Showing papers by "Robert Hall published in 1982"

Effects of stress management training and dietary changes in treating ischemic heart disease

Abstract: To evaluate the short-term effects of an intervention that consists of stress management training and dietary changes in patients with ischemic heart disease (IHD), we compared the cardiovascular status of 23 patients who received this intervention with a randomized control group of 23 patient who did not. After 24 days, patients in the experimental group demonstrated a 44% mean increase in duration of exercise, a 55% mean increase in total work performed, somewhat improved left ventricular regional wall motion during peak exercise, and a net change in the left ventricular ejection fraction from rest to maximum exercise of +6.4%. Also, we measured a 20.5% mean decrease in plasma cholesterol levels and a 91.0% mean reduction in frequency of anginal episodes. In this selected sample, short-term improvements in cardiovascular status seem to result from these adjuncts to conventional treatments of IHD.

Noninvasive assessment of the Ionescu-Shiley pericardial xenograft in the mitral position: preliminary experience.

Abstract: To establish noninvasive criteria for assessment of the Ionescu-Shiley pericardial xenograft in the mitral position, 29 patients with a normally functioning bioprosthesis were studied with m-mode echocardiography and phonocardiography. Two-dimensional echocardiograms were also obtained in ten of the patients. Although two-dimensional echocardiography provided simultaneous visualization of a greater number of stents and leaflets than the m-mode technique, the superior resolution of m-mode ultrasound permitted more detailed analyses of the xenograft's motion patterns. The anterior leaflet, recorded in all patients, had an average excursion of 1.2 +/- 0.22 cm. Leaflet thickness measured 4 mm or less. Coarse diastolic vibration of the anterior leaflet was recorded in two patients in the absence of both aortic insufficiency and prosthesis dysfunction. Ultrasonic estimates of prosthesis height and orifice diameter did not correlate with micrometer measurements, possibly due to the limited resolution of pulsed ultrasound in the presence of a highly reflective substance. Opening and closing of the pericardial leaflets were associated with the production of high frequency vibrations on the phonocardiogram. The potential usefulness and limitations of echocardiography for evaluating the function of bioprosthetic valves are discussed.