bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angina pectoris due to possible vasospasm of small coronary arteries
Authors: Kawakami Koichi , Shimada Toshio , Nakayama Kazuaki , Nagasaka Yukihiro , Tsukihashi Hironori , Murakami Rinji , Morioka Shigefumi , Moriyama Katsutoshi 
Published: February 2009

AbstractRecently, the presence of vasospasm in small coronary arteries is speculated in animals and humans. A 40‐year‐old female patient complained of chest pain at rest. Left ventriculogram showed normal wall motions. Left and right coronary arteries were also normal. After methylergometrine maleate was selectively administered to a right coronary artery, she complained of chest pain, and ST‐segment elevation was detected in leads II, III, and aVF of ECG. Right coronary arteriography was performed immediately, but no coronary stenosis was found. The next day, methylergometrine maleate was again administered intravenously and the patient complained of chest pain, but no ischemic changes were observed in ECG. Thallium‐201 myocardial scintigraphy followed immediately. Apical perfusion defect was detected in stress image. In the delayed image, it showed complete redistribution. Three days later, catheterization and scintigraphy were performed at the same time. When methylergometrine maleate was administered to the left coronary artery, she complained of chest pain within a few minutes of the injection; however, ECG remained unchanged. 201Tl myocardial scintigraphy was performed immediately. In the stress image, it showed apical perfusion defect as shown in the intravenous methylergometrine maleate injection study. It also showed complete redistribution in the delayed image. Apical perfusion defect can be attributed to myocardial ischemia of left coronary artery, which are too small to be detected by conventional coronary arteriography. Vasospasm in small coronary arteries may be involved in this phenomenon.
Restenosis following coronary angioplasty
Authors: Karas Steven P. , Santoian Edward C. , Gravanis Michael B. 
Published: February 2009

AbstractRestenosis is the most important problem limiting the success of coronary angioplasty. Clinically, restenosis is seen in approximately one‐third of patients undergoing percutaneous transluminal coronary angioplasty. Several clinical and angiographic risk factors have been identified which may contribute to the development of restenosis. Histopathologic studies indicate that restenosis is characterized by intimal proliferation of smooth muscle cells in a loose connective tissue matrix. These intimal lesions are associated predominantly with the nonatheromatous portion of the vessel wall. Thinning of the media of the plaque‐free wall and marked fragmentation of the internal elastic lamina are also seen. Traumatic injury of the vessel wall during angioplasty probably triggers a series of cellular and subcellular events which may ultimately lead to myointimal proliferation and restenosis. Although the exact mechanism by which this occurs is unknown, several factors may enhance smooth muscle cell growth and therefore may play a role in the development of restenosis. These include platelet deposition, mechanical stretching of the media, inflammation of the vessel wall, the activity of growth factors, and alterations in vessel geometry. These possible mechanisms of restenosis suggest several potential ways to limit the proliferative response to vascular injury. Anticoagulants and platelet antagonists, direct inhibitors of smooth muscle proliferation, anti‐inflammatory agents, growth factor inhibitors, and new devices which improve final vessel geometry are currently being tested as methods to curb restenosis. Unfortunately, no treatment has yet been shown to reduce significantly the rate of restenosis following angioplasty. The problem of restenosis will most likely be solved by better understanding of the basic molecular and biologic phenomena involved in vascular injury and repair.
Early predictors of smoking cessation after myocardial infarction
Authors: Di Tullio M. , Granata D. , Broccolino M. , Recalcati F. , Zaini G. , Belli C. , Taioli E. 
Published: February 2009

AbstractThe determinants of long‐term smoking cessation were evaluated in 80 patients who smoked cigarettes and survived a myocardial infarction. All patients underwent a program of rehabilitation and secondary prevention including in‐hospital counseling and physician‐guided reinforcing sessions at 1, 3, and 6 months after discharge. At 18 months of follow‐up, 53 patients (66.3%) had quit smoking. Variables associated with smoking cessation were duration of hospital stay ≥19 days (79 vs. 48%; p<0.005) and peak creatine phosphokinase (CPK) elevation ≥500 U/l (76 vs. 54%; p<0.05). Males tended to quit in higher proportion than females (68 vs. 44%). Age, prior myocardial infarction, other cardiovascular risk factors, infarction location, Killip class at entry, and duration of stay in coronary care unit did not significantly affect the quitting rates. Logistic regression analysis singled out the duration of hospital stay as a significant predictor of smoking cessation (p<0.005). Early and intensive secondary prevention during the hospital stay is crucial in promoting sustained smoking cessation after myocardial infarction.
Impaired left ventricular filling during ST‐segment depression provoked by dipyridamole infusion in patients with syndrome X
Authors: Nadazdin Aleksandar , Shahi Manjit , Foale Rodney A. 
Published: February 2009

AbstractThe left ventricular filling and regional wall motion patterns were compared in 6 normal subjects, 20 patients with coronary artery disease, and 10 patients with syndrome X by means of Doppler and two‐dimensional echocardiography during high‐dose (0.9 mg/kg body weight in 10 min) dipyridamole infusion. During the procedure none of the normal subjects had chest pain or significant ST depression (>0.1 mV) whereas 10 of 20 patients with coronary artery disease had ST depression, 3 with chest pain. Six patients with syndrome X had ST depression, 5 with chest pain. Regional wall motion abnormalities were identified in 6 patients with coronary artery disease who had ST depression but none were detected in normals or in patients with syndrome X. Compared with normals (−2.1±3.5%) there was a significant difference in percentage decrease in the peak early filling velocity in patients with coronary artery disease and ST depression (−10.3±6.2%; p<0.01) and in patients with syndrome X and ST depression (−9.4±6.9%; p<0.05). These findings indicate that, in the presence of dipyridamole‐induced ST depression, patients with syndrome X have an abnormal left ventricular filling pattern similar to that observed in patients with coronary artery disease. This suggests that myocardial ischemia occurs in patients with syndrome X but the absence of regional wall motion abnormality suggests that it is diffuse.
Cytomegalovirus myocarditis in transplanted heart verified by endomyocardial biopsy
Authors: Partanen J. , Nieminen M. S. , Krogerus L. , Geagea A. , Lautenschlager I. , Aarnio P. , Mattila S. 
Published: February 2009

AbstractCytomeglovirus infections are common disorders after heart transplantations. Manifestation of the virus without a clinical disease is still more prevalent. Differentiation of clinical infections from cytomegalovirus activations without major pathogenetic importance issues a challenge in the follow‐up of patients with cardiac transplants. The case describes a 56‐year‐old female patient with a multiple organ lethal infection and myocarditis due to cytomegalovirus diagnosed during life with endomyocardial biopsy.
Effect of the combination of low‐dose mexiletine and metoprolol on ventricular arrhythmia
Authors: Ravid Shmuel , Lampert Steven , Graboys Thomas B. 
Published: February 2009

AbstractAntiarrhythmic drug therapy is often ineffective or poorly tolerated. Combining antiarrhythmic agents with different electrophysiologic properties may have a synergistic antiarrhythmic effect when compared with each drug alone. If a lower dose of each drug can be used, combination therapy may also result in lower incidence of side effects. The goal of our study was to assess the complementary effect of low‐dose mexiletine and metoprolol, when compared with either drug alone. Ten patients with frequent ventricular arrhythmias including 7 patients with nonsustained ventricular tachycardia were evaluated in an open‐label sequential study. The response to drug therapy was evaluated by 24‐h continuous EKG monitoring, exercise stress testing, and echocardiogram after each treatment. Combination therapy effectively reduced ventricular arrhythmias in 8 patients (80%) in contrast to only 1 patient (10%) on metoprolol alone and 4 patients (40%) on mexiletine alone. In 5 patients (71 %) ventricular tachycardia was abolished. The number of couplets was reduced from 51 ± 39 to 1.9±2.4 (p<0.01) and total premature ventricular beats from 7790 ±9047 to 597±515 (p = 0.06). Combination therapy was well tolerated without proarrhythmia or precipitation of congestive heart failure. It is concluded that low‐dose mexiletine combined with metoprolol is effective in suppressing ventricular arrhythmias in selected patients, and enhances the antiarrhythmic effect of either drug alone without significant side effects.
The detection of myocardial ischemia by thallium‐201 myocardial scintigraphy in patients with multiple coronary arterioventricular connections
Authors: Kawakami Koichi , Shimada Toshio , Yamada Sachiko , Murakami Rinji , Morioka Shigefumi , Moriyama Katsutoshi 
Published: February 2009

AbstractThe question of whether myocardial ischemia could be induced in 5 patients with multiple coronary arterioventricular connections by thallium‐201 (201Tl) exercise stress myocardial scintigraphy was investigated. Both ST‐T changes on ECG and transient myocardial perfusion defects in myocardial scintigrams were observed in 2 patients (40%). In previous reports, all multiple coronary arterioventricular connections, which were shown in angiograms, have been regarded as either Thebesian veins or embryonic sinusoids. However, it is unlikely that Thebesian veins cause myocardial ischemia judging from anatomy. If the vessels cause myocardial ischemia, they should be regarded as multiple coronary arterioventricular fistula. Angiography itself cannot differentiate multiple coronary arterioventricular fistula from Thebesian veins or remnants of embryonic sinusoids. Exercise stress myocardial scintigraphy has a high potential to detect myocardial ischemia due to intracoronary steal. Exercise stress myocardial scintigraphy was used to demonstrate myocardial ischemia in multiple coronary arterioventricular connections. It is concluded that exercise stress myocardial scintigraphy is a reliable test to differentiate multiple coronary arterioventricular fistula from Thebesian veins or remnants of embryonic sinusoids in clinical practice.
Regression of left ventricular mass in systemic hypertension
Authors: Georgiou Demetrios , Brundage Bruce H. 
Published: February 2009

AbstractThe importance of treatment in systemic hypertension and cardiovascular morbidity and mortality has been established. Although systemic hypertension is the most important factor in the pathogenesis of left ventricular hypertrophy, other factors such as catecholamines and renin‐angiotensin system may be involved. Increased left ventricular mass causes reduction in coronary reserve and may lead to acute ischemic events. Equally efficacious antihypertensive agents may have diverse effects on left ventricular hypertrophy and left ventricular function. New tomographic techniques with improved spatial resolution are emerging in the evaluation of left ventricular mass and may therefore provide better assessment of changes in left ventricular mass. With improved measures of left ventricular mass the question as to whether regression of left ventricular mass provides an additional benefit beyond control of blood pressure in hypertensive individuals may be finally answered.
Which ventricular tachycardia is dangerous?
Authors: John Camm A. , Gusoy Sinan , Brugada Ramon , Brugada Josep , Brugada Pedro , Andries Erik 
Published: February 2009

AbstractThe treatment of ventricular arrhythmias remains a major challenge in cardiology. Several very helpful pieces of information can be obtained from the clinical history. The left ventricular function and the hemodynamic effects of a ventricular tachycardia are the two main factors affecting survival. Therefore, if a patient with sustained ventricular tachycardia presents with syncope or cardiac arrest, or if his functional class for dyspnea is III‐IV (NYHA classification), he is a candidate for an implantable defibrillator while otherwise medical therapy is advised.
“The Anti‐Ashman Maneuver”: A bedside method for distinguishing aberrancy from ventricular ectopy
Authors: Goldman Daniel S. , Damato Anthony N. 
Published: February 2009

AbstractThis is a report of a patient who develops new onset atrial fibrillation in the postoperative setting which is further complicated by the presence of wide beats in singles, pairs, and short runs. Presented are the differential diagnosis of these wide beats and a simple bedside maneuver to help distinguish their origin.
Oblique cine MRI for the evaluation of aortic regurgitation: Comparison with cineangiography
Authors: Nishimura Fumiaki 
Published: February 2009

AbstractThe results of oblique cine magnetic resonance imaging (MRI) through a long axis slice of the left ventricle in 40 patients was compared with cineangiography in order to determine the usefulness of cine MR imaging for the evaluation of aortic regurgitation (AR). A diastolic dark low‐intensity flow signal extending from the aortic valve into the left ventricle was seen in all 30 patients with AR, and in none of the 10 patients without AR. The length and area of the low‐intensity signal due to the regurgitant flow were planimetered, and the ratio to the length and area of the left ventricle was calculated. The best correlation with angiography was with the ratio of the area of the low‐intensity signal (ALIS) to the area of the left ventricle (ALV); it correctly classified the degree of regurgitation in 28 of the 30 patients (93.3%). The ALIS/ALV ratio was under 25% in all 11 patients with angiographic mild AR, 26–50% in 10 of the 11 patients with moderate AR, and over 51% in 7 of the 8 patients with severe AR. Thus the results point to a high degree of correlation between long axis oblique cine MRI and cineangiography in the identification of AR and in providing a semiquantitative estimation of its severity.
Changes of diastolic function induced by cigarette smoking: An echocardiographic study in patients with coronary artery disease
Authors: Stork T. , Eichstädt H. , Möckel M. , Bortfeldt R. , Hochrein H. , Müller R. 
Published: February 2009

AbstractIn 28 chronic smokers (11 women, 17 men, 53 ± 10 years old) with coronary artery disease (>75% stenosis), left ventricular (LV) relaxation and filling behavior was assessed before and after inhalation of 0.9 mg nicotine (1 cigarette) by echocardiography. The following acute nicotine‐mediated changes were noted (one‐sided Wilcoxon test): heart rate increased from 67 to 81 beats/min (p>.001); the early diastolic flow (E wave) integral decreased from 49 to 39 mm (p<.001); the late diastolic flow integral (A wave) increased from 36 to 41 mm (p<.01). Consecutively, the ratio between E and A wave flow integrals decreased from 1.4 to 0.9 (p<.001); the atrial contribution to LV filling rose from 42 to 53% (p<.001); and the isovolumetric relaxation period increased from 89 to 122 ms (p<.001). In cigarette smokers with coronary artery disease acute administration of nicotine hence causes a shift of mitral blood flow from early (E wave) to late (A wave) diastole and a prolongation of the isovolumetric relaxation time. Thus, cigarette smoking significantly affects LV diastolic function independently of its role as a risk factor for coronary atherosclerosis.
Chemotherapy‐induced myocardial infarction in a young man with hodgkin's disease
Authors: House Kenneth W. , Simon Sheryl R. , Pugh Reginald P. 
Published: February 2009

AbstractA 32‐year‐old male with stage IIIA nodular sclerosing Hodgkin's disease and no cardiac risk factors presented with chest pain after receiving chemotherapy consisting of multiple drugs, including vinca alkaloids. He completed an uncomplicated anterior wall myocardial infarction. Coronary angiography documented the absence of significant coronary artery disease. Exercise stress testing with gated scan confirmed loss of anterior wall motion and a decreased left ventricular ejection fraction. Vascular toxicity, including, rarely, myocardial infarction, has been reported following antineoplastic regimens containing vinca alkaloids. Hypercoagulable states, cardiac invasion by tumor, and coronary artery spasm are possible etiologies. Of these, coronary artery spasm appears most likely. Management should include discontinuation of the offending drug and supportive care.
Documentation of successful treatment of prosthetic mitral valve thrombosis with intravenous urokinase infusion for twenty‐four hours
Authors: Chen Henry J. , Schlaifer Jay D. , Guentzel Susan M. , Conti C. Richard 
Published: February 2009

AbstractProsthetic valve thrombosis is a life‐threatening situation requiring prompt diagnosis and treatment. Treatment has usually been surgical and has been associated with a high mortality. Thrombolytic therapy is a therapeutic alternative to surgery and has been successful in a number of cases. This report concerns the technique used to diagnose the condition, treatment strategy, and documentation of the results of therapy.
PTCA in patients with stable angina pectoris and multivessel disease: Is incomplete revascularization acceptable?
Authors: De Feyter P. J. 
Published: February 2009

AbstractOf all coronary angioplasties performed nowadays, 40% of the patients have multivessel disease. Angioplasty in patients with multivessel disease can be performed with a high immediate clinical success rate and an acceptable major complication rate. However, complete anatomic revascularization with coronary angioplasty is achieved in only 32 to 59%. This raises concern about the immediate and long‐term outcome of patients in whom incomplete revascularization is achieved. This report reviews the literature and provides evidence that incomplete revascularization with coronary angioplasty is a safe and effective treatment in selected patients with multivessel disease, provided that adequate (functional) revascularization can be achieved. Adequate revascularization includes dilation of all significant lesions supplying large areas of viable myocardium.
The effects of captopril on training in patients with ischemic heart disease
Authors: Macgowan Guy A. , O'Callaghan Declan , Webb Hillary , Horgan John H. 
Published: February 2009

AbstractWe studied a group of 30 patients to determine the effect of captopril on the exercise training response after a period of training in patients with ischemic heart disease but without cardiac failure. The study was a double‐blind placebo‐controlled comparison of captopril and placebo. The patients studied were 28 men and 2 women, mean age 53.6±6.9 years. All were 8 to 12 weeks post‐myocardial infarction or coronary artery bypass surgery. These patients underwent an organized exercise training program consisting of exercise training sessions 3 times weekly for a period of 8 weeks. On commencement and completion of the program patients were assessed for exercise tolerance using submaximal exercise stress testing. Patients were assessed in the untreated state. Both groups showed a statistically significant training effect with increased exercise duration, decreased heart rate for equal workload, increased energy expenditure, and reduced functional aerobic impairment. There was no statistically significant change in systolic blood pressure, but the captopril group alone showed a significant reduction in diastolic blood pressure (p < 0.001). The change in heart rate at rest over the 8‐week period was not significant in both groups. In summary, this study shows that treatment with captopril does not affect the exercise training response in patients with ischemic heart disease undergoing an organized exercise training program.
Multifocal atrial arrhythmia—A frequent misdiagnosis? A correlative study using the computerized ECG
Authors: Varriale Philip , David William , Chryssos Basil E. 
Published: February 2009

AbstractAll computerized ECGs taken over a 17‐week study period were reviewed for the detection of multifocal atrial arrhythmia (MAA)—tachycardia or rhythm—and correlated with the diagnostic statement of the ECG computer system. MAA was identified by the authors in 96 of 11,610 (0.8%) computerized ECGs. In all instances, this specific arrhythmia was misclassified by the computer system as atrial fibrillation. Moreover, during the over‐read, only 27.1% of ECGs were correctly diagnosed by the assigned electrocardiographers blinded to this study. MAA is not an uncommon atrial arrhythmia since it was identified in 14% of computerized ECGs interpreted as atrial fibrillation. This study supports the inference that MAA is indeed frequently misdiagnosed by most physicians and the need for improved ECG computer analysis programs for reliable detection of MAA.
Clinical significance of serum colloid osmotic pressure in relation to pulmonary edema and coronary instability in patients with unstable angina
Authors: Taniguchi Hiroya , Takayama Yasuo , Sugiura Tetsuro , Iwasaka Toshiji , Tamura Teruhiro , Kitashiro Shuji , Izuoka Toshio , Inada Mitsuo 
Published: February 2009

AbstractSeveral investigators demonstrated that severe reduction of colloid osmotic pressure (COP) predicts a fatal outcome in patients with cardiopulmonary failure. To evaluate the clinical significance of COP in relation to pulmonary edema, we studied 117 patients with unstable angina admitted in the hospital within 24 h after the chest pain. The mean COP of all 117 patients was 24.8±3.7 mmHg. COP was significantly lower in patients with pulmonary edema, according to the chest x‐ray findings, compared with the patients without it. Among 26 patients with emergency coronary arteriography, a fairly good correlation was observed between coronary jeopardy score and COP (r=–0.57, p<0.005). Furthermore, COP in patients who survived 26 months after the hospital discharge was significantly higher than that of the nonsurvivors. Thus, measurement of COP is advised for monitoring patients with unstable angina.
Effects of captopril on regional segment motion during acute coronary occlusion
Authors: Cosin J. , Rivera M. , Solaz J. , ándiz A. Hern , és F. Andr 
Published: February 2009

AbstractThe effects of captopril on myocardial segment function in different degrees of transient coronary occlusion were studied using ultrasonic dimension gauges in 15 open‐chest dogs.The occlusion procedures (OP) were performed on the left anterior descending coronary artery (LAD) in eight dogs and on the left circumflex coronary artery (Cx) in seven dogs. To measure the changes in segment shortening in the subendocardium we used eight dogs (ischemic and control zones: four dogs LAD and four dogs Cx). To measure the changes in wall thickening we used seven dogs (ischemic and control zones: three dogs LAD and four dogs Cx). Total coronary OP lasting 1 min and partial OP (70–80%) lasting 1 min and 2 min 30 s, before and after captopril (0.25 mg/kg i.v.) were performed. Left ventricular pressure, dP/dt, coronary flow, and ECG were monitored.Total coronary OP (1 min) changed segment shortening (18% LAD; 14% Cx) and wall thickening (19% LAD; 18% Cx) to values of dyskinesis (–3% and –4% for shortening; –6% and –5% for thickening). Captopril improved regional function maintaining positive values for shortening (4% LAD; 3% Cx) and thickening (0.3% LAD; 4% Cx). Similar responses were obtained during partial OP and captopril. Results suggest that captopril produced a significant improvement in the regional function parameters affected by ischemia both in total and partial obstructions.