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Title: Applications of Doppler stroke distance measurement in clinical cardiology
Author: Trent, R. J.
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 1997
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This thesis examines the potential applications of stroke distance measurement in clinical cardiology. Stroke distance is the linear analogue of stroke volume, measured by non-imaging Doppler ultrasound. Using magnetic resonance imaging, I have re-examined the relationships between linear and volumetric variables, also those between absolute and fractional volumetric measurements. Stroke distance appears to be moderately well correlated with stroke volume index and is also related to left ventricular ejection fraction. The degree of agreement between stroke distance and ejection fraction is similar to that between ejection fraction and stroke volume index. The role of stroke distance measurement within the coronary care unit is considered. The prognostic power of this variable in patients with myocardial infarction is described, and compared with published data for ejection fraction: Stroke distance is at least as good as ejection fraction in this respect, and is able to stratify mortality risk from zero to 29% at year. In addition, a low stroke distance value appears to be highly specific for a diagnosis of myocardial infarction in patients presenting with chest pain. The relationship between reperfusion after myocardial infarction and left ventricular function (stroke distance) at presentation is studied; subjects with electrocardiographic evidence or reperfusion occurring before admission to hospital had significantly better left ventricular function. Pre-hospital thrombolysis was associated with improved left ventricular function, in addition to a mortality benefit. The relationship between time to presentation and left ventricular function in myocardial infarction is also defined; greater left ventricular dysfunction is associated with earlier presentation. Stroke distance is compared with ejection fraction derived by radionuclide ventriculography as a predictor of the development of congestive heart failure. It appears to be at least the equal of ejection fraction as a predictor of cardiac death, or the development of cardiac failure. The role of stroke distance measurement during physiological stress is explored as a means of diagnosing myocardial ischaemia.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available