bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of the electrocardiographic changes in patients with hypertrophic cardiomyopathy
Authors: Tendera Michal , Polonski Lech , Wodniecki Jan , Kardaszewicz Piotr 
Published: August 2009

AbstractIn 75 patients with hypertrophic cardiomopathy (HCM) followed for a mean period of 5.5 years (range 2‐20 years), evolution of the electrocardiographic (EKG) changes was assessed. Progression of EKG abnormalities occurred in 35 patients (47%). It was manifested by an increase in precordial QRS voltage in 33 patients, development of new P‐wave mitral in 11 patients, and development or disappearance of pathologic Q waves in 14 patients. With follow‐up times >5 years, 5‐8 years, and >8 years, EKG progression was present in 27, 41, and 80% of patients, respectively. Age <30 years at the beginning of study and left ventricular outflow obstruction predisposed to EKG progression within 5‐8 years. Patients with progressive EKG changes were more prone to experience clinical deterioration than those without EKG progression (63 vs. 15%, p<0.001). With chronic verapamil administration, progression of EKG abnormalities occurred insignificantly less often than with propranolol treatment (35 vs. 64%, p=0.20). It is concluded that with long‐term follow‐up, HCM tends to progress in a significant proportion of adult patients.
Subjective visual echocardiographic estimate of left ventricular ejection fraction as an alternative to conventional echocardiographic methods: Comparison with contrast angiography
Authors: Mueller X. , Stauffer J. C. , Jaussi A. , Goy J. J. , Kappenberger L. 
Published: August 2009

AbstractLeft ventricular ejection fraction (LVEF) is a measure of ventricular function with clinical and prognostic significance and can be reliably calculated with various M‐mode and two‐dimensional echocardiographic formulas in selected, good quality echocardiographic formulas in selected, good quality echocardiograms. Subjective visual echocardiographic estimate of LVEF is a potentially less time consuming and more widely applicable method. In order to test its reliability, we performed a prospective blind trial in 40 consecutive patients undergoing biplane contrast ventriculography (BCV), to compare the visual estimate of LVEF during a complete echocardiogram of three independent observers with (1) cubed M‐mode formula, (2) Teichholz M‐mode formula, (3) length‐area method from the four‐chamber view, and (4) Simpson's single plane formula. BCV was the reference method. The best correlation with BCV was obtained by visual estimate [r of the three observers, respectively=0.75; 0.84; 0.81] and M‐mode measurements [r (1)=0.8; r(2)=0.8], but the most sophisticated methods provided the poorest estimate [r (3)=0.54; r(4)=0.49]. All correlation coefficients improved when good studies, defined as a definition of the endocardial surface of more than 75%, were selected (n=23), but the differences persisted. One observer systematically estimated higher values than the other two (Friedman's test, p<0.01) and this interobserver variability suggests that each echocardiographer should test himself against BCV in his lab in order to apply the visual estimate method reliably.
Endomyocardial biopsy in infants and children with cardiomyopathy
Authors: Narayan R. , Menahem S. , Chow C. W. , Dennett X. 
Published: August 2009

AbstractWe reviewed our experience of endomyocardial biopsy performed on 21 symptomatic infants and children with cardiomyopathy. Clinical congestive cardiomyopathy was noted in 18 patients, 2 had hypertrophic cardiomyopathy, and 1 a restrictive cardiomyopathy. The biopsy findings led to a diagnosis of hemiochromatosis in one patient, Adriamycin cardiomyopathy in another, and lymphocytic myocarditis in a third. Five patients had features of endocardial fibroelastosis, one endomyocardial fibrosis, and a further one, a mitochrondrial abnormality. In 11 patients normal or nonspecific features were seen. There were 2 myocardial perforations, both patients being successfully resuscitated. Endomyocardial biopsy, although occasionally hazardous, may sometimes provide valuable information which may lead to a diagnosis, facilitate treatment, and be of prognostic value. Despite the low positive yield, it may still be indicated in selected patients, in view of the seriousness and often poor prognosis of this disorder: 5 of our study group subsequently died.
Beta Receptor Derangement in Postinfarction Left Ventricular Perianeurysm Tissue
Authors: Levett James M. , Mcgrath Lynn B. , Bianchi John M. 
Published: August 2009

AbstractThe purpose of this study was to evaluate alterations in adrenergic receptor density in patients with postinfarction left ventricular aneurysms. Resected specimens from 4 patients with left ventricular aneurysm were studied using standard techniques to evaluate beta receptors, alpha receptors, and muscarinic receptors in the border zone, perianeurysm tissue, Only the beta receptors demonstrated up‐regulation around the aneurysm (p=0.0003). This indicates that infarction with aneurysm formation can alter adrenergic receptor density, which may affect cellular response and predispose to arrhythmogenesis.
Comparison of respiratory response of jogging in place and bruce treadmill exercise test
Authors: Papazoglou N. , Loussidis P. , Giannoulopoulos A. , Tsarouchas P. , Kioussis A. , Karatzas N. B. 
Published: August 2009

AbstractA comparison of the respiratory responses of jogging in place, an alternative exercise test we recently proposed, was made with those of the Bruce exercise test. We obtained on‐line measurements of heart rate, ventilation, oxygen uptake, and carbon dioxide production from 9 healthy subjects of mean age 25 years. There was a higher heart rate and ventilatory response with jogging than with the Bruce test, but by 10 minutes the responses of the two tests were similar. Oxygen consumption, while higher with jogging, rose in parallel with that of the Bruce test from the second to the seventh min, and the change of the ration of minute ventilation to oxygen consumption indicated that the anaerobic threshold occurred earlier during jogging. These results swhow that jogging in place is more vigorous than the graded exercise test and may produce ischemia earlier.
Single‐lead VDDpacing: Excellence or expedience?
Authors: Katritsis Demosthenes , Camm A. John 
Published: August 2009

AbstractThe interest in VDD pacemakers has been renewed by the introduction of single‐pass leads, and continuing modifications and technical developments promise significant improvement. However, convincing long‐term data confirming the reliability and the use of newer leads are not yet available. Compared with VVIR pacemakers VDD pacing has theoretical advantages over the VVIR mode, offering better hemodynamic and endocrine responses. However, its range of indications is narrow and rate adaptation is essential when sinus node chronotropic inadequacy is present or likely to occur. In addition, on certain occasions a VDD pacemaker may not maintain persistent atrial‐synchronous pacing, thus necessitating the use of a DDD unit.
Catheter balloon valvuloplasty of stenotic aortic valves—part II: Balloon valvuloplasty during life subsequent tissue examination
Authors: Waller Bruce F. , Van TASSEL James W. , Dorros G. , Lewin R. F. , King J. F. , Mckay Charles 
Published: August 2009

AbstractThis review discribes 23 patients with aortic valve stenosis who underwent balloon valvuloplasty during life and had subsequent valve tissue examined at the time of aortic valve replacement or at necropsy. Of 23 stenotic aortic valves, 17 were examined within 30 days (early) after balloon dilation. Of these 94% had non‐rheumatic (nonfused commissures) etiologies for the aortic stenosis. Of the 6 valves examined after 30 days (late) (restenosis), mechanisms of restenosis involve refusion of split commissures and probable elastic recoil. Clinical prediction of the aortic stenosis etiology prior to balloon valvuloplasty may help predict short‐and long‐term success of the dilation procedure.
Refractory cardiogenic shock and complete heart block after unsuspected verapamil‐sr and atenolol overdose
Authors: Frierson John , Bailly Daniel , Shultz Theodore , Sund Sheila , Dimas Alex 
Published: August 2009

AbstractA 57‐year‐old female presented with complete heart block and then developed refractory hypotension despite temporary pacing. Moderate left ventricular dys‐function with focal wall motion abnormalities, as well as severe hypoxemia, were demonstrated. However, neither significant coronary disease nor evidence for pulmonary embolus or other lung disease could be determined. Hemodynamic stabilization was achieved with the use of an intra‐aortic balloon pump and multiple high‐dose pressor agents. A retrospective diagnosis of toxic verapamil‐SR and atenolol ingestion was confirmed, and the patient gradually recovered. The relevant literature is reviewed and various treatment approaches are discussed.
Role of echo/doppler in the diagnosis of pulmonary embolism
Authors: Torbicki Adam , Tramarin Roberto , Morpurgo Mario 
Published: August 2009

AbstractEchocardiography supplemented with pulsed and continuous wave Doppler facilities is a potent diagnostic tool in many cardiovascular disorders. Its potential role in the management of patients with suspected pulmonary embolism, though less extensively studied, deserves attention. Benefits of echo/Doppler in these patients are as follows

Echo/Doppler is a noninvasive, relatively inexpensive technique, readily available and repeatable in critically ill patients at the bedside.
Echo/Doppler provides a number of independent parameters related to the pulmonary hemodynamics. These parameters include

Characteristics of blood flow velocity curves across the right heart valves as well as systolic and diastolic time intervals of the right ventricle
Motion pattern of the interventricular septum
Dimensions of the heart chambers and inferior vena cava
Thickness of the right ventricular free wall

Echocardiography allows detection of thrombi within right heart chambers or in major branches of the pulmonary artery in some patients.
Echo/Doppler may disclose alternative abnormalities explaining symptoms found in a patient with suspected pulmonary embolism such as pericardial disease, myocardial infarction, aortic dissection, hypovolemic shock, etc.
Pulmonary artery diastolic pressure: A simultaneous doppler echocardiography and catheterization study
Authors: Ge Zhiming , Duran C. M. G. , Zhang Yun , Ji Xiaoping , Fan Dongsheng 
Published: August 2009

AbstractPulmonary hypertension is an important determinant of the clinical presentation of and surgical approach to patients with heart disease. To confirm the utility of continuous wave Doppler echocardiography in assessing the pulmonary artery diastolic pressure in patients with pulmonary regurgitation, 51 patients representing the wide hemodynamic spectrum of pulmonary artery pressure underwent simultaneous determination of pulmonary artery diastolic pressure by continuous wave Doppler echocardiography and cardiac catheterization. Pulmonary artery diastolic pressure was estimated from the Doppler recordings by the end‐diastolic pressure gradient obtained by the modified Bernoulli equation plus the estimated right atrial pressure. A correlation was observed (r=0.935, SEE=7.4 mmHg) between Doppler and catheterization pulmonary artery diastolic pressure. In addition, comparison between the mean diastolic pressure. In addition, comparison between the mean diastolic pressure gradient across the pulmonary valve by Doppler and pulmonary artery diastolic pressure at catheterization yielded a high correlation (r=0.947, SEE=5.1 mmHg). These data demonstrate that continuous wave Doppler echocardiography is a useful noninvasive technique for evaluating the pulmonary artery diastolic pressure in patients with pulmonary regurgitation.
Coronary angiography using 4‐french preformed catheters‐percutaneous brachial approach
Authors: Kitazume Hidemasa , Kubo Ichiro , Ageishi Yoshio , Iwama Toru 
Published: August 2009

Abstract4‐French preformed catheter systems were developed for coronary angiography. After several new technical features were introduced, these catheters were applied in 384 outpatients between January 1989 and December 1989. Diagnostic coronary angiography was performed in all cases without major complications. In the left coronary artery, 4.0 cm left Judkins catheters were generally used; however, 3.5 cm left Judkins catheters were used if the patient was ≤164 cm tall and left Amplatz catheters were employed for those ≥165 cm tall. Although 4.0 cm right Judkins catheters were mainly used for right coronary arteries, there were no predictive factors for subsequent catheter selection. This technique is believed to be suited to meet the increasing demand for coronary angiography.
Comparison of clinical, morphological, and prognostic features in hypertrophic cardiomyopathy between japanese and western patients
Authors: Chikamori Taishiro , Mckenna William J. , Doi Yoshinori L. , Akizawa Masashi , Yonezawa Yoshihiro , Ozawa Toshio 
Published: August 2009

AbstractApical hypertrophic cardiomyopathy appears to be more common in Japan than in the West. Explanations for this difference include variable methods and criteria for the diagnosis. To assess morphological, clinical, and prognostic differences, 45 consecutive Japanese and 45 age‐ and gender‐matched Western patients with hypertrophic cardiomyopathy were evaluated in two referral institutions by the same individuals. The diagnosis of hypertrophic cardiomyopathy was based on the echocardiographic demonstration of unexplained left ventricular hypertrophy. Patients were aged 8 to 64 years (mean 50); there were 66 males and 24 females. The pattern of left ventricular hypertrophy was similar in Japanese and Western patients: asymmetric septal 64 vs. 76%, concentric 22 vs. 13%, and apical 13 vs. 11% (p = NS). The incidence of an echocardiographic or Doppler calculated left ventricular gradient of >30mmHg was similar (11 vs. 18%; p = NS). The maximal left ventricular wall thickness was greater in Western patients (23 ± 7 vs. 20 ± 4 mm; p = 0.03), but was not different when adjusted for body surface area. Clinical features including incidence of family history and ventricular tachycardia during 24‐h ambulatory electrocardiography were similar. During follow‐up (4.9 ± 4.0 years for Western vs. 4.4 ± 2.0 years for Japanese), disease‐related mortality was worse in Western patients (p < 0.05; 10 versus 2 patients). This evaluation, using the same diagnostic methods and criteria, reveals a worse prognosis in Western patients despite a similar clinical and morphological spectrum of hypertrophic cardiomyopathy.
Syncope and seizures of psychogenic origin: Identification with head‐upright tilt table testing
Authors: Grubb Blair P. , Gerard Gary , Wolfe Douglas A. , Samoil Daniela , Davenport Charles W. , Homan Richard W. , Temesy‐Armos Peter 
Published: August 2009

AbstractPsychogenic seizures and psychogenic syncope are common disorders but are difficult to identify. Head‐upright tilt table testing has emerged as a promising means of evaluating vasovagally mediated syncope and convulsive syncope. Of a total of 42 patients evaluated by head‐up tilt for recurrent syncope and 10 evaluated for recurrent idiopathic seizures, a total of 5 patients experienced syncope and 3 had tonic‐clonic seizure activity unaccompanied by any significant changes in blood pressure, heart rate, transcranial Doppler cerebral blood flow velocity, and electroencephalographic monitoring. Psychiatric evaluation revealed that seven patients suffered from conversion reactions and one from probable malingering. We conclude that patients who pass out or convulse during head‐upright tilt without any change in physiologic parameters can be presumed psychogenic in origin and may be referred for psychiatric evaluation without further expensive diagnostic studies.
Diastolic left ventricular function after renal transplantation in patients with normal and hypertrophied myocardium
Authors: Hüting Jürgen 
Published: August 2009

AbstractWhile diastolic left ventricular (LV) dysfunction is frequent and associated with cardiovascular complications in end‐stage renal disease treated with dialysis, controversial information exists on diastolic LV function after renal transplantation. Therefore, Doppler echocardiographic parameters of LV diastolic filling were analyzed in 17 transplanted patients with normal LV mass (< 150 g/m2; mean: 128 ± 17 g/m2) and 24 transplanted patients with LV hypertrophy (>150 g/m2; mean: 197 ± 36 g/m2) and compared with 28 normal controls without and 11 controls with LV hypertrophy. Mean age (normal vs. increased LV mass: 46 ± 13 vs. 48 ± 11 years; p = NS) and transplantation duration (60 ± 35 vs. 50 ± 37 months; p = NS) were comparable between renal patients, while systolic blood pressure (136 ± 12 vs. 149 ± 14 mmHg; p < 0.02) and serum creatinine (1.55 ± 0.45 vs. 1.98 ± 0.76 mg/dl; p < 0.05) were higher in patients with than without LV hypertrophy. In transplanted patients with LV hypertrophy, peak early/atrial filling velocity ratios were decreased (1.17 ± 0.34 vs. 0.94 ± 0.34; p < 0.05), mean atrial filling fractions were increased (37 ± 7% vs. 42 ± 7%; p < 0.05), and isovolumic relaxation periods were prolonged (86 ± 23 vs. 106 ± 26 ms; p < 0.02) compared with transplanted patients with normal LV mass. The frequency of pathologic peak early/atrial filling velocity ratios (12 vs. 42%; p < 0.05), atrial filling fractions (12 vs. 25%; p = NS) and isovolumic relaxation periods (6 vs. 29%; p = NS) was higher in transplanted patients with than without LV hypertrophy. Individual ratios of peak early/atrial filling velocity were inversely correlated with age in transplanted patients with normal LV mass (p < 0.002), and atrial filling fractions were correlated with LV mass index in transplanted patients with LV hypertrophy (p < 0.01). Diastolic LV function was comparable in both groups of transplanted patients with their corresponding non‐renal controls. It is concluded that, in transplanted patients, diastolic LV filling is comparable to nonrenal controls; it is age‐dependent in patients with normal LV mass and mass‐dependent in those with LV hypertrophy.
Incidence of sudden atheltic deaths between 1985 and 1990 in marion county, indiana
Authors: Waller Bruce F. , Waller Bruce F. , Hawley Dean A. , Clark Michael A. , Pless John E. 
Published: August 2009

AbstractRelatively little information is available concerning the incidence of sudden death in athletes in the United States. The present study provides annual incidence rates of sudden athletic deaths in Marion County, Indiana, home of Indianapolis, the “amateur sports capital of the world.” The overall incidence was 0.04% (18 athletic deaths in 44,481 forensic necropsies). This incidence varied slightly over the 6‐year study period: 1985 (0.06%), 1986 (0.03%), 1987 (0.04%), 1988 (0.09%), 1989 (0%), 1990 (0.01%). Of the 18 sudden athletic deaths, 88% were cardiac in origin. A retrospective analysis of preparticipation screening efforts suggests that most of the cardiac conditions responsible for death could have been detected.
Congenital absence of pericardium as unusual cause of T wave abnormalities in a young athlete
Authors: Di Pasquale G. , Ruffini M. , Piolanti S. , Pinelli G. , Gambari P. I. , Roversi R. 
Published: August 2009

AbstractThe congenital absence of pericardium is a rare condition which may determine electrocardiographic ST‐T abnormalities. The case of 16‐year‐old athlete who presented T‐wave abnormalities at standard electrocardiogram performed during a physical checkup is reported. Ventricular repolarization tended to normalize during exercise and in right lateral decubitus. Chest x‐ray and echocardiography showed typical signs of complete absence of the left pericardium. The definite diagnosis was made by computer tomography (CT) scan. The importance of a complete investigation of athletes with T‐wave abnormalities is emphasized. Diagnostic and therapeutic features of the congenital absence of pericardium are discussed.
Shoshin beriberi in an AIDS patient with end‐stage renal disease
Authors: Cage John Bright , Wall Barry M. 
Published: August 2009

AbstractAsymptomatic cardiomegaly and subsequent fulminant pulmonary edema developed in an AIDS patient with end‐stage renal disease who had no prior history of cardiac disease. Intravenous thiamine administration led to dramatic resolution of both obtundation and cardiovascular collapse within 4 hours. Prolonged thiamine administration led to decreased cardiomegaly. These findings are consistent with Shoshin beriberi.
Moricizine‐induced proarrhythmia
Authors: Seaborg Susan M. , Cowan Mark D. 
Published: August 2009

AbstractMoricizine is a Class I antiarrhythmic drug currently approved for the treatment of life‐threatening ventricular arrhythmias. The drug has received significant attention because of its role in the Cardiac Arrhythmia Suppression Trial. Previous data suggested that the agent has a relatively low proarrhythmic potential1 This may lead clinicians to use the drug empirically for less significant ventricular arrhythmias. We report a case of life‐threatening late proarrhythmia caused by moricizine and comment on our experience with this agent. We feel that this drug has significant proarrhythmic potential and should not be used empirically to treat ventricular ectopy especially in patients with underlying structural heart disease.
Intravenous thrombolytic therapy in myocardial infarction: An analytical review
Authors: Shammas Nicolas W. , Fitzpatrick Patricia , Zeitler Rodney 
Published: August 2009

AbstractThe properties and physiological effects of three currently FDA‐approved thrombolytic agents, streptokinase (SK), tissue plasminogen activator (tPA), and anisoylated plasmminogen activator complex (APSAC) are reviewed. All thrombolytic agents have been shown to reduce mortality postmyocardial infarction (MI). Comparative trials have failed to demonstrate a difference between the effects of tPA, SK, and APSAC on mortality. In addition, no consistent difference between the three agents on ejection fraction (EF) has been found despite a superior reperfusion rate with tPA at 90 min. Further‐more, reinfarction and interventional procedure rates were significantly higher after thrombolytic treatment, and the incidence of total strokes was higher with tPA than SK in some comparative studies. Based on analysis of the published megatrials, SK is a more cost‐effective thrombolytic agent for patients with acute MI than tPA or APSAC.