bluuebunny/crossref_metadata_2025 huggingface dataset:
The Elimination of Body Resonance Distortion from the Direct-Body Ballistocardiogram
Authors: TOBIN MICHAEL , EDSON JOHN N. , DICKES ROBERT , FLAMM GERALD H. , DEUTSCH LAWRENCE
Published: June 2012

A simple method of obtaining a force ballistocardiogram has been presented. This type of tracing has been derived from the direct-body ballistocardiogram by electrically filtering out body resonance distortion. The resultant force tracings appear to be closely related to cardiovascular events.
Visualization of the Coronary Sinus in Cineangiocardiography
Authors: CAMPETI FRANK , GRAMIAK RAYMOND , WATSON JAMES S. , RAMSEY GEORGE H. , WEINBERG SYDNEY
Published: June 2012

Reflux opacification of the coronary sinus was observed in 25 of 100 cases examined by cineangiocardiography. Of the 25 coronary sinus "positive" cases, 88 per cent were found to have cardiovascular lesions which are regularly associated with severe hypertension of the right heart chambers. The x-ray anatomy of the opacified sinus in different projections, and the movements by which it can be identified on x-ray motion picture films, are described in detail. The meaning of the reflux is discussed in relation to the diagnostic findings.
The Electrocardiogram in Congenital Heart Disease
Authors: BRINK A. J. , NEILL CATHERINE A.
Published: June 2012

The incidence of the four main types of axis deviation in each diagnostic group of congenital malformations of the heart was found by an examination of 2,752 electrocardiograms from the Harriet Lane Home Cardiac Clinic. Records from patients with dextrocardia or dextrarotation of the heart, and those with complete bundle branch block were excluded. The precordial and unipolar limb leads in the 289 electrocardiograms which showed left axis deviation were examined, and the types of precordial pattern most frequently seen in the different diagnostic groups analyzed. It is concluded that the precordial patterns show considerable difference in the various malformations associated with left axis deviation, and are of diagnostic aid.
Left Axis Deviation in Tricuspid Atresia and Single Ventricle
Authors: NEILL CATHERINE A. , BRINK A. J.
Published: June 2012

The electrocardiograms from 28 unselected autopsied cases of tricuspid atresia, and eight autopsied cases of single ventricle were analysed: only those cases of single ventricle which showed left axis deviation were included. Electrocardiographic evidence of left ventricular preponderance in the precordial and unipolar limb leads was found in 27 of the 28 cases of tricuspid atresia, and three of the eight of single ventricle: In only two cases of single ventricle was the electrocardiogram identical with that seen in tricuspid atresia, and in one of them tricuspid stenosis was present. Right auricular hypertrophy as evidenced by high peaked P waves, together with presystolic hepatic pulsations occurred in tricuspid atresia in those instances in which, at autopsy, the interauricular communication was found to be small.
Influence of Prostigmine and Acetylcholine on Ventricular Fibrillation Elicited by Focal Cooling
Authors: SCHERF D. , BUSSAN R. , GITTINGER W. C. , TORIN S.
Published: June 2012

Focal cooling of the exposed ventricle of the dog, beating at high rates, elicits ventricular fibrillation within a few seconds. The effect of this mode of cooling on hearts pre-treated with prostigmine or acetylcholine is studied. These compounds do not prevent ventricular fibrillation, but on the contrary some observations show that they enhance its appearance.
The Influence of Rheumatic Fever on Serum Concentrations of the Enzyme, Glutamic Oxalacetic Transaminase
Authors: NYDICK IRWIN , TANG JAMES , STOLLERMAN GENE H. , WRÓBLEWSKI FELIX , LADUE JOHN S.
Published: June 2012

Variations in serum concentration of the enzyme, glutamic oxalacetic transaminase, in 64 patients with rheumatic fever were studied. Elevations were noted in 17 of 26 patients with carditis of definite or questionable activity and transiently in one rheumatic subject with viral myocarditis. Except for one patient with polyarthritis and equivocal evidence of acute cardiac involvement, serum concentrations were normal during noncardiac rheumatic manifestations and inactive carditis. There was no relationship to temperature, sedimentation rate, white blood count or C-reactive protein. Intermittent necrosis of myocardial fibers probably leads to these increased serum transaminase concentrations.
Syndrome of Left Ventricular-Right Atrial Shunt Resulting from High Interventricular Septal Defect Associated with Defective Septal Leaflet of the Tricuspid Valve
Authors: STAHLMAN MILDRED , KAPLAN SAMUEL , HELMSWORTH JAMES A. , CLARK LELAND C. , SCOTT H. WILLIAM
Published: June 2012

Two similar cases of unusual congenital anomalies of the heart are presented, in which there existed a direct communication between the left ventricle and the right auricle through a defect involving the membranous portion of the interventricular septum with defective formation of the medial leaflet of the tricuspid valve. Data obtained at catheterization, operative and postmortem findings are presented in each case. The differential diagnosis of this type of lesion is discussed.
The Physiologic and Clinical Similarity Between Primary Amyloid of the Heart and Constrictive Pericarditis
Authors: GUNNAR ROLF M. , DILLON ROBERT F. , WALLYN RICHARD J. , ELISBERG EDWARD I.
Published: June 2012

When primary amyloid infiltrates the myocardium, there is a loss of distensibility and a resistance to contraction similar to that seen in constrictive pericarditis. The clinical similarity between these two entities has been noted previously on only a few occasions and only one previous case of amyloid has had catheterization studies. A case of amyloid of the heart is presented with catheterization studies and the reasons for the clinical and physiologic similarity to constrictive pericarditis are discussed.
Motion in Cardiovascular Radiography
Authors: DOTTER CHARLES T.
Published: June 2012

The minute has given way to the second as an expression of radiographic exposure duration. It is predicted that the millisecond will be the term of the future. Arterial blood velocity exceeds 50 cm. per second. In cardiovascular radiography, especially angiocardiography, maximum detail cannot be achieved unless the x-ray exposure is short enough to "stop" rapid movement. Practical experience indicates that exposures of 3 milliseconds' duration offer an economic alternative to high speed, serial angiocardiography. A method of achieving such exposures consists of a grid-controlled, hightension, switch tube operated in series with the diagnostic x-ray tube.
Sodium, Potassium and Magnesium Balance During Recovery from Congestive Heart Failure due to Cor Pulmonale and Other Heart Diseases
Authors: MADER IVAN J. , MORITA YOSHIKAZU , ISERI LLOYD T.
Published: June 2012

Five cases of congestive failure due to varied causes were studied metabolically during recovery. The cases of cor pulmonale showed changes in cations and osmotically active base, similar to changes in heart failure due to other causes. A difference in the movement of water was noted between three of the present cases and the usual case of congestive heart failure.
Cardiovascular Collapse in Acute Poliomyelitis
Authors: HILDES J. A. , SCHABERG A. , ALCOCK A. J. W.
Published: June 2012

Cardiovascular collapse accounted for approximately one-third of the deaths from acute poliomyelitis in two epidemics. This syndrome occurred early in the disease and only in cases of bulbar involvement. In all cases there was morphologic involvement of the medulla and in 75 per cent of the cases there was a varying degree of myocarditis. There was a much smaller incidence of less severe myocarditis in the cases dying of other causes. It is suggested that the combination of sustained vasoconstriction arising as a result of the medullary lesion and the presence of interstitial myocarditis leads to circulatory failure and pulmonary edema.
Pulmonary Stenosis and Ventricular Septal Defect with Arteriovenous Shunts
Authors: CALLAHAN JOHN A. , BRANDENBURG ROBERT O. , SWAN H. J. C.
Published: June 2012

Patients who have pulmonary stenosis and ventricular septal defect usually have a right-to-left intracardiac shunt. This paper presents hemodynamic and clinical data on 11 patients who have pulmonary stenosis, ventricular septal defect and left-to-right shunts. Four of these patients also have defects in the atrial septum, and three have demonstrable bidirectional shunts. The level and direction of shunts were determined by blood oxygen-saturation data and indicator-dilution studies. Choice of the form of treatment to be used in patients such as these should be based largely on hemodynamic considerations. Many resemble patients with tetralogy of Fallot who have had a successful pulmonary valvotomy.
A Study of Heart Sounds and Murmurs by Direct Heart Recordings
Authors: BERTRAND CHARLES A. , MILNE IAN G. , HORNICK RICHARD
Published: June 2012

A method is described for recording heart sounds and murmurs on the surface of the heart chambers and great vessels. Studies were performed on normal dogs and in those with murmurs of known origin, chiefly pulmonic and aortic stenosis. In addition, the reappearance of the murmurs in such cases was studied, following the release of caval occlusion. It was found that the systolic murmur of pulmonic stenosis returned almost immediately after release of caval occlusion, whereas the aortic murmurs did not return until usually from six to 10 beats after release. This may provide a basis for the differentiation of right heart and left heart murmurs by a carefully controlled Valsalva maneuver.
Diagnosis of Congenital Aortic Septal Defects
Authors: D'HEER H. A. H. , VAN NIEUWENHUIZEN C. L. C.
Published: June 2012

Two cases of aortic septal defect, diagnosed in life by means of cardiac catheterization, are described. An explanation is given of a method, used in these cases, whereby a correct diagnosis could be made before operation. Other methods for diagnosis and differential diagnosis are discussed.
Clinical Studies on Involvement of the Pulmonary Artery by Syphilitic Aortic Aneurysms
Authors: DONNELL JOHN J. , LEVINSON DAVID C. , GRIFFITH GEORGE C.
Published: June 2012

Cardiac catheterization and angiocardiography studies are reported in two patients with syphilitic aortic aneurysms, both of which compromised the pulmonary circulation. In the first instance the right main pulmonary artery was compressed and pulmonary hypertension proximal to the compression resulted. In the second patient the aneurysm ruptured into the pulmonary artery producing an aortic-pulmonary fistula. This patient also had pulmonary hypertension and evidence at cardiac catheterization of a large left-to-right shunt. The difficulty of making the clinical diagnosis of pulmonary artery compression by an aortic aneurysm is discussed. Cardiac catheterization and angiocardiography were essential for establishing this diagnosis in life.
Studies on the Renal Circulation and the Renal Function in Mitral Valvular Disease
Authors: WERKÖ LARS , BERGSTRÖM JONAS , BUCHT HÄRJE , EK JAN , ELIASCH HARALD , ERIKSSON KERSTIN , THOMASSON BENGT , VARNAUSKAS EDVARDAS
Published: June 2012

Renal circulation and function were studied simultaneously with pulmonary and systemic hemodynamics in 25 patients with mitral stenosis before and six weeks after valvulotomy. Postoperatively no essential change in renal circulation or function could be demonstrated whether significant relief of pulmonary hypertension had occurred or not. However, results from follow up studies made on 21 patients up to more than three years after operation showed that renal plasma flow could be increased in patients that were hemodynamically improved at the postoperative study. The effect of exercise was investigated in eight patients before and after valvulotomy. In seven the response pattern of renal circulation and function was essentially unchanged regardless of whether improvement in pulmonary pressures and cardiac output did or did not occur. In the eighth patient, the only one with elevated right atrial pressure before operation, the response to exercise improved markedly. Preoperative results obtained on seven patients who died in connection with operation showed that a fatal outcome was not necessarily related to the degree of impairment in renal circulation or function.
Livedo Reticularis with Ulcerations
Authors: FELDAKER MAURI , HINES EDGAR A. , KIERLAND ROBERT R.
Published: June 2012

Idiopathic livedo reticularis may be associated with ulcerations of the lower extremities beginning primarily during the warmer or summer months, as well as the more usual occurrence of winter ulcerations. Summer ulceration apparently is a new and rare entity which has many clinical and histopathologic features similar to winter ulcerations. Hypertension, Raynaud's phenomena, acrocyanosis and thrombosis of digital arteries were noted only in patients with winter ulcerations, while edema of the legs and feet was a more prominent feature in patients with summer ulcerations. Medical treatment, including rest in bed, elastic supportive bandages and a trial of hexamethonium (bistrium bromide) injections, seemed to be the treatment of choice. Lumbar sympathectomy did not seem to be of great permanent value.
The Serum Lipids in Human Atherosclerosis
Authors: PATERSON J. C. , CORNISH BETTY R. , ARMSTRONG E. C.
Published: June 2012

An attempt is being made to determine the relation of the serum lipids to the progression of human atherosclerosis. The serum lipids are estimated serially during life and are compared with the degree of atherosclerosis found post mortem. The findings in the first 50 fatalities in the series of 800 patients are reported. The results make a poor case for the effect of derangements of the serum lipids on the disease process. Elevation of the cholesterol-phospholipid ratio has the most suggestive atherogenic effect, but this is not consistent. The total serum cholesterol and the S
f
12-20 and 20-100 lipoproteins show no significant relationships.
The Calibration of Heart Sound Intensity
Authors: MCGREGOR MAURICE , RAPPAPORT MAURICE B. , SPRAGUE HOWARD B. , FRIEDLICH ALLAN L.
Published: June 2012

There is no standardized method for the calibration of total energy conducted to the surface of the chest caused by the cardiac sounds. Loudness is a subjective term which is dependent upon total energy, frequency of the main components and the specific sensitivity of the human hearing mechanism. A method is described in which the amplitude of the chief component of the heart sounds is compared to that produced by a standard sound signal at 80 decibels at 500 cycles per second and an intensity ratio calculated. The method has been applied to normal individuals of different ages and to those with mitral valve disease and those with pulmonary hypertension. The findings confirm the clinical observation that mitral stenosis with persisting mobility of the valve leaflets is associated with a loud first heart sound. However, the measurement of intensity of the second heart sound did not show so reliable a correlation between the loudness of the sound and the pulmonary blood pressure. The relationship is somewhat obscured by the wide range of normal values in the intensity of the second heart sound.
Report of Committee on Blood Vessel Banks
Authors: LORD JERE W. , GROSS ROBERT E. , HUFNAGEL CHARLES A. , LAZZARINI ABEL A.
Published: June 2012

Recent advances in the diagnosis and treatment of segmental lesions of large blood vessels have created a need for storage of arterial and venous grafts and plastic prostheses. It has been the purpose of this paper to describe in some detail the problems and technics of procurement, sterilization, preservation and utilization of arterial and venous grafts. Emphasis has been placed on the need for bacteriologic and histologic safeguards in the maintenance of a blood vessel bank. A brief section was devoted to the current status of plastic prostheses. Finally, it is of considerable importance to recognize the fact that this is a new field which is being subjected to intensive study and that advances and modifications will be forthcoming. Therefore, this paper represents an interim rather than a final report.
Clinical and Hemodynamic Studies of Tricuspid Stenosis
Authors: YU PAUL N. , HARKEN DWIGHT E. , LOVEJOY FRANK W. , NYE ROBERT E. , MAHONEY EARLE B.
Published: June 2012

Five patients with tricuspid stenosis accompanying mitral stenosis were studied. The characteristic features include a diastolic rumbling murmur in the tricuspid area, accentuated by inspiration, prominent "a" wave in the jugular pulse, prominent P wave in the electrocardiogram, absence of physical or electrocardiographic signs of right ventricular hypertrophy, and disproportionate right atrial enlargement by fluoroscopy. The diagnosis may be confirmed by the presence of a significant diastolic pressure gradient across the tricuspid valve. Mitral valvuloplasty alone produces no improvement. The concept of "functional tricuspid stenosis" is introduced and a one-stage operative technic for both mitral and triscuspid valvuloplasty described.
Some Clinical Features of Complete Heart Block
Authors: PENTON GEORGE B. , MILLER HAROLD , LEVINE SAMUEL A.
Published: June 2012

A review was made of 251 cases of complete heart block. They were divided into the following groups: coronary artery disease (nonacute), 58 cases; myocardial infarction (acute), 49 cases; hypertensive heart disease, 62 cases; rheumatic heart disease, 21 cases; miscellaneous, 16 cases; "etiology undetermined," 18 cases; and digitalis intoxication, 27 cases. Among the various clinical features analyzed were the sex and age factors, the occurrence of syncope, palpitation, congestive failure, anginal pain, and the duration of life after the onset of major symptoms. Methods of treatment are discussed.
The Electrocardiographic Effects of Hypocalcemia Induced in Normal Subjects with Edathamil Disodium
Authors: BECHTEL JACK T. , WHITE JEFFERSON E. , ESTES E. HARVEY
Published: June 2012

In the past, it has not been possible to study the electrocardiographic effects of hypocalcemia in normal subjects. Edathamil disodium is a powerful chelating agent with a strong affinity for ionic calcium when given intravenously. This agent was used to produce hypocalcemia in normal subjects so that electrocardiographic effects could be studied. The major changes produced in the electrocardiogram with the induction of hypocalcemia were shortening of the R-R interval, prolongation of the RS-T and Q-T intervals, all of which were proportional to the degree of hypocalcemia. No change in the spatial P, QRS and T vectors, no T wave flattening or inversion and no elevation or depression of the RS-T segment appeared with hypocalcemia.
Right Bundle-Branch Block. Hemodynamic, Vectorcardiographic and Electrocardiographic Observations
Authors: BRAUNWALD EUGENE , DONOSO EPHRAIM , SAPIN SAMUEL O. , GRISHMAN ARTHUR
Published: June 2012

The time intervals between the onset of ventricular depolarization and of right ventricular contraction were studied in 36 patients, by means of cardiac catheterization, and were correlated with their vectorcardiograms and electrocardiograms. The onset of right ventricular contraction was delayed in six subjects without heart disease but with the electrocardiographic picture of right bundle-branch block. The onset of right ventricular contraction was found to be normal in 10 of 15 patients with right ventricular hypertrophy with the electrocardiographic picture of right bundle branch block. This indicates that this electrocardiographic configuration is not necessarily accompanied by delayed right ventricular contraction.
The Effect of Age on Mean Spatial QRS and T Vectors
Authors: SIMONSON ERNST , KEYS ANCEL
Published: June 2012

The differentiation between normal and abnormal changes in conventional electrocardiography is substantially improved by consideration of normal age trends. For clinical application of spatial vectorcardiography, consideration of age trends is equally important. On the basis of statistical evaluation of magnitude, azimuth and elevation of mean spatial QRS and T vectors in 105 healthy young men and 178 healthy older men, upper and lower limits were determined for each age group. The age differences were highly significant for all items of vector analysis.
Clinical Manifestations of the Unperforated Aortic Sinus Aneurysm
Authors: STEINBERG ISRAEL , FINBY NATHANIEL
Published: June 2012

There are no diagnostic features for the recognition of unperforated aortic sinus aneurysms except for a grade 3 to 4 cardiac murmur. Linear or massive calcifications in the intracardiac portion of the root of the aorta continuous with the linear calcifications of the ascending aorta sometimes occurs in syphilitic aortic sinus aneurysms. Accordingly, a high index of suspicion and angiocardiography are advocated in order to establish the diagnosis during life.

Surgical repair of a localized congenital aortic sinus aneurysm through the right atrial approach seems feasible if there are no serious complicating aortic or cardiac lesions. The diffuse unruptured aneurysmal congenital and syphilitic aortic sinus aneurysms are better left alone. If rupture occurs, surgical repair, even though heroic, should be attempted.
Blood Pressure Studies Among American and Foreign-Born Students
Authors: SZENT-GYÖRGYI NÁNDOR
Published: June 2012

The relation of hypertension to race, sex, environment, and geographic origin in a young adult population is analyzed. Of the 3508 university students, 6.7 per cent were hypertensive. Among American men and women the incidence was 8.1 per cent and 3.1 per cent, respectively. The incidence of hypertension in all racial groups is significantly higher among American-born than among foreign-born males. After 10 years of residence in the United States, foreign-born students have the same high incidence of hypertension as those born in the United States and Canada. Detailed study is presented regarding the incidence of hypertension in different age groups among American and foreign-born white, Negro and Asian students.
The Use of the Lead-Field Concept in the Development of Leads Satisfactory for Vectorcardiography. I. The Sagittal Lead
Authors: REYNOLDS ERNEST W. , CORDES JEROME F. , WILLIS PARK W. , JOHNSTON FRANKLIN D.
Published: June 2012

After a brief discussion of the lead field concept and an illustration of its application using a Teledeltos paper model, studies carried out on patients, employing multiple electrode or grid arrangements located over the precordium and the left posterior chest, to obtain the sagittal component of cardiac electromotive forces (e.m.f.'s), are described. On the basis of these observations, a minimum of 15 properly arranged and connected electrodes should be employed in the anterior electrode system but fewer will be needed posteriorly. A scheme, using 63 electrodes mounted in sponge rubber, has been devised to simplify the grid arrangement.
Coronary Blood Flow, Myocardial Oxygen Consumption, and Myocardial Metabolism in Normal and Hyperthyroid Human Subjects
Authors: LEIGHT LEONARD , DEFAZIO VALENTINO , TALMERS FREDERICK N. , REGAN TIMOTHY J. , HELLEMS HARPER K.
Published: June 2012

The effects of thyroid hormone excess on myocardial hemodynamics and carbohydrate metabolism were determined in a group of subjects, and the findings compared with those obtained in a group of normal individuals. The results indicate that in thyrotoxicosis there tends to be an increase in coronary blood flow and myocardial oxygen consumption and a normal per cent extraction of oxygen by the myocardium. The metabolism of glucose, lactic acid, and pyruvic acid was virtually identical in the 2 groups. No relationship was demonstrable between the arterial levels of the carbohydrate substances and their extraction by the heart.
Relative Contribution of Blood from Each Lung to the Left-to-Right Shunt in Atrial Septal Defect
Authors: SWAN H. J.C. , HETZEL PETER S. , BURCHELL HOWARD B. , WOOD EARL H.
Published: June 2012

Arterial dilution curves of T-1824 have been recorded by oximeters after injection of T-1824 into both the right and left pulmonary arteries in patients with anomalous connections of the pulmonary veins, with atrial septal defects or with persistent common atrioventricular canals. The most extreme differences were found between the pairs of curves in the patients with the anomalous connection. These differences were less pronounced but clearly recognizable in the other conditions, and suggested a more general use of the term "anomalous pulmonary venous drainage. "The findings indicate that, in the usual case of atrial septal defect, a greater proportion of the blood from the right lung passes to the right atrium than does blood from the left lung.
Reassurance in the Management of Benign Hypertensive Disease
Authors: GOLDRING WILLIAM , CHASIS HERBERT , SCHREINER GEORGE E. , SMITH HOMER W. , Wilson Margaret
Published: June 2012

The therapeutic improvement achieved by administration of drugs in arterial hypertension and other disease states is widely recognized to be due to the potency of reassurance and suggestion as well as the possible pharmacologic action of the drugs employed. In this article Dr. Goldring and his associates evaluate the effectiveness of a calculated and deliberately dramatized regimen of reassurance on the blood pressure and on the symptoms in patients with benign hypertensive disease. These results help to explain why nonscientific treatment sometimes seems to be crowned with therapeutic success.
Effect of Chlorpromazine on Cerebral Hemodynamics and Cerebral Oxygen Metabolism in Man
Authors: MOYER JOHN H. , MORRIS GEORGE , PONTIUS ROBERT , HERSHBERGER ROBERT , Smith C. Polk
Published: June 2012

Cerebral blood flow frequently decreases following the intravenous administration of chlorpromazine, apparently a result of the reduction in arterial blood pressure. If arterial blood pressure does not decrease, cerebral blood flow is not altered. Chlorpromazine does not exert a depressant effect on cerebral oxygen consumption as morphine does.
Proposals for Ballistocardiographic Nomenclature and Conventions: Revised and Extended
Authors: SCARBOROUGH WILLIAM R. , TALBOT SAMUEL A. , BRAUNSTEIN JOHN R. , RAPPAPORT MAURICE B. , DOCK WILLIAM , SCARBOROUGH WILLIAM R. , HAMILTON W. F. , SMITH JOHN E. , NICKERSON JOHN L. , TALBOT SAMUEL A. , STARR ISAAC
Published: June 2012

The committee's first report, published in
Circulation
for June 1953, recommended a terminology and certain conventions for recording ballistocardiograms of the type then in use. However, it soon became apparent that the committee's work was far from complete.

Increasing knowledge of ballistic theory soon began to throw light on the relations of records secured by various instruments to one another, and a rapid advance in instrumentation began to provide records related to, but often not identical with, those which had been provided with a standard terminology by the committee in its first report. Accordingly, the committee has continued its labors to provide the rapidly advancing field with a uniform terminology.

While they were thus engaged, attention was called to the fact that the designation of spatial axes previously recommended for vector ballistocardiograms differed from that which had been recommended for electrocardiograms by another committee of the American Heart Association. The advantages of a common system for designating spatial axes were obvious to all. Accordingly, as the electrocardiographic usage had priority and as little had been published in the field of ballistocardiographic vectors the committee voted to withdraw their original recommendation and substitute one conforming to that in use by electrocardiographers. In the present communication this new convention is also set forth.

All members of the committee have shared in the deliberations and taken part in the decisions which form the basis of this report; but so much of the larger proportion of the actual work fell on Dr. Scarborough and Dr. Talbot that it was agreed without dissenting vote that only their names should appear as authors. This report has the endorsement of the committee as a whole, and the terminology it suggests is recommended as the official terminology of the American Heart Association.
A Linear Time Scale for Spatial Vectorcardiographic Data
Authors: ABILDSKOV J. A. , INGERSON W. E. , HISEY B. L.
Published: June 2012

Spatial vectorcardiograms have certain advantages over electrocardiograms for study of the heart's electric activity. They also have a marked disadvantage in that temporal relations are difficult to represent. Many of the advantages of the spatial vectorcardiogram can be retained and temporal relations can be adequately represented by presenting vectorcardiographic data as simultaneous traces of spatial magnitude and orientation about 2 axes. Such records have been derived from electrocardiographic leads obtained with 2 systems of electrode placement. The information known to beclinically important in the electrocardiogram was present in easily accessible form in these records.
The Effects of External Electric Currents on the Heart
Authors: ZOLL PAUL M. , PAUL MILTON H. , LINENTHAL ARTHUR J. , NORMAN LEONA R. , GIBSON WILLIAM
Published: June 2012

Clinically, application of electric currents to the heart has been limited to defibrillation in the operating room when the heart is exposed. In this paper technics are described for the external application of stimulating and countershock currents. They have been used successfully in man to terminate ventricular standstill from any cause and to stop ventricular tachycardia or fibrillation. For experimental purposes an additional technic has been developed for producing various cardiac arrhythmias by rapid external stimulation of the heart.
Serum Glutamic-Oxalacetic Transaminase in Coronary Artery Disease
Authors: OSTROW BERNARD H. , STEINBERG DANIEL , TICKTIN HOWARD E. , POLIS GEORGE N. , EVANS JOHN M.
Published: June 2012

The results of serial glutamic-oxalacetic transaminase (GOT) assays in 201 cases in which coronary artery disease was suspected are correlated with the clinical, laboratory, and electrocardiographic changes. In 95 per cent of the cases diagnosed as myocardial infarction on the basis of clinical and electrocardiographic evidence there was an elevation of serum GOT. On the other hand, in 12 per cent of the cases in which clinical and electrocardiographic findings were negative or equivocal with regard to myocardial infarction, there was an elevated serum GOT. In 18 cases that were autopsied the correlation between acute myocardial necrosis and serum GOT elevation was 100 per cent.
Blood Coagulation After a Fat Meal
Authors: BUZINA RATKO , KEYS ANCEL
Published: June 2012

The influence of meals on the coagulability of blood was studied in experiments on 20 men with parallel nonfed controls. The whole blood clotting time in siliconized tubes was not altered by a low-fat meal or by continued absence of a meal, but it was significantly shortened after a meal containing 100 Gm. of butterfat. The degree of lipemia did not determine the degree of shortening. There was no important effect on prothrombin time of the fatty meal as contrasted with the nonfatty meal or with no meal. Heparin tolerance results were difficult to interpret.
Intra-Atrial Block
Authors: BRADLEY SAMUEL M. , MARRIOTT HENRY J. L.
Published: June 2012

Attention is drawn to differences of opinion regarding the upper normal limit of P-wave duration and the definition of intra-atrial block. There seems to be good reason for accepting 0.11 sec. as the upper limit of normal and a P-wave duration of 0.12 sec. or more as indicative of intra-atrial block. By this criterion 4,500 consecutive electrocardiograms taken in a general hospital were examined and the findings are reported.
Studies Made by Simulating Systole at Necropsy
Authors: STARR ISAAC
Published: June 2012

In a previous publication we defined the relation between cardiac work and blood pressure measurements by means of multiple regression equations. In this communication we seek a simple method of estimating cardiac work from observations any doctor could make in the clinic.
Coronary Embolism
Authors: LEE SHRADER E. , BAWELL M. B. , MORAGUES V.
Published: June 2012

Data were selected in a review of the literature from about 54 cases of coronary embolism. A majority of the cases were men between 30 and 40 years of age. The sources of the emboli were chiefly vegetations from bacterial endocarditis and cardiac thrombi from pre-existent heart disease. These 2 sources accounted for the majority of the emboli. The left coronary artery was involved most frequently, and the type of death was usually sudden. Coronary emboli almost always produce death. A comparison of the various factors involved in coronary emboli has been made with coronary thrombosis.
Pressor Effects of Norepinephrine After Drastic Reduction of Sodium Intake
Authors: DAHL L. K.
Published: June 2012

The mechanisms whereby dietary sodium restriction leads to decreased arterial blood pressure is obscure. Previously reported studies of patients with arterial hypertension showed a lessened pressor response to norepinephrine after sodium restriction. In the present investigations, reduction in pressor response to norepinephrine during the low sodium period was observed only occasionally; sodium restriction decreases blood pressure in some hypertensive patients by other unknown mechanisms.
Thrombotic Obliteration of the Branches of the Aortic Arch
Authors: KALMANSOHN ROBERT B. , KALMANSOHN RICHARD W.
Published: June 2012

This report presents the sixth case of thrombotic obliteration of the branches of the aortic arch to be documented in this country. The world's literature on this subject is reviewed and analyzed from the standpoints of clinical characteristics, etiology, and pathology.
Aortic Aneurysm
Authors: ROBERTS BROOKE , DANIELSON GORDON , BLAKEMORE WILLIAM S.
Published: June 2012

An evaluation of the management of patients with aneurysm of the aorta seems timely because of new and promising methods of treatment. The risks of nonoperative and operative treatment are presented from the experiences with 101 patients admitted to the Hospital of the University of Pennsylvania during the years 1950 through 1955. Follow-up data indicate that the mortality of nonoperative treatment is considerably greater than that of excision of the lesion, in spite of the poor operative risk of many patients in this group. The nonoperative mortality within 1 year of diagnosis was approximately 50 per cent. Many of these patients died of rupture of the aneurysm.
Diagnostic and Prognostic Significance of Serum Transaminase Levels in Coronary Occlusive Disease
Authors: KATTUS A. A. , WATANABE R. , SEMENSON C. , Yamashita Joe
Published: June 2012

Clinical and experimental studies of acute myocardial infarction suggest that serum glutamic oxalacetic transaminase (SGO-T) levels may have both diagnostic and prognostic significance. The authors report their experience in 255 patients hospitalized because of chest pain strongly suggestive of acute myocardial infarction. The results of serial determinations are compared with the clinical data and the electrocardiographic findings. The data indicate that abnormally high levels have both diagnostic and prognostic significance.
Interatrial-Pressure Relationships after Closure of Atrial Septal Defects in Man
Authors: PEMBERTON ALBERT H. , KIRKLIN JOHN W. , WOOD EARL H.
Published: June 2012

Manifestations of left ventricular failure have been reported in the literature in some patients after surgical closure of atrial septal defects. The authors present their experience in their series of 85 cases and detailed hemodynamic measures in 16 patients.
George E. Brown Memorial Lecture
Authors: MONTGOMERY HUGH
Published: June 2012

It seems fair to say that prior to the use of the oxygen electrode there was a static concept of the oxygen tension of tissues. This was true in spite of the fact that Bazett and Sribyatta, with the gas bubble technic, had demonstrated one example of a labile oxygen tension, in the subcutaneous space of man.
17
They of course could not show the rapidity with which the changes take place. Experiments with the polarographic technic have shown that profound changes in oxygen tension can take place very rapidly, all the way from values approaching that of arterial blood down to zero.

In vasodilated skin oxygen tension approaches that of arterial blood. When different concentrations of oxygen are breathed, the changes in oxygen tension in such skin closely follow those of the arterial blood. When the circulation to skin is limited by peripheral arterial occlusion, oxygen is reduced and does not increase on vasodilatation as much as does that of normal skin. When a normal person breathes oxygen, the oxygen in the tissues that use little oxygen quickly reaches a pressure 4 or 5 times that produced when he breathes air. In the case of tissues that use greater amounts of oxygen this relationship is not so close. The higher tensions have not been found in the tissues that use the most oxygen. The transfer of oxygen from the capillaries to the tissue is rapid but not instantaneous.

The usual ranges of oxygen tension of various tissues such as skeletal muscle, heart muscle, brain, etc., are not yet known in terms of millimeters of mercury, but this should now be possible. It is hoped that local metabolisms will be measured reasonably accurately in intact tissues within the body. Perhaps the storage of oxygen by myoglobin and cytochromes can be derived, again in situ, from the metabolism and the rate of change of oxygen tension when the circulation is arrested.

The potentialities of the oxygen electrode are great, but limitations of the method should be respected. Further development of the method may free it of some of its defects. Other methods may supplant it, but if so they will need to be equally rapid and more capable of exact calibration.

In closing this presentation I want to thank our chairman, my friend Dr. Arthur Merrill, for allowing me to speak to you. I want also to thank Dr. George Brown, in memoriam, for his pioneering in the paths of study of the interrelations of circulatory and tissue physiology and medicine.
Surgical Treatment of Mitral Insufficiency by Total Circumferential "Purse-String" Suture of the Mitral Ring
Authors: GLOVER ROBERT P. , DAVILA JULIO C.
Published: June 2012

A new surgical procedure for correction of mitral insufficiency is presented. The clinical and hemodynamic results in 12 cases are discussed.
Selective Roentgenographic Contrast Examination and Electrokymography of the Left Heart in Experimental Mitral Insufficiency
Authors: NORDENSTRÖM BJÖRN , STAMER J. P. , FIGLEY MELVIN , SLOAN HERBERT
Published: June 2012

Difficulty in the accurate preoperative assessment of mitral insufficiency, clinically and by several laboratory methods, suggested the desirability of direct visualization of the regurgitant flow. Direct puncture of the left ventricle for the injection of radiopaque contrast material was used in dogs before and after the creation of mitral insufficiency by division of 1 chorda tendinea. The regurgitation was accurately recognized radiographically. Consistent alterations in left atrial border movement were also recorded by electrokymography.
Effect of Circulatory Changes on the Pulmonary Compliance of Normal Subjects and Patients with Mitral Stenosis
Authors: PRYOR W. W. , HICKAM J. B. , SIEKER H. O. , PAGE E. B.
Published: June 2012

Fulfillment by the lungs of their bellows function depends largely on their resiliency and elasticity. Unless the lungs can readily comply with the changes in the thoracic cage during inspiration and expiration, ventilation will be seriously impaired. Pulmonary compliance is expressed as the ratio of lung volume in liters to intraesophageal pressure in centimeters of water. The present study is concerned with the role of pulmonary vascular engorgement in reducing compliance in normal subjects and in patients with mitral stenosis.
Valvular Pulmonary Stenosis with Intact Ventricular Septum
Authors: BLOUNT S. GILBERT , VAN ELK JACK , BALCHUM OSCAR J. , SWAN HENRY
Published: June 2012

Clinical and physiologic studies have been carried out in 25 patients following surgical correction of congenital valvular pulmonary stenosis. The patients were operated upon under conditions of hypothermia and circulatory occlusion and the approach to the valve was transarterial, permitting plastic repair of the stenotic pulmonary valve with unimpaired vision and a dry operative field. The systolic pressure gradient between the right ventricle and the pulmonary artery has been completely abolished in 17 of the 25 patients. The results as reported in this series are considered to be superior to those obtained with the blind transventricular approach and the operative mortality certainly compares favorably with the transventricular approach.
Aging of Arteries in Relation to Hypertension
Authors: CONWAY JAMES , SMITH K. SHIRLEY
Published: June 2012

With a new clinical test for the assessment of the elastic quality of the arterial reservoir, evidence has been obtained suggesting that essential hypertension can be separated into 2 distinct clinical types. In one group the elevation of pressure appears to be the consequence of physiologic aging of arteries and in the other hypertension is imposed upon a normal elastic arterial system. Patients in the elastic group were younger and had a more severe type of hypertension than those in the inelastic group.
Circulatory Studies in Wernicke's Encephalopathy
Authors: GRAVALLESE MICHAEL A. , VICTOR MAURICE
Published: June 2012

Although Wernicke's disease is clearly related to thiamine deficiency, it is rarely accompanied by the overt signs of congestive failure. There are symptoms of disordered cardiovascular function in many patients with this disease, but the relation of these symptoms to thiamine deficiency has remained undefined. In the present study, an attempt is made to define these symptoms, particularly, in relation to specific treatment with thiamine. Part 1 of this study is concerned mainly with the determination of the cardiac output in 7 patients, as determined by the Evans blue dye-dilution technic; part 2 describes the postural response to tilting in 12 patients.
Heparin-Activated Clearing Factor
Authors: BAKER SAUL P.
Published: June 2012

A possible relationship may exist between the concentration of heparin-activated plasma clearing factor and alterations in lipid metabolism associated with advancing age, atherosclerosis, and other diseases. To test this hypothesis, 121 men were evaluated in the development and application of a standardized
in vitro
method for the determination of clearing factor response to minimal heparin stimulation. Eighty-four men, ranging from 21 to 93 years, selected from this group, were evaluated in an age-wise study. Patients with diagnoses of recent myocardial infarction (presumptive evidence of coronary atherosclerosis), cirrhosis of the liver, and chronic alcoholism were also tested.
Syncope as an Indication of Digitalis Toxicity
Authors: GLOTZER SOL
Published: June 2012

Increased sensitivity of the carotid sinus to stimulation is known to accompany digitalis toxicity. Syncope induced by deglutition as a manifestation of this hypersensitivity is exceedingly unusual and warrants description.
Radioactive Iodine Treatment of Angina Pectoris and Congestive Heart Failure
Authors: BLUMGART HERRMAN L. , FREEDBERG A. STONE , KURLAND GEORGE S.
Published: June 2012

This 66-year-old man with angina pectoris for 17 years before treatment, incapacitated for several years despite long periods of rest and other therapy, showed significant improvement 2 months after I
131
therapy and for the past 18 months he has been maintained in the hypometabolic state, free of pain despite greatly increased activity.
Wide Frequency Range Force Ballistocardiogram
Authors: REEVES T. J. , HEFNER L. L. , JONES W. B. , SPARKS J. E.
Published: June 2012

The ballistocardiograms of young normal subjects as recorded with a wide frequency range technic are described. These records contain high frequency forces not previously described. An analysis of these components in terms of known cardiovascular events strongly suggests that they have definite dynamic significance. In addition, these correlations offer evidence as to the genesis of some forces in the ballistocardiogram.
Atherosclerosis and the Fat Content of the Diet
Authors: PAGE IRVINE H. , STARE FREDRICK J. , CORCORAN A. C. , POLLACK HERBERT , WILKINSON CHARLES F.
Published: June 2012

A report to the American Heart Association and to the American Society for the Study of Arteriosclerosis the Nutrition Committee of the Council on Community Service and Education of the American Heart Association and others.
Serotonin and Antiserotonins
Authors: WILKINS ROBERT W. , HOLLANDER WILLIAM
Published: June 2012

Serotonin, a smooth-muscle constrictor, has been suggested as possibly important in the pathogenesis of arterial hypertension. The benzyl analog of serotonin (BAS) was developed as an antimetabolite of serotonin, and has certain demonstrable antiserotonin effects in man. Orally it has moderate antihypertensive and other clinical effects resembling those of reserpine, which also has a definite antiserotonin action. However, there is question whether the clinical effects of oral BAS or of reserpine in hypertension are due to "antiserotonin" or other pharmacologic actions. BAS is clinically useful in the therapy of some patients with essential hypertension.
An Assessment of the Exercise Capacity of Cardiac Patients
Authors: WYNDHAM C. H. , WARD J. S.
Published: June 2012

An attempt is made to relate the level of exercise at which disability occurs in cardiac patients with known oxygen consumption figures for various tasks. The limit to the maximum level of exercise in some patients with rheumatic heart disease is set by circulatory parameters, as in normal subjects, in others it is set by the excessive ventilatory cost of exercise.
Left Atrial Pressure Pulse in Mitral Valve Disease
Authors: MORROW ANDREW G. , BRAUNWALD EUGENE , HALLER J. ALEX , SHARP EDWARD H.
Published: June 2012

Left atrial pressures were determined by transbronchial puncture in 53 patients with mitral valve disease of proved type, and were analyzed by several methods. Two new methods of analysis, the rate of the
y
descent divided by the mean left atrial pressure, and the
y
descent for each 0.1-second interval divided by the mean left atrial pressure afforded the best separation of the patients with mitral insufficiency from those with mitral stenosis requiring a commissurotomy. In the presence of predominant mitral stenosis, however, the severity of accompanying mitral regurgitation could not be assessed.
Pulseless Disease due to Branchial Arteritis
Authors: KOSZEWSKI BOHDAN J. , HUBBARD THEODORE F.
Published: June 2012

A case of pulseless disease or branchial arteritis is described and findings of arteriography and arterial biopsy are observed. The primary lesion seems to consist of an acute neutrophilic periarteritis progressing to panarteritis, causing arterial thrombosis. Later stages are characterized by fibroblastic hypertrophy of adventitia with lymphocytic and plasmacellular infiltrations.

The anatomic changes are characteristic enough to regard the condition as an independent syndrome that can usually be well differentiated from other inflammatory and degenerative arterial diseases.

The arteritis in this case seemed to respond to combined steroid and anticoagulant therapy.
The Natural History of Rheumatic Heart Disease in the Third, Fourth, and Fifth Decades of Life
Authors: MAGIDA MELVILLE G. , STREITFELD FRANKLIN H.
Published: June 2012

This report is intended to contribute to an understanding of the natural morbidity of patients with chronic rheumatic heart disease in the third, fourth, and fifth decades of life. The data should prove useful in a consideration of the criteria for surgical intervention.