patients and comparison with 50 unoperated necropsy patients without rupture.

Thirty-eight patients (24 men and 14 women) with an acquired ventricular septal defect during acute myocardial infarction (AMI) (rupture group) were studied and their clinical and necropsy findings were compared with 50 patients who died during their first AMI without rupture (nonrupture group). The frequency of systemic hypertension (54 vs 52%), angina pectoris (28 vs 22%) and congestive heart failure (5 vs 0%) before the fatal AMI was similar for both rupture and nonrupture groups. Mean heart weights for men (498 vs 526 g) and women (397 vs 432 g) with and without septal rupture also were insignificantly different. Whereas previous studies of fatal AMI cases have shown that 50% of cases of fatal AMI without rupture have left ventricular scars, only 4 (10%) of the rupture cases had a left ventricular scar before the infarct that ruptured. The rupture group had a significantly more frequent (p less than 0.01) posterior location of the infarcts (74 vs 40%) and, therefore, a higher frequency of associated right ventricular infarcts 50 vs 18%). The number of 3 major (right, left anterior descending and left circumflex) epicardial coronary arteries narrowed at some point greater than 75% in cross-sectional area of atherosclerotic plaque was the same in both groups. The percent of these 3 arteries totally occluded or nearly so (greater than 95% in cross-sectional area) by plaque was significantly less (p less than 0.001) in the rupture group compared with the nonrupture group (9 of 99 arteries [9%] vs 38 of 144 arteries [26%]).(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1988

Significance of cardiac weight in patients having coronary artery bypass grafting for angina pectoris.

Cardiac weight at necropsy in 211 patients who had coronary artery bypass grafting (CABG) for angina pectoris, and its relation to early (less than 60 days) and late (greater than 60 days) death after CABG was sought. The 121 patients dying early had a lower mean heart weight than did the 90 patients dying late (444 +/- 94 vs 498 +/- 107 g; p less than 0.001). The mean heart weight of the 85 men dying early was less than that of the 75 men dying late (472 vs 506 g; p less than 0.05), and the mean heart weight of the 36 women dying early was less than that of the 15 women dying late (377 vs 459 g; p less than 0.005). Most patients with hearts of normal weight were in the early death group: of the 17 women with hearts of normal weight (less than or equal to 350 g), 16 (94%) died early (p less than 0.01), and of the 34 men with hearts of normal weight (less than or equal to 400 g), 21 (62%) died early (difference not significant). Conversely, most patients in the late death group had hearts of increased weight: of the 15 women dying late, 14 (93%) had hearts of increased weight, and of the 75 men dying late, 62 (83%) had hearts of increased weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Effects of percutaneous transluminal coronary angioplasty on atherosclerotic plaques and relation of plaque composition and arterial size to outcome.

To delineate their relation to outcome of percutaneous transluminal coronary angioplasty (PTCA), the atherosclerotic plaque composition and coronary artery size in 82 five-mm long segments at 28 PTCA sites were determined in 26 patients having PTCA. The 26 patients were subdivided into 3 groups according to the degree of angiographic patency at the end of the PTCA procedure and to the duration of survival after PTCA (less than or equal to 30 or greater than 30 days): early success (13 patients, 16 PTCA sites and 49 five-mm segments); early failure (4 patients, 4 PTCA sites and 16 five-mm segments) and late success (9 patients, 8 PTCA sites and 17 five-mm segments). The mean percent of plaque comprised of fibrous tissue among the 3 groups was 80 +/- 18%, 71 +/- 23% and 82 +/- 16% (difference not significant); the mean percent of plaque comprised of lipid was 17 +/- 16%, 21 +/- 24% and 16 +/- 15% (difference not significant); and of calcium it was 3 +/- 4%, 8 +/- 10% and 2 +/- 3% (p = 0.01). The mean coronary arterial internal diameter was 3.3 +/- 0.6, 3.9 +/- 1.2 and 3.2 +/- 0.7 mm (p less than 0.02). Plaque tear was present in 1 or more histologic sections in 25 of the 26 patients and the 1 patient without it had the longest interval (nearly 3 years) between PTCA and death. Plaque tear extending from intima into media with dissection was observed only in the early and late success groups (p = 0.03). Hemorrhage into plaque was present in 16 (80%) of 20 PTCA sites in the 2 early groups and in 3 (37%) of 8 sites in the late group (p less than 0.03). Occlusive thrombus (5 of 16, 1 of 4 and 1 of 8) and plaque debris (7 of 16, 1 of 4 and 2 of 8) in residual lumens were insignificantly different among the 3 groups and their 82 five-mm segments. Plaques that had greater than 25% lipid content, however, had an increased frequency of hemorrhage into plaque (p less than 0.004), occlusive thrombus (p = 0.0001) and plaque debris in residual lumens (p less than 0.05). These findings suggest that coronary arterial size and plaque composition are strong determinants of PTCA outcome. The ideal coronary arterial atherosclerotic narrowing for both technically and clinically successful PTCA appears to be a small (less than 3.3 mm in internal diameter) artery in which the plaque contains relatively little calcium and lipid.

Adult↗
PubMed1988

The aging heart.

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Aging↗