bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renin Release in Patients with Benign Essential Hypertension
Authors: KANEKO YOSHIHIRO , IKEDA TAKAO , TAKEDA TADANAO , INOUE GOSUKE , TAGAWA HRROSHI , UEDA HIDEO 
Published: June 2012

In 16 of 28 patients with benign essential hypertension, reduction of mean arterial pressure to 75 to 120 mm Hg by infusion of sodium nitroprusside caused significant increase in renin release estimated by the renal-systemic difference of renin activity and renal plasma flow (RPF). The threshold at which renin release increased was shifted to a range that was intermediate between that previously reported for normotensive subjects and that for patients with renovascular hypertension, but the average magnitude of renin release was almost comparable to that in normotensive subjects. In the other 12 patients, no significant renin release occurred during reduction in pressure of comparable degree.
The difference in renin release was difficult to explain by the difference in severity of hypertensive disease or in sodium excretion, but increased renin release was usually associated with a decrease in RBF and a rise in renal vascular resistance, while insignificant release was usually associated with an insignificant change in RBF and a decrease in resistance. The average known duration of hypertension was significantly greater in the unresponsive patients. It is suggested that renal sympathetic nerve activity may be a factor in the variations in renin release in patients with essential hypertension.
A Study of Duroziez's Murmur of Aortic Insufficiency in Man Utilizing an Electromagnetic Flowmeter
Authors: FOLTS JOHN D. , YOUNG WILLIAM P. , ROWE GEORGE G. 
Published: June 2012

Femoral arterial blood flow was recorded with an electromagnetic flowmeter at the time of open heart surgery on subjects with and without aortic insufficiency. The records demonstrated that subjects with severe aortic insufficiency and Duroziez's murmur had a large amount of retrograde flow in the femoral artery. Those subjects without significant aortic insufficiency and no Duroziez's murmur had little or no backflow. When only a moderate amount of aortic insufficiency was present, the correlation was less satisfactory. In some subjects who had femoral backflow, a second recording was made from the femoral artery after the aortic valve had been replaced, and in these instances there was no longer any measurable backflow. Postoperatively these patients did not have Duroziez's murmur.
It is concluded that Duroziez's crural murmur in subjects with aortic insufficiency is associated with retrograde diastolic femoral arterial blood flow.
Long-Term Physical Training and Cardiovascular Dynamics in Middle-Aged Men
Authors: HANSON JOHN S. , TABAKIN BURTON S. , LEVY ARTHUR M. , NEDDE WILLIAM 
Published: June 2012

The effects of a 7-month physical training program on the physiological responses to exercise and work capabilities of seven middle-aged, sedentary men have been evaluated. Testing involved bicycle ergometry and interval treadmill walking, as well as pre- and postconditioning hemodynamic investigations during five levels of treadmill walking up to a 25% grade.
Significant alterations of several parameters were observed in the trained state. Resting and exercise bradycardia were marked, the lowest heart rate registered being 49/min. Maximal physical working capacities and maximal oxygen uptakes were uniformly increased with group means of + 22 and + 18%, respectively. Work load capacities at heart rates 130, 150, and 170 were also augmented.
Resting and exercise cardiac output for a given oxygen uptake declined and produced relative hypokinesis. Stroke volume was greater at moderate and heaviest work loads. Cardiac minute work was reduced despite stroke volume increments.
Pulse wave and arterial pressure analyses indicated that tension-time index and ejection-time index were markedly reduced, while maximal pressure derivative and ventricular ejection rate were increased.
It is concluded that aside from subjective enhancement of well-being, a well-planned physical training program for middle-aged men can develop beneficial economy and efficiency of myocardial function and the oxygen transport system.
Factors Influencing the Restoration of Blood Flow Following Pulmonary Embolization as Determined by Angiography and Scanning
Authors: MURPHY MARVIN L. , BULLOCH ROBERT T. 
Published: June 2012

Twenty-five patients with proven pulmonary emboli were followed for at least 20 weeks with serial scans and, in select cases, angiograms to determine the factors influencing the rate of resolution. Fifteen patients showed complete resolution at some time during the observation period. Five of these 15 patients experienced recurrent embolic episodes either before or after complete resolution. The remaining 10 patients included two who died of recurrent massive emboli, three who had recurrent episodes resulting in incomplete resolution, two who showed incomplete resolution at 20 weeks without recurrent emboli, and three who were lost to follow-up.
Twenty-one patients exhibited prompt resolution in single or multiple embolic episodes, and four experienced slow resolution.
Recurrent embolization is the most significant event in preventing restoration of blood flow. This is most likely to occur in the patient who presents with (1) an initial field defect in excess of 35%, (2) associated heart disease, and (3) peripheral thrombophlebitis and pulmonary emboli without other disease. These factors identified the patients susceptible to recurrent embolization in this study.
A Study of Hemodynamics and Coronary Blood Flow in Man with Coronary Artery Disease
Authors: ROWE GEORGE G. , THOMSEN JAMES H. , STENLUND ROGER R. , MCKENNA DAVID H. , SIALER SALVADOR , CORLISS ROBERT J. 
Published: June 2012

Coronary blood flow was measured by the nitrous oxide method, and cardiac output was measured by the Fick principle, in a series of 31 human subjects with the clinical diagnosis of angina pectoris. Coronary arteriography was carried out on the same subjects as a part of the same procedure, and the extent and severity of the coronary artery lesions was determined. A numerical value was assigned to the severity of the coronary artery disease, an attempt was made to correlate the severity of coronary artery disease with the measured coronary blood flow and with various hemodynamic parameters which traditionally describe the systemic and pulmonary circulation. There was no correlation between any of the parameters measured and the severity of coronary artery disease demonstrated by angiography. It is concluded, therefore, that the nitrous oxide method for measuring coronary blood flow is not helpful in separating subjects with normal coronary arteries from those with coronary artery disease, nor are resting hemodynamic observations helpful.
Maximum flow through the coronary arteries of the dog heart was measured by postmortem perfusion. This flow rate is sufficient to provide a considerable factor of safety as far as constriction of the major coronary arteries is concerned. If these data are extrapolated to the coronary vessels of man, it would seem that a very large "safety factor" exists, and this may explain why severe coronary disease is not revealed by studies of coronary blood flow.
Salivary Sodium-Potassium Ratio and Plasma Renin Activity in Hypertension
Authors: ADLIN E. VICTOR , CHANNICK BERTRAM J. , MARKS ALLAN D. 
Published: June 2012

The cause of the suppression of plasma renin activity (PRA) in many patients with essential hypertension and normal aldosterone excretion is unknown. Since mineralocorticoid excess can lower PRA, we attempted to evaluate the activity of salt-retaining hormones in these patients by measuring the salivary Na/K ratio. The median Na/K ratio in 20 hypertensive patients with suppressed PRA and normal or low aldosterone excretion was 0.71. This was significantly lower than the median of 1.38 in 29 normal subjects and the median of 1.05 in 15 hypertensive patients with normal PRA.
Excess dietary intake of salt is a possible cause of PRA suppression in these patients, but our findings indicate that high rather than low Na/K ratios would be expected if this were present. On the other hand, both the salivary electrolyte changes and the suppression of PRA are consistent with the hypothesis that mineralocorticoid excess is present in these patients, despite the failure to demonstrate elevated excretion of aldosterone.
Transposition of the Great Arteries with Ventricular Septal Defect
Authors: WALDHAUSEN JOHN A. , BORUCHOW I. , MILLER WILLIAM W. , RASHKIND WILLIAM J. 
Published: June 2012

Infants with transposed great arteries need atrioseptostomy for adequate intracardiac mixing of the systemic and pulmonic circulations. Those with ventricular septal defect and pulmonary artery hypertension, with or without other associated lesions, usually require further surgical palliation.
Postseptostomy measurements of pulmonary artery pressures at systemic levels were obtained in ten infants with transposition of the great arteries and ventricular septal defects. Three had, in addition, patent ductus arteriosus, and two of these had aortic coarctation (one preductal with hypoplasia of the aortic arch). One had transposition of the great arteries, ventricular septal defect, and tricuspid atresia.
Four of the patients had surgical septectomy; the remaining seven had balloon atrioseptostomy. All had pulmonary artery banding; the three ductus arteriosus lesions were ligated; and both coarctations were repaired (one with reconstruction of the aortic arch). The only operative death was in one of the patients with transposition of the great arteries and ventricular septal defect only.
When the interatrial communication is adequate in patients with transposition, ventricular septal defect, and pulmonary artery hypertension, pulmonary vascular obstructive changes may be prevented by pulmonary artery banding and surgical correction of the associated lesions.
Subvalvar Pulmonary Obstruction Complicating the Postoperative Course of Balloon Atrial Septostomy in Transposition of the Great Arteries
Authors: TYNAN MICHAEL , CARR IAN , GRAHAM GERALD , CARTER R. E. BONHAM 
Published: June 2012

The immediate results of balloon atrial septostomy performed on 41 infants with transposition of the great arteries have been presented. There were ten hospital deaths, nine of these occurring in infants with additional cardiac malformations; five of these ten infants had operations for the additional malformations. The results show that an adequate interatrial defect can be created by balloon atrial septostomy, and it is suggested that this technique is of particular value in infants under three months of age.
Increasing cyanosis following an initial improvement after septostomy was more frequently associated with subvalvar pulmonary obstruction than with inadequacy of the atrial septal defect. Catheterization of the pulmonary artery and angiocardiography are important in the diagnosis of subvalvar pulmonary obstruction.
Pressure in a Vascular Implant in the Myocardium During Systole
Authors: BAIRD RONALD J. , MANKTELOW RALPH T. , SHAH PRAKASH A. 
Published: June 2012

The systolic pressure in the portion of an internal mammary artery which is within a myocardial tunnel may be much higher than aortic systolic pressure. The high pressure occurs in the distal portion of the tunnel and exists during the isovolumetric and ejection phases of myocardial systole. It occurs consistently in an implant which has passed initially into the inner half of the myocardium and inconsistently in more shallow implants. It is a result of systolic occlusion of the implant as it passes through different myocardial layers.
The presence of an implant-to-coronary pressure gradient during systole is probably another factor encouraging the formation of implant-to-coronary anastomoses and the subsequent flow through them.
The Cardiovascular Effect of Induced Controlled Anoxemia
Authors: SCARBOROUGH WILLIAM R. , PENNEYS RAYMOND , THOMAS CAROLINE B. , BAKER BENJAMIN M. , MASON ROBERT E. , Beser Jacob , Lore Salle A. , Saltzer Grace 
Published: June 2012

Cardiovascular responses were studied by means of the ballistocardiograph and electrocardiograph in 16 normal subjects and 11 patients with suspected coronary artery disease before, during and after the induction of oximetrically controlled anoxemia. Progressive and significant increases occurred in cardiac output, pulse rate, left ventricular work, maximum cardiac force and pulse pressure during anoxemia in all of the normal subjects and in the 5 patients whose ballistocardiograms allowed the calculation of these variables. The increase in cardiac output resulted almost entirely from an acceleration of cardiac rate. In the normal subjects control ballistocardiograms were normal in form and remained normal throughout anoxemia. Of the patients, 1 with normal, 2 with borderline and 1 with abnormal ballistocardiograms became abnormal or more abnormal. Two of the patients had a positive electrocardiographic test for coronary insufficiency while the test was negative in all of the normal subjects.
The linear relationship between left ventricular work and arterial oxygen saturation suggests that when cardiovascular function is tested by means of anoxemic stress the level of arterial desaturation should be controllable. This is made possible by the use of a variable oxygen-nitrogen mixture and an oximeter.
Use of the Ultrasonic Doppler Method for Timing of Valvular Movement
Authors: KOSTIS JOHN B. , FLEISCHMANN DIETRICH , BELLET SAMUEL 
Published: June 2012

The ultrasonic Doppler method was employed to time the rapid movements (opening and closure) of the mitral and aortic valves. To exclude signals due to slowly moving structures (heart walls), the Doppler tracing was processed by a filter that eliminated low frequencies. Clear tracings containing two deflections, one due to the opening and the other to the closure of each valve, were obtained. The valvular origin of the deflections was verified by recordings simultaneous with intratardiac pressures in five dogs.
The ultrasonic Doppler tracing was found to be a satisfactory aid in the differentiation of various extra heart sounds in 24 patients. Thus, the second heart sound precedes, the third heart sound follows, and the opening snap is simultaneous with the signal due to mitral opening. The fourth heart sound is simultaneous with the atrial component of the unfiltered Doppler signal. Ejection clicks and systolic clicks are simultaneous with or follow the signal due to aortic opening.
Because of its simplicity and safety, this method used in conjunction with the phonocardiogram should prove helpful in distinguishing the opening snap, third and fourth heart sounds, and certain additional auscultatory phenomena.
A Long-Time Study of the Blood Lipids of Two Students of Atherosclerosis
Authors: PAGE IRVINE H. , LEWIS LENA A. 
Published: June 2012

A study of serum cholesterol and lipoproteins covering periods of 28 years in a male physician and 17 years in a female research worker showed relative constancy for the cholesterol levels and greater variability for the lipoproteins. Cholesterol was reduced sharply and temporarily just after each influenzal infection. In the male, the level of cholesterol was slightly above 300 mg/100 ml for more than 13 years. An extremely low cholesterol and high carbohydrate diet proved unacceptable. A more liberal, relatively low-saturated fat, low-cholesterol, and high polyunsaturated fatty acid diet with about 30% of the calories from fat, maintained the cholesterol level between 230 and 270 mg and has been followed with relish for a number of years. A myocardial infarction occurred 27 years after the study began. Clofibrate since then has reduced the cholesterol level further.
The female subject is in good health and maintains cholesterol levels slightly below 300 mg on a usual American diet. She is 10 years younger than the male. Her —S 40-70 lipoproteins have usually been well below the male subject's. Weight gain and lack of exercise seemed regularly to increase both levels.
The data are presented because we believe them to be accurate; their interpretation is for the reader. We hope he must wait for some time for the outcome of the study.
Dermatoglyphics in Congenital Heart Disease
Authors: ALTER MILTON , SCHULENBERG ROBERT 
Published: June 2012

Dermatoglyphics form in utero during early gestation and may be influenced by genetic or environmental factors operating at that time. Since cardiac embryogenesis also occurs during early gestation, an analysis of dermatoglyphics in congenital heart disease (CHD) might reveal some types which are associated with aberrant dermatoglyphics.
Ten dermatoglyphic traits were analyzed in 225 individuals with CHD proved, in most instances, by extensive radiologic studies and at surgery. These traits were compared with dermatoglyphics in 200 normal control subjects. The analysis revealed that the atd angle was significantly increased in CHD. Except for endocardial fibroelastosis and atrioventricular canal, all subtypes of CHD had a wider atd angle than controls. In ventricular septal defect, patent ductus arteriosus, tetralogy of Fallot, and multiple cardiac defects, the increase was statistically significant. The present study confirms previous reports that the atd angle may be increased in CHD.
Hemodynamic Evaluation of Intra-Aortic Balloon Pumping in Man
Authors: BUCKLEY MORTIMER J. , LEINBACH ROBERT C. , KASTOR JOHN A. , LAIRD JOHN D. , KANTROWITZ ARTHUR R. , MADRAS PETER N. , SANDERS CHARLES A. , AUSTEN W. GERALD 
Published: June 2012

Intra-aortic balloon pumping is effective in reducing left ventricular peak systolic pressure and increasing cardiac output in patients with severe cardiogenic shock secondary to acute myocardial infarction. Associated with these effects is a reduction in intravenous catecholamine requirements and increased sensitivity to diuretics. Reduction in left ventricular end-diastolic pressure is implied by improvement in arterial blood gas saturation (reduced arterioalveolar gradient) and was shown directly in one patient. Total myocardial oxygen consumption is probably reduced by counterpulsation. Platelet levels have not fallen significantly with adequate heparinization and the slow infusion of low molecular weight dextran. No complications have occurred related to femoral artery cannulation, nor has there been significant damage to the aorta.
The findings suggest that this system is a safe means of assisting the failing left ventricle. The high mortality in this series (seven of eight patients) is related to the extent of irreversible myocardial damage which may be reduced by more aggressive, earlier application of counterpulsation.
Sodium-Excreting Ability Before and After Intracardiac Surgery
Authors: PACIFICO ALBERT D. , DIGERNESS STAN. , KIRKLIN JOHN W. 
Published: June 2012

Twenty-two patients were studied before, early after (2 to 4 weeks), and late after (6 to 12 months) open intracardiac surgery. Their urinary sodium excretion was measured during an eight-day period of oral sodium loading and the results compared with normal values previously established by Braunwald and colleagues.
Eight patients had normal urinary sodium excretion preoperatively. Two of six studied late postoperatively had abnormally low urinary sodium excretion at that time, both having had abnormally low excretion when studied early postoperatively. Fourteen patients had abnormally low urinary sodium excretion preoperatively. Nine of the patients from this group had normal sodium excretion when studied late postoperatively. Early postoperatively, 3 of 13 patients studied had abnormally low sodium excretion: one died three months later; one still had abnormally low excretion when studied late postoperatively; and one was not studied late after operation. No correlation existed between urinary sodium excretion and cardiac output, creatinine clearance, or intracardiac pressures.
Abnormally low sodium-excreting ability early postoperatively is a poor prognostic sign. Most patients with impaired sodium-excreting ability preoperatively regain normal ability late after intracardiac repair of their mechanical defect.
Totally Cloth-Covered Prostheses
Authors: HODAM ROBERT , STARR ALBERT , RAIBLE DON , GRISWOLD HERBERT 
Published: June 2012

This report deals with our experience with totally cloth-covered prostheses over a 28-month period from April, 1967 to August, 1969. During this interval 223 patients were treated with an operative mortality of 11%. The earliest model cloth-covered prosthesis proved in some instances to have an excessively large transprosthetic gradient.
8,9
The introduction of the composite seat design, however, has resulted in a prosthesis with very favorable hydraulic characteristics, as shown by late postoperative catheterization studies.

Early follow-up data indicate that the composite seat style prostheses have a favorably low rate of thromboembolic complications. In 88 patients receiving this style valve, there have been no early emboli and only one late embolus, despite the fact that a portion of the group are not taking anticoagulants. We stress, however, that these still represent short-term observations and must stand the test of time. Until the results of the double-blind study are completed, we continue to recommend long-term anticoagulation for all patients in whom this can be safely done.
The composite seat style totally cloth-covered prosthesis is recommended for all patients who are reoperated for ball variance. We also feel it should be considered strongly for young persons undergoing aortic valve replacement and for patients who for medical or social reasons cannot be safely anticoagulated.
Anastomosis of the Internal Mammary Artery to the Distal Left Anterior Descending Coronary Artery
Authors: GREEN GEORGE E. , STERTZER SIMON H. , GORDON RICHARD B. , TICE DAVID A. 
Published: June 2012

Postmortem studies suggest that segments of the left anterior descending coronary artery measuring 1.5 mm are rarely diseased. Bypass grafting to such segments has been performed in 31 patients. Ten patients having internal mammary to left anterior descending anastomosis have angiographically patent grafts 2 to 13 months after operation.
Symptoms of angina as well as symptoms of left ventricular failure have been strikingly relieved.
Prediction of Coronary Heart Disease Based on Clinical Suspicion, Age, Total Cholesterol, and Triglyceride
Authors: PAGE IRVINE H. , BERRETTONI J. N. , BUTKUS ANTANAS , SONES F. MASON 
Published: June 2012

Our results, based on the definition of coronary heart disease by cinearteriography, show that definite relationships exist among incidence of coronary heart disease (CHD), age, total cholesterol (TC), and total triglycerides, with less definite ones between free cholesterol, and phospholipids for a specific group of 450 male patients referred to the Cleveland Clinic because of suspected coronary heart disease. Equations and graphs of the association of incidence of CHD with these conditions are presented. The relationships were strong enough to be of aid in discriminating CHD from normal; the most useful being age, TC, and TG.
Incidence determinations were presented in terms of total incidence and incidence associated with the variable itself. Coronary angiography demonstrated 350 CHD and 100 normals or a ratio of 3.5 to 1. This ratio is a reflection of the high accuracy with which physicians suspect CHD.
Age and TC were good discriminators in these patients suspected of CHD. An improved relationship and better discrimination was obtained by relating incidence simultaneously to age, TC, and TG. The probability of having CHD is the total incidence corresponding to the patient's age, TC, and TG. The probability level of 0.90 gave 95% assurance of a correct prediction for the physician-selected group of patients. Twenty-nine per cent of them had probabilities above 0.90.