bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of intravenous streptokinase on infarct size and left ventricular function in acute myocardial infarction, prospective and randomized study
Authors: Durand P. , Asseman P. , Pruvost P. , Bertrand M. E. , Lablanche J.‐M. , Thery C. 
Published: February 2009

AbstractWithin 3 h after the onset of symptoms of myocardial infarction, 64 patients were randomly assigned to receive either a 1‐h intravenous infusion of 1,500,000 IU of streptokinase (SK) or a conventional therapy. Infarct size was estimated in CK gram equivalent (CKg) by measurement of CK‐MB every 3 hours during a 48‐h period. Enzymatic study revealed that myocardial infarction of the SK group was significantly smaller (61.4±45 vs. 89.4±56 CKg, p< .05). Angiograms were performed at early stage and five weeks after myocardial infarction. At first coronary angiogram, the infarct‐related vessel was open in 82% in the SK group versus 12% in controls. The SK group had higher global ejection fraction at second angiogram (57±11% vs. 49±11%, p<.02), but differences in regional wall motion were not significant. By analysis according to patency or occlusion of infarctrelated vessel, global and regional ejection fractions were significantly better at first and at second angiograms in all patients and in anterior infarctions with a patent infarctrelated coronary artery. There was no significant difference for inferior infarction. We conclude that intravenous streptokinase infusion early after the onset of myocardial infarction reduces infarct size and improves left ventricular function, chiefly in anterior infarction. This benefit appears to be closely correlated to patency of infarct‐related vessels.
Catheter ablation: Relationship of defibrillator waveform to the production of postshock ventricular tachyarrhythmias and myocardial damage
Authors: Chapman P. D. , Wetherbee J. N. , Troup P. J. , Klopfenstein H. S. 
Published: February 2009

AbstractThe myocardial damage and arrhythmogenicity of percutaneous transcatheter shocks utilizing two different defibrillator waveforms (truncated exponential and damped sinusoidal) were compared. Ten dogs (33.7±3.6 kg) were studied. Five received left ventricular damped sinusoidal R‐synchronous shocks during sinus rhythm and the other five received truncated exponential waveform shocks. Each dog received four energies (60, 120, 180, and 240 joules) randomly assigned to four left ventricular sites. The immediate postshock rhythms were recorded. Ventricular tachycardia occurred after 90% of the damped sinusoidal shocks compared to only 25 % of the truncated exponential shocks (p<0.005). The animals were sacrificed 14 days later. Infarct size as determined by planimetry was not significantly different for the two waveforms. Thus intracavitary shocks utilizing a truncated exponential waveform are less arrhythmogenic than damped sinusoidal waveform shocks but produce similar morphologic changes and therefore may offer a significant safety advantage for catheter ablation procedures.
Intermittent mitral regurgitation: An indicator of severe beall valve dysfunction
Authors: Coralli R. J. , Dorney E. R. , Walter P. F. 
Published: February 2009

AbstractThe Teflon disc of Beall valves is subject to extraordinary wear and tear. Clinical evidence of valvular dysfunction is critical in following patients who have implanted Beall valves. We describe 4 patients with the interesting auscultatory finding of intermittent mitral regurgitation. Each of these patients demonstrated severe wear of the Teflon disc with abnormal intermittent disc tilting noted at cardiac catheterization. Intermittent mitral regurgitation in patients with Beall valves in the mitral position heralds severe valvular dysfunction and should prompt urgent cardiac catheterization and valve replacement.
Shigella sonnei myocarditis
Authors: Caraco Y. , Raveh D. , Raz I. 
Published: February 2009

AbstractA 19‐year‐old male was admitted to our department because of high fever, abdominal pain, and diarrhea. Electrocardiogram (ECG) on admission revealed diffuse ST‐T changes which persisted for 5 days. Stool culture grew Shigella sonnei. We conclude that the infection with Shigella sonnei was the cause for these findings which were most probably due to myocarditis. To the best of our knowledge myocarditis as a complication of shigella infestation has never been reported.
Supernumerary right coronary artery
Authors: Gupta S. K. , Abraham A. K. , Reddy N. K. , Moorthy S. J. 
Published: February 2009

AbstractA rare case of a patient with supernumerary right coronary artery in whom the two vessels arose from the right coronary sinus from two separate ostia adjacent to each other is presented. The smaller vessel gave off the sinoatrial nodal branch and the posterior descending artery whereas the larger one gave off the conus branch, the right ventricular branches, and continued as acute marginal branch. This is the first case report in the English literature.
Plasma Atrial Natriuretic Peptide Level As an Index for the Severity of Congestive Heart Failure
Authors: Hara H. , Ogihara T. , Shima J. , Saito H. , Rakugi H. , Iinuma K. , Kumahara Y. , Minamino T. 
Published: February 2009

AbstractHuman atrial natriuretic peptide (hANP) is a vasodepressor and a natriuretic hormone. The levels of plasma hANP increase during extracellular volume expansion. In the present study, we investigated whether plasma levels of hANP were associated with the severity of congestive heart failure (CHF), and whether such an association could be used as a diagnostic aid. Plasma hANP levels in 102 patients with various heart diseases and correlation between the plasma hANP levels and the left ventricular ejection fraction (EF) determined from echocardiography in 43 patients were examined. The plasma levels of hANP were high during the state of extracellular fluid overloading and atrial distention as determined by high right atrial pressure and pulmonary capillary wedge pressure. The high plasma hANP levels decreased in CHF patients whose clinical state improved, but remained high in those patients who were refractory to treatment. Plasma hANP levels correlated inversely with left ventricular EF (r=‐0.41, p<0.01). In 9 patients re‐examined during the course of treatment the plasma hANP levels decreased with an increase in EF. These data indicate that the level of plasma hANP is a practical diagnostic indicator of the severity of CHF, and can also be used as a means for assessing the efficacy of the treatment.
Correlation of the Size of Isolated Right Ventricular Infarction with the Changes of ST Segment in Dogs
Authors: Aramaki Y. , Kuroiwa A. , Nakamura T. , Ninomiya K. , Fukuchi Y. , Fukumoto T. , Nakashima Y. 
Published: February 2009

AbstractVectorcardiographic, electrocardiographic, and hemodynamic changes in isolated infarction (infarct confined to the right ventricular free wall) were studied in 19 mongrel dogs. An isolated right ventricular infarction was produced by embolizing the right coronary artery with Spongel under closed chest conditions. The size of the infarct, identified by TTC staining, accounted for 6–65% (35.9±22.0%, mean ± SD) of the right ventricular free wall. The STx, STy, STz, and the spatial magnitude of the ST segment (STM) were continuously recorded with an automated, real‐time vectorcardiographic ST‐segment analyzer (ST‐monitor) using the Frank lead system. The cardiac index (CI) ratio (CI after embolization/CI before embolization) of all dogs with larger infarcts (infarct > 35% of the right ventricle) was below 1.0. In dogs with smaller infarcts (% RVI±35%), there were no differences in the hemodynamic data before and 4 h after embolization. In dogs with larger infarcts, however, pulmonary arterial pressure and heart rate 4 h after embolization were significantly decreased compared with those before embolization. In addition, right atrial pressure 4 h after embolization in the larger infarct group was significantly elevated compared with that in the smaller infarct group. In dogs with larger infarcts, STx, STy, and STM were significantly larger than in those with smaller infarcts both 15 min and 4 h after embolization. There were no significant correlations between infarct size and change in vectorcardiographic ST segments in the smaller infarct group. There was, however, a significant correlation between the size of the infarct (percent of right ventricle infarcted, % RVI) and the vectorcardiographic ST‐segment changes in the larger infarct group and in all dogs. These results suggest that an infarct size larger than 35% or the right ventricular free wall can induce detrimental hemodynamic changes and that the RV infarct size can be determined by vectorcardiographic ST deviation with a real‐time ST monitor using the Frank lead system.
Dose of urokinase for intracoronary thrombolysis in patients with acute myocardial infarction
Authors: Ohyagi A. , Hirose K. , Watanabe Y. , Nakai T. , Tsujimoto S. , Doyama K. , Suzuki Y. , Okazaki S. , Hirai M. 
Published: February 2009

AbstractIntracoronary thrombolysis is a logical therapeutic method and one of the challenging new treatments of acute myocardial infarction. However, a wide dose range of urokinase has been reported, and the optimal dose has not yet been established. In this study the fibrinolytic activity in patients with recanalized coronary arteries was compared with that in those with nonrecanalized arteries. The mean doses of urokinase in the recanalized and nonrecanalized groups were 910,700±161,730 international units (IU) and 1,008,000±151,800 IU, respectively. The fibrinolytic activity was measured with α2‐plasmin inhibitor, α2‐macroglobulin, fibrinogen, plasminogen, and fibrin degradation products. No significant difference was observed in the fibrinolytic activity between the recanalized and nonrecanalized groups. Because the fibrinolytic activity in the two groups was thought to be activated sufficiently and to a similar degree, it appears that 1,000,000 IU of urokinase is adequate for intracoronary thrombolysis and larger doses cannot be expected to result in a higher rate of recanalization.
Prediction of atrial and ventricular fibrillation complicating myocardial infarction from admission data: A Prospective Study
Authors: Flugelman M. Y. , Flugelman A. A. , Rozenman J. , Ben‐David J. , Shefer A. , Koren G. , Gotsman M. S. 
Published: February 2009

AbstractThis study set out to examine prospectively two logistic formulae based on admission clinical data to predict ventricular or atrial fibrillation complicating acute myocardial infarction. A prospective study of 87 consecutive patients with acute transmural myocardial infarction was conducted. The formula for predicting ventricular fibrillation from the diastolic blood pressure, degree of ST‐segment elevation, and QTc had a sensitivity of 93%, specificity of 83 %, and a predictive value for an abnormal test of 62% (13 of 14 patients who developed ventricular fibrillation were identified). The formula for predicting atrial fibrillation from the age of the patient, a history of heart failure, systolic blood pressure, and four electrocardiographic parameters had a sensitivity of 78%, specificity of 85%, and a predictive value of 67% (14 of 18 patients identified). Our study shows that patients with myocardial infarction who are liable to develop ventricular or atrial fibrillation can be identified on admission from simple clinical data.
Influence of left ventricular cavity dimension on electrocardiographic estimation of the extent of wall motion abnormalities
Authors: Giannuzzi P. , De Vito F. , Imparato A. , Tavazzi L. 
Published: February 2009

AbstractTo estimate the influence of left ventricular cavity dimension on the electrocardiographic estimation of the extent of wall motion abnormalities, two‐dimensional echocardiograms and standard 12‐lead electrocardiograms (ECG) were carried out on 221 patients within 3 months after acute myocardial infarction (MI). Among the patients with anterior MI (96 patients; 43.4%) both the extent of asynergy (% of asynergic segments, an echo index taking into account the type of asynergy) and the electrocardiographic signs of necrosis (number of Q waves ≥40 ms, Wagner's score) were significantly greater (p < 0.001) in those with left ventricular dilatation (60 patients) than in those with normal ventricular size (36 patients); within the latter group, the ECG‐asynergy correlations were good (r value 0.67–0.79). In patients with left ventricular dilatation no correlation was found. In inferior MI (108 patients, 48.9%), asynergy was more extensive in patients with left ventricular dilatation (p<0.001) than in those with normal left ventricle. However, the electrocardiographic extent of necrosis was similar in the two groups and no significant ECG‐asynergy correlation was found. Likewise, in anteroinferior MI (17 patients; 7.7%), the ECG‐asynergy correlations were statistically insignificant in both groups. In conclusion, the electrocardiographic patterns of necrosis are poorly related to the extent of asynergy and are greatly influenced by left ventricular dimensions.
Diverging effects of postextrasystolic potentiation on left ventricular segmental wall motion in coronary heart disease
Authors: Di Donato M. , Barletta G. A. , Maioli M. , Fantini F. 
Published: February 2009

AbstractThe effects of postextrasystolic potentiation (PESP) on regional left ventricular (LV) wall motion were evaluated in 40 coronary artery disease (CAD) patients. Of the 40 CAD patients, 20 had a prior myocardial infarction and 20 had a history of angina pectoris. PESP was obtained by applying programmed atrial stimulation during LV angiography, in a way that basal cycle length, premature beat, and postextrasystolic pause were almost identical in all patients. Segmental wall motion was evaluated by calculating regional ejection fraction (EF) of 5 different areas with a computerized method before and after the premature beat. The results were compared to those obtained in a group of 8 normal subjects. LV areas were classified as normokinetic, mildly hypokinetic, severely hypokinetic, and hyperkinetic, on the basis of their regional EF in respect to normals, and classified as “responder” (R) and “nonresponder” on the basis of the magnitude of the increase of regional EF with PESP. Of a total of 200 areas 129 were normokinetic (68% R), 45 were mildly hypokinetic (78% R), 17 severely hypokinetic (76% R), and 9 were hyperkinetic (78% R). Infarcted patients had a higher percentage of hypokinetic areas in basal conditions (p<0.001), however, the percentage of hypokinetic areas that responded to PESP was not significantly different from noninfarcted patients. In CAD patients, as a whole, a significant direct correlation was found between basal regional EF and regional EF after PESP (r=0.88, p<0.01). In conclusion, the results indicate: (1) normokinetic LV areas do not always respond to PESP; (2) while infarcted patients have a higher proportion of myocardial segments that are hypokinetic, the number of these areas that respond to PESP does not differ between infarcted and noninfarcted patients; (3) in CAD patients there is a direct relationship between the degree of basal regional function and the magnitude of the response to PESP.
Treatment of acute myocardial infarction with subcutaneous heparin at low doses
Authors: Ruggiero H. A. , Caprissi L. F. , Neuman J. , De Caprissi E. S. 
Published: February 2009

AbstractHeparin has been used intensively in the treatment of acute myocardial infarction and preinfarction angina (PA) at full doses as a single drug by us. However, heparin may be used at smaller doses for similar purposes. These doses are not exactly anticoagulant, even though they reduce blood hypercoagulability, and act mainly in an antithrombotic capacity. We studied 529 patients with acute myocardial infarction, of whom 262 were treated with subcutaneous heparin at low doses (5000 IU every 12 h) and 267 received conventional therapy without antithrombotic drugs. Heparin used was Heparina (Abbott) and Liquemine (Roche), in vials with the equivalence 1 cm3=50 mg=5000 IU. Blood rheologic factors (thrombo‐elastography, platelet adhesiveness, total blood viscosity, and number of platelets) were determined in all patients, those treated with heparin at low doses and also the control group, before and after the 30‐day treatment period. Diagnosis was based on clinical symptoms, laboratory studies, and electrocardiogram examination. In both the 262 patients treated with heparin at low doses and in the control group of 267 patients, baseline values of rheological factors were high. After 30 days (i.e., after study completion) these high values which are statistically significant compared with normal values, with p<0.0001 for both groups, remained constant in the control group who did not receive heparin. On the contrary, in the group treated with heparin at low doses, all these factors changed. Heparin provides protection against thrombosis by increasing the negative charge of the vessel wall and by other reactions at the endothelial surface. Heparin requires a plasmatic component called antithrombine III. Another important action of heparin is its activity as anti‐Xa which is said to be reason for its antithrombotic effect. When low molecular weight heparin is administered subcutaneously, higher anti‐Xa levels are obtained in blood as compared with those obtained with heparin of high molecular weights. Heparin obtained from intestinal mucosa has a great capacity to potentiate anti‐Xa, which does not occur with heparin of pulmonary origin. Heparin at low doses prevents thrombosis by inhibiting the coagulation cascade, acting selectively on the Xa which join the intrinsic and extrinsic systems. Heparin neutralizes activation of complement in several stages. Treatment of actue myocardial infarction with heparin during 30 days with full anticoagulant doses provides a mortality rate of 6.1%. These high doses were considered to be the reason for bleedings, even though heparin does not produce bleeding when administered correctly, as was the case in our study. With the low heparin doses used in this study subcutaneously during 30 days, there were no cases of bleedings.
Hemodynamic effects of oral isosorbide‐5‐mononitrate and dinitrate in ischemic heart failure
Authors: Rabinowitz B. , Hod H. , Chouraqui P. , Rath S. , Agranat O. , Neufeld H. N. 
Published: February 2009

AbstractIsosorbide‐5‐mononitrate (ISMN), the main metabolite of isosorbide dinitrate (ISDN) was recently introduced in clinical use. The hemodynamic effects of oral ISMN and ISDN, administered in equal doses, were studied in a randomized, crossover fashion in 20 patients with pump failure of ischemic etiology. Baseline hemodynamic criteria for admission into the study were: pulmonary capillary wedge pressure (PCW) of at least 20 mmHg and systolic arterial pressure (AP) above 90 mmHg. Hemodynamic parameters were serially measured and systemic vascular resistance was calculated up to 6 h postadministration of either ISMN or ISDN single dose (40 mg). Maximal effects obtained were statistically significantly different from baseline. While ISMN and ISDN appeared to be equipotent in reducing the filling pressure, with a maximum effect reached in 60–120 min, the mononitrate maintained its effects for a longer period.
Superior vena caval obstruction by lipomatous hypertrophy of the right atrium
Authors: Mcnamara R. F. , Taylor A. E. , Panner B. J. 
Published: February 2009

AbstractA structural abnormality was suspected when passage of a Swan‐Ganz catheter was obstructed at the distal superior vena cava (SVC). At autopsy, lipomatous hypertrophy of the right atrium markedly narrowed the lumen at the SVC‐right atrial junction.
Pressor effects from daily events and laboratory complex stimuli relating personality factors
Authors: Germanó G. , Ferrucci A. , Strano S. , Molle G. , Napoleoni M. G. , Pecchioli V. , Germanó U. , Pistone A. 
Published: February 2009

AbstractOur preliminary research has attempted to establish a series of methods to study the complex interactions occurring between pressor reactivity and personality profile. Ten untreated mild hypertensives (age 42.9±8) without damaged target organs were recruited from an outpatient hypertension center along with an equal number of normotensive volunteers (age 38.2±8.1). We performed a sequence of stressor types under laboratory conditions (sensory perceptual activities, psychomotor responses, and cognitive behavior) following an order ranging from inferior levels to superior levels of systemic integration. The subjects also underwent a 24‐h automatic noninvasive blood pressure recording which took into account the situational reactivity. They filled in MMPI and STAI questionnaires before and after the stressor batteries. Only the sensory‐perceptual test (Stroop color test modified), the arithmetic test, and the psychomotor test provoked a significant increase in blood pressure and, in the latter test, also a significant increase of the heart rate. The test batteries' mean differences were not significant between the two groups. Similarly, the answers to the trait‐anxiety questionnaires did not allow us to make a substantial division between normotensive and hypertensive subjects. On the contrary, the situational anxiety questionnaires showed a significant difference in the score reading preceding and following a task performed by the hypertensive subjects. We observed significant differences for both systolic and diastolic 24‐h blood pressure data in transition from a working situation to the sleeping period. However, there was not a significant difference in hypertensive blood pressure readings recorded during work and at home. The personality structures did not present remarkable differences between the two groups. With reference to the single personality dimensions, we found a number of higher scores expressing difficulty in adapting to social situations, a low capacity for self‐assertion, and a great sense of insecurity.
Dopamine‐induced increase in atrioventricular conduction in atrial fibrillation‐flutter
Authors: Gelfman D. M. , Ornato J. P. , Gonzalez E. R. 
Published: February 2009

AbstractWe report a patient with controlled atrial fibrillation‐flutter (AFF) and mitral stenosis who developed a marked increase in atrioventricular conduction during an infusion of low dose dopamine with development of hemodynamic compromise. This side effect has not been previously described in humans. Dopamine infusion should be used with caution in patients with AFF.