bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two‐year follow‐up after laser thermal balloon angioplasty (LTBA) in lower extremities: Initial experience
Authors: Masotti M. , Riambau V. , Crexells C. , Oriol A. 
Published: February 2009

AbstractWe describe the results obtained with the use of laser thermal balloon angioplasty (LTBA) in the treatment of atherosclerosis obliterans of the lower limbs in 37 patients (34 males, 3 females, mean age 58 ±9 years) with occlusive arterial disease (Fontaine stages II‐IV) presenting 39 significant lesions. Immediate results and two years of clinical follow‐up are analyzed. Initial ankle/brachial Doppler index was 0.51 ±0.17. Eighteen lesions were located in the iliac area (13 stenoses 2.3 ± 1 cm and 5 occlusions 4.2 ±3 cm) and 21 lesions in the femoropopliteal area (5 stenoses 2.6±2 cm and 16 occlusions 5.7±3 cm). A percutaneous procedure was used in 38 cases. In only one case was femoral dissection needed. The laser source was argon in 26 cases and Nd‐YAG in 13. Initial success was 85% (89% in iliac lesions and 81% in femoropopliteal lesions; 100% in stenoses and 70% in occlusions). The presence of occlusion (p <0.01) and/or calcium (p <0.05) negatively influenced the immediate results. No major complications were observed; seven (17%) minor complications occurred. Ankle/brachial Doppler index after treatment was 0.82±0.21. Cumulative clinical patency for successfully treated patients after two‐year follow‐up was 91%. LTBA thus represents an effective and less aggressive way of treating peripheral atherosclerosis obliterans. In spite of some limitations, it is useful in selected patients. The results of this study are very much like those in the literature for similar series and early experience.
Atrial natriuretic factor in essential hypertension: Echocardiographic and humoral correlates
Authors: Lucarini Alessandra R. , Favilla Stefania , Marini Cecilia , Lattanzi Fabio , Urbani Michelangelo P. , Salvetti Antonio 
Published: February 2009

AbstractAim of this study was to assess the relationship between plasma concentration of atrial natriuretic factor (ANF) and its two‐dimensional echocardiographic (left ventricular mass, left atrium diameter) and humoral (plasma renin and aldosterone) variables in essential hypertension (EH). We evaluated 32 patients with uncomplicated mild to moderate EH and 10 controls. They were studied in the supine position after 7 days of constant dietary sodium intake and were off therapy since at least 3 weeks. ANF values overlapped between EH patients and controls (27.8 ±11.5 vs. 19.5 ±7.4 pg/ml, p=NS). In EH, no significant correlation was found between ANF values and left ventricular mass (r=0.29), left atrial diameter (r=0.04), mean arterial blood pressure (r=0.26), plasma renin activity (r=0.00), and aldosterone (r=0.26). In EH, ANF values overlapped between the 15 patients with hypertrophy and the 17 patients with normal ventricular mass: 30.3 ± 17 vs. 25.6± 10.6 pg/ms (p = NS). We conclude that there is a substantial overlap in plasma ANF values between mild to moderate uncomplicated EH and controls, and left ventricular hypertrophy is not a major independent stimulus to ANF release in EH.
Blood coagulability and fibrinolytic activity before and after physical training during the recovery phase of acute myocardial infarction
Authors: Suzuki Toshikazu , Yamauchi Kazunobu , Yamada Yoshiji , Furumichi Takeo , Furui Hirohiko , Tsuzuki Jitsuki , Hayashi Hiroshi , Sotobata Iwao , Saito Hidehiko 
Published: February 2009

AbstractThe effects of physical training on hemostatic parameters were evaluated in 56 postmyocardial infarction (MI) patients before and after one month of systematic physical training and in 30 control post‐MI patients, who did not undergo such training. There were no significant changes in prothrombin time (PT) and alpha1‐ antitrypsin (α1AT) at the beginning and end of the study in either group. Levels of fibrinogen, Factor VIII: C (VIILC) and von Wildebrand antigen (vWf:Ag), and activities of ATIII and plasminogen (Plg) were significantly decreased in the group with physical training (p<0.05), while values were unchanged in the control group. Hematocrit, platelet counts, and alpha2‐plasmin inhibitor (α2PI) activities also decreased in the physical training group (p< 0.05). In contrast, these variables increased in the control group (p <0.05). Activated partial thromboplastin time (aPTT) tended to be prolonged in the group with physical training, while it was shortened in the control group. In a subset of 20 patients with physical training, resting levels of plasmin‐α2PI complex (PIC), thrombin‐antithrombin III complex (TAT), protein‐C (P‐C:Ag), plasminogen activator inhibitor‐1 (PAI‐1), VII:C, and P‐C activities had significantly decreased after one month of physical training (p<0.05), although tissue plasminogen activator activities remained unchanged. Physical training appeared to suppress coagulability as indicated by the decrease in fibrinogen, VIII:C, vWf:Ag, VII:C, and TAT, and prolongation of aPTT. The decrease in plasminogen, t‐PA:Ag, α2PI, PAI‐1, and PIC after physical training may result from the decreased coagulability. In conclusion, physical training appears to induce a suppression of the coagulation system in patients in the recovery phase of MI.
Acute circumferential subendocardial infarction
Authors: Hackel Donald B. , Wagner Galen S. 
Published: February 2009

AbstractA 48‐year‐old black man had his first attack of chest pain on exertion, radiating to both arms, in December 1982 (angina pectoris). It was undoubtedly preceded by a period of asymptomatic coronary atherosclerosis of unknown duration. The first anginal attack was followed by three to four similar episodes over the next four months. The attacks became more prolonged, frequent, and severe thereafter (so‐called “pre‐infarct” angina), and six days later the patient showed signs of having developed actual myocardial necrosis. The patient underwent saphenous vein coronary artery bypass surgery but could not be weaned from the pump. He died late on the day of surgery. He was found at autopsy to have severe old three‐vessel coronary artery disease with the myocardial changes that would be expected from the severe global ischemia to which this heart was undoubtedly subjected. Several basic and important differences between this sort of a circumferential subendocardial infarct and a transmural infarct are discussed, as is the basis for the striking subendocardial hemorrhage.
Black scorpion envenomation: Two cases and review of the literature
Authors: Blum Arnon , Lubezki Aharon , Sclarovsky Samuel 
Published: February 2009

AbstractScorpion envenomation is quite common in India, southeast Asia, the U.S. southwest, and Israel (in the Negev and around Jerusalem). Yellow scorpion is considered the most dangerous scorpion that causes cardiac toxicity. Two patients are described, who lived in a nonendemic area of yellow scorpions and were envenomated by the black scorpion. Both suffered temporary cardiac involvement (manifested by electrocardiographic changes) which reverted to a normal pattern within 24 h. These are the first two cases that have been reported (from black scorpion envenomation) and indicate that the toxin of the black scorpion is also cardiotoxic, but much less than the “yellow scorpion” toxin.
Intermittent coronary spasm during graded exercise
Authors: Caralis Dennis G. , Kern Morton J. , Dotson Sybil , Castello Ramon 
Published: February 2009

AbstractWe report a patient with Prinzmetal's angina with nearly normal coronary angiogram who not only developed severe myocardial ischemia during exercise, documented both electrocardiographically (ST elevation) and scintigraphically (with thallium‐201), but also did so intermittently as the graded exercise progressed. Diagnostic coronary angiography showed spontaneous focal spasm of the proximal left anterior descending coronary artery. This unique response to exercise in a patient with variant angina suggests that factors other than catecholamine stimulation alone are active and rapidly attenuated in some patients. This phenomenon could be overlooked without appropriate electrocardiographic monitoring.
Spontaneous and induced vasodepressor/vasovagal syncope in hypertrophic cardiomyopathy
Authors: Buja Gianfranco , Melacini Paola , Folino Antonio , Miorelli Manuela , Nava Andrea 
Published: February 2009

AbstractWe describe a 47‐year‐old man affected with hypertrophic cardiomyopathy and frequent episodes of syncope. During ambulatory Holter monitoring and head‐up tilt test, a syncopal attack was associated with sinus arrest and hypotension. This case suggests an additional mechanism of syncope in hypertrophic cardiomyopathy.
Predischarge exercise echocardiography in patients with unstable angina who respond to medical treatment
Authors: Amanullah Aman M. , Lindvall Kaj 
Published: February 2009

AbstractThe diagnostic and prognostic value of predischarge exercise echocardiography (echo) was assessed prospectively in 36 patients with unstable angina soon after stabilization on medical treatment. Two‐dimensional echo was performed at rest and immediately after a symptom‐limited exercise test. Patients with previous myocardial infarction, coronary revascularization, left bundle‐branch block and dilated cardiomyopathy were excluded. Left ventricular regional wall motion was analyzed visually and a wall motion score index (WMSI) was derived. Patients were followed prospectively for an average period of 26 months (range 16–34 months). The study end points were a new cardiac event defined as acute myocardial infarction or a need for coronary revascularization because of a recurrence of severe medically refractory angina. Sixteen patients (44%) had positive exercise electrocardiography (ECG), while exercise echo was positive in 22 patients (61%). Of 28 patients undergoing coronary angiography, 23 had significant coronary artery disease (CAD). The sensitivity of exercise ECG in detecting CAD was 61% while the corresponding result was 83% for exercise echo. Cardiac events occurred in 21 patients (58%). Exercise ECG was positive in 12 of these patients (57%), while a positive exercise echo was found in 17 patients (81%). There were significantly more patients with positive exercise echo among patients experiencing cardiac events than among those without cardiac events (p<0.01). In patients with CAD, WMSI decreased significantly after exercise (p<0.05). Exercise WMSI was also significantly lower in patients with CAD than in those without CAD (p<0.02). Exercise WMSI also discriminated patients with cardiac events from those without such events (p < 0.01). Thus predischarge exercise echo is highly sensitive in detecting significant CAD and in identifying subsequent cardiac events in patients with unstable angina stabilized on medical treatment.
Myocardial systolic function in systemic lupus erythematosus: A study based on radionuclide ventriculography
Authors: Bahl V. K. , Aradhye S. , Vasan R. S. , Malhotra A. , Reddy K. S. , Malaviya A. N. 
Published: February 2009

AbstractWe assessed left ventricular systolic function by means of radionuclide ventriculography in 20 consecutive unselected patients with systemic lupus erythematosus. All patients had normal left ventricular systolic function (defined as ejection fraction > 45%) in a resting state. Regional wall motion abnormalities were, however, seen in 4 patients (20%). Of these 20 patients, 8 were able to exercise on a bicycle ergometer. These patients were subjected to exercise radionuclide ventriculography. Of these 8 patients, 3 (37.5%) had an abnormal ventriculographic response to exercise (as evidenced by a subnormal rise in ejection fraction or a fall, appearance of a new regional wall motion abnormality or worsening of a pre‐existing one). This probably reflects subclinical left ventricular dysfunction unmasked by the stress of exercise. The clinical significance of these abnormalities on long‐term myocardial function and their possible reversibility with remission of the disease needs to be assessed in future studies.
Cardiac risk of speed traps
Authors: Cocco Giuseppe , Iselin Hans Ulrich 
Published: February 2009

AbstractTwenty‐two patients with stable cardiac disease drove into a radar trap while having an ambulatory electrocardiogram. All patients reported cardiac symptoms, heart rate increases, and appearance of repetitive ventricular arrhythmias. Myocardial ischemia was observed in some patients. Being caught while car speeding under the stresses of daily life may induce potentially dangerous cardiac effects. The data confirm the effects of stress and adrenergic tone on ventricular arrhythmias.
Direct current cardioversion of established atrial fibrillation
Authors: Lévy Samuel 
Published: February 2009

AbstractRestoration and maintenance of sinus rhythm is a desirable end point in patients with chronic atrial fibrillation. If clinically indicated, external cardioversion using direct current is the method of choice in most centers. The results range from 20 to 90% and are highly influenced by the underlying etiology. A number of determinants including age, duration of atrial fibrillation, and size of left atrium are usually taken into account in the indications but have been recently questioned. The use of prophylactic antiarrhythmic therapy has been shown to reduce the recurrence of atrial fibrillation significantly, but concerns remain regarding the safety of this treatment. In patients who failed external cardioversion, shocks delivered within the right atrium according to a recently described technique may be attempted. The initial results are promising, as 83% of patients are successfully cardioverted and 46% of patients are in sinus rhythm at 12 months. This new technique offers an additional alternative in patients with chronic atrial fibrillation and may therefore reduce the incidence of frightening embolic complications.
Pulsed doppler echocardiographic indices of left ventricular diastolic function in normal subjects
Authors: Bahl V. K. , Dave T. H. , Sundaram K. R. , Shrivastava S. 
Published: February 2009

AbstractTo establish the normal limits for various pulsed Doppler echocardiographic indices of left ventricular diastolic function, 92 healthy volunteers aged from 5 to 75 years were prospectively studied. The influence of various variables including age, gender, body surface area, fractional shortening, and left ventricular mass on these parameters was also assessed. Mean (2SD) values for 15 direct and 11 derived parameters were analyzed from transmittal inflow velocity waveform. No statistically significant differences were observed between males and females for any of these parameters. On stepwise multivariate linear regression analysis, age was found to be an independent strong determinant (p < 0.001) of peak velocity of early diastolic filling wave, area of atrial filling period, deceleration slope, normalized peak filling rate, and early filling fraction. There was a significant correlation between heart rate and time to peak early diastolic velocity, total diastolic time period, early diastolic period, atrial filling period, and atrial filling fraction. It was further observed that a significant correlation (p < 0.001) persisted between both age and heart rate with area of early filling period, one‐third filling area, one‐half filling area, ratio of early to atrial peak velocity and area, atrial filling fraction, and one‐third filling fraction. None of the parameters were found to correlate with fractional shortening or left ventricular mass. Thus an effort was made to establish normal limits for various Doppler‐derived parameters in healthy volunteers for future comparison in diseased states. Age and heart rate were found to have a significant influence on pattern of diastolic filling and should be taken into account while studying transmittal flow pattern in diseased states.
QT interval shortening and ST elevation in intracoronary ECG during PTCA
Authors: Maeda Toshihiro , Saikawa Tetsunori , Niwa Hiroko , Shimoyama Nobuo , Hara Masahide , Maruyama Tohru , Takaki Ryosaburo , Ito Morio , Kohmatsu Kohsei 
Published: February 2009

AbstractPercutaneous transluminal coronary angioplasty (PTCA) can provide a unique model of transient and reversible myocardial ischemia. The aim of this study was to assess the serial changes in QT interval during elective PTCA‐induced transient ischemia. The serial changes in QT interval before, during, and after PTCA of the left anterior descending artery (LAD) were measured in patients who showed ST elevation in intracoronary electrocardiogram. Twelve consecutive patients who showed ST‐segment elevation during PTCA‐induced ischemia in anterior precordial leads of the electrocardiogram (ECG) were enrolled in the present study. Target lesions for PTCA were all in the LAD. There were six patients with angina pectoris, two with non‐Q‐wave infarction, and four with Q‐wave myocardial infarction. During balloon inflation, QTc interval shortened in both intracoronary ECG (ic‐ECG) (0.472±0.013 vs 0.436±0.014) and surface ECG (0.462±0.012 vs 0.438±0.011). However, a significant shortening of the QT interval was more rapidly observed in the ic‐ECG (20 s) than in the surface ECG (40 s). We conclude that the QT interval in both ic‐ECG and surface ECG becomes shortened in PTCA‐induced myocardial ischemia, and that the ic‐ECG might be a good probe for detecting survived viable myocardium in the infarcted zone.
Massive main pulmonary artery embolism diagnosed with two‐dimensional doppler echocardiography
Authors: Gabrielsen Frede , Schmidt Arnold , Eggeling Thomas , Hoeher Martin , Kochs Matthias , Hombach Vinzenz 
Published: February 2009

AbstractThis report describes the usefulness of echocardiography in the differential diagnosis of acute cardiovascular events. In a 66‐year‐old patient with known aortic stenosis and mitral valve prothesis, who suddenly deteriorated with severe dyspnea, a thrombus within the pulmonary artery could be detected with 2‐D echo. Pulsedwave Doppler disclosed the resulting flow‐velocity disturbances.
Prognosis for patients with initially suspected acute myocardial infarction in relation to presence of chest pain
Authors: Herlitz Johan , Karlson Björn W. , Richter Arina , Strömbom Ulf , Hjalmarson Åke 
Published: February 2009

AbstractIn all 4,232 patients admitted to a single hospital during a 21‐month period due to initially suspected acute myocardial infarction (AMI), the prognosis and risk factor pattern were related to whether patients had chest pain or not. Symptoms other than chest pain that raised a suspicion of AMI were mainly acute heart failure, arrhythmia, and loss of consciousness. In 377 patients (9%) symptoms other than chest pain raised an initial suspicion of AMI. These patients developed a confirmed infarction during the first three days in hospital with a similar frequency (22%) as compared with patients having chest pain (22%). However, patients with “other symptoms” had a one‐year mortality of 28% versus 15% for chest pain patients (p < 0.001). Patients with “other symptoms” more often died in association with ventricular fibrillation and less often in association with cardiogenic shock as compared with chest pain patients. Among the 921 patients who developed early AMI, 64 (7%) had symptoms other than chest pain. They had a one‐year mortality of 48% versus 27% for chest pain patients (p<0.001). We conclude that in a nonselected group of patients hospitalized due to suspected AMI, those with symptoms other than chest pain have a one‐year mortality, which is nearly twice that of patients with chest pain.
Left ventricular diastolic dysfunction in coronary artery disease: Effects of coronary revascularization
Authors: Inoue Teruo , Morooka Shigenori , Hayashi Terumi , Takayanagi Kan , Sakai Yoshihiko , Takabatake Yutaka 
Published: February 2009

AbstractLeft ventricular diastolic dysfunction was studied globally and regionally in patients with coronary artery disease, and the effects of coronary revascularization were evaluated. A total of 25 patients with angina pectoris who had a stenotic lesion (≥90%) in only left anterior descending branch underwent coronary revascularization [percutaneous transluminal coronary angioplasty (PTCA) in 13 patients and coronary artery bypass graft (CABG) in 12]. Nine patients with normal coronary artery were studied as controls. Left ventricular volume and radial axes were measured on serial frames of one cardiac cycle by cine left ventriculography. The radial axes were drawn from the left ventricular gravity to left ventricular wall at every 20°. Left ventricular filling fraction and distension rate of radial axes were calculated at the times of 25%, 50%, 75%, and 100% of diastolic period, 100% being end‐diastole. Although there were no significant changes of the systolic function by revascularization, the filling fraction increased from 11.2±2.6 to 14.5±3.5% (p<0.001) at 25% time of diastole, from 29.9±4.9 to 32.5±5.0% (p<0.05) at 50% time in the PTCA group, and from 11.8±3.7 to 13.4±3.8% (p<0.01) at 25% time in the CABG group. The distension rate of radial axis to the anterior wall also increased significantly at 25% and 50% time of diastole after revascularization, and the change was marked in the PTCA group. However, these increases did not apply to the control patients. The results showed that the global and regional left ventricular early diastolic dysfunctions in patients with angina pectoris was partially reversible by coronary revascularization.
Exercise echocardiography after stabilization of unstable angina: Correlation with exercise thallium‐201 single photon emission computed tomography
Authors: Amanullah Aman M. , Lindvall Kaj , Bevegård Sture 
Published: February 2009

AbstractThe diagnostic usefulness of predischarge exercise echocardiography in 35 patients with unstable angina who responded to medical therapy was correlated with exercise thallium‐201 single photon emission computed tomography (TI‐SPECT) performed, on the average, three days after the exercise echocardiography. None of the patients had myocardial infarction prior to hospitalization or before TI‐SPECT and none had left bundle‐branch block on their rest electrocardiogram (ECG). Exercise echocardiography was positive in 21 patients and TI‐SPECT in 24. The results of the two techniques were concordant in 28 of 35 patients (agreement = 80%,k= 0.57±0.14, p<0.001). Wall‐by‐wall comparison of the distribution of exercise‐induced wall motion abnormalities with reversible thallium defects showed complete or partial correlation in all of 19 patients in whom both the tests were positive. A positive exercise ECG and positive exercise echocardiography identified 11 of 11 patients with angiographically verified significant coronary artery disease (CAD) and 11 of 12 patients (92%) with positive TI‐SPECT. Thus, exercise echocardiography is a valuable addition to routine predischarge exercise test in the noninvasive diagnosis of myocardial ischemia and shows a good correlation with TI‐SPECT in detecting and localizing ischemia in patients with unstable angina stabilized on medical therapy.