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Biomedical subjects

W C Roberts

Publications and source records attributed to W C Roberts.

At least 343 records · Page 19Linked to original sources
PubMed1985

Electrocardiographic observations in clinically isolated, pure, chronic, severe aortic regurgitation: analysis of 30 necropsy patients aged 19 to 65 years.

Certain electrocardiographic findings are described in 30 necropsy patients with clinically isolated pure, chronic, severe aortic regurgitation. They were 19 to 65 years old (mean 45). The hearts of the 22 men ranged in weight from 430 to 1,110 g (mean 717) and of the 8 women, from 375 to 950 g (mean 638). Four had grossly visible left ventricular (LV) scars. All but 1 patient was in sinus rhythm. The PR interval was greater than 0.20 second in 8 patients (28%) and the QRS duration was greater than or equal to 0.12 second in 6 patients (20%). Only 5 patients (17%) had 1 or more ventricular premature complexes recorded on the resting electrocardiogram analyzed. The mean QRS amplitude for each of the 12 leads averaged 23 mm. The highest mean QRS voltage occurred in leads V2 and V3 (each 38 mm), and the lowest in lead aVR (11 mm). The mean QRS voltage in V5 was higher than in V6 (33 vs 28 mm) and in 22 patients (73%) the QRS voltage in V5 was higher than in V6. The sum of the S wave in V1 plus the larger of the R wave in V5 or V6 (Sokolow-Lyon index) averaged 51 mm and in only 22 patients (73%) was it greater than 35 mm. The Romhilt-Estes voltage criteria for LV hypertrophy was fulfilled even less frequently, despite the severe degrees of LV hypertrophy in the patients studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Detailed anatomy of the normally functioning aortic valve in hearts of normal and increased weight.

The area, weight and 4 linear variables were measured in each aortic valve cusp in 100 necropsy patients with normally functioning aortic valves, and the volume of each sinus of Valsalva and the aortic area at the sinotubular junction were determined in the same patients. The sums of the aortic valve cuspal areas, cuspal weights and sinus of Valsalva volumes increased with age (p less than 0.001) and with heart weight (p less than 0.001). All 3 variables (cuspal area, cuspal weight and sinus of Valsalva volume) also increased with age and heart weight relative to each other. The luminal area of aorta at the sinotubular junction also increased with age and heart weight and it also increased as the sum of the aortic valve cuspal areas and weights and sinus of Valsalva volumes increased. In only 16% of the 100 patients were the 3 aortic valve cusps of similar size (less than 5% difference in area between cusps); in 51%, 1 cusp was of different size than the other 2, and in 33% of patients all 3 cusps were of different sizes.

Adolescent↗
PubMed1985

The king of hearts: analysis of 23 patients with hearts weighing 1,000 grams or more.

Certain clinical and morphologic features are described in 23 patients in whom the heart at necropsy weighed at least 1,000 g (mean 1,106). The heart weight to body weight ratio ranged from 1.2 to 2.7 (normal 0.40). The 23 patients were derived from examination of the hearts of 7,671 patients with various cardiovascular disorders over a 25-year period. The massive cardiomegaly was the result of aortic regurgitation in 14 patients (61%): isolated in 8, associated with mitral regurgitation in 4, and with ventricular septal defect in 2. Three others (13%) had combined aortic valve stenosis and aortic regurgitation and 1 patient (4%) had mitral stenosis and regurgitation and mild aortic stenosis. Four patients (17%) had hypertrophic cardiomyopathy, and 1 patient (4%) had ventricular septal defect with mitral stenosis. They were 20 to 64 years old (mean 42) and 21 (91%) were men. Four patients at necropsy had 1 or more major coronary arteries narrowed more than 75% in cross-sectional area by atherosclerotic plaques, and only 4 patients had grossly visible left ventricular (LV) scars, 2 of whom had insignificant coronary narrowing. Examination of electrocardiograms in 17 of the 23 patients disclosed that Sokolow-Lyon criteria for LV hypertrophy was achieved in only 12 patients (71%) and Romhilt-Holt QRS voltage criteria faired even worse. Total 12-lead QRS voltage was more than 175 mm (10 mm = 1 mV) in 16 patients (94%) and it was more than 250 mm in 13 patients (76%). Total 12-lead QRS voltage in 17 patients ranged from 140 to 601 mm (mean 323). Measurement of the sum of the 12-lead QRS voltage may be quite useful in diagnosing LV hypertrophy by electrocardiogram.

Adult↗
PubMed1985

Remnant saphenous veins after aortocoronary bypass grafting: analysis of 3,394 centimeters of unused vein from 402 patients.

To assess the status of a saphenous vein (SV) excised for coronary artery bypass grafting (CABG), 3,394 cm of remnant SV from 402 patients who underwent CABG were examined. The SV remnants were 0.5 to 52 cm long (mean 8.4). They were sectioned into 5-mm-long segments, and the resulting 6,788 five-millimeter segments were examined histologically: 5,896 (87%) were narrowed 0 to 25% in cross-sectional area by fibrous tissue; 853 (12%) were narrowed 26 to 50%; 23 (0.6%), 51 to 75%, and 16 (0.4%) segments were narrowed 76 to 100%. Of the 16 segments severely narrowed, 7 (44%) were nearly totally occluded by fibrous tissue. In 17 patients who died within 24 hours of CABG, similar degrees of luminal narrowing were observed in remnant segments and in utilized segments of SV. Thus, significant preexisting luminal narrowing of SV used for CABG is infrequent. The intimal fibrous thickening is variable within the same vein when each 5-mm-long segment is analyzed; it is variable from 1 vein to another in the same patient, and it varies among patients.

Adult↗
PubMed1985

The carcinoid syndrome: comparison of 21 necropsy subjects with carcinoid heart disease to 15 necropsy subjects without carcinoid heart disease.

Carcinoid heart disease is a morphologically specific type of cardiac disorder that involves the mural and valvular endocardium on the right side of the heart. Twenty-one subjects (57 percent) (Group I) with carcinoid heart disease and 15 subjects (43 percent) (Group II) without carcinoid heart disease were studied at necropsy. The two groups were similar in mean age (54 years versus 55 years), duration of clinical illness (4.7 years versus 6.3 years), body weight (50 kg versus 52 kg), systemic blood pressure (117/77 mm Hg versus 128/77 mm Hg), blood hematocrit levels (37 percent versus 36 percent), total serum protein levels (6.0 g/dl), and serum albumin levels (2.2 g/dl versus 2.6 g/dl). The two groups were different in the frequency of the presence of precordial murmurs consistent with tricuspid regurgitation and/or pulmonic stenosis (95 percent versus 13 percent), cardiomegaly by chest radiography (38 percent versus 0), low voltage on electrocardiography (47 percent versus 0), and location of the primary site of the carcinoid tumor. Total electrocardiographic 12-lead QRS voltage was similar in each group (105 mm versus 132 mm) (10 mm = 1 mV). Of Group I subjects, 43 percent died of cardiac causes; none of the Group II subjects died of cardiac causes. Of the 21 subjects with carcinoid heart disease, seven had left-sided cardiac involvement, but in none was it of functional significance. Thus, although carcinoid heart disease frequently is the cause of death in patients with the carcinoid syndrome, the development of carcinoid heart disease is not related to the duration of symptoms of the carcinoid syndrome.

Adult↗
PubMed1985

Analysis of page utilization and types of articles published in four major American cardiology journals in 1984.

Several peer-review journals devoted exclusively to cardiology are published in the U.S.A. Although the types of articles and the authors of (and reviewers for) the articles in the various American cardiologic journals are similar, the numbers of articles and pages utilized for them in the various journals are quite different. This article summarizes the results of counting the numbers of editorial (non-advertising) pages published and the types of articles published during 1984 in the American Heart Journal, the American Journal of Cardiology, Circulation, and the Journal of the American College of Cardiology.

Cardiology↗
PubMed1985

Anorexia nervosa and sudden death.

Necropsy findings and electrocardiograms from three women with anorexia nervosa were reviewed. Necropsy examination failed to establish an anatomic cause of death. Electrocardiograms recorded days or less before death showed various degrees of Q-T interval prolongation: Q-T intervals corrected for heart rate measured 0.61 s, 0.47 s, and 0.46 s, respectively. Terminal ventricular tachyarrhythmias were documented in two patients, including torsade de pointes in one. The necropsy and clinical findings in these three cases provide evidence that sudden death in anorexia nervosa, like sudden death in liquid-protein dieting, may result from ventricular tachyarrhythmias related to Q-T interval prolongation. For such patients, electrocardiographic monitoring should be routine.

Adult↗
PubMed1984

Sudden coronary death: comparison of patients with to those without coronary thrombus at necropsy.

Among 70 victims of sudden coronary death (SCD), certain clinical and morphologic findings in the 13 with a coronary thrombus are compared with the findings in 57 victims without a coronary thrombus. The 13 with a thrombus were younger than those without (mean age 43 vs 51 years, p less than 0.02); had a lower mean percent of cross-sectional area (XSA) narrowing by plaque at the site of maximal coronary stenosis (89% vs 95%, p less than 0.01); and had a higher mean percent of 5-mm segments of the 4 major epicardial coronary arteries minimally narrowed (0 to 25% in XSA) by plaque (27% vs 19%, p less than 0.001). No differences occurred in the 2 groups with regard to sex, previous angina pectoris or clinical acute myocardial infarction, healed myocardial infarction at necropsy, mean heart weight, number of major coronary arteries narrowed 76 to 100% in XSA by atherosclerotic plaque, or the mean percent of 5-mm segments of the 4 major epicardial coronary arteries narrowed 76 to 100% in XSA by atherosclerotic plaque. Thus, coronary thrombi are infrequent in victims of SCD, and when observed, their significance is uncertain because victims of SCD without coronary thrombi have similar amounts of severe coronary narrowing.

Adult↗