bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy‐induced increase of supraventricular arrhythmias in wolff‐parkinson‐white syndrome
Authors: Kounis Nicholas G. , Zavras George M. , Papadaki P.J. , Soufras G.D. , Kitrou M.P. , Poulos E.A. 
Published: February 2009

AbstractSix women suffering from Wolff‐Parkinson‐White syndrome and who were previously asymptomatic or nearly asymptomatic, were followed prospectively during and after their subsequent pregnancies. Three women experienced several attacks of supraventricular tachycardia (SVT) for the first time and the rest experienced an increase in their attacks. It seems that there is an increased tendency for SVT in pregnancy. Increased adrenergic sensitivity by estrogens, increased plasma volume, stress, and anxiety during pregnancy may be some of the causative factors.
Are there gender differences in patients with coronary artery disease presenting with spontaneous sustained ventricular tachycardia and ventricular fibrillation?
Authors: Martinez‐Rubio Antoni , Borggrefe Martin , Shenasa Mohammad , Chen Xu , Wichter Thomas , Fetsch Thomas , Reinhardt Lurz , Breithardt Günter 
Published: February 2009

AbstractThe incidence of coronary artery disease (CAD) is greater in men than in women. The aim of the study was to analyze whether any gender‐related differences in patients with CAD and documented spontaneous sustained ventricular tachyarrhythmias exist, and which parameters influence the induction of sustained ventricular tachyarrhythmias. The data of 250 patients [43 women (17.2%) and 207 men (82.8%)] with spontaneous sustained ventricular tachycardia [n = 190 (76%)] and fibrillation [n = 60 (24%)] who underwent coronary and left ventricular angiography, electrophysiological study, and signal‐averaging electrocardiogram (ECG) form the basis of this analysis. No gender‐related differences could be observed in age, number of diseased coronary arteries, history, location and number of myocardial infarctions, presence of left ventricular aneurysm, ejection fraction, type of spontaneous or induced arrhythmias, right ventricular effective refractory period, and signal‐averaged ECG parameters. Age, presence of previous myocardial infarction, and ejection fraction were significant predictors (p<0.001) of inducibility of sustained ventricular tachyarrhythmias. Once CAD has begun, female and male patients present similar clinical and electrophysiologic characteristics. Thus, both genders should benefit similarly from diagnostic and therapeutic approaches if they are referred to the hospital or to invasive interventions at similar intervals in the course of their illness.
Pathology of tricuspid valve stenosis and pure tricuspid regurgitation—Part II
Authors: Waller Bruce E. , Howard Jane , Fess Stephen 
Published: February 2009

AbstractThis three‐part article examines the histologic and morphologic basis for stenotic and purely regurgitant tricuspid valves. In Part I, conditions producing tricuspid valve stenosis were reviewed. In Part II, conditions producing pure tricuspid regurgitation are discussed. In contrast to the relatively few causes of tricuspid stenosis, the causes of pure (no element of stenosis) tricuspid regurgitation are multiple. Some of the conditions producing pure regurgitation include floppy tricuspid valves, infective endocarditis, papillary muscle dysfunction, rheumatic disease, and Ebstein's anomaly.
The influence of angiographically demonstrated coronary collaterals on the results of stress echocardiography
Authors: Stone David A. , Corretti Mary C. , Hawke Mary W. , Herzog William , Rodriguez Samuel , Plotnick Gary D. 
Published: February 2009

AbstractPrevious studies using thallium‐201 scintigraphy have suggested that angiographic coronary collaterals can protect against the development of stress‐induced perfusion abnormalities, but the effect of collaterals on stress echocardiography (SECHO) has not been determined. In this study, 21 consecutive patients referred for cardiac catheterization underwent SECHO and coronary angiography. Of the 21 study patients, there was a total of 16 significantly obstructed coronary arteries (≥ 70% stenosis) in 14 patients. SECHO revealed stress‐induced wall motion abnormalities in the distribution of seven of nine obstructed coronary vessels without angiographic collaterals, but in only one of seven vessels with collaterals (p ≤ 0.05). Six of eight obstructed vessels not associated with a stress‐induced wall motion abnormality had collaterals, whereas only one of eight obstructed vessels associated with a stress‐induced wall motion abnormality had collaterals. We conclude that (1) angiographically demonstrated coronary collaterals can protect against the development of stress‐induced wall motion abnormalities despite the presence of a high‐grade coronary artery obstruction, and (2) the lack of a stress‐induced wall motion abnormality on SECHO in the perfusion territory of an obstructed vessel may suggest the presence of adequate collateral perfusion.
Effect of precordial electrocardiographic electrode placement on st‐segment measurement during exercise
Authors: Bertolet Barry D. , Boyette Alice F. , Mardis Michele , Hill James A. 
Published: February 2009

AbstractResearch protocols often utilize serial exercise testing to examine the efficacy of anti‐ischemic therapies. These tests, however, are prone to multiple sources of bias. This investigation sought to determine the influence of varying precordial electrocardiographic (ECG) electrode placement on the detection of exercise‐induced ST‐segment shifts. Fifteen coronary artery disease patients with abnormal exercise tests were studied. Based on the previous exercise test, the precordial electrode position exhibiting the greatest ST‐segment shift was selected as the reference electrode. Four additional electrodes were placed around this reference electrode and exercise testing was performed. ECG strips were recorded every minute. The time‐to‐onset and ‐offset of ischemic‐type ST‐segment depression was recorded. ST‐segment depression was recorded during exercise from the reference electrode in 12 of 15 patients. Ischemic‐type ST‐depression was also recorded in each of these 12 patients with the surrounding electrodes; however, the time‐to‐onset detected by all four surrounding electrodes concurred in only 5 of 12 (42%) patients. The time‐to‐offset of the ST‐segment depression concurred in 9 of 12 (75%) patients. Serial ECGs recorded from similar but not exactly the same precordial ECG electrode position should yield similar results for the detection of ischemia, but time‐to‐onset or ‐offset of ischemia may differ by 60 s or more. Small changes in the time‐to‐onset and ‐offset of ischemia should not be considered reliable indicators of anti‐ischemia efficacy.
Pulmonary venous flow in constrictive pericarditis
Authors: Shapira Oz M. , Aldea Gabriel S. , Shemin Richard J. , Connelley Gilbert P. 
Published: February 2009

AbstractA 35‐year‐old white female patient presented with radiation‐induced constrictive pericarditis. Intraoperative transesophageal echocardiography revealed a uniphasic diastolic flow pattern. This pulmonary flow pattern reverted to a normal biphasic systolic/diastolic profile immediately following radical pericardiectomy. This abnormal flow pattern was previously described as typical for restrictive cardiomyopathy. However, in this case it is most likely due to a marked decrease in left atrial compliance induced by the thick fibrous scar encasing the atria.
Clinical applications of body surface potential mapping
Authors: Green Larry S. , Abildskov J. A. 
Published: February 2009

AbstractAccumulated evidence suggests that the electrocardiographic information provided by the standard 12‐lead electrocardiogram can be improved by use of multilead electrocardiograms. The clinical utility of body surface potential mapping is related to the selective regional information provided by the increased number of leads. That clinical utility includes such things as improved localization of accessory pathways in preexcitation syndromes, improved localization of pacing sites within the ventricles, localization of late potentials, and improved recognition of acute myocardial ischemia. Recording equipment and interpretation schemes are available to make possible more widespread application of potential mapping.
Cardiac consequences of diabetes mellitus
Authors: Shehadeh Abbas , Regan Timothy J. 
Published: February 2009

AbstractA variety of disciplines including noninvasive and invasive cardiac methodologies, as well as epidemiologic studies, have provided information that has altered our view on the relation of diabetes to cardiac disease. Instead of an exclusive focus on coronary artery disease, it is now recognized that heart muscle can be independently involved in diabetic patients. In diabetics without known cardiac disease, abnormalities of left ventricular mechanical function have been demonstrated in 40 to 50% of subjects, and it is primarily a diastolic phenomenon. Left ventricular hypertrophy may eventually appear in the absence of hypertension. The diastolic dysfunction appears related to interstitial collagen deposition, largely attributable to diminished degradation. The presence of even moderate obesity intensifies the abnormality. Reversibility of this process is not readily achieved with chronic insulin therapy. Experimental studies have indicated normalization of the collagen alteration by endurance training, begun relatively early in the disease process. General measures of management include the control of other cardiac risk factors and a reasonable program of physical activity. The high mortality during an initial acute myocardial infarction has been attributed to heart failure, which is managed as in nondiabetic patients. Recently, the early introduction of aspirin, thrombolysis, and beta‐adrenergic blockade has reduced mortality during the initial infarction. Chronic use of the latter agent over the subsequent years has also proven to be more beneficial in diabetic patients with acute myocardial infarction compared with nondiabetic patients.
Myocardial damage after successful thrombolysis is associated with the duration of ST re‐elevation at reperfusion
Authors: Ochiai Masahiko , Isshiki Takaaki , Hirose Yoshihiro , Toyoizumi Hideki , Oshma Akio , Kondo Kiyoyuki , Sato Tomohide , Miyashita Hideo , Tamura Tsutomu 
Published: February 2009

AbstractThe purpose of this study was to investigate the significance of ST re‐elevation at reperfusion using strict criteria for patient inclusion and exclusion. Twenty‐nine patients who had a first anterior infarction with single‐vessel disease, successful recanalization by intracoronary thrombolysis (ICT) with urokinase, and an angiographically confirmed patent infarct‐related artery after 4 weeks, were divided into three groups according to the deviation of the ST segment at reperfusion: Group A, 10 patients with sustained ST re‐elevation; Group B, 10 patients with transient ST re‐elevation; and Group C, 9 patients with ST reduction. Left ventricular (LV) function was evaluated from cineventriculograms performed in the 30° right anterior projection 4 weeks after ICT. LV ejection fraction and regional wall motion of the infarct area, evaluated by the centerline method (SD/chords), were significantly lower in Group A (44 ± 10%, ‐3.2 ± 0.4) than in Group B (61 ± 9%, ‐1.9 ± 0.7) and Group C (60 ± 5%, ‐2.0 ± 0.4) (p < 0.01). Peak creatine kinase (CK) activity was significantly higher in Group A (5848 ± 2112 IU) than in Group B (2485 ± 1254 IU) and Group C (1889 ± 1525 IU) (p < 0.05). These data suggest that a sustained ST re‐elevation at reperfusion was strongly associated with marked LV dysfunction and higher peak CK activity. It was concluded that sustained, not transient, ST re‐elevation associated with successful reperfusion indicates extensive myocardial damage.
Rapid reversal of digitalis delirium using digoxin immune fab therapy
Authors: Varriale Philip , Mossavi Ahmad 
Published: February 2009

AbstractA fulminant psychiatric disturbance, as the sole noncardiac manifestation of digitalis toxicity, emerged in a 85‐year‐old woman during treatment for congestive heart failure. Described more than a century ago as ‘digitalis delirium,’ the disorder is characterized by severe agitation, delusional thinking, assaultive behavior, and even death. Digoxin immune Fab therapy was begun because of the fulminant psychiatric manifestations of this toxic state and the clear danger of self‐inflicted physical harm. Within 3 h of therapy, a complete and spectacular resolution of all mental symptoms was observed.
Ventricular tachyarrhythmias, myocardial ischemia, and sudden cardiac death in patients with hypertensive heart disease
Authors: Zehender Manfred , Faber Thomas , Koscheck Ursula , Just Hanjörg , Meinertz Thomas 
Published: February 2009

AbstractHypertensive heart disease is increasingly considered to be a strong and independent risk factor for sudden cardiac death. Ventricular tachyarrhythmias in these patients are common and mainly the result of electrophysiologic abnormalities and increased electrical vulnerability of the hypertrophic myocardium. However, proarrhythmia in the hypertrophic heart often is facilitated and aggravated by electrolyte disturbances, the sympathoadrenergic tone, transient blood pressure crisis, and especially by the occurrence of myocardial ischemia. Myocardial ischemia in the setting of hypertensive heart disease may result from stenotic lesions in large and/or small coronary artery vessels and, in the absence of both, will result from the altered cellular oxygen supply and consumption in the hypertrophic myocardium. Recent studies have shown that acute and transient myocardial ischemia are common in many hypertensives, often fail to be symptomatic, and that the dynamic interaction of left ventricular hypertrophy, transient myocardial ischemia, and ventricular tachyarrhythmias may provide a crucial link for the high incidence of sudden cardiac death in patients with hypertensive heart disease.
Evaluation of antihypertensive effects of once‐a‐day isradipine and fosinopril: A double‐blind crossover study by means of ambulatory blood pressure monitoring
Authors: Perticone Francesco , Pugliese Fabiola , Marcantonio Anna Maria , Cloro Cosima , Maio Raffaele , Mattioli Pier Luigi 
Published: February 2009

AbstractWe compared the efficacy and tolerability of is‐radipine (ISR) and fosinopril (FOS) once‐a‐day administration in 17 outpatients, 9 men and 8 women, aged 35–65 years (mean ± SD= 58 ± 10 years), affected by mild to moderate primary systemic hypertension. The patients were given single‐blind placebo for 2 weeks and thereafter, in double‐blind, randomized, crossover sequence, ISR (5 mg) and FOS (20 mg), both for 4 weeks. At the end of each period, patients underwent 24‐h noninvasive blood pressure (BP) monitoring by means of an A&D TM 2420 Monitor Model 7, with readings taken every 10 min during the day (from 7 A.M. to 11 P.M.), and every 20 min during the night (from 11 P.M. to 7 A.M.). Similarly, BP load (BPL) as percentage of systolic and diastolic BP reading > 140 and > 90 mmHg was investigated. Both ISR and FOS induced a highly significant (p<0.0001) decrease in BP from 158/96 ± 7/6 mmHg to 133/86 ± 6/6 and to 132/83 ± 10/7 mmHg, respectively. Mean BP decreased from 117 ± 6 mmHg to 102 ± 6 mmHg (ISR) (p<0.0001) and to 99 ± 8 mmHg (FOS) (p<0.0001). Both ISR and FOS significantly (p<0.0001) reduced systolic BPL from 78 ± 16% to 44 ± 13% and 28 ± 12%, respectively, and diastolic BPL from 70 ± 15% to 40 ± 13% (p<0.0001) and 35 ± 13% (p<0.0001), respectively. A significant difference between the two drugs in systolic (p<0.0002) BPL was observed. No significant differences in heart rate were noted. No unexpected adverse effects were observed in any patient under either therapy. Both ISR and FOS resulted in very effective decrease in BP; however, FOS proved to be significantly more effective than ISR.
Treatment of acute myocardial infarction with streptokinase does not appear to modulate circulating neutrophil function
Authors: Adams Susan A. , Froese Steven P. , Kirsch Ralph E. , Shephard Enid G. , Robson Simon C. , Green Belinda K. W. , Commerford Patrick J. 
Published: February 2009

AbstractThe administration of thrombolytic therapy is the most common method of achieving patency of the occluded coronary artery in patients with acute myocardial infarction (AMI). However, thrombolytic agents and the byproducts of fibrinolysis have the potential to affect neutrophil activation and thus function, thereby augmenting myocardial damage further. This study assessed the effect of streptokinase administration on the function of circulating neutrophils in patients with AMI. For this neutrophil adherence to human umbilical vein endothelial cells, homotypic neutrophil aggregation, and CDII b and L‐selectin expression on the neutrophil membrane prior to and I h and 6 h after thrombolytic therapy was monitored. The study population included patients with AMI who received aspirin and streptokinase, and healthy laboratory workers who received aspirin only; all subjects acted as their own controls. Circulating fibrin degradation products and white cells were markedly raised following administration of streptokinase. No significant differences in neutrophil adherence to endothelium, homotypic neutrophil interactions, and CDI Ib or L‐selectin expression were demonstrated between neutrophils, either pre‐ or post‐thrombolytic therapy in the infarct group, or between neutrophils from the infarct group and from the control group. It was concluded that streptokinase produces an abrupt neutrophil leukocytosis together with a marked increase in circulating levels of fibrin degradation products. The assay systems used were unable to show significant sequential changes in circulating neutrophil adhesion and L‐selectin or CD I l b expression in patients with AM1 following thrombolytic therapy or when these patients were compared with controls.
Captopril in acute myocardial infarction: Beneficial effects on infarct size and arrhythmias
Authors: Bussmann Wulf‐Dirk , Micke Guido , Hildenbrand Ralf , Klepzig Harald 
Published: February 2009

AbstractIt is known from experiments that angiotensin‐converting enzyme inhibitors can limit infarct size. In a prospective, randomized, placebo‐controlled double‐blind study, 22 patients were given 1.5–2.0 mg captopril/h I.V., while 24 patients were given placebo. Medication was started between 2 and 18 h from the onset of infarction. The two groups were matched for age, infarct location, and time of intervention. With the exception of one patient in either group, all were concurrently given nitroglycerin. The necrosis parameters were provided by the quantitative measurement of the QRS complex. The Q wave decreased with captopril treatment (—0.003 mV), but increased with placebo (+0.14 mV, p < 0.05). The number of ventricular premature beats at 24 h from the start of treatment was 25/h with placebo, and 9/h with captopril (p < 0.02). Ventricular fibrillation occurred seven times in the placebo group, but did not occur in the captopril group. The creatine kinase infarct weight was 59 gram‐equivalents (gEq) with placebo, and 45 gEq with captopril (p = NS). Mean arterial pressure was reduced by 12 mmHg with captopril treatment. The results show a beneficial effect of captopril on infarct size and electrical instability, over and above the effect of standard management with nitroglycerin and thrombolysis.
The effects of age and gender on brachial artery endothelium‐dependent vasoactivity are stimulus‐dependent
Authors: Corretti Mary C. , Plotnick Gary D. , Vogel Robert A. 
Published: February 2009

AbstractImpaired endothelium‐dependent vasomotion in response to flow‐mediated, cholinergic, and cold pressor stimulation has been demonstrated in the presence of both atherosclerosis and cardiac risk factors. This study investigated the effects of different vasoactive stimuli on brachial artery vasomotion with respect to age and gender. Forty healthy subjects (20 men and 20 women), ages 23 to 52 years, were studied. Using 7.5 MHz ultrasound, brachial artery diameter and Doppler flow velocity at baseline, following 5 min of ipsilateral blood pressure cuff occlusion (flow‐mediated), during contralateral hand immersion in ice (cold pressor) and after sublingual nitroglycerin administration, were measured in older subjects (> 40 yrs) and younger subjects (< 40 yrs). Among normal subjects, % diameter change in response to the flowmediated stimulus was less in older men than in younger men (6.8 ± 3.2% vs. 11.5 ± 7.4%, p < 0.05); older and younger women had comparable responses (10.0 ± 5.3% vs. 11.6 ± 4.3%, p = NS). With cold pressor, normal older men and older women vasoconstricted (–1.2 ± 0.9%, –2.2 ± 4.7%) compared with younger subjects who vasodilated (1.4 ± 2.5%, 0.6 ± 2.3%, p<0.02). The cold pressor test elicited comparable responses among older normal subjects. Nitroglycerin, a nonendothelium‐mediated stimulus, induced significant vasodilatation in all the groups. In conclusion, endothelium‐mediated responses in subjects of varying age and gender are stimulus‐dependent. Flow‐mediated vasodilatation could not differentiate older premenopausal women from younger women; cold pressor stimulus could.
Intracardiac thrombi: Frequency, location, etiology, and complications: A morphologic review—Part I
Authors: Waller Bruce F. , Grider Larry , Rohr Todd M. , Mclaughlin Todd , Taliercio Charles P. , Fetters Julie 
Published: February 2009

AbstractIntracardiac thrombus is a frequent finding at necropsy. Various cardiac disorders have been associated with its presence. Part I of this 5‐part article focuses on classification by location and etiology and reviews primary cardiomyopathy as a specific condition associated with intracardiac thrombus.
Thymoma with pericardial tamponade
Authors: Woldow Andrew , Kotler Morris , Goldstein Steven , Milcu Maria 
Published: February 2009

AbstractThymomas are tumors of the anterior mediastinum. They are most often seen in adults aged 45 to 50 years. These tumors are routinely asymptomatic for prolonged periods of time. The most common presentation is discovery on routine chest x‐ray. We therefore present a case report of an elderly woman who presented with symptoms of dyspnea caused by a malignant thymoma. To our knowledge, symptomatic pericardial tamponade due to a thymoma with a massive pericardial effusion has not been described previously.