bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computer Diagnosis of Biventricular Hypertrophy from the Orthogonal Electrocardiogram
Authors: GAMBOA RAUL , KLINGEMAN JACK D. , PIPBERGER HUBERT V. 
Published: June 2012

Orthogonal electrocardiograms obtained from 87 patients with necropsy evidence of biventricular hypertrophy (BVH) were compared to record samples obtained from normal subjects (N) and patients with left or right ventricular hypertrophy (LVH or RVH). From 333 different ECG measurements an attempt was made to select optimal discriminators of the various pathological entities. The best separation between the BVH sample and other entities was obtained by utilizing linear discriminant function analysis and a likelihood ratio test. By using a combined covariance matrix of BVH versus N, LVH, and RVH, 69% of the BVH sample was correctly classified, thus demonstrating that multivariate analysis can lead to a substantial improvement in diagnostic classification over previous studies reported in the literature.
To test the multivariate classification method against completely independent record samples, new series of LVH and RVH cases were compared to the BVH sample. The results were similar to those obtained against the original samples. When a "clinical" BVH sample was classified by the combined covariance matrix, 44% of the new cases were classified correctly.
A search was also made for optimal scalar and vectorial measurements that can be used in routine ECG interpretation without access to computer facilities. On using 96 percentile ranges, the separations were less efficient than those obtained by multivariate analysis but they still compared very favorably with previous reports.
Pharmacodynamic Effects of a New Antihypertensive Drug, Catapres (ST-155)
Authors: ONESTI GADDO , SCHWARTZ ALLAN B. , KIM KWAN E. , SWARTZ CHARLES , BREST ALBERT N. 
Published: June 2012

Catapres is a new imidazoline compound with potent antihypertensive properties. Significant reduction in blood pressure occurs between 1 and 4 hours after oral administration, with the peak effect occurring at 2 to 4 hours and the antihypertensive effect extending for 6 to 10 hours. Blood pressure is reduced in both the supine and erect positions, although the orthostatic response is the more prominent.
Cardiac output is reduced moderately in both the supine and erect positions. Peripheral vascular resistance is also reduced, particularly in the erect posture. Accordingly, the cardiac hemodynamic findings suggest that the antihypertensive effect of Catapres is related to the combination of reduction in cardiac output plus decrease in peripheral resistance. Renal blood flow and glomerular filtration rate are preserved in both the supine and erect positions following Catapres administration. Contrasting with the preservation of renal blood flow and glomerular filtration rate, however, is the marked reduction in sodium chloride excretion which follows acute administration of the drug.
The clinical utility of the drug was demonstrated in the chronic outpatient study. Although Catapres administered alone exerted only modest antihypertensive effects, a markedly enhanced antihypertensive response was achieved when the drug was combined with a potent oral diuretic, with 80% of patients so treated achieving significant blood pressure reduction in both the supine and erect positions.
The Coronary Arteries in Early Life in Three Different Ethnic Groups
Authors: VLODAVER ZEEV , KAHN HAROLD A. , NEUFELD HENRY N. 
Published: June 2012

The histologic changes in the coronary arteries in full-term fetuses, infants, and children of 211 consecutive necropsy specimens from Ashkenazy, Yemenite, and Bedouin groups were studied, excluding cardiac deaths.
The developmental structural pattern of the coronary arteries is similar in the three ethnic groups.
Differences in the intensity and quantity of the structural findings between the sexes and among various ethnic groups are found in early life. The intimal tissue in the Ashkenazy male develops in an eccentric form, has more collagen tissue components, and is more highly developed than in the Ashkenazy female. Structural findings in the internal elastic membrane and the elastic fibers of the intima are less apparent in the Bedouin group, particularly in the female, than in the Ashkenazy and Yemenite groups.
Statistical analysis of the quantitative data showed the intima and musculo-elastic layers to be more developed in the Ashkenazy male than in the Yemenite and Bedouin males. However, Ashkenazy males clearly have more intima and musculo-elastic tissue than do the Ashkenazy females. This was not true for Yemenites and was found in only one of three age groups among Bedouins.
The relationship between the structural findings in coronary arteries of children under 10 years and the reported prevalence of coronary heart disease in the corresponding adult population in these three different ethnic groups has been pointed out.
Subpulmonic Obstruction in Complete (d) Transposition Produced by Redundant Tricuspid Tissue
Authors: RIEMENSCHNEIDER THOMAS A. , GOLDBERG STANLEY J. , RUTTENBERG HERBERT D. , GYEPES MICHAEL T. 
Published: June 2012

Two cases are reported in which complete transposition of the great vessels was associated with an unusual form of subpulmonic obstruction. In each case, redundant tricuspid valvular tissue protruded through a ventricular septal defect into the left ventricular outflow tract, producing severe obstruction to the outflow of blood from the left ventricle.
The clinical course suggested the presence of left ventricular outflow obstruction. Both patients demonstrated progressive clinical deterioration characterized by increasing cyanosis, respiratory distress, and decrease in intensity of the cardiac murmur. Serial laboratory determinations revealed increasing hemoglobin and decreasing systemic oxygen saturation. The clinical deterioration was relieved only temporarily by atrial balloon septostomy.
The angiographic findings appear to be specific for this type of subpulmonic obstruction. In each case, a large asymmetric filling defect was demonstrated at the anterior border of the left ventricular outflow tract below the pulmonic valve.
When the clinical and laboratory findings suggest pulmonary or subpulmonary obstruction, careful evaluation of the outflow tract is indicated. If diagnosed clinically, redundant tricuspid tissue could perhaps be resected during a definitive operation, thus relieving the outflow obstruction.
The Dicrotic Arterial Pulse
Authors: EWY GORDON A. , RIOS JORGE C. , MARCUS FRANK I. 
Published: June 2012

The study consisted of observations on nine male patients with palpable dicrotic as evidenced by cardiomegaly and the presence of prominent atrial and ventricular diastolic gallop sounds. Most of these patients were diagnosed as having primary myocardial disease.
The indirect carotid pulse was characterized by a single systolic wave, a low dicrotic notch, and a large dicrotic wave. The direct brachial arterial pressure pulse had a similar configuration with a shortened ejection time index. The hemodynamic data on these patients was characterized by low cardiac output, low stroke volume, elevated pulmonary arterial wedge pressures, and high total systemic resistance. From these observations we conclude that the presence of a marked dicrotic pulse in afebrile patients at rest may indicate severe functional impairment of the myocardium.
Gamma-Glutamyl-Transpeptidase in Myocardial Infarction
Authors: RAVENS KURT G. , GUDBJARNASON SIGMUNDUR , COWAN CHARLES M. , BING RICHARD J. 
Published: June 2012

The activity of γ-glutamyl-transpeptidase was determined serially in patients with acute myocardial infarction up to 32 days after the onset of chest pain. Peak enzyme activity was found in all patients between the eighth and eleventh day after infarction. Some patients showed a rise in serum activity 48 hr after infarction.
In 33 mongrel dogs with experimental myocardial infarction, γ-glutamyl-transpeptidase activity was estimated in the homogenate of the normal and necrotic heart muscle as soluble and particle-bound enzyme activity. The changes of free and particle-bound activity showed different patterns. The soluble enzyme activity was highest during the first 4 days and approached normal level after 8 days. Particle-bound activity was significantly decreased after 24 hr and showed thereafter a continuous rise to 10 times the control values 10 days after the coronary artery occlusion.
These studies indicate that several determinations of γ-glutamyl-transpeptidase activity in serum of patients with myocardial infarction may reflect the reparative processes taking place in the infarcted tissue.
Comparative Effects of Aging and Coronary Heart Disease on Submaximal and Maximal Exercise
Authors: KASSER IRWIN S. , BRUCE ROBERT A. 
Published: June 2012

The relative contributions of aging and coronary heart disease to the impairment of functional capacity were assessed in 117 coronary patients, 117 age-matched healthy middle-aged men, and 62 healthy young men by utilizing a multistage treadmill test of maximal exercise.
With aging alone, duration of exertion and maximal exercise heart rate were diminished while maximal systolic pressure increased. The percentage of heart rate reserve from submaximal (stage 1) to maximal exercise was unaltered so that the relative heart rate stress of submaximal work on the heart was not affected. Transient postexertional S-T depression was related to increasing age and high cardiac work loads.
With coronary disease, maximal duration, maximal heart rate, maximal systolic pressure, and heart rate difference (maximal heart rate during exercise minus resting heart rate just before exercise) were all reduced, while the relative heart rate stress of submaximal exercise was greater.
The frequency of S-T depression was both age and disease dependent. Postexertional S-T depression of myocardial ischemia was prolonged and usually associated with angina in patients with coronary occlusive disease and subnormal performance in contrast to a more transient painless response which occurred in healthy subjects with performance which was "supernormal" in comparison with normals who exhibited no S-T depression.
Large Anomalous Fibrous Sac in the Right Side of the Heart
Authors: SUTHERLAND R. D. , STANGER PAUL , CLIMIE A. R. W. , QQINN MICHAEL H. F. , EDWARDS JESSE E. 
Published: June 2012

In an adult with atrial septal defect, an unusual conical-shaped fibrous sac resembling a closed windsock occupied the right ventricle and main pulmonary artery. The base of the sac being attached by fibrous strands to the right atrium suggests that the structure is derived from the right valve of the sinus venosus.
The sac is considered to have filled with blood, thereby reducing potential right ventricular diastolic volume.
It is probable that the sac emptied into the right atrium during right ventricular systole, thereby creating a functional state comparable to that of tricuspid insufficiency. Occupation of right ventricular space by the sac established a state somewhat comparable to that in Ebstein's anomaly of the tricuspid valve.
The Management of Cardiac Patients in Relation to Surgery
Authors: ERNSTENE A. CARLTON 
Published: June 2012

Skillful anesthesia and surgical operations do not significantly increase the demands upon the heart for work. Patients who have organic heart disease but who have been able to carry on normal daily activities without symptoms referable to the heart tolerate anesthesia and operation without difficulty provided that anoxia, hemorrhage and shock are avoided. Hypertension, cardiac enlargement, valvular disease other than advanced aortic stenosis, and electrocardiographic abnormalities, per se, do not increase surgical mortality or postoperative morbidity. When symptomatic myocardial insufficiency or evidence of congestive heart failure is present, a period of preoperativre treatment with rest, digitalis, sodium restriction and mercurial diuretics is advisable. Treatment should be as thorough as possible during the interval in which the operation can be safely delayed. With adequate management, patients who have had myocardial failure can be expected to tolerate aniesthesia and surgery satisfactorily. Postoperative complications, such as pneumonia, atelectasis, thromboembolic accidents and abdominal distention, are not well borne, however, and may be responsible for a return of cardiac decompensation.
Patients who have auricular fibrillation or auricular flutter should be digitalized before operation even though there have been no symptoms of impaired myocardial reserve and regardless of the ventricular rate.
Surgery should be avoided if possible in persons who have severe coronary disease, aortic stenosis, coronary ostial steniosis due to syphilitic aortitis, and high grade or complete auriculoventricular block complicated by the Stokes-Adams syndrome. Spinal anesthesia should not be employed in the presence of these conditions.
The decision as to the exact type of operation to be performed is seldom influenced by the existence of organic heart disease.
The presence of organic heart disease is only occasionally of more than secondary importance in determining the choice of the anesthetic agent to be given by inhalation. Cyclopropane, however, should not be used.
Although unimportant disturbances of cardiac rhythm occur frequently during anesthesia and operation, serious complications such as ventricular tachycardia, standstill of the heart and ventricular fibrillation are uncommon. The treatment of these conditions has been discussed.
Postoperative cardiac complications are not common and are seldom responsible for death of the patient. The greatest incidence occurs in patientswhohaveseverecoronaryarterydisease.
The intravenous administration of fluids which contain sodium should be avoided during operation and the postoperative period unless their use is specifically indicated.
Atrial Tachysystole (Flutter?) with Apparent Exit Block
Authors: JAVIER ROGER P. , NARULA ONKAR S. , SAMET PHILIP 
Published: June 2012

A case of atrial tachysystole with apparent exit block is reported in which the basic cycle length of atrial activity is 260 msec. Simultaneous right intra-atrial electrograms show cycle lengths of 510 to 780 msec which are roughly multiples of 260 msec establishing the diagnosis of exit block. Rapid atrial stimulation (1,200/min) to overdrive the rapid ectopic atrial pacemaker was only transiently successful in converting the arrhythmia to atrial fibrillation with a slower ventricular response. Two days later the rhythm converted to normal sinus rhythm (cycle length, 600 msec) with periods of sino-atrial block measuring 2,400 and 1,240 msec. Atrial rate further slowed so that the patient ultimately required a permanent demand pacemaker.
The case supports the theory of repetitive discharge from an ectopic atrial pacemaker to explain the mechanism producing atrial tachysystoles that simulate atrial flutter.
Ventricular Echo Beats in the Human Heart Elicited by Induced Ventricular Premature Beats
Authors: SCHUILENBURG R. M. , DURRER D. 
Published: June 2012

In three patients, all having as their only hemodynamic abnormality an elevated cardiac index at rest, ventricular echo beats could be elicited by ventricular premature beats induced during regular driving of the ventricle. The occurrence of ventricular echo beats was in each case limited to a small delay-range of the premature beat. Retardation of retrograde conduction of the premature ventricular impulse to the atria appeared to be a necessary condition for the initiation of the echo phenomenon.
One of the patients had retardation of antegrade A-V conduction of sinus and premature atrial beats. Atrial echo beats could be elicited in this case.
The genesis of the ventricular echo phenomenon in these cases could be explained by the dual conducting system theory.
Progressive Muscular Dystrophy
Authors: DEMANY MARTIAL A. , ZIMMERMAN HENRY A. 
Published: June 2012

This paper describes the case of a young man with progressive muscular dystrophy who had supraventricular arrhythmias and intractable congestive failure. Hemodynamic studies and left cineventriculographic findings were compatible with a diagnosis of severe left ventricular failure.
Coronary cinearteriography showed an abrupt ending of the artery to the sino-atrial node. At necropsy, a noninflammatory degeneration was found in this particular vessel. The pathogenesis of the cardiac arrhythmias seen in this condition is discussed in the light of these cineangiographic and histopathologic observations.
Childhood Leukemic Heart Disease
Authors: SUMNERS J. E. , JOHNSON W. W. , AINGER L. E. 
Published: June 2012

One hundred sixteen hearts of children dying with leukemia during the 5-year period of 1962 to 1967 were examined at necropsy. Forty-four per cent of the patients had at least one focus of leukemic infiltration, a slightly higher incidence than previously reported. The evidence suggests that peripheral leukocyte count, type of leukemia, and length of survival are factors that influence cardiac infiltration. Increased survival time due to improved therapy may explain the increase in percentage of hearts with leukemic infiltration. Electrocardiographic patterns, in general, were found, as previously reported, to be nonspecific for leukemic myocardial infiltration.
Cardiac hypertrophy of significant degree was found in 33 of 99 hearts evaluated for this aspect. Anemia, intrinsic to leukemia, is proposed as the principal factor responsible for this hypertrophy inasmuch as all possible alternate mechanisms were excluded and since previous clinical as well as experimental animal studies clearly have shown that chronic anemia frequently results in cardiac hypertrophy regardless of the etiology of the anemia.
Primary Pulmonary Hypertension in a Child
Authors: RAO B. N. SATYANARAYANA , MOLLER JAMES H. , EDWARDS JESSE E. 
Published: June 2012

Clinical, pharmacologic, and pathologic findings presented are those in a 12-year-old boy with primary pulmonary hypertension associated with medial hypertrophy of the pulmonary muscular arteries and arterioles.
Intrapulmonary arterial administration of acetylcholine, tolazoline (Priscoline), or isoproterenol resulted in a fall in pulmonary vascular resistance and pressure.
Perforation of the right ventricle by an indwelling catheter terminated studies on the results of long-term intrapulmonary arterial administration of drugs shown to be effective.
Arterial Hypoxemia Following Acute Myocardial Infarction
Authors: VALENCIA A. , BURGESS J. H. 
Published: June 2012

Arterial hypoxemia was common in 53 patients following acute myocardial infarction. It was most marked in patients with evidence of left ventricular failure. Arterial oxygen tension, however, was reduced in many of the patients who were without evidence of failure.
An increase in arterial oxygen tension following three deep breaths suggested maldistribution of ventilation. Right-to-left shunting of blood was demonstrated by 100% oxygen studies. There was a significant correlation between reduced arterial oxygen tension and low pulmonary diffusing capacity, but a poor correlation between the former and a low cardiac index. We suggest that the hypoxemia following acute myocardial infarction is the result of abnormalities in small airways as well as of vascular congestion in the lungs.
The patients with the lowest arterial oxygen tension at the time of study subsequently had more marked arrhythmias and a higher mortality rate.
Intrapericardial Cyst Formation in Constrictive Pericarditis Simulating Tricuspid Stenosis
Authors: PITT AUBREY , CUTFORTH ROBERT H. , BENDER HARVEY W. , HUMPHRIES J. O'NEAL , STIRLING GEORGE R. , CRILEY J. MICHAEL , ROSS RICHARD S. 
Published: June 2012

Two cases of constrictive pericarditis with intrapericardial cyst formation are presented. In each, a tricuspid diastolic murmur was present, and confirmation of a tricuspid valve gradient was obtained at cardiac catheterization. Angiographic studies revealed that the tricuspid valves were distorted by the cysts. In both patients, surgical excision was successfully achieved.
In case 1 a blood-containing cyst was found, the etiology of which is obscure. Case 2 was associated with rheumatoid arthritis, and the compression resulted from a chronic abscess that probably arose at a previous pericardiectomy.
Plasma Renin Activity in Patients with Coarctation of the Aorta
Authors: WERNING CLAUS , SCHÖNBECK MANFRED , WEIDMANN PETER , BAUMANN KLAUS , GYSLING ETZEL , WIRZ PIERRE , SIEGENTHALER WALTER 
Published: June 2012

In 10 patients with coarctation of the aorta, plasma renin activity was measured after recumbency and orthostatism in peripheral venous blood and, in some cases, in renal venous blood also. In nine of these patients, basic plasma renin values and those obtained under stimulatory conditions lay within normal range, and only in one patient were the values elevated. However, since this patient displayed the lowest gradient of mean arterial blood pressure proximal and distal to the stenosis, it can be regarded as improbable that the elevation in plasma renin activity was caused by the coarctation. Plasma renin activity in the renal venous blood of both kidneys, which was measured in three patients, showed no elevation.
On the basis of observations of other authors and of our own studies it can be concluded that the kidneys can contribute to the development of prestenotic hypertension in acute constriction of the aorta in experiments with animals, but in chronic coarctation in animals or in man the humoral or renal theory has no importance to the pathogenesis of hypertension.
Results of Repair of Tetralogy of Fallot
Authors: GOTSMAN M. S. , BECK W. , BARNARD C. N. , O'DONOVAN T. G. , SCHRIRE V. 
Published: June 2012

One hundred and forty-six patients had radical operations for tetralogy of Fallot. In the early phase vertical ventriculotomy was used, often with extensive reconstruction of the outflow tract. In the late phase, transverse ventriculotomy was introduced and fewer outflow tract patches were inserted. The overall mortality (operative and late) was 10% to 13% in the first phase and 7% in the second phase.
Ninety-one patients were investigated by cardiac catheterization 1 year after surgery; 21 were virtually cured, four had residual outflow tract gradients of more than 50 mm Hg, and 12 had severe pulmonary incompetence. Six had a residual ventricular septal defect, and three had associated lesions. Pulmonary incompetence occurred in three patients who had infundibular resection only; otherwise it was associated with pulmonary valvulotomy and was more severe if an outflow tract patch was carried across the pulmonary valve ring.
Seven patients were recatheterized 5 years after the first postoperative study. The hemodynamics did not alter.
Right ventricular angiocardiography in 32 patients showed that half the patients after infundibular resection only showed a noncontractile portion of the outflow tract, and patients with a patch had an inert anterior wall of the right ventricle. A patch carried across the valve ring reestablished an inert but adequate conduit.