bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma kinetics of chylomicron‐like emulsion in renal transplant patients receiving cyclosporin‐based immunosuppression
Authors: De Lima JosÉ Jayme Galvão , Da Maria , Krieger Eduardo M. , Latrilha Conceição M. , Toftoletto Odaly , Ianhez Luis Estevan , Maranhã Raul C. 
Published: February 2009

AbstractBackground: Atherosclerotic cardiovascular disease is prevalent among renal transplant patients. Increase in serum total cholesterol, low‐density lipoprotein, and very low‐density lipoprotein is common in those patients. Alterations in chylomicron metabolism, however, are also related to atherogenesis and were not studied in renal transplant.Hypothesis: The aim of this study was to evaluate chylomicron metabolism in renal transplant recipients receiving cyclosporin‐based immunosuppression. We determined the plasma kinetics of triglyceride‐rich emulsions labeled with pHjtriolein and [l4C]cholesteryl oleate that are known to mimic the chylomicron metabolism when injected into the blood stream.Methods: Fourteen renal transplant recipients with normal renal function (10 men, 4 women, aged 40 $pL 6.1 years) and 17 age‐ and gender‐matched healthy controls received bolus injections of the chylomicron‐like emulsion. Plasma samples were then taken at regular intervals during 60 min. Disappearance curves of the labels and the respective fractional clearance rates (FCR) were calculated in order to measure lipolysis and chylomicron remnant removal from the plasma.Results: Fasting serum lipid levels did not differ in the two groups. The difference between Median FCR of [3H]triolein
emulsion in renal transplant patients and that obtained in the controls (0.07 vs. 0.11 min‐1, NS) was not statistically significant. Median FCR of [14C]cholesteryl oleate also did not differ between the groups (patients: 0.044 controls: 0.046, NS).Conclusion: These results indicate that neither chylomicron lipolysis nor remnant removal are affected in stable renal transplant patients treated with cyclosporin‐based immunosuppression.
Assessment of mitral valve volume by quantitative three‐dimensional echocardiography in patients with rheumatic mitral valve stenosis
Authors: Limbu Yuba Raj , Chen Haozhu , Shen Xuedong , Pan Cuizhen , Shi YuefanG. 
Published: February 2009

AbstractBackground: Thickening of mitral leaflets in rheumatic mitral valve stenosis is well described in necropsy studies; however, volume computation of the thickening mitral leaflets has not been attempted. Atrial fibrillation is one of the complications of rheumatic mitral stenosis. Quantitative assessment of thickened mitral valve and its relation to clinical complications is clinically desirable.Hypothesis: The study was undertaken to compare measurement of mitral valve volume in normal subjects and in patients with rheumatic mitral valve stenosis.Methods: An HP Sonos 2500 echocardiography system with 5 MHz multiplane transesophageal transducer was used for data acquisition, and TomTec Echoscan computer setup was used to off‐line volume computation. Study subjects included 10 normal subjects (mean age 44.8 years) and 36 patients with rheumatic mitral valve stenosis (22 female, 14 male) with an age range of 25 to 69 years (mean age 47 $pL 9.6 years). Mitral valve volumes were compared between the normal subjects and patients with mitral valve stenosis, and further comparison was made between the sinus rhythm (SR) and atrial fibrillation (AF) groups in patients with mitral valve stenosis. In all study subjects, the mitral valve area (MVA) was determined by two‐dimensional echocardiography.Results: Quantitative three‐dimensional (3‐D) echocardiography showed that mitral valve volume was significantly larger in patients with mitral valve stenosis than in normal subjects (9.0 $pL 2.2 and 4.5 $pL 0.7 ml, respectively, p<0.001). When patients with mitral valve stenosis were divided into the SR and AF groups, mitral valve volume was found to be significantly larger in the AF group than in the SR group (9.76 $pL 2.2 ml.and 7.72 $pL 1.5 ml, respectively, p < 0.01) and patients in the AF group tended to be older (p < 0.05) with larger left atrial diameter (LAD) (p<0.01). However, MVA between the two groups showed no statistical significance (1.1 $pL 0.43 and 1.0 $pL 0.34 cm2, respectively, p >0.2). When the study subjects were divided into two groups (< 50 and > 50 years) according to age, the comparison of mitral valve volume between these two groups (9.37 $pL 2.18 and 8.56 $pL 2.14 ml, p >0.2) showed no statistical significance.Conclusions: Quantitative 3‐D echocardiography can be applied for the measurement of mitral valve volume in vivo. Patients with rheumatic mitral valve stenosis with atrial fibril lation have a propensity to have a larger mitral valve volume and are older than the patients with sinus rhythm; however, the age per se does not seem to be a cause for larger mitral valve volume.
Early postexercise thallium‐201 reinjection after sublingual nitroglycerin augmentation: Effects on detection of myocardial ischemia and/or viability
Authors: Antonopoulos Athanassios , Georgiou Evangelos , Kyriakidis Michael , Nikolopoulos Dimitrios , Toutouzas Pavlos , Proukakis Charalambos 
Published: February 2009

AbstractBackground: Thallium‐201 (201Tl) reinjection after conventional redistribution imaging is a standard procedure, resulting in enhanced 201 Tl redistribution which is compatible with viable myocardium. Although this method significantly improves identification of viable myocardium, it increases the investigation time by approximately 1 h. Thus, this technique is suboptimal from the standpoint of patient convenience, since its routine performance may be impractical in a high‐volume nuclear medicine laboratory.Hypothesis: This study was undertaken to evaluate the efficacy of an early 201Tl reinjection and imaging protocol in combination with sublingual nitroglycerin, to detect myocardial ischemia and/or viability, and to reduce the need for conventional (4 h) redistribution imaging.Materials and Methods: In this study, 62 consecutive coronary patients, referred for the detection of possible myocardial ischemia and/or viability, were involved (mean age 55 years, range 41‐70). Of those, 50 had previous angina attacks, with 42 having a history of previous myocardial infarction; 10 patients had coronary artery bypass grafting; and the remaining 2 had atypical chest pain. Immediately after the completion of the initial postexer‐cise imaging, 0.3 mg sublingual nitroglycerin followed by the reinjection of 1 m Ci of 201Tl were administered, and two further sets of images were acquired 1 h and 4h later.Results: In each set of i mages, a total of496 segments were analyzed. On postexercise imaging, 305 (61%) segments demonstrated defects of which 198 (65%) showed enhanced thallium uptake, 97 (32%) did not change, and 10(3%) showed reverse redistribution on 1 h reinjection imaging (IRI). Of the 97 persistent defects, only 17 (6%) showed fill‐in of 201 Tl on 4 h redistribution imaging (CRI), while 12 (4%) segments showed reverse redistribution. On the other hand, after analyzing the 62 patients of the 1 h IRI, 17 (27%) remained unchanged while in only 1 patient (6%) of 17 the diagnosis changed from myocardial necrosis to ischemia after analysis ofthe 4h CRI.Conclusion: These results indicate that early postexercise reinjection of 201Tl in combination with sublingual nitroglycerin followed by l h image acquisition may prove useful for a comprehensive and convenient assessment of myocardial ischemia and/or viability.
Transient cerebral ischemic attack and left atrial free‐floating thrombus: A case report
Authors: Abaci Adnan , Kabakci Giray , Tokgöuzoglu Lale , Kes Sirri , Ersoy $Uunsal 
Published: February 2009

AbstractA patient with rheumatic mitral stenosis was found to have a free‐floating thrombus in the left atrium during echocardiography. Subsequently, the patient underwent surgical treatment. At surgery, a free thrombus was found within the left atrium. The postoperative course of the patient was satisfactory.
Ascending aortic aneurysm and dissection in young adults with bicuspid aortic valve: Implications for echocardiographic surveillance
Authors: Burks John M. , Illes Richard W. , Keating Edward C. , Lubbe Willem J. 
Published: February 2009

AbstractBicuspid aortic valve (BAV) is an independent risk factor for aneurysm and dissection of the ascending aorta. Despite this association, routine imaging of the aorta has not been recommended for patients with BAV. We describe two young men who developed life‐threatening aneurysm or dissection of the ascending aorta; one had a normally functioning BAV and the other was 10 years after valve replacement. The pathology of this condition is very similar to that found in the Marfan syndrome. We recommend echocardiographic surveillance of the ascending aorta at regular intervals, and consideration of beta‐adrenergic blockade among patients with significant dilation.
Alternate Patterns of Ventricular Activation during Supraventricular Bigeminy
Authors: Littmann Laszlo 
Published: February 2009

AbstractSeveral investigators have previously noted that in the presence of bigeminal atrial extrasystoles, the premature beats may exhibit an alternate pattern of ventricular excitation either in the form of alternating left and right bundlebranch block, or alternating right bundle‐branch block and normal intraventricular conduction. However, the association of alternating intraventricular conduction with other types of supraventricular bigeminy has rarely been documented. In this report we present five diverse forms of supraventricular bigeminy exhibiting the phenomenon of alternating ventricular excitation on the early beats. Our findings suggest that the exact mechanism of supraventricular bigeminy is irrelevant in terms of subsequent ventricular events. Practically any type of supraventricular bigeminy may result in an alternate pattern of ventricular activation.
Successful management of myocardial infarction during pregnancy in a renal transplant recipient
Authors: Bhaktaram Vivi K.J. , Asirvatham Sam , Sebastian Cherian , Sivaram Chittur A. , Pederson James A. , Stanley John R. , Pennington Larry R. 
Published: February 2009

AbstractMyocardial infarction (MI) complicating pregnancy in a renal transplant recipient is described. Management challenges of MI in pregnancy and the possible predisposing roles of renal transplantation and erythropoietin (EPO) use are discussed.
Cardiac involvement in acquired immunodeficiency syndrome—a review to push action
Authors: Mllei JosÉ , Grana Daniel , Alonso Graciela Fernández , Matturri Luigi 
Published: February 2009

AbstractAs more effective therapies have produced longer survival times for human immunodeficiency virus (HIV)‐infected patients, new complications of late‐stage HIV infection including HIV‐related heart disease have emerged. Almost any agent that can cause disseminated infection in patients with acquired immunodeficiency syndrome (AIDS) may involve myocardium, but clinical evidence of cardiac disease is usually overshadowed by manifestations in other organs, primarily the brain and lungs. Cardiac abnormalities are found at autopsy in two‐thirds of patients with AIDS, and more than 150 reports of cardiac complications have been published. Cardiac involvement in HIV disease includes pericardial effusion, myocarditis, dilated cardiomyopathy, and/or endocardial involvement at any stage of the disease. This review deals with all the cardiac manifestations of AIDS and serves to highlight two problems and one indication. First of all, there are very few clinical studies. Current knowledge is based almost exclusively on echocardiography and autopsy studies. Observational or clinical trials would be useful. Second, there exists very poor information on the impact of treatment; and epidemiologic and clinicopathologic studies are mandatory for obtaining detailed data concerning the mechanisms of myocardial damage in AIDS. Finally, because cardiac complications are often clinically inapparent or subtle in the initial stages, periodic screening of HIV‐positive patients by electrocardiogram and echocardiogram is probably indicated. in addition, AIDS may also provide the opportunity to gain insights into the pathogenesis of little understood cardiac diseases such as lymphocytic myocarditis and dilated cardiomyopathy.
“Nonspecific” chest pain associated with high long‐term mortality: Results from the primary prevention study in göteborg, sweden
Authors: Wilhelmsen Lars , Rosengren Annika , Hagman Marianne , Lappas Georg 
Published: February 2009

AbstractBackground: The syndrome angina pectoris with effort‐related chest pain or discomfort is usually easy to recognize. However, vague and nonspecific symptoms may cause little reason for extensive evaluation. The prognosis of such patients in the general population has so far not been well described.Hypothesis:The study was undertaken to investigate longterm prognosis in men with chest pain considered to be non‐specific in comparison with men with typical angina pectoris (AP) or prior myocardial infarction (MI), and men without chest pain.Methods: At the second screening of the Göteborg Primary Prevention Study in 1974‐1977, 6,488 men aged 51 to 59 years at baseline were available for the present analysis. Men who had responded positively to a postal questionnaire about chest pain during exercise or at rest were interviewed by a physician according to a Rose questionnaire at the screening examination. Those with typical or probable AP were further examined by a single experienced physician. The following four groups were formed: Group 1: men who did not complain of chest pain (n = 5,545). Group 2: men who had not consulted any doctor because of chest pain, but who had chest pain according to a questionnaire (n = 441);these men were not considered to have AP according to a three‐step examination by experienced physicians. Group 3: typical AP (n = 232). Group 4: men who had suffered an MI (n = 134).Results:During 16 years of follow‐up, coronary heart disease (CHD) mortality forGroups 1 4 was 8.0,19.5,24.8, and 48.5%, respectively. Mortality from all cardiovascular diseases was 1 1.5,24.5,3 1.2, and 59.0% respectively. Noncardiovasculardisease mortality was 14.1,17.7,14.3, and 8.7%, respectively. Thus, the relative risk (RR) for CHD mortality among men with nonspecific chest pain (Group 2) was 2.77 95% confidence interval (CI) 2.20,3.50, for all cardiovascular disease mortality 2.46 (95% CI 2.00,3.02), and for non‐cardiovascular disease mortality I .60 (95% CI 1.28, 2.00). Total mortality in this group was as high )44%) as among those with typical AP (45%), but the highest mortality was found among men with a previous MI (68%). in men without chest pain it was 26%. Patients of Groups 2 4 had higher levels of cardiovascular risk factors than those in Group 1. Neither any specific questions in the Rose questionnaire, nor electrocardiographic changes at rest (uncommon) were of prognostic significance. Serum cholesterol, systolic blood pressure, diabetes, and smoking were significant predictors of outcome, both with respect to fatal CHD and to total mortality during the 16‐year follow‐up.
Twenty‐four‐hour ambulatory oxygen desaturation and electrocardiographic recording in obstructive sleep apnea syndrome
Authors: Noda Akiko , To Riekol , Ashima Nobuonak, , Yokota Mitsuhiro , Okada Tamotsu , Yasuma Fumihiko 
Published: February 2009

AbstractBackground: Although nocturnal pulseoximetry is routinely performed in obstructive sleep apnea syndrome (OSAS), pulseoximetry over a 24‐h period has not been studied.Hypothesis: The purpose of the study was to determine whether simultaneous 24‐h oxygen desaturation and electrocardiographic (ECG) recording might be used to screen for daytime sleep sequelae in patients with OSAS.Methods: Simultaneous recording of arterial oxygen saturation (SpO2) and ECG was conducted over a 24‐h period in 18 male patients with OSAS (mean age 51.3 years) who were diagnosed by standard polysomnography (PSG), and in 15 agematched healthy subjects (mean age 52.7 years) as controls to evaluate circadian variation of these parameters. The measures of heart rate variability (HRV) were calculated from 24‐h ambulatory ECGs. Seventeen patients with OSAS showed excessive daytime sleepiness (EDS). We calculated the duration in which SpO2 decreased to <90% (duration of SpO2 > 90%). The number of apnea/hypopneas per hour (AHI) during sleep was investigated with Apnomonitors (Chest MI, Co., Tokyo) on the same day as the SpO2 recordings.Results: Controls showed no episodes of oxygen desaturation. in patients with OSAS, driving (33.3% of patients with OSAS) was the most common activity in which SpO2 decreased to <90%, followed by daytime napping (27.8%) and resting after meals (22.2%). The duration of SpO2 < 90% over a 24‐h period correlated significantly with the duration levels recorded during sleep (r = 0.99, p < 0.05) and in the afternoon (r = 0.62, p <0.05), and with the AHI (r = 0.55, p>0.05), but not with the duration of SpO2> 90% in the morning. The number of ventricular premature beats correlated significantly with the duration of SpO2>90% for a 24‐h period, but not with measures of HRV. Ventricular tachycardia was found in two (11.1 %) and ST‐T depression in three patients (16.6%) with underlying cardiac diseases.Conclusion: Our results suggest that daytime sleep attacks accompanied by oxygen desaturation in patients with moderate to severe OSAS may contribute to the occurrence of traffic or cardiovascular accidents. We conclude that 24‐h ambulatory recordings of SpO2 and ECG are useful for screening for daytime sleep sequelae associated with the potential risk of this pathology in OSAS during social activities.
A case of atypical aortic coarctation with refractory congestive heart failure‐treatment with axillo‐iliac artery bypass
Authors: Nakao Kazuhisa , Shibata Junichi , Kikutake Shuuhei , Nagata Tsuyoshi , Uraguchi Kenichirou , Hidaka Yoshio , Imaeumi Tsutomu 
Published: February 2009

AbstractCoarctation of the aorta is rare. We present a case of atypical coarctation due to aortitis syndrome with congestive heart failure refractory to conventional medical treatment. Although indications for surgical treatment are not well established and, in general, treatment of choice is an aorto‐aortic bypass, we selected axillo‐iliac bypass with subcutaneous tunnel because of severe heart failure. Postoperatively, the pressure gradient disappeared and heart failure was improved.
A review of the amyloidoses that infiltrate the heart
Authors: MCCARTHY, III ROBERT E. , Kasper EDWARD K. 
Published: February 2009

AbstractPrimary amyloidosis, systemic senile amyloidosis, isolated atrial amyloidosis, and transthyretin isoleucine 122 amyloidosis frequently involve the heart. Amyloid fibrils infiltrate the myocardium, impairing ventricular contraction and relaxation. The clinical manifestations of cardiac infiltration in these disorders are protean, though congestive heart failure and arrhythmias are most common. Treatment of cardiac amyloidosis is directed at the underlying cause and at relief of symptoms. Heart transplantation is not a viable treatment option for patients with primary amyloidosis; its role in the other amyloidoses has not been established. The prognosis of patients with cardiac amyloidosis varies and is largely determined by the underlying disorder responsible for amyloid infiltration.
Value of t‐wave direction with lead iii st‐segment depression in acute anterior wall myocardial infarction: Electrocardiographic prediction of a “wrapped” left anterior descending artery
Authors: Porter Avital , Sclarovsky Samuel , Ben‐Gal Tuvia , Herz Itzhak , Solodky Alejandro , Sagie Alex 
Published: February 2009

AbstractBackground: Lead III ST‐segment depression during acute anterior wall myocardial infarction (AMI) has been attributed to reciprocal changes. However, the value of the T‐wave direction (positive or negative) in predicting the site of obstruction and type of the left anterior descending (LAD) artery is not clear and has not been studied before.Hypothesis: The aim of the study was to assess retrospectively the correlation between two patterns of lead III ST‐segment depression, and type of LAD artery and its level of obstruction during first AMI.Methods: The study group consisted of 48 consecutive patients, admitted to the coronary care unit for first AMI, who showed ST‐segment elevation in lead aVL and ST‐segment depression in lead III on admission 12‐lead electrocardiogram. The patients were divided by T‐wave direction into Group 1 (n = 31), negative T wave, and Group 2 (n = 17), positive T wave. The coronary angiogram was evaluated for type of LAD (“wrapped”, i.e., surrounding the apex or not), site of obstruction (pre‐ or postdiagonal branch), and other significant coronary artery obstructions.Results: Mean lead III ST‐segment depression was 1.99 ± 1.32 mm in Group 1 and 1.13 ± 0.74 mm in Group 2 (p = 0.004); mean ST‐segment elevation in aVL was 1.35 ± 0.84 mm and 1.23 ± 0.5 mm, respectively (p = 0.5). A wrapped LAD was found in 12 patients (38.7%) in Group 1 and in 13 in Group 2 (76.4%) (p = 0.02). The sensitivity of lead III ST‐segment depression with positive T wave to predict a wrapped LAD was 52%, and the specificity was 82% with a positive predictive value of 76%. On angiography, 25 patients (80%) in Group 1 and 13 (76%) in Group 2 had prediagonal occlusion of the LAD (p = 0.77 ). No significant difference between groups was found for right and circumflex coronary artery involvement or incidence of multivessel disease.Conclusions: The presence of lead III ST‐segment depression with positive T wave associated with ST‐segment elevation in aVL in the early course of AMI can serve as an early electrocardiographic marker of prediagonal occlusion of a “wrapped” LAD.
Electrophysiologic significance of leftward qrs axis deviation in bifascicular and trifascicular blocks
Authors: Ducceschi Valentino , Sarubbi Berardo , D'Andrea Antonello , Liccardo Biagio , Lucca Pasqualina , Mayer Maria Serena , Scialdone Antonino , Santangelo Lucio , Iacono Aldo 
Published: February 2009

AbstractBackground: Intraventricular conduction disturbances determine complete impairment of impulse propagation along the right or left bundle branch or the two left fascicles.Hypothesis: This study was undertaken to investigate the electrophysiologic significance of QRS axis (QRSA) orientation in bifascicular and trifascicular blocks.Methods: A group of 76 subjects, 43 with right bundle‐branch block (RBBB) and left anterior hemiblock (LAH) (Group A), and 33 with left bundle‐branch block (LBBB) (Group B) was submitted to electrophysiologic evaluation.Results: In Group A, QRSA was inversely related only to intraventricular conduction, while in Group B, QRSA inversely related to infrahisal conduction times. A value of <60° was considered the cut‐off point for determin‐ing subjects with a considerable leftward QRSA deviation. Of the 27 Group A patients with a QRSA <‐60°, 38.5% developed an infrahisal second‐degree atrioventricular (AV) block during incremental atrial stimulation (IAS) in comparison with 11.1 % of those with QRSA >‐60°. Of the 9 Group B patients with a QRSA <‐60°, 44.4% exhibited severe impairment of infrahisal conduction at baseline and 66.6% developed an infrahisal second‐degree AV block during IAS, whereas among the remaining 24 with a QRSA >60°, in only 8.3% were both infrahisal (HV1 and HV2) intervals dangerously prolonged, and 23.8% encountered an infrahisal second‐degree AV block during IAS. In Group A, atrioventricular conduction time >200 ms exhibited a better predictive accuracy than QRSA <60° for the development of an infrahisal second‐degree AV block during IAS, whereas the latter appeared the best noninvasive predictor in Group B with a slightly lesser predictive accuracy than HV >80 ms.Conclusion: The degree of leftward QRSA deviation seems to reflect the entity of intraventricular conduction delay in patients with RBBB + LAH, while it appears to be directly related to infrahisal conduction prolongation in those with LBBB.