bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vector u loop in patients with old myocardial infarction
Authors: Yang Q. , Kiyoshige K. , Fujimoto T. , Katayama M. , Fujino K. , Saito K. , Nakaya Y. , Mori H. 
Published: July 2009

AbstractThe U loop of the vectorcardiogram was examined qualitatively and quantitatively in 100 normal subjects and 67 patients with old myocardial infarction, using a direct‐writing vectorcardiograph with memory function. In the control group, the U loop was directed to the left, anteriorly and inferiorly, and it was inscribed counterclockwise in the horizontal plane. In patients with anterior myocardial infarction, the U loop tended to be displaced to the right, and in patients with inferior myocardial infarction to the right and superiorly. The shape of the U loop in patients was also different from that of normal subjects. The maximum U vector was significantly smaller in magnitude both in patients with anterior and inferior myocardial infarction than that of normal subjects (p>0.01). In patients with ventricular aneurysm, the magnitude of the maximum U vector was significantly smaller and its direction was displaced more to the right and posteriorly than those without aneurysm (p>0.01). In standard 12‐lead electrocardiogram (ECG), observation of the U wave in patients with old myocardial infarction was difficult, especially in the limb lead, because of the small size of the U wave. Therefore, vectorcardiographic observation may be more useful than electrocardiographic observation for the analysis of the U wave in patients with old myocardial infarction.
Influence of risk factors on long‐term survival following acute myocardial infarction: A follow‐up study in central japan
Authors: Enomoto N. , Yamauchi K. , Hayashi H. , Saito H. , Hamajima N. , Sasaki R. , Sotobata I. , Tanimura H. 
Published: July 2009

AbstractThe long‐term survival rate following acute myocardial infarction (AMI) was studied in 358 patients in central Japan who were monitored for 8 to 20 years after discharge from hospital for AMI. Fifteen‐year cardiac survival rates were 65% in males and 72% in females. In both sexes, the survival rate decreased with increasing age at the time of AMI. The survival rate was significantly lower in recurrent MI than in first MI patients. Those who had smoked cigarettes before AMI or had hyperlipidemia during hospitalization did not show any significant decrease in cardiac survival rate, which may be due to cessation of smoking or control of hyperlipidemia after AMI. The 15‐year survival rate was significantly lower in patients with a past history of angina pectoris or hypertension. Patients with a large infarct had a lower survival rate, as did those with a large cardiothoracic ratio on chest x‐ray, and those who received digitalis during hospitalization. On the other hand, patients who were administered anticoagulants during hospitalization had a higher survival rate. Multiple regression analysis gave similar results. In conclusion, factors that reduced long‐term survival rate after AMI were older age at time of the first attack, reduced cardiac function, and a history of angina pectoris or hypertension. Anticoagulant therapy appeared to improve the long‐term survival rate.
Prediction of mortality after myocardial infarction by simple clinical variables recorded during hospitalization
Authors: Plérard L. A. , Dubois C. , Albert A. , Smeets J.‐P. , Kulbertus H. E. 
Published: July 2009

AbstractSimple clinical variables obtainable in any coronary care unit and in any patient were recorded in 769 consecutive patients who were admitted with acute myocardial infarction (AMI) and who were discharged from the hospital and followed for up to 3 years. To identify the patients at highest and lowest risk of posthospital mortality, a prognostic index was established from a stepwise logistic discriminant analysis of variables obtained in a consecutive series of 418 patients discharged alive from one of two coronary care units admitting new patients on alternate days. This prognostic index was validated by applying it to a comparison group of 351 consecutive control patients discharged from the other coronary care unit. In the training group, 59 of the 418 patients (14%) died during the first year after hospital discharge and 34 (8%) died during the second or third year. The stepwise logistic discriminant analysis made it possible to distinguish between 1‐year survivors and nonsurvivors, but not between the patients who died during the second and third years and the 3‐year survivors. Four variables were selected for obtaining a 1‐year prognostic index: the maximum grade of left ventricular function during hospitalization (0 to 4), history of previous AMI (1 or 0), predischarge cardiothoracic ratio (0 to 0.99), and complete bundle branch block (1 or 0). Prognostic index = 7.0196‐0.6515 function ‐1.6623 previous AMI ‐0.0729 cardiothoracic ratio ‐1.0813 bundle branch block. This index was validated in the comparison group. Patients were allocated into three classes with increasing values of the index associated with decreasing risk of 1‐year mortality: patients at high risk (index ≤ 1; mortality 30%), patients at intermediate risk (1 < index ≤ 3; mortality 9%) and those at low risk (index > 3; mortality 3%). Easily obtainable variables may identify patients at risk of dying during the first year after hospital discharge, but not those at risk of dying during the second or third year.
Effect of isosorbide dinitrate on cardiac output in severe cardiac failure: Relation to initial hemodynamics, ventricular volume, and the preload reserve mechanism
Authors: Lewis B. S. , Hardoff R. , Halon D. A. 
Published: July 2009

AbstractIsosorbide dinitrate (ISDN) improves the clinical and hemodynamic state of patients with heart failure, but may cause dizziness and syncope. To characterize patients in whom cardiac output falls with high‐dose nitrate therapy and to examine further the pathophysiology of the fall in cardiac output in these patients, we studies the effect of sublingual ISDN on forward cardiac output in 14 patients with severe cardiac failure (New York Heart Association grades 3–4). We examined systolic and diastolic left ventricular (LV) function from pressure and volume analyses of LV function. After administration of 15 mg ISDN, cardiac output was either unaltered or increased in 7 patients (Group 1) (11±12%, mean±SD), and decreased in 7 (Group 2) (‐13±10%) (Group 1 vs. 2, p<0.002). Initial systemic arterial pressure, LV ejection fraction, wedge and LV transmural filling pressures were similar in both groups, but Group 2 patients had a lower systemic vascular resistance (p=0.07) and tended to have a larger initial LV end‐diastolic volume and increased end‐diastolic compliance; following ISDN the decrease in LV filling pressure and end‐diastolic volume was larger and the product of the changes greater (p<0.02). Thus ISDN decreases filling pressure and improves forward cardiac output in some patients with congestive heart failure, but large doses may decrease cardiac output in a subset of patients who have a lower systemic vascular resistance and a larger more compliant ventricle, maintaining forward blood flow predominantly by a preload reserve mechanism. As a simple clinical guide, cardiac output is likely to fall when the wedge pressure is reduced to < 10 mmHg.
Mitral leaflet motion: Age and implications for the diagnosis of mitral valve prolapse
Authors: Froom P. , Kriwisky M. , Ribak J. , Shochat I. , Tamir A. , Lewis B. S. 
Published: July 2009

AbstractThe extent of posterior mitral leaflet motion (PMLM) during systole in relation to age was studied in 300 asymptomatic men aged 18–42 years. PMLM of 4 mm or more on two‐dimensional directed M‐mode echocardiography was found in 8% (16/200) of subjects under age 35 years, but in only 2% (2/100) of those aged 35 years or more (p<0.05). On two‐dimensional echocardiography, 16% (31/200) of men under 35 years old had PMLM ≥0.40 mm2 compared with 1% (1/100) of those 35 years or more (p<0.001). The findings were not related to differences in left ventricular cavity dimensions or in the extent of systolic ventricular contraction. Body mass index (BMI) increased with age, but there was a significant and independent negative correlation of age with PMLM after controlling for BMI. The data are compatible with the hypothesis that the aging process is associated with decreased mobility of the mitral valve or annulus with lesser degrees of backward bowing or billowing of the leaflets during systole. Age should be taken into account in determining “normal” values for mitral leaflet motion.
Two‐dimensional and pulsed doppler echocardiographic diagnosis of an acquired aortic right ventricular fistula
Authors: Chow W.‐H. , Lee P.‐K. , Cheung K.‐L. , Mok C.‐K. 
Published: July 2009

AbstractA patient with an asymptomatic aortic right ventricular fistula acquired after aortic valve and mitral valve replacement is presented. This was diagnosed by two‐dimensional and pulsed Doppler echocardiography, and confirmed at cardiac catheterization.
Effects of intracoronary injection of ergonovine on angiographic normal coronary arteries: Study of 108 consecutive patients
Authors: Fournier J. A. , Cortacero J. A. P. , Turáa A. , Hernáanez‐Aparicio C. , Granado C. , Vallejo J. 
Published: July 2009

AbstractTo assess the local and systemic intracoronary (IC) ergonovine maleate (EM), single or repeated 25 m̈g bolus injections were administered to 108 consecutive patients with chest pain and normal coronary arteriograms. Coronary artery spasm (CAS) was induced in 17 (15.7%) patients. None of these patients developed ST‐segment depression, and ST‐segment elevation appeared in only 6 (35.3%). In 59 of the 91 patients without CAS, both the IC and the intravenous (IV) EM arteriographic and hemodynamic effects were compared. The mean diameter of the vessels was reduced by 15% (p < 0.001) after two single 25 m̈g ICEM injections. Only insignificant changes were induced in the heart rate (baseline 80±15; after ICEM 79 ± 15 beats/min; p=NS) and systolic aortic pressure (baseline 147 ± 27; after ICEM 149±28 mmHG; p=NS). Following 350 m̈g of cumulative IVEM, the mean coronary diameter decreased by 20% (p<0.01 vs. ICEM dose) and the heart rate diminished slightly (76 ± 12 beats/min, p<0.01). However, the systolic aortic pressures did increase by 16% (171±28 mmHg; p<0.001). No major complications were observed. Thus, to induce CAS the IC delivery route appears to be safe, allows for more accurate titration, and adverse systemic effects, such as hypertension, are avoided.
Cardiovascular reactivity and silent ischemia in response to mental stress in symptomatic and asymptomatic coronary artery disease patients: Results of a pilot study
Authors: Norvell N. , Roth D. L. , Franco E. , Pepine C. J. 
Published: July 2009

AbstractThe current study was designed to examine cardiovascular reactivity to psychological tasks and its relationship to provocation of ischemia in asymptomatic coronary artery disease (CAD) patients with documented silent ischemia and those with painful ischemia. ECG, heart rate, and blood pressure responses to mental stress were collected for 13 patients with coronary artery disease (CAD) and for 6 healthy control subjects. Six of the CAD patients were asymptomatic (documented silent ischemia and no history of angina), while the remaining 7 were symptomatic (history of angina). Three types of mental stress were employed: white noise (a passive stressor), digits repeated backwards (an active stressor), and a math task plus white noise (active +passive stressor). Results indicate that significant increases in heart rate and blood pressure, but not silent ischemic episodes, were in‐ duced by the mental stress tasks. In addition, patients with documented exercise‐induced and ambulant silent ischemia showed trends of blunted autonomic responsiveness to the stressors. On the digits backwards task, the CAD patients with silent ischemia showed significantly lower diastolic blood pressure responses compared with controls or angina patients. Findings suggest that ischemic episodes are not easily induced by brief mental stress. However, results indicate that asymptomatic CAD patients with silent ischemia may be lacking in autonomic responsiveness, particularly in terms of peripheral resistance, to mental stress in comparison with health controls and symptomatic ischemic patients. Further investigation is needed to explore how patients with silent ischemia typically respond autonomically to mental stress and how blunted reactivity may relate to the provocation of unrecognized ischemic episodes.
Elevated pain threshold in patients with effort‐induced angina pectoris and asymptomatic myocardial ischemia during exercise test
Authors: Pedersen F. , Pietersen A. , Madsen J. K. , Ballegaard S. , Meyer C. , Trojaborg W. 
Published: July 2009

AbstractThe purpose of the present study was to analyze the prevalence of asymptomatic (silent) myocardial ischemia during exercise testing among patients with effort‐induced angina pectoris, and further, to compare the pain threshold of patients with symptomatic and asymptomatic myocardial ischemia. A group of 26 patients comprised the study. In half of the patients myocardial ischemia during the exercise testing was silent and in one half it was symptomatic. Asymptomatic myocardial ischemia was defined as an asymptomatic ST‐segment depression ≥0.1 mV, lasting longer than 60 s during an exercise test. In patients with asymptomatic ischemia the pain thresholds both on toe and finger were significantly higher than in patients with symptomatic ischemia: mean values were 10.1 versus 4.9 mA on the toes, p <0.025, and 8.4 versus 2.5 mA on the fingers, p <0.01. We conclude that asymptomatic myocardial ischemia during exercise test is seen often in patients with angina pectoris and that this may be due to an increased pain threshold.
Native valve infective endocarditis in the 1970s versus the 1980s: Underlying cardiac lesions and infecting organisms
Authors: Weinberger I. , Rotenberg Z. , Zacharovitch D. , Fuchs J. , Davidson E. , Agmon J. 
Published: July 2009

AbstractA retrospective review of the records of 135 patients with proven or suspected endocarditis, seen between January 1970 and December 1987, is presented. Among the findings: (1) Mitral valve prolapse (MVP) as an underlying lesion was more common in the 1980s group of patients (22%) than in the 1970s group (6%, p < 0.01); (2) no significant difference was found in the occurrence of pathogens between the 1970s and the 1980s groups of patients; (3) in most patients (17 of 19) with MVP, the organisms isolated were Streptococci viridans; (4) most patients (15 of 17) with MVP had undergone a dental procedure without prior antibiotic treatment in the two months prior to admission. Prophylactic antibiotic treatment is suggested in patients with MVP undergoing dental procedure, especially in a subset of patients with flail or redundant valve leaflet as 16 of our MVP patients (out of 17) had this pathology on echocardiogram.
Prophylactic treatment after electroconversion of atrial fibrillation
Authors: Karlson B. W. , Herlitz J. , Edvardsson N. , Olsson S. B. 
Published: July 2009

AbstractAtrial fibrillation is a common arrhythmia. Sinus rhythm can often be restored by electroconversion, but the relapse rate is high. Various antiarrhythmic drugs have been used to maintain sinus rhythm after electroconversion. This article reviews the experience with these drugs and suggests a treatment strategy.
Unrecognized left ventricular dysfunction in an apparently healthy cocaine abuse population
Authors: Bertolet B. D. , Freund G. , Perchalski D. L. , Pepine C. J. , Martin C. A. , Williams C. M. 
Published: July 2009

AbstractTo determine the frequency and severity of clinically unrecognized left ventricular (LV) dysfunction related to cocaine use, 84 asymptomatic cocaine abusers underwent cardiac evaluation which included chest x‐ray, electrocardiography (ECG), and radionuclide angiography after a two‐week abstinence from cocaine use. LV dysfunction was discovered in 6/84 (7%). Regional wall motion abnormalities suggesting a localized myocardial abnormality were found in 2, whereas an ejection fraction <50% suggesting a more global process was noted in 4. An abnormal chest x‐ray was found in only 1 subject and none had abnormal ECGs. in each of these cases, repeated and protracted use of cocaine was documented and the suggestion of cardiac dysfunction was supported by at least one other independent abnormal finding. in these 6 cases, the dysfunction was clinically unrecognized and unsuspected after routine evaluation. The significance of subclinical LV dysfunction in this population has not been determined and requires long‐term study.
Lidocaine in the early phase of acute myocardial infarction: The controversy over prophylactic or selective use
Authors: Zehender M. , Kasper W. , Just H. 
Published: July 2009

AbstractIn acute myocardial infarction, lidocaine is considered the drug of choice for the treatment of malignant ventricular arrhythmias. While initially a so‐called “selective” treatment strategy prevailed, in which lidocaine was administered only after the onset of certain “warning arrhythmias,” the prophylactic use of lidocaine in acute myocardial infarction has been gaining wider usage in intravenous and intramuscular application in recent years. Both therapeutic applications have been found to be problematic of late, which has led to increasingly restrictive use of lidocaine. While in selective treatment forms, the definition and prompt recognition of the so‐called warning arrhythmias created especially acute problems, the prophylactic therapeutic use is problematic due to the occurrence of sometimes serious side effects, which is to be expected as the size of the collective being treated increases. Both treatment forms also appear limited by the narrow preventive efficacy of lidocaine against malignant ventricular arrhythmias, especially against ventricular fibrillation. The current therapeutic recommendation for lidocaine in acute myocardial infarction should be limited to patients presenting with very frequent and complex ventricular arrhythmias, especially when these are elicited by an R‐on‐T phenomenon. Side effects and other therapeutic problems encountered when me therapeutic modality is switched or adjusted can be greatly reduced by careful dosing and selection of the optimal combination substances.
Myocardial infarction during a football game: Empiric estimation of the contribution of skeletal muscle damage to the serum creatine kinase activity
Authors: Studer P. P. , Bachmann C. , Gertsch M. , Peheim E. , Stäubli M. 
Published: July 2009

AbstractA 40‐year‐old untrained participant of a competitive football game experienced chest pain after 20 minutes of playing time. An acute anterior myocardial infarction was diagnosed by electrocardiographic criteria and the creatine kinase rose to its maximum of 3900 U/l (normal range < 125 U/I) by 24 h with a CK‐MB fraction of 6.1% In order to estimate the contribution of skeletal muscular work to CK activity, the course of CK activity was prospectively measured in 11 untrained participants of a competitive football game, who had normal electrocardiographic findings on exercise testing. Individual peak values of CK correlated positively (p < 0.01) with the time spent in play. Based on this observation we could estimate that, at most, 14% of the total CK was contributed by skeletal muscle damage in our patient. When total CK was elevated above 125 U/I, the percentage of CK‐MB activity did not exceed 6% of total CK in any case. 3‐methylhistidine, an indicator of contractile protein turnover and creatinine were prospectively determined in spot urine samples before the game and for up to 48 h after the game. 3‐methylhistidine/creatinine ratios did not change from baseline after the game and no correlation with CK was found. Urine 3‐methylhistidine/creatinine, measured within 48 h after a football game, does not contribute to the quantification of skeletal muscle damage.
Treatment with diltiazem preoperatively in open heart surgery for myocardial protection: Experimental studies in dogs with chronic healed myocardial infarction
Authors: BrÄutigamd P. , Just H. , Freudenberg N. 
Published: July 2009

AbstractCalcium antagonists have become important in open heart surgery because of their effects on myocardial protection and cardioplegia. We evaluated the effect of pretreatment with the calcium antagonist diltiazem for myocardial protection in dogs with experimentally induced, chronic, healed myocardial infarction in a double‐blind randomized study. One group consisted of 5 dogs treated with diltiazem (10 mg/kg body weight) for 7 days preoperatively, while a second group of 4 dogs were treated with placebo. All animals then underwent hypothermic, ischemic cardiac arrest (90 min) with extracorporeal circulation (ECC), followed by 30 min of reperfusion. Hemodynamic parameters were measured before and after ECC. An EKG was recorded during the entire procedure. The myocardium was studied by light microscopy for fresh necroses. The old, experimentally induced infarction scars were quantified by a new method that was developed for planimetry of the histological specimens. The diltiazem group compared with the placebo group showed myocardial cell necroses to a smaller extent. The hemodynamic studies supported the contention that diltiazem given preoperatively has a myocardial protective effect. These results encourage further studies on the use of diltiazem preoperatively for myocardial protection.
Relation of angiographically defined coronary artery disease to serum lipoprotein levels
Authors: O'Sullivan J. J. , Matthew A. , Conroy R. M. , Erwin R. J. , Duggan P. F. 
Published: July 2009

AbstractThe relationship of coronary artery disease to plasma lipoproteins was examined in 43 men admitted to our unit with suspected ischemic heart disease. Coronary arteriography was performed, and a score reflecting the severity of disease was assigned to the angiogram. Plasma, obtained after a 12‐h overnight fast, was assayed for triglycerides, total cholesterol, high‐density lipoprotein (HDL) cholesterol, and HDL‐3 cholesterol. HDL‐2 cholesterol was found by subtraction. The cholesterol contents of very low‐density lipoprotein (VLDL) and low‐density lipoprotein (LDL) were quantitated by the Freid‐wald equation. Men with high coronary scores tended to be older, and subjects with moderate coronary disease had significantly higher total and LDL cholesterol values than those with minimal disease. Age was the only factor to be significantly associated with coronary score and there was no significant association between coronary score and total LDL and HDL cholesterol or its subfractions when the age factor was taken into account.