bluuebunny/crossref_metadata_2025 huggingface dataset:
ChemInform Abstract: Ligand Binding to Nucleic Acids and Proteins: Does Selectivity Increase with Strength?
Authors: Schneider Hans‐Joerg
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Alk‐1‐enylhydrazines
Authors: Collier S. J. , McLaws M. D.
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: N‐Silylenamines
Authors: Collier S. J.
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Stereoselective Synthesis of Saturated Heterocycles via Palladium‐Catalyzed Alkene Carboetherification and Carboamination Reactions
Authors: Wolfe John P.
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Organic Semiconductors in Potentiometric Gas Sensors
Authors: Janata Jiri , Josowicz Mira
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Aminated Sugars: Synthesis and Biological Activity
Authors: Nicotra Francesco , La Ferla Barbara , Airoldi Cristina
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: The Reduction of Nitriles to Aldehydes: Applications of Raney Nickel/Sodium Hypophosphite Monohydrate, of Raney Nickel/Formic Acid or Raney(Ni/Al)alloy/Formic Acid
Authors: Staskun Benjamin , van Es Theodorus
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Progress in the Studies on Rutaecarpine
Authors: Lee Seung Ho , Son Jong‐Keun , Jeong Byeong Seon , Jeong Tae‐Cheon , Chang Hyeon Wook , Lee Eung‐Seok , Jahng Yurngdong
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Synthesis and Reactivity of an Enantiomerically Pure N‐methyl‐2‐silyl‐substituted Pyrrolidine
Authors: Strohfeldt K. , Seibel T. , Wich P. , Strohmann C.
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Primary or Secondary? Versatile Nitrilases in Plant Metabolism
Authors: Piotrowski Markus
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
ChemInform Abstract: Chemical Biology Approaches to Probe the Proteome
Authors: Ovaa Huib , van Leeuwen Fred
Published: February 2009

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 of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
Renal side effect of nifedipine
Authors: Pourrat J. P. , Douste‐Blazy P.
Published: February 2009

The possibility of a renal‐related side effect from nifedipine has been investigated by comparing the effects on plasma creatinine level of coronary arteriography in two groups of patients: one group treated with nifedipine and the other treated with various drugs but without calcium inhibitor. Results showed a moderate (mean, 13%) but highly significant rise in the 27 patients receiving various drugs but no calcium inhibitor. Plasma creatinine change was not significant (mean, 3%) in the 26 patients treated with nifedipine. In the conditions of this study, this difference could only be related to nifedipine treatment. In conclusion, nifedipine may have exerted a protective effect against radiocontrast media nephrotoxicity, which deserves further investigation.
Serious adverse effects of amiodarones
Authors: Mc GOVERN B. , Garan H. , Ruskin J. N.
Published: February 2009

Amiodarone is an effective antiarrhythmic drug which has been used successfully to treat a variety of cardiac arrhythmias. Early reports emphasized both the striking efficacy of this agent and the relative paucity of side effects necessitating discontinuing treatment with this drug. As amiodarone has been used more widely and in more diverse patient populations, reports of serious thyroid, pulmonary, cardiovascular, and other adverse reactions have appeared in the literature. In this paper, we review the serious adverse effects that have been reported to date. The incidence of these reactions varies considerably in different series, and cannot be explained solely by different doses employed or by varying methods of drug administration. The final role of amiodarone in the therapy of cardiac arrhythmias cannot be determined until the long‐term toxicity has been more thoroughly investigated.
Noninvasive detection of pulmonary hypertension
Authors: Algeo S. , Morrison D. , Ovitt T. , Goldman S.
Published: February 2009

Plain chest x‐rays, twelve‐lead electrocardiograms, and M‐mode echocardiograms were analyzed in 50 control patients and 79 consecutive patients with pulmonary hypertension documented at cardiac catheter‐ization in order to determine the relative values of these noninvasive techniques as screening tests in detecting pulmonary hypertension. The sensitivity and specificity of selected findings previously described as being associated with pulmonary hypertension were calculated for each test. All test results were found to have sensitivities too low to function as satisfactory noninvasive screening techniques. Most findings were highly specific for pulmonary hypertension when present. Patients with pulmonary vascular disease were detected more frequently than those with pulmonary hypertension due to pulmonary venous congestion.
Cardiac function in hyperthyroidism
Authors: Iskandrian A. S. , Hakki A‐H. , Mattleman S.
Published: February 2009

It is accepted that thyroid hormones, thyrox‐ine and tri‐iodothyronine have direct inotropic and chronotropic effects on the heart. However, the mechanisms of manifestations are still uncertain. The following discusses and evaluates some of the theories regarding the interaction of these hormones with cardiac function.
Left ventricular function during atrial pacing: A radionuclide angiographic study
Authors: Rozenman Y. , Weiss A. T. , Atlan H. , Gotsman M. S.
Published: February 2009

Multigated radionuclide angiography was performed at rest and during atrial pacing in 10 normal subjects. Left ventricular volumes in diastole and systole were measured by total counts in the region of interest of the left ventricle. Stroke volume, cardiac output, ejection fraction, and rates of ejection for each heart rate were calculated. As heart rate increased, there was a gradual decrease in end‐diastolic, end‐systolic, and stroke volumes without a significant change in cardiac output and ejection fraction. Ejection fraction rate increased and the uncorrected ejection rate decreased with the increase in heart rate. The normal response to tachycardia induced by atrial pacing was a decrease in ventricular volumes witthout a change in ejection fraction or cardiac output.
Evidence for coronary spasm during flushing in the carcinoid syndrome
Authors: Petersen K.‐G. , Seemann W.‐R. , Plagwitz R. , Kerp L.
Published: February 2009

In this report we present the history of a patient with symptomatic carcinoid syndrome. During flushing he suffered from variant angina. The observation of coronary spasm due to excess 5‐hydroxytryptamine (5‐HT) is discussed with regard to the discharge of 5‐HT from clotting platelets in the coronary arteries.
Increased incidence of side effects after encainide: A newly developed antiarrhythmic drug
Authors: Berchtold‐Kanz E. , Schwarz G. , Hust M. , Nitsche K. , Just H.
Published: February 2009

In a clinical trial the efficacy of encainide, a newly developed class I antiarrhythmic agent, was compared with the well‐known mexiletine. Nine patients with different underlying cardiac disease and chronic complex ventricular ectopies (documented by 24‐h Holter monitoring, confirmed during the initial placebo period) entered the study. The dosage of encainide was increased from 25 to 75 mg three times daily and the antiarrhythmic effect monitored by repeated 24‐h Holter registration and in some patients by treadmill exercise testing. During the clinical followup we noted a high incidence of so‐called “minor side effects” (headache, dizziness, blurred vision, tremor, and nausea), which caused us to terminate the study. In all instances adverse effects emerged before ectopic activity was suppressed satisfactorily prohibiting further increment of dosage. These results indicate that encainide cannot be regarded as an antiarrhythmic drug of first choice in routine clinical application.
Criss‐cross heart with straddling right atrioventricular valve
Authors: Ekici E.
Published: February 2009

Angiocardiographic appearance of a crisscross heart with straddling tricuspid valve has been presented. Atrial situs was normal and the right atrium was connected to the morphological right ventricle situated superiorly and to the left of the left ventricle. The left atrium was connected to the morphological left ventricle situated inferiorly and to the right of the right ventricle. The interventricular septum was horizontal in position. Both great arteries arose from the right ventricle with the anterior aorta. The case was concluded as a criss‐cross heart with concordant atrioventricular (A‐V) connection and double outlet right ventricle (DORV). Straddling of the right A‐V valve was recognized in another institution by two‐dimensional (2‐D) echocar‐diography and confirmed by right atrial angiography in our institution. The value of combined investigation with selective four‐chamber angiography, especially including right atrial angiography and 2‐D echocar‐diography in the diagnosis of such complex cardiac anomalies has been stressed.
Elimination of unstable angina by diltiazem under temporary pacing
Authors: Ishikawa T. , Imamura T. , Koiwaya Y. , Tanaka K.
Published: February 2009

We describe two patients in whom spontaneous angina following acute myocardial infarction (postinfarction angina caused by coronary artery spasm) and worsening angina were successfully eliminated after clinical dosage of oral diltiazem, while marked sinus node suppression developed and temporary pacing was performed. The patients were females (one was 67 years and one was 64 years old), and had no history of sinus node dysfunction. The occurrence of the adverse effect was not during angina, and the intervals between the initiation of diltiazem and the occurrence were 6 days after 120 mg/day in one patient, and 4 h after a single administration of 60 mg in the other. Diltiazem is also efficacious in the elimination of unstable angina, however one should note that diltiazem may remarkably suppress not only atrioven‐tricular node activity but also sinus node activity in some patients.
Role of percutaneous transluminal coronary angioplasty in patients with variant angina and coexistent coronary stenosis refractory to maximal medical therapy
Authors: Leisch F. , Herbinger W. , Brücke P.
Published: February 2009

Percutaneous transluminal coronary angioplasty (PTCA) was performed with initial success in 7 patients with variant angina and significant (>60%) coronary stenosis. The mean degree of stenosis was reduced from 77 ±12% to 29 ±15% and the mean systolic pressure gradient from 78 ±18 to 25 ±9 mmHg. Apart from a reversible spasm in one patient, PTCA was free of acute complications. Despite long‐term treatment with nifedi‐pine, nitrates, and warfarin (patients 1 to 5) or aspirin (patients 6 and 7) restenoses occurred in 4 of 7 patients. An aortocoronary bypass was necessary in 2 patients, 3 respectively 6 weeks after PTCA because of tighter re‐stenoses than before PTCA. Another patient underwent successful repeat angioplasty after 6 weeks and remained improved. During a mean follow‐up observation of 21 months (6 to 30 months), 4 patients were asymptomatic, even without medication. In one of these patients, the follow‐up angiography (6 months after PTCA) demonstrated a restenosis. These results suggest that PTCA can be performed without a higher risk of acute complications in patients with variant angina. Although the recurrence rate is high in these patients, sustained clinical improvement was achieved in a substantial percentage of patients in our study.
Wolff‐parkinson‐white syndrome type B and left bundle‐branch block: Electrophysiologic and radionuclide study
Authors: Rakovec P. , Kranjec I. , Fettich J. J. , Jakopin J. , Fidler V. , Turk J.
Published: February 2009

Coinciding left bundle‐branch block and Wolff‐Parkmson‐White syndrome type B, a very rare electrocardiographic occurrence, was found in a patient with dilated cadiomyopathy. Electrophysiologic study revealed eccentric retrograde atrial activation during ventricular pacing, suggesting right‐sided accessory pathway. At programmed atrial pacing, effective refractory period of the accessory pathway was 310 ms; at shorter pacing coupling intervals, normal atrioventricular conduction with left bundle‐branch block was seen. Left bundle‐branch block was seen also with His bundle pacing. Radionuclide phase imaging demonstrated right ventricular phase advance and left ventricular phase delay; both right and left ventricular phase images revealed broad phase distribution histograms. Combined electrophysiologic and radionuclide investigations are useful to disclose complex conduction abnormalities and their mechanical correlates.
Delay in diagnosis of right atrial myxoma
Authors: Northcote R. J. , Ballantyne D. , Sethia B.
Published: February 2009

Clinical, echocardiographic, and nuclear angiographic findings in a 51‐year‐old woman who presented with a history of dyspnea are discussed. Initial echocardiography revealed no abnormality. However, a subsequent radionuclide angiogram revealed a filling defect on the right side of the heart. This represented a right atrial myxoma. Radionuclide angiography can provide a useful noninvasive tool in the diagnosis of intracardiac tumors when echocardiography has not been helpful.
Interaction of chronic cigarette and ethanol use on myocardium
Authors: Ahmed S. S. , Torres R. , Regan T. J.
Published: February 2009

Chronic cigarette use is common in persons who habitually use other cardioactive agents that have been causally associated with heart disease. This study was undertaken to determine if cigarette use intensifies the abnormalities of myocardial function and composition observed in experimental alcoholism over an 18‐month period. Young adult male beagles with tracheostomy were divided into four groups. There were 10 controls (group 1); 9 smoked seven cigarettes per day (group 2); 7 were fed ethanol as 20% of calories (group 3), and 6 received both ethanol and cigarettes (group 4). After a period of 18 months, left ventricular function was assessed under anesthesia. Heart rate, left ventricular end‐diastolic pressures, and volumes (indicator dilution) did not differ in the four groups. An index of contractility derived by normalizing peak dP/dt for pre‐ and afterload was reduced significantly below the level of 2.41 ±0.7 cm/s in controls to 1.41±0.35 in group 2, 1.19±0.38 in group 3, and 1.28±0.17 in the ethanol cigarette group (each p<0.002). Arterial pressures were moderately elevated above group 1 in all three experimental groups without evidence of left ventricular hypertrophy. In contrast to smoking, which elicited no abnormalities of myocardial composition, ethanol reduced myocardial potassium and sodium in group 3 without a gain of water content. In group 4, no further decline of tissue cations was observed. Thus, cigarette use when combined with ethanol over a relatively long period produced no greater myocardial abnormalities than ethanol alone and may not be essential to the genesis of cardiomyopathy in alcoholics.
Adverse effects of atrial fibrillation and syncope induced by calcium‐channel blockers in hypertrophic cardiomyopathy
Authors: Doiuchi J. , Hamada M. , Ochi T. , Ito T. , Kokubu T.
Published: February 2009

Calcium‐channel blockers are useful for the treatment of hypertrophic cardiomyopathy (HCM), but, their adverse effects, especially, those of diltiazem, have not been of much concern. Forty patients with HCM were treated with calcium‐channel blockers such as nifedipine diltiazem, and verapamil. Atrial fibrillation was induced by diltiazem in two patients and verapamil induced syn cope in one patient. The clinical and hemodynamic characteristics of the patients were as follows. All of them had the obstructive type of HCM (HOCM). One of them had a high pressure gradient of the left ventricular outflow tract and the others had earlier onset. In these patients, the left atrial overload seemed to be severe. The vasodilating action of calcium‐channel blockers decreases the systemic pressure and in turn, may increase the pressure gradient and the left ventricular end‐diastolic pressure. The elevated left ventricular end‐diastolic pressure causes the left atrial overload which could be at risk of atrial fibrillation in patients with HCM. Therefore, calcium‐channel blockers should be used carefully in peculiar cases of HOCM.
Paroxysmal vagally mediated av block with recurrent syncope
Authors: Talwar K. K. , Edvardsson N. , Varnauskas E.
Published: February 2009

Paroxysmal complete atrioventricular (AV) block without associated electrocardiographic (ECG) abnormality is not a well recognized entity. A mother and her daughter had recurrent syncopal episodes, but a normal ECG. The episodes were preceded by nausea and vomiting. ECG during these episodes revealed complete heart block. In the mother, one episode was promptly reversed by atropine. Electrophysiological evaluation of the sinus and AV nodal function and atrial and ventricular effective refractory periods before and after autonomic blockade was normal. Provocative manoeuvres failed to induce AV block. Paroxysmal AV block was vagally mediated in one of the patients, as indicated by prompt response to atropine. In the second case, the vagal dependence could not be proved but appears to be the most likely explanation. It thus appears that paroxysmal, vagally mediated complete AV block should be seriously considered in patients with unexplained syncope.
Mitral valve prolapse in the ventriculogram: Scintigraphic, electrocardiographic, and hemodynamic abnormalities
Authors: Tebbe U. , Schicha H. , Neumann P. , Voth E. , Emrich D. , Neuhaus K.‐L. , Kreuzer H.
Published: February 2009

Patients with mitral valve prolapse (MVP) frequently have chest pain, which may be difficult to differentiate from angina pectoris in coronary artery disease (CAD). We performed resting and exercise ECGs, pulmonary arterial pressure measurements, radionuclide ven‐triculography (99mmtechnetium), and perfusion scintigrams (20lthallium) in 56 patients with angiographically proven MVP and no CAD. Pathological results were obtained in 31% of exercise ECGs, 33% of pulmonary arterial pressure measurements during exercise, 22% of radionuclide ventriculographies, and in 75% of thallium perfusion scintigrams. A significant correlation in pathological results was found only between exercise ECG and both radionuclide ventriculography and pulmonary arterial pressure measurements. Because of the high prevalence of falsepositive perfusion scintigrams in patients with typical or atypical chest pain, the use of exercise 2 T1 imaging as a screening method to separate patients with MVP from those with CAD will not be appropriate. The variability of cardiac abnormalities in our patients with MVP and angiographically normal coronary arteries suggests that the MVP syndrome may represent a variable combination of metabolic, ischemic, or myopathic disorders.
Prevalence of mitral valve prolapse in presumably healthy korean adults
Authors: Lee W. R. , Sheikh M. U. , Lee K. J.
Published: February 2009

This cross‐sectional study on mitral valve prolapse (MVP) in Korean adults revealed a relatively low overall prevalence at 2.5% (5 of the 200 subjects). Three of 5 subjects with MVP were females and the majority (4 of 5 subjects) were under 30 years of age. All subjects with MVP had thoracic skeletal deformities (4 straight back syndrome and 1 pectus excavatum). All subjects with MVP did not have cardiac history and they were all asymptomatic except for one who had intermittent palpitation of mild degree.
Natural history of left anterior descending coronary artery obstruction: Significance of location of stenoses in medically treated patients
Authors: Samaha J. K. , Connor M. J. , Tribble R. , Kroetz F. W. , Sullivan J. M. , Ramanathan K. B. , Mirvis D. M.
Published: February 2009

We examined the prognostic significance of an obstructive lesion in the proximal left anterior descending (LAD) coronary artery. Five‐year or longer followup data were examined from 311 patients with >70% obstruction of the LAD treated without surgery. Mortality was compared in subsets with lesions proximal to and distal to the first septal perforating artery. Survival curves were worse in patients with proximal than with distal LAD disease (p<0.05); lesion location remained a significant determinant of survival when ejection fraction, age, and sex were controlled using a Cox regression model. However, when patient subsets were examined, survival with proximal LAD disease was worse than with distal obstruction only in the presence of an associated right coronary artery lesion and an ejection fraction of less than 40% (p<0.01). Patients with proximal LAD plus right coronary lesions had a 5‐year mortality rate (34.08 ± 8.9%) that was not significantly (p>0.05) different from that of a group of 66 patients with >50% narrowing of the left main coronary artery (24.02d̊4.3%). Thus, proximal LAD disease is more significant than is a distal lesion only in the presence of right coronary obstruction. This twovessel combination results in a mortality rate as high as that associated with left main coronary artery obstruction.
Rest‐exercise radionuclide angiographic assessment of left ventricular function in chronic aortic regurgitation: Significance of serial studies in medically versus surgically treated groups
Authors: Lumia F. J. , Macmillan R. M. , Germon P. A. , Kornberg B. , Fernandez J. , Maranhao V.
Published: February 2009

Forty consecutive asymptomatic patients with chronic aortic regurgitation who underwent three serial yearly rest and postexercise radionuclide angiograms were compared with 27 consecutive patients with chronic aortic regurgitation and aortic valve replacement who were studied preoperatively, 3 and 15 months postoperatively. Patients were divided into four subgroups based upon the resting left ventricular ejection fraction and the functional reserve on the initial study. Of the 40 medically treated patients, 19 (47.5%) and 24 (60%) demonstrated a response at least one type lower at 12 months and 24 months, respectively. Initial functional reserve, initial duration of exercise, and the change in exercise duration during the 24 months was not associated with changes in resting or postexercise left ventricular ejection fraction. A seesaw pattern was observed between the resting and the postexercise left ventricular ejection fraction as ventricular function deteriorated. We observed in the surgical groups a reversal of the seesaw interaction between the resting and postexercise ejection fraction seen in the medical patients. In the surgical groups the left ventricular end‐diastolic pressure, initial functional reserve, initial duration of exercise, and change in exercise duration postoperatively were not predictors of improvement in left ventricular function at 15 months. Comparing medical and surgical serial data, we suggest yearly radionuclide angiographic determination of rest left ventricular ejection fraction in asymptomatic patients with chronic aortic regurgitation. When the rest ejection fraction is <50%, exercise angiography should be performed to determine functional reserve. When functional reserve is also abnormal, surgery should be recommended.
Efficacy of diltiazem for medically refractory stable angina: Long‐Term follow‐up
Authors: Schroeder J. S. , Beier‐Scott L. , Ginsburg R. , Bristow M. R. , Mcauley B. J.
Published: February 2009

To assess the efficacy of long‐term diltiazem therapy when added to beta blockers and nitrates, we prospectively studied patients with chronic exertional angina who were determined to have medically refractory angina pectoris which was too severe to enter placebocontrolled studies. The mean follow‐up time was 24.6 months (8‐47 months) and all patients were seen every 2‐4 months. Angina frequency decreased from a prediltiazem frequency of 9.5 episodes per week (1‐40 per week) to 3.3 attacks per week (0‐21 per week) at 6 months and 3.3 attacks per week (0‐40 per week) at the patients's last evaluation. Similar reductions in nitroglycerin consumption were reported. Five patients had an increase in angina frequency during the mean 24.6 months of follow‐up, which necessitated coronary bypass surgery, 8, 10, 12, 19, and 23 months after study entry, respectively. Diltiazem daily dosage ranged from 120 to 480 mg/day, the mean daily dose was 298 mg/day. Twenty (65%) patients remained on beta‐blocker therapy and 19 (61%) patients on nitrate therapy in an effort to achieve a completely painfree state. New cardiovascular events were documented in 3 patients during the follow‐up period, with one patient having an uncomplicated myocardial infarction at 6 months, one patient hospitalized for prolonged chest pain at 2 months, and one patient dying following cardiover‐sion for unrelated atrial fibrillation at 14 months poststudy entry. Adverse effects were reported during 19 of the 354 patient visits, but no patient had to stop therapy because of these. Sinus bradycardia required reduction of betablocker dosage in three patients and prolonged PR inteval was observed in two additional patients. Five patients exhibited mild transient, and three patients chronic elevations in liver enzymes. We conclude that the addition of diltiazem in patients who have severe angina on combinations of beta blockers and nitrates results in a marked reduction in angina frequency. Furthermore, this agent is well tolerated with minimal adverse effects.
Antihypertensive effectiveness of terazosin: A new long‐acting alpha‐adrenergic inhibitor
Authors: Chrysant S. G. , Bal I. S. , Johnson B. , Mcpherson M. A.
Published: February 2009

Eighteen patients aged 35‐70 years (mean + SEM 58+2) with poorly controlled hypertension on various regimens, participated in the present studies. After a 4‐week placebo‐controlled lead‐in period, 12 patients were randomized to terazosin treatment and 6 to placebo. They were followed in the clinic every 2 weeks for 13 weeks, where their supine (5 min) and the upright (2 min) arterial pressure and heart rate were measured. In addition, all patients had a complete laboratory evaluation at the beginning and end of the study. Depending on pressure response, the experimental drug was increased at each visit from 1.0 mg/day to 2.0, 5.0,15.0, and 20.0 mg/day, if the supine diastolic pressure was greater than 90 mmHg. Terazosin decreased the systolic and diastolic pressure in both the supine and upright positions, and had no significant effect on heart rate. Placebo did not exert any effects on either arterial pressure or heart rate. No adverse clinical or metabolic effects were observed with the administration of either terazosin or placebo. We conclude that: (1) Terazosin is a new effective long‐acting alpha blocker given in combination with other antihypertensive drugs, and (2) it is safe and well tolerated by the patients.
Cardiac arrhythmias during sleep in morbidly obese sleep‐apneic patients before and after gastric bypass surgery
Authors: Peiser J. , Ovnat A. , Uwyyed K. , Lavie P. , Charuzi I.
Published: February 2009

Fourteen morbidly obese patients scheduled for gastric bypass surgery were diagnosed preoperatively as suffering from sleep apnea syndrome. There were 13 males and 1 female aged 24 to 59 years. Mean preoperative excessive body weight was 222 ±38%; mean apnea index prior to surgery was 84 ±44. A whole night lead II ECG tracing was performed as part of the polyhypno‐graphic recordings and was evaluated for cardiac arrhythmias. Studies were performed in all patients preoperatively and 6 months thereafter. Statistical analysis was done using the Student's paired t‐test. In this group a high incidence of atrial and ventricular arrhythmias was found. Marked sinus arrhythmia was encountered in all patients and extreme sinus bradycardia in 4 of them. In a consecutive sleep study performed 6 months postoperatively most cardiac arrhythmias disappeared. Marked sinus arrhythmia persisted in only two patients and severe ventricular premature beats (Lown's grade III‐IV), found preoperatively in all patients, were still present postoperatively in only two, although in a much milder form. Surgical weight reduction, therefore, is a valuable method in the abolishment of life‐threatening cardiac arrhythmias of the morbidly obese sleep‐apneic patient.
Effect of Vitamin C on Platelet Adhesiveness and Platelet Aggregation in Coronary Artery Disease Patients
Authors: Bordia A. , Verma S. K.
Published: February 2009

The effect of oral administration of vitamin C on platelet adhesive index (PAI), platelet aggregate ratio (PAg R) and serum ascorbic acid levels was studied. Feeding 75 g of butter to healthy males (group I, n=10 cases), enhanced the tendency of platelet adhesiveness (PAd) and platelet aggregation (PAg) to a significant level at the end of 4 h, This was distinctly prevented when 1 g of vitamin C was added to the fatty meal. In coronary artery disease (CAD) patients (group II, n=20 cases) 10 days of vitamin C administration at 1 g every 8 hours decreased the PAd (p<0.001) and PAg (p<0.05) significantly. There was also a significant (p <0.001) rise in the vitamin C levels. The study brings out a property of vitamin C which may be of considerable importance in prevention of chronic thromboatherosclerotic disease of the arteries.
M‐Mode echocardiography in supine and standing position in control subjects and patients with auscultatory evidence of mitral valve prolapse but negative supine echocardiography: Does sensitivity improve?
Authors: Ansari A.
Published: February 2009

Approximately 10–20% of patients with auscultatory evidence of mitral valve prolapse (MVP) have “false negative” echocardiograms. Pharmacological maneuvers do not significantly improve the sensitivity and may cause side effects. It is well known that auscultatory features of MVP change and not uncommonly can be heard only in the standing position. Therefore M‐mode echo was performed in both supine and standing positions in 10 normal control subjects and 25 patients of comparable age and sex who had auscultatory evidence of MVP but negative echo in supine position. All 10 control subjects had normal echo in both supine and standing positions. No instance of false positive MVP was noted. Of the 25 patients with “false negative” supine echo, 5 showed evidence of MVP (3 pansystolic and 2 late systolic) in standing position. Based on these results the following conclusions were reached. (1) In normal individuals the MVE remains uninfluenced by change in posure. (2) There is modest (20%) improvement in sensitivity of detecting MVP when M‐mode echo is performed in standing position in addition to supine position. (3) Change in posture is preferable to the use of pharmacological maneuver to improve the sensitivity of detecting MVP because it is physiological, devoid of any cost, and does not produce side effects. (4) M‐mode echo in standing position or two‐dimensional echo in supine position can be used to confirm the diagnosis of MVP in those patients who have “false negative” and/or nondiagnostic supine echo in the presence of auscultatory features of midsystolic click and mid‐ or late‐systolic murmurs.
Balloon pump support of the failing right heart
Authors: Gold J. P. , Shemin R. J. , Disesa V. J. , Cohn L. , Collins J. J.
Published: February 2009

This report reviews a clinical experience with pulmonary artery counterpulsation with a balloon pump in a patient with pulmonary embolization superimposed upon severe trivalvular rheumatic heart disease. This patient underwent a pulmonary embolectomy and triplevalve replacement requiring a pulmonary artery balloon pump for bypass discontinuation and postbypass hemo‐ynamic support. The field of right heart counterpulsation is briefly reviewed, and the technical details of the implantation and management of the device are elaborated.
Interaction between clonidine and alpha blockers
Authors: Jounela A. J. , Kanniainen E. , Lilja M.
Published: February 2009

This report reviews the available evidence for and against the combined use of clonidine and prazosin in treating hypertension. Clinical studies have resulted in modest or no enhancement of the antihypertensive effects when prazosin has been added to clonidine. This report discusses the possible mechanisms of an interaction of clonidine and prazosin, which may show cause that the antihypertensive effects of these drugs are not additive.
Role of coronary spasm in the genesis of myocardial infarction: Study of a case treated by isosorbide dinitrate in situ then by transluminal angioplasty
Authors: Grollier G. , Scanu P. , Commeau P. , Foucault J. P. , Potier J.C.
Published: February 2009

We report the observation of a 62‐year‐old patient who was admitted for unstable angina. A prolonged chest pain (more than two hours) with a major electrocardiographic lesion in the posterior leads needed an urgent coronary arteriography in order to attempt a recanalization. Antecedents of arteriopathy of the lower limbs with aortobifemoral bypass required an axillary artery right side approach. A selective right coronary opacification showed complete occlusion at the junction of segments 1 and 2. An intracoronary injection of isosorbide dinitrate relieved a coronary spasm and allowed a complete visualization of the right coronary artery. This appeared to be very atherosclerotic with several severe narrowings, and a subocclusive lesion at the site of the initial occlusion. Percutaneous transluminal coronary angioplasties (PTCA) were performed and led to a real ‘restructuring’ of the right coronary artery. The clinical outcome was excellent without recurrent angina pectoris. An angiographic control performed 6 months after PTCA demonstrated the persistence of the coronary recanalization and an evident improvement of the segmental contractility. This report emphasizes the role of coronary spasm in the genesis of my‐cardial infarction and shows that PTCA may be performed as a first approach at the acute phase of myocardial infarction; to our knowledge it is the first PTCA performed by an axillary approach at the acute stage of myocardial infarction.
Sustained beneficial hemodynamic effects of low transdermal nitroglycerin doses compared with placebo in patients with congestive heart failure
Authors: Bolognese L. , Sarasso G. , Rognoni G. , Makmur J. , Fornaro G. , Perucca A. , Rossi P.
Published: February 2009

In an attempt to resolve some of the controversies concerning the dose requirements and duration of effects of transdermal nitroglycerin (NTG) in patients with heart failure (CHF), the short‐term hemodynamic responses to transdermal NTG, in a 20 cm2 self‐adhesive patch (10 mg/24 h), were evaluated in 10 patients with severe chronic CHF using a randomized, within‐patient, double‐blind, placebo‐controlled cross‐over trial. Serial hemodynamic measurements over 24 h revealed sustained effects that began 1 h after the application of nitroglycerin patch and fully persisted throughout the study. The peak effect occurred at 4 h with the pulmonary capillary wedge pressure decreasing from 33.7±8.4 to 21.4±9 mmHg (mean ± SD) (p>0.05) and the cardiac index increasing from 2.5±0.6 to 3±0.6 1/min/m2 (p>0.01). Transdermal nitroglycerin also significantly reduced pulmonary arterial and right atrial pressures (from 43.5±9.5 to 31 ±11.4 and from 7.4±6.6 to 3.8±4.7 at peak effect, respectively) as well as pulmonary and systemic vascular resistances (from 10.7±6.6 to 6.5±3.2 and from 26.2±5.1 to 22.5±5.7, respectively). There was no change in heart rate or systemic arterial pressure. These beneficial hemodynamic responses persisted for 24 h. No rebound deterioration occurred upon withdrawal of the nitroglycerin. No significant hemodynamic changes occurred during placebo treatment period. Thus, low doses (10 mg/24 h) of transdermal nitroglycerin induce significant hemodynamic benefit that is sustained for 24 h in patients with heart failure. The lack of attenuation of the effects with this dose suggests that larger doses may in fact promote the development of tolerance.
Complete absence of pulmonary veins
Authors: Ralston M. A. , Teske D. W.
Published: February 2009

Various types of pulmonary venous return abnormalities have been described in the literature. This report presents a case in which a 4‐h‐old neonate presented with cyanotic heart disease and respiratory distress. This neonate was subsequently shown to have complete absence of the pulmonary veins (CAPV), a previously undescribed malformation. The case summary describes the physical findings, radiographic and electrocardiographic features, cardiac catheterization data, and results from autopsy. A discussion of the case, theories of embryological etiology for this malformation, and differential diagnoses follow. Surgical treatment for CAPV is not yet possible.
Clinicopharmacological studies of a newly synthesized cardiotonic agent (TA‐064) in patients with congestive heart failure
Authors: Bito K. , Kinoshita M. , Ozaki N. , Sakoda S. , Tsutamoto T. , Motomura M. , Mitsunami K. , Fukuhara T. , Kawakita S.
Published: February 2009

In animal experiments, a new inotropic agent, (‐)‐(R)‐1 ‐(p‐hydroxphenyl)‐2‐[(3,4‐dimethoxyphenetyl)amino]ethanol, designated TA‐064 was found to possess a more positive inotropic than chronotropic action. Its effectiveness and lack of significant toxicity make it beneficial for clinical use as a cardiotonic in human heart failure. The effects of TA‐064 were investigated in patients with various types of heart disease (n=29). Cardiac output increased, left ventricular end‐systolic dimension decreased, and left ventricular fractional shortening increased for 15 minutes after a single intravenous dose (1 mg). The plasma level of TA‐064 at the cessation of infusion was 61.1 ± 49.6 ng/ml and thereafter declined biexponentially. After a single oral dose (10 mg), TA‐064 appeared in the plasma at 30 minutes and reached its peak levels of 13.7 ± 5.6 ng/ml at 60 minutes. Seven hours later, the plasma level was 5.9 ± 3.1 ng/ml which was considered to be within the effective range according to the results after intravenous administration. In conclusion, minimal effective plasma levels of TA‐064 are obtained by oral administration of 10 mg three times a day.
Familial case of permanent form of junctional reciprocating tachycardia: Possible role of the HLA system
Authors: Perticone F. , Marsico S. A. , Marsico S. A.
Published: February 2009

The permanent form of junctional reciprocating tachycardia (PJRT) is a very rare arrhythmia with the following clinical and electrocardiographic findings: (1) it occurs predominantly in infants and children; (2) it is almost incessant and refractory to pharmacological therapy; (3) the onset is commonly related to a critical shortening of the P‐P cycle length without P‐R prolongation; (4) during tachycardia the ECG shows an R‐P longer than P‐R interval, with a negative P wave in leads II, III, aVF. Recently, the anatomic and electrophysiological characteristics underlying PJRT have been identified: there is an accessory pathway of working myocardium with decremental properties, located in the posterior pyramidal space. A case of familial PJRT is reported: the arrhythmia has been documented in a 72‐year‐old female and in her 16‐year‐old grandson. Several triggering tachycardia mechanisms have been observed. Tachycardia was almost incessant and the heart rates were 115 and 135 beats/min, respectively. Typing according to the HLA system, performed in all members of the family, demonstrated the Bw41 antigen in both our patients as well as in the boy's paternal uncle. This is the first documented familial case of PJRT, but the possible significance and correlation with the Bw41 antigen should be further investigated.
Right bundle‐branch block in coronary artery disease: a hemodynamic and angiographic study
Authors: Dabizzi R. P. , Aiazzi L. , Barletta G. A. , Teodori G.
Published: February 2009

Thirty‐four patients with right bundle‐branch block (RBBB) and coronary artery disease (CAD) (RBBB was not pre‐existent to clinical development of CAD) and 52 consecutive CAD patients without conduction disturbances were studied and compared to verify whether the presence of RBBB implies more severe and extensive left ventricular myocardial damage as well as more severe CAD. The two groups did not differ either in age or in New York Heart Association functional class. The incidence or location of previous myocardial infarction (MI) was not different in the two groups. No significant differences were found in left ventricular volumes or ejection fraction. Higher end‐diastolic left ventricular pressure and more severe and diffuse left ventricular wall asynergy were present in RBBB patients. At coronary arteriography, more severe involvement of the right coronary artery in CAD patients without conduction disturbances was the only significant finding. The group of patients with CAD and RBBB without MI showed significantly less involvement of the left anterior descending coronary artery and significantly more severe damage of the inferior wall of the left ventricle than the group with CAD without RBBB and MI. Patients with inferior wall MI and RBBB had more severe asynergy of the posterobasal region of the left ventricle than did patients with inferior wall MI without RBBB. The group of patients with anterior wall MI and RBBB had a higher left ventricular end‐diastolic pressure, a lower left ventricular ejection fraction, and a greater extent of myocardial damage compared to similar patients of the control group. The groups with MI and RBBB had the same Gensini's score as similar groups without RBBB. The hemodynamic, angiographic, and ventriculographic findings in 14 of the 34 RBBB patients who had also presented an abnormal QRS frontal axis deviation showed no significant differences in comparison both with the CAD control group and the remaining RBBB patients with normal QRS frontal axis. These data support the hypothesis that conduction defects and diffuse left ventricular damage do not emanate from anatomical coronary lesions.
Association of coronary calcification with obstructive disease in coronary arteries in indian patients
Authors: Wasir H. S. , Dev V. , Kaul U. , Rajani M. , Mukherjee S. , Sharma S. , Bhatia M. L.
Published: February 2009

A total of 1150 consecutive patients (1052 males and 98 females; age 51.2±10.1 years) with suspected coronary artery disease (Group I) were subjected to fluoroscopy for detection of coronary artery calcification (CAC) and coronary angiography. Another group (Group II) of 120 patients (95 males and 25 females; age 51.4±9.4 years) catheterized for cardiac diseases other than coronary artery disease (CAD) were subjected to the same protocol of fluoroscopy and coronary angiography to exclude incidental CAD in view of their age. CAC was present in 240 patients (20.0%) in Group I. Of these, 200 (83.4%) had triple‐vessel disease (TVD); 20 (8.3%) had double‐vessel disease (DVD); 19 (7.9%) had single‐vessel disease (SVD); and 37 (15.4%) patients had left main coronary disease (LMCAD). Only one of these patients had insignificant CAD considered as “normal” coronary arteries (NC). Incidence of LMCAD, TVD, DVD, SVD, and NC in patients without CAC was 4.4%, 56.3%, 18.2%, 14.0%, and 11.5%, respectively. Incidence of CAC in patients with LMCAD, TVD, DVD, SVD, and NC was 48.1%, 28.1%, 10.8%, 13.0%, and 1.0% respectively. In Group II (n = 120), 24 patients (20%) had CAD, CAC was present in 5 patients with CAD (20.9%), and in two patients without CAD (2%). CAC is relatively uncommon in Indian CAD patients. Its presence, however, indicates severe multivessel disease.
The old‐age heart: Normal aging changes which can produce or mimic cardiac disease
Authors: Waller B. F.
Published: February 2009

The elderly segment of our society may triple by the year 2050. Specific cardiovascular data on the normal aging heart will be needed to provide proper medical and surgical therapy for this patient group. This report reviews normal aging changes of the very elderly heart. Expected or normal aging changes include brown atrophy of the myocardium, increased subepicardial fat, focal amyloid deposits, sigmoid‐shaped ventricular septum, and calcific deposits in the aortic valve, mitral annulus and epicardial coronary arteries. Certain normal aging changes may produce clinical heart disease: aortic valve calcium (aortic stenosis), mitral valve annular calcium (mitral stenosis), amyloid deposits (amyloid heart disease). Certain normal aging changes may mimic heart disease: sigmoid‐shaped ventricular septum (hypertrophic cardiomyopathy), mitral leaflet “buckling” (floppy mitral valve).