bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of dopamine and dobutamine in patients requiring postoperative circulatory support
Authors: Disesa V. J. , Gold J. P. , Shemin R. J. , Collins J. J. , Cohn L. H. 
Published: February 2009

AbstractWe compared dopamine and dobutamine following cardiac surgery in a sequential cross‐over study of 9 patients who required inotropic support after volume replenishment. Seven patients had mitral valve replacement, 2 with simultaneous coronary revascularization (CABG), and 1 each with simultaneous tricuspid annuloplasty and aortic valve replacement; 1 had isolated CABG and 1 had repair of a postinfarction ventricular septal defect. Heart rate, right and left atrial pressures, pulmonary and mean arterial pressure, systemic and pulmonary vascular resistance, and cardiac index were measured and calculated. Inotropic support with dopamine or dobutamine was begun for treatment of low cardiac index within 12 hours postoperatively. Measurements were made after 20 minutes on either agent at 5–10 m̈g/kg per min when cardiac output and general clinical state were stable. Each patient was then switched to the other agent at approximately the same dose rate, titrating the dosage to the same cardiac output, and repeat measurements were made at 20 minutes when again stable. Similar dosages of dopamine (6.2±1.7 m̈g/kg/min) and dobutamine (6.7±2.5 m̈g/kg/min) produced equivalent heart rate (103±19 vs. 102±13 beats/min, p=NS), cardiac index (2.8±1.1 vs. 2.9±1.2 l/min/m2, p=NS), and pulmonary arterial pressure and vascular resistance. Mean systemic arterial pressure was significantly lower with dobutamine (59±5 vs. 67±7 mmHg, p<0.05) as were mean left (14±5 vs. 18±6 mmHg, p<0.0001) and right (9±2 vs. 11±2 mmHg, p<0.05) atrial pressures. Systemic vascular resistance was also reduced with dobutamine but the difference was not statistically significant.
Argon laser recanalization of three totally occluded human right coronary arteries
Authors: Choy D. S. J. , Marco J. , Fournial G. , Stertzer S. 
Published: February 2009

AbstractWe report the successful recanalization, in vivo, of three totally occluded human right coronary arteries with an argon laser catheter during coronary artery bypass surgery. The laser catheter and technique of laser recanalization are described. At 15 days postoperatively, two of the laser‐treated arteries were reoccluded angiographically. The third patient refused postoperative angiography.
Studies on ergometer exercise testing I. Significance of the type of st‐segment response, sex, and chest pain
Authors: Pellinen T. J. , Virtanen K. S. , Valle M. , Frick M. H. 
Published: February 2009

AbstractErgometer exercise electrocardiographic (EECG) data were surveyed in a series of 328 patients (277 men and 51 women) subjected to coronary arteriography. The sensitivity and specificity of EECG for coronary artery disease (CAD) were 84% and 54%, respectively. The predictive accuracy of a positive test for CAD was 95% in men and 81% in women. The predictive accuracy of a negative test was 25% in men and 62% in women. When slowly ascending ST depression was considered insignificant, the sensitivity of EECG declined to 71%, with an increase in specificity to 64%. CAD was present in 89% of the patients with slowly ascending ST depression and 65% of them had a multivessel disease. Seventy‐two subjects had postexercise ST‐segment elevation. The predictive value of this sign for CAD was 94%. Exercise‐induced chest pain had quite a similar diagnostic significance as EECG. The prevalence of CAD in patients with a history of typical angina was 94% in both sexes. Atypical chest pain was associated with normal coronary arteriography in 59% of males and 100% of females.
Incidence of systemic thromboembolic lesions in acute myocardial infarction
Authors: Puletti M. , Cusmano E. , Testa M. G. , Borgia C. , Fanari F. , Curione M. 
Published: February 2009

AbstractIn a series of 1277 cases of acute myocardial infarction, 30 episodes of systemic, noncerebral, thromboembolic lesions in 22 patients have been detected. Locations most frequently involved were the extremities (60%), kidneys (16.6%), spleen (13.3%), and mesentery (10%). The incidence of thromboembolism has been higher in patients over the age of 60. In the great majority of cases, the myocardial infarction has been anterolateral, often with a superimposed pump failure. Mortality has been very high (54.5%), perhaps in relation to the advanced age of the patients and to the extension of the infarction. Embolism at the extremities has been well treated with Fogarty's catheter. Among patients whose postmortem examination has been performed a high incidence of ventricular aneurysm (3 of 7) and mural thrombosis (5 of 7) has resulted. In the cases of ventricular aneurysm, episodes of atrial fibrillation have always occurred.
Eosinophilic endomyocardiopathy
Authors: Kudenchuk P. J. , Hosenpud J. D. , Fletcher S. 
Published: February 2009

AbstractA young patient with a severely elevated eosinophil count died from manifestations of severe eosinophilic endomyocardiopathy. Echocardiographic and hemodynamic evaluation were diagnostic of a rapidly progressive restrictive cardiomyopathy. Progression of cardiac disease in the face of medical treatment is an ominous sign and may argue for earlier surgical intervention in this syndrome.
Isolated rheumatic tricuspid regurgitation and stenosis
Authors: Fujii S. , Funaki K. , Denzumi N. 
Published: February 2009

AbstractThe case of a 73‐year‐old man with right heart failure and systolic and diastolic murmur at the fourth left intercostal space is described. There was a history of rheumatic fever. Two‐dimensional echocardiography showed rheumatic change of the tricuspid valve with giant right atrium and ventricle, which was confirmed during operation. This is an unusual case of isolated tricuspid regurgitation and stenosis with convincing evidence of rheumatic etiology.
Effect of propranolol on indices of intermittent myocardial ischemia, assessed by exercise testing and ambulatory st‐segment monitoring
Authors: Khurmi N. S. , Bowles M. J. , O'Hara M. J. , Raftery E. B. 
Published: February 2009

AbstractSeventy three patients (63 males and 10 females) aged 41–75 years with established stable exertional angina pectoris were studied in a double‐blind fashion to confirm the efficacy of 80 mg propranolol administered three times daily and also to examine its effect on ST‐segment changes in the electrocardiogram by ambulatory ST‐segment monitoring and exercise testing using on‐line computer analysis. During ambulatory monitoring, episodes of ST‐segment depression in lead CM5 were significantly reduced from 6.5±0.7 during placebo to 3.4±0.6 during propranolol therapy (p<0.001). The total duration of ST‐segment depression was also significantly reduced and the maximal depth of ST‐segment depression improved from 2.6±0.2 mm during placebo to 1.7±0.2 mm during propranolol therapy (p<0.001). The mean ± SEM exercise time of 5.5±0.2 minutes on placebo increased to 8.6±0.4 minutes on propranolol 240 mg daily (p<0.001). The 1 mm ST‐segment depression time of 3.5±0.2 minutes on placebo in lead CM5 was prolonged to 6.2±0.3 minutes during propranolol therapy (p<0.001). Propranolol treatment significantly reduced the resting and maximal heart rates (p<0.001). The maximal ST‐segment depression during exercise in lead CM5 was reduced from 2.3±0.1 mm on placebo to 1.9±0.1 mm with propranolol (p<0.01). Similarly, the rate‐pressure product at peak exercise of 188±5 units on placebo was reduced to 144±3 units with propranolol (p<0.001). Eleven patients were rendered angina free during treadmill testing. Two patients were withdrawn due to adverse effects. In conclusion, propranolol is confirmed to be an effective antianginal agent which improves the ST‐segment changes during controlled as well as uncontrolled conditions and acts by lowering the heart rate and rate‐pressure product.
Chest pain in acute myocardial infarction: A descriptive study according to subjective assessment and morphine requirement
Authors: Herlitz J. , Richterova A. , Bondestam E. , Hjalmarson Å , Holmberg S. , Hovgren C. 
Published: February 2009

AbstractIn 722 patients with suspected acute myocardial infarction (MI) we have tried to describe the course of chest pain according to their own assessment and morphine requirement. Patients were asked to score pain from 0‐10 every second hour after arrival in the coronary care unit (CCU) and also to score their maximal pain at home. A very high intensity of chest pain was observed at home (mean score 7.1). At arrival in the CCU the mean pain score already had declined to 1.8, although 51% still had chest pain. Pain score declined successively during the first 12 hours in the CCU. At 24 hours after arrival, 20% still had some chest discomfort. in one quarter of the series a score of more than 0 was observed later than 24 hours after arrival in CCU. Patients developing definite MI had, as expected, a longer duration of pain and a much higher requirement of morphine compared with those with no MI. The difference between MI and no MI patients regarding subjective assessment of the initial intensity of pain at home and in hospital was, however, surprisingly low.
Electrophysiologic effects of ethmozin on sinus node function in patients with and without sinus node dysfunction
Authors: Shugushev K. Kh. , Rosenshtraukh L. V. , Smetnev A. S. 
Published: February 2009

AbstractTo compare the effects of ethmozin on sinus node (SN) function in the presence (9 patients) and absence (17 patients) of SN dysfunction, sinus cycle length (SCL), maximal corrected sinus recovery time (CSRT), paced cycle length yielding peak SN suppression, and indirect sinoatrial SA conduction time (SACT) were determined before and after intravenous administration of ethmozin in the dose 2 mg/kg. The mean ± SD SCL were significantly shortened in patients with normal SN and were not changed in patients with SN dysfunction after ethmozin administration. The mean maximal CSRT was 252±72 before and 284±86 ms after ethmozin administration in patients with normal SN function (p<0.05). in patients with SN dysfunction (p<0.1) the mean maximal CSRT was found to be 1016±434 before and 2170±1756 ms after ethmozin administration. The mean SACT was 158±41 before and 174±51 ms after drug administration in patients with normal SN (p<0.05). Four out of nine patients with SN dysfunction developed second degree SA exit block after ethmozin administration, whereas SACT increased significantly in the remaining group of patients (180±35 to 210±32 ms; p<0.05). The PR, PA, AH, and HV intervals significantly lengthened and the valves of QRS and QT were not changed after ethmozin administration in either group. The conclusion is drawn that ethmozin should be administered cautiously to patients with SN dysfunction, particularly to patients with SA exit block, sinus pauses, or secondary pauses (in particular, with bradycardia‐tachycardia syndrome).
Rupture of the pericardium presenting as postpericardial trauma syndrome late after blunt chest injury
Authors: Kyriakidis M. , Vassiliadis J. , Kyriakidis C. Robinson , Toutouzas P. 
Published: February 2009

AbstractA 40‐year‐old man presented with a clinical picture of postpericardial trauma syndrome six weeks after blunt injury to the chest. Posttraumatic pericardial rupture was diagnosed at exploratory thoracotomy. The presence of aortic regurgitation due to a previously undiagnosed congenital sinus of Valsalva aneurysm complicated the clinical picture. To our knowledge this is the first report of postpericardial trauma syndrome associated with pericardial rupture after blunt chest injury. It emphasizes the high index of suspicion required for diagnosis of pericardial rupture, a condition with potentially lethal complications.
Severe aortic regurgitation: A rare presentation of giant cell arteritis
Authors: Vered Z. , Pras M. , Horowitz A. , Rath S. , Neufeld H. N. 
Published: February 2009

AbstractA 53‐year‐old patient with no past history of rheumatic fever or lues presented with severe aortic regurgitation, underwent hemodynamic evaluation, and subsequently, an uneventful aortic valve replacement. The initial pathological interpretation was nonspecific aortitis. Six months following surgery arthralgia, muscular pain, difficulty in mastication, and fatigue occurred. There was no fever, however, sedimentation rate was 100/130. Cardiac examination was normal. Review of the pathological specimens revealed granulomatous arteritis with giant cells, typical of giant cell arteritis. Though the association of aortic regurgitation and giant cell arteritis is well recognized, only two such cases of severe aortic regurgitation requiring valve replacements have yet been described, of them, one probably had Takayasu's arteritis. An accurate diagnosis is of importance since steroid treatment is effective, and if introduced early, the inflammatory process may be arrested.
Relationship between systolic time intervals and arterial blood pressure
Authors: Cinelli P. , De Scalzi M. , De Leonardis V. , Citi S. 
Published: February 2009

AbstractIt has been suggested that systolic time intervals (STI) can be used to monitor the cardiac effects of antihypertensive treatments and also to evaluate hypertensive patients. STI changes observed in hypertensives have been ascribed to myocardial disease, although they could be due to the existence of a relationship between STI and blood pressure. A group of 37 subjects (18 normotensives and 19 hypertensives) with no signs of heart failure and left ventricular dysfunction were studied to examine the relationship of STI to blood pressure. Pacing with an external battery pulse generator was performed at the rate of 95 beats/min in order to eliminate differences in heart rate. STI were measured from good quality high speed (100 mm/s) recordings and the average value of 10 consecutive cardiac cycles was used for statistical analysis. Normal subjects showed significantly lower values of preejection period (PEP), electromechanical systole (QS2), and pre‐ejection period/left ventricular ejection time ratio (PEP/LVET). Moreover, a significant inverse relationship between diastolic pressure and LVET and significant direct relationships between diastolic pressure and PEP, systolic pressure and PEP, diastolic pressure and PEP/LVET, and between systolic pressure and PEP/LVET were demonstrated. We suggest to consider the relation of STI to blood pressure to provide regression equations to best appreciate and use STI.
“Flipped” lactic dehydrogenase pattern in acute coronary insufficiency
Authors: Weinberger I. , Rotenberg Z. , Sagie A. , Fuchs J. , Sperling O. , Agmon J. 
Published: February 2009

AbstractSerum lactic dehydrogenase (LDH) isoenzymes were measured 24, 48, and 72 hours after admission in 85 patients with acute coronary insufficiency (ACI) and 10 patients with stable angina pectoris who served as controls. The above patients did not develop myocardial infarction according to the criteria of development of new Q waves or elevation of cardiac enzymes. In 15 patients with ACI a “flipped” LDH pattern (LDH1 > LDH2) was found in the presence of normal total LDH activity and normal creatine kinase‐MB. The values of LDH 1:2 ratio ranged between 1.02 and 1.13 (normal values 0.45–0.75). In the 10 control patients, normal levels of total LDH and normal LDH enzyme distribution and creatine kinase‐MB were found. A possible explanation for the flipped LDH pattern in the ACI patients (indicating some myocardial damage) could be myocytolysis and coagulation necrosis found on postmortem examinations. The conclusion of our study is that LDH isoenzymes should be measured in patients with ACI to determine the LDH 1:2 ratio. The finding of a “flipped” LDH pattern demonstrating myocardial damage, lacking in stable angina, may also be helpful in patients who developed the clinical picture of ACI more than 24 hours before arrival at the hospital, since by that time the creatine kinase‐MB may have already returned to normal. An additional advantage of measuring LDH isoenzymes in these patients may be that patients with “flipped” LDH pattern may need a longer rest and earlier coronary angiographic evaluation.
QRS complex recovery during one year after acute myocardial infarction
Authors: Richter A. , Herlitz J. , Hjalmarson R. 
Published: February 2009

AbstractThe recovery of the ECG signs of anterior myocardial infarction has been studied in 70 patients. A significant increase in R‐wave amplitude and decrease in Q‐wave amplitude on 24‐lead precordial mapping was observed during one year after infarction. Patients with lower initial heart rate showed a greater recovery of R‐and Q‐wave amplitudes, as did patients with smaller infarcts, as assessed by peak heat‐stable lactate dehydrogenase (LDH).
Right ventricular infarction: Unusual electrocardiographic and electrophysiological manifestations
Authors: Kriwisky M. , Ackerman Z. , Mosseri M. , Gotsman M. S. , Hasin Y. 
Published: February 2009

AbstractRight ventricular infarction occurs in 19–43% of patients with acute inferior wall infarction (Lorell et al., 1979). Its clinical, hemodynamic, and anatomic features are well known and include associated inferior wall infarction, distended neck veins, clear lung fields, hypotension, and heart block (Cintron et al., 1981; Coma‐Canella et al., 1979; Lloyd et al., 1981; Lopez‐Sendon et al., 1981; Raabe and Chester, 1978; Rotman et al., 1974). Isolated right ventricular infarction is less frequent and occurs in 2.5–4.6% of autopsy studies of myocardial infarction (Cohn et al., 1974; Erhardt et al., 1976; Wartman and Hellerstein, 1948). This report describes a patient with isolated right ventricular infarction with unusual electrophysiological findings. Her initial electrocardiogram showed atrial escape rhythm with incomplete right bundle‐branch block and left posterior hemiblock. Later, she developed atrioventricular (AV) block with supra‐ and infra‐Hisian, “phase 4,” conduction defects. The sinus malfunction and high degree AV block persisted over 2 weeks and an atrioventricular sequential pacemaker was implanted. Hymodynamic study showed that her cardiac output was highly dependent on the heart rate and properly timed AV interval, and the pacemaker was programmed accordingly.
Laser‐assisted endocardiectomy for refractory ventricular tachyarrhythmias: preliminaRy intraoperative experience
Authors: Isner J. M. , Mark N. A. Estes , Payne D. D. , Rastegar H. , Clarke R. H. , Cleveland R. J. 
Published: February 2009

AbstractPrevious in vitro investigations utilizing necropsy specimens have suggested a potential role for laser irradiation in the treatment of refractory ventricular tachyarrhythmias associated with pathologically thickened endocardium. In the patient described in the present report, findings of these previous in vitro studies were applied intraoperatively to a patient undergoing surgery for ischemic heart disease associated with ventricular tachyarrhythmias. Aneurysm resection and manual subendocardial resection were performed using standard techniques. Laser irradiation was used to ablate pathologically thickened endocardium involving the papillary muscle and thereby avoid mitral valve replacement. Postoperatively, there was no auscultatory evidence of mitral regurgitation, and ventricular tachycardia could not be induced by electrophysiologic provocative testing. This preliminary experience confirms that laser irradiation is both a feasible and potentially advantageous means of accomplishing endocardial debridement in patients undergoing arrhythmiaablation procedures.
Predictors of the variation of the ejection fraction during exercise in patients with and without coronary heart disease
Authors: Peperstraete B. , Decoodt P. , Paternot J. , Dumont N. , Verhas M. , Telerman M. 
Published: February 2009

AbstractThe aim of this study was to determine the factors influencing the different response of the ejection fraction (EF) of the left ventricle at exercise observed in patients with and without significant coronary heart disease. We have studied 98 patients referred for coronary angiography (82 men, 16 women), of whom 49 patients had a previous myocardial infarction and 71 patients had significant coronary heart disease. Exercise testing was performed and combined with a cardiac blood pool imaging at equilibrium. The variation of the EF between rest and peak exercise (ΔEF) was measured. Twelve clinical, exercise‐related, isotopic, and coronary arteriographic variables were examined in a linear univariate and statistical analysis. In the univariate regression, seven variables were significant regressors on the ΔEF. In the multivariate regression, only four variables were significant regressors on the ΔEF. Three independent predictors were found: the rate‐pressure product, the ST depression, and the occurrence of a previous myocardial infarction. These three independent predictors reflect the myocardial functional reserve.
Pericardial effusion: Diagnostic value of the subcostal acoustic window (inferior vena cava‐right atrial projection)
Authors: Candell‐Riera J. , Garc‐a‐del‐castillo H. , Permanyer‐Miralda G. , Soler‐Soler J. 
Published: February 2009

AbstractTo validate the usefulness of the subcostal acoustic window (inferior vena cava‐right atrial projection) for the echocardiographic diagnosis of pericardial effusion we studied 40 patients with pericardial effusion detected through the parasternal approach. A group of 100 patients without evidence of effusion constitutes the control group. In all patients in the control group, a contact between the right atrial wall and the diaphragm was noted during the cardiac cycle (specificity: 100%). This had also been detected in 15 of 18 patients with mild effusion and in only 1 of 11 patients with moderate effusion, and in none of 11 patients with severe effusion (overall sensitivity: 60%). Therefore, moderate and severe pericardial effusions can be detected in most cases (95.4%) below the right atrial wall through the subcostal inferior vena cava‐right atrial projection. The echocardiographic criteria for its diagnosis is the lack of contact through the cardiac cycle between right atrial wall and the diaphragm.
Arrhythmogenic right ventricular dysplasia presenting with ventricular tachycardia in a father and son
Authors: B‐Lundqvist C. , Eneström S. , Edvardsson N. , Olsson S. B. 
Published: February 2009

AbstractA father and his son presented with ventricular tachycardia of left bundle‐branch block configuration, two years apart. The patients had no clinical signs of right or left ventricular dysfunction. The diagnosis of arrhythmogenic right ventricular dysplasia was based on right ventricular angiographic and radionuclide findings. Microscopic sections obtained at surgery for the ventricular tachycardia in the father revealed abnormal infiltration of fat and focal fibrosis in the right ventricular myocardium, confirming the diagnosis. The importance of thorough evaluation of right and left ventricular function and structure in patients with ventricular tachycardia of right ventricular origin is emphasized. Currently available diagnostic techniques and management are presented.