bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional significance of coronary collateral perfusion in preserving myocardial integrity
Authors: Fujita M. , Sasayama S. , Ohno A. , Yamanishi K. , Hirai T. 
Published: February 2009

AbstractCoronary collateral perfusion to the completely obstructed coronary artery was evaluated by coronary cineangiography in 32 patients. In 13 patients, there was neither history of severe chest pain of longer than 30‐min duration nor electrocardiographic evidence of a transmural myocardial infarction (Group I). Among patients undergoing intracoronary thrombolytic therapy for the completely occluded infarct‐related coronary artery within 6 h after the onset of symptoms of the first acute myocardial infarction, 19 patients had a history of preinfarction angina (Group II). Collateral visualization (collateral index) was found to be significantly greater in Group I (2.5 ± 0.5, SD) than in Group II (0.9 ± 1.0) (p<0.01). Group I patients had a longer history of angina (25 ± 25 months) than did Group II patients (17±18 months) (p=NS). These findings indicate that well‐developed coronary collateral vessels preserve myocardial integrity upon acute coronary occlusion and that a long‐standing angina indicative of myocardial ischemia may play an important role in developing collateral channels.
Cardiac catheterization for patients with postinfarction angina
Authors: Tomlinson G. C. , Kern K. B. , Lancaster L. D. , Gay R. G. , Goldman S. 
Published: February 2009

AbstractA retrospective review was conducted to determine the incidence of cardiac catheterization for postinfarction angina, the associated coronary anatomy, and the subsequent clinical course. Over one year, 30 of 178 myocardial infarctions were complicated by postinfarction angina resulting in cardiac catheterization. This was 18% of cardiac catheterizations for evaluation of coronary artery disease. Among the 30 patients, 3 had left main disease, 3 had triple‐vessel disease, 11 had double‐vessel disease, 11 had single‐vessel disease, and 2 had no significant disease. Nine patients had proximal left anterior descending disease without left main disease. In contrast to previous autopsy or surgical series, the extent of coronary artery involvement was less severe and followed a distribution similar to that found in uncomplicated myocardial infarctions. Nevertheless, 17 of the 30 patients underwent revascularization with angioplasty or bypass surgery compared with 41 of 137 without postinfarction angina (p=0.01). Clinical characteristics of the patients with postinfarction angina did not predict who would ultimately require revascularization. Cardiac catheterization is necessary for management of patients with postinfarction angina, because a majority of them will require revascularization.
Termination of refractory ventricular tachycardia by a combination of intravenous sotalol and overdrive ventricular pacing
Authors: Llewellyn M. J. , Ramsdale D. R. 
Published: February 2009

AbstractRight ventricular overdrive pacing is an effective method for termination of ventricular tachycardia. This may be due to alteration in conduction rate, conduction pathways, or refractory periods of myocardial tissue. The procedure can be facilitated by antiarrhythmic drugs which increase tachycardia cycle length. Sotalol possesses beta‐blocking action, has been shown to increase duration of action potentials and refractory periods throughout myocardial tissue and accessory pathways, and can suppress and prevent recurrent malignant ventricular arrhythmias. We describe two cases with ventricular tachycardia which were terminated transiently by cardioversion, but were resistant to various antiarrhythmic drugs. Right ventricular overdrive pacing was used in both cases, but was only effective after the administration of intravenous sotalol. We conclude that the unique properties of sotalol may make it especially effective in this context. Caution is required because of the hypotensive and negative inotropic actions of beta blockers, and possible acceleration of ventricular tachycardia by overdrive pacing.
Hemodynamic effects of transdermal nitroglycerin in subjects with angina and without congestive heart failure: Comparison between never treated and chronically treated subjects
Authors: Mattioli G. , Tondi S. , Magnavacchi P. , Giulio Zennaro R. , Nardini M. 
Published: February 2009

AbstractTwo groups of patients with angina were studied: Group A, 9 patients not treated previously with nitroderivatives; Group B, 8 patients, treated with transdermally administered nitroderivatives for at least 4 weeks. Hemodynamic parameters did not differ significantly in these groups under baseline conditions; only systolic blood pressure was higher in Group B (165±16 mmHg) than in Group A (144±15 mmHg). Hemodynamic modifications produced by administering nitroglycerin transdermally in these patient groups were evaluated 100 min after the transdermal application. In Group A significant reduction of systolic (144±15 to 126±18 mmHg, p<0.01) and diastolic blood pressure (83.36± to 70.1±13 mmHg, p<0.05), mean right atrial pressure (4.8±2.1 to 3±1.7 mmHg, p<0.005), mean pulmonary arterial pressure (18.6±2.6 to 16.7±2.8 mmHg, p<0.01), and significant increase of heart rate (72±10 to 83.5±12.4 beats/min, p<0.005) were noted. In Group B we noted only a significant reduction in systolic (170±25 to 150.5±16 mmHg, p<0.05) and diastolic blood pressure (88.7±15.5 to 77.5±9.2 mmHg, p<0.05) without other modifications. We conclude that prolonged treatment with adequate doses of transdermal nitroglycerin causes the hemodynamic effects of the medication to dissipate from the venous tone and significant arteriodilative effect to persist.
Acute aortic regurgitation due to spontaneous rupture of a bicuspid aortic valve: Detection by echocardiography
Authors: Ciampricotti R. , El Gamal M. , Mashhour Y. A. S. 
Published: February 2009

AbstractA 42‐year‐old man was admitted with acute severe aortic regurgitation. There were no signs of a systemic infection. M‐mode and two‐dimensional echocardiography revealed bicuspid aortic valve and echocardiographic features consistent with aortic leaflet rupture. The diagnosis was confirmed at surgery. This report illustrates that spontaneous rupture of a bicuspid aortic valve should be considered in acute aortic regurgitation without infective endocarditis.
Occurrence of anterior st depression in inferior myocardial infarction and relation to clinical outcome
Authors: Herlitz J. , Hjalmarson Å A. 
Published: February 2009

AbstractIn 229 patients admitted to the coronary care unit (CCU) at Sahlgren's Hospital developing inferior myocardial infarction, and with no previous myocardial infarction, the clinical outcome was related to the presence of ST‐segment depression in 16 anterior chest leads. In all, 64% had anterior ST‐segment depression. These patients differed from those not having ST depression in several aspects. They had larger infarcts, as assessed by serum enzyme activity and ECG recording. They were more prone to congestive heart failure and required more treatment for this complication. Their intensity and duration of pain during the first 4 days appeared to be more substantial. During a 5‐year follow‐up, patients with anterior ST depression tended to have a higher mortality. We conclude that among patients with inferior myocardial infarction and no previous infarction, those with anterior ST‐segment depression form a subgroup with a more severe clinical course.
Atrial extension of mitral annular calcification mimicking intracardiac tumor
Authors: Teja K. , Gibson R. S. , Nolan S. P. 
Published: February 2009

AbstractLiquefaction necrosis of mitral annular calcification occurs in 3% of autopsied cases. The liquified material can spread intramurally in various directions creating suspicious appearing mass lesions on chest x‐ray or echocardiography. An incidential finding of an echogenic left atrial calcified mass in a 57‐year‐old woman was suspected to be an intracardiac tumor for which she underwent exploratory cardiotomy. Instead, culture‐negative liquified pasty material was removed from the posterior left atrial wall adjacent to the calcified mitral annulus. This case illustrates that liquefaction necrosis of mitral annular calcification may spread to contiguous structures and masquerade as an intracardiac tumor. This relatively unknown aspect of mitral annular calcification should be considered in the differential diagnosis of echogenic left atrial mass lesions.
Short‐term reproducibility of dipyridamole‐echocardiography test
Authors: Picano E. , Masini M. , Lattanzi F. , Distante A. , L'Abbate A. , Ciuti M. , Chella P. 
Published: February 2009

AbstractThe aim of this study was to assess the short‐term reproducibility of dipyridamole‐echocardiography test (DET) consisting of two‐dimensional echo monitoring during dipyridamole infusion (up to 0.84 mg/kg in 10 min). The diagnostic end‐point of the test is the detection of new onset or worsening regional asynergy. A group of 87 patients with rest and/or effort angina performed two DETs on two consecutive days. All 60 patients with a positive DET had a positive repeat test, and the 27 negative DETs were also negative on the following day. The timing of the asynergy was also very similar between the two tests, both in patients with angina on effort (r=.93, p<0.01) and at rest (r=.92, p<0.01). In conclusion, DET has a very high short‐term reproducibility regarding the presence and timing of asynergy.
The Role of active myocarditis in the development of heart failure in chronic chagas' disease: A study based on endomyocardial biopsies
Authors: De Higuchi M. Lourdes , Floriano Morais C. De , Pereira Barreto A. C. , Lopes E. A. , Stolf N. , Bellotti G. , Pileggi F. 
Published: February 2009

AbstractThe authors analyze the presence of active myocarditis in endomyocardial biopsies from 38 patients with chronic Chagas' disease diagnosed serologically. The patients were divided into three clinical groups of increasing severity. Group I: 13 patients with normal electrocardiograms, normal chest x‐rays, and no symptoms; Group II: 13 patients with abnormal electrocardiograms and no cardiomegaly; and Group III: 12 patients with abnormal electrocardiograms, cardiomegaly and heart failure. In order to diagnose myocarditis activity, two sets of criteria were used: one mainly observing histopathologic aspects of inflammatory cells aggressing cardiac fibers; and the other counting the mean number of lymphocytes per high power microscopic field. The results of both methods showed a higher incidence of active myocarditis in the clinical group with heart failure. The present report clearly shows the important role played by activity of myocarditis in the development of heart failure in chronic Chagas' disease. Therefore, the possibility of using drugs to control early stages of the activity of the inflammatory process is suggested. On the other hand, endomyocardial biopsy (EMB) seems to be an adequate method to evaluate the intensity of the cardiac inflammatory process in Chagas' heart disease.
Coronary arteritis in nonspecific aortoarteritis
Authors: Bahl V. K. , Dev V. , Narula J. , Mukhopadhyaya S. , Bhatia M. L. 
Published: February 2009

AbstractNonostial distal coronary artery involvement in nonspecific aortoarteritis is rare. We report a 35‐year‐old patient with features of nonspecific aortoarteritis who had an inferolateral myocardial infarction and on coronary angiography was shown to have severe disease of the left circumflex artery in its middle third.
Devices external pulse generator: A reliable temporary pacemaker?
Authors: Inoue D. , Katsume H. , Ilichi H. , Ochiai M. 
Published: February 2009

AbstractTwo cases of malfunctioning APC (American Pacemaker Company) Devices pacemakers are reported. Two patients with sick sinus syndrome were temporarily paced using APC Devices pacemaker models EC 4542 and EV 4543 respectively, which showed transient increase (53% and 83% of the preset rate, respectively) in pacing rate. The sudden increase of the pacing rate might be the pacemaker's design to switch to fixed‐rate pacing at nominally 25% higher than the selected rate in the presence of an excessive level of electrical interference. However, the increased rate was much faster than the interference rate. Great caution should be paid when APC Devices pacemaker is to be used.
Sinus arrest associated with clonidine therapy
Authors: Schwartz E. , Friedman E. , Mouallem M. , Farfel Z. 
Published: February 2009

AbstractA 65‐year‐old male with diabetes, hypertension, and mild renal failure developed dizziness and syncope one week after starting clonidine 0.45 mg/day. A continuous ECG recording revealed sinus bradycardia, nodal rhythm, and multiple episodes of sinus arrest lasting up to 4.5 seconds. Upon discontinuation of clonidine, serial continuous ECG recordings revealed gradual decrease in the number and duration of the sinus arrest episodes, until their complete disappearance shortly after the third day off clonidine. This report shows that clonidine may cause a concentration‐dependent sinus node dysfunction in addition to the atrioventricular (AV) node abnormalities previously ascribed to it.
Morbidity during five years after myocardial infarction and its relation to infarct size
Authors: Herlitz J. , Bengtson A. , HJALMARSON Å. , Karlson B. W. 
Published: February 2009

AbstractIn 809 patients with a recent myocardial infarction, morbidity during 5‐year follow‐up was assessed. The overall 5‐year mortality rate was 33% (39% in patients with larger infarcts and 26% in patients with smaller infarcts) as judged from maximum serum enzyme activity (p<.001). In terms of morbidity, no significant association with estimated infarct size was observed. Patients with smaller infarcts tended to have a higher reinfarction rate and were rehospitalized more often, whereas a similar proportion of patients with large and small infarcts developed stroke. Among survivors, chest pain tended to be more common in patients having smaller infarcts, whereas symptoms of dyspnea and claudicatio intermittens were similar in both groups, as were smoking habits, work capability, and varying forms of medication. We thus conclude that during a 5‐year follow‐up after acute myocardial infarction, mortality, but not morbidity, was related to the original infarct size.
The echo doppler spectrum of valvular abnormalities in the hospitalized octogenarian
Authors: Zavitsanos J. P. , Goldman A. P. , Kotler M. N. , Maze S. S. , Kochar G. , Parry W. 
Published: February 2009

AbstractCardiac valves thicken and become more opaque with advancing age. As more individuals live longer and as more treatment modalities such as valvuloplasty evolve, the presence and significance of these valvular abnormalities become important. We retrospectively studied 628 octogenarian patients to try and define further the presence and significance of these abnormalities detected by Doppler echocardiography. A group of 547 patients were suitable for analysis. Age ranged from 80 to 96 years (mean 84.4). The female:male ratio was 1.9:1. Mitral, aortic, and tricuspid regurgitation (MR, AR, and TR) were significant if the jet moved > 2 cm from the plane of the valve away or toward the transducer, depending on transducer position. Mitral regurgitation was detected in 331 patients (60.5%) and was significant in 82 patients (15%). Aortic regurgitation was detected in 276 patients (50.5%) and was significant in 70 patients (12.8%). Tricuspid regurgitation was detected in 131 patients (23.9%) and was significant in 30 patients (5.5%). Regurgitant lesions were detected in two valves in 150 patients (27.4%) three valves in 57 patients (10.4%), in all four valves in 17 patients (3.1%). Aortic stenosis was detected in 160 patients (29.3%). The gradient range was 16‐156 mmHg (mean 47.8). Significant aortic stenosis was present in 70 patients (12.8%) (gradient >50 mmHg), of whom 54 had isolated pure aortic stenosis and 16 had mixed lesion. In 40% of these patients, significant aortic stenosis was an unexpected finding at two‐dimensional echocardiography. Valvular pathology is common in the octogenarian population. It is uncertain to what extent this represents physical adaptation to aging or true pathology, but these findings may have important implications with regard to bacterial endocarditis prophylaxis and potential valvuloplasty in the aged population.
Mechanism of prolongation of pre‐ejection period in the hypertrophied left ventricle with normal systolic function in unanesthetized hypertensive dogs
Authors: Matsuno Y. , Morioka S. , Murakami Y. , Kobayashi S. , Moriyama K. 
Published: February 2009

AbstractTo determine the mechanism for prolongation of pre‐ejection period (PEP) in the hypertensive heart with normal systolic function, cardiac catheterizations, echocardiograms, and electrocardiograms were performed at the baseline period (CS, control stage) and eight weeks (HS, hypertensive stage) after the induction of systemic hypertension by Page's method in unanesthetized dogs. Mean aortic blood pressure increased significantly (96 ± 12 to 137±26 mmHg) (p<0.05). Diastolic aortic pressure also increased significantly (80±12 to 118±24 mmHg) (p<0.01). Left ventricular (LV) PEP of HS was significantly prolonged (72±12 vs. 87±22 ms, CS vs. HS). The ratio of LV pre‐ejection period to ejection time (PEP/ET) also increased significantly (0.33 ±0.04 to 0.42 ±0.07) (p<0.05). LV end‐diastolic wall stress as an index of preload decreased significantly (7.7 ±2.5 vs. 5.9± 1.8 103 dynes/cm2, CS vs. HS). Heart rate, mean velocity of circumferential fiber shortening (VCF) and end‐systolic wall stress of HS did not change. That is, myocardial contractility in the hypertensive heart of HS most likely is not depressed. At autopsy, left ventricle to body weight ratio of HS was significantly (p<0.01) greater than the sham‐operated dogs (5.7±0.8vs. 4.3±0.5 g/kg). From these findings, there are two possible factors responsible for prolongation of PEP of HS. First, elevated diastolic aortic pressure may influence PEP. Second, the prolonged PEP is possibly caused by the decrease of preload. Boudoulas et al. reported that the abnormalities in systolic time intervals (STI) were equivalent in patient subgroups with high and low diastolic arterial pressure within hypertensive groups. Therefore, we conclude that the main factor to prolong PEP in the hypertensive heart with normal systolic function is possibly the decrease of preload rather than the depressed myocardial contractility or elevated diastolic aortic pressure.
Differences in composition of sweat induced by thermal exposure and by running exercise
Authors: Fukumoto T. , Tanaka T. , Fujioka H. , Yoshihara S. , Ochi T. , Kuroiwa A. 
Published: February 2009

AbstractTo determine the differences in sweat composition between sweat induced by thermal stress alone and that induced by physical exercise, seven young healthy men first sat in a hot room and then performed running exercise. A 20‐minute stay in a climate chamber at 40°C resulted in a 5% reduction in body weight. The same body weight loss was induced by running exercise. Both sodium and chloride concentrations were much lower in the sweat induced by thermal exposure than that induced by the running exercise (p<0.01), while urea nitrogen and creatinine concentrations were significantly higher after thermal exposure than after the running exercise (p<0.01). Potassium concentrations did not differ significantly with either procedure. These findings suggest that sweat composition varies with the kind of induction and that more salt seems to be lost through exercise‐induced sweating than by just sitting in a hot environment.
Biphasic response of coronary arterial diameter to intracoronary ergonovine
Authors: Mohri M. , Okamatsu S. , Nakamura M. 
Published: February 2009

AbstractThis report presents a case of paradoxical coronary arterial dilation induced by intracoronary ergonovine. When compared with the control angiogram, the right coronary artery obviously dilated with selective, intracoronary administration of cumulative doses of 5 μg and 15 μg ergonovine without concomitant hemodynamic changes. Additional intracoronary infusion of 35 μg ergonovine into the right coronary artery inversely increased vascular tone of the vessel associated with a focal hyper‐constriction. Such a biphasic response of arterial diameter to intracoronary ergonovine was also observed in the left coronary artery, but the degree of dilation was much smaller.
Quinine overdose: Review of toxicity and treatment
Authors: Goldenberg A. M. , Wexler L. F. 
Published: February 2009

AbstractQuinine sulfate is a commonly prescribed remedy for idiopathic nocturnal leg cramps and is now available “over the counter.” A 24‐year‐old man ingested 8 g (a commonly dispensed quantity) of quinine sulfate in a suicide attempt. Despite hemoperfusion begun 10 h after ingestion, the patient died. This report reviews the toxic manifestations of quinine and the currently available modes of treatment.
Changes in the levels of plasma atrial natriuretic peptide, hemodynamic measurements, and the levels of vasoactive hormones during the clinical course of congestive heart failure
Authors: Hara H. , Ogihara T. , Nakamaru M. , Rakugi H. , Tateyama H. 
Published: February 2009

AbstractTo investigate the mechanism for the release of human atrial natriuretic peptide (hANP) and the pathophysiological role of hANP in patients with congestive heart failure (CHF), plasma hANP levels in patients with dilated cardiomyopathy (DCM) or acute myocardial infarction (AMI) were determined serially, and the relationship between plasma ANP levels and hemodynamic measurements or various vasoactive hormones was analyzed during the clinical course of congestive heart failure. In 63 patients with either AMI or DCM, plasma hANP, plasma renin activity, aldosterone concentration, and catecholamines were measured over 4 weeks, during the course of CHF. Cardiac catheterization with a Swan‐Ganz catheter was also performed. Plasma hANP in patients with DCM was elevated continuously during the clinical course. Plasma hANP levels in patients with AMI of Groups II and IV of Forrester's class decreased on days 7 and 14 and those in patients with AMI of Group I changed within normal limits. Plasma hANP levels were correlated positively with pulmonary artery pressure and pulmonary capillary wedge pressure in patients with AMI or DCM. Plasma renin activity, noradrenaline, and adrenaline levels were elevated in the acute phase of myocardial infarction and had a tendency to decrease upon improvement in clinical status. Plasma renin activity and noradrenaline level correlated positively with plasma hANP levels. These data indicate that plasma hANP levels are regulated by atrial distension and severity of cardiac impairment, and that plasma hANP and plasma renin activity or catecholamines correlated closely during the clinical course of CHF, indicating that these hormones may be involved in the volume and electrolytes status in CHF.