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Biomedical subjects

W L Henry

Publications and source records attributed to W L Henry.

At least 109 records · Page 6Linked to original sources
PubMed1979

Echocardiographic assessment of cardiac anatomy and function in acromegalic patients.

Echocardiography was used to evaluate cardiac anatomy and function in 25 patients with accromegaly. Eighty per cent of the patients (20 of 25) had abnormal echocardiograms including 13 patients without other signs or symptoms of cardiac involvement. The most common abnormality was increased left ventricular mass with concentric left ventricular wall thickening, which was found in 64 per cent (16 of 25) of the patients. Increased left ventricular transverse dimension at end diastole was found in 36 per cent (nine of 25) of the patients. Other echocardiographic abnormalities found included left atrial or aortic root enlargement (three patients), disproportionate septal thickening (one patient) and depressed left ventricular ejection fraction (three patients). Since five of the patients with increased left ventricular mass had no history of hypertension or hyperthyroidism, the increased mass cannot be ascribed solely to these conditions commonly associated with acromegaly. Furthermore, the degree of cardiac hypertrophy showed no significant correlation with pre- or post-treatment growth hormone levels, or with known duration of acromegaly prior to treatment. Thus, although the pathophysiology and significance of cardiac abnormalities in acromegalic patients is not yeat fully understood, echocardiography does provide a sensitive tool for detecting such abnormalities before they are otherwise apparent.

Acromegaly↗
PubMed1979

Echocardiographic assessment of cardiac anatomy and function in hypertensive subjects.

Cardiovascular complications are a major source of morbidity and mortality in hypertensive patients. To assess the prevalence of anatomic and functional abnormalities of the heart in such patients, we studied 234 asymptomatic subjects with mild-to-moderate systemic hypertension by echocardiography. After adjusting the echocardiographic values for age and body surface area, we found abnormally increased ventricular septal and/or posterobasal free-wall thickness in 61% of the hypertensive subjects. We found increased left atrial, aortic root, and left ventricular internal dimension (at end-diastole) in 5-7%, and decreased mitral valve closing velocity (E-F slope) and left ventricular ejection fraction were noted in six and 15% of the subjects, respectively. Four percent of the patients had disproportionate septal thickening (i.e., ventricular septal-to-left ventricular free-wall thickness ratio greater than or equal to 1.3). In contrast to the high prevalence of cardiac abnormalities detected by echocardiography, less than 10% of the hypertensive subjects had abnormal 12-lead ECGs or abnormal chest x-rays. These findings demonstrate a high prevalence of cardiac abnormalities in a population of asymptomatic hypertensive subjects. These abnormalities can be detected by echocardiography before they are otherwise apparent.

Adult↗
PubMed1979

Echocardiographic comparison of black and white hypertensive subjects.

Echocardiography was used to compare cardiac structure and function in 35 pairs of hypertensive blacks and hypertensive whites matched for age, sex, level and known duration of hypertension, treatment status, and renin level.Echocardiographic abnormalities were common in both groups and included increased ventricular septal thickness and/or left ventricular free-wall thickness in 51 percent of black hypertensives and 69 percent of white hypertensives. Paired analysis indicated no significant difference between black and white hypertensive subjects in any of the echocardiographic parameters including ventricular transverse dimensions (at end diastole and at end systole), left atrial and aortic root dimensions, left ventricular ejection fraction, and mitral valve E-F slope. Thus echocardiographic evaluation of black and white hypertensive subjects, matched for clinical characteristics, suggests a similar prevalence of cardiac abnormalities in the two groups.

Adult↗
PubMed1978

Abnormal right ventricular size and ventricular septal motion after atrial septal defect closure: etiology and functional significance.

Postoperative echocardiogram often demonstrate persistent right ventricular dilatation and paradoxic ventricular septal motion after repair of an atrial septal defect. To determine the prevalence, causes and significance of these echocardiographic abnormalities, 31 patients were studied with catheterization and echocardiography before and after repair of an atrial septal defect. Before operation, every patient manifested right ventricular dilatation, and all but one had abnormal septal motion. After operation, right ventricular dilatation was noted in 24 (77%) and abnormal septal motion in 21 (68%) patients despite the absence of residual left to right shunting in 30 (97%). These echocardiographic abnormalities could be correlated with age at operation and length of postoperative follow-up study but did not correlate with the degree of preoperative right ventricular enlargement or with shunt size or right ventricular pressure before or after operation. There was no associated functional deficit as demonstrated by the normal maximal oxygen consumption in all 13 patients who underwent treadmill exercise testing 5 to 38 months after operation; these patients included 9 with persistent right ventricular enlargement and abnormal septal motion.

Adolescent↗
PubMed1978

Exercise-induced left ventricular dysfunction in symptomatic and asymptomatic patients with aortic regurgitation: assessment with radionuclide cineangiography.

In patients with aortic regurgitation,, left ventricular dysfunction at rest, which is associated with a poor long-term prognosis, often develops before severe symptoms. To determine whether evidence of left ventricular dysfunction could be detected before it appeared at rest, 43 patients with severe aortic regurgitation were studied using radionuclide cineangiography during exercise. In 30 normal subjects, left ventricular ejection fraction increased during exercise (57 +/- 1 percent [mean +/- standard error] at rest, 71 +/- 2 percent during exercise, P less than 0.001). In contrast, among 21 symptomatic patients, ejection fraction was normal at rest in 14 patients (average 47 +/- 2 percent) but normal during exercise in only one patient (average 38 +/- 2 percent, P less than 0.001). Ejection fraction was normal at rest in 21 of 22 asymptomatic patients (average 62 +/- 2 percent) but was normal during exercise in only 13 (average 57 +/- 3 percent, P less than 0.001). Thus, exericse-induced left ventricular dysfunction can precede symptoms and dysfunction at rest. Radionuclide assessment of left ventricular function during exercise may prove valuable in sequentially following the state of left ventricular function in patients before the onset of symptoms or of irreversible left ventricular failure.

Adolescent↗
PubMed1978

Echocardiographic abnormalities in patients with transfusion-dependent anemia and secondary myocardial iron deposition.

The heart was evaluated by echocardiography in 56 patients at risk for myocardial iron deposition. Fifty-four had congenital anemia for which they required repeated transfusions, and two had primary hemochromatosis. The data, plotted according to one of three functions of the body surface area, were compared to values obtained in 105 normal subjects whose age spanned a similar range. Left ventricular wall thickness, transverse dimension and mass, as well as left atrial transverse dimension, were increased in the majority of patients with chronic iron overload despite the infrequent occurrence of cardiac enlargement on routine chest films (32 per cent) or electrocardiographic abnormality (16 per cent). Left ventricular ejection fraction was normal in all but four patients. These four patients died within a six month follow-up period suggesting that deterioration in systolic function is an indicator of poor prognosis. Our findings indicate that echocardiography provides a simple noninvasive means for assessing changes in cardiac structure and function that should prove useful in the serial evaluation of patients who are at risk for the development of myocardial iron deposition.

Adolescent↗
PubMed1978

Blood chemistry abnormalities in bacterial endocarditis of narcotic addicts.

We recently treated two narcotic addicts with bacterial endocarditis who developed the syndrome of inappropriate antidiuretic hormone secretion (SIADH). This prompted a retrospective review of blood chemistry studies in all narcotic addicts admitted to our hospital over a 30-month period because of a clinical suspicion of bacterial endocarditis. Patients with culture-positive endocarditis (group 1) had significantly lower plasma osmolality, sodium, calcium and albumin values (P less than .02, .001, .005, and .005 respectively) than addicts without endocarditis (group 2). More than 90% of those in group 1 had hyponatremia, and 48% had plasma hypoosmolality. These findings may be of value in the initial evaluation of ill narcotic addicts for hospitalization.

Adult↗
PubMed1978

Prevalence and characteristics of disproportionate ventricular septal thickening in patients with coronary artery disease.

Echocardiographic or necropsy studies were performed in 151 patients with coronary artery disease. Prevalence of disproportionate septal thickening (septal to free wall ratio greater than or equal to 1.3) was 11%. An abnormally increased septal-free wall ratio in these patients had two principal etiologies. First, it was a manifestation of genetically transmitted hypertrophic cardiomyopathy, as evidenced by disproportionate septal thickening in first degree relatives. Second, it was due to disproportionate septal thickening which did not appear to be a manifestation of genetically transmitted hypertrophic cardiomyopathy. This latter conclusion was suggested by negative echocardiographic studies in some families of patients with both coronary artery disease and disproportionate septal thickening. In addition, numerous disorganized cardiac muscle cells, characteristically present in patients with genetically transmitted hypertrophic cardiomyopathy, were absent from the septum of all patients with disproportionate septal thickening studied at necropsy. Although the mechanism responsible for this secondary type of disproportionate septal thickening is unknown, our results indicate that the presence of disproportionate septal thickening in a patient with coronary artery disease does not, per se, indicate the coexistence of genetically transmitted hypertrophic cardiomyopathy.

Coronary Disease↗
PubMed1978

Echocardiographic measurements in normal subjects. Growth-related changes that occur between infancy and early adulthood.

Echocardiographic measurements of the left ventricular dimensions and wall thicknesses at end diastole and end systole, aortic root and left atrial dimensions, mitral valve E-F slope, left ventricular ejection fraction, percent fractional shortening of the left ventricular internal dimension, estimated left ventricular mass and percentage systolic thickening of the ventricular septum and left ventricular free wall were obtained in 105 normal subjects ranging from one day to 23 years of age. Each parameter was found to follow a linear regression upon one of three functions of the body surface area. The internal dimensions of left ventricle, the left atrium, and the aortic root, and the mitral valve E-F slope varied in a linear relation to the cube root of the body surface area. Thickness of the ventricular septum and left ventricular free wall varied in a linear relation to the square root of the body surface area. Estimated left ventricular mass varied linearly with the direct measurement of body surface area. Ejection fraction, percent fractional shortening of the left ventricle and percent systolic thickening of the ventricular septum and left ventricular free wall were independent of body surface area despite a marked increase in the size of the left ventricle during normal growth and development.

Adolescent↗
PubMed1978

Left ventricular outflow tract obstruction due to systolic anterior motion of the anterior mitral leaflet in patients with concentric left ventricular hypertrophy.

Patients with hypertrophic cardiomyopathy (i.e., asymmetric septal hypertrophy) may show obstruction to left ventricular outflow under basal conditions or with provocative maneuvers. The presence of dynamic left ventricular outflow tract obstruction in patients with concentric ventricular wall thickening (but without abnormalities of the aortic valve) has been less well appreciated. Clinical and morphologic features of five patients with nondilated left ventricles and with left ventricular outflow obstruction are presented. In each patient peak systolic pressure gradients between left ventricle and systematic artery were measured at cardiac catheterization and ranged from 60-140 mm Hg under basal conditions or with provocation. Each patient had echocardiographically documented systolic anterior motion of the anterior mitral leaflet, which was apparently responsible for the outflow obstruction, and concentric left ventricular wall thickening (septal-free wall thickness ratio of less than 1.3). Two of the five patients had evidence of genetically transmitted hypertrophic cardiomyopathy, as evidenced by disorganized muscle cells in the ventricular septum or asymmetric septal hypertrophy in first degree relatives. Hence, left ventricular outflow tract obstruction associated with systolic anterior motion of the anterior mitral leaflet may occur in some patients with concentric left ventricular hypertrophy who do not have typical hypertrophic cardiomyopathy.

Adult↗
PubMed1978

An ultrasound system for combined cardiac imaging and Doppler blood flow measurement in man.

An ultrasound instrument has been developed that combines a real-time cross-sectional imaging system and a spectrum analyzer-based Doppler velocimeter. This combination allows the Doppler sample volume to be superimposed on the cross-sectional image of the heart so that the sample volume can be located accurately. The same 2.2 MHz transducer utilized for cross-sectional imaging is stopped mechanically and quickly switched to transmit and receive the Doppler ultrasound signal. Preliminary experience in 20 young and adult normal subjects indicates that it is possible to place the Doppler sample volume in the proximal main pulmonary artery at a point where the sound beam and blood flow stream are parallel. Measurement of the distance from transducer to the sample volume and the peak blood flow velocities in the main pulmonary artery of normal subjects indicates that these quantities are within the measurement capabilities of the system. The ultimate goal of this device is to make measurements of volume blood flow in man noninvasively.

Coronary Circulation↗
PubMed1978

Electrocardiographic findings in patients with obstructive and nonobstructive hypertrophic cardiomyopathy.

One hundred and thiry-four patients with hypertrophic cardiomyopathy were evaluated by standard 12-lead electrocardiography. Normal electrocardiograms were extremely uncommon, occurring in less than 7% of each subgroup of patients (i.e., those with or without either symptoms or obstruction to left ventricular outflow), with the exception of those who were both asymptomatic and had no left ventricular outflow obstruction. Even in this subgroup, however, normal electrocardiograms occurred in only 27% of patients. Repolarization abnormalities and left ventricular hypertrophy were the most common abnormalities, occurring in 81% and 62%, respectively, of the total population. A broad spectrum of other electrocardiographic abnormalities was found, but none was unique to hypertrophic cardiomyopathy. Patients with vs those without electrocardiographic left ventricular hypertrophy or left atrial abnormality had significantly (P less than 0.005) greater mean ventricular septal thickness (22 +/- 0.6 vs 19 +/- 0.6 mm) and left atrial dimension (48 +/- 1 vs 40 +/- 1 mm) measured by echocardiography, and signficantly (P less than 0.01) higher mean pulmonary capillary wedge pressure (16 +/- 1 vs 10 +/- 1 mm Hg) and left ventricular end-diastolic pressure (20 +/- 1 vs 15 +/- 1 mm Hg). The high prevalence and diverse nature of electrocardiographic abnormalities suggest that any patient with an unusual and unexplained electrocardiogram should be suspected of having hypertrophic cardiomyopathy even if the physical examination is normal, as is often the case in patients without obstruction.

Cardiomyopathy, Hypertrophic↗
PubMed1978

Effects of self-induced starvation on cardiac size and function in anorexia nervosa.

Cardiac size, function and rhythm were examined in 11 patients with anorexia nervosa. Mean left ventricular, left atrial and aortic dimensions on echocardiogram were below normal adult values at baseline. In addition to decreased cardiac dimensions--ventricular ectopy, relative hypotension, bradycardia and blunted heart rate--response to exercise were noted. Left ventricular systolic function, however, was unimpaired as indicated by normal echocardiographic fractional shortening, and by normal exercise augmentation of ejection fraction determined by radionuclide cineangiography. Eight of the patients responded to treatment with a mean weight gain of 32%. In these eight, cardiac dimensions increased toward normal: left ventricular dimension increased by 13%; left atrial dimension by 20%; aortic dimension by 15% and estimated left ventricular mass by 20%. We conclude that abnormalities of heart size and rhythm occur in patients with anorexia nervosa. However, cardiac dimensions, including left ventricular mass, may increase following nutritional rehabilitation, accompanied by an increase in heart rate and blood pressure.

Adolescent↗