bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of amiodarone and desethylamiodarone in a patient with acute myocardial infarction after intravenous administration
Authors: Latini R. , D'Aranno V. , Barbieri E. , Fabbri A. , Zampieri P. , Trevi G. P. , Zardini P. 
Published: February 2009

AbstractThe autopsy tissues concentration of amiodarone and desethylamiodarone of a man with acute myocardial infarction treated acutely with intravenous amiodarone is reported. Our data indicate that amiodarone is quickly distributed into all highly perfused tissues after intravenous administration with a high amiodarone/desethylamiodarone ratio. We also report here the autopsy case of a woman who died after 30 days of oral therapy with amiodarone. The increase in heart/plasma ratio of amiodarone and desethylamiodarone concentrations and the decrease in amiodarone/desethylamiodarone ratio after one month of therapy could explain the latency in the antiarrhythmic action of the drug.
Prevention and elimination of heart arrhythmias by adaptation to intermittent high altitude hypoxia
Authors: Meerson F. Z. , Ustinova E. E. , Orlova E. H. 
Published: February 2009

AbstractIt was shown that adaptation to intermittent hypoxia in altitude chamber prevented the poststress fall of the electrical threshold of heart fibrillation. In acute ischemia, the number of fibrillation episodes and the death rate of preadapted animals were 2‐3 fold lower than in controls. The adaptation to hypoxia resulted in a significant increase in concentration of opioid peptide β‐endorphin in adrenal glands while stress‐induced changes in β‐endorphin in brain structures of adapted animals were much less pronounced. In animals with postinfarction cardiosclerosis, the course of hypoxic actions resulted in restoration of the decreased heart fibrillation threshold, reduced the heart ectopic activity which had developed on the background of vagal bradycardia, and eliminated depression of the heart contractile function. Simultaneously, the adaptation induced a decrease of the postinfarction scar by one‐third and an increase of vascularization of the myocardial zone adjacent to the scar.
Coronary collateral vessels in patients with previous myocardial infarction
Authors: Nakatsuka M. , Matsuda Y. , Ozaki M. , Ogawa H. , Moritani K. , Khono M. , Miura T. , Shimizu T. , Furutani Y. , Kusukawa R. 
Published: February 2009

AbstractTo assess the degree of collateral vessels after myocardial infarction, coronary angiograms, left ventriculograms, and exercise thallium‐201 myocardial scintigrams of 36 patients with previous myocardial infarction were reviewed. All 36 patients had total occlusion of infarct‐related coronary artery and no more than 70% stenosis in other coronary arteries. In 19 of 36 patients with transient reduction of thallium‐201 uptake in the infarcted area during exercise (Group A), good collaterals were observed in 10 patients, intermediate collaterals in 7 patients, and poor collaterals in 2 patients. In 17 of 36 patients without transient reduction of thallium‐201 uptake in the infarcted area during exercise (Group B), good collaterals were seen in 2 patients, intermediate collaterals in 7 patients, and poor collaterals in 8 patients (p<0.025). Left ventricular contractions in the infarcted area were normal or hypokinetic in 10 patients and akinetic or dyskinetic in 9 patients in Group A. In Group B, 1 patient had hypokinetic contraction and 16 patients had akinetic or dyskinetic contraction (p<0.005). Thus, patients with transient reduction of thallium‐201 uptake in the infarcted area during exercise had well developed collaterals and preserved left ventricular contraction, compared to those in patients without transient reduction of thallium‐201 uptake in the infarcted area during exercise. These results suggest that the presence of viable myocardium in the infarcted area might be related to the degree of collateral vessels.
accessory atrioventricular pathway, supra ‐, and infrahisian conduction impaired due to mitral annulus calcification
Authors: Kriwisky M. , Goldstein J. , Gotsman M. S. 
Published: February 2009

AbstractDisorders of conduction occurring simultaneously in both normal and accessory pathways of patients with Wolff‐Parkinson‐White (WPW) syndrome have only rarely been observed. To our knowledge this is the first report of impaired conduction in both pathways in WPW syndrome due to mitral annulus calcification (MAC). This case of WPW syndrome type A presented the following conduction abnormalities: (1) right bundle‐branch block; (2) transient second‐degree AV block with prolonged PR interval of the conducted beats; (3) during electrophysiological study, induction of tachycardia, dependent (phase 3) second‐degree AV block, and occasionally conduction of two consecutive beats, the second showing an increased H‐V interval (from 25 to 60 ms) and left bundle‐branch block (LBBB) pattern, due to (4) infrahisian conduction abnormality.
Three‐week beta‐adrenergic blockade does not impair or improve general intellectual function in young healthy males
Authors: Brooks B. , Danielsen U. , Kayser L. , Jørgensen B. , Hansen J. E. M. , Perrild H. 
Published: February 2009

AbstractThe widespread use of beta blockers in treatment of both cardiovascular and nonvascular conditions has generated interest in changes in functions of the central nervous system during treatment. We studied the effect of 3 weeks of beta blockade on learning and memory ability, concentration, and verbal abstraction in 32 young normotensive healthy men. We chose healthy males to exclude the possible influence of changes related to a hypertensive state. Subjects were randomized into a 3‐week treatment protocol with either atenolol 50 mg × 2 (cardioselective, hydrophilic), metoprolol 100 mg × 2 (cardioselective, lipophilic), propranolol 80 mg × 2 (noncardioselective, lipophilic), or placebo × 2. Each subject underwent two neuropsychological testing sessions. We found no significant enhancement or impairment of intellectual or psychomotor performances after the 3‐week treatment with beta‐adrenergic‐blocking agents compared to a placebo‐treated control group. Differences in pharmacokinetic profiles of the drugs (e.g., central nervous system penetrability, lipophilicity, or membranestabilizing effect) did not influence the test outcome. Antihypertensive treatment with beta blockers over a prolonged period does not affect young peoples' learning and memory abilities or reasoning powers, nor their ability to concentrate and perform psychometric tasks.
Refractory swallowing‐induced paroxysmal supraventricular tachycardia
Authors: Ransbottom J. C. , Mirro M. J. 
Published: February 2009

AbstractA 51‐year‐old female with a two‐year history of palpitations associated with swallowing was evaluated by intracardiac electrophysiologic studies. Intracardiac recordings documented the presence of an ectopic left atrial focus induced by swallowing with no evidence of accessory pathway conduction. Gastrointestinal evaluation did not demonstrate any significant disorder. The tachycardia was refractory to all pharmacologic therapy including investigational therapy with mexiletine and amiodarone.
Prompt detection of myocardial injury by assay of creatine kinase isoforms in initial plasma samples
Authors: Abendschein D. , Seacord L. M. , Nohara R. , Sobel B. E. , Jaffe A. S. 
Published: February 2009

AbstractTo determine the sensitivity and specificity of assays of isoforms of the MM isoenzyme of creatine kinase (CK) and MB‐CK for the diagnosis or exclusion of acute myocardial infarction in plasma samples obtained at the time of presentation to the emergency room of patients with suspected myocardial infarction, 50 patients in whom the diagnosis was ultimately established and 31 in whom infarction was ultimately excluded were evaluated. Of the 50 patients in whom infarction was ultimately established, 47 had an increased ratio of the MM3 to the MM1 isoform or elevated MB‐CK in the plasma sample initially available. The specificity of the approach was 77%, sensitivity 94%. The availability of rapid assays for MM‐CK isoforms and for MB‐CK should facilitate determination of the presence or absence of acute myocardial injury sufficiently promptly so that decisions regarding treatment can be made optimally.
Daily serial evaluation of left ventricular function with equilibrium radionuclide ventriculography following thrombolysis during acute myocardial infarction
Authors: MARX J. D. , Van ASWEGEN A. , KLEYNHANS P. H. T. , HERBST C. P. , OTTO A. C. , DE WET J. I. 
Published: February 2009

AbstractThe changes in ventricular function after reperfusion by coronary thrombolysis are important when deciding about further definitive treatment necessary to ensure long‐term vessel patency. The purpose of this study was to evaluate the early changes in left ventricular function after reperfusion. Left ventricular function was serially evaluated for 10 days in a group of 18 patients receiving intracoronary thrombolytic therapy for an acute myocardial infarction. Comparison of the global ventricular function in the successfully and unsuccessfully reperfused groups of patients showed significantly better function in the successful group than the unsuccessful group after the first day, which was maintained for the entire study period. Global and regional ventricular function in the successfully reperfused patients showed significant early improvement during the initial 72 h with maintenance of this improvement for the study period of 10 days. In the patients in whom reperfusion was unsuccessful, regional ventricular function showed no change, while the global function declined from day 5 to day 8 of the study period. This study then confirms the significant improvement in ventricular function after successful reperfusion. The time course pattern of the change in ventricular function indicates that the most significant improvement occurs within the first 72 h after reperfusion. These changes are similar to those previously reported in experimental animals.
Multipurpose A2 catheter approach to left heart catheterization in severe aortic stenosis
Authors: Nicholson W. J. 
Published: February 2009

AbstractAn approach has been presented for the performance of right and left heart catheterization, left ventriculography, supravalvular aortography, and coronary arteriography utilizing a #8 French, A2 multipurpose catheter. Using the manipulations described herein, the left ventricle was entered in 96% of the patients. The multipurpose catheter is an excellent catheter for left ventriculography, negating the need for catheter exchange once the left ventricle has been entered. Likewise, this catheter provides excellent supravalvular aortography and selective coronary arteriography supplemented as needed with preformed coronary arteriographic catheters. This method provides a very safe, efficient approach to the performance of complete heart catheterization in patients with clinically significant aortic stenosis.
Aortic regurgitation secondary to diastolic prolapse of a tubular intimal flap into the left ventricle in a patient with anuloaortic ectasia
Authors: Matsuo T. , Ikushima I. , Hanada Y. , Nakagawa S. , Koiwaya Y. , Tanaka K. 
Published: February 2009

AbstractA 32‐year‐old man with distal skeletal manifestations of Marfan's syndrome had experienced shortness of breath and orthopnea for one month. Physical examination showed the presence of severe aortic regurgitation. Both noninvasive and invasive studies revealed that the aortic regurgitation was induced by previously undescribed peculiar and unusual etiology: diastolic prolapse of a circumferentially dissected tubular intimal flap into the left ventricle. The patient underwent surgical repair with striking clinical improvement.
Cost and efficacy of intravenous streptokinase plus PTCA for acute myocardial infarction when therapy is initiated in community hospitals
Authors: Leimbach W. N. , Hagan A. D. , Vaughan H. L. , Sonnenschein R. C. , Mccoy J. D. , Basta L. L. 
Published: February 2009

AbstractThe costs and clinical results of a thrombolytic therapy protocol using intravenous (IV) streptokinase in small community hospitals prior to emergency transfer for cardiac catheterization for possible percutaneous transluminal coronary angioplasty (PTCA) were prospectively studied in 56 patients with an acute myocardial infarction [Tulsa Heart Center‐Myocardial Infarction Study Team (THC‐MIST) protocol]. Findings were compared to those for 53 similar patients receiving “conventional therapy” during the same study period. The reperfusion rate for IV streptokinase was 63%. Additional emergency PTCA yielded a total reperfusion rate of 95%. Despite emergency cardiac catheterization for all THC‐MIST patients, average hospital charges were not significantly different between the two groups ($20,495 vs. $20,722; THC‐MIST vs. conventional therapy, respectively). Total charges (hospital plus physician fees) were also not significantly different ($22,986 vs. $22,400; THC‐MIST vs. conventional therapy, respectively). Intensive care unit (ICU) days and total hospital stays were significantly less for THC‐MIST patients (3.1 vs. 5.8 ICU days, p<0.05 and 8.8 vs. 12.4 hospital days, p<0.05; THC‐MIST vs. conventional therapy, respectively). Thus initiation of IV streptokinase in community hospitals for acute myocardial infarction with subsequent transfer for possible PTCA can yield high reperfusion rates without significantly increasing health care costs.
Ischemic blocks during early phase of anterior myocardial infarction: Correlation with st‐segment shift
Authors: Sclarovsky S. , Sagie A. , Strasbero B. , Shnapick Y. , Rechavia E. , Kusniec J. , Agmon J. 
Published: February 2009

AbstractOf 760 consecutive cases with anterior acute myocardial infarction (AMI), 55 developed acute bundle‐branch block (BBB), fascicular block, or high‐degree atrioventricular block during the hyperacute ECG stage of AMI. According to the direction of the ST segment during the acute ischemic episode, patients were divided into two groups. Group A consisted of 32 patients who developed BBB during ST‐segment elevation, positive T wave, and absent or minimal Q wave. Group B consisted of 23 patients who developed BBB during ST‐segment depression and evolved into anterior AMI. Group A was characterized by a higher incidence of right BBB and left anterior hemiblock [91% vs. 26% and 56% vs. 13%, respectively (p<0.005)]. Group B was characterized by a higher incidence of left BBB and left posterior hemiblock [57% vs. 9% and 26% vs. 12%, respectively (p<0.001)]. The BBB was transient (disappearing within hours to one day) in 14 patients in Group A and in 5 patients in Group B. The incidence of progression to high‐degree atrioventricular block was almost equal in the two groups (25% and 26%). The mortality rate was very high in both groups, but higher in Group B [74% vs. 59% (p=NS)] especially in those with LBBB (85%). Most patients died on the day of occurrence of BBB [Group A, 50% vs. Group B, 70% (p=NS)]. The causes of death in both groups were cardiogenic shock and/or electromechanical dissociation. It is concluded that there is a correlation between the ECG pattern of ST‐segment shift and the type of BBB, and that cardiac mortality is very high in this group of patients, especially in those with ST‐segment depression and left BBB.
Quantitation of myocardial fibrosis and its relation to function in essential hypertension and hypertrophic cardiomyopathy
Authors: Sugihara N. , Genda A. , Shimizu M. , Suematu T. , Kita Y. , Horita Y. , Takeda R. 
Published: February 2009

AbstractMyocardial interstitial fibrosis is an important microscopic feature of hypertrophic cardiomyopathy. To determine whether interstitial fibrosis of the myocardium in hypertrophic cardiomyopathy and essential hypertension differ in quality or quantity, and to determine whether fibrosis affects cardiac function directly, we measured the percentage of fibrosis in patients of both categories and compared the severity of fibrosis with several cardiac functions. Left and right ventricular endomyocardial biopsies were performed in 25 patients with essential hypertension and in 19 patients with hypertrophic cardiomyopathy. Interstitial fibrosis was classified into four different microscopic types, and the percentage of total and of each type was calculated using the point‐counting method. Although the percentage of total fibrosis was similar between the two groups, the type of fibrosis was different. There was no correlation between the percentage of total fibrosis and the mean size of myocytes in either group. Although there was a significant correlation between the percentage of total fibrosis and the thickness of the interventricular septum in hypertrophic cardiomyopathy, such correlation was lacking in hypertension. There was no correlation between the percentage of total fibrosis and the ejection fraction, cardiac index, or left ventricular end‐diastolic pressure in either group. We concluded that the amount of myocardial interstitial fibrosis in hypertrophic cardiomyopathy is no greater than that in essential hypertension, but the type of fibrosis is different. Furthermore, in subjects in whom the ejection fraction is normal or only slightly decreased, fibrosis does not influence global cardiac functions.
Necropsy study of right atrial appendage: Morphology and quantitative measurements
Authors: Manolis A. S. , Varriale P. , Baptist S. J. 
Published: February 2009

AbstractThe right atrial appendage (RAA) of 23 randomly selected autopsied patients was examined at necropsy, and data related to orifice size and appendicular depth measurements and features of the endocardial surface were recorded. The study included 21 men and 2 women aged 71 ± 15 years (range, 32‐91); underlying coronary artery disease was present in 16 patients. The orifice size of the RAA measured 2.0± 1.0 cm (range, 0‐5 cm). The orifice size was slightly, but not significantly, smaller in patients over age 70 years compared with those younger than 70. In hearts weighing more than 450 g, the orifice was significantly larger (2.6 cm) than in hearts weighing less (1.4 cm). The appendicular depth averaged 1.2 ±0.7 cm (range, 0‐2.5 cm), and a significant difference was noted in patients older and younger than 70 years (depth of 0.9 cm vs. 1.5 cm; p<0.05). The RAA depth was 0.5 cm or less in 8 patients (35%), 6 of whom represented patients older than 70 years. Antemortem mural thrombi within the RAA were found in three hearts and completely filled the lumen in one. The suitability of the RAA as a site for atrial pacing and secure electrode implantation, particularly when anatomical deficiencies are identified, was also considered. Atrial lead displacement, a relatively common postoperative complication, may be related more to implantation within a shallow appendicular fossa and/or one with larger orifice than to faulty technique. Because these anatomical deficiencies threaten stable electrode implantation more prevalently in patients older than 70 years and in those with markedly enlarged hearts, we support the use of the grasping (screw‐in) atrial electrode in these circumstances for a more effective active lead fixation.
Silent myocardial ischemia: Prognostic significance and therapeutic implications
Authors: Conti C. R. 
Published: February 2009

AbstractEvidence is now accumulating which strongly suggests that prognosis of patients with painless myocardial ischemia determined either by ambulatory ECG monitoring or exercise testing may be no different than the prognosis of patients who have overt clinical manifestations of myocardial ischemia associated with transient ischemic ECG changes. In my view the goal of therapy for patients with clinical manifestations of coronary artery disease should be the elimination of myocardial ischemia. Medical therapy, coronary angioplasty, or coronary artery surgery should be rendered and then followed by objective documentation of therapeutic efficacy.
Combined effects of cocaine and nicotine on cardiovascular performance in a canine model
Authors: Mehta Mahaveer C. , Jain Abnash C. , Billie Mike 
Published: February 2009

AbstractBackground:With the proliferation of cocaine abuse, increased incidence of catastrophic cardiovascular events such as angina pectoris, myocardial infarction, ventricular arrhythmias, or sudden death are reported. Many of these patients also smoke cigarettes before and after cocaine use, leading to a high frequency of simultaneous exposure to both drugs. Cocaine's and nicotine's independent effects on cardiodynamics are well documented, but combined effects of both on complete cardiovascular hemodynamics remain unknown.Hypothesis:The study aimed to determine whether these effects are additive, synergistic, or antagonistic and was therefore designed to investigate the cardiovascular changes produced as a result of combined administration of cocaine and nicotine in a canine model.Methods:Initially, in phase I, 30 experiments were performed to study the dose‐response curve of both drugs. in phase II and III, 12 dogs were subjected to 30 experiments. in phase II, cocaine was given intravenously (IV) followed by nicotine. in phase HI, sequence of drug administration was reversed to study the effects on hemodynamics and coronary artery blood flow reserve.Results:Hemodynamic parameters observed were Phase I: Dose‐response curve established the IV bolus dose of cocaine 2 mg/kg and nicotine 50 μg/kg. Phase II: Cocaine increased heart rate, blood pressure, and dP/dt, but nicotine administration after cocaine produced marked significant synergistic excitatory effects: dP/dt increased from 1810 ± 210 to 6300 ± 460 (p< 0.003). Phase III: Nicotine significantly increased heart rate, mean arterial pressures, left ventricular end‐diastolic pressure, pulmonary artery, pulmonary capillary wedge, and right atrial pressures. Nicotine increased dP/dt (1810 ± 192 to 5000 ± 160 mmHg/s; p < 0.004). These excitatory effects of nicotine were attenuated by cocaine when administered as a second drug (dP/dt decreased to 1925 ± 144 from 5000 ± 160 mmHg/s; p < 0.004).Conclusions:Cocaine, when administered alone, caused increase in heart rate, blood pressure, and dP/dt, but nicotine showed a significant increase in all the hemodynamic parameters. Both drugs reduced coronary blood flow reserve. in combination, cocaine plus nicotine administration had synergistic excitatory effects in dogs. A reversed drug combination, that is, nicotine plus cocaine, attenuated the excitatory effects of nicotine.
Significance of breast lesion descriptors in the ACR BI‐RADS MRI lexicon
Authors: Agrawal Garima , Su Min‐Ying , Nalcioglu Orhan , Feig Stephen A. , Chen Jeon‐Hor 
Published: February 2009

AbstractIn recent years, dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) has altered the clinical management for women with breast cancer. In March 2007, the American Cancer Society (ACS) issued a new guideline recommending annual MRI screening for high‐risk women. This guideline is expected to substantially increase the number of women each year who receive breast MRI. The diagnosis of breast MRI involves the description of morphological and enhancement kinetics features. To standardize the communication language, the Breast Imaging Reporting and Data System (BI‐RADS) MRI lexicon was developed by the American College of Radiology (ACR). In this article, the authors will review various appearances of breast lesions on MRI by using the standardized terms of the ACR BI‐RADS MRI lexicon. The purpose is to familiarize all medical professionals with the breast MRI lexicon because the use of this imaging modality is rapidly growing in the field of breast disease. By using this common language, a comprehensive analysis of both morphological and kinetic features used in image interpretation will help radiologists and other clinicians to communicate more clearly and consistently. This may, in turn, help physicians and patients to jointly select an appropriate management protocol for each patient's clinical situation. Cancer 2009. © 2009 American Cancer Society.