bluuebunny/crossref_metadata_2025 huggingface dataset:
Lewis Acid Catalyzed Amino‐Claisen Rearrangement: A Facile One‐Pot Synthesis of 2‐Allylarylamines from N‐Allylarylamines.
Authors: Jain Seema , Pandey Neelesh , Kishore D.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Axially Chiral NHC—Pd(II) Complexes in the Oxidative Kinetic Resolution of Secondary Alcohols Using Molecular Oxygen as a Terminal Oxidant.
Authors: Chen Tao , Jiang Jia‐Jun , Xu Qin , Shi Min
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Open Air Palladium‐Catalyzed Cyanation — The Use of PMHS to Protect from Oxygen.
Authors: Martin Michael T. , Liu Bing , Cooley Bobby E. Jr. , Eaddy John F.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
A Simple, Rapid and Efficient Protocol for the Synthesis of Methylthiomethyl Esters under Swern Oxidation Conditions.
Authors: Jadhav Sunil B. , Ghosh Usha
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
An Efficient One‐Pot Asymmetric Synthesis of Biaryl Compounds via Diels—Alder/Retro‐Diels—Alder Cascade Reactions.
Authors: Liu Yongxiang , Li Kui , Dai Mingji , Wang Kai , Wu Wanqing , Chen Jiahua , Quan Junmin , Yang Zhen
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis of Heterocyclic Systems by Transition Metal Catalyzed Cyclization—Migration Reactions — A Diversity‐Oriented Strategy for the Construction of Spirocyclic 3(2H)‐Furanones and 3‐Pyrrolones.
Authors: Binder Joerg T. , Crone Benedikt , Kirsch Stefan F. , Liebert Clemence , Menz Helge
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Suppression of β‐Hydride Elimination in the Intramolecular Hydrocarboxylation of Alkynes Leading to the Formation of Lactones.
Authors: Huo Zhibao , Patil Nitin T. , Jin Tienan , Pahadi Nirmal K. , Yamamoto Yoshinori
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Gold Catalysis: Selectivity Problems in Hydroarylations with Pyrroles.
Authors: Hashmi A. Stephen K. , Salathe Ralph , Frey Wolfgang
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Direct Palladium‐Catalyzed C‐3 Arylation of Indoles.
Authors: Zhang Zhiqiang , Hu Zhizhi , Yu Zhixiao , Lei Peng , Chi Haijun , Wang Yue , He Ren
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Recyclable Copper‐Catalyst in Aqueous Media: O‐ and N‐Arylation Reactions Towards the Benzofuroindole Framework.
Authors: Carril Monica , SanMartin Raul , Dominguez Esther , Tellitu Imanol
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Oxidation—Reduction Reactions of 1,3‐Dithioles and Their Ions.
Authors: Yunnikova L. P. , Makhova T. V.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis of 1,2‐Disubstituted Benzimidazoles by a Cu‐Catalyzed Cascade Aryl Amination/Condensation Process.
Authors: Zou Benli , Yuan Qiliang , Ma Dawei
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis and Rearrangement of 2‐(N‐Methyl‐N‐nitroamino)‐4‐phenylthiazole.
Authors: Spaleniak G. , Daszkiewicz Z. , Kyziol J. B.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis of 5‐Benzoylmethyl‐4‐ (2‐benzoylvinylthio)carbamidoyl‐2‐imino‐1,3,4‐thiadiazolidine Perchlorate.
Authors: Nizovtseva T. V. , Abramova E. V. , Nakhmanovich A. S. , Larina L. I. , Lopyrev V. A.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis of 2‐Arylbenzothiazoles by DDQ‐Promoted Cyclization of Thioformanilides: A Solution‐Phase Strategy for Library Synthesis.
Authors: Bose D. Subhas , Idrees Mohd. , Srikanth Bingi
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Rapid and Efficient Microwave‐Assisted Synthesis of 5‐Amino‐3‐aralkoxy(methoxy)amino‐1,2,4‐oxadiazoles.
Authors: Kurz Thomas , Lolak Nabih , Geffken Detlef
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Dialkyl 2H‐1‐Benzothiopyran‐2,3‐dicarboxylates via Intramolecular Wittig Reaction.
Authors: Hekmatshoar Rahim , Javanshir Shahrzad , Heravi Majid M.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Conjugate Addition of 2‐ and 4‐Pyridylcuprates: An Expeditious Asymmetric Synthesis of Natural (‐)‐Evoninic Acid.
Authors: Spivey Alan C. , Shukla Lena , Hayler Judy F.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
A Simple and Efficient Automatable One Step Synthesis of Triazolopyridines from Carboxylic Acids.
Authors: Wang Ying , Sarris Kathy , Sauer Daryl R. , Djuric Stevan W.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Structure—Activity Relationship Analysis of a Novel Necroptosis Inhibitor, Necrostatin‐5 (VIa).
Authors: Wang Ke , Li Jinfeng , Degterev Alexei , Hsu Emily , Yuan Junying , Yuan Chengye
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Three‐Component, One‐Pot Sequential Synthesis of N‐Aryl, N′‐Alkyl Barbiturates.
Authors: Volonterio Alessandro , Zanda Matteo
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
A Cascade Reaction Consisting of Pictet—Spengler‐Type Cyclization and Smiles Rearrangement: Application to the Synthesis of Novel Pyrrole‐Fused Dihydropteridines.
Authors: Xiang Jinbao , Zheng Lianyou , Chen Feng , Dang Qun , Bai Xu
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis and Crystal Structure of Ethyl 7‐Chloro‐3‐amino‐9‐(4‐bromophenyl)thieno‐[3,2‐b]benzothiazine 4,4‐Dioxide 2‐Carboxylate.
Authors: Charris Jaime , Barazarte Arthur , Ferrer Rosa , Camacho Jose , Gamboa Neira , Rodrigues Juan , Atencio Reinaldo , Gonzalez Teresa
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Stereoselective One‐Pot Synthesis of Functionalized Phosphonates by Three‐Component Reaction Between Trimethylphosphite, Dialkyl Acetylenedicarboxylates and Aldehyde Semicarbazones.
Authors: Anary‐Abbasinejad Mohammad , Ascarrian Najmeh
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Diapolycopenedioic Acid Xylosyl Ester, a Novel Glyco‐C30‐carotenoic Acid Produced by a New Marine Bacterium Rubritalea squalenifaciens.
Authors: Shindo Kazutoshi , Mikami Kanae , Tamesada Emiko , Takaichi Shinichi , Adachi Kyoko , Misawa Norihiko , Maoka Takashi
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Orizalanasterolides A and B from Rice Hulls of Oryza sativa
Authors: Chung Ill‐Min , Ali Mohd , Ahmad Ateeque
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Marine Bacteria. Part 35. Bromoalterochromides A and A′, Unprecedented Chromopeptides from a Marine Pseudoalteromonas maricaloris Strain KMM 636T.
Authors: Speitling Michael , Smetanina Olga F. , Kuznetsova Tatyana A. , Laatsch Hartmut
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis and Biological Evaluation of New Conformationally Biased Integrin Ligands Based on a Tetrahydroazoninone Scaffold [cf. (VII)].
Authors: Banfi Luca , Basso Andrea , Damonte Gianluca , De Pellegrini Federico , Galatini Andrea , Guanti Giuseppe , Monfardini Ilaria , Riva Renata , Scapolla Carlo
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Total Synthesis of (.+‐.)‐trans‐Dihydronarciclasine Through a Highly endo‐Selective Diels—Alder Cycloaddition of 3,5‐Dibromo‐2‐pyrone.
Authors: Shin In‐Ji , Choi Eun‐Sil , Cho Cheon‐Gyu
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Enantioselective Synthesis of (‐)‐Pinellic Acid.
Authors: Naidu S. Vasudeva , Kumar Pradeep
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Polycavernoside C and C2, the New Analogues of the Human Lethal Toxin Polycavernoside A, from the Red Alga, Gracilaria edulis.
Authors: Yotsu‐Yamashita Mari , Abe Kazumi , Seki Tetsuya , Fujiwara Kenshu , Yasumoto Takeshi
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthesis, Structural Revision, and Antioxidant Activities of Antimutagenic Homoisoflavonoids from Hoffmanossegia intricata.
Authors: Siddaiah Vidavalur , Maheswara Muchchintala , Rao Chunduri Venkata , Venkateswarlu Somepalli , Subbaraju Gottumukkala V.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Phase Diagram, Growth and Spectral Properties of Nd3+:GdMg(BO2)5 Crystal.
Authors: Fan Junmei , Lin Zhoubin , Zhang Lizhen , Wang Guofu
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Stable Chalcogen Radicals
Authors: Rawson Jeremy M. , Alberola Antonio
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Synthetic Molecular Machines
Authors: Kay Euan R. , Leigh David A.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Shape‐Persistent Acetylenic Macrocycles for Ordered Systems
Authors: Hoeger Sigurd
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Rhodium‐Catalyzed Hydroformylation
Authors: Kramer Paul C. J. , Reek Joost N. H. , van Leeuwen Piet W. N. M.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Carbonylation of Methanol to Acetic Acid and Methyl Acetate to Acetic Anhydride
Authors: Morris George
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Modified Mesoporous Materials as Pd Scavengers and Catalyst Supports
Authors: Crudden Cathleen M. , McEleney Kevin , MacQuarrie Stephanie L. , Blanc Alexandre , Sateesh Mutyala , Webb Jonathan D.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Parallel Solution‐Phase Synthesis
Authors: Peet Norton P. , Kim Hwa‐Ok
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Recent Trends in the Synthesis of O‐Glycosides of 2‐Amino‐2‐deoxysugars
Authors: Bongat Aileen F. G. , Demchenko Alexei V.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Natural Phosphoglycans Containing Glycosyl Phosphate Units: Structural Diversity and Chemical Synthesis
Authors: Nikolaev Andrei V. , Botvinko Irina V. , Ross Andrew J.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Recent Developments in the Isolation and Synthesis of D‐Homosteroids and Related Compounds
Authors: Wolfling Janos
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Recent Developments of Lewis Acid Catalysis: Lanthanoid Catalysts with Long Perfluoro‐Chain in Organic Chemistry
Authors: Ma Yun , Wang Limin , Shao Juehua , Tian He
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Enantioenriched Cyanohydrin O‐Phosphates: Synthesis and Applications as Chiral Building Blocks
Authors: Baeza Alejandro , Sansano Jose M. , Saa Jose M. , Najera Carmen
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Bioinspired Organic Chemistry
Authors: Webb Simon J.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Olefin Metathesis and Isomerization: From Undesired Side Reactions to a Useful Synthetic Methodology
Authors: Schmidt Bernd
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Ruthenium Aryloxide Catalysts: Synthesis and Applications in Ring‐Closing Metathesis
Authors: Conrad J. C. , Snelgrove J. L. , Eeelman M. D. , Hall S. , Fogg D. E.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Generation of Alkene Radical Cations by Heterolysis of β‐Substituted Radicals: Mechanism, Stereochemistry, and Application in Synthesis
Authors: Crich David , Brebion Franck , Suk Dae‐Hwan
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Thermochemistry of Anilines
Authors: Slayden Suzanne W. , Liebman Joel F.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Reliable Safety Assessment Depends on Species Differences in Epigenetic Mechanisms of Gene Regulation
Authors: Yamada Tomoya
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Computational Modeling of Catalytic Reactivity
Authors: Van Santen R. A. , Offermans W. K. , Malek K. , Pidko E. A.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Quantum Mechanical Tunneling in Organic Reactive Intermediates
Authors: Sheridan Robert S.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Chemical Contamination in Aquatic Ecosystems
Authors: Iwata Hisato , Kim Eun‐Young , Yamauchi Masanobu , Inoue Suguru , Agusa Tetsuro , Tanabe Shinsuke
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
The Chromophore Structural Changes During the Photocycle of Phytochrome: A Combined Resonance Raman and Quantum Chemical Approach
Authors: Mroginski Maria Andrea , Murgida Daniel H. , Hildebrandt Peter
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Molecular Packing and Symmetry of Two‐Dimensional Crystals
Authors: Plass Katherine E. , Grzesiak Adam L. , Matzger Adam J.
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
Analytical Aspects of Aromatic Amines
Authors: Zabicky Jacob
Published: June 2007

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF.
The significance of lower extremity peripheral arterial disease
Authors: Dieter Robert S. , Chu William W. , Pacanowski John P. , McBride Patrick E. , Tanke Timothy E.
Published: June 2007

The role of the cardiologist is expanding and involves the management of patients with lower extremity atherosclerotic occlusive arterial disease. Peripheral arterial disease (PAD) remains an underdiagnosed and undertreated disease. The purpose of this review is to educate the clinician on the significance of lower extremity atherosclerotic occlusive arterial disease. Pathophysiology and anatomy are briefly reviewed. The definition of PAD is based upon both anatomic and functional considerations. Risk factors for PAD include traditional atherosclerotic risk factors. There is a considerable overlap between coronary and cerebrovascular diseases and PAD. Diagnosis is made mainly by history and physical examination. Noninvasive and invasive tests help diagnosis and localize disease. Expanded therapies to improve outcomes include lifestyle changes, medical treatment, interventional cardiovascular procedures, or surgical intervention.
Cardiac amyloidosis presenting with elevations of cardiac troponin I and angina pectoris
Authors: Cantwell Ryan V. , Aviles Ronnier J. , Bjornsson Johannes , Wright R. Scott , Freeman William K. , Oh Jae K. , Hoyer James D. , Markovic Svetomir , Jaffe Allan S.
Published: June 2007

We present the case of a 43‐year‐old male who was initially evaluated for angina pectoris and dyspnea. His CK, CK‐MB, and cTnI were all elevated following a blood transfusion and he underwent coronary arteriography, which demonstrated no luminal obstructions. After several months, he was transferred to Mayo Clinic where diagnoses of fulminant cardiac amyloidosis and systemic multiple myeloma were established. The cTnI remained elevated despite normalization of the CK and CK‐MB. Despite aggressive treatment, the patient died. Postmortem analysis demonstrated amyloid cardiac deposition including involvement of the coronary microvasculature. Electron microscopy revealed myocyte compression injury from amyloid infiltration. We believe this is the first report of elevated troponin I in a patient with cardiac amyloidosis. The electron microscopy in our case confirms cardiac damage as the mechanism for cTnI elevation. This observation strengthens our knowledge about the specificity of cTnI for the detection of cardiac injury.
Hypertrophic cardiomyopathy complicated by severe bradycardias: A pedigree report
Authors: Wang Dao Wen , Deng You Bin
Published: June 2007

We describe four patients with nonobstructive hypertrophic cardiomyopathy (HCM) from an extended Chinese family. The patients had remarkably similar physical and echocardiographic findings including a harsh localized systolic murmur and apical left ventricular hypertrophy. All four had severe sinus bradycardia and atrial‐ventricular conduction block (AVB) manifest by recurrent syncope. Two died suddenly due to bradycardia. Holter monitoring showed no tachycardias. Late potentials were not present. We conclude that this unusual form of HCM may be caused by a new and as yet unknown gene mutation.
Primary pericardial fibrosarcoma presenting as “near” cardiac tamponade
Authors: Matsakas Evangelos P. , Lazaros George A. , Panou Fotis K. , Karavidas Apostolos I. , Papalimberi Elisavet P , Scotis Ioannis D. , Zacharoulis Apostolos A.
Published: June 2007

A 19‐year‐old male presented with fever, substernal pain, dyspnea, and distended neck veins. Diagnostic investigations, such as echocardiography and magnetic resonance imaging, provided evidence of a large mass within the pericardial sac, attached by a broad base to the parietal pericardium and lying along the right ventricular free wall. A partial pericardiectomy was performed to relieve the patient's symptoms, and histologic examination of a biopsy specimen showed features of a malignant, spindle cell, mesenchymal neoplasm. The patient underwent surgical treatment during which the tumor was found to infiltrate the anterior surface of the right ventricle. Histologically, the tumor was identified as a high‐grade fibrosarcoma, and additional chemotherapy was given.
Sustained ventricular tachycardia as a marker of inadequate myocardial perfusion during the acute phase of myocardial infarction
Authors: Sala M. Fiol , Bárcena J. Pérez , Rota J. I. Ayestaran , Roca J. Velasco , López A. Carrillo , Puigdevall J. M. Raurich , Soldevilla J. Guindo , Bayés Luna A. De
Published: June 2007

Background: Sustained ventricular tachycardia (VT) complicating the acute phase of myocardial infarction (AMI) is a quite rare event but with short‐term unfavorable prognosis. The clinical characteristics as well as the therapeutic implications have not yet been well defined.

Hypothesis: This paper attempts to prove that VT may be considered a marker of inadequate myocardial perfusion after thrombolysis.

Methods: To assess the clinic‐electroangiographic characteristics and prognosis of patients with VT occurring within the first 4 days of an AMI, a case‐control study was carried out in 23 patients from a total of 1, 100 patients (1.9%) hospitalized with AMI between March 1993 and July 1997. These patients were compared with a control group of 131 patients hospitalized consecutively. A statistical analysis was made using the chi‐square test, t‐test, and logistic regression.

Results: There were no differences among groups with regard to age, gender, and area of necrosis. Average time for the onset of VT was 26 h (range 0‐92 h). Sixteen patients underwent coronary angiography: 4 patients had left main coronary artery disease, 2 had single‐vessel disease, 8 had lesions in two vessels, and 2 had triple‐vessel disease. Univariate analysis showed that patients with VT had a higher incidence of creatine phosphokinase (CPK)‐MB peak > 300 UI/l (61 vs. 30%; p < 0.001), more frequent occurrence of previous AMI (48 vs. 17%; p < 0.001), and acute intraventricular conduction disorders (26 vs. 4%; p< 0.001). Furthermore, these patients suffered ischemia previous to VT more frequently (65 vs. 11%; p < 0.0001), and had a greater mortality rate than that in the control group (35 vs. 4%; p < 0.0001). In the multivariant analysis, the variables related to the occurrence of VT were CPK‐MB peak > 300IU/l (OR 5.9;95% CI1.6‐21), acute intraventricular conduction disorders (OR 9.02;95% CI 1.748), and ischemia immediately prior to VT (odds ratio [OR] 19.64;95% confidence interval [CI] 5.3‐73).

Conclusions: Ventricular tachycardia may be considered a marker of inadequate myocardial perfusion after thrombolysis; therefore, a more aggressive revascularization treatment in these patients would be advisable. The profile of patients with AMI, hospitalized in the coronary care unit, who will likely suffer from VT is previous AMI, CPK‐MB peak > 300, acute intraventricular conduction disorders, Killip > I, and ischemia previous to VT.
Prolonged low‐dose thrombolytic therapy: A novel adjunctive strategy in the management of an infected right atrial thrombus
Authors: Chuang Sheila , Mehta Rajendra H. , Fay William P.
Published: June 2007

An 81‐year‐old man presented with a large, infected right atrial thrombus that was refractory to anticoagulants and several courses of antibiotics. The risk of surgical removal of the thrombus, which was associated with a pacemaker electrode, was considered prohibitive. The patient was treated for 7 days with low‐dose (40 mg/day) tissue‐type plasminogen activator (t‐PA). Hemostatic monitoring during infusion revealed (1) aplasma t‐PA antigen that was approximately 5% of that achieved during short‐course t‐PA for acute myocardial infarction, (2) biochemical evidence of prolonged clot lysis, and (3) no significant depletion of fibrinogen or plas‐minogen. Nearly complete dissolution of the thrombus was observed. His bacteremia was eradicated by intravenous penicillin despite the presence of the pacemaker lead. This case highlights the benefits of combined antibiotic and thrombolytic therapy and documents for the first time the response of the human hemostatic system to prolonged t‐PA infusion and the plasma t‐PA levels attained when thrombolytic therapy is administered in this manner. Prolonged courses of fibrinolytic agents may be a good alternative to surgical intervention in selected patients with infected, right‐sided intracardiac thrombi.
Long‐term prognostic value of an index of myocardial performance in patients with myocardial infarction
Authors: Szymański Piotr , Rezler Joanna , Stec Sebastian , Budaj Andrzej
Published: June 2007

Background: The Tei index of myocardial performance (IMP), which combines parameters of both systolic and diastolic ventricular function, is a useful prognostic factor in many clinical settings.

Hypothesis: This study assessed the long‐term prognostic value of IMP in patients discharged from hospital after acute myocardial infarction (AMI).

Methods: Doppler/echocardiographic studies were recorded in 90 consecutive patients on Day 14 ± 2 following an AMI. The IMP was calculated from the Doppler recordings, as a sum of isovolumetric contraction time and isovolumetric relaxation time, divided by the ejection time.

Results: The patients were followed for an average (SD) of 57.8 (16.1) months. During this period there were 22 (24%) cardiac events, defined as cardiac deaths (10) or Nonfatal recurrent myocardial infarctions (12). After multivariate Cox analysis, Tei index > 0.55 (relative risk [RR] 4.45; 95% confidence interval [CI] 1.28‐15.45; p = 0.019), LV end‐systolic volume > 65 ml (RR 3.23; 95% CI 1.34‐7.79; p = 0.009), and mitral E wave deceleration time ⩽ 0.145 s (RR 2.94; 95% CI 1.24‐6.92; p = 0.014) were the only independent predictors of cardiac events during the follow‐up period. In a subgroup of patients with preserved LV systolic function (ejection fraction > 0.40), IMP was the only predictor of cardiac events (RR 6.37; 95% CI 1.32‐30.77, p = 0.02).

Conclusions: The Tei index of myocardial performance, which is simple and easy to calculate, is a useful tool for risk assessment in patients following myocardial infarction, and in a subgroup of patients with Normal or only mildly impaired systolic function.
Clinical and angiographic follow‐up after long versus short stenting in unselected chronic coronary occlusions
Authors: Choi Si‐Wan , Lee Cheol Whan , Hong Myeong‐Ki , Lee Jae‐Hwan , Kim Jae‐Joong , Park Seong‐Wook , Park Seung‐Jung
Published: June 2007

Background: Few data are available on the efficacy of long stenting for lesions in unselected chronic total occlusion (CTO).

Hypothesis: The study was undertaken to evaluate the angiographic restenosis and long‐term clinical outcomes after long stent implantation in patients with CTO.

Methods: Our retrospective analysis includes a consecutive series of stent implantation in 220 patients with CTO. We compared angiographic restenosis, target lesion revascularization, and long‐term clinical outcomes of short stenting (< 20 mm, Group 1, n = 113) with a concurrent series of long stenting (≥ 20 mm, Group 2, n = 107).

Results: Angiographic follow‐up was obtained in 174 patients (79.5% of those eligible), and the rates of angiographic restenosis were 19.3% in Group 1 and 33.7% in Group 2 (p < 0.05). In multivariate analysis, the postinterventional minimal lumen diameter was the only independent predictor of restenosis (odds ratio = 0.20, 95% confidence interval 0.08‐0.49, p < 0.01). The angiographic restenosis rate was significantly lower in Group 1 than in Group 2 in patients with final minimal lumen diameter < 3.0 mm (28.9 vs. 55.9%, respectively, p < 0.05). However, the angiographic restenosis rate was not significantly different between the two groups in patients with final minimal lumen diameter ≥ 3 mm (12.0 vs. 19.2%, respectively, p = NS). During the follow‐up (29.1 ± 10.8 months), there was no difference between the two groups in death, nonfatal myocardial infarction, and target lesion revascularization.

Conclusions: The use of long (≥20 mm) versus short (< 20 mm) stents in patients with CTO is associated with a higher angiographic restenosis rate, but there is an equivalent risk of restenosis in selected patients with relatively large‐sized vessels.
Secondary prognosis after cardioembolic stroke of atrial origin: The role of left atrial and left atrial appendage dysfunction
Authors: Panagiotopoulos Konstantinos , Toumanidis Savvas , Vemmos Konstantinos , Saridakis Nikolaos , Stamatelopoulos Stamatis
Published: June 2007

Background: Secondary prevention studies for cardioembolic strokes show a remarkable variability in stroke recurrence rates. Various reports have raised questions regarding differences in baseline clinical characteristics and in methodology to explain this wide variability.

Hypothesis: The purpose of the present study is to examine the 2‐year outcome after first cardioembolic stroke of atrial origin and to correlate secondary prognosis with left atrial and left atrial appendage dysfunction.

Methods: Baseline evaluation included computed tomographic and/or magnetic resonance scanning, Doppler scanning, digital subtraction angiography, and transthoracic and transesophageal echocardiography to establish the diagnosis of atrial source of emboli. Twenty‐six patients in nonrheumatic atrial fibrillation and 13 in sinus rhythm were followed for recurrent stroke and vascular death as endpoints (event ±).

Results: Patients in sinus rhythm had a total of 23% (standard deviation ± 12%) recurrence rate. All event (+) patients were on aspirin and died from this second cardioembolic stroke. Of patients in nonrheumatic atrial fibrillation, 50% were event (+) at the end of the first year (death rate 46%). Patients on warfarin therapy had 20% recurrence rate versus 70% on aspirin (relative risk 0.18, 95% confidence interval, 0.05‐0.48, p 0.041). Inward peak velocity of left atrial appendage was the only echocardiographic variable significantly reduced in event (+) patients (21 ± 7 vs. 31 ± 17 cm/s, p 0.048).

Conclusions: Patients with nonrheumatic atrial fibrillation and first atrial origin cardioembolic stroke are at increased risk for recurrence if severe dysfunction of the left atrial appendage is present and if they do not receive warfarin treatment. Patients with sinus rhythm and first atrial origin cardioembolic stroke form a small stroke subgroup, in which recurrences are accompanied by a remarkably high death rate.
Nonsurgical septal reduction therapy for hypertrophic obstructive cardiomyopathy: Short‐term results in 50 consecutive procedures
Authors: Nielsen Christopher D. , Killip Donna , Spencer William H.
Published: June 2007

Background: Nonsurgical septal reduction therapy (NSRT) has been shown to improve left ventricular outflow tract (LVOT) gradients, decrease septal thickness, and improve symptoms in patients with hypertrophic obstructive cardiomyopathy (HOCM). The major complication of this procedure has been the development of complete heart block (CHB) requiring permanent pacemaker implantation, which has been reported in up to 33% of patients in early studies. Since this procedure was first reported, there have been refinements in the technique such as the use of echocardiographic contrast material to localize the site of infarction, slower injection of alcohol, as well as improvement in balloon technology.

Hypothesis: We sought to determine the results of NSRT using echocardiographic contrast localization, slow injection of alcohol, and short balloon length. We theorized that the incidence CHB would be lower than earlier reported results using these refined techniques.

Methods: We performed 50 NSRT procedures on 46 patients using echocardiographic contrast localization, slow alcohol injection, and currently available balloons. Patients had an echocardiogram before, immediately after NSRT, and at 3 months, and a treadmill test before and at 3 months after NSRT. In the hospital, patients were observed for the development of CHB or other complications, and infarct size was determined by serial creatine kinase (CK) measurements.

Results: There was a decrease in the LVOT gradient from 84.2 (± 30.8) mmHg at baseline, to 18.5 (± 14.8) mmHg immediately after NSRT (p < 0.001). At 3 months, the gradient was not statistically different at 22.7 (± 22.2) mmHg (p = 0.27). The septal thickness decreased from 2.21 (± 0.66) cm at baseline, to 1.67 (± 0.51) cm at 3 months (p < 0.001). New York Heart Association symptom class improved from 3.2 (± 0.4) at baseline, to 1.1 (± 0.6) at 3 months (p < 0.001). Mean treadmill time in 30 patients was 235 (± 142) s at baseline, to 367 (± 159) s at 3 months (p < 0.001). Of the 50 procedures, 45 were performed in patients without a previously placed permanent pacemaker or intracardiac cardioverter defibrillator; only 3 (6.7%) of the 45 developed complete heart blocks required permanent pacing. While only three patients in the series had a preexisting left bundle‐branch block (LBBB), two of the three patients who required a permanent pacemaker had an LBBB before the procedure.

Conclusion: Using contrast echocardiographic localization, slow injection of alcohol, and shorter balloon catheters, there continues to be excellent improvement in LVOT gradients, septal thickness, and symptoms, with a reduced incidence of CHB requiring permanent pacemaker implantation. Left bundle‐branch block appears to be a strong predictor for the development of CHB after NSRT.
Patients with large myocardial infarction gain a greater improvement in exercise capacity after exercise training than those with small to medium infarction
Authors: Sakuragi Satoru , Takagi Shuichi , Suzuki Shoji , Sakamaki Fumio , Takaki Hiroshi , Aihara Naohiko , Yasumura Yoshio , Goto Yoichi
Published: June 2007

Background: It remains unclear whether patients with large‐size myocardial infarction (MI) achieve the same benefit from exercise training as do those with small‐ to medium‐size MI.

Hypothesis: This study was designed to determine the magnitude and mechanisms underlying improvement in exercise capacity in patients with large‐size MI after cardiac rehabilitation.

Methods: In all, 296 patients who participated in a cardiac rehabilitation program after acute MI were divided into two groups according to the peak serum creatine phosphokinase (CPK) level: the group with large infarction (Group 1) (≥ 5000 U/l peak CPK, 64 patients) and the group with less extensive infarction (Group 2) (< 5000 U/l, 232 patients). Exercise capacity was assessed before and after a 3‐month cardiac rehabilitation program that included exercise training.

Results: Before exercise training, both the peak work rate (p < 0.05) and peak oxygen uptake (VO2) (p < 0.01) were significantly lower in Group 1 than in Group 2. After exercise training, the changes in peak work rate and peak VO2 were significantly greater in Group 1 than in Group 2 (both p < 0.01). The infarction size measured by the peak CPK level correlated significantly with both the baseline exercise capacity and its improvement after exercise training, although these correlations were insignificant in a multivariate analysis. In the multivariate analysis, the improvement in exercise capacity is determined by age and baseline exercise capacity, which is determined by the duration of inactivity, minute ventilation (VE)/ VCO2 slope and left ventricular end‐diastolic pressure.

Conclusions: Compared with patients with small‐ to medium‐size myocardial infarction, patients with large infarction gain a greater improvement in exercise capacity after exercise training due to reversal of physical deconditioning and improvement in congestive heart failure.
Type of alcoholic beverage and first acute myocardial infarction: A case‐control study in a mediterranean country
Authors: Fernández‐Jarne E. , Martínez‐Losa E. , Serrano‐Martínez M. , Prado‐Santamaría M. , Brugarolas‐Brufau C , Martínez‐González M. A.
Published: June 2007

Background: Although international comparisons have consistently found an inverse association between wine and coronary heart disease, few epidemiologic studies are available in Southern Europe. We assessed the association of wine, red wine, and the pattern of drinking wine during meals with the risk of myocardial infarction.

Hypothesis: We specifically evaluated three hypotheses: (1) Is the protection against incidence of nonfatal myocardial infarction stronger for wine than for other alcoholic beverages? (2) Does the wine consumed during meals represent a more beneficial pattern of alcohol consumption? (3) Is red wine more advantageous than other types of wine?

Methods: A case‐control study (171 cases, 171 matched controls) was conducted in Spain. Multiple dietary and nondietary potential confounders were assessed.

Results: Exposure to wine, red wine, and wine during meals was associated with risk reductions similar to those of other alcoholic beverages (point estimates of the odds ratio for low and high intake were 0.48 and 0.38 for wine; 0.42 and 0.55 for other beverages). However, after controlling for total alcohol intake, wine consumption (g/day) improved the prediction of a myocardial infarction.

Conclusions: Our data showed that red wine or drinking wine during meals was similar to alcohol from other sources for reducing coronary risk. However, an additional benefit of wine, keeping constant overall alcohol intake, deserves further research.
Intravenous amiodarone for cardioversion of recent‐onset atrial fibrillation
Authors: Cybulski Jacek , Kułakowski Piotr , Budaj Andrzej , Danielewicz Henryk , MacIejewicz Janusz , Kawka‐Urbanek Teresa , Ceremuzyński Leszek
Published: June 2007

Background: Atrial fibrillation (AF) is one of the most common causes of hospital admission, with a prevalence of up to 5% of the population, increasing with advancing age. Emergency direct current cardioversion is the therapy of choice when arrhythmia leads to hemodynamic compromise, but in patients who are hemodynamically stable, antiarrhythmic drugs are usually given to restore sinus rhythm.

Hypothesis: The study was undertaken to assess the efficacy of intravenous amiodarone in cardioversion of recent‐onset paroxysmal atrial fibrillation (AF). No standard antiarrhythmic therapy has been accepted for pharmacologic cardioversion of AF. Amiodarone seems to be a promising candidate, but only few randomized trials are available and the results are inconsistent.

Methods: In all, 160 patients with AF lasting < 24 h were randomly assigned (2:1 fashion) to the amiodarone group (n = 106) receiving 5 mg/kg as a 30 min intravenous (IV) infusion, followed by IV infusion of 10 mg/kg during 20 h diluted in 1000 ml of 10% glucose with 20 IU of rapid‐action insulin, 80 mEq of potassium chloride, and 8 g of magnesium sulphate (GIKM), or to the control group (n = 54) receiving 1000 ml of GIKM alone. Treatment was continued up to 20 h independent of sinus rhythm restoration.

Results: Sinus rhythm was restored 20 h after initiation of therapy in 88 (83%) patients in the amiodarone group and in 24 (44%) patients in the control group (p < 0.0001). The difference between efficacy of the two treatment modalities became significant already after 8 h of therapy (53 vs. 14 patients with sinus rhythm, respectively, p < 0.05). The mean dose of amio‐darone administered until sinus rhythm restoration was 740 ± 296 mg. The presence and the type of underlying heart disease did not influence the conversion rate in either group. In two patients (1.8%) treated with amiodarone, the return of sinus rhythm was preceded by asystole.

Conclusion: Amiodarone is effective in the termination of AF lasting < 24 h. It may be particularly useful in patients with organic heart disease in whom class I antiarrhythmic agents may be contraindicated. During treatment, the heart rhythm should be monitored continuously.
Differences in the morphology and duration between premature P waves and the preceding sinus complexes in patients with a history of paroxysmal atrial fibrillation
Authors: Dilaveris Polychronis E. , Pantazis Antonios , Zervopoulos George , Tzannetis George , Kallikazaros John , Stefanadis Christodoulos , Toutouzas Pavlos K.
Published: June 2007

Background: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Experimental and human mapping studies have demonstrated that perpetuation of AF is due to the presence of multiple reentrant wavelets with various sizes in the right and left atria.

Hypothesis: Atrial fibrillation may be induced by atrial ectopic beats originating in the pulmonary veins, and premature P‐wave (PPW) patterns may help to identify the source of firing.

Methods: To evaluate the morphology and duration of PPWs, 12‐lead digital electrocardiogram (ECG) strips containing clearly definable PPWs not merging with the preceding T waves were obtained in 25 patients with AF history (9 men, mean age 59.5 ± 2.2 years) and 25 subjects without any previous AF history (11 men, mean age 53.6 ± 2.5 years). The polarity of PPWs was evaluated in all 12 ECG leads. Previously described indices, such as P maximum, P dispersion (= P maximum –P minimum), P mean, and P standard deviation were also calculated.

Results: Premature P‐wave patterns were characterized by more positive P waves in lead V1. All P‐wave analysis indices were significantly higher in patients with AF than in controls when calculated in the sinus beat, whereas they did not differ between the two groups when calculated in the PPW. P‐wave indices did not differ between the PPW and the sinus P wave in either patients with AF or controls, except for P mean, which was significantly higher in the sinus (110.1 ± 1.7 ms) than in the PPW (100 ± 2 ms) only in patients with AF (p = 0.001).

Conclusion: The evaluation of PPW patterns is only feasible in a small percentage of short‐lasting digital 12‐lead ECG recordings containing ectopic atrial beats. Premature P wave patterns are characterized by more positive P waves in lead V1, which indicates a left atrial origin in the ectopic foci. The observed differences in P‐wave analysis indices between patients with AF and controls and between sinus beats and PPWs may be attributed to the presence of electrophysiologic changes in the atrial substrate.