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Biomedical subjects

W C Roberts

Publications and source records attributed to W C Roberts.

At least 271 records · Page 15Linked to original sources
PubMed1987

Idiopathic dilated cardiomyopathy: analysis of 152 necropsy patients.

Certain clinical and cardiac necropsy findings are described in 152 patients aged 16 to 78 years (mean 45) with idiopathic dilated cardiomyopathy: 109 (72%) were men and 43 (28%) were women. Compared with the women, the men had a significantly (p less than 0.05) shorter mean duration of chronic congestive heart failure (CHF) (43 vs 69 months), a higher percentage of habitual alcoholism (40 vs 24%) and a higher mean heart weight (632 vs 551 g). The male to female ratio among the 58 known alcoholics was 7.3:1 and among the 70 known nonalcoholics, 1.5:1 (p less than 0.05). The mean duration of clinical evidence of CHF was similar among the known alcoholics and the known non-alcoholics (each 50 months). Of the 152 patients, 148 (97%) had clinical evidence of chronic CHF; in 114 patients it was the initial manifestation of idiopathic dilated cardiomyopathy, and in most it became intractable and caused death. The interval from onset of chronic CHF to death (known in 120 patients) ranged from 1 to 264 months (mean 54). Comparison of the 27 patients surviving greater than 72 months after onset of chronic CHF to the 64 patients surviving less than or equal to 36 months disclosed a significantly higher frequency in the longer survival group of older patients, of women, of habitual alcoholics, of patients with chest pain syndromes, diabetes mellitus, pulmonary emboli, of patients treated with warfarin and of patients with larger hearts at necropsy. Each of the 4 patients without chronic CHF died suddenly and sudden death was the initial manifestation of idiopathic dilated cardiomyopathy in them. An additional 33 patients also died suddenly, but each of them previously had had chronic CHF. Of the 79 patients (of the 131 for whom information was available) with either pulmonary or systemic emboli or both, 67 (85%) had either right- or left-sided thrombi or mural endocardial plaques or both, whereas of the 52 patients without emboli, 36 (69%) had intracardiac thrombi or plaques (p less than (0.05). Electrocardiograms in the last 6 months of life in 101 patients disclosed atrial fibrillation in 25; complete left (41 patients) or right (6 patients) bundle branch block or indeterminate intraventricular conduction delay (4 patients) in 51 patients; QRS voltage indicative of ventricular hypertrophy in 44 patients (left ventricular in 39 patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1987

Cardiac morphologic observations after operative closure of acquired ventricular septal defect during acute myocardial infarction: analysis of 16 necropsy patients.

Certain cardiac morphologic findings are described in 16 necropsy patients having operative closure of an acquired ventricular septal defect (VSD) during acute myocardial infarction (AMI). Of the 16 patients, 6 were women (mean age 69 +/- 7 years) and 10 were men (mean age 60 +/- 11 years). The AMI associated with the VSD was the first coronary event in 13 patients (81%). At least 6 patients had a history of systemic hypertension. Conduction disturbances were diagnosed by electrocardiogram in 5 patients (31%). The median interval from the onset of the AMI to death was 11 days, and from the onset of the AMI to operative closure of the VSD, 4 days. Eight patients died in the operating room or within 2 hours of operation. Coronary artery bypass grafting was performed simultaneously with the VSD closure in 7 patients. Death was attributed to unsuccessful VSD closure in 5 patients, to inadequate left ventricular cavity after resection of necrotic myocardium in 5 patients and to inadequate viable left ventricular myocardium in 4 patients. Heart weights were increased in 14 patients (88%). The AMI associated with the VSD was anterior in 9 patients and posterior (inferior) in 7. Healed myocardial infarcts were present in 3 patients. All 16 patients had severe (greater than 75% in cross-sectional area) narrowing of 1 or more of the 4 major epicardial coronary arteries.

Aged↗
PubMed1987

Retractions.

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Crime↗
PubMed1987

Frequency and significance of mitral anular calcium in hypertrophic cardiomyopathy: analysis of 200 necropsy patients.

To determine the frequency and significance of mitral anular calcium (MAC) in hypertrophic cardiomyopathy (HC), 43 clinical and morphologic variables in 200 necropsy cases of HC were examined. Of 100 patients less than 40 years of age, none had MAC. Of the 100 necropsy patients greater than 40 years, 30 (30%) had MAC, 21 (70%) of whom were women. The mean age of the 30 MAC patients was older than that of the 70 non-MAC patients greater than 40 years of age (66 years vs 53 years). The frequency of MAC increased with age. MAC was present in 3 of 31 patients (10%) aged 41 to 50 years; in 6 of 34 patients (18%) aged 51 to 60 years; in 11 of 21 patients (52%) aged 61 to 70 years; and in 10 of 14 patients (71%) aged 71 to 90 years. Compared with the 70 patients greater than 40 years of age without MAC, the 30 patients greater than 40 years of age with MAC had higher average systemic arterial peak systolic pressure (133 mm Hg vs 113 mm Hg); a larger percentage of the MAC patients had calcific deposits in the epicardial coronary arteries (93% vs 41%) and in the aortic valve cusps (33% vs 6%); and a larger percentage of the MAC patients had severe narrowing by atherosclerotic plaques of 1 or more of the 4 major epicardial coronary arteries (47% vs 24%). The frequency of a history of systemic hypertension, diabetes mellitus and total serum cholesterol levels greater than 200 mg/dl in the patients with and without MAC was similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Frequency of systemic hypertension in various cardiovascular diseases.

The clinical frequencies of systemic hypertension and necropsy evidence of cardiomegaly in various cardiovascular conditions are summarized. Systemic hypertension is present in greater than 50% of patients with various coronary events, in greater than 75% of patients with various cerebrovascular events and in greater than 90% of patients with aortic dissection. Hypertension is the sole underlying factor in most patients with nontraumatic cerebral arterial or aortic (dissection = partial rupture) rupture. In association with hypercholesterolemia (serum total cholesterol levels greater than 150 mg/dl), hypertension clearly accelerates atherosclerosis and its devastating consequences.

Aortic Diseases↗
PubMed1987

Calcification of healed myocardial infarcts.

Clinical and necropsy findings are described in 21 patients, aged 43 to 78 years (mean 63) (19 men [90%]), who had grossly visible calcified myocardial infarcts. The interval from the first clinically apparent acute myocardial infarct to death (20 patients) ranged from 2 to 26 years (mean 12). This interval was greater than 5 years in 17 patients (85%) and greater than 10 years in 11 patients (55%). The ages at the first clinically apparent acute myocardial infarct ranged from 36 to 72 years (mean 51). Of the 21 patients, 17 (81%) had clinical evidence of chronic congestive heart failure; 12 (57%) had left ventricular aneurysms; 8 (38%) had documented episodes of ventricular tachycardia; and 5 had angina pectoris. At necropsy, the heart weight was increased (greater than 400 g) in all (mean 557 g), the left ventricular cavity was dilated in all, and at least 1 and usually 2 or 3 (86%) major epicardial coronary arteries were narrowed greater than 75% in cross-sectional area by atherosclerotic plaque. Thus, patients with calcified myocardial infarcts are usually men, they usually have a myocardial infarct that calcifies at a relatively young age, the calcified wall is usually part of an aneurysmal wall, the left ventricular cavity is almost always dilated, heart weight is increased, and progressive congestive heart failure is the usual mode of death.

Adult↗
PubMed1987

Regional myocyte hypertrophy and increased interstitial myocardial fibrosis in hypertrophic cardiomyopathy.

The purpose of this study was to determine if the thickened cardiac walls of patients with hypertrophic cardiomyopathy (HC) are due to increased size or number of myocytes or increased amounts of fibrous tissue. Eight patients, aged 18 to 42 years, who died from complications of HC and 8 age-matched control subjects without heart disease were studied. A 1.5-cm3 block of tissue was removed from the left ventricular free wall, right ventricular free wall and ventricular septum (VS). Each region of each wall was evaluated for fibrous tissue by point counting; cell diameter was measured using an ocular micrometer disc. Cell layers were counted across the walls. The results revealed that increased cell size, cell layers and fibrous tissue are characteristic of HC, but only in the VS are all 3 significantly increased. The fibrous tissue was most extensive in the VS (19 +/- 9%), but it was more extensive than in the control subjects in all 3 walls. Cell diameters were largest in the layers closest to the left ventricular cavity.

Adult↗