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Spodick, D. H.

Publications and source records attributed to Spodick, D. H..

At least 19 records

Recovery from exercise at varying work loads - Time course of responses of heart rate and systolic intervals

The time course of the recovery period was characterized by noninvasive measurements after 4 minute bicycle exercise at 3 separate work loads in volunteers with normal peak responses. Most responses started immediately to return toward resting control values. Left ventricular ejection time and stroke volume change are discussed. Changes in pre-ejection period were determined by changes in isovolume contraction time, and factors affecting the degree and rate of return are considered. The rates of change in the ejection time index and in the ratio pre-ejection period/left ventricular ejection time were virtually independent of load throughout most of recovery.

Nandi, P. S.

Comparative orthostatic responses - Standing vs. head-up tilt

In both physiologic and clinical studies, standing is often loosely equated with head-up tilt (HUT) although the cardiovascular effects of these variants of orthostasis have not been formally compared, except for heart rate. The effects of HUT and standing were measured noninvasively in male volunteers satisfying identical criteria for age and normal status. In both postures, there were significant increases in heart rate, pre-ejection period, isovolumic contraction time, and the ratio of pre-ejection to ejection period, and significant decreases in ejection period and ejection time index. All of these changes were greater for standing than for tilt. Pulse transmission time changed significantly (-14%) only with tilt. We conclude that head-up tilt and standing are rather comparable but not physiologically identical forms of orthostasis.

Spodick, D. H.

Perception of binary acoustic events associated with the first heart sound

The resolving power of the auditory apparatus permits discrete vibrations associated with cardiac activity to be perceived as one or more events. Irrespective of the vibratory combinations recorded by conventional phonocardiography, in normal adults and in most adult patients auscultators tend to discriminate only two discrete events associated with the first heart sound S1. It is stressed that the heart sound S4 may be present when a binary acoustic event associated with S1 occurs in the sequence 'low pitched sound preceding high pitched sound', i.e., its components are perceived by auscultation as 'dull-sharp'. The question of S4 audibility arises in those individuals, normal and diseased, in whom the major components of S1 ought to be, at least clinically, at their customary high pitch and indeed on the PCG appear as high frequency oscillations. It is revealed that the apparent audibility of recorded S4 is not related to P-R interval, P-S4 interval, or relative amplitude of S4. The significant S4-LFC (low frequency component of S1) differences can be related to acoustic modification of the early component of S1.

Spodick, D. H.

Postural effects on the noninvasive baselines of ventricular performance

The effects of posture on time-based noninvasive measurements were determined utilizing the sequence supine-sitting-standing in a formal protocol in which observer biases were eliminated by blinding the measurement and calculation phases. Compared to the supine posture, the sitting and standing postures produced significant increases in heart rate, isovolumic contraction time, pre-ejection period and pre-ejection period/left-ventricular ejection time and significant decreases in ejection time and ejection time index. The response patterns are consistent with the hemodynamic correlates cited in the literature which show increased adrenergic activity and decreased venous return in the sitting and standing postures, the effect on venous return being dominant.

Lance, V. Q.

Heart rate-left ventricular ejection time relations - Variations during postural change and cardiovascular challenges

Experiments were conducted on healthy human subjects to determine HR-LVET (Heart Rate-Left Ventricular Ejection Time) regression relations in different postures, including tilt, and during isometric exercise. The subjects were tested in the resting state in supine and sitting positions, during isometric handgrip in supine and sitting positions and during 70 deg headup tilt. The recordings included a bipolar electrocardiogram and a right external carotid pulse curve. Comparison of the HR-LVET relation for the conditions under analysis revealed differences among the respective regression equations, which can be explained by the well-established differences in stroke volume and ejection rate among these states. These differences appear to account for the fact that under conditions in which stroke volume variations should be the major determinant, slopes will be similar but intercepts will vary. Since substantial differences among intercepts are observed, caution should be exercised whenever the intercept factor is used to predict LVET for HR.

Lance, V. Q.

Noninvasive stress testing - Methodology for elimination of the phonocardiogram

Measurement by systolic time intervals (STI) of cardiac responses requires extremely careful recording during actual stress test performance. Previous work indicated no significant changes in the pulse transmission time (PTT) during exercise and other challenges. Since external STI depend on the carotid pulse offset by the PTT as an aortic curve equivalent, stable PTT implies that timing of the carotid upstroke and the carotid incisura would respectively track the pre-ejection period and the aortic incisura. In ten subjects, STIs were recorded at supine rest, sitting, standing, during prompt and sustained squatting and during isometric and dynamic exercise. The results demonstrated the tracking of both points. Coefficients of correlation and of determination were uniformly high for all challenges except isometric handgrip (IHG). Since left ventricular ejection time is obtained directly from the pulse curve, with the exception of IHG, STI responses during stress testing can be measured without a phonocardiogram.

Spodick, D. H.

Duration of diastole versus cycle length as correlates of left ventricular ejection time

Studies were done on 82 normal subjects to evaluate cycle length vs duration of diastole as determinants of left ventricular ejection time. Cycle length and its reciprocal, heart rate, had the highest correlation with left ventricular ejection time. Removal of the self-correlation of left ventricular ejection time within cycle length reduces the correlation so that, of all intervals, duration of diastole had the highest correlation as a determinant of left ventricular ejection time. Cycle length and heart rate remain valuable as spuriously close but not misleading correlates for predicting or correcting left ventricular ejection time.

Weisdorf, D.

Constant-load versus heart rate-targeted exercise - Responses of systolic intervals

Various systolic intervals were measured prior to and during heart rate-targeted bicycle ergometer exercise. There were striking similarities within each matched exercise set for Q-Im, isovolumetric contraction time, preejection period (PEP), and PEP/left ventricular ejection time (LVET). LVET was significantly shorter for rate-targeted exercise. It is concluded that either constant-load or rate-targeted bicycle ergometry may be used with the choice of method determined by the purpose of the protocol, and that systolic intervals (except LVET) should not be much altered owing to the method chosen.

Lance, V. Q.

Systolic and diastolic time intervals in pulsus alternans - Significance of alternating isovolumic relaxation

Systolic and diastolic time intervals in 14 cardiac patients with pulsus alternans revealed significant alternation of preinjection period (PEP), isovolumic contraction time (IVCT), left ventricular ejection time (LVET), ejection time index (ETI), PEP/LVET, and carotid dD/dt with better functional values in the strong beats. Cycle length, duration of electromechanical systole (EMS) and total diastole, i.e., isovolumic relaxation period (IRP) and diastolic filling period (DFP) occurred in 7 out of 8 patients. These diastolic intervals alternated reciprocally such that the IRP of the strong beats encroached upon the DFP of the next (weak) beats.

Spodick, D. H.

Ejection time by ear densitogram and its derivative - Clinical and physiologic applications.

Ear densitographic ejection times (EDET) and first derivative ear densitogram ejection times (dEDET) were studied to determine whether their reliability and validity justify their substitution for ejection times derived from the far less stable carotid pulse tracing. Inter- and intra-subject comparisons were made on thirty individuals under a wide variety of disease and challenge states. Statistical analysis of the data - which had been obtained through a blinded procedure - showed an overall correlation (r) of .98 for carotid vs EDET and .99 for carotid vs dEDET. The t-test demonstrated no significant differences among ejection times derived from the three methods. Moreover, the close tracking at rest and during challenges of ejection times derived from these curves with those from the carotid indicate that either method may be substituted for standard carotid curves without sacrificing reliability or validity of the measure.

Quarry-Pigott, V.

Effects of posture on exercise performance - Measurement by systolic time intervals.

Because posture significantly influences cardiac performance, the effects of moderate supine and upright ergometer exercise were compared on the basis of proportional (+37%) rate increments over resting control. Supine exercise produced significant decreases in left ventricular ejection time (LVET), pre-ejection period (PEP), and isovolumic contraction time (IVCT). Ejection time index (ETI) and corrected ejection time (LVETc) did not change significantly. Upright exercise produced greater decreases in PEP and LVET, but despite the rate increase there was no change in LVET, which resulted in sharp increases in ETI and LVETc. The discordant directional effects on LVET and its rate-correcting indices between the two postures were consistent with hemodynamic studies demonstrating lack of stroke volume change during supine exercise and increased stroke volume over control during light to moderate upright exercise.

Spodick, D. H.

The first derivative of the carotid displacement pulse.

The amplitude and time relationships of the carotid derivative in normal individuals and unselected cardiac patients is investigated together with the effects of different contraction strengths in patients with pulsus alternans and subjects challenged with isoproterenol and propranolol. Data regarding the relationship between the preejection period (PEP) and the ratio of peak to total amplitude of the carotid displacement pulse derivative are presented. It is found that cardiac abnormality tends to reduce the rate of rise of the carotid displacement pulse. The results obtained show that the PEP is a somewhat more sensitive index of the changes studied than the carotid displacement derivative.

Khan, A. H.

Cardiovascular responses to glucagon - Physiologic measurement by external recordings.

Assessment by noninvasive polygraphic techniques of the cardiovascular responses of normal subjects to intravenous injections of glucagon and glucagon diluent. A blinding procedure which eliminated observer bias was used during the reading of tracings. Analysis of group results showed that glucagon provoked uniformly significant changes, including increase in heart rate, blood pressure, pressure-rate product, and ejection time index, and decrease in prejection period, mechanical and electromechanical systole, left ventricular ejection time, and the ratio PEP/LVET. The principal results correlated well with those of previous studies of the hemodynamic effects of glucagon.

Byrne, M. J.

Densitography - A new method for evaluation of cardiac performance of rest and during exercise.

The validity of the densitographic curves obtained from the pinna of the ear for measuring the systolic intervals has been investigated in 28 subjects. This technique is found to permit the performance of noninvasive physiologic studies during physical activities, exercise tests, flight conditions, and probably long-term monitoring of critically ill patients. Densitographic curves constitute an excellent substitute by which to measure time-base intervals of the cardiac cycle when the carotid pulse tracing is not available.

Chirife, R.

Cardiocirculatory responses to exercise - Physiologic study by noninvasive techniques.

The changes from rest to exercise were determined for certain phases of the cardiac cycle in ten healthy male subjects who underwent submaximal, physiologically paced bicycle ergometry. ECGs, phonocardiograms, and carotid pu lse tracings were recorded. The preejection period and isovolumic contraction time decreased with exercise. Changes in left ventricular ejection time appeared to depend on the severity or the duration of stress. Pulse transmission time did not change significantly. The data obtained in the study and comparison of these results to those obtained by invasive methods indicate that noninvasive techniques, when used in the manner suggested, are appropriate means for detecting a variety of cardiocirculatory changes during exercise.

Pigott, V. M.