bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Diphenylhydantoin on Left Ventricular Function in Patients with Heart Disease
Authors: LIEBERSON ALAN D. , SCHUMACHER RICHARD R. , CHILDRESS RICHARD H. , BOYD DANIEL L. , WILLIAMS JOHN F. 
Published: June 2012

The effect of 250 mg of diphenylhydantoin, administered intravenously, on left ventricular function was determined during cardiac catheterization in nine patients with heart disease.
Five minutes after drug administration, left ventricular end-diastolic pressure rose in each patient from an average of 6.0 mm Hg to 10.0 mm Hg. Concurrently, stroke work and stroke power indices decreased in each patient by an average of 22.0% and 22.2%, respectively. Stroke volume index decreased in seven patients and maximum left ventricular dp/dt fell in eight patients. Over the next 25 minutes, all parameters returned to control values. Cardiac index was unchanged, whereas generally small and insignificant changes were observed in heart rate and systemic arterial pressure throughout the study.
Although this study has demonstrated that diphenylhydantoin depresses myocardial function, the effect may have limited clinical significance since it was relatively short-lived and did not reduce cardiac output or greatly elevate ventricular end-diastolic pressure. Furthermore, the absence of a significant systemic hypotensive effect is of distinct clinical importance.
The Percutaneous Femoral Artery Approach to Selective Coronary Arteriography
Authors: SPELLBERG RICHARD D. , UNGAR IRVIN 
Published: June 2012

Experience in performing 267 selective coronary arteriograms by both the exposed brachial artery and percutaneous femoral artery techniques has proved the latter to be the technique of choice.
The percutaneous femoral artery approach obviates the need for performing a cutdown over the small caliber brachial artery with the associated difficulties of catheter manipulation from this vessel. We have been able to intubate the left coronary artery with ease in all of 122 patients in whom this approach was attempted. The right coronary has been selectively entered in approximately 90% of these patients. The stability of the position of the catheter in the coronary ostia during manipulation of the patient, coughing, and deep breathing is an outstanding feature of this technique.
Trends in Systolic Blood Pressure in the Thousand Aviator Cohort over a Twenty-four-Year Period
Authors: OBERMAN ALBERT , LANE NORMAN E. , HARLAN WILLIAM R. , GRAYBIEL ASHTON , MITCHELL ROBERT E. 
Published: June 2012

A cohort of 1,056 normotensive, healthy, young men initially examined in 1940 at the mean age of 24 years was followed at three periodic intervals through 1964. The cohort demonstrated little rise in mean systolic blood pressure beyond age 35; a portion of this cohort showed no change of systolic blood pressure with age. If the men are classified by quintile according to systolic blood pressure in 1940, those men in the upper quintile tend to remain high; when classified by quintile in 1951, those men at the extremes maintained their relative position through 1964. Predictive utility of a systolic blood pressure may be a function of its actual level as well as the age of the individual.
Two factors further influenced the systolic blood pressure of this cohort, namely, parental longevity and gain in weight. The significant effect of parental longevity became less important relative to gain in weight as time progressed and after 1940 affected primarily those men who had gained weight.
Evaluation of the Contractile State of the Human Heart from the First Derivative of the Apexcardiogram
Authors: REALE ATTILIO 
Published: June 2012

The first derivatives of the left ventricular pressure pulse (dp/dt LV) and of the apexcardiogram (Δ ACG) were recorded 73 times in 45 subjects, and the time intervals from the peak of the R wave of the electrocardiogram to the peak of the derivatives (t-dp/dt LV and t-Δ ACG) were determined under different circulatory conditions. These parameters express the duration of the development of maximum tension during isometric contraction of the ventricle. The values obtained from the left ventricular pressure pulse and from the ACG showed close correlation both at rest and after pharmacological interventions which enhanced or depressed the myocardial contractile state. During orciprenaline infusion, t-dp/dt LV and t-Δ ACG were consistently shortened, while they increased in most cases after beta-adrenergic receptor blockade.
Determination of the time to peak derivative of the ACG, a parameter so far unexplored, is proposed as a simple method of detecting changes in the myocardial contractile state in the intact human being.
Evaluation of Roentgen Cinedensitometry for Flow Measurement in Models and in the Intact Circulation
Authors: RUTISHAUSER WILHELM , SIMON HANSJÖRG , STUCKY JEAN PAUL , SCHAD NIKLAUS , NOSEDA GIORGIO , WELLAUER JOSEF 
Published: June 2012

The flow of blood in vitro and in the carotid artery of the dog was calculated by a new cinedensitometric technique and compared with the flow as measured simultaneously by graduated cylinder and stopwatch. Cineangiographic films were projected onto a frosted screen and the light intensity was measured at two neighboring cross sections of the vessel in question. The passage of the contrast medium yielded a pair of indicator-dilution curves of which the difference in mean transit time was calculated. The distance between the cross sections and the diameter of the vessel was measured with the aid of x-ray-dense scales. The flow through the vessel was calculated as the product of cross-sectional area and mean velocity.
The correlation coefficient between the volumetric flow and the flow as found by cinedensitometry was 0.976 in vitro and 0.946 in the intact dog with no systematic deviation from the line of identity. The method enables the blood flow in the intact circulation to be calculated in milliliters per second in any vessel that can be clearly visualized by cineangiocardiography.
Vectorcardiographic Diagnosis of Left Ventricular Hypertrophy
Authors: ROMHILT DONALD W. , GREENFIELD JOSEPH C. , ESTES E. HARVEY 
Published: June 2012

The vectorcardiographic diagnosis of left ventricular hypertrophy, using the Frank lead system, was evaluated in 93 autopsied male patients (70 with hypertrophy of the left ventricle and 23 without such hypertrophy). The criterion of the maximal QRS magnitude in the transverse plane greater than 2.2 mv below the age of 50 years and 1.8 mv at the age of 50 or more was positive in 61% of hypertrophied hearts and negative for all the nonhypertrophied hearts. The criterion of the T loop vector greater than H°-70° in the transverse plane was positive in 82% of 49 hypertrophied hearts and positive in one (7%) of 15 normal hearts for which the T loop was available.
The maximal QRS magnitudes in the frontal and sagittal planes had too low a sensitivity to be of value while the angles of the maximal QRS vector in the transverse and sagittal planes was too nonspecific to be useful.
By combining the QRS magnitude and the T loop vector in the transverse plane, the diagnosis of left ventricular hypertrophy was made in 90% of 49 hypertrophied hearts for which the T loop was available.
Recognition and Significance of Intraventricular Block due to Myocardial Infarction (Peri-infarction Block)
Authors: SHADAKSHARAPPA K. S. , KALBFLEISCH J. M. , CONRAD L. L. , SARKAR N. K. 
Published: June 2012

Evidence of peri-infarction block was found in 39% of the electrocardiograms of 1,938 patients with definite evidence of myocardial infarction. It most commonly occurred acutely or within several days following infarction and was more common with recurrent infarction. Peri-infarction block infrequently disappeared and was associated with higher values for serum glutamic-oxalacetic transaminase and a greater mortality in the first year following myocardial infarction. There was no autopsy correlation of peri-infarction block and ventricular aneurysmal formation.
The term "peri-infarction block" is appropriate only when abnormal intraventricular conduction occurs in association with definite electrocardiographic evidence of myocardial infarction.
Amiloride
Authors: BULL MARCIA B. , LARAGH JOHN H. 
Published: June 2012

Amiloride, a new, well-tolerated oral natriuretic and mild diuretic agent, has been evaluated alone and in combination with other diuretics. Its remarkable ability to promote retention rather than loss of potassium makes it a useful adjunct in the management of even the most severe edematous states. It also retards the alkalosis produced by certain of the stronger diuretics by blocking hydrogen secretion and promoting bicarbonate loss. In addition to being a valuable adjunctive agent, the compound may be useful alone because of the advantages inherent in steady, sustained natriuretic therapy with a mild diuresis as opposed to incurring precipitous alterations in fluid and electrolyte balance with the intermittent use of more potent agents. In certain patients it was mildly antihypertensive.
Amiloride produced marked increases in aldosterone secretion with lesser rises in plasma renin. The adrenal stimulation therefore appeared to result from both potassium retention and renin activation consequent to natriuresis.
The compound appears to act primarily in the distal nephron, blocking both sodium-hydrogen exchange and sodium-potassium exchange. Like triamterene, but unlike spirolactone, amiloride has the characteristics of a noncompetitive inhibitor of aldosteronedirected sodium and potassium transport. Because of this, it may be expected to produce more predictable effects than spirolactone and at least in certain instances to be more powerful. It may also be preferable to spirolactone for the acute control of derangements in potassium balance because of its more rapid onset and disappearance of action.
No significant toxicity was encountered; however, serum potassium values should be carefully monitored, especially in situations involving impaired renal function.
Drug Therapy of Dissecting Aortic Aneurysms
Authors: LINDSAY JOSEPH , HURST J. WILLIS 
Published: June 2012

The records of 56 patients with proved acute aortic dissection were studied for factors bearing on the applicability of vigorous drug therapy to reduce arterial pressure. Fourteen patients had an arterial pressure of 120 mm Hg systolic or less. Fifteen additional patients had evidence of occlusion of a major branch of the aorta. More than half of the 56 patients, therefore, could not have received antihypertensive drugs.
The presence of a contraindication to drug therapy marked a patient for an early death. All 29 died within 2 weeks. Twelve of the 27 in whom no contraindications to drug therapy were observed survived more than 2 weeks and six survived more than a year even though none were placed on a vigorous antihypertensive regimen.
Assessment of the efficacy of drug therapy of dissecting aortic aneurysm should take into account these facets of the natural history.
Transposition of the Great Arteries
Authors: PLAUTH W. H. , NADAS A. S. , BERNHARD W. F. , GROSS R. E. 
Published: June 2012

Experience with 74 consecutive patients with transposition of the great arteries treated by palliative methods at the Children's Hospital Medical Center in Boston from June 1950 to September 1966 forms the basis for this report. Four palliative techniques were considered in detail. The specific palliative approach suggested depended on the anatomy and physiology in the individual case. Atrial septal defect creation was used largely for patients with an intact ventricular septum to improve arterial saturation, vent the left atrium, and prevent development of pulmonary vascular obstructive changes. Pulmonary artery banding was the procedure used mainly for infants with large ventricular septal defect, adequate mixing, and pulmonary arterial hypertension. The combined operation was performed on infants with ventricular defect in whom arterial-venous mixing was less than optimal through a relatively small ventricular septal defect. Arterial shunt operations were used for cyanotic infants, not in congestive failure, with ventricular septal defect and severe pulmonic stenosis.
The authors recommend palliative surgery in the neonatal period for all patients with transposition of the great arteries, except for the few with type IIA lesions who have just the optimal amount of arterial saturation and absence of congestive heart failure. At present at least an 84% survival rate can be expected from the palliative surgical procedures even in the critically ill infant in the first days of life.
Polyethylene Catheter Embolism
Authors: WELLMANN KLAUS F. , REINHARD ARTHUR , SALAZAR EDGARDO P. 
Published: June 2012

A 62-year-old man died from tricuspid monilial endocarditis and systemic candidiasis associated with embolization to the right heart of a 36-cm fragment of one polyethylene catheter received in the venous system approximately one year earlier. Thirty-six additional cases of catheter embolism are reviewed and tabulated. In 17 of the 37 patients the catheter fragment had reached the right side of the heart, and in eight, a branch of the pulmonary artery. In six of 13 patients who died, catheter embolism was the exclusive or a major contributory cause of death. Measures designed to prevent the breakage and embolization of polyethylene tubes and to facilitate their retrieval in case of loss are discussed. If a catheter fragment has been lost into the venous system, it should be located and removed at once.
Monilial endocarditis and systemic candidiasis are briefly reviewed. The reported case is the first in which these entities have been associated with catheter embolism to the heart, and the fourth in which monilial endocarditis affected the tricuspid valve.
Effects of Physical Training in Dogs with Coronary Artery Ligation
Authors: KAPLINSKY ELIEZER , HOOD WILLIAM B. , McCARTHY BRIAN , McCOMBS H. LOUIS , LOWN BERNARD 
Published: June 2012

This experiment was designed to determine whether physical conditioning can be achieved in the presence of acute myocardial infarction and whether such an exercise program is harmful. For this purpose the effects of a 5-weeks' treadmill-exercise program and inactivity were compared in two groups of dogs in which acute myocardial infarction was produced by coronary artery ligation.
The exercised group of animals tolerated the training program well, and neither arrhythmia nor sudden death occurred. At the end of the training program the exercised group of animals displayed the characteristic changes of physical conditioning, namely, reduction in exercise heart rate, cardiac output, and blood lactate levels; rise in circulating epinephrine levels with exercise was also suppressed by conditioning. Postmortem examination revealed neither ventricular dilatation nor aneurysm formation.
The Frontal Plane Vectorcardiogram in Old Inferior Myocardial Infarction
Authors: YOUNG ELIOT , WILLIAMS CONGER 
Published: June 2012

The early part of the frontal plane QRS loop (Frank lead system) was analyzed in 100 consecutive patients with an old inferior myocardial infarction. In order to be included in this study, all cases had to fulfill, at some time, Myers' classical ECG criteria for the diagnosis. The vectorcardiogram was made months to years after the patient's original acute episode.
Several scalar and planar parameters, pertaining to these frontal plane early QRS vectors, were analyzed. As a result of this analysis and in order to prevent overlap with values found in 315 normal control subjects, VCG criteria, based on the interrelationships of several of these parameters, were proposed for the diagnosis of old inferior myocardial infarction. Pitfalls in the use of only scalar or planar analyses were pointed out.
In 90 of the 100 cases the diagnosis was made on the basis of the proposed VCG criteria. However, the ECG made at the same time fulfilled Myers' or Goldberger's classical criteria in only 42 of the 100 cases. All cases diagnosed from the ECG were also diagnosed from the VCG.
Restoration of Sinus Rhythm After Mitral Valve Replacement
Authors: FISHER R. DARRYL , MASON DEAN T. , MORROW ANDREW G. 
Published: June 2012

Factors relating to the successful and sustained restoration of sinus rhythm were examined in 100 patients following mitral valve replacement. Of the 30 patients who established sinus rhythm in the postoperative period, 24 were in sinus rhythm before operation and 6 converted spontaneously. All 30 had normal mean left atrial pressure at rest and only mild or moderate roentgenographic evidence of left atrial enlargement. All 70 patients with atrial fibrillation following valve replacement had been in atrial fibrillation preoperatively; in 24 of them cardioversion was not attempted. In the other 46 patients, electrical conversion was attempted on one or more occasions; in 31 (68%), sinus rhythm was maintained for at least 24 hours, but only 9 were in sinus rhythm 18 months later. Two additional patients maintained sinus rhythm on a long-term basis after conversion with maintenance quinidine.
Among the 15 patients refractory to countershock, the mean left atrial pressure averaged 11.1 ± 1.3 mm Hg, and among the 22 patients who reverted to atrial fibrillation it was 13.3 ± 0.9 mm Hg. In contrast, mean left atrial pressure was significantly less (8.1 ± 0.9 mm Hg) and left atrial enlargement only moderate in the patients who maintained sinus rhythm after cardioversion. Importantly, all patients with mean left atrial pressures greater than 12 mm Hg and/or marked left atrial enlargement were refractory to countershock or relapsed to atrial fibrillation, while 64% of patients with normal mean left atrial pressures sures and only moderate left atrial enlargement maintained sinus rhythm permanently. Right atrial pressures were normal in both groups.
Thus, elevated left atrial pressure and increased left atrial size both militate against the chronic establishment of sinus rhythm. This study indicates that following mitral valve replacement permanent maintenance of sinus rhythm can be anticipated in about two of three patients in whom the mean left atrial pressure is normal and in whom left atrial enlargement is only moderate.
Hemodynamic Response to Discoid Mitral Valve Replacement
Authors: MATLOFF JACK M. , DALEN JAMES E. , DEXTER LEWIS , HARKEN DWIGHT E. 
Published: June 2012

Hemodynamic studies were performed before and daily for 7 to 10 days after mitral valve replacement with a discoid prosthesis in 15 patients.

Left atrial mean pressure fell from a mean of 27.5 mm Hg before surgery to normal levels (mean 11 mm Hg) within 24 hours of surgery. Cardiac index reached normal levels (mean 2.97 L/min/m
2
) within 48 hours of valve replacement, and remained in the normal range throughout the early postoperative period in 12 of the 15 patients. The association of normal left atrial pressure and cardiac output in response to the increased metabolic demands of the postoperative period has not been reported with caged-ball mitral valve replacement.

Pulmonary artery mean pressure and pulmonary vascular resistance showed a sharp decrease toward normal in the early postoperative period. In seven patients with systemic pulmonary hypertension, pulmonary artery mean pressure decreased from 72 mm Hg before surgery to 38 mm Hg at 7 to 10 days.
The observed hemodynamic findings in these patients are consistent with experimental evidence that discoid mitral prostheses offer less resistance to blood flow than caged-ball mitral prostheses.
Chapter 5: Arrhythmias
Authors: MCINTOSH HENRY D. 
Published: June 2012

Ventricular fibrillation was the most common major arrhythmia reported, having occurred in 59 of 12,367 studies (0.48%). The age-related incidence of the complication is shown in figure 1 and the relative incidence was as follows:
[see table in the PDF file]
The relative incidence may reflect the severity of the heart disease since most of the infants studied were critically ill. Twelve of the 13 patients less than 60 days old in whom ventricular fibrillation developed had coarctation tion of the aorta, aortic stenosis, hypoplasia of the left heart, or mitral atresia. Patients with these diagnoses represented approximately 10% of all patients under the age of 60 days who were studied.
Hemodynamic Effects of Lidocaine in Patients with Heart Disease
Authors: SCHUMACHER RICHARD R. , LIEBERSON ALAN D. , CHILDRESS RICHARD H. , WILLIAMS JOHN F. 
Published: June 2012

The intravenous administration of 50 mg of lidocaine as a single bolus to four patients with heart disease did not result in a significant change in cardiac output or left ventricular end-diastolic pressure (LVEDP). Two patients had moderate decrease in systemic arterial pressure which was not accompanied by symptoms, was of short duration, and did not require therapeutic intervention. Left ventricular function, as assessed by the relationship of changes in stroke volume index (SVI) and stroke work index (SWI) to changes in LVEDP, was not significantly affected nor was the maximum rate of rise of left ventricular pressure (dp/dt).
The intravenous injection of 100 mg of lidocaine into eight additional patients with heart disease did not produce a statistically significant change in any of these hemodynamic variables when compared to their respective control values. Examination of individual responses, however, revealed that some depression of left ventricular function occurred in at least three and probably four of these patients. Nevertheless, this depression of myocardial function was not of sufficient magnitude to produce symptoms or reduce the cardiac output and generally did not result in an inordinate increase in LVEDP.
It is concluded that 100 mg or less of lidocaine injected intravenously has remarkably few, if any, adverse hemodynamic effects of clinical significance in man.
Annuloplasty in Children and Young Adolescents with Severe Rheumatic Mitral Insufficiency
Authors: KLOTH HOWARD H. , REED GEORGE E. , TICE DAVID A. , DOYLE EUGENIE F. , KIELY BRIAN , SPAGNUOLO MARIO 
Published: June 2012

Eleven patients aged 8 to 15 years underwent measured asymmetrical annuloplasty for severe mitral regurgitation in the years 1961 through 1966. They had had a total of 20 attacks of acute rheumatic fever. The intervals between the last attack of acute rheumatic fever and operation ranged from 2 to 8 years. The criteria for surgery were congestive failure and progressive cardiac enlargement. Using the hydraulic formula of Gorlin, a mitral annuloplasty was tailored to the size of each patient so that insufficiency was eliminated without producing hemodynamically significant stenosis.
In this group of 11 children there has been one death. The majority of our 11 patients reacquired murmurs of mitral regurgitation. Satisfactory results, however, are not dependent on complete hemodynamic correction. All patients have improved remarkably and have sustained this improvement up to 7 years. These results suggest that mitral annuloplasty should be the operation of choice in children with severe mitral regurgitation.